How to Pinpoint Reputable Nutritional Supplements…Navigating Through Subpar Products, Price Sensitivity, and Marketing Hype

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Howdy!

Robert Kress here...

Whether you are a practitioner who wants to provide the best to their patients, or a consumer who understands that there are different levels of nutritional supplements- and it makes a difference, then you understand...

Quality…is a really big issue.

Consumers want results, and they are looking for trustworthy practitioners to help guide them.

We don’t want to be ripped off, but certainly willing to pay a premium price to make sure they are getting the best.

Like anything that becomes popular, nutritional medicine brings to the table both quality…and lack of quality, or even downright dangerous products.

It’s our job to know the difference. But first you might be asking…

Why Nutritional Medicine?

There are many reasons to consider adding nutritional medicine to your practice.

• Commercial food sources do not have the nutritional relevance they once did…coupled with a typical Western Diet, often leaves people deficient in certain vitamins and minerals
• Cultural issues, such as stress, lack of sleep, and ‘habits’ of cigarette smoking and maybe a bit too much alcohol consumption challenge one’s nutritional relevancy
• Almost all medication therapy leads to drug induced nutrient depletions

And my favorite…

Nutritional therapy can often do what medication therapy can’t

Let me explain.

Allopathic medicine is often based around a “wait ‘till they’re sick” to begin to treat. It takes a very “black and white” approach…

• You are either sick or you’re not
• You either have diabetes or you don’t
• You have adrenal function, or you don’t

You and I both know that you don’t just get sick…and nutritional and functional medicine allows you to step into the “grey area” and help move the patient back to health before falling into the cycle of illness.

For instance, someone looking for help losing weight. You ask about their blood sugar levels, as it’s a marker for insulin resistance and metabolic syndrome, risk factors for weight gain.

They tell you their doctor say’s it’s a little high, about 110, so they will “keep an eye on it.”

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Excuse my expletives, but “keep an eye on it”?

So… we just wait until it gets to 126 and they can be tagged as diabetic, go on metformin, all the while increasing risks for cardiovascular disease?

This is all too often the case, isn’t it?

But what if…what if we focus on healthy eating, drop the pop and the junk food, move a little bit more?

Maybe add some berberine, or chromium, some fish oil, or other natural supplements that support healthy insulin sensitivity and blood sugar?

Can you imagine how much better they would feel if in just 30 days their blood sugar numbers dropped down below one-hundred, they had more energy, digestion and even mood improved- instead of tracking on down the path of “keep an eye on it.”

When you can give someone back their health, there is no better feeling, it’s total professional reward.

Aren’t all Supplements the Same? Isn’t USP verified good enough?

What I would like to talk about is transparency in the nutritional industry. This is a call out to a large segment of the nutritional industry which does not exist on a basis of transparency and trust, regardless of how they attempt to swoon the public via marketing and price. 

Examples of Transparency in Nutrition

I am a big fan of nutrition and a stickler for quality. There are constant “issues of quality” making news in the nutritional industry. 

Let’s take a look at some glaring examples of why quality matters!

Bilberry

Bilberry has been a historical “counterfeiting” example.

Bilberry has shown benefits such as visual and vascular enhancing properties, moderates visual fatigue, supports light to dark adjustment, promotes retinas own antioxidant defenses, supports integrity of vascular walls by enhancing vitamin C within cells.

Azo dyes have been used to mimic the color of bilberry, counterfeiting with mulberry or black bean skins.

In testing, anthocyanins content is used as standard to identify bilberry utilizing UV spectrometry testing method. Bilberry is identified as having 25% anthocyanins, where mulberry is at22-24%, and black bean skin at 20%.

The botanical supplier, Indena has reported that at least 15 to 20% bilberry samples adulterated, but what is really interesting, which shows that UV spectrometry might not be the best testing method is that in an Australian study in 2006 using HPLC (High Performance Liquid Chromatography) one extract only had 9% anthocyanins where researchers reported, “probably not from bilberry.”

Sports and weight loss supplements infamous for being tainted

Numerous elicit substances have been discovered in sports and weight loss supplements including stimulants, antidepressants diuretics, seizure medications, and laxatives.

