Buy This, Not That: How to Shop for Supplements

Dr. Amanda Frick:

This is the Thorne Podcast, the show that navigates the complex world of wellness and explores the latest science behind diet, supplements and lifestyle approaches to good health. I'm Dr. Amanda Frick, the Vice President of Medical Affairs at Thorne and a naturopathic doctor. As a reminder, the recommendations made in this podcast are the recommendations of the individuals who express them and not the recommendations of Thorne. Statements in this podcast have not been evaluated by the Food and Drug Administration. Any products mentioned are not intended to diagnose, treat, cure, or prevent any disease.

Hi, everyone. Welcome to The Thorne Podcast. Thanks for giving us a listen, and I'm really excited for today's conversation. Our guest this week is Dr. Jennifer Greer. She's the Director of Medical Education in Thorne's Department of Medical Affairs. Welcome back to the show, Dr. Greer.

Dr. Jennifer Greer:

Thank you. It's good to be here. I'm excited to chat today.

Dr. Amanda Frick:

Just to get started, because we haven't caught up in a while, I know that you're always diving into the research and you're super interested. So what's been getting your attention in the last six months about the world of health and wellness?

Dr. Jennifer Greer:

Oh, there's so much going on, which is super interesting. I think that people are really interested in health and wellness right now, and because of that increased interest, it's driving the world of research a little more. And one thing that really has gotten a lot of interest in the last year is women's health. So I'm seeing more and more not just interest in women's health issues, but expanding research studies to include more women across the life range. And so different ages of women, different life experiences in research, targeting women's issues, and then on top of that, more women in these science positions that are also driving this from the industry side as well, which I just think is really cool.

Dr. Amanda Frick:

I am here for that for now and for a very long time after. Let's hope this is not a passing trend.

Dr. Jennifer Greer:

Yes, agreed. Agreed. I try not to talk about it as a trend because I don't want it to be a trend. I just want it to be what it is from here on out, but I'm glad for the new interest and increased focused on it.

Dr. Amanda Frick:

Let's make it a new standard.

Dr. Jennifer Greer:

I like it.

Dr. Amanda Frick:

Okay, so it's time to get into our main topic for this week, and that is what to look for in a supplement brand. So imagine for a second you're walking into the pharmacy or the grocery store, and you head to the supplement aisle, and there's just so many options. You're bombarded with bottles and packages, flashy designs, marketing design to get your attention. And then the labels are covered in complicated ingredient names and graphics and things you've never heard of because this can be really confusing to a lot of people and results in possibly making bad choices based on things like price or label design and may not be the best choice for you based on what you're trying to get in your nutritional supplement product. So what should people do? What should we be looking for when we're looking at supplements and brands in the nutrition space?

Dr. Jennifer Greer:

Oh, I love this question. There's so much to look for. There's so much to think about and I know it can be super overwhelming depending on the store you go in. There might be hundreds of products sometimes and they're arranged in different ways and some of the labels are really flashy, some of them are really plain, and so it can be tricky to know where to get started. I think if you are thinking about it ahead of time and you can go in with a little bit of a game plan, so I know when I'm going in the store today I want to look at multi-vitamins, then that can narrow you so you're not quite so overwhelmed and you can start there knowing some things that would be important to look for on the labels. But if you just happen to be walking in the store, you're not looking for anything specific, that's a great time to just spend some time looking at different labels, getting to know some brand names, maybe taking out your phone and putting some stuff in your notes app or making a voice note to remind yourself to check a website later so you can get even more information than what's available in the store.

Dr. Amanda Frick:

Got it. That makes sense. So there's so many different things that can be showing up on a label. I think I'm just going to double click on some of these extra things. So what's up with certifications? We see things like NSF or TGA or USP. What do all these things mean? What does it mean for someone who's shopping for a supplement?

