nikaLIVE: How to choose a dietary supplement?

As data from the latest report of the Supreme Audit Office indicate, the dietary supplements market in Poland is currently beyond the control of the Chief Sanitary Inspectorate. Only 5% of dietary supplements introduced to the market in 2017-2020 were verified . What about the rest - we don't know. This means that it is very easy to come across a low-quality product. On NikeLIVE, we asked pharmacist Aleksandra Golecka-Kuzniak, co-founder of the Gemini Pharmacy chain, what we should pay attention to so as not to make a mistake. You can listen and watch the conversation at this link . Below is its text version.

What is number 1 when choosing a dietary supplement? Where should we start?

The key is not to buy supplements based on marketing slogans and declarations of their greatness declared by their manufacturers . It is important to carefully and thoroughly check the composition . First, we check the active substances declared by the manufacturer. These substances should have proven effectiveness in clinical trials . Only in this case we have a guarantee that it is an ingredient that will actually have an effect on our body. I think that a great example of the lack of such effectiveness is L-carnitine, commonly used in weight loss supplements. It has been available on the market for as long as I can remember and is widely used by consumers. So far, numerous clinical trials have been conducted on both animals and humans, and none of these studies has shown the effect that is attributed to L-carnitine as a "fat burner".

There are plenty of such ingredients, e.g. plant extracts used in dietary supplements, which sound very exotic, often have no research-confirmed effectiveness. It is worth focusing on taking substances that make sense, because we know that they will have an effect on our body. Another thing is the form of these active substances . We have different chemical forms of individual active ingredients, which are, to a greater or lesser extent, absorbed by our intestines and better or worse absorbed by our body. An example is vitamin B12 used in supplements in several forms, from which we know today (and it has been repeatedly confirmed in research) that methylcobalamin is the form of vitamin B12 best absorbed by the human body. And it is best to supplement it, especially for vegans, vegetarians and pregnant women. This is not secret knowledge, it just takes some time to sit in front of the computer, read on the Internet, check such things and choose what will really benefit our body.

What about ingredient doses? We are often tempted to buy something in a larger dose to make sure it works.

Sometimes we think that more is better. This is absolutely not the case with supplements. Selecting the optimal dose is extremely important. As we know, taking microdoses, which will be only a fraction of our needs, obviously makes no sense. But it is equally pointless to take too large doses, especially since we should still remember (and this is where we should have started this live) that before we reach for supplements, we should take proper care of our diet . It is supposed to be a well-balanced diet, it is crucial to keep our body in the right condition. And only then should we reach for supplements and supplement what we cannot actually get from this well-balanced diet.

This means we pay special attention to active ingredients. What about the auxiliaries? Can they be dangerous?

Unfortunately, they can be harmful and are commonly found in supplements. There are plenty of these substances added to supplements and various types of food products. These additives are substances that improve the appearance, taste, smell, stabilizers , substances that make the supplements look better and more attractive to our eyes. However, they can cause a number of side effects and harm our body. They may irritate the mucous membrane of the digestive tract and intestines, and may have adverse effects on the nervous system and kidneys . Finally, they may be pro-inflammatory and even carcinogenic . A very famous case currently on the agenda is titanium dioxide (E171) . Its use in supplements and medicinal products is prohibited. However, it was used for many years. Its carcinogenic effect has recently been proven. We never know what effect these types of excipients will have. Because it only comes out after years of using them. The very commonly used magnesium stearate is also a good example. It is surprising to me that many patients, when they see this ingredient on the label, think that it is a magnesium salt that is supposed to provide them with magnesium to their body. And that's not true.

Magnesium stearate can also be found in supplements under the name magnesium salts of fatty acids, right?

Exactly. Magnesium stearate is a filler that ensures that the tablets are very smooth and do not stick together in the jar. At the same time, this substance has the property of sticking to the wall of the small intestine , as a result of which a thin impermeable coating is created on the surface of the intestine, which makes it difficult to absorb any other nutrients. Therefore, the use of several preparations that contain this ingredient will cause this layer to grow over many years and this effect will be cumulative. Another example is shellac, commonly used in supplements. It is a component of insect excrement . It is used to produce paints, varnishes and nail polishes, and at the same time it is used to shine the coating of dietary supplements. And what health properties can such a substance have? Phosphates, diphosphates, hardened oils (soybean, palm) and many other auxiliary substances are also added. Today we know that all this is harmful to our body , but it is still added to supplements. It is true that in micro quantities, but considering that we take these additives often, for a long time and in various products, I would recommend trying to avoid them in every possible way.

