I’m an RD—Before Taking Any Supplements, You Should Understand These 5 Facts About Their Safety and Efficacy
While certain supplements can absolutely benefit some individuals, there are a few things to be aware of before introducing any new supplement into your routine. Ahead, some important considerations you may want to make before starting a new supplement according to a registered dietitian with a strong clinical background (hi, it's me!).
Supplements cannot replace a well-rounded eating pattern
Anyone that's strolled around a pharmacy or a vitamin store has likely spotted the expansive array of over-the-counter supplements available. There are herbal supplements, multivitamins, protein powders, minerals, and more. Where to begin?
The first bit of advice I want to convey is that regardless of the kind of supplement you take, it will not replace a balanced eating pattern. “Supplements do exactly what their name suggest: They supplement a balanced eating pattern," says Diana Mesa, RD, LDN, CDCES, founder and owner of En La Mesa Nutrition. "You still want to aim to get a variety of nutrient-dense foods as much as possible.”
This is because food gives us nutrients that supplements just can’t mimic. “The vitamins and minerals in our foods work synergistically, meaning they work together. The benefits that we receive when eating nutrient-dense foods may not be the same ones we receive when we forego eating those entirely and replace them with a supplement,” says Mesa.
More importantly, food gives us energy. Next time diet culture tries to convince you that restricting your food intake for the sake of weight loss is "good" or remotely safe, remember that your body needs food (yes, meaning calories) to prevent malnutrition, complete your daily activities and ultimately, to live, to breathe, to be well. Most herbal, vitamin, and mineral supplements won’t provide the literal life-giving energy that food can.
“Supplements do exactly what their name suggest: They supplement a balanced eating pattern," says Diana Mesa RD, LDN, CDCES, founder and owner of En La Mesa Nutrition. "You still want to aim to get a variety of nutrient-dense foods as much as possible.”
The FDA isn't required to test supplements for safety before they're sold
As stated in the 1994 Dietary Supplement Health and Education Act (DSHEA), the FDA, “does NOT have the authority to approve dietary supplements for safety and effectiveness, or to approve their labeling, before the supplements are sold to the public.”
Please read that twice. And yes, there have been instances, as described in a 2015 study published in the New England Journal of Medicine, where supplements have caused unwanted side effects or harms among unsuspecting consumers.
That being said, finding a third-party tested supplement ensures that the supplement’s label is accurate. “Organizations such as NSF International, US Pharmacopeia, and ConsumerLab put their seal on the product label to certify the product meets those safety standards,” says Mesa. You can check the product label or go to the websites of these third-party testers to verify whether the supplement you are considering has been third-party tested.
There isn't strong research backing the benefits of most supplements on the market
While third-party testing helps ensure the information you read on a supplement label is accurate, the efficacy of said testing is iffy depending on the supplement you're searching for.
Many supplements are well-studied and backed by research, particularly most vitamins and minerals. However, some supplements may have limited or low-quality research. This is often the case for herbal supplements. (To caveat, there are some very well-studied herbal supplements—it's just that ones with less conclusive research get most of the attention.)
With all of this being said, it's important to speak with a trusted medical provider before starting a new supplement to ensure it is safe and well-researched. Some red flags that may signal a supplement is not well-studied include:
- There are only animal or in vitro studies
- The studies have small sample sizes
- There are a limited number of studies
To dig deeper, check out the fact sheets on dietary supplements from The National Institutes of Health (NIH). These outlines provide high-quality information on a wide range of supplements, and are a great place to see what the research says about safety, efficacy, and dosage for a given supplement. “Also, avoid taking more than the recommended amount on the label, unless otherwise instructed by a medical professional collaborating on your care,” adds Mesa.
Drug-nutrient interactions are a thing, and you should prepare accordingly
Certain supplements can interact with medications, and vice versa. This can result in altered absorption or metabolism of a medication—causing it to work faster, slower, or not at all. On the flipside, certain medications can deplete certain nutrient stores and lead to deficiencies. “For example, St. John’s Wort, a popular supplement taken for depression, may make birth control meds less effective and reduce the effectiveness of other drugs like immunosuppressants. And vitamin E can interact with blood thinners, increasing the risk of bleeding,” says Mesa.
That being said, before starting a new supplement, speak with your healthcare team to ensure there are no potential drug-nutrient interactions.
Supplements aren't always a good idea for folks with health conditions
There are certain health conditions that warrant special consideration before starting supplementation. People who should be extra careful about taking a supplement include:
- Those with liver illness or injury
- Immunocompromised individuals
- Those with kidney disease
- Those undergoing radiation treatment or chemotherapy
For these conditions, certain supplements may interfere with treatment. Having one of these conditions may also put you at higher risk of adverse side effects from supplementation. Again, it is not to say that you must avoid all supplements, but we’d recommend speaking with your healthcare team before starting a new supplement.
Supplements are a popular way of boosting health, but there is a lot to consider before starting a new one. Despite the common impression that they are “natural” and therefore safe, they are not well-regulated by the FDA, so you’ll want to be sure you find a supplement that is third-party tested. It is also helpful to understand what the research says on that specific supplement, whether there are drug-nutrient interactions at play, and whether the supplement is compatible with your health conditions. Always lastly, be sure to check with your healthcare team for help deciding if a supplement is right for you.
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