Choosing Supplements
Below, I've answered some of the most common questions about how to choose among the many supplements available.
Q: Are natural forms of vitamins better than synthetic forms?
A: In most cases, natural and synthetic vitamins and minerals are handled by the body in exactly the same way. A good example of this is the B-complex vitamins, which can be obtained in supplements as "natural" B vitamins (usually from brewer's yeast or a similar substance) or as purified chemicals that are listed on the product label as thiamin (B-1), riboflavin (B-2), niacin (B-3), and so forth. When either of these supplemental sources of B vitamins is consumed, the vitamins are absorbed, transported, and utilized by the body in exactly the same way—so we can say with confidence that there is no difference between natural and synthetic when it comes to B vitamins. Two interesting exceptions to this example are folic acid, which is better absorbed as the synthetic form (compared to natural forms found in foods), and vitamin E, which is far superior in the natural versus the synthetic form. In the case of vitamin E, very good scientific data exist showing that natural vitamin E is absorbed and retained in the body two to three times better than the synthetic forms. Natural vitamin E costs a bit more than the synthetic variety, but the small added cost is more than justified by the higher activity.
Q: Should I choose a brand-name or generic vitamin/mineral supplement?
A: The ultimate answer to this question is less about generics or brand-name products than it is about choosing between supplements that provide "basic" versus "optimal" levels of particular nutrients. Therefore, your answer to this question will depend on two primary factors: How much money can you afford to spend on a supplement, and are you looking for a basic or an optimal supplement?
Many of the generic or private-label store-brand supplements on the market will do a satisfactory job of helping you meet the basic RDA (recommended daily allowance) levels for essential vitamins and minerals. The primary limitation with these generic products, and even with many brand-name supplements, is that the basic RDA levels of most vitamins and minerals fall far below the levels associated with optimal health and certainly below those needed for optimal cortisol control. Chapter 8 outlines many of the details surrounding the use of vitamins and minerals for cortisol control, but a couple of the most important are worth highlighting here:
With respect to the B vitamins, there is very good scientific evidence to support daily intakes at 200–500 percent of RDA levels for optimal stress response and cortisol control. These levels are two to five times higher than the levels found in most multivitamin products.
Calcium and magnesium are two minerals that are known to help regulate the body's stress response, yet most generic supplements and "one-tablet-a-day" type brand-name supplements provide only a small fraction of the 250–500 milligrams (mg) of calcium and the 125–250 mg of magnesium needed to aid cortisol control. The primary reason for skimping on the calcium and magnesium in these products is due not to costs (both are very cheap), but to space considerations in the capsules and tablets. Both calcium and magnesium are bulky minerals—that is, they take up a lot of space—so an optimal daily dosage requires more than a single capsule each day (and sometimes as many as four capsules, depending on the mineral source).
The bottom line here is that everybody should take at least a basic multivitamin/multimineral supplement—and virtually any product, generic or brand-name, found on the shelf at Wal-Mart, Rite-Aid, or your local grocery store will satisfy the basic RDA-level requirements. However, if you are interested in a supplement that delivers more than the rock-bottom levels of cortisol-controlling nutrients, and if you can afford to spend a little more on your daily supplement regimen, then you will want to consider a multivitamin/mineral supplement that provides higher levels of B-complex vitamins, calcium, and magnesium.
Q: What should I consider when I am shopping for herbal supplements?
A: When it comes to selecting herbal supplements, the situation can quickly get very confusing. Because herbals are really a form of natural medicine, it is crucial that you select the right form of the herb so that you get the safest and most effective product. Herbal supplements are absolutely an area in which generic products are not equivalent to brand-name products. It is vitally important to select either the exact product that has been used in clinical studies, or a product that contains a chemically equivalent form of the herb that has been studied. The easiest way for most consumers to select a safe and effective herb is to determine/select only those extracts that have been "standardized" to provide a uniform level of the key active ingredients in each batch of the product (see the supplement descriptions in Chapter 8 for details on these standards). The best scenario would be to select only those specific products that have undergone clinical studies of their own (rather than selecting products that contain ingredients on which studies have been conducted)—but there are far fewer finished products that have been subjected to clinical testing than there are raw ingredients (magnolia bark, theanine, etc.) that have been evaluated in such research.
Q: Where is the best place to buy supplements?
A: The preceding three questions should offer enough general guidance to help you weed through the many less desirable supplement products on the market and select products that can make a difference in your overall health. With the explosive growth in the supplement market over the past decade, consumers can now find vitamins, minerals, herbs, and other supplements for sale in a variety of places—including specialty supplement stores, natural-foods stores, drugstores, grocery stores, discount department stores, and through direct marketing, infomercials, catalog sales, and the Internet. Is any one of these outlets better than the others? Not really—but they each have their own particular niche.
For example, the least expensive "bargain" products will be found at supermarkets and discount department stores (e.g., Wal-Mart), but these products may suffer from many of the problems outlined above with regard to basic versus optimal supplementation. Supplements that are a step above the cheapest and most basic of products can typically be found at drugstores, natural-foods markets, and specialty supplement outlets. These are the middle-of-the-road products that do a decent job of balancing high-quality and optimal nutrient levels with moderate prices.
The most expensive products, and those with the widest range in terms of quality, safety, and effectiveness, are typically sold through direct sales channels such as the Internet, catalogs, and independent sales agents. In some cases, these products are designed to deliver optimal levels of all nutrients in the most bioavailable forms, but the obvious downside is their high price. In other cases, all you get is the high price—without any of the optimal levels of the crucial nutrients. So how can you differentiate between these premium-priced products? By asking to see the results from their clinical studies. Products in this "premium" category will almost certainly need to justify their high price with strong scientific evidence to support their claims and to show that their product is justified at this price. If the company cannot provide you with scientific evidence to support its premium products, then you are well advised to look elsewhere for your supplement.
by Shawn M Talbott, PhD