Many people ask me about medical grade supplements vs. over-the-counter (OTC) supplements that can be purchased at outside stores or online. Is your OTC multi-vitamin the same thing that you can get at a medical office? In a word- no.
One reason is that over the counter vitamins are not regulated by the government. A recent expose` showed that some OTC supplements that were called gluten-free had gluten in them, some that said they contained a certain amount in a capsule had less than the amount listed, and one didn’t even contain the ingredient listed on the label at all! There are literally thousands of OTC supplement companies, and they all say the same things about their products – pure, high quality, etc., etc. – but usually they are not able to back up those claims. OTC and MLM supplement companies are good at marketing their products, and have huge marketing budgets for flashy ads and materials, but this does not mean that they are good.
People often come in to my office with a bag of OTC supplements that they are taking, frequently from a company that their friend or co-worker recommended. They always think they are getting a great product. They always ask me to verify their supplements, and I always have to tell them that I cannot vouch for the quality of that product at all.
These same patients are often shocked when we do their micronutrient test, and find that they are low or completely deficient in X, Y, and Z, and they tell me that they have been taking X, Y, and Z for years!
One reason that OTC supplements are not the same has to do with the ingredients themselves. For example, many people don’t know that there are often multiple forms of a single vitamin – from cheap and synthetic, to more pricey but natural and much better for you. OTC vitamins almost always use the cheap and synthetic forms. For example, folic acid is a cheap and synthetic form of the naturally occurring vitamin folate, and many people (due to common genetic mutations such as MTHFR) need the methylated natural forms of their B vitamins, including methyl folate and methyl B12. Folic acid can actually block the folate receptor and prevent it from responding to the better, more natural vitamin folate. Vitamin B6 (pyridoxine) is better as the more expensive P5P (pyridoxine-5-phosphate). Vitamin E is better as the pricier mixed tocopherols as opposed to alpha tocopherol only, and so on. Medical grade supplements usually contain the best forms of these vitamins, to ensure that your body is getting the most natural and effective form of the vitamin – even if it costs a little more.
Another big reason that OTC vitamins are not the same as medical grade vitamins is the concentrations found in the product. For example, Motrin (Ibuprofen) used to be a prescription drug only, and was 800 mg per pill. When it became available OTC, they lowered the dose to 200 mg. Vitamins are often the same, with much lower doses being the norm in OTC products. For example, in fish oil pills, OTC products usually say “1000 mg per pill!” in big letters, so that people think they are getting a lot. In reality, the most important part of that fish oil is the omega-3 fraction of the oil. In OTC fish oil, there is usually only around 200-400 mg of omega-3 (EPA + DHA) per 1000 mg of oil in a capsule. Since our daily goal for EPA+ DHA should be 1500 – 2000 mg per day, you would have to take 5-10 of those OTC fish oil pills to get what you need, as opposed to usually 2 of the medical grade capsules, so the OTC products aren’t really cheaper at all.
The bioavailability of OTC products is also often a big problem. Many of the “one-a-day” kinds of multivitamins, have small amounts of lots of different things crammed into one small pill – so that the label looks good, and again, people think they are getting a lot. In reality, many of those compacted pills are excreted in the stool undigested and unabsorbed, because they compacted so tightly, that they don’t even dissolve well.
Another way that OTC products “fool” the public is by saying that they are “100% RDA” of something. I semi-jokingly tell patients that if their vitamin says 100% RDA, that is a weak or pathetic vitamin. In reality, the RDA (recommended daily allowance) is the amount of a vitamin that you would have to get, in order to not have a vitamin deficiency disease. The amount of that same vitamin that you need to be optimally healthy, is often many times more.
The other thing that many people do not take into consideration is that individual need for a given nutrient is different than just measuring a blood level of that nutrient. Just because you are in the normal range on a vitamin blood test does not mean that you are getting enough for your individual genetic and health situation. Integrative doctors are well-versed in that kind of analysis.
Medical grade supplements are manufactured to the same strict standards as pharmaceutical drugs. OTC supplements cannot say that. Integrative doctors prescribe vitamins, minerals, and other nutrients the way other doctors prescribe drugs. We are intentionally trying to alter your biochemistry. The difference is that we are doing it in a safe and natural way to optimize your biochemistry, instead of messing it up with a drug. In summary - in order to carry the supplements that I do at my office, I have to show an active, current medical license. Can your health food store say that?