Supplementation FAQs




Why supplement? Basics information you should know.

Many people these days are aware that something is missing in their diets. People around the world, Americans in particular, are realizing that the old adage, "You are what you eat," may mean exactly that. While rethinking the way we eat and drink is becoming increasingly more necessary in a society that revolves around fast food and stuff in the grocery store that has been processed, preserved, and in other ways altered from the original natural ingredients, there is an effective and reliable method to boost the nutrition we receive daily: nutritional supplementation.

Nutritionists now know so many of the killer and metabolic diseases of generations past (beriberi, pellagra, rickets, scurvy) to be nothing more than acute vitamin deficiencies (of thiamin, niacin, vitamin D and vitamin C, respectively). These are diseases that proper diets would have prevented. It is widely known that we are not able to get everything we need simply by "eating right." Today's fast-paced life does not lend itself to the thoughtful planning of meals to ensure maximum nutrition for most people.  

The nutrients commonly found in meat and vegetables some 50 years ago simply aren't there now. Just as Alpha hay in 5 different geographical regions is strong or weak in various nutrients; various vegetables are the same, having different levels of vitamins and minerals, depending upon the geographical region they came from. There are some generalities related to vitamin and mineral deficiencies in the foods we eat (and that we feed to our animals).

However, the biggest difference is aging. 50 years ago, the average adult human being was lucky to live past 70, and unless they were farmers or health nuts, they were lucky to have active and productive later years. Now, it's commonplace for people to be in their 80's, 90's, and even over 100 years old. As a body ages, how it deals with food, the metabolic rate, and the bioavailability changes. The Ph levels in the digestive tract rise, body weight is more challenging to maintain, and foods are broken down more slowly and with less benefit to the body. Therefore, the body doesn't get everything it needs to maintain optimum health and to repair injuries and the normal wear and tear of various parts (such as knees, hips, heart, kidneys, and lungs), even when a diet is balanced. Therefore, proper supplementation is both justified and necessary to maintain a balanced diet and optimum health.

Supplementation is an answer. Providing the body these extra nutrients in forms the body can use is vital to good health. It won't solve everything, but it will allow your body to have a fighting chance. However, store shelves are flooded with an endless variety of supplements: single herbs, herbal combinations, individual vitamins, "complete" multivitamins, minerals, and ultra trace minerals. So, what should a person take?  Education on supplementation is important. Learn what is right for you, what's good, better, and best for the body, how to quickly pick safe products without getting a college degree in nutrition. Caring companies that already have the degrees and knowledge can help you do just that.

Don't be fooled by the big ads, paid endorsements, appearances of public acceptance, popularity, or other forms of some of the "snake oil" salesmen out there. Take a moment to learn the basics and save yourself (and your animals) from wasting money on inferior products and potentially damaging ingredients!

When should I begin using supplements?

It is recommended that all adults take a vitamin and mineral supplement, especially those who have a poor diet. This becomes even more important when we get older, when injuries, overuse, or illness starts slowing the body down with aches and pains, when a person suffers from poor digestion, less energy or poor general health, and when a woman is pregnant, trying to become pregnant or is nursing.

What is bioavailability?

How does an ordinary person understand the differences between supplements? Why is it important? It all boils down to the bioavailability of a nutrient, which means the absorption amounts actually available to be used in the biological processes in the body. In other words, how much of a given nutrient will be available for the body to use, not just what gets into the bloodstream, but also what the tissues and cells of the body actually put to positive work within the body. Without going into a great deal of chemistry, understand that when nutrients are processed by the manufacturer, they are generally mixed with other elements or binders. All minerals require binders. Product labels may not reflect the accurate information. Few companies list the actual elemental amount of the minerals they are selling. Be aware and start getting the most for your money (and body).

How do I know if I'm getting a good product?

Nearly every nutrient – every vitamin, mineral, amino acid, and enzyme – has a "normal" balance within a healthy body. Too much of certain nutrients can cause a toxic effect, a variety of diseases, physical or mental problems, and potentially even cause death. Too little can do the same. There is a great deal of information in journals, universities, colleges, and from researchers around the world about the "safe" levels of most nutrients within the body of a variety of species. It's the job of trained and credentialed professionals, with the knowledge to understand what they are looking at and the experience to ask the right questions, to sort through the glut of information and determine which nutrients need to go into a product and at what levels to be both safe and effective. The problem is that many companies cut corners with quality in some way, figuring that they can get away with it because the average layperson won't know any better. This can range anywhere from using ingredients that have been poorly or incorrectly manufactured to simply using an ingredient that's cheaper and less effective as opposed to one that would cost them more, but would also do a better job.

