by Dr. John Neustadt

Walk into any supermarket, drugstore or health food store across America, and you’ll see shelves and overflowing aisles dedicated to supplements—vitamins, minerals, herbs, and blends for everything from healthy sleep to healthy weight, optimal mood, strong bones, balanced blood sugar levels, high energy, optimal digestion and more. The bottles seem to beckon with golden promise, but it’s difficult to determine how valid any of their claims are. 

The FDA regulates the manufacturing of supplements, but as they state on their own website: “The FDA is not authorized to review dietary supplement products for safety and effectiveness before they are marketed.¹“ This leaves consumers vulnerable to either outright fraud or to inferior grade nutrients. 

How can you determine whether the product you’re buying is made from the highest-quality, most absorbable, well-tolerated ingredients? How do you know the blends are properly balanced and reflect the latest scientific research? Are you sure the amounts claimed on the label accurately reflect what’s in the bottle? 

These questions are more important than ever today, as Americans focus on wellness and the dietary supplement industry continues to rapidly expand. A 2019 survey commissioned by the Council for Responsible Nutrition (CNR) reported that dietary supplement use had reached a new, all-time high, with over three-quarters (77%) of US adults taking dietary supplements.² Dietary supplement manufacturers and ingredient suppliers operate in all 50 states. The dietary supplement industry provides jobs for more than 750,000 Americans and generates $5.75 billion in state and local taxes and $9.2 billion in federal taxes.³ In the US alone, Americans spend $122 billion each year, and that number continues to grow as consumers search for more ways to get and stay healthy.

Dietary supplements can be packaged as pills, capsules, powders, and liquids. They’re not intended to replace an optimal diet, but rather to “supplement” a healthy diet. This article provides a guide to the top three ways supplement companies fail consumers and will help you protect yourself against inferior quality supplements so that you can make informed purchases and reap all the profound health benefits that high-quality products provide.

They Use Nutrients You Can’t Absorb

Swallowing nutrients, either from food or dietary supplements, is only the first step. To benefit from nutrients, your body has to absorb them. And not all nutrients are easily absorbed. In particular, minerals, such as magnesium, calcium, selenium, boron, copper, and zinc, can be hard for the body to fully utilize. For instance, your gut may only absorb 0.4–2.5% of the important trace mineral chromium from your food.⁴

In supplement form, minerals are always combined with other substances, such as oxides, sulfates, carbonate, organic acids, or amino acid chelates. Not all forms are equally absorbed by the body and many dietary supplement manufactures save money by choosing inexpensive mineral complexes that the body cannot use. 

Calcium carbonate is the most common form of calcium in supplements, but this mineral salt is poorly absorbed and can cause constipation.⁵ Magnesium oxide is also inexpensive and commonly found in vitamin and mineral formulas. Although magnesium oxide offers a high percentage of elemental magnesium, its bioavailability is low.⁶ We absorb only about 4% of the magnesium as magnesium oxide.⁷ This means that 96% of what you put in your mouth is just passing right through you and being eliminated in your stool. In fact, magnesium oxide is so poorly absorbed that it’s used in higher amounts as a laxative.

The body’s first step to absorbing a mineral is to cleave the mineral from its carrier. This occurs in the stomach, and for both carbonates and oxides, ample stomach acid is required. But stomach acid production can be low if we take acid-blocking medications like Protonix, Prilosec, Nexium, and Aciphex; have an untreated Helicobacter pylori (H. pylori) infection; or if we’re chronically stressed. Stomach acid production also declines steadily with age: it has been estimated that 10–21% of people sixty to sixty-nine years old, 31% of those seventy to seventy-nine years old, and 37% of those above the age have low or no stomach acid (hypochlorhydria or achlorhydria), and this rate may be higher in people with autoimmune conditions.⁸ 

Other, more efficient complexes include organic acids such as citrate and malate and amino acid chelates. Magnesium citrate and magnesium malate are better absorbed than magnesium oxide.⁹ Calcium citrate is better absorbed than calcium carbonate.¹⁰ The intestinal absorption of calcium citrate is approximately 24% better than that of calcium carbonate independent of intake with meals.¹¹ And unlike carbonate forms of minerals, citrate and malate forms do not require stomach acid for absorption. 

