Written by Dr. Vanessa Craig

The world of supplements is incredibly confusing and taking supplements can come with some very serious risks. But estimates are that more than 50% people consume dietary supplements, fuelling a $35 billion industry that is shockingly poorly regulated.

When I first started researching collagen supplements to take myself, I was stunned at what I discovered—and it led me to use my knowledge of nutrition and biomedical background to create Formettā. (Take a look at my post about The Formettā difference and the science behind it all to learn about my motivation for developing a high-quality, natural collagen supplement and all the research that went into it.)

A mystery concoction

The supplement industry has a big problem with labelling (1). One issue is the use of so-called “proprietary blends”—a catch-all term that allows manufacturers to conceal the precise ingredients in their products. Instead of disclosing the amount of each individual ingredient to ensure the doses provided are accurate and effective, “proprietary blends” give companies the chance to save money by underdosing on expensive ingredients. That’s a benefit for the company—but certainly not for consumers who are left in the dark about the actual dosages of the supplements they’re taking.

The outside doesn’t always match the inside

Even if all the ingredients are listed, there’s no guarantee that the contents actually match the label. A 2018 study analysed almost 800 supplements and 20% of them contained more than one unapproved pharmaceutical ingredient. An astonishing 33 products contained three or more unapproved ingredients (2).

Contamination is another potential hazard with supplements. For example, in 2009 the FDA found 72 weight-loss products containing unlisted ingredients, including traces of lead and arsenic (3).

Is it really innocuous?

To further complicate the challenge of selecting dietary supplements, producers are free to throw around terms like ‘natural’ and ‘pure’ without any standardised definition of those words. There’s no regulation around ‘real,’ ‘fresh,’ ‘original,’ ‘traditional,’ ‘authentic,’ or ‘genuine’ either, which can mislead even the most careful label-readers about the contents and quality of supplements.

Even supplementing with seemingly harmless substances like garlic and green tea can be risky. When taken in high doses, as is often the case with supplements, garlic acts as a blood thinner (4, 5). Anyone on medication to prevent blood clots who also takes garlic supplements may be dangerously increasing their risk of excessive bleeding. Likewise, ginseng, green tea extracts, and vitamin K supplements can negate the effectiveness of certain blood-thinning drugs (6, 7, 8).

Patients with prescriptions to treat depression or other psychiatric problems could have complications from many dietary supplements, including such as ginseng, ginkgo and even psyllium husk (9).

Marketing something as ‘natural’ and sticking on a shelf in a health food store doesn’t indicate that it has any scientifically-proven benefits—and it doesn’t make it trustworthy or safe for all consumers.

Too much of a good thing

Another concern people may not realise is that more is not always better. Ingesting high levels of vitamins or nutrients—and particularly micronutrients–can negate any health benefits and even create health risks.

A lot of people are chugging down zinc tablets right now to support their immune systems, which is concerning. Zinc and copper compete for absorption in your small intestine and, over time, high levels of zinc can cause copper deficiency, triggering anaemia and severe blood disorders.

People also need to be cautious with vitamins A, D, and E, calcium, and folate. Supplementing with vitamins A, D, E, and K may be dangerous as these fat-soluble vitamins build up in your tissues over time and have been associated with many serious conditions (10). Several health risks are now linked to calcium supplements, such as heart attacks, cancer, and kidney stones (11).

Supplementing with folate, a B vitamin that plays a crucial role in cell growth and DNA formation in the human body, is incredibly tricky. A lack of folate leads to DNA damage and can cause cancer, but, in people with cancer, excessive folate will actually accelerate cancer (11,12).

When care turns to catastrophe

Research over many years reports the links between several supplements and an increase in serious medical conditions, including certain cancers, cardiovascular disease, and kidney stones. Every year, supplements send roughly 23,000 people to the emergency room and require hospitalisations for more than 2,000 patients in the US alone (13). And the adverse medical outcomes reported with the use of dietary supplements are no small matter: strokes, acute liver injuries, kidney failure, pulmonary embolisms, and even death.