Dr. Jennifer Greer:

Actually what it really means is that you can know that you are buying something that is what it says it is. And so that's where some of these third party certifications can really play an important role. I think there's a big misnomer in the dietary supplement industry that supplements aren't regulated. So you'll hear that a lot and first of all, let's put that theory or that myth to bed. Supplements are regulated. They're regulated by the FDA as dietary supplements. And then beyond that, companies also have the option to undertake third-party testing and certifications as well. And what that does is that really strengthens what you're saying about your product. One of those is NSF, which is an international organization. They have two sides to what they do. One is their general third-party certification side, the other is their NSF Certified for Sport® line.

And so some supplements will carry an NSF Certified for Sport® specific logo where others might just be general NSF testing. Both of those are good. The main difference is if it's an NSF Certified for Sport® product, that means that it is guaranteed to be free from the hundreds of banned substances that an athlete might be tested for. But in general, most places, if let's say your supplement company you're looking at like Thorne, has NSF Certified for Sport® products, the bulk of those products are being made in the same facility. So having NSF certifications of any kind are going to be really good. NSF Certified for Sport®, even better. 

TGA is the Therapeutic Goods Administration. This is also a really good one to know about. They are Australia's regulatory body, and they have some of the most stringent guidelines in the world for dietary supplement regulations. So if you're seeing that as a regulation, that's a good-to-go product as well.

USP is another one that people hear about a lot. This is another third party. They can help to verify that what the company is saying they are using in their product is what's in there. And that's really the bottom line. 

If you're looking for a third-party certification, what that is doing is that's verifying what this product says on the label is really what's in the product. The amount is what's in there, and the company who creates this product has regulatory standards in place for quality assurance and making sure that they are testing their products, that they're having this third-party testing done to be free of microbial contamination or unwanted ingredients and that they really are what they say they are on the label.

Dr. Amanda Frick:

So basically it just means you don't have to only trust the brand. They've had it looked at and verified by somebody else, and so they've gone through a rigorous process to make sure that that can be on there and these aren't pay-to-play stickers. There's testing and extra things you have to do to be able to qualify for this.

Dr. Jennifer Greer:

Right, exactly. It's a huge process, and there is of course expense related to that. And so it's a big undertaking for a company to say, "Yes, I want to invest in third-party testing," and then the third-party bodies are going to come in and also evaluate your whole facility. And those things can be a surprise. So it's not like you can just hide the things that you're doing when you have these organizations coming in and making sure your standards are what you say they are.

Dr. Amanda Frick:

Okay. So let's say I have found four different options on the shelf. They all have the same certification, so I'm starting to look at ingredients. What are the types of things, or do you have any key tips, hot tips that I could use or things that I should be looking for on the ingredients that would make me know I'm looking at a quality product?

Dr. Jennifer Greer:

Yeah, I do have some of those. So my first thing when I pick up a product is I'm going to look first at the vitamins, and my eye immediately goes to if there's B vitamins in it, what type of B12 and what type of folate are in this product. And I like those two because if you're seeing a type of B12 like methylcobalamin, hydroxacobalamin or adenosylcobalamin, those tend to be the more well-absorbed and quickly utilized forms of B12, whereas the typical maybe less expensive nutrient that you'll see is cyanocobalamin.

With folate or folic acid, folate comes in a variety of different forms. A lot of people are looking for a methylated folate for genetic reasons, and that would show up as something like 5-MTHF on the label or another type of folate vs. folic acid. It's not to say that folic acid is bad, but some people need a more readily active form, which just means the type of folate that your body can use immediately without having to convert it. So that's one place that I like to start. I know you have some of you like to start with as well. What are some of yours?

Dr. Amanda Frick:

Yeah, I mean without stealing yours, those are a couple of my top two. I tend to look at minerals. It's a little harder because you have to memorize them, which of course I've spent a lot of time doing, but I want to stay away from forms that may cause GI upset, so I might look like, I want to avoid something like magnesium oxide unless I'm specifically taking it to utilize it for relaxing the bowels. If I want to take it in my normal multi-vitamin, that is not what I want to be taking on a daily basis.

