Tuesday, December 9, 2008

How To Determine Quality in Supplements, Part 2

A good share of doctors who are evaluating a supplement line and/or a specific product do it like this: They will look at the label and check for certain ingredients. All done. If they like what they see in terms of ingredients, that is all they think they need to know.

Allow me ask this question: If a healthcare consumer were looking through the yellow pages for a good holistic practitioner, would you say that they have investigated their choices thoroughly by simply looking at the educational degrees of the various practitioners and the services offered? I think you would agree that just because someone has certain letters behind their name and offers a particular service does mean that their level of expertise is what you are after. I heard a joke that illustrates this point. “Do you know what you call a medical student who graduates with a C average? Answer: Doctor.”

I have been adjusted by chiropractors who I will never let touch me again, but others seem to have a magic touch. I have met self-proclaimed nutritional gurus who are so “out there” in their philosophies that I wonder how they ever got be doctors, but I would trust my own family to others. If you are like me, you don’t want just anyone with his/her name on a shingle adjusting your spine or overseeing your medical care.

Shouldn’t we be just as scrutinizing with the supplements that we are taking on a daily basis, and shouldn’t doctors be even more scrutinizing when it comes to supplements with which they trust their livelihoods?

If you believe that a supplement line merely calling themselves “professional” and talks quality and markets themselves to doctors automatically makes them a company turning a quality product, then I have some beachfront property in Kansas I would like to sell you. :-)

Everyone Talks Quality
When was the last time you saw an advertising line like this: “Our quality control is above average.” Never, right? Nearly every supplement manufacturer will provide you with full-color advertising showing people in white lab coats looking at samples in a test tube or through a microscope. Everyone says that they are second to none in terms of quality, just like every restaurant says that they maintain a clean kitchen, just like every car manufacturer wants you to believe that their brand of car is the safest and most reliable on the road, etc. So how do you differentiate effective marketing from true quality?

Unfortunately, there IS a big problem with quality in dietary supplements. Bear in mind that the supplement industry is not regulated by the FDA, and that means that standards of quality are self-imposed. In other words, it is up to each individual company how much money they want to spend on quality measures. And that is perhaps why there are not more companies that are GMP certified (see my last post).

There is much more to determining the quality of a product or supplement line than just looking at the ingredients of a label, because there are some serious problems that exist in the supplement industry regarding quality that I’ll talk more about in the next post. For today’s post, however, I want to focus on the difference between what’s on a label and what is actually represented in a product.

Analyzing Raw Materials
Nearly all supplement companies get their raw materials from third-party suppliers. Remember, there are no FDA standards to guide supplement companies in how they select their raw materials, so most of the time companies make their decisions based upon price and based upon the claims of the raw material suppliers. If the companies selecting these raw materials don’t analyze what they are buying prior to the purchase, then they really have no idea what they are getting.

For example, the therapeutic parts of the herb, Echinacea, are in the flowering bud, not the stem or the roots. Yet a supplement company can buy a batch of Echinacea from a third-party supplier not knowing that most of the raw material is stems and roots and possessing almost no therapeutic benefits.

Even the true therapeutic parts of the plants can vary from batch to batch, and that’s why comprehensive lab analysis are important to verify the different constituents of the plant.

The herb, St. John’s Wort, for example, contains hyperforin and hypericins that give the herb the therapeutic benefits. In a recent analysis of four different suppliers of St. John’s Wort, all varying in price, the lab analysis showed the following:

The first three samples, ranging in price from $12.32/kg to $19.00/kg, all had incomplete assay information and/or had incorrect assay methods. There was no detectable hyperforin in any of them, and although there were adequate levels of hypericins, all three samples had suspect adulteration with synthetic hypericin. All three samples also had heavy metal contamination.

In contrast, the fourth sample of St. John’s Wort – by far the most expensive of the four at $36.00/kg – was identity confirmed with a complete and correct assay method, had therapeutic amounts of hyperforin at 3.0%, and therapeutic amounts of natural, unadulterated hypericins at 0.3%. Likewise, there was not any heavy metal contamination.

A scrutinizing supplement company would know what to look for in all four samples, so they would first of all have to know what a correct and complete assay method looks like to be able to determine if the information presented in the assay report actually means anything. It’s not enough to just have an assay. You have to know the correct assay methods. Secondly, the scrutinizing company would know what levels of the therapeutic agents to look for, as well as levels and types of possible adulteration. Thus, a company that is truly in the health business will choose, in this case, sample #4 even though it is three times more expensive than some of the other samples.

As a last point, what do you think the suppliers of samples 1, 2, and 3 do after a company with high standards rejects their raw materials? You guessed it. They just take their shoddy raw material and go sell it to another supplement company who either doesn’t do any raw material analysis at all, or one who doesn’t perform the proper methods of evaluation.

So price is definitely not the way a responsible consumer, whether it be a practitioner or a patient, should be choosing their supplements.

In my last and final post on this subject, I’ll address six other markers of true quality in supplements. Stay tuned.