The human gut and its role in our health has become an area of intense research over the past decade - for excellent reason. You may have heard the statement “we’re more bacteria than we are human” due to the fact that we have roughly 10x more bacteria than human cells in our body. The ‘normal’ gut has hundreds of bacterial species, each of which has profound effects on our health and well-being. Some of these species are considered good, and beneficial, while others are detrimental when conditions allow them to grow out of control.
The gut plays major roles in digestion, metabolism, immunity, protection from infection, and regulates 80% of our immune system.
Granted the scope of our gut and its relationship to the rest of our body, I’m always surprised at how poorly people treat it (usually secondary to having no education on the subject). There are a few kinds of bacteria to understand first, let’s take a look at those. Each type as a ‘time and a place’, in other words, specific roles and benefits. It’s when they take over or get eliminated that start the process of digestive disruption and other health complications.
Our “Essential” bacteria (the good guys), are already inside the gut. They’re friendly, and, as stated above, play major roles in metabolism, immunity, and overall health.
The bad guys (these are also called “opportunistic flora”, because they’re normally controlled by the good guy bacteria. When gut health gets compromised for various reasons, the bad guys get their opportunity to take over and create some nasty health issues.
Transitional flora are the bacteria we get from the outside environment (through food, drink, living and breathing, playing in the mud, etc). These bacteria too can be beneficial OR not, and are kept in check normally by the good bacteria.
What are Probiotics?
Simply put, probiotics are strains of bacteria that support our native beneficial “good guys” and help prevent the bad strains from overgrowing and taking over. In cases of impaired digestion (diarrhea, constipation, inflammation, gas bloating etc) probiotics can be really helpful. Patients with inflammatory bowel diseases have about 25% less of the beneficial bacteria in their guts than healthy people. While it makes sense to introduce more beneficial bacteria via probiotics into the diet as an initial strategy, there are a few things to be aware of.
If you have established digestive disorders, work with an experienced health care practitioner rather than self-diagnose. The gut is a complex galaxy, and if infections have set in, you’ll need guidance on natural or pharmaceutical antimicrobials. You may also need to use what’s called a biofilm disruptor. Bacteria in the gut can form a biofilm, which is a protective layer the bacteria form to protect themselves from our immune system defenses.
So, in order to get the most out of probiotics, make sure you clear out any existing infections or overgrowth of bad bacteria - don’t trouble shoot this on your own. Once you’re ready to begin supplementation (symptoms have been cleared, you’re healthy to begin with, or want to protect your gut for the future) choose a brand such as THORNE, which is above and beyond anything you’ll find over the counter for various reasons:
- All products are manufactured in-house, within an FDA-approved facility following Good Manufacturing Practices;
- Analytical testing and documentation are used to ensure products are pure, potent and free of contaminants (microbes, heavy metals etc);
- THORNE is also regularly inspected by the Australian TGA (their FDA) and NSF International;
- THORNE’s Sports Performance Line is designed for elite athletes, whereby products are guaranteed to be free of banned substances;
- Regular collaboration in clinical research and product development (which means products are designed to fit actual clinical needs).
Prebiotics - laying the foundation
Another critical piece for the gut, and critical for probiotics to take hold, are prebiotics. Prebiotics are indigestible carbohydrates that reach the colon intact and feed many strains of good bacteria. Top food sources of prebiotic fibers include Saurkraut, Kimchee, and resistant starch (RS) - named such because again, it resists digestion in the stomach and small intestine, reaching the colon intact where more good bacteria can be fed. Resistant starch is highly beneficial AND supported amongst low-carb advocates.
Best food sources include potatoes and unripe bananas - however, certain flours are great sources without the extra carbs and include potato starch, plantain and green banana flour. Gram dosages can be obtained from tablespoon servings.
In summary, its important for so many reasons to nourish your gut. Taking probiotics as well as including prebiotic food sources in your diet is an excellent starting point if you’re healthy. THORNE’s FloraSport20B is a very complete formulation, of tremendous benefit for athletes and those who travel. The data is also very compelling for those suffering from antibiotic induced diarrhea.
If your gut and digestive health are compromised, see a functional medicine practitioner who can run proper labs and determine the best strategy.
MS, CSCS, CCN, CNS
CISSN Via International Society of Sports Nutrition.
This article on amino acids has been long-time coming – it’s part one of several! Among the supplements I recommend to my clients, amino acids (AA’s) are high on the list, for several reasons - some of which I’ll cover here.
Let’s start with the basics. Many people aren’t familiar with the term amino acids, or, aren’t aware of what they are.
There are three key players in the nutritional world of macronutrients (macro = something large-scale, nutrients = substances that provide nourishment essential for growth). Proteins, Carbohydrates, and Fats. Collectively, these three macronutrients (often referred to as macro’s) provide the bulk energy we need to function. Try exist without them and you’ll quickly find yourself grumpy, fatigued, and sick.
