Written Jun 20th, 2014 by Franco Varriano
[Guest Post] Health Product Quality: 3 Things You Need to Know by Dr. Warren Brown, ND
Today’s guest post is brought to you by Dr. Warren Brown, a naturopathic physician and former member of the Bastyr Center for Natural Health’s Formulary Review Committee.
Several years ago I was offered the opportunity to join the Bastyr Center for Natural Health’s Formulary Review Committee. I was a student at the time and I wanted to learn more about how our clinic’s dispensary went about selecting the natural health products that would be made available to the patients of our school’s teaching clinic. What I learned during my two years on the committee has influenced my treatment plans ever since, and I now make it a point to have a brief discussion about the quality of dietary supplements with all of my new patients.
Many patients and healthcare providers are unfamiliar with the amount of work and expertise required to make a quality dietary supplement. It can be a highly sophisticated process that can require multiple parties and in some cases, hundreds of steps in order to move from raw materials to finished product. This is and should be a complex and scientific process.
At each step in the process of making a dietary supplement, a supplier, processor, manufacturer, or distributor incurs cost. Generally, the companies that are willing to invest in this process are the ones with the highest quality products and often the more expensive ones. Those companies that cut corners in this process are able to lower their production costs, which frequently result in a lower quality product. However, price isn’t always a sign of quality, since marketing can also be a factor of cost.
Here are the 3 most common areas where dietary supplement companies fail:
There are two potential failures in this category. First, the raw materials that go into a formula can sometimes be misidentified, i.e. genus and/or species of the plant are incorrect. Ligusticum porteri (osha), for example, can easily be confused with some types of hemlock. Secondly, going back a step, the formulator may have assumed that a similar form of a nutrient would have the same desired therapeutic affect. B12 is a good example of this since some formulas contain cyanocobalamin instead of the superior form methylcobalamin. This is common with minerals as well. Magnesium oxide, a poorly bio-available form of magnesium, is often used in favor of other forms due to cost and/or incompetence on the part of the formulator.
The purity discussion typically centers around isolating the desired ingredient. However, contamination from heavy metals, bacteria, aflatoxins, pesticides, herbicides, PCBs, dioxins, etc. is becoming the bigger problem. Several months ago, a major brand carried in stores all over the U.S. was found to be contaminated with mercury. Flow agents, sometimes called anticaking agents, are another common adulterant found in supplements. Flow agents are compounds that are added to raw materials to help them pass through machinery without getting stuck. They help increase product yield, but have no therapeutic value.
Often a product company will aim for a large label with an extensive list of ingredients to give the impression of being comprehensive and to cover all of the latest trends research. But only some, or none of those ingredients, will contain a physiologic dose of the ingredients. This is often the reason why the desired therapeutic effect is not reached.
There are many different organizations that have proposed procedural standards with the intent of ensuring quality. Some of these are third-party groups that set standards like GMP (Good Manufacturing Practices), USP (United States Pharmacopea), and NSF (National Sanitation Foundation). Products that meet these standards are allowed to use a corresponding logo on the label. There are other groups like the EQP (Emerson Quality Program) that have established their own quality standards and have identified products that meet those standards in an effort to help healthcare providers make more informed decisions about product quality. The EQP evaluates products based on product design, manufacturing controls, and raw ingredient and finished product testing.
Fortunately, there are many brands that meet or exceed the criteria set forth by these widely recognized quality assurance organizations. I have compiled a list of some of these brands below. It is worth mentioning that while I prescribe these excellent brands to my patients regularly, I have no financial affiliations with any of them.
- Vital nutrients
- Integrative Therapeutics
- Pure Encapsulations
- Gaia Herbs
- Douglas Laboratories
- Thorne (new to Fullscript US)
- United States Pharmacopea: http://www.usp.org/dietary-supplements/overview
- National Sanitation Foundation: http://www.nsf.org/services/by-industry/dietary-supplements
- Good Manufacturing Practices: http://www.ispe.org/gmp-resources
- American Botanical Council: http://www.abc.herbalgram.org (enter “quality” in the search field or subscribe to their newsletter)
- Emerson Quality Program: http://www.emersonecologics.com/quality
Dr. Warren Brown is a naturopathic physician and former member of the Bastyr Center for Natural Health’s Formulary Review Committee. His practice in Suwanee, Georgia focuses on sports medicine and men’s health.
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