Editor’s Note: A podcast chasing life with Dr. Sanjay Gupta explores the medicine behind the mysteries of life, big and small. You can listen to the episode here.
(CNN) – Walk down the aisle of supplements at your local drugstore. This will face a wall of floor-to-ceiling options. Not only are regular suspects (vitamins and minerals), but there are also a variety of items such as turmeric, fish oil, probiotics, and melatonin. – Fat (not muscle!), a combination intended to cure erectile dysfunction and increase memory. The optional flood does not stop there. Endless social media posts are a Life-changing supplements Or regimens can help eliminate “cortisol berry” and protect against the flu or “reset” your hormones.
But how many exactly do humans need to buy in races to optimize our health and live our best lives? All this noise around the supplement creates confusion and anxiety, obscuring what science is and making it difficult to separate facts from wishful thinking.
In its most fundamental sense, these products are intended to supplement food in a meal with additional “dietary ingredients.” You are not at fault for thinking that the Food and Drug Administration regulates supplements.
Thanks to the 1994 law called the Health and Education Act of Nutrition Supplements, or the DSHEA, supplements are regulated like a food subcategory, not a medical subcategory. This essentially means that the FDA does not have the authority to approve dietary supplements before they are sold, unlike drugs that have been shown to be safe and effective in clinical trials.
“DSHEA is the current framework where all dietary supplements are on sale,” said Supplement Safety Advocate Dr. Peter Cohen, who recently followed a podcast to CNN Chief Medical Correspondent Dr. Sanjay Gupta, who followed her life.
The law allowed the industry to explode from around 4,000 products in 1994 to around 90,000 products in 2017, according to estimates from the 2022 AMA Journal of Ethics Policy Paper.
“Now, the 1994 law was originally designed to better regulate vitamins and minerals,” explained Cohen, an associate professor of medicine at Harvard Medical School and an internist at the Cambridge Health Alliance, where he leads the supplement research program. “Unfortunately, unfortunately, in my opinion, the same structure is extended to contain all the properties of the plant. They are sold as many different types of extracts, such as cow thyroid extracts, live microorganisms such as both bacteria and yeast, and probiotics. “Nutrition.”
You can listen to the full episode here.
The FDA has the authority to take action against poor or misbranded supplements, which are on the market. “The FDA is in a position to look for problems in the market after the supplements are sold, and is working to identify products to identify products that are then to identify products. This is extremely difficult because there is no effective system to detect harm and they try to remove those dangerous products,” Cohen said.
Although regulations exist, he said, “we sell us anything we choose to declare and identify as a dietary supplement,” he said. He called it “a system that emphasizes access and minimizes security guarantees, or at least leaves safety in the manufacturer’s courts.”
What should consumers do before defeating money at health food stores? Cohen explains what you need to know about product claims and offers five tips when deciding which supplements to buy, maintain, or throw.
How the FDA can and cannot regulate the supplement industry doesn’t even address the issues of what actually works and what really needs.
Some studies have shown that certain well-known vitamins or minerals may be useful for certain conditions, but recommendations often change once new information is revealed. Quality clinical trials are expensive and difficult to carry out (or because data is collected through epidemiological studies, it is not possible to clearly demonstrate the cause and effect). They are rarely done with less known (or blended) supplements.
The labels needed for US supplements essentially occupy the grey zone, and the average consumer may not be aware that they are expected to read between the lines.
Product labels can contain claims about the effect of supplements on body structure or function (for example, “helps support flexibility”). However, according to DSHEA, the label “cannot assert that it is diagnosed, mitigated, treated, treated or prevented a particular disease or disease.”
By law, manufacturers allow health adjacent claims in those grey zones, as long as they include a disclaimer that claims are not evaluated by the FDA.
Things won’t change anytime soon.
“The central concern I have with the current regulatory framework that really keeps us from actually moving forward is that there is no incentive for manufacturers to carry out carefully conducted clinical trials,” Cohen said.