Protein can be broken down further into what are called amino acids - 20 of them, specifically. 8 are categorized as ‘essential’ because they cannot be made by the body, and thus must be obtained from the diet - these 8 will be the focus of this article. Essential AA’s are necessary to stimulate muscle protein synthesis, critical for on-going muscle recovery and growth.
The 8 Essential AA’s we’ll focus on:
Isoleucine, Leucine and Valine (collectively referred to as Branched-Chain Amino Acids, or BCAA’s, and a major personal favorite);
Maintaining what’s referred to as the “amino acid pool” in the body is critical, while being difficult without dietary intervention. Amino acids are constantly in use by the body for structural rebuilding, hormones, enzymes, and immune system chemicals. They aren’t stored in the body like carbs and fats are, thus require constant replenishment. This is possible via food, and supplemental sources. My clients and I prefer both!
THORNE’S “AMINO COMPLEX” is an excellent supplemental source of essential amino acids, complete with 1.25gms of Leucine/serving. Leucine is one of the 3 Branched Chain Amino Acids (BCAA’s) playing key roles in fat loss, muscle protein synthesis, and the preservation of lean mass during fat-loss cycles. My clients and I consume 1-2 servings of AMINO COMPLEX during training sessions, and another serving later in the day to fend off cravings and regulate blood sugar levels.
Supplement quality is critical. Low quality products will be ineffective and ingredients are unpredictable. THORNE products are one of the lines I use regularly personally and professionally – they have arguably the most comprehensive list of NSF Certified for Sport products on the market. Due to this, THORNE has partnered with many US National Teams in addition to collaborating with the Mayo Clinic. If you’re looking for world-class sports nutrition and performance products, check out THORNE’s extensive product line. You can order AMINO COMPLEX using the practitioner code HCP-1108-188. Berry flavor comes highly recommended.
Slash your recovery time with these four science-backed supplements.
Written by Ashleigh Gass, MS, CSCS, CCN, CNS, CISS N & the STRONG Editors
Dietary supplements are a hot button topic these days. With sports nutrition becoming more mainstream, a lot of us are wondering if popping the right pills can really help with everything from muscle building to a faster recovery, and if so, which ones are best? Although numerous studies have recently questioned the quality and reliability of some brands of pills and powders, plenty of science still backs the benefits of supplementation when it comes to post-workout recovery, particularly when supported by a sound nutrition strategy.
Check out the full article here: View PDF
This article was just released in STRONG Fitness magazine, in their digital training guide for this quarter.
HOW DO YOU GET PUMPED UP FOR A GOOD WORKOUT?
Do you throw some high-energy tracks on your playlist and blast it on your drive to the gym? Or do you watch the latest viral fitspo video circulating the Internet? Or are you like a growing population of fitness buffs that turn to a pre-workout formula to help get you through the grind?
Check out the full article here: View PDF
Till next time,
Brilliant Fitness and Nutrition, INC.
MS, CCN, CSCS, CISSN, Pn1
Certified Strength and Conditioning Specialist
Medical Exercise Specialist
Certified Sports Nutritionist from The International Society of Sports Nutrition
Masters: Human Nutrition
Certified Clinical Nutritionist
Ashleigh was just featured in Florida Fitness Photography Magazine.
Click the link below to check out the interview!
This new eBook was written by Dr Francisco Torres and Ashleigh Gass and is a practical approach to weight loss, health, and more!. It is now available on Amazon... Here is a link where you can download your copy today! Click Here
This book is dedicated to all those who are working on managing weight for a healthy lifestyle. Your perseverance encourages us. When times get tough, remember that you can and will win. Thrive to be forever young!
This is an example of one client that has flourished in part because Ashleigh taught her years ago to follow key points covered in this book...
In September, 2012, I was referred to Ashleigh. For a few years, I’d really been having challenges. Kidney transplant in 2005, hysterectomy in 2011, years of immune compromise, with a frozen shoulder to boot. At that time, I was also on full dose medications for infections, chronic shoulder and neck pain, and an immunosuppressant drug called “Prograf”.
Ash dove in and did numerous assessments, in addition to communicating with my doctor. Nutritionally, we changed a fair bit and really worked to boost my immune system. On the training front, we did a lot of injury prevention work while also improving my overall strength. She referred me to Dr. Joe Giovatto, who did my A.R.T soft tissue work on the side, making a huge difference with the shoulder. I am eternally grateful for their work – the only option presented to me by my physical therapist was a surgical procedure called “manipulation under anaesthesia”, because my shoulder “wasn’t getting better”. Thank God I didn’t take that path. This shoulder injury usually takes 20+ months to heal – Ash and Dr. Joe did it in less than 9 weeks.
