How to Choose Supplements, According to a Dietitian

You're learning more about your health and want to do more. You're on the hunt for an unrivaled vitamin D supplement. Your Amazon search pulls up exactly two thousand options. How do you choose the right one? 

Choosing a supplement takes some consideration. And while supplements can have beneficial effects, not all are safe, effective, or even necessary. 

This article will cover quality and safety, dosages, manufacturers, and when supplements are needed. Read on for your roadmap!

Allergies

Ensure you're not allergic to any ingredients in your supplements before taking them. Read your label carefully before use.

If you think you're having an allergic reaction, seek immediate medical attention. Symptoms may include breathing difficulties, itchiness, and rash.

What Are Dietary Supplements?

In 1994, Congress categorized dietary supplements as 'foods' under the Dietary Supplement Health and Education Act (DSHEA) unless they are specifically labeled as pharmaceutical drugs (intended to treat a disease).

DSHEA asserted that supplements are products containing dietary ingredients. Those ingredients can consist of the following:

Amino acids
Concentrates, constituents (a plant's active ingredients), extracts, and metabolites (a product of metabolism)
"Dietary substances" in food, like enzymes and probiotics
Herbs and other botanicals (plant medicines)
Vitamins and minerals
Combinations of the above dietary ingredients

Dietary supplements come in many forms, including capsules, gummies, liquids, pills, tablets, softgels, and powders.

Some conventional foods are also considered dietary supplements, like teas and bars.

Reading the label in front of the shelves in a pharmacy.

d3sign / Getty Images

How to Choose a High-Quality Supplement

Sometimes, we equate "natural" with "better." And that can be true.

However, having "natural" on the label does not always mean a product is better or safer.

Significant considerations include quality, purity, and strength. 

Supplement Warning

Researchers completed a study of adverse events due to supplements. The reports documented the following in some individuals 25 and younger:

Hospitalization
Disability
Death

Moreover, the following supplement categories had a three-fold increase in the risk for severe medical events compared to vitamins:

Muscle building
Energy
Weight loss

The use of these types of supplements is not advisable.

In the U.S., the Food and Drug Administration (FDA) doesn't regulate supplements the way it regulates prescription medications.

That means that the ashwagandha capsule you're about to take may not contain what the label says. Or it may contain harmful contaminants like the following: 

Heavy metals like lead, cadmium, or mercury
Toxins
Unlisted pharmaceuticals

So, what do manufacturers do to help ensure the quality and purity of their products to protect your health? Some employ third-party testers.

Third-Party Testers

Private organizations (or "third-party" testers) exist that test supplements for quality and purity.

Third-party testing is not legally required. However, some manufacturers decide to undergo it.

Notable third-party testers include the following:

Check your supplement label for a certificate of analysis (COA) from one of these third-party testers.

The testing process takes a lot of resources. Manufacturers sometimes need to increase product prices to defray certification costs.

Third-Party Testing

Third-party testing involves labs that evaluate the following:

Are listed ingredients actually present?
Do amounts reflect what's on the label?  
Are there contaminants?
Does the product contain ingredients not listed on the label?

Third-party testing does not ensure that a product:

Is effective or safe for everyone.
Will not interact with other supplements or medications.

Bring your supplement label to a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist. They can help: 

Review the ingredients to see if they're right for you, considering any health conditions. 
Flag potential interactions with your current supplements and medications.

Supplements can be surprisingly potent. They can also decrease or increase the effects of your medications.

What if a Third-Party Tester Didn't Test My Product?

Did none of the above organizations test your supplement? You still have options!

The following include alternate avenues:

See if the manufacturer has Current Good Manufacturing Practices (CGMP) status.
Find the manufacturer online.
Research their reputation using reputable sources.
Check if and how the manufacturer tests their products.
Consider speaking with the manufacturer directly. 
Does something seem off or not feel right? Other options are available to you.

Other Considerations for Choosing a Supplement

There are several factors to consider when choosing a supplement.