And then other than minerals or main ingredients, I always look at the other ingredients, too. So I'm looking for things that range from excipients that could compromise absorption like magnesium stearate, things that would be included on something like Thorne's “No List” because we don't want to use them. Anything I see on our “No List,” I'm looking at any other brand to make sure it's not there. So magnesium stearate is my top hit, but then also things like added sulfites, which you wouldn't think belong in supplements, but they can be found there, and just some of the things that I want to make sure I'm avoiding like I would on any label.

Dr. Jennifer Greer:

Yeah, me, too. And then one other thing that I look for is the number of added ingredients. So when you're past the active ingredients, you're in the inactive ones, are there maybe two or three that are used as manufacturing aids and that are completely appropriate, they're not affecting the quality of the product, or are there 10 or 15 things in that additional ingredients section? And that can help a lot. too.

Dr. Amanda Frick:

Yeah, that totally makes sense. What's up with these trademarked or brand things? So if I'm going to look for ashwagandha and I see one that says like Shoden® ashwagandha trademark, what does that mean? Why would a brand choose to use a trademarked or a branded ingredient?

Dr. Jennifer Greer:

A lot of times, especially with botanical extracts, those companies have developed an extract that is standardized to the parts of that plant that are really active or that are most important for your body when you are using that plant, right? And so when they trademark that ingredient, they also do clinical trials with that or various research trials. So when you look for ingredients or you're looking at the research behind a product, when you see a trademarked product, you're going to also be able to find research on that particular ingredient. That can help you to know what that ingredient's been studied for, what sort of dosing or amounts in supplements, if it really matches what's in the clinical trials that are out there. And it gives you some clarity around the ingredient, too, because you can then head to the website of the raw material supplier who makes that trademarked ingredient. You can read all about their practices, you can see what their third-party certifications are and understand what they're doing to make a safe product as well.

Dr. Amanda Frick:

So it's almost giving you that traceability aspect of the chain of ingredients.

Dr. Jennifer Greer:

Absolutely, yeah.

Dr. Amanda Frick:

What do you think that does or how does that impact cost?

Dr. Jennifer Greer:

I think that that definitely increases cost of the finished good because the raw material is going to be more expensive. And that really boils down to things like the more you invest in quality, the more material is going to cost because it costs money to do things the right way. It also costs money to run clinical trials, and so that can make those ingredients more expensive as well. So it's a little bit of the old adage that you get what you pay for. I think that there's an extent on both ends of that, that you have to be careful with, but really when premium ingredients tend to have premium prices, it's because they've done the work behind that that requires it.

Dr. Amanda Frick:

That's great. That's a great segue to the next topic I wanted to discuss, which is price. We talked a little bit about earlier, if you don't really know what you're looking at, you're going for the cheaper one, which may not always be the best choice. So we've covered a little bit of that, but what else is there that goes into the cost or what are some other reasons why if they seem like the same, what's going into that price difference from brand to brand?

Dr. Jennifer Greer:

Really I think that's where you're seeing a lot of quality. Again, I know we keep talking about quality. I think quality though is, it's near and dear to my heart because I want people, I want myself, I want my family and my friends to use a product that is created in a facility where it's clean, where things are not being cross-contaminated with allergens, where they're taking special care to ensure that the product is free from any extra ingredients that it doesn't need, that they're using the most-absorbable forms, that the ingredients in the product have been studied and sometimes even finished products will have studies on them as well. Again, all of those things cost money, which is going to drive up the price a bit. I saw something recently that said something along the lines of generic ingredients are generic for a reason, so they're there to be a cheap ingredient because there's always going to be someone who wants to make a cheaper product, and they're not going to be as concerned about the details.

And that's not to say that all generic ingredients are bad, they're certainly not, but they may not be as high quality as something else that's out there. So I think there has to be a balance of price along with quality to make sure that you're getting something that does what you want it to do, versus spending your money on a product that doesn't work for you at all. If the difference is it's a $10 product versus a $14 product, the $10 product, you're buying it every single month, you're not seeing any benefit from it, probably a slightly more expensive product, if it's going to give what you are looking for and benefit your body in that way, then in the long run you're not spending money. I'm probably not explaining this well. Just thinking as I'm saying it, so sorry if you're not following me here. But ultimately what I'm trying to say is there has to be a balance between price and you don't want to go just for the cheapest thing because the cheapest thing may not give you what you're looking for and then you would be ultimately wasting money.