The old adage, "You get what you pay for." is NOT always true in the nutritional supplement industry or with pharmaceutical companies! In many cases, companies do NOT always offer the best product, quality ingredients, or even usable forms of an ingredient even when they are often charging the highest prices.

Form counts! Once a person wades through the maze of nutrients and herbs, they are confronted with another aspect of supplementation: what is the best form? Different products use different forms of apparently the same mineral. Calcium is a good example. There are many different forms: calcium chelate, calcium citrate, calcium lactate, calcium carbonate, etc. Which is the best? Calcium chelate, followed by calcium citrate, which are the only ones MD's Choice uses in their products. And which is the worst? Calcium carbonate, which, unfortunately, is the one most often used in supplements. Calcium carbonate is limestone! How much of that do you think your body can use?

Any metallic mineral that is combined with "Oxide" is only slightly more useful to your body than licking the side of a rusty metal building! Of course, though the lick is free, it may include other unidentifiable objects, so it really wouldn't be advisable. So, when a company puts iron oxide in their product, they are actually putting RUST in there. How does that make you feel? There is a lot of scientific evidence that has shown that less than 10% of any mineral in an oxide form is actually usable to the human body. Example: 10mg of iron oxide only contains about 1mg of actual Iron, and only a fractional amount of it can be used by the body.

Without knowing the specific form that a mineral in a product is in, a person cannot figure out the actual (elemental) amount of a given ingredient in a product, making it impossible to approximate the amount of the actual mineral that is available to your body (for actual use). This means that you would not be able to make educated decisions and ensure that you are getting enough of the specific mineral your body needs, but also not getting too much, either of which can be harmful.

So, how does the average person find out such things? Hopefully, looking at the label on the bottle will be enough. However, this leads to another issue, namely, the difference between "combined form" and "elemental form".

There are two different ways that the amount of minerals (such as calcium and iron) are listed on bottles:

  1. In the combined form (no mineral can be delivered to a body in its pure form), which has the name of the mineral and the name of whatever it is combined with listed after the name of the mineral.
  2. The elemental form (the actual amount of the mineral minus whatever it is combined with).
You ALWAYS want and need to know what the elemental amount (real amount of the minerals) that you will be ingesting is. How do you tell the difference? Well, if the company is dishonest, it is nearly impossible. However, based on the March 1999 FDA labeling regulations, all nutritional supplements are suppose to designate the difference between the two forms. This is a little challenging, but here are some examples that might help:
  1. Combined Form – "Calcium Carbonate.....500mg". Only about 50mg is actually the calcium, approximately 10% of the carbonate version.
  2. Elemental Form – "Calcium (as carbonate).....500mg". There is actually 500mg of calcium, but it took about 5,000mg of the carbonate to get that elemental amount. 
  3. Not Specified – In the Supplement Facts box it says "Calcium" with nothing but numbers after the name, yet, in the "Other Ingredients" (listed at the bottom of the facts box), it says "Calcium _______" (fill in the blank with the combined form of calcium that supplement uses). In this situation, you really can't tell how much calcium is in the product. Odds are that they listed the total combined amount. In any new nutritional supplement, this violated the March '99 FDA label regulations.
Ingredients: Why is the chelated form the best?

There is a consensus in the medical and nutrition communities that chelates are the most readily absorbed mineral form available. From 50-90% of the nutrient is available to a normal body for absorption. The chelation process involves combining single mineral atoms with amino acids, or proteins, or something else the body can easily recognize (and use) to help transport the mineral actually into the body. The chelates quickly fall away (from the actual mineral), thus allowing them to be easily absorbed with minimum effort. Each person's mineral needs change throughout the day based on food intake, environment, exercise level, etc. Making the minerals readily available in chelated forms is the most efficient, and best way to supply your body with what it actually requires.

Unfortunately, some minerals in the chelate form can be extremely expensive to manufacture, which drives up the price of a supplement significantly. So, supplement companies have to strike a balance between providing the best form to providing a product that is affordable for the average person. If the company really knows what they're doing, they can create a product that is both affordable and high in bioavailability. For instance, calcium in the amino acid chelate form is the most bioavailable form of that mineral, but it is also very expensive, whereas calcium citrate chelate is just a little bit less bioavailable, but is significantly less expensive. MD's Choice uses calcium citrate chelate in their supplements, providing calcium that is highly bioavailble, but also enabling them to keep their prices reasonable.

