This is my article published in St. Louis Magazine, April 2018

Pssst. Wanna buy a vitamin? Good, because everybody’s selling one. Retailers, chiropractors, radio hosts, multilevel marketers, realtors, co-workers, faceless internet reps. Yes, anyone can sell you a nutritional supplement, which begs the question Who’s really minding the U.S. supplement store?

The recent data and stories are a bit alarming. One 2015 study identified over 20,000 emergency room visits in a single year from adverse reactions to nutritional supplements, with symptoms ranging from rapid heart rate to digestive disorders to dizziness. Poison control centers reported a significant increase in calls in the past few years due to symptoms associated with supplement ingestion. Four major retailers were recently cited for selling nutritional products found to contain mostly powdered rice and wheat fillers. Now, that’s a hard pill to swallow.

Before all supplements get a bad rap, let’s take a look at what they are, who’s testing for legitimacy, and where you should go to purchase quality products.

What are nutritional supplements? The FDA defines them as vitamins, minerals, amino acids, herbs, and enzymes sold primarily as pills, powder, liquid, and energy bars. They may be used as part of a comprehensive plan to treat medical conditions or they may be used for disease prevention and optimizing wellbeing. Considering the potential benefits, it makes sense to find a product with a strong independent rating.

Who does legitimate independent testing? Not the FDA, as nutritional supplements are regulated under the Dietary Supplement Health and Education Act of 1994, unlike most foods and drugs. In other words, there is little oversight until the finished product is sitting on the shelf. Remember ephedra, the infamous weight loss herb linked to more than 18,000 serious health risks and deaths in the late ’90s and early 2000s? It wasn't banned by the FDA until 2004, due to its classification. Supplement manufacturers often tout independent testing but may, in fact, be the primary study sponsor or have affiliations with the researchers. Overall, the most highly regarded supplement testing is done through several independent organizations. Look for official seals from NSF International or USP, two not-for-profit, evidence-based groups testing for potency, purity, and ingredient consistency. Manufacturers may volunteer to have their products reviewed. In addition, respected independent laboratories such as Consumer Lab and Lab Door report product testing results on a wide range of brands.

Where should you buy supplements? Because they’re not highly regulated, contact your medical doctor for advice. There’s considerable risk in self-diagnosing or assuming a vitamin rep knows your health history or potential interactions with prescription medicine. In fact, in the state of Missouri, it is illegal for any health practitioner operating as a trainer, health coach, or nutritionist to recommend specific nutritional supplements. They may give general dietary advice, but are not allowed to diagnose or to provide medical treatment by selling a brand of supplements.

According to Basima Williams, an osteopath at PALM Health, you should consider several key elements when choosing a supplement, including “the science behind the products, the ingredients themselves, the manufacturing process, and the combined effect among product ingredients.”

Bottom line? While the U.S. sorts out the regulatory issue, it’s up to us to investigate the risks and benefits of nutritional supplements, along with specific brand quality, and to work with a medical professional in choosing what, if anything, to take. And that’s a much easier pill to swallow.

A St. Louis expert tells you how to avoid buying useless, falsely labeled vitamins