Whereas if you spend a little bit more on a higher quality product, then your body is able to absorb it better, it's able to utilize it better. You're getting what you're looking for in that product.

Dr. Amanda Frick:

Got it. Makes sense. So price really does matter sometimes. I think that another important thing to note is even if it is a generic ingredient or what we'd call that or isn't branded, something like vitamin C, the most, one of the most bioavailable is one of the simplest. And so then once you've taken that into account, maybe you don't need a branded ingredient, but that goes back to what the bigger story is with your brand. So especially if you're a power supplement user, like sticking with your brand that's been tried and true for you and trusting that they're making the right choices in their ingredients is such a big deal.

Dr. Jennifer Greer:

Agreed.

Dr. Amanda Frick:

So one thing I've noticed on the shelves with supplements is that some of them will say, “supports liver health,” or they make claims about what the product's actually used for. Is this stuff real? Are they always real? Does it mean I can trust it or how does that work? What should I be looking for? If I'm reading a bunch of confusing messaging on the bottles?

Dr. Jennifer Greer:

You should be looking for more information, I think is the bottom line. So sometimes it's real, sometimes it's not real. I have seen supplement companies, even just recently, there was a company that had certain claims on its packaging in the stores, and it had a lawsuit against it because those claims were not verifiable or accurate. And that company has to change all of their packaging moving forward. They can't say that on their packaging anymore. So if you walk into a store, you think, "I'm looking for something for supporting my liver health, and I don't know where to start because I don't know what ingredients do that," and you see a bunch of bottles that have that on the label, I think the first thing you might want to do is think about just if you're able to whip your phone out there, go to their website, read more about it, you'll often see more information.

A lot of times the product page itself on a website going to be pretty brief. You're going to see a few bullet points about what that product is meant to accomplish. But if you dive deeper into a website, you can look for things like ingredients pages where you'll see more detail on certain types of ingredients that include references to the research studies that have been done on those ingredients. You can also find a lot of companies will have blog posts that talk more in detail about the ingredients they use and the products that they make. And those things are often highly referenced as well. And that can lead you back to some of the research. I also think it's just good to ask questions, see what's out there, what sort of options there are. If you're in a store that has a large section of say, liver support products and you start looking on the labels to see what's in them, you're going to notice trends of certain ingredients because those are things that are more likely to be shown beneficial for that area. So look at more than one product, take a look at a product's website, dive deeper into their website and see what sort of resources are out there.

Dr. Amanda Frick:

Great, thank you. So if you're listening to this show, you probably already utilize some Thorne products, but if you don't or if you know people who don't, send them this episode. Even if they end up going with another brand, you deserve and they deserve to know what you're putting into your body, and this will help. So now we're going to take a short break and when we get back, we'll take on some questions.

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Dr. Amanda Frick:

And we are back. Now it's time to answer some questions from the community. Our first question this week comes from a listener who asks, "I've noticed that some supplement brands talk a lot about bioavailability. What does that mean and how do I know if a product is bioavailable?"

Dr. Jennifer Greer:

So bioavailability is… Really what it boils down to is this supplement nutrient ingredient in a form that your body is able to use? Is it able to absorb it well? Can your cells use it quickly and can it be metabolized by your body in an appropriate way that's quick and easy for it to use? Earlier we talked about vitamin B12 and some forms of it like methylcobalamin or folate in its methylfolate form vs. folic acid. So that's something that you can think of as a bioavailable form. 

Let's look at folic acid and folate specifically. So folic acid is a B vitamin that your body needs for many different purposes, but in order to use it, it has to take folic acid and convert it to folate. And to do that, it has to put a methyl group on it and that's what makes methylfolate.

