Supplements, do they work?

So a person I follow on twitter and facebook has a blog, girlwithnoname. She has been doing a long personal experiment with three supplements she was sent. Check out her blog for her opinions and results.

So, after reading what she had to say, it got me to thinking. How many different times in my life have I tried some kind of supplement in a desperate attempt to achieve some form of relief? I've also tried prescription meds for pain relief, over the counter nsaids and ointments, tips and tricks suggested to me by anyone from my doctor to total strangers, all in an attempt alleviate the pain.

We'll start with the supplements and what I've found to be true about them.

Key Points

• Federal regulations for dietary supplements are very different from those for prescription and over-the-counter drugs. For example, a dietary supplement manufacturer does not have to prove a product's safety and effectiveness before it is marketed.
• If you are thinking about using a dietary supplement, first get information on it from reliable sources. Keep in mind that dietary supplements may interact with medications or other dietary supplements and may contain ingredients not listed on the label.
• Tell your health care providers about any complementary and alternative practices you use, including dietary supplements. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

 The first point is, to me, the most important.

Allowable levels of contaminants vary greatly between agencies, with the FDA's standards being the least stringent. PCB standards vary the most. The FDA's tolerance level for PCBs is 2,000 parts per billion (ppb), while the State of California's limit under Proposition 65 (the most stringent standard) is only 90 ppb, assuming daily consumption of one 1,000 mg fish oil capsule. Similar disparities exist for mercury and dioxins.

Although no longer commercially produced in the United States, PCBs may be present in products and materials produced before the 1979 PCB ban. Products that may contain PCBs include:

• Transformers and capacitors
• Other electrical equipment including voltage regulators, switches, reclosers, bushings, and electromagnets
• Oil used in motors and hydraulic systems
• Old electrical devices or appliances containing PCB capacitors
• Fluorescent light ballasts
• Cable insulation
• Thermal insulation material including fiberglass, felt, foam, and cork
• Adhesives and tapes
• Oil-based paint
• Caulking
• Plastics
• Carbonless copy paper
• Floor finish

So, according to our gubbernment friends, it's just peachy if you eat some floor finish with your vitamin C. And keep in mind, that's in what is regulated, many vitamins supplements aren't.

Straight from the fda website

Dietary Supplements

FDA regulates both finished dietary supplement products and dietary ingredients under a different set of regulations than those covering "conventional" foods and drug products (prescription and Over-the-Counter). Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), the dietary supplement or dietary ingredient manufacturer is responsible for ensuring that a dietary supplement or ingredient is safe before it is marketed. FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market. Generally, manufacturers do not need to register their products with FDA nor get FDA approval before producing or selling dietary supplements.* Manufacturers must make sure that product label information is truthful and not misleading. Under the FDA Final Rule 21 CFR 111, all domestic and foreign companies that manufacture, package, label or hold dietary supplement, including those involved with testing, quality control, and dietary supplement distribution in the U.S., must comply with the Dietary Supplement Current Good Manufacturing Practices (cGMPS) for quality control. In addition, the manufacturer, packer, or distributor whose name appears on the label of a dietary supplement marketed in the United States is required to submit to FDA all serious adverse event reports associated with use of the dietary supplement in the United States.

FDA's other responsibilities include product information, such as labeling, claims, package inserts, and accompanying literature. The Federal Trade Commission regulates dietary supplement advertising.

*Domestic and foreign facilities that manufacture/process, pack, or hold food for human or animal consumption in the United States are required to register their facility with the FDA. For more information, see Registration of Food Facilities.

So, after reading that fascinating information you may be asking hmm, just what kind of wonderful safety information is found in the cGMPS? Well, what it boils down to is this:

Manufacturers:

• Under the Dietary Supplement Health and Education Act (DSHEA), manufacturers have an essential responsibility to substantiate the safety of their products and for determining that any representations or claims made about their products are substantiated by adequate evidence to show that they are not false or misleading.
• The CGMPs will help to ensure manufacturers produce unadulterated and properly labeled dietary supplements.
• Under the CGMP rule, manufacturers are required to:
  • Employ qualified employees and supervisors;
  • Design and construct their physical plant in a manner to protect dietary ingredients and dietary supplements from becoming adulterated during manufacturing, packaging, labeling and holding;
  • Use equipment and utensils that are of appropriate design, construction, and workmanship for the intended use;
  • Establish and use master manufacturing and batch production records;
  • Establish procedures for quality control operations;
  • Hold and distribute dietary supplements and materials used to manufacture dietary supplements under appropriate conditions of temperature, humidity, light, and sanitation so that the quality of the dietary supplement is not affected;
  • Keep a written record of each product complaint related to CGMPs; and
  • Retain records for 1 year past the shelf life date, if shelf life dating is used, or 2 years beyond the date of distribution of the last batch of dietary supplements associated with those records.
• Examples of product quality problems that the rule will help prevent are:
  • dietary supplements that contain ingredients in amounts that are greater than those listed on the label dietary supplements that contain ingredients in amounts that are less than those listed on the label
  • wrong ingredient,
  • other contaminant (e.g., bacteria, pesticide, glass, lead),
  • foreign material in a dietary supplement container,
  • improper packaging, and
  • mislabeled
• The interim final rule allows manufacturers to petition FDA for an exemption from the requirement of 100 percent identity testing of one or more dietary ingredients used in manufacturing the dietary supplement. The manufacturer would provide data to demonstrate that its proposed reduced frequency of identity testing does not materially diminish assurance that the dietary ingredient is the correct dietary ingredient. Each petition will be considered on a case by case basis.

