Dietary Supplements: Why Form, Dose and Quality Matter
Dietary Supplement Quality:
What you really need to know about your supplements is not as easy to figure out as it should be. We want to help you stop wasting your money, time and potentially health on dietary supplements that dont work. There are very few supplements on the market that are providing you with the four major items you should be concerned with. Those are, what kind of vitamin or mineral should I be taking, what form of that vitamin, what is the proper dose to be effective and is this vitamin quality?
My journey taught me that we have to be really informed when taking dietary supplements of any kind. One of the most important concepts I learned from Dr. Josh Trutt was that of ‘kind, form, dose, quality.’ I asked Dr. Trutt to share the insights into what this means and why it matters.
Did you know that there are 8 forms of Vitamin E?
Did you know that you have to take a dose of at least 150mg of magnesium for it to be effective?
Did you know that the detoxifying benefits of milk thistle is really hard to absorb?
Interviewer (David Goldberg): Hey guys, it’s really excited to be here with you today. I was able to grab some time with our chief medical officer Dr. Josh Trutt, and hopefully over the next couple of weeks and months and many years, we’re gonna have an opportunity to have a lot of conversations about, how we can know what we should be doing to help our bodies, and where I’d like to start just because I learned so much from you in this process, and so much of it is information that I really think we should all know. One of the most impactful things that were was around the concept of what we now call, form dose and quality as it pertains to dietary supplements. I think that the question that comes before that is what should I be taking, what actual vitamin or mineral should I be taking. We’re gonna adjust that in another video, because it’s a much take a little while. But in particular this is actionable information that you guys can use around what is the proper form, what is the proper dose and how do we actually discern the quality. So Dr. Trutt, I’d love to understand you know, explain to me again this concept of form. What does that mean?
Form, Dose, Quality
Interviewee (Dr. Josh Trutt): Sure. You know, one of the common misconceptions out there about vitamins is that for example, vitamin E is vitamin E, and in reality there are at least eight types of vitamin E, eight forms of vitamin E. So four of them are in a family of molecules called took overalls, Alpha, Beta, Gamma, Delta it’s called overall and the other four are called tocotrienols. Alpha, Beta, Gamma, Delta, tocotrienols. For many years, for decades the only version that you would find in supplements was alpha tocopherol. The other seven were ignored, and over time studies came out showing that high doses of alpha tocopherol are not good for you, that they may increase cancer risk. So my job as the doctor is, when a patient comes to me say, hey this story just came out in the New York Times that says I shouldn’t be taking vitamin E, it’s gonna increase my risk of prostate cancer. My next question is, Oh, what form was that study done and invariably when it comes to my minions turned out to be alpha tocopherol. So depending what you want, you know those forms do different things and if you’re interested for example in cancer prevention, you’d be much better off using Delta tocotrienols and that’s not commonly found, I’ve never seen it in the multivitamin, it can be obtained as a standalone product from very good sources and that would be my [02:38 inaudible].
David: And I think that’s such a good example to me, it’s the one that really made it hit home is that vitamin E has at least eight different forms and they’re not created equal, and I as a layman now I kind of have a better idea of what I should be looking for on the label of it, like I should feel to read at least label and say [02:57 inaudible] what does it say in the parentheses, what form is it? And I think what we’re saying is that we want to look for something that in its proper form is a dope Delta total tocotrienol. So it could tells into the second question which became really important to me is in my learning process which is around dose. So one of the things that I think a lot of us here is that, oh why do I take vitamins it’s just going to give me really expensive [03:29 inaudible] and it seems as though that’s actually a more complex answer which is first of course are you taking the right thing, and then are you taking the right form and then there’s this question of dose.
Dr. Trutt: Yeah, so that’s a multi-layered answer. One issue with dose is that a lot of supplements are not well absorbed, particularly plant-based supplements like turmeric or milk thistle. So milk thistle if you swallow it, it’s been well studied to have benefits on detoxification and liver function, but it doesn’t absorb very well. So some companies have found that if you find it to phosphatidylcholine, which is a type of healthy fat that your cell membranes are made of then that phosphatidylcholine will serve as like a water taxi and carrying the milk thistle into the cells where it can help you. So that’s a great example where what form of milk thistle should I be using. Well I should be using one that’s about to phosphatidylcholine, but the next question is okay, how much? Well studies have been done on that in many cases, you have to find a brand where the companies that manufacture it have done human trials something called a peak a study or a pharmacokinetic study, which means we gave them three doses and then we drew their blood, we saw how much of it absorbed and we looked at their liver function test and see if it improved. Right? So it’s not a mystery, for many supplements it’s not a mystery, how much you need, you shouldn’t be guessing and just say, “well, I’ll get this bottle off the shelf and I’ll take some.” [05:08 inaudible] two to four capsules a day. What is it? Two. Is it four? So these things have been worked out for many-many supplements and my job is figuring out reading those studies and using the exact amount that was eaten that study and say, “hey, this is beneficial for humans.”
David: Right. And I think that’s again one of those things are so interesting to me is that first, there is real research out there, and we should be using it. These are peer-reviewed scientific research papers, and in many cases using human data, human child data as opposed to just being in a laboratory with my store or some other mechanism, and that ultimately brings up to me kind of the third big question which is, if we are taking the right thing, which again we’re going come back to that, in its proper form and its proper dose how do we start to protect ourselves against understanding quality and knowing that we’re getting something, because just it’s on a you know a shelf at the grocery store or on a website somewhere, how do we really know what [06:14 inaudible] should be right?
Dr. Trutt: Right. So there are simple things where you can look at the bottle and make sure it says CGMP, you know that it’s certified that they’re using good manufacturing practices, but for consumers there are many companies that are putting out good products, but it’s also well-known that there are quite a lot of supplements that don’t really continue in the bottle, what it says on the label. So things that you can use to protect yourself, you want to use a brand that’s been independently tested by a third-party and there are two ways that a consumer can figure that out. One is there’s a website called Emerson Ecologics, and they have something called a quality program, so you can go to their website and click on the quality program and they will show you a list of all the companies that have submitted to independent third-party testing. If it’s a product where there are things from many different companies that are being put into one, because one of the best form of Delta tocotrienol and the best form milk thistle and that couldn’t all be obtained from one company, because they’ve packed it, they want to know that a third party is working with the group that’s putting all the supplements together, and testing those and that should be readily available on their website, should be able to figure that out.
David: And is there anything on the label that we should look out for in terms of just things that you should know.
Dr. Trutt: Well you want to make sure that obviously you look that there are no added well fillers is the common thing. I have a lot of patients that come to me that say, “hey, listen I don’t want to take magnesium steroid, you know I’ve heard that magnesium steroid just kind of like soap when it gets into your body, I want to use an organic rice filler” because they do need to use like flow [08:07 inaudible], if when you’re mixing a number of ingredients, there’s to be something you never keep it from all gumming up in the machine, so you want something that’s organic obviously one GMO, and most of us want stuff that’s gluten free, so there are a number of things like that that are easy to check.
David: So yeah, and I think that’s so interesting and you’re thinking about how these things are compiled and where they come from and independent testing. Some of these things that we as consumers especially as we’re all getting more cognizant to what we’re eating if it’s organic or not or what water were drinking you know, these are things that should be more regularly available to us, and I appreciate you taking the time to answer that question for us. Thank you guys for joining us. We’re going to have a whole bunch of other conversations here with Dr. Trutt, because I am always asking questions, Doc really appreciate your time, and we’ll talk to you guys soon leave a comment or note and let us know if you have any additional questions or anything that we can help answer, we are always here to help. Thanks.
Dr. Trutt: Thank you.