So if you are taking a nutrient that is already in the methylated form, that's going to be the most bioavailable form, it's already the form your body needs to use, and so you don't have to do any extra work to convert it there. That's really the main thing that we're talking about with bioavailability. You also hear that in forms of say herbal extracts, some are going to be easier for your body to absorb and use. At Thorne, we have quite a few herbal extracts that are called phytosomes. What that means is you're basically taking the botanical nutrient, you surround it in a fatty substance, and then your cells are able to take that in and use it better. Botanical extracts are notorious for being clumpy. They sort of stick together, their active ingredients do. And if you think about the tiny level of molecules that are being used in your blood, if they're all clumped up together, that's hard for your body to take apart and send out to your cells and for your cells to use. But if they're not clumped up together, then that's easier to absorb and use. And so certain forms are going to be more bioavailable because they're just in an easier to use or easier to absorb form.

Dr. Amanda Frick:

And does that apply across the board or, I mean, does everybody need the most bioavailable form? I mean if your body has to convert it to use it, doesn't it do that or why does that matter?

Dr. Jennifer Greer:

It does, and some people are more efficient at doing that than others or their bodies are more efficient. And that kind of boils down to our genetics and what we inherited really. You may have heard people talk about the MTHFR gene, and that's the one that I'm referring to when I talk about the body's ability to convert folic acid to folate. And so that's a gene that's related to using methyl groups, putting methyl groups on different substances, moving those. That's something that your body has to do, not just with folate, but other substances as well. And sometimes genetically we're really, really good at doing that and sometimes genetically we're just not as efficient at it.

So for people who are not as efficient, it's even more important to have those bioavailable forms because then your body's going to get more out of that nutrient or that product when you take it. For people who don't have those genetic mutations, it also can be great to have more bioavailable forms. Often with a more bioavailable form, you can have a lower dose than you might need with a non-bioavailable form, so you're actually getting more for your money as in more bang for your buck if you've got a bioavailable form because your body can use it easier and better.

Dr. Amanda Frick:

Yeah, I think it's funny that you say some people are inefficient at methylating, but some people is like nearly two thirds of the population.

Dr. Jennifer Greer:

[Laughs] It's true. It's true.

Dr. Amanda Frick:

Some, in air quotes. OK, let's take another question. So this one is, "There are so many different daily multi-vitamin formulas. What are the most important minerals for everyday use?"

Dr. Jennifer Greer:

This is a great question actually. I think that we talk about vitamins a lot and maybe not minerals as much. For most everyone, magnesium is a great mineral to think about for everyday use. Part of it is just because the commercial farming, the soils are a bit more depleted of nutrients, so our foods naturally don't have as much magnesium in them as they did in the past. And magnesium is a mineral that our body uses for hundreds of different chemical reactions. Different enzymes need magnesium. Your metabolism, so many things, your muscles to contract, all of those things require magnesium. And so making sure that you're getting enough magnesium in your diet can be really hard. So I think magnesium is a great one to think about for most people.

I also often hear people talk about zinc. Zinc I think is a little bit maybe not as important as magnesium as an everyday mineral, but there are certainly times when zinc is great to supplement, and a lot of times people will think about zinc when they're thinking about things that can support healthy immune function or men's health. Often zinc is a nutrient that comes up, it plays a role in metabolism in the body too, but is maybe not as much of an everyday nutrient than zinc is. And then some other minerals are you're more likely to get them in your diet and not need to supplement as much. So I think magnesium is really my big go-to there.

Dr. Amanda Frick:

Fan favorite.

Dr. Jennifer Greer:

Yes, always.

Dr. Amanda Frick:

You may or may not find a plethora of blogs on our Take 5 Daily posts about magnesium, just saying. OK, someone else asked, "I'm worried about fillers and artificial ingredients and supplements. Are there specific ingredients I should avoid and how can I tell if a brand is using clean formulas?"

