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Professional Consultants

DONNA F. SMITH, C.C.N., C.N.
Licensed, Board Certified
Clinical Nutritionist

WILLIAM H. BRELAND, P.T., S.C.S.
Physical Therapist
Board Certified Sports Specialist

ROBERT J. WOLFF, D.C.
Chiropractor

T. ROGER HUMPHREY, M.D.
Physician

Advanced Clinical Nutrition
Wichita Falls, Tx
76309-3119
Office (940) 761-4045
Fax (940) 761-2881
E-Mail: wsnqas@aol.com


The information and services provided are for nutritional support, and not for the treatment of any medical condition or disease. By using this web site, you understand and abide by this disclaimer.

Copyright 1999
Donna F. Smith

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PEP Step - Nutritional Supplements

by Donna F. Smith, C.C.N., C.N.


Introduction

     In the medical industry, physicians provide medical testing, then based upon the test results, prescribe pharmaceutical grade (potent) medications for their patients. Prescriptions are written and given to the patient who purchases his or her medications from a local pharmacy. Pharmacies also carry over-the-counter (OTC) drugs for minor medical complaints and conditions that do not require medical testing and a written prescription prior to purchase. Prescribed medications from licensed healthcare professionals are more potent and formulated to target the specific "clinical" medical symptom or condition. OTC drugs are less potent and used for non-clinical medical symptoms or conditions. From years of medical clinical practice and drug research, physicians and the public know that OTC drugs are not potent enough to combat abnormal medical test results, nor is it safe to take prescribed medications for minor complaints without professional guidance.
     Similarly, in the nutrition industry, clinical nutritionists' provide nutritional testing, then based upon the test results, recommend clinically-formulated nutritional supplements for their clientele. Clinical formulations are potent and designed to target and then correct the nutritional deficiencies of a specific organ, gland or body system. The rate at which the nutrition industry has grown in the past 20 years, for instance, has continued to increase and yet is not fully established or understood.
     Unlike the medical industry, the nutrition industry does not yet have a system for writing prescriptions so that their clients may obtain their clinical supplements from a local pharmacy. The current system is that nutritional supplements formulated for clinical use are only sold to licensed and certified health care professionals, who must then provide them to their patients and clients themselves, after performing specific nutritional tests. They are not dispensed over-the-counter in stores or through mail order companies without recommendation from a health care professional.
     In the medical industry, OTC drugs are available for lay person use. In the nutrition industry, OTC supplements are available for lay person use. OTC supplements are, like OTC drugs, less potent. They are sold over-the-counter in health food stores, department stores, pharmacies and through mail order (MO) and independent distributorship companies. Like OTC drugs, OTC/MO supplements are not formulated for clinical use. Thus, they are available to the public without first requiring nutrition testing and guidance from nutritional healthcare professionals.
     Using OTC drugs to treat a "clinical" medical symptom or condition may initially provide some relief; however, the effect is short-term because OTC drugs are not potent enough to effect "clinical" conditions. It is the same with OTC/MO supplements in respect to "clinical" nutrition deficiencies.
     Clinically-formulated nutritional supplements generally cost more than OTC/MO supplements just like prescribed medications generally cost more than OTC drugs. However, this is not always the case. The price for any supplement is based upon the direct cost of manufacturing the supplement, i.e, the growing and formulation of the ingredients. Some clinical supplements are not costly in their manufacturing, even though they are potent and formulated for clinical use requiring testing and guidance from a healthcare professional before they may be purchased.
     There are many factors that determine the quality and potency of nutritional supplements and their ability to effectively improve your health. These factors include processing techniques, daily dosage requirements, the quality and source of the ingredients, agricultural conditions, and formulations. By formulations, I mean, the combined metabolic effect of various vitamins and minerals and how they interact with each other when combined in a capsule or tablet. Some companies may provide quality supplements from whole food sources, but their formulations work against, instead of with, the principles of nutritional biochemistry.
     These factors, as well as guidelines on where and how to obtain your supplements will be discussed in this article.