It’s been several months now, I have my health and flu strength back. My doctor was literally shocked at the recent lab tests, which were so good he’s lowered my dose of Prograf. First time in 8 years that’s been possible, and it’s mostly unheard of. Instead of getting sick a lot and having a frozen shoulder, I fight off infections easily (while doing chin ups and squats!!). My quality of life is better than it’s been in years, and I am HAPPY!!
I am strong, happy, awesomely well, and have the ability again to LIVE LIFE.
Download your copy today from Amazon! Click Here
Medicare Ruling Levels Playing Field Among Nutrition Professionals and Registered Dietitians in Hospitals
June 11, 2014
CHICAGO, IL—A landmark federal ruling that all qualified nutrition professionals—not just Registered Dietitians—may order therapeutic diets in hospitals, has leveled the playing field between nutrition professionals and Registered Dietitians.
The U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid (CMS) ruled [i] that:
“all patient diets, including therapeutic diets, must be ordered by a practitioner responsible for the care of the patient, or by a qualified dietitian or qualified nutrition professional as authorized by the medical staff and in accordance with State law.” [emphasis added]
The ruling adopts the Board for Certification of Nutrition Specialists’ (BCNS) formal recommendation to CMS that qualified nutrition professionals obtain any privileges granted to Registered Dietitians.
The ruling goes on to state:
“We agree with commenters that the regulatory language for § 482.28 should be inclusive of all qualified nutrition professionals. We do not agree with commenters who requested that we use the term “registered dietitian” or define “qualified dietitian” as an individual specifically registered with the Commission on Dietetic Registration. We agree that a more flexible approach would be the best way to ensure that patients benefit from the improved quality of care that these professionals can bring to hospital food and dietetic services.” [ii] [emphasis added]
“This ruling has vast implications for the nutrition profession,” said BCNS President Sidney Stohs, PhD, CNS, FACN, ATS. “It embraces the right of a variety of highly qualified nutrition professionals—such as Certified Nutrition Specialists—to practice in hospitals, and rejects the assertion that Registered Dietitians should have an exclusive right to provide medical nutrition therapy.”
“Most importantly,” said Dr. Stohs, “this ruling is a victory for patients, giving hospitals flexibility in determining which type of nutrition provider will best serve its patients’ health.”
The Board for Certification of Nutrition Specialists (BCNS) is the foremost credentialing body for advanced nutrition professionals. Its Certified Nutrition Specialist® certifying program is accredited by the National Commission for Certifying Agencies (NCCA), the preeminent standard of excellence for certifying bodies, and is featured in the U.S. Department of Labor’s Definition of the Nutritionist Profession. The BCNS’ Center for Nutrition Advocacy is the leading advocate ensuring public access to a range of nutrition professionals.
More detail on the final rule and implications are available at BCNS’ advocacy initiative, the Center for Nutrition Advocacy: NutritionAdvocacy.org/recent-rulings
[i] Final Ruling on Regulatory Provisions to Promote Program Efficiency Transparency, Efficiency and Burden Reduction. May 12, 2014.
[ii] Centers for Medicare & Medicaid Services
42 CFR Parts 413, 416, 440, 442, 482, 483, 485, 486, 488, 491, and 493
Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction; Part II p 45
A little while back, I wrote an article called "Great Guts", where I covered the basics of our gastrointestinal (GI) system, otherwise known as the "second brain", and the "enteric nervous system". Ever wonder why our GI system is referred to as the "second brain"? It's because this organ system has its own, independently working lymphatic and nervous systems - and a huge amount of whole-body resources dedicated to it (2).
In "Great Guts", I focused primarily on the big picture of the GI system, covering the basics of structure and function as a whole, the importance of its health, and a bit about what can happen when it's sick. Briefly, I outlined some steps necessary to improve it, which included food and supplement strategies.
A few clients as of late have inspired this next article. On the positive side, clients whom, after restoring healthy gut bacteria, have finally rid themselves of allergies and asthma, while reducing inflammatory markers and losing fat (around the abdomen, mainly). On the "makes me insane" side, a couple new clients who, either themselves, or, their family members, insist they need to have their gallbladder removed. Having "pain", or "gallstones" are a couple reasons this occurs (removal of the gallbladder is quickly becoming the number one surgery in the US). One of these clients (let's call him Jack) was told by his primary care physician that he HAD TO have his gallbladder removed. I quickly referred him to another local MD who specializes in nutritional/preventative medicine. Jack didn't have anything wrong with his gallbladder at all - what he had was a bleeding ulcer. Yep - choke. Upon treatment of this, his symptoms quickly resolved and he's back in action - gallbladder intact!
Rather than unwind why the organ is sick and diseased in the first place, conventional medicine, combined with lack of responsibility on behalf of the patient to dig deep and get second opinions - the gallbladder is removed. And at that point, long-term complications really begin to brew. Complications for the rest of the GI system - because the patient will continue to live in the EXACT manner that created a sick organ in the first place. This usually happens because our current, typical mainstream medical community spends exactly ZERO time educating patients on what the heck caused problems in the first place.