Dr. Jennifer Greer:

This is a great question too. We talked earlier about, you mentioned magnesium stearate and how that's one of the things on our “No List” at Thorne because it can interfere with absorption. I think that's a great one to look for on supplement bottles in the extra ingredients. Another thing are things like added sugars or different types of artificial sweeteners. I would look out for colors and flavors as well. So it's generally considered people are looking for natural forms of those vs. artificial ones. And then we mentioned earlier the length of that section on the label, right? The number of extra ingredients. The more extra ingredients you see in a product, are they just trying to take up space in a capsule? It just makes me question what's happening in this product that so many extra ingredients are needed?

Dr. Amanda Frick:

I think it's important to note too, it's not fun to add extra ingredients. And so usually when brands are using a lot of extra ingredients, it's because it makes manufacturing them really easy or it makes the equipment easier to clean. And so even if it's not affecting absorption, which it may or may not be, depending on what they're using, it's still an indication of shortcuts or trying to make things easier at the possible expense of the quality to the customer. And so it's like that's part of that story, too, about why so many added things. They're definitely needed because some things are really fine powder and they're hard to work with and they would never get into a capsule or there would be so much waste and so you have to use something, but maybe you don't have to use 20 somethings. You have to use one or two somethings.

Dr. Jennifer Greer:

Yes, agreed. Agreed.

Dr. Amanda Frick:

And then another question is, "How can I tell if the dosages of ingredients listed on a supplement facts label are effective and based on science? Do brands disclose this information?"

Dr. Jennifer Greer:

So we talked about this maybe just a smidge before too, but I think this is where being interested and curious comes in and being willing to ask some questions or look some things up. A company's website is a great place for information and the companies who really care about what they're putting out there are going to put out more information rather than less. And so you're going to see things like ingredient pages that talk about those ingredients, how they've been studied, blog posts that talk about their products. You mentioned you'll see lots of magnesium blogs on our Take 5 [Daily] blog, and those are going to have studies referenced in them because we care about our formulas that we're making. We want to use researched ingredients in researched amounts, and that's something that I think you can look for as well. It's a little bit harder to sort of suss that out in the aisle at the grocery store. That's one of those things where doing a little more research, asking the questions and digging into the information is going to get you more information and help you know what you need to know.

Dr. Amanda Frick:

Makes sense. We had a couple more questions, which we mostly covered, but talking about third-party testing. How about, are there any red flags to look for in the supplement industry?

Dr. Jennifer Greer:

There are, and one of those is I would say consider just doing a quick search about the company or the product that you're interested in. Sometimes you will see things that come up where that particular product or that particular company has been questioned about its practices or its ingredients in the past. It doesn't mean that they didn't learn from that and move forward in a better manner, but it's something that's good to know and some information points to have about potential red flags for a company.

When you're looking at labels, often you will see certifications that are actually on the label and that can help you know, but not everyone puts all of their certifications on the label, and that can sometimes simply be because of space, there isn't room for them. And so that's another time where if you go to the website, companies that are really upfront about their practices and what they're doing will have a lot of information available. What are they doing about quality? How are they doing that? What does a day in their quality department look like? How many times are they testing their products? What sorts of things are they testing for? The more information you see available, I think the more you can feel comfortable. Whereas if companies are trying to hide things in their products or hide what they're doing, they're not going to be as upfront and transparent.

Dr. Amanda Frick:

Great. Thank you. Well, folks, I think that is all the time that we have for this week. If you like what you've heard, tell a friend about our show and make sure to tune in next time for more health and wellness discussions. Thank you for listening to the show and thanks, Dr. Greer, for podcasting with me.

Dr. Jennifer Greer:

Thanks for having me.

Dr. Amanda Frick:

Thanks for listening to The Thorne Podcast. Make sure to never miss an episode by subscribing to the show on your podcast app of choice. If you've got a health or wellness question you'd like answered, simply follow our Instagram and shoot a message to @ThorneHealth. You can also learn more about the topics we discussed by visiting Thorne.com and checking out the latest news videos and stories on Thorne's Take 5 Daily blog. Once again, thanks for tuning in, and don't forget to join us next time for another episode of The Thorne Podcast.