A few years ago the FDA pulled over a dozen weight loss supplements off the market which were being sold through the internet for containing the dangerous drug sibutramine.

Sibutramine was the active ingredient in the prescription drug known as Meridia, which was pulled from the U.S. market due to its potential to substantially increase blood pressure and pulse rate in some patients and present a significant risk for patients with a history of coronary artery disease, congestive heart failure, arrhythmia's, or stroke. 

Ginseng

Fake ginseng always has and always will be a problem- here and in Asia.

Not all ginseng is alike, American Ginseng, which 90% is grown in Wisconsin is calming, cooling, and highly sought out after in Asia, demanding a price of $9,000 / pound.

Korean Red is another popular ginseng, although highly sought after here in America. Korean ginseng provides a heating or stimulating effect.

In the 1970’s numerous batch studies shown that 25% had no ginseng at all, total counterfeit imposters.

In 2015 $400,000 of fake (low grade China) Ginseng, packaged as Korean was discovered in Hong Kong, while other reports have shown Korean ginseng being sold in Hong Kong and marketed as American Ginseng. At $9,000 per pound, you can see the profit potential using cheaper Korean ginseng offers.

Curcumin/Turmeric

Curcumin is the active ingredient of turmeric, a spice in the ginger family. Curcumin has become one of the most popular supplements, and for good reason as it is an excellent anti-inflammatory and offers support for mind, heart, liver, kidney, digestion, and more.

It has been reported that there is more demand than supply due to its popularity…which would lead one to ask, “how can there be readily products available?”

The answer is that adulteration, and substituting synthetic curcumin is a very big problem.

Testing and high price is the cornerstone to quality products.

If the turmeric/curcumin is cheap- there’s a good chance it’s not actual curcumin.

Sabinsa, one of the world’s biggest importers discovered that almost half imported into the country spiked with synthetic curcumin.

The testing that most labs use for curcumin is HPLC an HPTLC, and where this is a reliable procedure for many supplements, it’s not for curcumin as it cannot identify synthetic product.

The proper testing needed for curcumin is carbon dating, and it happens to be quite expensive with on a handful of reliable labs properly performing it.  

This does not even speak about the low bioavailability in standard curcumin, and that there are better curcumin products on the market with enhanced bioavailability- such as Indena’s Meriva, and Sabinsa’s C3 Complex and Bioperine.

Other Examples of Quality to Look out for…

Take fish oil supplements for example.  Benefits include cardiovascular health, memory and cognition, respiratory health, immune support, gastrointestinal comfort, skin health, and even reducing breast cancer risk factors. The problem is that many products can be contaminated and rancid. 

Our seas and environment contain toxins including dioxins, PCB’s, as well as heavy metals such as mercury, lead, arsenic and cadmium. These toxins can then be passed on to the consumer through the food source or supplement if quality is not held to the highest regard. 

For quality fish oil, I recommend smaller fish such as anchovies and sardines, or even krill.  Smaller fish accumulate fewer toxins since they are on the bottom of the food chain. Larger fish not only accumulate toxins from the environment, but from the fish they eat as well. 

Fish oil must be purified to remove the toxins, and tested to ensure the removal of the toxins, as well as other pathogens including E. Coli, salmonella, yeast, molds, other bacteria (things you would never imagine would be in a nutritional supplement.) 

As you can see, there are different levels of ‘quality.’

Probiotics

One of the biggest areas of nutritional science over the last many years- which show no signs of slowing down- are probiotics.

Probiotics are marketing gold- as more products are coming to market in the form of supplements, drinks, and more…although, like the rest, not all probiotics are the same.

In our gut alone, there are over 1000 unique strains, and we have hundreds of trillions of good bacteria in our bodies.

Most experts believe probiotic therapy should consist of at least 5 PROVEN strains, at varying concentrations (1 billion to over 100 billion)- depending on what is being treated, understanding different strains have different affects are areas of colonization in the body.

Where this is not a lesson on therapeutics, but quality…I want the take home to be the amount of care and clinical proof that needs to go into a quality probiotic supplement.