Due to the above inspirations, this article will focus more on the symphony of the GI system - how the various organs communicate with each other, and why you want to do all in your power to keep them.
Let's continue on the gallbladder kick, and take a look at what this organ does. Actually, let's take a look at the liver, pancreas,and gallbladder as a system - because they work together. First, a picture, so you can see where these organs are relative to one another.
Most of you know that the liver detoxifies stuff - stuff like alcohol. Everybody knows on some level that a night of drinking kicks the liver into overdrive. Beyond detoxification though, the liver has an important role in digestion: it produces and secretes bile - about a pint of it daily. Bile is made up of bile salts, bile pigments, and cholesterol, and is responsible for the emulsification of fats. Emulsification is the process of breaking large molecules of fat (incoming from the diet) into smaller molecules that can be digested. So, now you know that the liver does more than just detoxify stuff.
The gallbladder works with the liver by storing about half its bile (the small intestine stores the other half), until dietary fat arrives. When it does, the gallbladder releases bile into the small intestine. When bile is stored for too long in the gallbladder, stones can form, and warning signs begin (some of these signs include pain when pressing on the gallbladder, gallstones on an ultrasound, and greasy, loose stools). If this process is allowed to continue, and reasons for gallbladder dysfunction aren't addressed, it can become infected and may HAVE TO be removed.
Removal presents serious complications long-term, however. Complications arising from significant handicap in the digestion of dietary fats (including the beloved family of omega-3 fatty acids), and major essential fatty acid deficiencies. This can lead to increased inflammation in the body, which opens the gate to bigger, meaner problems.
Gallbladder removal as a primary 'treatment' strategy would have been like the neurosurgeon amputating my leg below the knee to 'treat' the temporary loss of sensory and motor function of my foot and calf, secondary to a 7mm disc blowout at L5-S1. When that disc herniated, it displaced the L5-S1 nerve root, which shut down the function of my lower limb. Of course, the neurosurgeon knew that in order to take the compression off the nerve root, he needed to focus his efforts in the lower back - not amputate the leg. See where i'm going with this? Address the cause of dysfunction, rather than cutting out the dysfunction as though the body invented it out of thin air.
Now let's look at the pancreas, an organ most people associate on some level with insulin, and diabetes. When bile is released from the gallbladder, the pancreas jumps in and begins to release pancreatic juices into the small intestine. These juices contain digestive enzymes, as well as an alkaline fluid that helps neutralize stomach acid. The digestive enzymes include trypsin and chymotrypsin (they help digest protein), amylase (which helps digest polysaccharides), and lipase (which helps digest fats).
At this point, I really hope you're grasping how a few of the key organs of digestion work together, in unison, to assist the digestive process. How the liver produces and secretes bile, then transfers it to the gallbladder, which then stores it until fatty acids arrive, at which point bile is again secreted into the small intestine. And the moment bile is released into the small intestine, the pancreas "knows" to release it's pancreatic juices, loaded with digestive enzymes, to continue this amazing process known as digestion.
And now I ask you - knowing what you know now, explain to yourself why preservation of this system, the gallbladder in particular, is so critical. Really think through the implications of having this organ removed as a primary treatment protocol.
If you are having problems with digestion, or have been told you need to have your gallbladder removed, go see an MD or DO (they MUST have a subspecialty in nutritional biochemistry/preventative nutrition, etc) or a Naturopathic Physician, pronto. In the Clearwater area, here are a few of your key people: Dr. Agin, MD., Dr. Broussard, DO., Dr. Sheila Dean, RD, PhD, CCN., and Dr. Minkoff, MD.
In the meantime, pony up, clean up your diet and begin an exercise program.
Remove major food toxins from your diet: refined cereal grains, industrial seed oils, sugar, and processed soy. This stuff is found in soda, bread, commercial fruit juice, pastries and muffins. It's all making you fat anyway - extra incentive to remove it all.
Till next time,
Brilliant Fitness and Nutrition, INC.
MS, CCN, CSCS, CISSN, Pn1
Certified Strength and Conditioning Specialist
Medical Exercise Specialist
Certified Sports Nutritionist from The International Society of Sports Nutrition
Masters: Human Nutrition
Certified Clinical Nutritionist
Resources used in writing this article:
- Berardi: The Essentials of Sport and Exercise Nutrition.
- Lord & Bralley: Laboratory Evaluations for Integrative and Functional Medicine.
- Devlin: Textbook of Biochemistry with Clinical Correlations, 7th edition.
Rebuttal to recent general media articles “Skip the Supplements” and “Herbal Supplements Are Often Not What They Seem”.
Ashleigh Gass, MS, CSCS, CISSN, CCN, CNS.
