Optimum Nutrition Therapy
Food as Medicine – Food as Pleasure
Choosing the Best Supplements

Vitamin supplements can be very beneficial to our healthy eating in a stressful twentieth-century lifestyle. But not all supplements are the same. Analysis of a wide variety of multi-vitamin tablets to find out how much it would cost to get the basic optimum vitamin requirements produced a range between 20 cents and over $7.50 a day! And with so many supplements available, all promising perfect health, it’s easy to become confused. For instance, if you’re looking for a simple multivitamin preparation to meet the basic optimum requirements, you have at least twenty products to choose from. So picking the right supplements is an art in itself! This section explains what to look for in a good supplement.

While the golden rule of any supplement program is to achieve the right doses and take these regularly, there are many other issues to consider when choosing supplements. Is it better to have natural rather than synthetic nutrients? Are capsules better than tablets? Are certain forms of minerals better absorbed? Are there good and bad combinations? What if you’re on medication - are there any drug-nutrient indications or situations when you shouldn’t take supplements?


A great deal of nonsense has been said and written about the advantages of natural vitamins. First of all, many products claiming to be natural simply aren’t. By law, a certain percentage of a product must be natural for the product to be declared ‘natural’. The percentage varies from country to country. By careful wording some supplements sound natural but really aren’t. For instance, ‘vitamin C with rosehips’ invariably means synthetic vitamin C with added rosehips, although it is often confused with vitamin C from rosehips. So which is better?

By definition, a synthetic vitamin must contain all the properties of the vitamin found in nature. If it doesn’t then the chemists haven’t done their job properly. This is the case with vitamin E. Natural d-alpha tocopherol succinate is 36 per cent more potent than the synthetic vitamin E called dl-alpha tocopherol (in this case the ‘l’ dictates the chemical difference). So natural vitamin E, usually derived from wheat germ or soy oil, is better.

However, synthetic vitamin C (ascorbic acid) has the same biological potency as the natural substance, according to Dr Linus Pauling, although chromatography and Kirlian photography have shown visible differences between the two. No one has yet shown that natural vitamin C is more potent or beneficial to take. Indeed, most vitamin C is synthesized by taking a ‘natural’ sugar, such as dextrose; two chemical reactions later you have ascorbic acid. This is little different from the chemical reactions that take place in animals that convert sugar to vitamin C. Vitamin C derived from, say, acerola cherries - the most concentrated source - is also considerably bulkier and more expensive. Acerola is only 20 per cent vitamin C, so a 1,000mg tablet would be five times as large as a normal tablet and would cost you ten times as much!

It is true that vitamins derived from natural sources may contain unknown elements that increase their potency. Vitamin E, called d-alpha tocopherol, is found with other tocopherols, beta, gamma and delta tocopherol. So the inclusion of these with a measured amount of d-alpha tocopherol may be of benefit. Vitamin C is found in nature together with the bioflavanoids, active nutrients that appear to increase the potency of vitamin C, particularly in its capacity of strengthening the capillaries or tiny blood vessels. Good sources of bioflavanoids are berries and citrus fruit, so the addition of citrus bioflavanoids or berry extracts to vitamin C tablets is one step closer to nature.

It is possible that yeast and rice bran, which are excellent sources of B vitamins, also contain unknown beneficial ingredients, so these vitamins are best supplied with yeast or rice bran. Brewer’s yeast tablets or powder are far less efficient ways of taking B vitamins than B Complex vitamin supplements with a little added yeast - one would have to eat pounds of yeast tablets to get optimum levels of B vitamins. However, watch out for yeast. Some people are allergic to it and if you react badly to any vitamin supplements it could be yeast causing the problem. For this reason many supplements are yeast-free.

There are many other potentially helpful substances that may be provided with nutrients in a complex. Included here are co-enzymes that help to convert the nutrient into its active form. Vitamin B6 needs to be converted from pyridoxine to pyridoxal-5-phosphate before it becomes active in the body. For this reason a number of B6 supplements contain zinc. There are now supplements of pyridoxal-5-phosphate which should, theoretically, be more usable. Time will tell how much of an advantage these innovations will prove. But the key point is to make sure you get enough of each of the essential nutrients.


The general rule is to take supplements with food. This is primarily because the presence of stomach acid helps many minerals to be absorbed and the fat soluble vitamins are carried by fats or oils, present in most meals. Nutrients do, however, compete for absorption. For example, if a person wanted to absorb a large amount of a specific amino acid such as lysine (good for the arteries and for preventing herpes) more will be absorbed if it is taken on an empty stomach or with non-protein foods such as a piece of fruit. Similarly, a tiny mineral like selenium will be absorbed better on its own than as part of a multi-mineral.