Be aware that, sometimes, a product may say only "Calcium Citrate" on the label when, in fact, what's in the supplement is actually calcium citrate chelate.

Can non-chelated forms of minerals work?

Yes, to a lesser degree, how much less depending on the form. Take calcium for example. 500mg of calcium carbonate nets about 50mg of actual calcium, of which only about 5 to 10 mg of calcium will make it into the system (assuming everything else is correct). Whereas, 50 mg of calcium as calcium citrate chelate nets the same 50mg of actual calcium (as above), but offers 40 to 48mg of actual calcium to the body in a form the body can actually use easily.

What else should I look for on the label?

In addition to nutrient form and absorption, another factor enters the equation. Nutritionists call it "complementary nutrition". Basically, what this means is that some nutrients require other nutrients to increase or even activate their utilization by the body. For example, in a properly formulated, high quality calcium supplement, specific amounts of magnesium, boron, zinc, and manganese tremendously increases the effectiveness of calcium within the body. This combination of nutrients is more effective when taken together in the proper balance than when calcium (in any form) is taken independently. A company that honestly wants to provide the best supplementation possible will be aware of these important nutrient "partnerships" and use them in their supplements.

This is where learning whether you can trust a company to know, understand, and deal with the science for you comes into play. Odds are that if a company has iron oxide or calcium carbonate in ANY of their products or they fail to list the "last names" (forms) their minerals and other ingredients are in, then they either don't know the science or don't care! I wouldn't waste my money on products from that company.

The same is true with any company with a "glucosamine" product. Glucosamine MUST be combined with something for the body to see it and for the joint tissues to use it. If a company won't tell you the form of glucosamine they are using, then maybe it's because they don't know or because it changes for batch to batch. Or it may be because they don't realize there are actually differences in how the different forms act and react within the body.

Whatever the reason, the companies that have products that clearly fit into this category should be either steered clear of or more drastically inspected rather than being blindly trusted because of pretty marketing, nice salespeople, or a couple of correct, but misleading answers.

How can I determine the best product for the money?

The answer to this question is tough. First, you need to understand the basics about nutrition. Second, you need to define your goal (mask the problem with drugs, deal with the slower healing process by using nutrition, or a healthy combination of the two). Third, you need to look for reasons to trust any company. And, lastly, you need to evaluate how a company treats you – before, during, and after the purchase (and use) of their product.

There are a few shortcuts to figuring out if a company knows what it's doing. (Please refer to the above sections). These companies often have 5 or more products claiming to do the exact same thing, perhaps with different brand names, for the sole purpose of making money rather than solving any of the problem you purchased the product for. There usually isn't an accredited professional (doctor, veterinarian, or nutritionist) in a responsible position with this company or with their name and credentials on the product label as "developed" or "formulated" by. Some companies that manufacture their products under several different brand names hope that if you try one of their products, and it doesn't work, you might go out and try another product they own that's under a different brand name, meaing that you're actually wasting your money buying exactly the same thing. It's a marketing and numbers game.

There are basically three general types of companies in the nutritional supplement industry:

  1. Companies that focus on marketing and popularity, including ingredients that they believe are popular regardless of whether or not those ingredients are helpful and safe for daily prolonged use.
  2. Companies that concoct some ingredients in their bathtub or back room to solve a problem they've had personal experience with. They believe the concoction worked for them and might work for others, so they decide to try to market it. This is often a small, regional company, and they may or may not have a truly safe or effective product. Please understand that "effective" does NOT always mean "safe". There usually isn't an accredited professional (doctor, veterinarian, nutritionist) associated with this company or with their name and credentials on the product label as "developed" or "formulated" by. Having their names and credentials listed in that fashion not only implies responsibility, but it also means that they are willing to stake their reputation and even their license to practice on that product. If it turns out that a company is doing things that are unethical or unsafe, any doctors directly linked to that company could be in danger of losing their license, which means that if you see a doctor's name on a label, you can be darn sure that they are 100% confident that it's a good product.
  3. Companies that have a foundation based on science and show the safe and effective logic of their product in their literature and information, backed by cross-scientific credentials and/or actual science that's relatively easy to understand and is consistent with either their product or the ingredients contained within. They have the credentials, where appropriate. Their science may or may not be public information. After all, they are likely trying to protect their formula, process, or method that makes their product different or better from the array of copy cats. They may be small or large, but they consistently talk about effective safety, and they have the solid guarantees to back up their beliefs.