Recent media articles “Skip the Supplements” and “Herbal Supplements Are Often Not What They Seem” caught my attention and inspired this rebuttal. Even though some of the information presented in these articles was correct, we weren’t given any information about the other side of the story. This is significant - because the other side of the story would have given consumers an opportunity to learn about hundreds of excellent nutritional supplement companies and their respective products. Yet again, the general public was left flapping in the breeze of misleading, incomplete nutrition articles geared towards “poo-poo-ing” the nutritional supplement industry.
Perhaps these articles were written with the intention to “protect” the public from purchasing supplements from certain companies, or to discourage people from taking nutritional supplements in general. If the former is correct, the articles would have had far greater value if they’d pointed out the many companies following stringent manufacturing practices. If the latter is correct and the articles were written to dissuade people from taking nutritional supplements in general, well, once again, specifics would have been beneficial. As opposed to painting the entire supplement industry, and supplements in general, with the same brush, clarification should have been made to differentiate legit companies from those not willing to follow manufacturing guidelines, and clinically effective supplements vs. supplements without an effective track record.
Part of the problem with these articles is that they lead to massive confusion among the already nutritionally confused general public. Even worse, what if patients receiving effective nutritional therapy from medical nutritionists, DOs, NDs, or MDs specializing in nutritional medicine become scared of their treatment protocols as a result of reading these articles? When confusion dominates, people generally reach a stand-still on that topic and do nothing, or, even worse, quit the entire thing.
Much of the confusion could have been dodged if these articles had been titled “Skip the Non-CGMP Compliant Supplements (Current Good Manufacturing Practices), or “Herbal Supplements are Often Not What They Seem When You Don’t Know What You’re Talking About”, or “Seek professional guidance when choosing supplements” or “Research highlight on supplements that work and the companies that make them”. At the very least, these articles would have been useful had they:
a. Educated the public about FDA-approved CGMPs, FDA-approved manufacturing facilities, and the various independent organizations that certify nutritional supplements;
b. Educated the public about various companies that follow the same, strict manufacturing standards found within pharmaceutical companies;
c. Educated the public about which supplements to skip, exactly;
d. Educated the public about which herbal supplements aren’t what they seem;
e. Provided appropriate resources for the public to search for companies following a, and b; and
f. Provided insight into nutritional supplements that have been proven beneficial for specific health conditions.
However, none of the above points were covered in any way, or even alluded to. Thus, we were left with a few more unhelpful, one-sided, confusing nutritional supplement articles.
My intention with this article is to give you, the consumer, correct information to think with when choosing nutritional supplements, and a few resources to research if you have a health condition you think may respond well to the assistance of nutritional supplementation. My disclaimer is as follows: personally, and professionally, I follow, and teach “food comes first”. With every client under my guidance, I work with their MD to improve various markers found in their blood work, mostly with the implementation of new food rules. Clients learn to cook and store abundant amounts of vegetables, meats, and seafoods. They learn the basic principles of nutrient timing, and the use of training/nutritional supplements deemed necessary. Key supplements are usually magnesium, fish oil, vitamin D, probiotics, and amino acids. Additional supplements are used and prescribed by the MD or RD based on symptom profile and/or lab results.
Now, let’s get started.
Part One: What are “Current Good Manufacturing Practices”, and how do we know whether a company follows them? Are there other regulatory agencies within the supplement industry?
According to the FDA, Good Manufacturing Practices are defined as:
“The Dietary Supplement (DS) CGMP (Current Good Manufacturing Practices) rule in 21 CFR part 111 (“the DS CGMP rule”) requires persons who manufacture, package, label, or hold a dietary supplement to establish and follow current good manufacturing practice to ensure the quality of the dietary supplement and to ensure that the dietary supplement is packaged and labeled as specified in the master manufacturing record”.
In short, CGMPs are a set of rules some companies voluntarily follow in the manufacturing process to ensure all raw materials used are high quality, and high purity. These rules are followed to make sure you, the consumer, are protected, and that your products have been tested for safety, and purity. When a company follows these rules, additional product tests include those for potency, purity, disintegration, weight, hardness, thickness, and stability.
Within CGMPs, there are several additional, independent organizations that offer quality testing and allow products that pass these tests to display their seals of approval. These seals of approval provide assurance that the product was properly manufactured, contains the ingredients listed on the label, and does not contain harmful levels of contaminants. Organizations that offer this quality testing include:
- U.S. Pharmacopeia (www.usp.org/dietary-supplements/overview)
- ConsumerLab.com (www.consumerlab.com)
- NSF International (www.nsf.com)
Notice the emphasis on some companies voluntarily follow. In the $28 billion supplement industry, made up of ~450 U.S. companies, about 70% don’t follow these regulations. F.D.A resources are limited, thus making enforcement a challenging process.
The articles were both correct in stating:
“The F.D.A requires that companies test the products they sell to make sure that they are safe. But the system essentially operates on the honor code” .
