"Supplements" are substances which we can use like drugs. In the U.S. and Canada, supplements are not regulated for purity or efficacy: we must trust the suppliers to ensure these important qualities. When I started using them, my pharmacist was also learning about supplements, and we spoke at length about this issue. She claimed to have researched the best manufacturers. She chose (and therefore I used) "Nature's Bounty."
Supplements have been part of my treatment plan for a long time: they include fish oils, vitamin D3, mysterious Chinese herbs compounded by my acupuncturist, cranberry powder, and a magnesium/riboflavin/feverfew tab called Migrelief (which really relieves my migraines)
. I've periodically tested their efficacy by stopping, assessing, and restarting them. They help. If that difference is founded on the placebo effect, I don't care.
Last month I had an experience which jerked me out of that happy place.
I mentioned to my p-doc that I was having trouble staying asleep. She suggested I try melatonin. I asked how much; she said, "knowing you, start small." I was pleased to find a liquid version with a marked dropper so I began with 0.25 mg equivalent. And that was enough! Lovely stuff: easy sleepiness within 20 minutes, stayed asleep with energetic and creative dreams, woke refreshed 8 hours later.
When I traveled the following week, I forgot my liquid melatonin. I went to a health food store and discovered the smallest tablet was 1mg, four times as large. I was able to halve it without totally crumbly results, so I thought I'd sleep like a lamb at twice my previous dose. But no—ZERO effect. Was this due to dosing sublingually versus through my digestive system? I kept doubling the pill dose with no result. When I made it home, I was taking 5mg (the typical dose available) with no pleasant sleep. Switched back to 0.25 liquid and slipped into the ocean like a sleepy seal.
The moral of the story: I don't know if a supplement isn't working because it's not effective in my body, or because there's not enough, or not even any, of the active ingredient in the bottle I bought.
And then this week, propinquity! A fascinating article in BioMedCentral:DNA barcoding detects contamination and substitution in North American herbal products
Newmaster, Grguric, Shanmughanandhan, Ramalingam and Ragupathy
It provides extensive detail on how unreliable supplement labels can be, from a Canadian group with zero ties to the supplement production industry.
So, supplement users, how do you ensure their quality?