However no-one wants to end up taking each supplement separately so, unless you have a specific need or deficiency and want to maximize absorption by taking the nutrient on its own, spread your nutrients out through the day and take with meals, as nature intended.

There is, however, always one exception. If you want to take the alkaline-forming ‘ascorbate’ type of vitamin C in quite large doses (3 grams plus a day) take it away from meals to avoid neutralizing stomach acidity. If you ever experience a burning sensation after taking vitamin C as ascorbic acid (a weak acid) one possibility is that you have some gastrointestinal irritation or even an ulcer. See your doctor and have this checked out. While vitamin C helps to heal wounds the acid form can irritate an existent problem and should be avoided.


There are very few dangerous drug-nutrient interactions, however there are many drugs which interfere with the action of nutrients, increasing your need.

  • Aspirin increases the need for vitamin C
  • The birth control pill and HRT increase the need for B6, B12, folic acid and zinc
  • Antibiotics increase the need for B vitamins and beneficial bacteria
  • Paracetamol/Ibuprofen increases the need for antioxidants

  • Potentially dangerous combinations are:

    • Warfarin (a blood thinning drug), aspirin, vitamin E and high EPA/DHA fish oils. These all thin the blood and the combined effect is too much. It is better to reduce the drugs and increase the nutrients, but first check with your doctor.
    • MAOI anti-depressants (such as Nardil or Parstelin) and yeast containing supplements. Yeast and alcohol and specific foods must be avoided while on these drugs.
    • Anti-convulsants and folic acid. Some of these drugs are anti-folate, creating an increased need, yet supplementation can impair the action of the drug. Specialist advice from your doctor and nutrition consultant is recommended. For epileptics be careful of supplementing the brain nutrient DMAE or high dose essential fatty acids such as evening primrose oil.
    • Folic acid without B12. In cases of B12 deficiency supplementing folic acid can reduce symptoms while the underlying deficiency gets worse. Therefore, it is best to supplement both nutrients, preferably as part of a B complex.


Supplements often contain other ingredients necessary for their production. While capsules don’t really need anything added, tablets usually do to allow the ingredients to stick together to form the tablet. Tablets start off as powders. To get the bulk right ‘fillers’ are added. ‘Binders’ are added to give the mixture the right consistency and lubricants are also used. Only when this is done can the mixture be turned into small, uneven granules, which are then pressed into tablets under considerable force. Granulating allows the mixture to lock together, forming a solid mass. The tablet may then be coated with a ‘protein coating’ to protect it from deterioration and make it easier to swallow.

Unfortunately, many tablets also have artificial coloring and flavoring added, as well as a sugar coating. For instance, many vitamin C tablets are made to look orange and taste sweet, since we associate vitamin C with oranges! Vitamin C is naturally almost white and certainly isn’t sweet - and nor should your supplement be. As a rule of thumb, only buy supplements that declare their fillers and binders (sometimes also called ‘excipients’). Companies with integrity are usually only too happy to display this information. The following fillers and binders are fine to use and some add extra nutritious properties to the tablet:

  • Dicalcium phosphate - a natural filler providing calcium and phosphate
  • Cellulose - a natural binder consisting of plant fiber
  • Alginic acid/sodium alginate - a natural binder from seaweed
  • Gum acacia/gum arabic - a natural vegetable gum
  • Calcium or magnesium stearate - a natural lubricant (usually from animal source)
  • Silica - a natural lubricant
  • Zein - a corn protein for coating the tablet
  • Brazil wax - a natural coating from palm trees

Stearate, which is the chemical name for saturated fat, is used as a lubricant. The cheapest source is from animal source, although non-animal source stearates are available. If you’re a strict vegan/vegetarian you may want to check this with the supplement company. If a product is labeled ‘suitable for vegans’ it cannot legally contain any animal source ingredients.

Most large tablets are coated. This makes them shiny, smooth and easier to swallow. This isn’t so necessary with small tablets. If a tablet is ‘chalky’ or rough on the outside then it isn’t coated. Coating, depending on the substance used, can also protect the ingredients, increasing the shelf-life. Avoid sugar coated, artificially colored supplements. Natural colors, for example from berry extracts, are fine.

Occasionally, a manufacturer over-coats a batch of tablets and, particularly for those with poor digestion or a lack of stomach acid, this can inhibit the tablet’s disintegration. Most reliable companies check the disintegration time of each batch to rule out this possibility.

