Many people with autoimmune and chronic health conditions follow specialized dietary and lifestyle protocols to manage their condition yet find they still suffer from symptoms. One culprit to investigate is whether your supplement ingredients and medications are triggering inflammation.
Easy access to supplements is a mixed blessing
The United States benefits from wide access to nutritional supplements, whereas other countries have much stricter regulations that make access difficult. While the FDA has strict labeling rules regarding the contents and effects of supplements, we can still buy them just about anywhere — in the corner drug store, grocery, online, at specialty supplement outlets, and more.
As the rate of “mysterious” and “untreatable” illness grows, patients who are failed by the conventional medical model are turning to supplements in hopes of getting help. This has created a gargantuan market for the health supplement industry. In response, the FDA is mounting an increasingly aggressive approach to supplement regulation, which in turn will necessitate an ongoing battle to protect consumer access.
Due to producers’ easy access to ingredients, we have to be wary of ineffective, poor quality, fraudulent, and even unsafe products. It’s important to be an informed and mindful supplement shopper to assure they will not do cause harm.
Quality standards for supplements
Despite the “open season” on ingredient availability, the supplement industry does have standards of quality. Supplement manufacturers can voluntarily comply with these standards in order to assure consumers of the purest ingredients and highest quality.
The highest quality supplements are made by companies who:
- Have an advising health care professional along with a scientific advisory board
- Can provide peer-reviewed studies that support the ingredients
- Test products regularly for purity at independent labs
- Certify ingredients with independent organizations such as NSF International.
Some of these companies sell only to licensed practitioners, offering educational seminars for them to learn about the products and how to incorporate them into their patients’ health care plans. Others sell to the open market but can still prove ingredient purity and quality.
Labeling: what’s really in this product?
We tend to look at ingredient labels with an eye for the ingredients we seek. Yet it’s important to read the entire label to see whether the other ingredients may be problem. Fillers and stabilizers may contain ingredients that are inflammatory for many people, including gluten, nightshades, dairy, and corn — yet the label does not reflect this.
The FDA has strict rules about labeling active and inactive ingredients. Active ingredients in supplements and medications are closely regulated and monitored by the FDA. However, excipients (fillers) are considered inactive and are in a wider and less-regulated category called FDA-approved substances.
This is where things can get tricky. The FDA isn’t concerned about which fillers are used as long as they fall into the FDA-approved category. Therefore, companies change them regularly to whatever is the lowest cost to save money.
Fillers in name-brand vs. generic medications: While your name-brand medication may use one set of fillers, generic versions of those medications sometimes use different fillers in order to save money.
If you switch from a name-brand medication to a generic, check the new medication for different fillers. Even brand-name manufacturers change fillers regularly without notification, so it’s wise to check ingredients every time you get a new bottle.
Fillers in supplements: Supplement companies use a variety of fillers and can change them at any time unannounced. Even though you’ve vetted the ingredients on your trusty old supplements, it’s best to check the label every time you buy a new bottle.
Two tips: Look out for wording changes on the label such as “New recipe,” “New look,” “New and improved.”
Secondly, when a label’s look changes, frequently an ingredient change comes with it. When in doubt, compare the new bottle’s ingredients to the old.
Fillers don’t always reveal their source
Excipients (fillers) in supplements and medications serve various functions. They provide bulk to an otherwise small-volume ingredient, help a tablet dissolve in the gut, assist with absorption, and more. Some fillers are only present to keep the other ingredients from sticking in the production machinery.
Many of these fillers are sourced from wheat, rice, barley, corn, or potato, all of which are known to be reactive for many people with autoimmunity.
The problem is, these fillers do not reveal their hidden source. Instead, on the supplement label you will see (source added in parentheses):
- Dextrose (corn starch)
- Dextri-maltose (barley malt)
- Dextrans (sugar)
- Dextrins (primarily corn and potato, but can come from wheat, rice, tapioca)
- Dextrate (starch – source not listed)
- Maltodextrin (corn, wheat, potato, rice)
- Pregelatinized starch (corn, wheat, potato, tapioca)*
- Sodium starch glycolate (commonly potato, but has other starch sources)*
Look out for any starches — they are primarily derived from corn, potato (and tapioca), and they have been known to contain starch from wheat.
Some vitamin E is sourced from wheat germ, and most vitamin C is sourced from corn.
In addition, some medications have problematic fillers:
- Some thyroid medications contain corn or gluten — and it’s not easy to tell from the ingredients list.
- Some Type 2 diabetes oral medications reportedly contain gluten.
- In the case of Type 1 diabetes, gluten has been shown to cross-react with pancreatic islet cells.
If you take thyroid medication, Stop the Thyroid Madness keeps an updated list of thyroid medication ingredients.
What to avoid in supplements
Avoid cheap, mass-market supplements and those with:
- Ingredients and fillers to which you know you react, such as corn, soy, or wheat. Remember, even a small amount can cause symptoms.
- Synthetic ingredients
- Poor quality ingredients
- Artificial flavors and colors
- A long list of fillers or excipients
- Ingredients you are not familiar with
If you have autoimmunity, you might want to avoid certain immune-stimulating ingredients that are commonly found in supplements.
If you have allergies or sensitivities to certain foods, avoid supplements made in factories that make products containing them. Any FDA approved label will tell you which allergenic substances are processed on the same machinery, and which ingredients it’s guaranteed free of. Keep in mind this only applies to compounds known to be truly allergenic, such as peanuts, versus immune reactive in sensitive individuals, such as gluten.
Seven tips to assure safe ingredients in supplements and medications
- Read the ingredient label every time you buy a product — even on the products you’ve used before.
- Become familiar with the names of fillers and ingredients you need to avoid. Carry a list in your wallet.
- Periodically re-confirm the absence of gluten, grains, nightshade, dairy, and other reactive foods in your supplements and medications. Keep an eye out for label changes that could signal ingredient changes.
- If uncertain about a product, call the maker and ask. Most companies have customer reps who field ingredient questions, and if they don’t have the answer, they should get one for you. Don’t accept,”We don’t know.”
- Remind your health care practitioner that you will be verifying the gluten-, grain-, nightshade- (etc.) free status of your supplements and medications. If you need to ask for second-choice options, do so.
- Never settle for an unclear answer about a supplement or medication.
- If uncertain about the ingredients in a prescription product, ask your pharmacist. They may not know the source of an ingredient but can call the producer to ask. If your pharmacist doesn’t have the contact number, you can find it online.
While the availability of health supplements is a blessing, it’s important to understand that one must be discerning about quality and ingredients and mindful of changes that might lead to symptoms.
Once you get the hang of being aware of what’s in your supplements and medications, it becomes second nature, and you can rest more easily knowing you aren’t adding reactive ingredients to your diet.