Straight Talk About Supplements | Part 1
Supplements & Snake Oil
5 Things You Need to Know About Supplements
Dr. Aaron Hartman
October 17, 2023
Ironically, the snake is emblematic of both good doctors and swindlers. On the one hand, snakes are literally part of the symbol for medicine (called the caduceus). On the other hand, “snake oil” has become the catch-all label for anything phony or adulterated.
Supplements also live at the intersection of those two worlds. We love them and hate them for good reasons. Supplements offer the best of medicine and the worst of human deception.
Let’s look at both ends of that spectrum in this series: Straight Talk About Supplements & Snake Oil.
Broadly speaking, there are five things you need to know about supplements.
1. Supplements Come in Different Forms
While it may seem obvious, it’s worth stating: Supplements come in many different forms—typically capsules, pills, powders, or liquids. Supplements contain at least one dietary ingredient, such as vitamins, minerals, herbs, botanicals, amino acids or enzymes.
One form isn’t necessarily better or more pure than another in every case, but the form matters. The form impacts the bioactivity & bioavailability of the ingredients.
- Bioactive substances are biologically active and have an effect upon a living organism, tissue, or cell.
- Bioavailable substances are those that are able to be digested and absorbed.
Bioactive and bioavailable substances are more difficult to harvest and harder to fit into a single pill or capsule, which is why lower grade supplements typically rely on synthetic components which are not bioactive or bioavailable—meaning they are not readily digested and absorbed. They, therefore, have less impact on your health than their higher grade equivalents.[1]
That leads us to the second thing you need to know about supplements: they come in different grades.
2. Supplements Come in Different Grades
This point may not be as intuitive as the first. Supplements come in four different different grades (veterinary, nutritional, medicinal, and pharmaceutical):
- Veterinary-grade supplements are those made specifically for animal use.
- Nutritional-grade supplements are those made purely to deliver a specific dose of a vitamin or mineral. These are the most common supplements sold in stores. Nutritional grade supplements typically rely on synthetic components, which are least expensive to produce and fit into a single pill or capsule.
- Medicinal-grade supplements contain particular nutrients, which at higher levels have pharmaceutical effects (e.g. high dose niacin raises HDL and lowers LDL cholesterol).
- Pharmaceutical-grade supplements have the highest grade of purity, use only bioactive and bioavailable components, and are third-party tested for both content and purity.
These four supplement grades vary widely in their bioactivity and bioavailability. They also vary in accountability of third-party testing. Unfortunately, there is no organizational oversight that monitors individual supplements or brands and assigns these grades. I will return to this when I address supplement safety.
3. Supplements Are Only Meant to Supplement
Modern, western medicine is overly reliant, perhaps even obsessed, with pharmaceutical solutions. It’s wonderful that supplements provide natural substances our bodies need to function optimally. Given our natural bent towards drugs, however, it’s easy to fall into a similar mindset with supplements and view them as a shortcut to health. Take these pills or stir this powder into your smoothie and you’re good to go.
Given our natural bent towards drugs, however, it’s easy to fall into a similar mindset with supplements and view them as a shortcut to health. Take these pills or stir this powder into your smoothie and you’re good to go.
When we use supplements like pharmaceuticals to relieve symptoms or prop up deficiencies, we fail to uncover and address the root cause. Used in that way, we’re working against ourselves. Supplements cannot replace the value of a nutrient-rich diet and wise lifestyle medicine.
4. Supplements Can Be Powerful
When supplements are selected wisely and added to an already nutrient-rich diet and positive lifestyle… they can be powerful.
Just a few examples of effective supplements:
- Vitamin D can strengthen bone and cardiovascular health and bolster immunity.
- Folic Acid can reduce birth defects when taken by pregnant women.
- Vitamins C & E can prevent cell damage.
- Fish Oil can support brain function, heart health, and modulate inflammation.
- Probiotics support GI health with cascading benefits in immunity, stress, and brain function.
- Vitamin A can slow down vision loss from age-related macular degeneration.
- Protein & Collagen can promote lean muscle mass and connective tissue health.
- Melatonin can reduce inflammation and support healthy sleep cycles.
Supplements Aren’t Always Safe
If supplements can be powerful, it also means they can harm. Just because something is natural doesn’t make it harmless. Poisonous mushrooms are quite natural. I don’t advise them.
Just because something is natural doesn’t make it harmless. Poisonous mushrooms are quite natural. I don’t advise them.
So we can’t consume just anything. We need to be wise in what we ingest and how much. But we also have to contend with human deceitfulness. Ingredients may be adulterated or falsified. Unfortunately, that isn’t just a hypothetical possibility. We have a deep history of food, drug, and supplement adulteration in the United States.[2] And we have mounting evidence of ongoing deceit.[3]
Snake oil salesmen are still among us. Some brands synthesize or adulterate their products and falsify studies citing benefits. Digital swindlers will sell you products claiming to come from reputable brands. The supplement industry is not highly regulated, and sadly, it’s not always honest.
It’s still the wild wild west out there. You cannot simply purchase the least expensive multivitamin and trust that it is harmless.
It’s still the wild wild west out there. You cannot simply purchase the least expensive multivitamin and trust that it is harmless.
What’s Next?
In my next article, I’m going to dive deeper into the specific safety concerns we face when selecting and using supplements.
Then, I will walk you through my process of vetting supplements and provide you with recommendations for how you can wisely select supplements for you and your family.
“With great power comes great responsibility.” That’s true for Spiderman, and it’s true for supplements.
New to Supplements?
Get Started With Our Wellness Essentials Bundle
I’m often asked, “If you had to pick only 3 supplements to recommend to me, what would they be?” Here is my answer. You need a quality multi-vitamin, a good source of Vitamin D, and you need to boost your Omega 3 fatty acids. If you can invest further in your health, I also recommend a strong source of probiotics and a detox formula. If you are new to supplements and looking for a safe, reliable way to boost your overall health, here are the must-haves to get started:
Footnotes
- Bioavailability: Examples of this would be the white zinc oxide coating of lower-end multivitamins or the use of cyanocobalamin (cyanide molecule attached to cobalamin) as a source for the vitamin B12 (e.g. Centrum). These multivitamins were known during my residency training as ‘bedpan pills.’ Older individuals in the hospital and nursing homes often passed them in their stool into their bedpans—undigested and unabsorbed. In other words, useless. Back to Article
- Whether it is the ‘blue milk’ of Upton Sinclair’s The Jungle that led to the Food and Drug act of 1906, the adulteration of 5HTP that led to the discovery of eosinophilia-myalgia syndrome (EMS) in 1989, or the initial references above, due diligence is therefore necessary when choosing any supplements or food-based products. Back to Article
- Look to the next article in this series… Back to Article
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