To sum up, the entire composition is important, not only the active substances. Now that we've checked this, what do we do next? Where do we go next?

The key is what the supplement manufacturer declares and what tests the dietary supplement has undergone. In the case of supplements, we are only supervised by the Sanitary Inspection . Therefore, the amount of research necessary to introduce a dietary supplement to sale is small. This is only a microbiological purity test and a test for heavy metal content . And this is the basis. Interestingly, there are manufacturers who, having only these two tests in their portfolio, boast about them as if they were something extra, and this is simply the necessary minimum. But if the manufacturer obtains the ingredients in a transparent way, from a transparent source of good quality, and performs additional tests, we will certainly find such information on its website or product leaflet.

And what additional tests can these be? What to look for on this website?

Nowadays, in dietary supplements, it is unique but very desirable to test the compliance of the composition declared by the manufacturer on the label with what is actually contained in the dietary supplement. This study can cover both qualitative and quantitative composition . Is the list of substances consistent with what is written on the label and whether the doses are also consistent with the declaration? And whether there are any other substances that are not declared by the manufacturer on the packaging and may also have some effect on our body. In addition, it would be very important to test the stability of the preparation throughout its shelf life. There is a whole group of products, for example probiotics, where the shelf life of the preparation, i.e. in this case bacterial strains, very often does not last until the expiry date . So such a test at the manufacturer's is also very valuable.

How can we check where a given supplement was produced? Is this information on the packaging? Is it obligatory to include it? Or do we have to look on the website?

Only on the manufacturer's website. A manufacturer who is not ashamed or afraid of where the active substances he uses in his preparations come from, where exactly he produces and to what standard, talks about it transparently on his website. So that's where we should look for such information.

Are there many manufacturers who openly say where and to what standard the supplement was produced, what tests it undergoes and this package is really extended? How would you rate it, percentage-wise or overall, when it comes to the Polish market?

I'm definitely not going to try the percentage. But this is a very small group of producers today. Indeed, most manufacturers rely on this bare minimum, both in terms of research and the quality of the production process. Of course, it is a matter of costs , both additional research and the production plant where we want to produce dietary supplements.

All these things you mentioned may seem complicated to people who do not know how to produce supplements, but want to buy a good product for themselves. Is it worth asking a pharmacist or doctor for help?

Of course. As my grandmother used to say, a wise man is always worth listening to. So it is worth asking for advice from specialists instead of listening to the opinion of the proverbial Kowalski on the Internet. However, there is one thing I want to say clearly. I believe that the Polish market of dietary supplements has a very bad reputation today. Not without reason. This is due to the fact that in recent years the Polish market has been flooded with very poor quality products . This resulted in very limited control by the Sanitary Inspection. Therefore, there were very high-profile cases of withdrawal from the market of products that people had already been taking for years, and they should not have been available either in pharmacies or in any other place. Therefore, I often encounter the fact that even my pharmacist or doctor friends, when asked for advice on supplementing their diet, are the first to say: "I hope it's not a supplement." And it doesn't have to be this way, in my opinion. Let's just look for something that is actually of decent quality .

The nikalab company decided to fight the stereotype that a dietary supplement is a product of lower quality. Could you rate nikalab supplements based on the criteria you mentioned?

I am delighted with this quality. This is definitely unique on the market . This is certainly a very cost-intensive process . But by taking this supplement, we have a guarantee that we will support our body and not harm it. Nikalab products contain active ingredients in easily digestible forms , we have optimal doses and only active substances that have clinically proven effectiveness . We have a very transparent supply chain. On the nikalab website we can read where each raw material used in each supplement comes from. These preparations are free of the excipients I mentioned today, which may be harmful to us. There are no fillers, no preservatives, no allergens, the composition is absolutely transparent . And we have the entire production process in accordance with the GMP standard. This also means the quality of the production process itself, as in the case of medicinal products. And we have a number of tests that cover entire series of products, not just the minimum number of tests for selected batches. This is something that can certainly dispel the myth of poor quality supplements.