“The Food and Drug Administration doesn’t regulate dietary supplements as drugs - they aren’t tested for safety and efficacy before they’re sold. Many aren’t made according to minimal standards of manufacturing, and many are mislabeled, accidentally or intentionally. They aren’t often what they say they are”.
Thankfully, many companies do follow CGMPs, and voluntarily register with one, or all of the organizations listed above. These organizations are recognized by regulatory agencies at the local, state, federal and international level, and certification demonstrates that a product complies with all standard requirements. Nutritional companies who register with these organizations are subject to periodic facility audits and product testing to verify that their products continue to comply with the standards.
When a nutritional supplement company follows these guidelines, it means that the final product complies with specific standards for safety, quality or performance. Reviews typically include comprehensive formulation/material reviews, testing and facility inspections. Most certified products bear the certifier’s mark on their packaging to help consumers and other buyers make educated purchasing decisions.
When you buy supplements from companies who follow GMPs and are registered with NSF, U.S. Pharmacopeia, and/or ConsumerLab.com, you know your supplements aren’t “powdered rice and weeds”, or “contaminated with feces and urine”, or “found to contain anabolic steroids” - seriously? By gosh, I knew there was something in that protein powder from grass-fed cows I’ve been using lately.
Look for logos like these on supplement containers/bottles:
Logical next questions would be:
1. Why do some companies choose to follow CGMPs, while others do not; and
2. Which companies follow CGMPs.
It boils down to finances and ethics, basically. Ethical companies with strong financial backing care about product quality and consumer success. They follow CGMP guidelines. There are significant costs associated with “doing it right”, which can be broken down into “fixed” and “variable” costs. Fixed costs include variables such as quality control for maintaining quality procedures and implementation, and training staff to ensure exact oversight and implementation. Variable costs include the testing of raw materials for purity, potency, authenticity, microbial load, etc, and validation of certificates of analysis for all raw materials used. These fixed and variable costs will run anywhere from small millions to large millions - depending on the size of the company. Thus, financial backing has a great deal to do with whether a company follows all the appropriate guidelines. But, when they do, they:
1. Demonstrate compliance with national or international standards and regulations;
2. Demonstrate independent validation and verification of their commitment to safety and quality;
3. Increase credibility and acceptance with retailers, consumers and regulators; and
4. Benefit from enhanced product quality and safety.
What was conveniently left out of these articles was any mention of third party certification organizations such as the NSF, AOAC, and appropriate resources readers could access to determine safe supplement companies to buy from. There are hundreds of companies that DO follow GMP’s, that DO carry with them a Certificate of Analysis (C.O.A), assuring us that what’s written on the label is what’s in the bottle.
A list of 286 companies who follow NSF guidelines can be found here.
Professionally, I am a member of ARIIX International’s Scientific Advisory Board. We develop science-based products with the intention of improving people’s health. ARIIX is compliant with all CGMPs, in addition to being compliant with the AOAC (Association of Analytical Communities), the USP (United States Pharmacopeia), the FDA (Food and Drug Association), and USDA (U.S. Department of Agriculture) and the EPA (Environmental Protection Agency). And yes, it costs MILLIONS of dollars to adhere to all these regulations.
Part Two: “Approximately 50,000 adverse reactions to dietary supplements occur every year, and yet few consumers know this”.
Really? What, like loose stools secondary to high-dose vitamin C consumption, or the occasional niacin flush? Reality check - not one of the hundreds of consumers I’ve worked with had any idea that their antacid drugs completely shut down hydrochloric acid secretion by the stomach. Instead they’ve been left wondering why their mid-section resembles that of a bloated jelly donut, and embarrassed because they fart constantly. See, when you take antacids long-term, you impair digestion. The gateway to bloating, SIBO (Small Intestinal Bacterial Overgrowth), constant farting and blubber tummy opens wide.
They were also entirely unaware that the statin medications they were finger-wagged into taking blocked Coenzyme Q10 production (big problem - more on this later).
I suppose the estimated 700,000 people who end up in emergency rooms due to adverse drug reactions is totally acceptable though, right? I mean, why settle for 50,000 adverse reactions when you could knock it out of the park with 700,000.
Properly prescribed/administered drugs cause about 106,000 deaths annually, making them the 4th leading cause of death in the U.S. The opioid pain medication Vicodin, and the stimulant Adderall deserve special pats on the back - they are in the top 5 most commonly abused prescription drugs by teens. Straight off of The National Institute on Drug Abuse statistics page.
For another layer of fun here, let’s take a look at several defects in nutrient absorption induced by really common medications:
Antacids (medications to ‘treat’ acid reflux) inhibit the absorption of folate, riboflavin, calcium, iron, zinc, folate, vitamin B12 and vitamin D. Because these medications actually inhibit nutrient absorption by suppressing stomach acid production, they are now being linked to degenerative conditions such as osteopenia, osteoporosis, and macular degeneration (to name a few). The Journal of the American Medical Association (JAMA) published a study demonstrating strong associations between stomach-acid suppressing medications and overgrowth of a potentially serious intestinal micro-organism called clostridium difficile. Bloated mid-section and chronic diarrhea, anyone?.