“One thing we haven’t talked about yet is that another part of the law can argue that supplements have health effects that are not proven in humans,” he pointed out. “You can do that without a clinical trial, so what incentive is it to invest millions of dollars in money to do a clinical trial?
“The only potential outcome is negative. If you’re right, you’re beneficial to your health and all you did was prove that your claim was correct, so you were already promoting it,” he said. “But if it turns out that it doesn’t actually work the way you wanted it to, all that money will be wasted and then you’re having problems. But the good news is, even if the research comes out negative, I think you can continue to sell it as if it works.”
The FDA has certain best practice rules when it comes to manufacturing, but lacks supervision to ensure that what’s actually on the label is in the supplement. Therefore, it is essential to choose supplements with discerning eyes.
“Take away all supplements that do not contain official NSF (NSF International) or USP (US Pharmacopeia) stamps,” Cohen said in an email, referring to two independent, non-profit institutions that test and prove the supplement.
“The FDA doesn’t test supplements before they’re sold,” he said. “Unless the supplement is certified by a high-quality third-party organization, such as NSF or USP, you can’t know what’s actually in the bottle.”
“Both of these groups dive deep into the quality of their production,” Cohen told Gupta on a podcast. “They look at the original ingredients that are coming when consumers are about to buy this online or in the store, and the labels accurately represent the content of the product.”
Another reputable third-party tester is ConsumerLab.com.
However, don’t forget that none of these organizations test their effectiveness. That is, whether or not the supplement does what it claims.
“If something is good for your gut health or encourages immunity, these claims will not be valued by these companies,” Cohen told Gupta. “Companies are just looking. Is the powder in the bottle the same as the label’s content?”
There are fewer good rules of thumb when checking supplement ingredients lists.
“Turn all supplements that list two or more plant ingredients on the label,” Cohen said.
“Manufacturers don’t need to share details about each ingredient when mixing multiple plant ingredients in the same supplement,” he said. For example, you may not know the ratio of one ingredient to the other ingredients, how fresh each is, the process by which each is prepared and then mixed.
“The only way to ensure that the label provides ample information about the plant is to choose only a single iconic supplement,” he added.
When shopping for dietary supplements, avoid products that claim in ambiguous languages to promote health benefits in ambiguous languages.
“Supplement claims have not been reviewed by the FDA and manufacturers do not need to conduct supplement research to show profits before selling the product,” he said.
Cohen said it would be best to avoid supplements with these types of claims and instead “it’s best to get information about the benefits and risks of supplements from trusted and independent sources, such as the National Institutes of Health’s Nutritional Supplements Office.”
Supplements can lose their efficacy. Or, like fish oil, it can even get worse.
“Turn all supplements that have passed their expiration date,” Cohen said.
“Supplements that exceed their expiration dates rarely have the correct amount of active ingredients, as listed on the label,” he explained.
It is important to incorporate physician-prescribed supplements into your routine on a consistent basis. After an annual wellness visit, your doctor may say, for example, you need more iron or vitamin B12 or vitamin D based on a blood test.
“Take up all the supplements your doctor recommends,” Cohen said.
“Many vitamin and mineral supplements are key to treating a variety of health conditions. So, if your doctor recommends one or more supplements, don’t forget to take them regularly,” he said.
According to Cohen, most healthy people probably don’t even need to take a multivitamin.
“My clinical experience is no matter how you eat, as long as people are getting enough vitamins and minerals, unless they’re on a very restrictive diet,” he told Gupta.
“Whether you’re eating mostly manufactured or processed foods, or growing everything in your own garden for replenishment, I don’t see any serious vitamin defects in my practice.”
Of course, it’s not a bad idea to check with your doctor before starting a new supplement and certainly let them know what you’re currently taking during your annual exam. Some supplements can interact with certain medications, while others should not be used by people with certain health conditions.
We hope these 5 tips will help you understand supplements better. Listen to the entire episode here. Check out our new episodes of Chasing Life Podcast next week.
