A Guide to Commercial Supplements

As a practitioner and health professional, I am continually asked for advice and recommendations on commercial supplements and this post is by way of addressing some of the common questions that people have about over the counter (OTC) supplements - herbal or nutritional.

The supplements market is a booming business, more so in the image-conscious US where the health & fitness industries dominate. However, the UK is catching up fast and partly due to the many health campaigns aimed at enabling people to take control of their own health & well-being, it has undoubtedly resulted in a growing market for nutritional and herbal supplements in an attempt to prevent illness, optimise health and improve vitality. However, due to the vast array of products on the market, the numerous brands each with their own style of aggressive marketing and selling technique, it is not surprising that many are baffled and downright confused as to what to buy. Here are some of the brands that I recommend to patients and those who seek my advice:

• Solgar http://www.solgar.co.uk/
• Solaray http://www.solaray.co.uk/
• Quest http://www.questexcellence.com/
• Lamberts http://www.lambertshealthcare.co.uk/
• Biocare http://www.biocare.co.uk/
• Higher Nature http://www.highernature.co.uk/
• Nature's Aid http://www.naturesaid.co.uk/
• A. Vogel (previously Bioforce) http://www.avogel.co.uk/
• Tisserand (for essential oils) http://www.tisserand.com/

I normally tell those who ask that it is never recommended that they buy a local or chain supermarket brand, nor any of the high street chemists' brand or the own brands from chain health food shops. The quality is not always great and many are persuaded by the cheap deals or bulk buys. On a long-term basis, this is not sensible and it is far more cost-effective to spend a little more on a brand of better quality which is likely to be effective rather than wasting money on supplements which are no better than chalk tablets.

Online purchasing is a mixed bag.... if you know the brand and it has been recommended, it is safe to purchase them but ONLY from their own brand's website if you want to be totally safe. However, there are other outlets that will sell these recommended brands so it may be worthwhile spending some time investigating the best option for you. It always astonishes me that so many are incredibly careless about what they purchase as supplements online without any regard to its safety or quality. They may as well be swallowing a whole load of placebos but worse still, it is hard to tell whether any of the products have any dangerous substances in them. Some of the unknown brands may have sub-therapeutic doses or may contain added ingredients (for example bulking agents, excipients or adjuvants) that are not listed in the ingredients. It is this very sort of thing that can prove to be unsafe as it is impossible to trace the cause of any adverse reaction or side effect to the supplement. The guarantee and reassurance that one has when purchasing from the brand's own website is really in its safety and effectiveness. A reputable high street health food shop (usually NOT part of a chain) should stock a good range of the above-mentioned brands. These shops normally sell whole foods and a range of other health products so it is worth investigating your nearest store.

The following is a simple guide to some of the commercialy available preparations:

Tablets: A controlled quantity of finely milled herbal material is compressed and given a thin coating. Some are enteric-coated to prevent stomach acids from altering the active ingredients. These allow absorption of the herb in its original form and concentration in the small intestine without change in its chemical composition. A herbal practitioner may prescribe herbal tablets to be administered in a similar manner to conventional medicines, ie. to be taken at regular intervals before, with or after food.

Capsules: 80% of all herbal supplements are sold in this form. Convenient, palatable & portable. Disadvantage that it contains dried, ground herbs which may lose their potency more quickly. Need to take more of the whole herb extract unlike the concentrated extract. A herbal practitioner could prescribe these and they are taken in a similar manner to conventional medicines ie. before, with or after food.

Standardised Extracts: Preparations that have a known quantity of a key compound or ingredient that is the designated marker of the herb’s potency. This gives the assurance of potency & medicinal benefit. Standardised products are available in capsules, tablets & liquid form (tincture or glycerite). There is some argument over the actual benefit of standardisation over whole herb preparations and the synergy of active ingredients.

Tinctures & Fluid Extracts: Fresh or dried herbs are soaked (macerated) in a solvent – alcohol for tinctures and glycerine for gycerites (non-alcoholic) in order to release the active compounds. The process takes a few days and the mixture if filtered to produce the liquid preparation. Concentrations vary depending on the herb:solvent ratio ie. Fluid Extract (1:1) being the most concentrated and 1:5 tincture being the least concentrated. Using fresh herbs yield lower concentrations of active constituents than using dried herbs. Usually, a teaspoon of the tincture is taken 3 times a day in a little water before meals but again, this can vary, depending on the dosage requirements.

Herbal Teas: Most familiar & traditional form of preparation. Dried leaves and flowers are particularly suited to infusions as it releases important volatile oils (eg. mint, sage, chamomile) but bark, roots, seeds and berries are also used. Usually 2 heaped teaspoons of the dried herb is infused into a cup of boiling water for about 10 minutes. The liquid is strained and drunk at regular intervals depending on the dosage requirements.

Always follow dosage and storage instructions as stated by the manufacturers. To ensure the best quality and safety, it is always best to seek the advice and help from a professional herbalist or nutritionist. Never self-medicate and it is ill advised to mix prescription medicines with OTC supplements without seeking proper help and advice beforehand. For more information go to http://www.nimh.org.uk/ for herbal and nutritional supplements, or http://www.ion.ac.uk/ or http://www.bant.org.uk/ for specific help & advice on nutritional supplements.