There is a multimillion dollar company that had a big list of scientific abstracts and articles – all of which were real – in an article they handed out to their resellers entitled "The Truth About Glucosamine and Chondroitin Sulphate", which told about the benefits of certain specific ingredients and their effect within the body. There was just one problem. The form of glucosamine that all this great scientific information was for was not the form of glucosamine that they put in their product! They use Glucosamine HCl in their product, whereas the scientific studies they quoted were for Glucosamine Sulphate. With some careful wording, they made it sound like the glucosamine they used was backed by all that positive scientific data, when the truth is that Glucosamine HCl has contrary science and does not have nearly as much positive science and results, which, of course, is the reason why they quoted the other studies instead. Many resellers were duped, believing this "big" company had incredible science behind their product, when, in fact, the majority of the science they were using didn't even apply to their product. This shows that, as a consumer, you must compare the marketing to the product. If they don't match, then something is very wrong!

MD's Choice prides itself on knowing and having the science on the ingredients contained within their products. The doctors, veterinarians, nutritionists, pharmacologist, and biochemist associated with MD's Choice care about both the safety and effectiveness of their products. The professionals that formulated and/or developed a given product have their name and credentials listed on each and every product. They clearly understand why various ingredients and nutrients are included or not included in their formulas, and they don't have 5 or 10 different formulas trying to deal with the same problem! They know herbs often work – as herbs are plant-derived drugs. At the same time, they understand that drugs (in any form, including herbs) are not intended or healthy to the body for a daily prolonged period of time.

Sulfur (MSM): Is it needed by the body? How is it used?

MSM (Methylsulfonylmethane) is a naturally occurring nutrient composed of sulfur and methyl groups and a nutritional component of many foods. It is found in the normal diets of humans and almost all other animals. MSM is made up of 34% sulfur, the fourth most abundant mineral in the body. Sulfer is a vital building block of connective tissue, while methyl groups support energy production. This versatile nutrient demonstrates its value as a daily dietary supplement for people (and animals) of all ages and activity levels. MSM supports healthy, active lifestyles and benefits multiple structures and functions within the body, including connective tissues and the respiratory system.

Liquid products are the most absorbable, but are they always the best kind to take?

Nutrients incorporated into a liquid concentrate or loose powder capsule usually ensures maximum absorption. This is because the digestive tract does not have to put forth the effort to break down compressed tablets or eat through "candy" coatings to get to the nutrients. Tablets are made by subjecting the ingredients to high-pressure compression, adding a binding agent and often a protective coating. Ingredients combined in this process undergo changes that may impair their strength or bioavailability. There are many cases of people taking a wide variety of both prescription medicines and nutritional supplements in tablet form in which the tablets have passed completely through their systems with little or no absorption, some tablets with the coating and part of the writing STILL ON THE TABLET! This normally occurs in the elderly or ill persons who have high pH levels in their stomachs, thus impairing their stomach's ability to dissolve tablets properly. Undissolved tablets cannot help you!

However, there are exceptions and cautions to the liquid part of the above logic. Contrary to what the orange juice manufacturers want you to think, in the real world, Vitamin C has very little "staying power" once put in liquid. It begins a very serious breakdown within days of being put in liquid. Nearly 50% of the amount started with is gone within 30 days of being in liquid.

Glucosamine of any type is not stable in liquid form. If you are seeing any results from a liquid joint supplement, what you are really seeing is a pain masking effect (from herbs or other ingredients) rather than a healing effect. Glucosamine HCl begins breaking down within 27 hours of hitting liquid – long before it gets to the store shelf and you. Glucosamine Sulphate starts breaking down within 6 months of being mixed with liquid. For this reason, MD's Choice does not have a joint supplement in liquid form. They believe it's more important to have a joint supplement that actually works and retains its effectiveness than one that was created in the hopes of tricking unwitting consumers who believe that liquid supplements are always better.

Be wary of liquid, paste, gel, and otherwise moist joint supplements containing Glucosamine of any form. Not all ingredients and/or nutrients are actually better, faster, or more bioavailable (usable to the body) when in a liquid form.

