South Africans are increasingly turning to preventative care to enhance their health and prevent disease. This is no surprise, given the spread of health care information, the rising costs of medication and the fact that 85%1 of us are dependent on the government health system in case we fall ill. More and more of us are relying on pharmacy staff for guidance as we self-medicate, and we are spending significantly more money on preventative medicine, including supplements.
The most common supplements include vitamins, minerals, enzymes, herbs, extracts, probiotics and amino acids. Shelves are stacked with so many options, how do you know which supplement and brand to choose?
We’ve put together a checklist to help you make an informed choice the next time you visit the supplement aisle.
1. Good Manufacturing Practice (GMP) compliance
Ensure that the company you’re buying from complies to Good Manufacturing Practice (GMP), a set of manufacturing, wholesaling and distribution practices that ensure that medicines (and related substances) are of high quality, safety and efficacy. GMP is a prerequisite for health product manufacturing in South Africa and this is regulated by SAHPRA.
2. Availability of a package insert
Check if the product has a package insert. Package inserts, prepared by the medication manufacturer, contains the product information (characteristics, risks, and recommended uses) and prescribing information needed to administer the medication.
3. Contact details and a valid company address
Ensure you have a company to contact should you experience any side effects or if you need more information pertaining to the supplement. You can also check out the company’s website and make sure the information on it is recent and updated.
4. A full list of ingredients
When purchasing a supplement, read the label carefully. Ingredients are listed in order of predominance, with the highest amounts listed first. Watch out for:
• Serving size and the amount of the active ingredient. This indicates how much you should take for the required dosage to be effective and to not exceed the Recommended Daily Allowance (RDA).
• Additives, preservatives, fillers, binders, artificial sweeteners, colourants or flavourings. While certain additives are necessary (to extend shelf life, for example), its best to avoid products with too many additives.
• Food allergens. If you have an allergy, check if the product includes any food allergens – the most common ones being milk, eggs, seafood, nuts, soy and wheat.
• Animal-derived ingredients. For those with specific dietary requirements like vegans, watch out for animal-derived ingredients including gelatine, collagen, magnesium stearate, and lanolin.
• Health claims. Avoid products that make unfounded health claims, promote unrealistic testimonials or use misleading phrases.
5. Awareness of supplementation interactions
Supplements can interact with prescription and over-the-counter (OTC) medications, other supplements, as well as food and alcohol. They also have side-effects; some can be toxic if overconsumed and certain supplements can even be dangerous when mixed with another supplement. For example, St. John’s Wort has side effects and over 500 interactions with other substances! Conversely, two supplements can work synergistically.
To get the best out of your supplement, stick to the recommended dosages, keep track for how long you take it and take note of how it affects you. When in doubt, always consult your doctor or pharmacist.
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When to consult a health care professional when supplementing
Always consult a health care professional before adding a supplement to your diet in the following cases:
• If you’re on chronic or acute medication, such as heart medications, diuretics, blood thinners, aspirin, steroids, antiretrovirals and antibiotics.
• If you’re pregnant or breastfeeding. Typically, safety and efficacy for such patients have not been tested, so ensure that what you are taking is safe for your baby by consulting your doctor. Pre-natal vitamins are especially formulated for the needs of these women.
• If you’re getting treatment for cancer or have had cancer, as some supplements can make treatments less effective.
• If you’re going to have surgery, because supplements such vitamin E, garlic, ginkgo biloba and ginseng, can cause bleeding. Supplements which act as sedatives, like kava and valerian, can increase the effects of the anaesthesia during surgery.
• If you’re younger than 18 or older than 65. Few supplements have been tested in children or the dosage hasn’t been established, while older adults may metabolize medications differently.