Supplementing is not as harmless as it might seem

While the big players in the supplement industry may claim that self-regulation ensures the safety and effectiveness of their products, the existing lack of transparency and the spread of misinformation benefits supplement producers, not consumers. Without always knowing what’s in the supplements on the shelves, customers need to be cautious and check out the science behind the supplements they want to take.

Be smart about choosing supplements

Sometimes supplements are a necessary component of a healthy lifestyle, but there’s a big difference between supplementing wisely and potentially endangering your health. Our blog post on supplementing wisely digs into why we might need dietary supplements to feel our best and combat some of the unpleasant effects of ageing.

And, of course, Formettā lists all ingredients in full, with amounts provided for each one. So you can be certain that Formettā is a reliable source for bioactive collagen peptides and complementary ingredients—all in meaningful doses that make a nutritionally-significant impact.

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Footnotes

1. Hamburg MA. Letter from commissioner of food and drugs to manufacturers of dietary supplements. http://www.fda.gov/downloads/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/UCM236985.pdf. Published December 15, 2010. Accessed June 2017.

2. Tucker J, Fischer T, Upjohn L, Mazzera D, Kumar M. “Unapproved Pharmaceutical Ingredients Included in Dietary Supplements Associated With US Food and Drug Administration Warnings.” JAMA Netw Open. 2018;1(6):e183337.

3. U.S. Food and Drug Administration. Questions and Answers about FDA’s Initiative Against Contaminated Weight Loss Products. https://www.fda.gov/drugs/questions-answers/questions-and-answers-about-fdas-initiative-against-contaminated-weight-loss-products. Published February 28, 2018. Accessed May 2020.

4. Vaes, L. P., & Chyka, P. A. (2000). “Interactions of Warfarin with Garlic, Ginger, Ginkgo, or Ginseng: Nature of the Evidence.” Annals of Pharmacotherapy, 34(12), 1478–1482.

5. Sunter W. “Warfarin and garlic.” Pharmacology. 1991;246:722.

6. Dong H, Ma J, Li T, et al. “Global deregulation of ginseng products may be a safety hazard to warfarin takers: solid evidence of ginseng-warfarin interaction.” Sci Rep. 2017;7(1):5813. Published 2017 Jul 19.

7. Lurie Y, Loebstein R, Kurnik D, Almog S, Halkin H. “Warfarin and vitamin K intake in the era of pharmacogenetics.” Br J Clin Pharmacol. 2010;70(2):164‐170. doi:10.1111/j.1365-2125.2010.03672.x

8. Cheng TO. “Green tea may inhibit warfarin.” Int J Cardiol. 2007 Feb 7;115(2):236. Epub 2006 Jun 6.

9. Fugh-Berman A. “Herb-drug interactions.” Lancet. 2000 Jan 8;355(9198):134-8.

10. Hamishehkar H, Ranjdoost F, Asgharian P, Mahmoodpoor A, Sanaie S. “Vitamins, Are They Safe?.” Adv Pharm Bull. 2016;6(4):467‐477. doi:10.15171/apb.2016.061

11.Li K, Wang XF, Li DY, et al. “The good, the bad, and the ugly of calcium supplementation: a review of calcium intake on human health.” Clin Interv Aging. 2018;13:2443‐2452. Published 2018 Nov 28. doi:10.2147/CIA.S157523

12.Pieroth R, Paver S, Day S, Lammersfeld C. “Folate and Its Impact on Cancer Risk.” Curr Nutr Rep. 2018;7(3):70‐84. doi:10.1007/s13668-018-0237-y

13. Geller AI, Shehab N, Weidle NJ, Lovegrove MC, Wolpert BJ, Timbo BB, Mozersky RP, Budnitz DS. “Emergency Department Visits for Adverse Events Related to Dietary Supplements.” N Engl J Med. 2015 Oct 15; 373(16):1531-40.