If you're considering taking nutrients or herbal supplements, discuss the following with your healthcare provider (HCP) or registered dietitian nutritionist (RD or RDN):

Are you already getting enough of a nutrient from your diet?
Check your Tolerable Upper Intake Levels (ULs)—taking amounts above ULs can lead to too much of the vitamin or mineral and, thus, adverse effects.
What are the manufacturer's recommendations on the label?
What dosage do you need?
How often do you need to take the product?
How to take the product (e.g., with or without specific foods, away from medications or other supplements to help absorption).
What form (e.g., liquid or capsule) best suits your current needs?
Will the product interact with any other supplements or with prescription medications? If so, what's the best approach?
Has someone suggested a supplement from a multi-level marketing
Are you an athlete? If so, you'll need to abide by specific guidelines around supplement use.

Dosage

Knowing how much of a supplement to take can be daunting. There's much to consider regarding dosage, including, but not limited to, the following factors:

Age (ex., a child's dosage will likely be different than an adult's)
Weight (ex., grams per kilogram (g/kg) of body weight)
Health conditions
Whether you take over-the-counter and prescription medications or other supplements
How much of a nutrient you're already getting from the food you eat
Your Recommended Dietary Allowance (RDA) or Adequate Intake (AI) for specific nutrients

The National Institutes of Health (NIH) is an excellent resource for understanding your RDA or AI for nutrients like calcium, vitamin D, and more.

Botanicals and Herbal Supplements

Botanical medicines, also called "botanicals" or "phytomedicines," include plants and their parts typically used for medicinal purposes. Botanicals encompass a broader category, which includes herbs. They may naturally contain some vitamins and minerals.

Consider the following before using botanicals: 

Avoid using a plant if you're allergic to it or its parts.
Botanicals and herbs can be pretty potent.
They aren't always standardized to active components (parts).
They don't always have a standard dosage.
Dosages can differ by weight, age, or condition.
Some can potentiate (increase the effects of) medications, potentially causing adverse effects.
Some can also decrease medication absorption, potentially causing complications.
They can contain harmful contaminants.

It's essential to follow the guidance of your healthcare provider when considering botanical medicines, their dosages, and more. 

Interactions

Again, supplements can increase or decrease the effectiveness of prescription and over-the-counter medications.

Common supplement medication interactions include, but aren't limited to, the following:

As mentioned, pharmacists are marvelous resources for helping determine medication and supplement interactions. Reach out to your local pharmacist if you have questions.

Do You Need a Supplement?

Friends, family, and advertisements may inspire you to try a specific supplement. However, when you eat a balanced diet, you'll likely be able to get all the nutrients you need. 

However, supplementing may be a viable option if you're navigating the following factors and your healthcare provider has determined you need it:

Supplement Use in Pregnancy, Breastfeeding, and Children

Your healthcare provider will help you carefully evaluate the safety and use of herbal medicines and supplements during pregnancy, breastfeeding, or in children.

How Do Registered Dietitian Nutritionists (RDNs) Help?

RDNs (or RDs) are highly trained, credentialed nutrition experts who can conduct medical nutrition therapy (MNT). MNT involves a nutrition diagnosis, therapeutic interventions, counseling, and more. RDNs can help chart a course for your nutrition plan.

A candid conversation about nutrient deficiency questions with your healthcare provider is a good starting point. The following talking points can help you chart a sound course forward:

Check in with your healthcare provider if you have deficiency symptoms.
Discuss whether you need lab work to confirm a deficiency.
Chat about whether you can meet your needs through food or if you need a supplement.
Discuss whether you may benefit from further guidance from an RD. If so, request a referral.

Summary

Not all supplements are created equal. Some may be safer than others. Here are some pointers to keep in mind when considering them:

Read your product's labels.
Make sure you're not allergic to any of the listed ingredients.
Look for a certificate of analysis (COA) on the label by third-party testers like ConsumerLab.com, USP, and NSF.org.
Talk with your healthcare provider before taking supplements to ensure the safest route.
Listen to your body.

Try to do your best to strive for a balanced diet. A food-forward approach to nutrition can help ensure you get the nutrients you need from your food.

However, there are specific instances where people may need additional nutrition interventions. Your healthcare provider and RDN can help you chart a path forward and find the support you need.

Search This Blog

Parasitic Diseases