Not All Vitamins are Created Equal

© 2014 Dr. Sharon Norling

In June 2002, the Journal of the American Medical Association (JAMA) published a two-part paper by two researchers associated with Harvard Medical School that sparked widespread media attention in recommending vitamin supplements for the general public. The abstract of that paper reads as follows:

Vitamin deficiency syndromes such as scurvy and beriberi are uncommon in Western societies. However, suboptimal intake of some vitamins is a risk factor for chronic diseases, and common in the general population. Suboptimal folic acid levels, along with suboptimal levels of vitamin B6, and vitamin B12, are a risk factor for cardiovascular disease, neural tube defects and colon and breast cancer; low levels of vitamin D contribute to osteopenia and fractures; and low levels of antioxidant vitamins (vitamin A, E and C) may increase risk for several chronic diseases. Most people do not consume an optimal amount of all vitamins by diet alone. Pending strong evidence of effectiveness from randomized trials, it appears prudent for all adults to take vitamin supplements. The evidence base for tailoring the contents of multivitamins to specific characteristics of patients such as age, sex and physical activity and for testing vitamin levels to guide specific supplementation practices is limited. Physicians should make specific efforts to learn about their patients’ use of vitamins to ensure they are taking vitamins they should.

According to the Food and Drug Administration (FDA), the dietary supplement industry has exploded in the past decade to about 29,000 products, and about 1,000 new products are introduced each year. Choosing the right high quality supplements can improve your health and decrease your symptoms, though this selection process is not always as simple as it sounds. The number of different formulas and brands of dietary supplements makes it confusing when deciding which to buy, and there are currently no established standards as to what multivitamins should contain. One reason for the lack of uniformed standards is that people’s diets and nutritional needs differ. Nutrient requirements vary depending on age, gender and health status, use of substances such as alcohol or tobacco and medications being taken.

There are also no standards requiring that the ingredients in the bottle match what is written on the label. Vitamins and dietary supplements are a food source, and, therefore, it is important to remember that claims made for their effectiveness are not approved by the FDA. However, the lack of approval doesn’t mean the supplements are not effective. Research and clinical trials have shown that vitamins can have significant health benefits with minimal to no side effects.

Many labeling recommendations were issued and some were revised by the Institute of Medicine including a major update in January 2001. However, the FDA has yet to require that product labeling include much of this new information. In addition to selecting a product that appears to have the right ingredients, one should be confident that it: contains what it claims, breaks down properly once inside the body so its ingredients can be effectively assimilated and that it is free of toxins, pesticides, bacteria, mold and other impurities.

The Dietary Supplement Health and Educations Act of 1994 (DSHEA) granted the FDA the authority to establish Good Manufacturing Practices (GMP). GMP regulations deal with designing, building and implementing advanced controls into the system to reduce the chance of product contamination, mix-ups and errors in the manufacturing of vitamins and supplements. High quality nutritional supplements are often manufactured in plants that are inspected and certified by organizations, such as:

• National Sanitation Foundation (NSF)
• National Nutritional Foods Association (NNFA)
• Therapeutic Goods Administration (TGA)

True quality cannot usually be achieved without a qualified scientific staff supported by research. Are your supplements produced in a certified GMP facility?, as a part of its mission to independently evaluate products that affect health and nutrition, recently purchased many of the leading multivitamin products sold in the U.S., tested them for their quality and evaluated them against the most recently recommended Dietary Reference Intakes (DRIs).

In one of its most surprising findings, Consumer Labs (CL), through its independent testing, did not approve L’il Critters Gummy Vites for the following reasons.

L’il Critters Gummy Vites, distributed by Northwest Natural Products, Inc., contained a high amount of lead and was missing half of the folic acid claimed. Lead is of particular concern to children as low amounts can affect mental functioning. It is astounding to me that any lead is allowed in any vitamins today, especially children’s vitamins!

If you are healthy, you may only need a good, high quality multivitamin. However, if you are attempting to gain benefit from nutrition, are treating a symptom or have health issues, you may want to look for a product with higher dosages of several nutrients that have been shown to be beneficial.

Vitamins, minerals and supplements derived from organic sources may be your first choice. In choosing whole foods, we avoid chemical additives, pesticides and hormones, so it is appropriate to choose organic when purchasing supplements as well. Look for vitamins that state on the label that the product does not include wheat, gluten, corn protein, yeast, soy protein, dairy products, nuts, tree nuts, crustacean shellfish or artificial colors, sweeteners or preservatives.

If you have a medical problem or are pregnant or nursing, be sure to consult a nutrition specialist or knowledgeable physician before taking any supplements. A physician educated in nutrition will take into consideration your medical history, your food choices, and your current medications and choose any diagnostic tests necessary to prescribe a dietary and supplement program.
You have heard the saying, “If it sounds too good to be true, it probably is.” Use caution and good sense when you encounter inflated claims for vitamin supplements. Your e-mail junk box is probably filled with messages making these claims for various herbs and supplements. Keep in mind that cheaper often means poor quality. Buy your vitamin supplements from health care providers, nutrition stores and whole foods markets. The most expensive vitamin or supplement you can take is one that does not serve its purpose or makes you ill!

How to Choose Quality Vitamins:

• Use organic sources whenever possible.
• Nutrients should be tested for toxic substances and any kind of contamination.
• No artificial ingredients should be used in manufacturing.
• Look for hypoallergenic products.
• Check the expiration date.
• Contact the lab that makes the vitamin supplements and ask them how they test their products. Check
• Choose only high quality vitamins even if they cost a little more.
• Keep in mind that some of the highest quality products are only available through healthcare providers.

Evidence is accumulating that taking multivitamin/mineral supplements is good health insurance. Make sure you are using the best quality and coupling it with a good diet, as we also need fiber, omega-3 fatty acids and other ingredients for healthy living!

Written by: Dr. Sharon Norling, MBA