The ever-popular cholesterol medications contribute to disease in their own special way. They prevent important enzymes from making Coenzyme Q10 (one of the most important antioxidants used by the heart, and for cellular energy production in general), and interfere with vitamin A, D, E and B12 absorption. These drugs also interfere with digestion and absorption of fatty acids, which we know to be critical in the health and maintenance of the nervous system. Cholesterol medication as the “one and only”, knee-jerk reaction to ‘treating high cholesterol’ makes as much sense as cutting off your hand to make a hangnail stop bleeding.
Weight loss medications really deserve the adverse reaction gold star. Do you also think we should “Skip the Supplements”, say, fish oil, or L-carnitine, for example, in favor of Qsymia? Qsymia, a popular prescription weight loss medication, is a nice little stack of phentermine and topiramate. It’s made clear on Qsymia’s website that:
“the precise mechanism of action of the 2 ingredients on chronic weight management is unknown”,
“Qsymia is a federally controlled substance (CIV) because it contains phentermine and can be abused or lead to drug dependence”.
In contrast, not only do we know the (many) fat mobilizing mechanisms of action behind fish oil and L-carnitine, we know that both are fairly impossible to abuse or become dependent on. Interestingly, I started working with another weight-loss client 3 weeks ago. On day 2, she runs into my office, dropping her prescription Qsymia on my desk. I’ll never forget her exact words:
“My doctor gave me these to try lose weight, they make me feel crazy. I’m giving these to you to throw away, it’s terrible stuff and I don’t want it in my home”.
I saved them for the next outrageous house party. Just kidding.
She’s since lost 15lbs, with clean eating and by-gosh, nutritional supplements. Fish oil, magnesium, vitamin D, and amino acids, specifically. Her blood glucose levels have dropped down into non-diabetic ranges for the first time in 6 years. Shucks!
Part 3: Many health conditions respond brilliantly to specific nutritional supplement intervention, and research does prove it.
The often used stance of “you get everything you need from your diet” assumes that people eat an abundance of nutrient-dense foods every single day. Those of us who work with people and actually see what they eat know this is a total joke. Step one is ALWAYS to help them improve food quality - but even then, most people benefit from supplementation. As mentioned above, the top picks are usually magnesium, fish oil, vitamin D, and training supplements such as creatine and branched chain amino acids (BCAAs).
Perhaps forgotten, perhaps conveniently tucked away, was the 2002 article published in the prestigious Journal of the American Medical Association: Vitamins for chronic disease prevention in adults: clinical applications. This article clearly states that suboptimal intake of some vitamins is a risk factor for chronic diseases and common in the general publication, especially the elderly. Among their conclusions, authors state:
“most people do not consume an optimal amount of all vitamins by diet alone. Pending strong evidence of effectiveness from randomized trials, it appears prudent for all adults to take vitamin supplements”.
Paragraph one in “Skip the Supplements” cautiously ridicules St. John’s wort and probiotics by stating:
“Parents whose children are admitted to our hospital occasionally bring along something extra to help with their care: dietary supplements, like St. John’s wort to ameliorate mild depression or probiotics for better health”.
Please, allow me to insert a few key points you seem to have overlooked.
Probiotics have become well-respected for their role in the restoration and maintenance of healthy gut bacteria (referred to as the gut ‘flora’). This article, published in the Journal of Neurogastroenterology and Motility, titled “Irritable Bowel Syndrome, Gut Microbiota and Probiotics” (2011) states:
“In recent years, numerous studies have been conducted to understand the pathogenesis and treatment of IBS. However, IBS remains one of the most difficult GI disorders to manage regardless of its benign nature. Recommending probiotics has long been an alternative to the conventional medicine for the treatment of many diseases and is an attractive treatment modality for IBS considering its low costs and favorable safety profiles. In the context of dysbiosis as the pathogenesis of IBS, probiotic treatment seems reasonable and possibly ideal as it restores the intestinal microbiota. Many studies have indicated that probiotics might play important roles in maintaining gut homeostasis by the modulation of immunity and increasing epithelial barrier function. Clinical studies and systemic meta-analyses have shown that some strains of probiotics have beneficial effects in selected patients.”
Another study, published in the Journal of Alimentary and Pharmacological Therapeutics, September 2005, titled “A probiotic mixture alleviates symptoms in irritable bowel syndrome patients: a controlled 6-month intervention” made some helpful conclusions about a probiotic mixture used. This double-blind, placebo controlled study (considered the gold standard in medical studies) tracked 103 subjects over a 6-month period. Those in the probiotic group experienced a 42% reduction in symptoms. The authors concluded:
“the results indicate that this probiotic mixture is effective in alleviating irritable bowel syndrome symptoms. Considering the high prevalence of irritable bowel syndrome and the lack of effective therapies, even a slight reduction in symptoms could have positive public health consequences”.