So, they sort of, kind of basically have to tell you the truth about what it is you're consuming. Of course, unless you happen to be a chemist understanding many of the ingredients can be darn near impossible.

So, lets look at the ingredients of costco multivitamins shall we?
Ingredients:
Dibasic Calcium Phosphate, Cellulose Gel, Potassium Chloride, Ascorbic Acid, Magnesium Oxide, Starch (Corn and Tapioca), dl-Alpha Tocopheryl Acetate, Niacinamide, Tribasic Calcium Phosphate, Ferrous Furmarate, Croscarmellose Sodium, Manganese Sulfate, Zinc Oxide, Hydroxypropyl Methylcellulose, Gelatin, Asian Ginseng Root Extract, , d-Calcium Pantothenate, Magnesium Stearate, Silicon Dioxide, Thiamin Mononitrate, Riboflavin, Copper Oxide, Beta Carotene, Polyethylene Glycol, Vitamin A Acetate, Chromium Chloride, Sodium Selenate, Folic Acid, Lycopene, Sodium Borate, Lutein, Potassium Iodide, , Biotin, Cyanocobalamin, Sodium Metavanadate, Nickelous Sulfate, Stannous Chloride, Vitamin D3 (Cholecalciferol).

Dicalcium phosphate (DCP) is a commonly used filler in
tablet formulas. Coarser grades of this excipient are known
to flow well and have good compactibility. However, DCP
is insoluble and can be very abrasive, which could cause
reduced tooling life due to wear on the equipment during
tablet manufacture. High levels of lubricants are required
to overcome the abrasiveness, but elevated levels of hy-
drophobic lubricants can impact the mechanical strength
of the tablets and disintegration/dissolution performance.
These concerns have led to investigations of the use of
other materials in tablet development.

You want to know what cellulose gel is? Me too. No one seems to know exactly. If you can find a straight answer I'd love to hear it. Here is what I did find.
a unique ingredient. In water, with shear, MCC forms a three-dimensional matrix comprised of millions of insoluble microcrystals that form an extremely stable, thixotropic gel. Avicel microcrystalline cellulose functions at any temperature and provides superior freeze/thaw and heat stability to finished products.

So at this point we have abrasive, filler, filler and temperature stability.  Are  you hungry yet?

*dl-Alpha Tocopheryl Acetate a very fancy way of saying vitamen E
*Pyridoxine Hydrochloride for us silly people is B6.
*Polyethylene Glycol is used as a laxative, put in eye drops and about 300 other things.

So, my point is (yes, I actually do have a point) that with everything you eat or drink, be smart. Read labels. And if it claims to be some magic pill that is going to do wonders, don't bother.

Taking vitamins isn't a bad thing. I take them every day. Knowing what you're taking and what it is going to do, or not do, is important. How much actual vitamin is in that vitamin and how much is useless filler? Well, you generally get what you pay for.

So when you walk down the vitamin and supplement isle in the store do you wonder how much of it is crap? I do. So I research before I ingest. I learn what it is, what's in it, what it's supposed to do and what it's been shown to actually do. I think and this is purely my personal opinion, that much of the positive results people claim with various supplements is the very fabulous and oft overlooked placebo effect. If you think it's going to work, it's going to work.

What about the prescription drugs? Well, I can answer that pretty quick. Most of them mask the pain. Most of them have worse side effects than benefits. If you want to sleep a lot, pain meds are the way to go. Yes, I have days when I eat percocet like candy so I can function. But that's all it does is allow me to function, barely.

 At one point in time I was taking several different supplements. Shark something or other that was supposed to help with my knees. It didn't. Fish oil. I'd  rather eat the fish, it  tastes better.

If you eat a healthy diet you get the vitamins and other nutrients you need. Be good to your body. Feed it well. It will appreciate it. The human body is a complex machine that requires complex fuel. Like any engine, you put in the wrong fuel and it won't run, at least not well or long.