10 Rules to Know Before You Start Taking Any New Supplement

Cut through the hearsay and myth when it comes to buying and taking vitamins and supplements.

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As an expert on supplements and the author of The Supplement HandbookMark A. Moyad, MD, MPH, knows that there is a lot of confusion, hearsay, and marketing hype that sometimes overpower the scientifically sound research about supplements.

More: 7 Doctor-Approved Ways to Avoid Bogus Supplements

One of the most common questions he gets is "How do I start taking supplements?" Here are his 10 rules to keep in mind to help you answer that question before you start taking supplements.

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If you're thinking of starting supplements, you probably already have a good reason to do so

You don't necessarily need to take a supplement if you're perfectly healthy, just like you wouldn't take a drug if you didn't have any health issues. If you do have a health condition, though, or you're at higher risk of a disease, such as heart disease or diabetes due to lifestyle or family history, you may want to consider taking a supplement just like you would consider taking a drug.

What I've found over the last 30 years is that virtually all people have their own unique story that involves some health concern, large or small. In other words, almost everyone could potentially benefit from some type of supplement, even if it's something as simple as a multivitamin to reduce cancer or cataract risk.

More: 9 Simple Ways to Boost Your Heart Health

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Do your homework

Your body is a temple, so do not introduce any pill into your temple unless you have done your homework that the benefit outweighs the risk. Keep in mind that many effective dietary supplements are actually treated as drugs in other countries.

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It's OK to start with children's dosages

"Start low and go slow and you'll save side effects and dough" is usually my mantra with supplements, especially in order to avoid dietary supplement-induced ER trips. Children's supplements, which are usually cheaper, are great options for adults, especially considering that many companies are making larger and larger pills that are based on marketing tactics, not science.

Some people simply cannot take large doses of certain supplements due to side effects, and in many cases, a large dose isn't needed anyway. Look at antiallergy drugs like Claritin and Benadryl. Adults who take the children's version of these drugs often have an excellent response. As with a multivitamin, the children's version is often easier to take and safer.

More: The Truth Behind 5 Popular Weight Loss Supplements

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The goal is NOT to be on supplements indefinitely

My mantra throughout my career with any drug or supplement is to take the lowest effective dose at the lowest price for the shortest time (based on the research). Following this simple rule will keep you from developing a tolerance or resistance or becoming addicted (if this is a possibility), and it will help you maintain your focus on making healthy lifestyle changes.

If your healthcare professional does not subscribe to this mantra, I would find another doctor. The goal of any doctor-patient relationship should be to create independence and educational empowerment, not dependence and a self-medication philosophy. Understandably, there are supplements that can help prevent breast cancer recurrence, and can help heal and prevent other diseases, but remember to follow doctor recommendations. 

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Know the difference between generic and patented

When a supplement is invented, produced, and sold, 99 percent of the time it starts as a generic, which is different from the drug world, where most drugs start as a patented form.

In other words, if you are paying more for your supplement compared to a similar, cheaper option, it is time to buy the cheaper option. The same goes with how you can save with prescription drugs: Don't let folks tell you that you need to spend more for one you can get for cheap at your regular drugstore.

More: How to Find Safer Herbal Supplements

 
 
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Quality factors to look for

There is no ideal dietary supplement, or herbal supplement, but below is a partial list of some of the characteristics many people look for in the "perfect" product (these would be reported either on the packaging or the supplement's website). Remember, some different rules may apply to sports supplements, but this is a good list to start:

• Heart healthy
• Safe for mental health
• Safe during pregnancy and for children
• Respected quality-control testing and monitoring methods employed
• Supplement fact panel on the label is in a readable size and font (People misread things all the time because the type is just too small)
• Vegetarian or even vegan friendly (contains no animal products)
• BPA-free container
• Biodegradable container (or otherwise environmentally friendly)
• Phthalate free
• No artificial coloring
• No artificial flavoring
• No sugar or artificial sweeteners
• No fragrances
• No gluten
• Non-GMO
• No hormones
• No lactose
• No pesticides or herbicides
• No preservatives
• No or low sodium
• No starch
• No yeast
• No allergens (including soy, peanuts, tree nuts, and such)
• Halal friendly
• Kosher friendly
• Tested for heavy metals (such as arsenic, cadmium, lead, mercury)
• Tested for total bacteria count, yeast and mold, Salmonella, E. coli, Staphylococcus aureus, and bile-tolerant gram-negative bacteria

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Blood tests aren't always necessary

Do Test: There are clearly some cases in which you need a blood test if your doctor suspects a nutrient deficiency—say, with potassium, magnesium, iron, or vitamin B12—especially when a drug increases the risk of one. Iron blood testing for anemia is a gold standard for women with fatigue from excessive blood loss from menstruation, and B12 and magnesium testing may be warranted if you're on acid reflux medication long-term.

Be Wary: Be leery about extensive blood panel tests for amino acids, antioxidants, B-complex vitamins, fatty acids, metabolites, minerals, or vitamins. If your panel does reveal some deficiencies, always ask if correcting them (taking more of whatever nutrient is low) will produce a tangible, beneficial result. Just because a blood test improves does not always mean your health will improve.

More: 10 Anti-Nutrients to Ditch

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Collaborate with your doctor and pharmacist

When it comes to dietary supplements, companies have to say "check with your doctor." But it's often a hollow statement because there's a general lack of education and knowledge about dietary supplements in health care, and the manufacturers know that! This is slowly changing, though.

Whether you're seeing a conventional or an alternative practitioner, investigate the supplements you're interested in, and when you go to consult with him or her, take your research with you. Supplement research is moving as fast as any research now, and it's up to you to help your practitioner arrive at the right decision, and more research will help you know how to avoid bogus supplements

Pharmacists are really improving their education in this area, too, and understand or can look up drug and supplement interactions.

 
 
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Take with food, unless otherwise directed

Always try to take your supplement with or right after a meal, unless the directions or your doctor tells you to take it on an empty stomach. Taking it with a meal maximizes your stomach acid, which aids absorption, and minimizes the chances of getting gastrointestinal upset—research lingo for an upset stomach, a common side effect of supplements.

More: The 15 Best Sneeze-Stifling Supplements

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You can get too much of a good thing

Some people like to talk about all the supplements they take every day as if it's a healthy thing. But all those pills make the liver work extra hard to metabolize and detoxify the ingredients (virtually every supplement contains contaminants—such as heavy metals or silicon dioxide, which is sand—even if it's just small amounts).

They may not be treated like prescription drugs, but supplements can still hurt you (for example, yes, you can get too much vitamin D). A few well-done studies have shown that too much selenium (200 micrograms a day) has been associated with an increased risk of type 2 diabetes, aggressive prostate cancer, and skin cancer recurrence, and with no benefit for heart health. Selenium is a wonderful and probably disease-preventing nutrient; however, either too little or too much can be harmful. Here are some other ways you can OD on supplements.

• Too much vitamin A = liver toxicity
• Too much calcium, vitamin D, or vitamin C = kidney stones
• Too much red yeast rice extract = muscle pain, liver toxicity
• Too much 5-HTP or St. John's wort = nausea
• Too much vitamin B6 = sensory peripheral neuropathy

• Too much fish oil = gastrointestinal upset and an increase in bad cholesterol (LDL)
• Too much zinc = loss of taste and smell
• Too much iron = constipation
• Too much magnesium = diarrhea
• Too much iodine = thyroid problems
• Too much L-arginine = unsafe drop in blood pressure.

I could go on with every supplement ever invented, but I think you get the point. I always recommend taking the lowest dosage possible in every case.

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