The supplement industry contributed over $150 Billion to the U.S. economy in 2019 and is expected to hit $216 billion by 2026. More than two-thirds of Americans take supplements each year, ranging from vitamins and herbs to fish oil. Studies show that 60 to 80% of cancer patients are going online to Dr. Google and using supplements during their treatments to mitigate side effects. Almost all of these items are over the counter so they must be safe, right? No. This is dangerous especially during cancer treatment. As a Fellow of the American Board of Naturopathic Oncology Dr. Bye is trained in what is safe during treatment.
As it turns out, the supplement industry is subject to only the very lightest regulation by the FDA. The Dietary Supplement Health and Education Act (DSHEA) of 1994 permanently classifies dietary supplements as food items and thus excuses them from the regulation that is applied to drugs. Any supplement that was on the market before 1994 can be sold by manufacturers without any FDA approval. Every ingredient that does not make the 1994 cutoff must demonstrate GRAS (generally recognized as safe) but no standard for efficacy before going to market. However, if a supplement is to be removed from the market, proof of harm must be established.
Due to this lax approach to the supplement or “nutraceutical” industry, there can be little correlation between what’s on the label vs what’s in the bottle of a given dietary supplement. In 2013 a Canadian group of researchers tested 44 different bottles of supplements, distributed by 12 popular companies. DNA testing showed that one-third of the tested bottles contained 0% of the labeled ingredient and were instead composed of cheap fillers like wheat, rice, soy. Other bottles had adulterants with the potential of triggering severe allergic reactions in unsuspecting, susceptible people. This is dangerous folks.
What about fish oil? Surely it is more difficult to counterfeit fish oil? Yes, that is true, the oil you’re taking has a high likelihood of being rancid. A recent series of studies from South Africa, Norway and New Zealand have demonstrated that between 80-92% of commercial fish oils have elevated levels of oxidation. Another study from Poland demonstrated that oxidation levels rose by 22% within 3 weeks of a bottle of fish oil capsules being opened if it was stored at room temperature away from light. We at Journey to Wellness always advise putting fish oil in the refrigerator after opening it. Oxidation drives inflammatory processes in the body. How ironic – and tragic – that we may be increasing inflammation and disease by taking a supplement that is advertised as an anti-inflammatory!
So what can be done? For starters, it is always best to try to get your nutrition from food, not supplements. Eating a whole-food, plant-based diet will go a long way toward meeting that goal as long as you have good digestion. You need to choose healthy foods and then break them down into usable parts with good digestion. The digestive piece starts to wane about age 40. Poor digestion is a common thread we see in our cancer patients and gets worse with treatment unless you have Naturopathic oncology support. As Naturopathic physicians, we do digestion well, and are well trained in nutrition, supplements and herbs. We know how to vet them. We have extensive training in what to look for in supplements and herbs. It is important to know what form it needs to be in, what active ingredients need to be in it and what is the most bioavailable and absorbable form. Given that, it is best to work with a Naturopathic oncologist who is board certified when you are going through cancer treatment.
For those who do not have cancer, and don’t want to get it, you too can benefit from a doctor well trained in nutrition, supplements and herbs. There are good companies out there that making high-quality products. Many of these companies will only sell to medical practitioners who then prescribe these products to their patients. These companies have independent third-party testing of all their products and adhere to rigorous manufacturing standards. As licensed naturopathic doctors, we can steer you toward the supplements that best suit your needs and are GRAS and of high-quality. Once you get them home they should be stored in a cool, dark place (and all oils should be kept in the fridge after opening).
It’s the wild West out there, but with the right guidance there is value to be found. As we tell our patients everyday, the only person in charge of your health is you. It is our job to teach our patients how to take care of the vehicle through which they experience their lives. Because, unlike your car, if you do not take care of your body you cannot buy a new one.
Cynthia Bye, ND, FABNO
Board Certified in Naturopathic Oncology
Oxidation levels of North American over-the-counter n-3 (omega-3) supplements and the influence of supplement formulation and delivery form on evaluating oxidative safety
DNA barcoding detects contamination and substitution in North American herbal products
- Steven G Newmaster, Meghan Grguric, Dhivya Shanmughanandhan, Sathishkumar Ramalingam &
- Subramanyam Ragupathy BMC Medicine volume 11, Article number: 222 (2013) —
J Altern Complement Med. 2009 Jun; 15(6): 673–680.
Factors Related to the Use of Dietary Supplements by Cancer Survivors