Processing Techniques - Three methods

1.

Whole Foods - Foods, Spices, Herbs are dehydrated, and the individual content of each vitamin, mineral or enzyme is measured. For example, carrots are dehydrated and cold-press processed to maintain essential oils and nutrients intact, then the amount of vitamin A in the dehydrated carrots is measured. The labels on the supplement bottles reflect the total amount of Vitamin A in the whole foods, whether the Vitamin is A from carrots or other vitamins from other foods.

1. Depending upon the potency, quality, and formulation, some whole food supplements are designed for clinical use in nutritional therapy, and others are designed for non-clinical use for health maintenance.
2. Whole food supplements are beneficial for short- and long-term use.
3. Both clinical and non-clinical (OTC/Mail Order) whole food formulations can be used daily, throughout the lifetime, to utritionally support the body in its efforts to maintain health and wellness.
4. Supplement bottle labels list sources of whole foods, such as carrots, beets, etc.
5. Pure single herbs and spices are also whole food supplements. An example is the Golden Seal herb. Herbal Combinations may consist of whole food herbs or extracted herbal ingredients.
2. Whole Food Extracts - Vitamins and minerals are extracted from whole foods, and the amount of nutrients in the extracted form is measured.
1. Depending upon the potency, quality, and formulation, some whole food extracted supplements are designed for clinical use in nutritional therapy, and others are designed for health maintenance.
2. Whole food extracts are beneficial for short-term use. Professional guidance is a must for long-term use of whole food extract supplements, whether they are formulated for clinical use or over-the-counter/mail order.
3. Clinically-formulated whole food extracted supplements are used to affect specific nutrient levels for a specific time period, then discontinued as soon as the desired nutrient level has been attained.
4. Over-the-counter(OTC) and Mail Order (MO) whole food extracts are used for certain personal situations for a short-period of time, such as occasionally supplementing your diet occasionally when you skip a meal or you are going through a time of personal or business stress. They are not designed for unsupervised long-term use.
5. Some whole food extracted supplement bottles list their food sources; others do not
6. This processing technique of whole food extracted supplements discussed here is not the same as herbal or other food extracts or tinctures. Further PEP Steps will coach you on the purpose, use and how to prepare your own herbal extracts and tinctures.
3. Synthetic - Synthetic vitamins and minerals are produced in chemical laboratories from substances with similar but incomplete molecular structures as compared to whole foods. Some are produced by using whole foods or extracts, and then adding synthetic substances to them. Labels generally do not provide the sources from which vitamins and minerals are derived. Synthetic supplements are generally of low quality, low potency, may be poorly formulated and cost very little compared to whole food or whole food extracted supplements.

Nutrition Industry and Research   
     Though the nutrition industry is one of the most rapidly growing industries today and its clinical research has progressed significantly since the early 1900s, our nutritional scientists are still discovering new vitamins/minerals and principles of nutritional biochemistry. Health is best produced when the body receives all the nutrients it requires. Too much or too little of a specific nutrient leads to nutritional deficiencies, then to biochemical imbalances, then to nutrition-related diseases.
    
When you choose whole food supplements, you are assured that you are getting the "unknown" vitamins and minerals yet to be discovered which may be vital to the metabolism of all the other nutrients in that particular food. Therefore, your best results will be achieved by choosing whole food supplements whenever they are available to you. We know of only two supplement manufacturing companies in the United States that provide whole food vitamin/minerals supplements: they are Standard Process Laboratories and Mannatech, Inc. There are a variety of OTC/MO whole food herb companies . We have recommended Nature's Sunshine Product Herbs since 1980.

4.

Standard Process Laboratories provides whole food supplements for clinical use only to licensed and certified clinical nutritionists and healthcare professionals. 90% of the clinically-formulated supplements recommended and provided by Advanced Clinical Nutrition are from Standard Process Laboratories.