 Many of the better supplements will also declare that the product is free from sugar and gluten. If you are allergic to milk or yeast do check that the tablets are also free from lactose (milk sugar) and yeast. B vitamins can be derived from yeast, so you need to be careful. If in doubt, contact the company and ask for an independent ‘assay’ of the ingredients: good companies will supply this information. Sometimes glucose, fructose or dextrose is used to sweeten a tablet and yet the tablet still declares ‘no sugar’. These are best avoided. A small amount of fructose is the least evil if you’re having difficulty enticing a child to take vitamins. Any other preservatives or flavoring agents should be avoided unless they are natural. For instance, pineapple essence is a natural additive.

If you are vegan or vegetarian choose supplements that state this. Retinol (vitamin A) can either be derived from animal source, synthesized or derived from a vegetable source, such as retinal palmitate. Vitamin D can be synthesized, derived from sheep wool or from a vegetable source. Companies do not have to state the source of the nutrients, just their chemical form.


If you have difficulty swallowing pills or supplements this is unlikely to have anything to do with the size of your throat. Some people have a psychological aversion to pills - others simply haven’t learnt the technique.

Supplements are not drugs. As you take each one know what it does for you. Think about its positive effects. Say to yourself, for example, "this vitamin C helps keep my immune system strong." Regarding the technique of swallowing, the best time to develop this is when you are drinking a thick drink, like a protein shake. This stimulates the swallowing reflex. Between mouthfuls put the supplement in your mouth, take a mouthful of the drink and gulp it and the supplement down. Once you get the hang of swallowing it’s easy.

Supplements can always be crushed or, in the case of capsules, mixed in drinks.


Labeling laws vary from country to country, but many of the same principles stand. Depending on the ingredients, different laws apply and, since these change from time to time, many manufacturers are as confused as members of the public are! The Figure below shows a typical product. Here’s how to read the small print.

You ought not to find a multi-vitamin label as bad as this one! But it will give you some idea of what to look out for. Directions for when and how to take the tablets are given, as well as extra information and a guarantee of quality. These are the things to go for when you are buying supplements: do not be misled by an attractive-looking label or a very cheap price, but do not pay too much either!

Unfortunately, not all supplements are true to their labels, so it is not always best to buy the cheapest. Reputable vitamin companies should give you a list of all the ingredients on the label.


Not all supplements are created equal. When it comes to protecting your health, quality should be your number-one priority. In most cases the quality of the supplement dictates its effectiveness.

Quality Standards

Manufacturers are not held to the same standards as pharmaceutical companies. As a result, there are far too many ‘fly-by-night’ operations offering cheap supplements of questionable quality.

For this reason, Optimum Nutrition Therapy chose Metagenics as its supplement supplier. Quality is their top priority. They have gone so far as to self impose GMP (Good Manufacturing Practices), a very expensive, government standard, which is placed on pharmaceutical companies to ensure purity and consistent quality.

In addition, they use one or more organizations, like NNFA - The National Nutritional Foods Association, NSF International, USP – US Pharmacopoeia, TGA – Therapeutic Goods Administration of Australia, to ensure quality and safety of their products.

Be wary of companies who profess to be in accordance with GMP certification, but are not actually certified.

Evaluating Ingredients

Without quality ingredients even the best scientific formula won’t live up to its health-promoting potential.

Bargain nutritional supplements are often made from low-cost, sometimes inferior, raw materials. To verify the quality of ingredients hi-tech laboratories are necessary for comprehensive, scientific evaluation. This is very expensive and few companies are able to do this sort of testing.

Metagenics' Functional Medicine Research Center conducts human clinical trials on some of their products, and around 200 articles from their scientist and clinicians have appeared in medical journals.

We have seen the health of our client improve when using these products.


For a supplement to be good value it must be well made, well formulated and well priced. The quality of manufacture is hard to assess unless you have an advanced chemistry laboratory in your back room! However, there are four simple tests you can do:

  1. Are the stated number of tablets actually in the bottle? (We tested one company and found an average of 95 tablets instead of 100!)
  2. Is the tablet coated all round and therefore easy to swallow? (Uncoated or badly coated tablets can break up or taste unpleasant.)
  3. Does the label tell you everything you need to know? (The better the company the more information they will want to give you.)
  4. Does the company emphasize their quality control and, if asked, can they supply you with independent analyses on their products

Information in this section has been provided by world leading nutritionist Patrick Holford.