In the United States supplemental nutrients and phytotherapies, i.e. botanical medicines, are primarily under the umbrella of dietary supplements, leaving the field loosely regulated with little governmental quality assurance or scientific evidence of effectiveness. They are often dismissed as alternative therapies in stark contrast to countries like Germany and Switzerland which have long histories of serious research into supplemental nutrients and phytotherapies and where, not only are supplements recommended by doctors, some are available by prescription only.
While scientific research on dietary supplements are primarily funded by supplement companies, even in countries outside the United States, high quality research is available and a number of reputable sources collect the data from those studies and distribute evidence-based monographs for the benefit of health professionals and consumers. The American Botanical Council, ConsumerLab, The European Medicines Agency, The National Institutes of Health, and The Therapeutic Research Center are some of the institutes and agencies that produce monographs on dietary supplements; some of these monographs are free, but others require a subscription.
Before starting a supplement, it’s important to know the common adverse effects and contraindications for use whenever possible, including medical conditions and pharmaceuticals. Like pharmaceuticals, dietary supplements are not appropriate for everyone and there are risks associated with use. Even common vitamins, which are required for normal body functions, can have adverse effects at the wrong dosages or if they interact with medications, supplements, or health issues.
Many supplements have potentially toxic components or environmental contaminates that need to be removed or diluted before use as an effective remedy; therefore, standardization is important. By isolating, modifying, and standardizing active constituents from raw material, supplements become safer and more effective. This is where quality assurance becomes crucial. There is a misconception that dietary supplements are safer than pharmaceuticals because they are natural, but that is far from the reality. Besides potentially toxic components, with the loose regulations in the US, there are no governmental assurances in place that the supplement you are purchasing actually contains that expected nutrient or botanical at the correct dosage and without contamination. You have to place your trust in the supplement company.
When choosing a supplement company look for The Good Manufacturing Practice (GMP) seal showing the company follows the minimal safety and quality assurance guidelines issued by the FDA in 2007 as well as voluntary participation in one of several non-profit groups that certify dietary supplements and manufacturing facilities according to their standards, including: The United States Pharmacopeia (USP) and NSF International. Beyond that, there are at least two independent laboratories which test a selection of commercially available supplements for dosage, purity, and other quality standards, Labdoor and ConsumerLab; ConsumerLab also has a certification program for supplement companies. These organizations can help consumers make more informed choices about the quality of the dietary supplements they buy. Labdoor is currently free for use online and ConsumerLab is a subscription service.
In the US, buying dietary supplements is easier than obtaining prescription medication, but it also takes much more effort to know if the supplements are effective, of good quality, and appropriate for your use. Look for information from trusted sources before you buy and always disclose any supplements you are taking to your healthcare provider(s) to reduce the risk of potentially dangerous interactions.