Supplements – What’s The Difference Between Practitioner Strength And Over The Counter??

Most people take some kind of supplement on a daily basis, whether it be a multivitamin, fish oils or other products which they have researched and found to be good, or hopefully gotten with the advice of a qualified naturopath. There are dozens of different brands on the market – how do you know which is best? I am always surprised to find my patients taking the cheapest brand of a herb or nutrient that they have been told to try or have decided to based on what they have read somewhere about their condition. Price can very well be an indicator of quality, although this is not always the case.

There is a HUGE variation in the types and quality of over the counter supplements. Here are some common things that can affect the quality and efficacy of supplements…

Nutrient or herb levels are not in therapeutic range
The herb or nutrient levels are often too low to have a therapeutic effect. This is true for many of the cheaper brands, which is one of the reasons why patients often do not get results with them.

Poor bioavailability
The vitamin or mineral are in the wrong type. You may be surprised to learn that each individual nutrient is available in different forms, each with different properties and different absorption rates. Two such examples are iron and calcium, which are commonly recommended in the wrong form by doctors and pharmacists. Iron in commonly used products such as ferro-C is a ferrous fumerate, which is very poorly absorbed in the intestines, leading to constipation and bowel symptoms. Many people who are reading this would have experienced this ill effect of iron, which is easily avoided by using an amino acid chelate of iron, which aids absorption. Calcium is another example, with the commonly used calcium carbonate (found in caltrate) not having very good absorption rates.

Incorrect plant part or adulteration
I never recommend over the counter herbal supplements, as I cannot guarantee their potency, or that they are indeed what they say they are. Mediherb are one of the few Australian companies that produce herbal medicines that do comprehensive testing to ensure that the herbs they receive from suppliers are the correct herb, and that the levels of active constituents are in range. They do this with the use of multiple tests to evaluate the levels of actives and to identify possible adulteration.

It is unfortunate that there are a lot of dishonest suppliers of herbs across the world. There have been many identified cases of adulteration, where the supplier either uses a similar herb that is cheaper or adds chemicals to the herbal product so that certain colourations of markers are elevated. Without comprehensive testing most herbal companies will think that the herb they have is genuine when it may indeed be a fake.

A test of all Tribulus products on the market has shown that not only do most products use the incorrect plant part (fruit instead of leaf), but often the wrong species are used or a different plant altogether! This means that you are not gaining the benefit which is outlined for the herb as different types have different levels of active compounds.

Another example is Korean ginseng. Korean ginseng is an expensive herb, and is commonly adulterated with different plant parts and different speicies of ginseng. Without thorough testing there is no way to determine that the herb is inferior, as the most basic testing that comapinies do will not show the subtle variations which make Korean ginseng unique.

I would rarely recommend an over the counter herbal supplement, and I urge you to think about what exactly your supplement company has done to ensure your safety before taking herbal tablets and capsules.

Excipients and compression
Excipients are the compounds used to stabilise a tablet and help it stick together. Certain excipients can impair absorption of the nutrients that the tablet contains. Other excipients can contain what, lactose or gluten which are allergenic. The way that a capsule is compressed can also be an issue. A common problem is slippery elm capsules, which can be too compressed to actually expand, leaving just a small compact pellet to pass through the intestines. This means you will not get the maximum benefit from the product.

Oxidation
Many nutrients and particularly oils are susceptible o oxidation and are not stable in supplement form. Vitamin D and coenzyme Q10 are 2 such nutrients that unless specially prepared do not last very well in a capsule form.

Fish oil is a classic example with huge price variations across the market. When looking at spending money on fish oils ask yourself, if you saw two of the same car, one for $500 and one for $5000, which one would you buy? Would you be wary as to why the other was so much cheaper. The same can be said for fish oils capsules. Producing 1000 fish oil capsules for just $30 comes at a price. Good quality fish oils that are fee from contaminants and have good levels of EPA and DHA should be around the $30 for 60 capsules. Poor manufacturing practice leads to oxidisation of the omega 3 oils, greatly reducing the benefits. If you’re still not sure, cut open your fish oil capsule, smell and taste it. It should smell fresh, not like anchovies!

Practitioner vs over the counter supplements
The reason that our naturopaths only prescribe quality practitioner strength supplements, is because to get a reliable and effective clinical result every time, we need to know what we are prescribing. I am quite ruthless when it comes to allowing products into our dispensary at Shift, because ultimately we want you to get results and to do that we need to use the very best. We only prescribe herbs and supplements manufactured by companies that have stringent quality testing built in to their process, which ensure they are safe for you and that they will work! I have personally been to the labs and manufacturing facilities of most of our suppliers and I can vouch that they really are the best of the best.

I hope this has helped to shed some light on why prices vary so much between companies. To be sure you are getting the very best in quality, see a Shift at Brisbane Natural Health naturopath and they will hook you up with the good stuff an take the guess work out of it for you!

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