5. Mannatech provides whole food supplements for over-the-counter and mail order purchasing. If you are interested in learning more about Mannatech, go to this Internet Web Site - www.mannapages.com/wsn.
6. Nature' Sunshine Products provide OTC and MO whole food herbs in their single herb and herbal combination product lines. Ask us how you can get 25-30% discounts on these products and order from your home. These products will be used to coach you on "How To Convert Your Medicine Chest To A Health Chest."

     Advanced Clinical Nutrition also provides whole food extract clinically-formulated supplements from a variety of professional companies which are provided for short-term use to raise nutrient levels, then discontinue them when test results indicate. However, for long-term use, only whole food supplements are recommended.

Choosing Supplements

     When nutritional tests yield abnormal clinical results, that is, results which lie outside the nutritional or medical reference ranges, clinically-formulated supplements are required to correct deficiencies and imbalances to improve health.
     Once you have attained health maintenance or wellness by adhering to your food chemistry dietary plan and taking clinically-formulated supplements under the guidance of a nutritional health professional, clinically-formulated, over-the-counter or mail order supplements may then be used to maintain nutrient levels, i.e., health. However, should updated nutritional testing performed for monitoring your ability to maintain your good health, similar to the annual medical examination for early detection of disease, indicate that over-the-counter/mail order supplements are not sufficient to maintain your health, you will be advised to reconsider your supplements choices.
     Some people with inherent or acquired organ/gland weaknesses may require clinically-formulated supplements for the rest of their lives to maintain health. An acquired weakness occurs when someone has had organs and glands removed surgically. Nutritional supplements are needed to support the areas of the body that were dependent upon the removed organ or gland or to compensate for a incomplete body system. For example, gall bladder removal requires a long-term, clinically-formulated supplement to help with the metabolism of fats and oils. Otherwise many health problem will arise from the body's inability to process fats and oils properly because of the missing gall bladder.
     An acquired weakness may also result from an injury in which the body was unable to totally repair and recover. Examples may include injuries from sports activities or car accidents.

Clinically-Formulated Supplements

     As stated above, clinically-formulated supplements are available only through licensed and certified health professionals after performing nutritional tests. You may obtain your clinically-formulated supplements from the professional who performed your tests or from other health professionals.
7.

Advanced Clinical Nutrition:
Advanced Clinical Nutrition (ACN) provides complete nutritional service - testing, dietary plans, clinical and non-clinical supplements and lifestyle education. Guidelines for purchasing clinically-formulated supplements from ACN are as follows:

1. Based upon your nutritional tests, we will recommend the exact supplements your body requires to assist in its healing.
2. One month's supply of clinically-formulated supplements are mailed within two weeks, generally 3-7 days, after receiving payment.
3. A Patient/Client Schedule and Program of Care will accompany your supplements. This lists the names of the supplements you will be taking, the daily dosage, their purpose, and any other special instructions.
4. Because nutritional discoveries are being publicized every year, you can have confidence that the clinical supplements we recommend and supply to our clients have been researched and tested to be safe and effective. Our supplement selections are based upon the clinical research presented at bi-annual and annual scientific symposiums of the International and American Associations of Clinical Nutritionists and the Clinical Nutrition Certification Board, which provides continuing education unit hours (CEU) for all clinical nutrition professionals. Some supplements have been used clinically since the 1920s.
5. In addition, we also have hundreds of hours in the clinical use of the supplements we have been recommending within our own nutritional practice since 1991.
6. Clients who choose our full clinical nutrition service - testing, dietary plan, supplements and personal education program get the best results. Our success is over 90% in assisting our clients in improving their health. Your success is insured when clients implement all four aspects of the program.
8. Other Healthcare Professionals:
Some of our clients are currently working with other healthcare professionals for specific healthcare services, such as medicine, chiropractic, acupuncture, etc. Some of these professionals also provide clinically-formulated supplements for their patients, though they may not provide the extensive clinical nutrition testing and analysis services that we do. Some of our clients are healthcare professionals and can order clinical-formulations for themselves. Therefore, in these cases, we provide the nutritional testing, dietary plans and make supplement recommendations in the form of a written "Supplement Guidelines;" however, we do not provide clinically-formulated supplements for these clients. If you have a healthcare professional from whom you would prefer to obtain your clinical supplements or you are a healthcare professional who would prefer to order your own supplements, please use the following guidelines.
1. Provide Advanced Clinical Nutrition with the name, address and phone number of the health care professional providing your clinically-formulated supplements.
2. Advanced Clinical Nutrition will then provide "Supplement Guidelines," listing those organs and glands, in order of priority, which need "clinical" nutrition support. Your "Supplement Guidelines" will also list individual vitamins or minerals required in addition to those which will support specific organs, glands and body systems.
3.