And finally, minerals can be chelated, or bound, to amino acids. To create an amino acid chelate, a mineral such as magnesium is molecularly bonded with one or more amino acids, which creates a readily absorbable organic compound. Chelated minerals are well absorbed, and thus lower doses are needed.¹² Even in the presence of low stomach acid, the amino acid chelated form of minerals and those combined with organic acids are better absorbed than the oxide or carbonate forms. For example, chelated zinc (as zinc citrate and zinc gluconate) was absorbed around 11% more effectively in one study than non-chelated zinc (as zinc oxide).¹³ For all of these reasons, NBI does not use any oxide minerals. Instead, its products use only amino acid chelated or the organic acid (eg, citrate) forms of minerals. 

They Use Nutrients Your Body Can’t Use

Genetic variation is the spice of life. Some of us are, for instance, supertasters—we have more taste buds than most people and thus foods and flavors taste more strongly to us.¹⁴ Some of us are lactose intolerant—we have reduced levels of the enzyme that allows us to digest dairy products.¹⁵ And some of us have a variation of a gene called methyltetrahydrofolate reductase (MTHFR) that prevents or impairs our body from easily forming the active forms of vitamin B12 and folic acid. 

Vitamin B12 and folic acid help breakdown homocysteine. Although homocysteine is naturally produced by the body, it’s toxic. The active form of vitamin B12, methylcobalamin, donates a methyl group to homocysteine, which then turns into methionine, an essential amino acid. 

Once B12 donates its methyl group, it needs a new one. Methylfolate is the sole molecule than can donate a methyl group to vitamin B12, thereby recycling vitamin B12 into its active form, methylcobalamin. When your levels of methylcobalamin or methyl folate are too low, homocysteine builds. High homocysteine can damage blood vessels and has been linked to an increased risk of cardiovascular disease, dementia, and osteoporosis.

While our bodies can convert inactive vitamin B12 and folic acid into their active, methylated forms, many of us have a common variant of the MTHFR gene that reduced the ability to activate these vitamins up to 70%.¹⁶ The frequency of this genetic mutation is high, especially in Europeans—as much as a third of the population—and particularly in Caucasians. This gene variant has been linked to Type 1 diabetes, cardiovascular disease, male infertility, cancer, depression, and bipolar disorder among other conditions.¹⁷

Numerous supplements contain inactive forms of B12 and folate, and those don’t provide much help to those who have trouble converting them to active forms. While people can get tested for this, it’s more economical just to take supplements that contain nutrients that the body can

use even if you have this genetic polymorphism¹⁸. Instead, look for products that contain methylcobalamin and methyltetrahydrofolate, like Supreme Multivitamin. 

They Don’t Use Doses Supported by Clinical Trials

Many vitamin supplements cite impressive data from clinical trials on their websites or the landing pages of popular storefronts, but then they may use a lower dose of nutrient that was used in the studies.

Consider elderberry extract—a popular remedy to support immune function and help increase resistance to viral infections such as colds and flu. The dose shown to be effective in a randomized, double-blind clinical trial was 15 mL of liquid extract four times per day, but the common dose on one of the most popular brands found in health food stores recommends 10 mL twice a day—only one third the amount proven effective.¹⁹ 

In a similar vein, some products on the market provide less than the 45 mg per day of MK4 that has been shown in studies to work. There are more than 25 clinical trials on MK4 showing that 45 mg/day promotes healthy bone density and maintains strong bones.^20-22 To stay true to the dose used in the research, NBI only uses the clinically validated amount of MK4 (45 mg/day) in its Osteo-K and Osteo-K Minis products. 

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