I’m just getting warmed up here, folks.
St. John’s Wort has been used for thousands of years as a mild antidepressant. St. John’s Wort, an herb called Hypericum perforatum, contains hyperforin, which is a serotonin reuptake inhibitor. Hyperforin crosses the blood-brain barrier, and appears to be responsible for the antidepressant activity of the herb.
“Herbal Supplements Are Often Not What They Seem”, you say? Correct - they are often times much more than they seem. Several easily found studies on PubMed (a database of medical studies, supported by the US National Library of Medicine National Institutes of Health) makes this abundantly clear:
Study 1: Phytotherapy Research, July 2013 “Hypericum perforatum: Pharmacokinetic, Mechanism of Action, Tolerability, and Clinical Drug-Drug Interactions”:
“Hypericum perforatum (HP) belongs to the Hypericaceae family and is one of the oldest used and most extensively investigated medicinal herbs. Various clinical trials have shown that HP has a comparable antidepressant efficacy as some currently used antidepressant drugs in the treatment of mild/moderate depression. Interestingly, low-hyperforin-content preparations are effective in the treatment of depression. Moreover, HP is also used to treat certain forms of anxiety.”
The second easily found article, (published in CNS Drugs, 2003) written by German Researcher, Butterweck, at The Institute of Pharmacology and Toxicology, brings further clarity to the use of St. John’s Wort:
“Extracts of Hypericum perforatum L. (St John's wort) are now successfully competing for status as a standard antidepressant therapy. Because of this, great effort has been devoted to identifying the active antidepressant compounds in the extract. From a phytochemical point of view, St John's wort is one of the best-investigated medicinal plants.”
He further states:
“recent neuroendocrine studies suggest that St John's wort is involved in the regulation of genes that control hypothalamic-pituitary-adrenal axis function. With regard to the antidepressant effects of St John's wort extract, many of the pharmacological activities appear to be attributable to the naphthodianthrone hypericin, the phloroglucinol derivative hyperforin and several flavonoids. This review integrates new findings of possible mechanisms that may underlie the antidepressant action of St John's wort and its active constituents with a large body of existing literature”.
So folks, would you prefer guidance from a professional on the use of medicinal herbs and nutritional supplements, or, be put on Zoloft, add ten pounds of weight (the average weight gain quoted on the official Zoloft website) with possible “chances of suicidal tendencies, agitation, hallucinations, coma, overactive reflexes, high or low blood pressure, nausea, vomiting, rash, hives, joint pain, swelling of the face, tongue, eyes or mouth, headache, or decreased ability to make decisions”?
On a Friday night, overactive reflexes may come in handy but I’ll pass on the rest and opt for the “often not what they seem” herbal supplements.
I’ve just clipped the tip of the iceberg here, without going into a shred of the literature on sports nutrition supplements such as creatine, branched chain amino acids, beta-alanine, glutamine, or protein. I figure it’ll all end up in another article - this one’s already 8 pages and counting!
To wrap this up, please follow these guidelines when choosing nutritional supplements:
1. If you’re buying OTC (over-the-counter) supplements, make sure the company follows CGMPs. It won’t be hard to determine this.
2. If you are wanting to treat a specific set of symptoms or suspect you’re sick, work with a functional medicine doctor, a good RD, or medical nutritionist, etc. Objective tests can determine a great deal, after which you can take professional-grade nutritional supplements without worrying about quality.
Hopefully, to you, the general public, this article has served it’s purpose and given you useful information towards your search for health, and the use of high-quality supplements. To the supplement industry, I hope it’ll help you defend your rights to make high-quality supplements that help people.
References and resources used for this article:
Dial S, Delaney JA, Barkun AN, Suissa S. "Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease." JAMA 2005 Dec 21;294(23):2989-95.
Aliment Pharmacol Ther. 2005 Sep 1;22(5):387-94.
A probiotic mixture alleviates symptoms in irritable bowel syndrome patients: a controlled 6-month intervention.
Kajander K, Hatakka K, Poussa T, Färkkilä M, Korpela R.
Age and Antacids: A Double Whammy Against Your Body’s Optimal Health.
Mechanism of action of St. John’s wort in depression: what is known?
Vitamins for chronic disease prevention in adults: clinical applications.
Retail Prescriptioin Drugs Filled at Pharmacies (Annual per Capita by Age). The Henry J.Kaiser Family Foundation.
Office of Dietary Supplements: National Institutes of Health.
National Institute on Drug Abuse: The Science of Drug Abuse & Addiction.
FDA: Dietary Supplements.