Provide this information regarding supplements chosen. (This is not required for private session or self-designed program clients.)

1. Brand Name and Ingredients list - in the order as listed on container
2. Milligrams, grams, etc. per capsule, tablet or scoop
3. Serving - ex. 6 capsules represents (number) mg.
4. Form - capsule, tablet, powder, etc.
5. Recommended daily amount on the bottle
4. We recommend that you simply record the information and provide it to us by e-mail or in writing by regular before actually purchasing them. Some supplement purchases are not returnable.
5. Your Patient/Client Schedule and Program of Care (POC), which will list the supplements you have selected, daily dosage and special instructions, if any, will be mailed or e-mailed within three days from receipt of the above information.
6. Then, for best results, take your supplements daily as directed on your POC until your Re-Evaluation Analysis for best results, unless your Clinical Nutritionist's review of your Monthly Progress Reports indicate a need for adjusting these supplements. If changes or adjustments in your supplements occur in between your three-month clinical nutrition analysis re-evaluations, an updated Supplement Guidelines will be attached to your Monthly Progress Report.
7. You will then repeat these procedures regarding any new supplement.

Using OTC/MO Supplements to Raise Nutrient Levels Initially

     Because of the various discounted supplements provided through mail order, over-the-counter and independent distributorships, or other reasons, some clients may choose to use non-clinical supplements initially to raise their nutrient levels and then switch to clinical-formulations to complete the process of correcting "clinical" deficiencies.
     How does this work? Here is an analogy that may help you to understand. Think of a person who has just returned to civilization after being in the desert without water. A glass or a gallon of water relieves the devastating thirst and can assist in restoring health; however, if the person's body does not become completely "hydrated" again from water alone, he or she will die. Drinking water, at first, begins the restoration, but depending upon the severity of dehydration, either electrolyte replacement beverages or an IV injection is required to completely restore electrolyte balance. Either of these latter methods require professional assistance and clinical formulations, nutritionally or medically or both.
     Similarly, you may choose OTC/MO supplements, if you desire. Updated nutritional test results will keep you informed of their effectiveness. If updated test results show that your selections of OTC/MO supplements are improving your nutrient levels, then you will be advised to continue them until your test results plateau. At that time, your improvement will continue only by switching to clinical formulations.
     If updated nutritional tests show minimal or no improvement, you will be informed so that you may re-evaluate your supplement choices.

Over-the-Counter (OTC) and Mail Order (MO) Supplements


     If you have chosen to use non-clinical supplements to initially raise your clinical deficiencies, please use the following guidelines:

9.

Notify us that you are choosing non-clinical supplements so that you may receive your "Supplement Guidelines."

