Supplement labels, decoded: six checks before you buy

A supplement label packs a lot into a small box. This Tech Tuesday decodes it, one line at a time.

Why the label matters

Supplements are regulated differently from medicines. Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), the FDA doesn't have the authority to approve dietary supplements for safety and effectiveness, or to approve their labels, before they're sold. The companies that make and sell them are responsible for their safety and labeling. That makes a careful read of the label, and a conversation with your doctor or pharmacist, worth the time.

Six label checks

1. Serving size and amount per serving. Start with the Supplement Facts panel. One serving might be one capsule or three, and every amount listed is per serving.
2. % Daily Value. This column shows how much of an ingredient's Daily Value one serving provides. A symbol in the column means no Daily Value has been set for that ingredient. If a number looks very high, ask your doctor or pharmacist about it. Also note any "proprietary blend": the label gives the blend's total weight and lists its ingredients in order of amount, but often not how much of each one is inside.
3. Other ingredients. Fillers, binders and flavorings are listed here. Check for anything you avoid, including allergens.
4. A third-party seal. Independent groups test products and let those that pass display a seal:
   • USP Verified: contains the listed ingredients in the declared amounts, doesn't contain harmful levels of specified contaminants, breaks down in the body within a set time and was made under FDA good manufacturing practices.
   • NSF/ANSI 173: checks that what's on the label is in the bottle, reviews ingredient safety and screens for contaminants.
   • NSF Certified for Sport: adds screening for substances banned by most major athletic organizations.

   A seal is about quality. According to the NIH Office of Dietary Supplements, it doesn't mean a product is safe for you or that it works.

5. Wording that sounds like a drug claim. Supplements may describe how an ingredient supports the body's normal structure or function, with an FDA disclaimer. Under FDA rules, a product meant to treat or prevent a disease is a drug. A supplement label that promises that is a red flag.
6. Interactions with your medicines. Some supplements interact with medicines. St. John's wort, for example, can make many medicines less effective. Tell your doctors and pharmacist about every supplement you take, and keep taking your medications as prescribed.

What's on our shelf

Monarch Bay Chiropractic carries practitioner-grade supplements in four groups:

• joint, muscle and inflammation support;
• immune and seasonal support;
• foundational daily nutrition;
• sports, recovery and metabolic support.

Patients can ask Dr. Scott Kirchner, D.C., which ones, if any, fit their plan. We don't sell online. Patients reserve by phone, then pick up at our Dana Point or Mission Viejo office.

Quick answers

Does the FDA approve supplements before they're sold?
No. Under DSHEA (1994), the FDA doesn't have that authority. Companies are responsible for safety and labeling.

What does a USP or NSF seal mean?
The product passed independent quality testing, such as checks that the label matches what's inside and screening for contaminants. A seal doesn't mean the product works or suits you.

What's a "proprietary blend"?
A mix of ingredients listed with one total weight. The ingredients appear in order of amount, but the label often doesn't say how much of each is inside.

Should I tell my doctor about supplements I take?
Yes. Tell your doctors and pharmacist about everything you take, because some supplements interact with medicines.

How do patients get supplements from your shelf?
Reserve by phone, then pick up at either office.

Reserve and pick up

Patients can reserve supplements by calling (949) 661-9777, then pick them up at either office.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

General information, not medical advice. Please talk with your own doctor about your situation.

Sources

1. U.S. Food and Drug Administration. FDA 101: Dietary Supplements. https://www.fda.gov/consumers/consumer-updates/fda-101-dietary-supplements
2. U.S. Food and Drug Administration. Dietary Supplements. https://www.fda.gov/food/dietary-supplements
3. U.S. Food and Drug Administration. Dietary Supplement Labeling Guide: Chapter IV. Nutrition Labeling. https://www.fda.gov/food/dietary-supplements-guidance-documents-regulatory-information/dietary-supplement-labeling-guide-chapter-iv-nutrition-labeling
4. U.S. Food and Drug Administration. Structure/Function Claims. https://www.fda.gov/food/nutrition-food-labeling-and-critical-foods/structurefunction-claims
5. NIH Office of Dietary Supplements. Dietary Supplements: What You Need to Know. https://ods.od.nih.gov/factsheets/WYNTK-Consumer/
6. U.S. Pharmacopeia. USP Verified Mark. https://www.usp.org/verification-services/verified-mark
7. NSF. Supplement and vitamin certification. https://www.nsf.org/consumer-resources/articles/supplement-vitamin-certification