Dietary supplements designed to support wellness can include many ingredients, or a combination, including vitamins, minerals, amino acids, medical herbs, and other natural substances. In the United States, supplements aren’t regulated as rigorously compared to prescription drugs. This can cause discrepancies between dietary supplements produced by different manufacturers. Ingredient sourcing and quality measures may vary significantly between products, potentially impacting their efficacy and safety.
If you’re getting started with dietary supplements, here’s five facts about supplement ingredients that you should know.
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5 facts about supplement ingredients that you should know
Understanding how to read supplement labels is an important factor in understanding supplement ingredients. Knowing what keywords to look for and quality considerations to be aware of can help ensure your patients are receiving safe and accurately labeled products.
1. Excipients are not just fillers
Excipients, the inactive or “other ingredients” on supplement labels are substances that are similar to additives in food products. Excipients are added during manufacturing and aim to improve various aspects of the supplement, including
- Nutritional value
- Texture (5)
When supplements are used as directed, excipients are overall safe and pose little health risk. Some excipients may contain allergens, such as wheat, eggs, and dairy, that can cause an adverse reaction in sensitive individuals. (1) Always examine supplement labels to ensure safety for each patient’s individual needs.
2. Natural doesn’t always mean safe
Supplements are often marketed to consumers using language that convinces consumers of the product’s health benefits and purity, such as “100% natural.” Although this may be one of their health claims, that doesn’t guarantee consumer safety. For example, certain natural ingredients and vitamins can cause adverse effects at high doses, such as gastrointestinal upset caused by high intake of vitamin C. (7)(8)
3. Not all extracts are standardized
Standardization is a process that manufacturers may use for extracts to ensure that all of their batches have similar doses. Non-standardized products may have doses inconsistent with the label, which can impact consumer safety. U.S. law does not require dietary supplements to be standardized, so it’s important to check the label of any extract-containing products. (4)
4. Ingredients are not pre-approved by the FDA
Before becoming available on the U.S. market, dietary supplement companies are responsible for ensuring that their products are safe and comply with other labeling and quality requirements, such as current Good Manufacturing Practices (cGMP). However, supplements are not pre-approved by the U.S Food and Drug Administration (FDA) for evidence of their safety or effectiveness. (6) This can lead to the inclusion of improper active ingredients, such as ginseng leaves instead of roots, inaccurate nutrient content, or exclusion of ingredients listed on the label. (3)
5. Quality matters
With so many supplements to choose from, it’s important to get one with high-quality ingredients that you can trust. Higher quality supplements help ensure patient safety and promote treatment plan success. High-quality supplements are often transparent about their health claims, manufacturing process, and ingredient sourcing. They may also have achieved third-party certification, which can support certain health claims or ingredient information about the product, such as gluten-free.
The bottom line
Supplements aren’t regulated by the FDA as strictly as prescription drugs. This allows supplement ingredient sourcing, manufacturing, and distribution to vary by manufacturer. The supplement label can tell you a lot about the ingredients, so knowing what key things to look for on the label is essential. Choosing high-quality products with transparent product information can also help ensure that the information on the label is accurate.
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- Balbani, A. P., Stelzer, L. B., & Montovani, J. C. (2006). Pharmaceutical excipients and the information on drug labels. Brazilian Journal of Otorhinolaryngology, 72(3), 400–406. https://doi.org/10.1016/s1808-8694(15)30976-9
- Congressional Research Service. (2018). How FDA approves drugs and regulates their safety and effectiveness. https://sgp.fas.org/crs/misc/R41983.pdf
- Ichim, M. C., & de Boer, H. J. (2021). A review of authenticity and authentication of commercial ginseng herbal medicines and food supplements. Frontiers in Pharmacology, 11, 612071. https://doi.org/10.3389/fphar.2020.612071
- National Institutes of Health. (2020). Botanical dietary supplements – Background information. https://ods.od.nih.gov/factsheets/BotanicalBackground-Consumer/
- U.S. Food & Drug Administration. (2004). Overview of food ingredients, additives & colors. https://www.fda.gov/food/food-ingredients-packaging/overview-food-ingredients-additives-colors
- U.S. Food & Drug Administration. (n.d.). Is it really ‘FDA approved’? https://www.fda.gov/consumers/consumer-updates/it-really-fda-approved
- U.S. Food & Drug Administration. (n.d.). Some imported dietary supplements and nonprescription drug products may harm you. https://www.fda.gov/consumers/consumer-updates/some-imported-dietary-supplements-and-nonprescription-drug-products-may-harm-you
- Wooltorton E. (2003). Too much of a good thing? Toxic effects of vitamin and mineral supplements. CMAJ: Canadian Medical Association Journal, 169(1), 47–48.