10. Then after reviewing your personalized supplement guidelines and selecting the supplements you would like to use, provide our office with the following information. (Private session and self-designed program clients are not required to provide this information.)
1. Brand Name and Supplement Name
2. Ingredients list - in order as listed on container
3. Milligrams, grams, etc. per capsule, tablet or scoop
4. Form - capsule, tablet, powder, etc.
5. Recommended daily amount on the bottle
11. We recommend that you simply record the information and provide it to us by e-mail or in writing by regular mail before actually purchasing them. Some supplements are not returnable after purchase.
12. Your Patient/Client Schedule and Program of Care (POC), which lists the supplements you have selected, daily dosage and special instructions, if any, will be mailed or e-mailed within three days from receipt of the above information.
13. Then for best results, take your supplements daily as directed on your POC until your Re-Evaluation Analysis, unless your Clinical Nutritionist's review of your Monthly Progress Reports indicate a need for adjusting these supplements. If changes or adjustments in your supplements occur in between your three-month clinical nutrition analysis re-evaluations, an updated "Supplement Guidelines" will be attached to your Monthly Progress Report.
14. You will then repeat these procedures regarding any new supplement.

Unethical Supplement Practices
     Manufacturers and distributors of "clinically-formulated" supplements screen the businesses to whom they sell their products. First, by having the healthcare professional submit an application that includes license or certification verification. Then, following up periodically by visiting the healthcare business to assure that their products are not sold over-the-counter, but stocked in a private room or behind the counter where public access is not available, similar to the separation of over-the-counter and prescribed drugs in a pharmacy.
     Because the nutrition industry is a rapidly growing industry, laws are changing and will be changing to assure the public's protection in respect to unethical supplement practices. Though at this time it is not unlawful to violate these two conditions required by clinically-formulated companies to purchase their products for re-sale, it is certainly unethical and unsafe for the consumer.
     Occasionally, we learn of a health food store, pharmacy or mail order company selling clinically-formulated supplements over-the-counter to the public without first receiving recommendations from a healthcare professional who has performed nutritional tests on the individual. Sometimes, these businesses have misrepresented themselves to the manufacturing or distributing company by continuing to sale the products when the licensed or certified healthcare professional is no longer with the business or by not being honest in their intentions for reselling. There may be any number of reasons the business does not follow the rules and conditions for purchasing and selling clinically-formulated products.
     Occasionally, we learn of manufacturers and distributors who sell the same products to both the public and healthcare professionals. They simply change the labels and usually the price - one label and price for the healthcare professional and another label and price for over-the-counter/mail order buyers. Healthcare professionals soon identify these unethical companies because their products are often not potent enough to affect "clinical" nutritional levels as expected.
     Some healthcare professionals sell clinically-formulated supplements to their patients and clients without performing any tests.
     Conversely, we have experienced unethical consumers who obtain the manufacturer's name from clinically-formulated supplement bottles and then misrepresent themselves in order to obtain clinical products at wholesale costs.
     In time, the manufacturer or distributor becomes aware of these unethical health care businesses and consumers and then immediately discontinues future sales of their clinical products to them.
     As a consumer, you need to be aware of these unethical practices, which one day may also be illegal, and protect yourself from the unknowing solicitation of the services of unethical healthcare practitioners or supplement companies.

Consumer Guidelines For Protection Against Unethical Supplement Practices
     When you engage the services of nutritional healthcare professionals, you can be assured you are getting ethical and safe service and products when you observe them following these rules:

15. Clinically-formulated supplements are available for purchase only after nutritional tests have been performed by a licensed or certified nutritional healthcare professional or a written nutritional prescription has been provided from the professional who performed the tests.
16. Clinically-formulated supplements are stocked behind counters or in a private room - not visible or easily accessible to the public.
17. The healthcare professional, along with the manufacturing/distributing companies, make efforts to educate their clients/patients on differences between clinical and non-clinical.

Having this knowledge will allow you to protect yourself from the unethical practices of others.


Conclusion
     This PEP Step - Nutritional Supplements article has been provided to help you understand the differences between clinical and non-clinical supplements and the factors involved in manufacturing and formulating safe, effective supplements. With this knowledge you can make the right choices in where to purchase your supplements and which type of supplements, clinical or non-clinical, will meet your nutritional needs. Following the guidelines and procedures in this article will assist you in making informed nutritional supplement decisions. We hope that we have accomplished this goal. If any questions arise after reading this PEP Step, please e-mail wsnqas@aol.com.

Copyright 1999 Donna F. Smith

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