5 Keys For a Quality Probiotic

1. Viability- From sourcing, shipping to manufacturing and packaging, controlled for moisture and temperature to ensure viability.
2. Quality sources stability, adherence to intestinal cells, as well as acid, bile and enzyme tolerance.
3. Authenticated strains- probiotics are genetically and functionally diverse, thus authentication is critical.
4. Appropriate condition and biologic local specific strains.
5. Independent lab testing to verify potency and purity.

A lot of these big brands also go off of the mantra, “Verified by the USP.” I would like to suggest going beyond USP, and even cGMP and NSF.

Consumers are often not aware of the problems which exist in the nutritional industry.  They often find themselves only buying on price at a Walmart or Walgreens, not knowing that there is a difference.

What is USP verified?

Basically, for a dietary product to carry the USP seal, it must:

• Contain the ingredients listed on the label in the declared potency and amounts
• Not contain harmful levels of specified contaminants
• Break down and release into the body within a specified amount of time, and
• Have been made according to the FDA cGMPs (current good manufacturing practices) using sanitary and well-controlled procedures.

Let’s talk cGMP’s - NSF

Current Good Manufacturing Practices, are guidelines that provide a system of processes, procedures and documentation to assure a product has the identity, strength, composition, quality and purity that appear on its label.

NSF International independently registers manufacturers as meeting GMP requirements- which is open to manufacturers of supplements, as well as ingredients and raw materials, distribution, warehousing and packaging companies.

There are a number of steps that are taken to become GMP certified, such as auditors visiting facilities to assess personal, physical plant and grounds, equipment, records and recordkeeping, recall procedures holding and distribution- and a lot more- it’s quite an exhaustive, although necessary process.

So…as you can see, if a supplement is not GMP certified- than it opens the door for a lot of issues…so as a health care practitioner, in my mind, GMP certification is costly to the manufacturer, thus ups the price of the product- although required- no if’s, and’s or but’s.

Going Beyond- Finding the best supplements for your practice

This is where I truly believe we can set ourselves apart- on both quality and efficacy, so I would like to share with you some factors that do not fall under the guidelines of GMP’s.

1. Products free of common allergens and toxins such as: irridated ingredients, GMO’s, wheat, gluten, nuts, egg, soy, dairy, preservatives, hydrogenated oils, coatings, shellac, binders, fillers, excipients, sugars, artificial flavors, sweeteners and colorings.
2. Vegetarian and non-porcine capsules to limit allergic reactions and toxin exposure.
3. Nutritional company to be a primary manufacturer to further ensure quality to control.
4. Clinical backing that the active ingredients are in sufficient quantities to be clinically effective.
5. Ingredients sourced from trusted industry leaders and suppliers, and tested for purity and potency by independent certified laboratories.
6. Full Disclosure- Supplement labels to list all ingredients, including composition of raw material as well as standardizations of herbal extracts provide to indicate primary active marker compounds.
7. Total transparency and support providing access to product information sheets, studies which supplement formulations were based upon, known drug interactions, supplement monographs, and C of A’s (certificates of Analysis)
8. Enhanced Testing including analytical testing on EACH BATCH of raw material or finished product for identity, potency, microbiological contaminants and impurities.
9. A real-time stability program to ensure that all finished products meet label claim throughout shelf life.

All well and good…so where to start.

If you are new to the world of clinical nutritional supplements, below I have made a list of some of my favorite companies- ones I use in my practice, as well as with my family.

• Pure Encapsulations
• Thorne
• Designs for Health
• Ortho Molecular
• Metagenics
• Xymogen
• …and many more

This is just a small list- if there is another company you are interested in, due-diligence is key.

You might also want to check out a Practitioner Grade Supplement Wholesaler such as Emerson Ecologic’s.

Emerson contains all high grade lines- although still of varying levels of assurance on testing- thus Emerson has even created their own EQP Standards.

I hope this information has given you a ton of value.

I encourage you to learn more, reach out to me with any questions, and recognize how quality nutrition can impact your practice, and your patients’ lives.

In good health and good fortune,

Rob

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