Diana Dyer, MS, RD, CNSD Last Modified: November 1, 2001
This article is reprinted from Diana Dyer's book A Dietitian's Cancer Story, reviewed for OncoLink by Katrina Claghorn, RD, Oncology Dietitian.
The choices available in the health food or grocery store are overwhelming.
Here are some general guidelines to help you choose a quality product.
Vitamins and Minerals:
Choose a supplement with the "USP" notation on the label. Having this on
the label means the company is legally responsible to the FDA for meeting
dissolution standards, which means the product has been tested to ensure it will
actually disintegrate in your body. Additionally, this product has been tested
to determine that the amounts indicated on the label are actually in the
supplement and have met purity standards. Only the term "USP" guarantees that
these important standards have been met.
The "USP" dissolution standard has not been tested with "sustained or
timed release" products.
Check the expiration date. I have seen stores selling vitamins in a big
"2 for 1" sale which were very close to the expiration date.
Take your vitamin or mineral supplement with food. That is especially
important with fat-soluble vitamins which need to be in the presence of fat to
(Source: Tufts University Health and Nutrition Letter, November, 1997)
Herbs and other Dietary Supplements
Currently, there are no regulations in effect that assure consumers of either
the quantity or quality of herbs or other dietary supplements being purchased.
Consumer Reports has published their investigative research showing widely
varying contents (quantity and purity) of various dietary supplements bought
from retail stores. "Standardization" of a product is optional at this time,
and indeed, there are widely differing (and contentious) views among herbalists
about the pros and cons of standardizing herbs for only one active constituent.
In addition, apparently even "standardized" herbs are not always what they say
they are. I found two references which listed brand names of products which are
reputed to "truly" supply standardized products, but I can't verify the
accuracy of their reporting:
Herbal Choice, Botalia Gold, Murdock Madaus Schwabe, Nature's Way, Eclectic Institute, Pytopharmica, Nature's Herbs, KAL.
(Source: American Health, Jan/Feb. 1997, page 33)
Eclectic Institute, Nature's Herb Company, Nature's Way, Penn Herb Company, Ltd. (Source: New Herbal Remedies, by Rodale Press, 1997, page 47)
I recently learned of a trade organization called the "National Nutritional
Foods Association" which requires its members who manufacture herbal and other
dietary supplements to agree to random independent testing of their products
for both quality and quantity as part of their "TrueLabel Program." Upon
calling them, I found out they would not give me the names of their members
over the telephone but suggested that I call each company to ask if they
belonged to the NNFA.
This will take some legwork on your part, but may be helpful in determining if
a company has enough internal quality control to be confident that outside,
independent testing will verify the information they have put on the label.
This industry is still evolving and hopefully will move toward defining,
implementing, and enforcing standards so that consumers don't have to be in the
position of "Buyer, beware," as is the unfortunate current situation. when I
have called a couple of herb companies, all were willing to tell me if they
belonged to the NNFA or not. All wanted to know why I was asking. If you call
the companies yourself, simply say that as a consumer, you would like some
indicator of quality control of the products you are choosing to buy.
Conveying this information to the manufacturers will hopefully give them the
message that higher and more consistent standards for the herbal industry are
Some additional advice I give my clients is the importance of keeping a diary
or log of all the supplements they are consuming, including brand name, dosage,
frequency, along with recording any signs, symptoms, or changes they might
notice that should be brought to the attention of their cancer team members. In
addition, if you are starting a new
complementary therapy such as
meditation, yoga, guided imagery, etc., keep records of when you started that,
too, along with any changes you observe. All of this information should be
incorporated into your medical records because all of these strategies are
contributing to your healing.
It is also advisable to introduce or change only one new herb, supplement, or
therapy at a time. I recommend waiting 3-4 days at a minimum. That way the
development of any adverse effects can be more easily traced to a particular
change or addition, just like with a medication. currently there is VERY
LITTLE information available to guide practitioners regarding potential unsafe
combinations of medications and herbs. If you do develop any unusual side
effects or symptoms, stop your supplements and notify your physician(s) and any
additional health care practitioner who is guiding you on choices of