This is of course true, too, for any pharmaceuticals that health care practitioner might prescribe. But in that case, the rigorous pre-market approval process for drugs provides a higher confidence factor, at least as far as the manufacturing parameters of the product are concerned..
Reputation at stake
“Their reputation is on the line when they recommend or distribute a product. From a relationship standpoint they really rely on us to have vetted the ingredients in our products and to have really done our homework on dosages and safety issues,” Guilliams, who is the company’s vice president of scientific affairs, told NutraIngredients-USA.
This reliance on the quality reputation of a given manufacturer is true of the other avenues of supplement distribution too. But it’s heightened in the practitioner channel. In a regular supplement distribution location, the words “disease” and “treatment” ought not to appear anywhere. In a health care practice, they are central to the mission, and patients can naturally assume that if an integrative practitioner recommends a supplement, the purpose is in part to help them heal or help them avoid health problems in the future.
“Even though dietary supplements are not intended to be used to treat disease, in functional medicine integrative clinicians are using dietary supplements to bridge the gap in helping their patients to get better. Clinicians are looking for products that use the right ingredients in the right dosages, the dosages that have been used in clinical trials,” Guilliams said.
Guilliams said that while the quality control aspect of doing business in the practitioner control channel might place and extra burden, Ortho Molecular, which manufactures most of its own products, is relieved of the need to try to prove why their products are better than the cheapest multivitamin off the big box shelf.
“We do have the luxury of selling to individuals who are looking for and know the importance of that specific information,” he said.
Rigid adherence to labeling laws
Guilliams said this extra burden means that Ortho Molecular, which is based in Stevens Points, WI, must be extra rigorous when it comes to making sure their products match label claim and that all the ingredients are properly and specifically spelled out. In one sense, it is merely adhering to every syllable of the letter of the GMP regulations, but in his opinion it isn’t always done in the dietary supplement business.
Some companies that offer multi-ingredient products tend to skirt this issue, Guilliams said. In some popular lines of “whole food” supplements, for example, Guilliams said that (possibly synthetic) vitamins that are added in during the manufacturing process to bring the end product based mostly on food ingredients up to label strength don’t appear on the labels once the product is in the bottle. This could give the end user the impression that all of the vitamin and mineral content claimed on the label is derived from the food ingredients. In his mind this practice bends the labeling rules to the breaking point.
“The labeling laws are clear that the source of the vitamin and mineral must be included on the label. For example, everyone that uses pyridoxine HCL should label their vitamin B6 as pyridoxine HCL,” Guilliams said.
Familiarity breeds confidence
Some clinicians who don’t offer supplements through their practices raise an ethical point about the whole sector. What’s to stop a clinician from making sure that every patient walks out the door with one supplement or another, and pocketing a little extra profit on every visit?
Guilliams said that Ortho Molecular and other companies in the practitioner channel have to rely on the integrity of their customers, the clinicians, to not improperly recommend their products or to sell them in a subsidiary fashion, such as via a website. Guilliams said Ortho Molecular wants to make sure that practitioners have an actual clinical relationship with the end users, and that they are not just pushing supplements with a “doctor recommended” gloss on them. But even with those possible issues taken into account, he said there are powerful arguments in favor of having clinicians be intimately familiar with the supplements they recommend to their patients.
“A lot of clinicians tells us that they know that we are really doing our homework. They tell us, ‘If I just send them down the street and say go get some glucosamine or vitamin C or whatever, I’m not sure they’ll get the stuff that will give them the outcomes they are looking for',” Guilliams said.