Clinical Studies: Can they always be trusted?

A normal person assumes that a "clinical study" is absolutely science-based and gives real world results as to the absorption, use, effectiveness, and safety of a given product and/or its ingredients. That is not always true, but what many companies want you to believe. While such a study, when done correctly is beneficial and generally accurate; it is something most companies cannot easily afford to have done on their specific product, because it's extremely expensive, labor intensive, and time prohibitive. It's not just the cost of product, but the care, feeding, and housing of the study animals, the materials and labor costs to gather the raw data, and the expense of correctly evaluating the data to reach some type of usable and accurate scientific conclusion that can be justified, understood, and accepted within the professional community. Understand that shorter versions of these "scientific studies" are usually very incomplete and can be extremely misleading to the normal person. Credentials by a cross section of the right type of people with a broad base of knowledge and experience, as well as a lot of in-depth, third party ingredient-specific research is usually much better and more complete than any short term "clinical study" with a few bodies being tested on a specific product for a short period of time.

What makes a "good" study?

  1. An accurate starting place – Knowing the specific levels of given nutrients and specifically defined problems and goals before the study begins. Have a reasonable belief that the study will either prove (or disprove) a given therory.
  2. Detailed preplanning – Defining the specific problems, tests and goals and knowing the potential negatives to beware of and watch for are important and makes the test more real and more beneficial.
  3. Using placebos – Adding a placebo (a fake, harmless version) into the mix in a subset of the test subjects helps justify the numbers and effects. It should be a "blind" or, preferably, a "double blind" study. A blind study is when the test subjects taking the real ingredient vs. those taking the placebo don't know which is which. A double blind study is the same as a blind one, except with a crossover at the halfway point, where Group 1 getting the real ingredient are now given the placebo, and Group 2 that were receiving the placebo now get the real ingredient, then tests compare the differences each group experiences.
  4. Time – Thorough and responsible testing takes time – lots of it. With drugs, the initial effects can usually be seen within a matter of days or weeks, but what about the side effects? In order to receive a "green light" from the FDA, drugs have to undergo a years-long period of tests and studies, often including biopsy evaluation of internal organs. Yet, even with those processes in place to insure that a drug is safe, mistakes and oversights still happen. How many times have you heard in the news about devastating side effects from some drug being discovered months or years after it was approved by the FDA and released to the public? So, what about those "natural" ingredients, the herbs and other things you find in nutritional supplements? Unlike with drugs, the initial effects of such nutritional ingredients usually takes several weeks, months, or perhaps even years, and discovering any side effects can take a very long time indeed. Just because something was not synthetically cooked up in a laboratory does not mean that it shouldn't be put through a long, rigorous period of testing to make sure it's safe for a person to take, particularly for an extended length of time. A 30 or 60-day "trial" for a nutritional product is generally a waste of time, and the results are worthless.
  5. Numbers – The more test subjects in a given experiment, the more accurate the information gathered. Having less than 24 test subjects is a waste of time and money and allows the focus group to be too easily hand selected for potential to produce the desired results. The minimum number should be 50 to 100, with 500 to 1000+ being the optimum for more complete and accurate results. Of couse, more numbers means more money.
  6. Type and level of testing – Variability and specificity is imperative.
  7. Third party testing – Having the studies done by a disinterested third party that has nothing to gain or lose by the results is also important. Company paid researchers, whether private or academic, are more likely to "find" facts that justify the results the company funding the project wants and to potentially disregard or downplay some of the negatives discovered. Be careful of company studies, ones that were funded by the company.
Paid endorsements vs. testimonials. What's the difference?

Paid endorsements are exactly that. Someone, often a person who is famous, is paid (whether with money, free products, or something else) to praise the benefits of some product. In some cases, the person has never even used the product! They're just saying what they've been told to. The company invests money in this big name person hoping it will increase product awareness and sales. Such endorsements should never be accepted as proof of a product's quality or effectiveness.

Testimonials, on the other hand, are given by people who have used the product themselves or on another person (or animal) and seen the results for themselves. These people aren't paid to say what the company wants them to. As a consumer, look for non-paid endorsements and testimonials (both professional and volunteered) from people who have actual experience with the product, particularly over an extended period of time. These are usually more impressive, more personal, and often more accurate testimonials for the product. Don't be afraid to ask questions.

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