Nutrition Should be Prescribed, Not Peddled

Beware of any company that sells opportunity and not product. Nutrition should be prescribed, not peddled. Reputable companies sell only to health care professionals, because they don't want their products hawked. When products are peddled, the focus shifts from quality products and the health of the individual to marketing and profits.

There are no "cookbook" approaches to optimal health. Nutrition that is peddled uses a "cookbook," or "one-size-fits-all" approach. Functional medicine practitioners have the knowledge, skill and tools to individually assess and tailor nutritional programs. They should select only products that are proven safe and efficacious in therapeutic strengths. A thorough and careful history should be the basis of all nutritional interventions. The health care professional is best able to do this. That is why I do not give professional advice over the phone based on a set of symptoms, and I do not adjust people because they have a "crick" in their neck. Symptoms are a flag for further evaluation and systematic assessment in order to tailor specific, individualized, intervention programs aimed at the cause, not just the symptoms. To not do so is malpractice. It puts the patient at risk and is unprofessional.

Health care professionals and patients are bombarded with inflated claims and hyped advertising from thousands of nutritional companies. Many practitioners with whom I deal are just as confused as their patients, and although they may feel a patient is a candidate for nutritional intervention, they do not know how to discern quality. Also, many doctors feel overwhelmed by requests from their patients to evaluate the quality of newer companies or products.

I always keep an open mind to new products and companies, but I have found that by just asking a few key questions, I eliminate 95 percent or more of the companies out there. When a patient asks me to evaluate a new company or product, or if they are trying to sell me (an ever-increasing phenomenon), I ask a few basic questions about quality control. It is amazing how many companies and people make claims of quality for their products, but are unable to document or substantiate them. You never hear about them again, which is fine by me.

Here are some features to look for to differentiate between quality nutritional companies and others.

1. Every batch is assayed after manufacturing by a third party for product content. Many companies assay their product before manufacturing and guarantee what they put into the process; however, they don't guarantee what comes out. Many ingredients are unstable, and a portion inherently gets lost or destroyed in the manufacturing process. Sometimes, by changing the manufacturing procedure, you can minimize this; in other situations it is unavoidable, and the only way to combat the loss is to compensate by increasing the amount of raw material put into the manufacturing process (which of course, is more expensive). Descartes said "to measure is to know." Companies that don't perform after tableting assays may unknowingly put products out that contain much less than their label claims. Product assays should be done by high-pressure liquid chromatography (HPLC) and other scientifically accepted measures.

2. Products are tested for pesticides, heavy metal, microbial and pharmaceutical adulteration and contamination. This is especially important in herbs, which can be infected by various microorganisms and yeasts that can cause ill health. Because the rhizomes (roots) of herbs concentrate minerals (and heavy metals), many herbal products on the market are tainted with mercury and other heavy metals. Finally, some Chinese herbs are tainted with pharmaceutical drugs, and it is imperative that your source for these herbs screens for these contaminants. It is possible that the cases of severe reactions to herbal products were actually due to heavy metal or pharmaceutical contamination of these products. It is possible to get more mercury from one serving of herbal products than from amalgram fillings, yet there is little attention being paid to these phenomena.

3. Products should undergo dissolution tests, meaning that they are proven to be absorbable by the body. These tests should be more than the acid/vinegar tests, and should be USP (U.S. Pharmacopoeia) adhered-to tests for pH and stimulated peristalsis (churning) of the stomach.

4. The company uses the most "bio-available" substances (which aren't the least expensive). For instance, most products use calcium carbonate, an inorganic mineral. Inorganic minerals may inhibit the absorption of other inorganic minerals in the diet. Furthermore, these minerals may block certain oral medications, reducing their availability (e.g., thyroid medication). Also, inorganic minerals frequently cause gastric irritation. The most bio-available minerals are fully reacted, true amino acid chelates. Even though true mineral chelates have 2-3 times the absorption rate, their LD50 value (a lethal dose for half of a population) is two to three times as much. For instance, approximately 225 mg of ferrous sulfate (inorganic iron) can kill an infant; however, it takes over 800 mg of ferrous glycinate (a true amino acid chelate) to cause death. Because there are no regulation standards, many companies claim to have amino acid chelates; however, you should check for a patent.

5. The company uses no unnatural fillers or binders. A common practice with low-grade supplements is to coat the pill with shellac, which virtually makes the pill indigestible, to extend shelf life. Many cheaper excipients are allergenic and may cause uncomfortable symptoms in sensitive individuals.

6. The company is in the health business, not the pill business. In other words, their priorities and focus are aligned with the needs of the practitioners and patients. Reputable companies will never put practioners' reputation at risk or patients' health at risk by releasing ineffective, unsubstantiated products. Most outlets for cheap supplements are trained in margins, not health.

7. The company has a commitment to research, and their research team, not the accounting team, designs the products.

8. Does the company make products that contain therapeutic amounts of the listed ingredients? Another common practice for companies is to use a lot of a little bit of everything. The problem with this "shotgun" approach is that nutrients are added to a product just so they can appear on the label ("window dressing"), but are too low in potency to have any therapeutic effect. Just because a product claims to have this or that in it, doesn't mean it is bio-available or in therapeutic amounts. Reputable companies only put out products that are therapeutic, thus not misleading the consumer, who is often not able to discern what the true therapeutic levels are for a nutrient.

9. Use a company that conforms to the FDA's good manufacturing practices (GMP).

These are just a few of the key features functional medicine practitioners look for when selecting nutritional products for their patients and practice. Patients should get their nutritional products from you because you choose the highest quality and safest products that they cannot get elsewhere, and because you have the knowledge and expertise to tailor their chiropractic and nutritional programs to their needs, while being able to monitor their health in an ethical and caring environment.

Do quality products cost more? Yes. The honorable John Ruskin (1819-1900) had this to say about price:

It is unwise to pay too much. But it's worse to pay too little. When you pay too much, you lose a little money, that is all. When you pay too little, you sometimes lose everything, because the thing you bought was incapable of doing the thing it was bought to do. The common law of business balance prohibits paying a little and getting a lot. It can't be done. If you deal with the lowest bidder, it is well to add something for the risk you run. And if you do that, you will have enough to pay for something better. There is hardly anything in the world that someone can't make a little worse and sell a little cheaper - and people who consider price alone are this man's lawful prey.

If you recommend a product to a patient, make sure that you have done the research to ensure you are giving the highest quality, and the safest, most efficacious product. After all, you aren't selling bottles or pills. You are selling the services and products your patients want and the expertise they need to achieve health. Your reputation and your patients' health are on the line.

The most expensive product is the one that doesn't work!

Nicholas Calvino,DC
Pleasant Hill, CA adjustme@cyberdude.com
http://www.drlowe.com/nutrition/drcalvino/drcalvino.htm