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What supplements are patients looking for the most, and how can pharmacists help?
According to a Council for Responsible Nutrition 2019 Survey, 77% of adults in the United States take dietary supplements, the highest number reported to date.1 This places pharmacists in a unique position to offer both products and educational advice. What are patients looking for, and how can pharmacists help?
Neal Smoller, PharmD, is a holistic pharmacist, founder of Supplement School, and owner of Village Apothecary in Woodstock, New York. Smoller shared what he sees as the biggest trends in supplements: collagen and cannabidiol (CBD). According to Smoller, collagen is a “trendy protein supplement that we use as a cornerstone of holistic care.” He noted that his patients who are protein-deficient often take collagen, and praises its unique amino acid profile and structure. “People aren’t getting enough collagen-rich foods like organ meats or bone broth in their diets, so it’s my protein of choice for omnivores who want to supplement. It supports a healthy [gastrointestinal] tract, healthy joints, and optimal protein levels.” Smoller said that CBD is popular in his patients for anxiety, sleep, and pain.
Jennifer Burch, PharmD, CDCES, is the pharmacist and owner of Central Pharmacy/Central Compounding Center South in Durham, North Carolina. She sees a high demand for supplements pertaining to the immune system and stress, especially during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Some popular supplements include vitamin A, vitamin D, vitamin C, N-acetylcysteine, glutathione, zinc, theanine, melatonin, probiotics, digestive enzymes, and CBD oil.
With all the products out there, what should pharmacists look for when deciding what to stock? Smoller recommends that no matter what brands pharmacists decide to keep in their pharmacies, the products should meet high quality standards, “this includes not just GMP compliance and cleanliness, but therapeutic requirements, and ethics of the brand in question.” For example, with collagen, Smoller looks for products with excellent farming standards that are proven to be low in heavy metals, and ensures the manufacturing process has no dilution or spiking of the protein. With CBD, Smoller noted that there are “too many products with poor quality.” He deals with transparent brands, or “those that give us full access to their production flow and a certificate of analysis on each lot (third party verified),” he said.
During COVID-19, Smoller saw an uptick in demand for immune blends, zinc, and vitamin C among patients looking to boost their immune system. Smoller stocks and recommends zinc lozenges “but we give people honest advice—no supplement will protect you as the charlatans are advising. Be healthy and well, but don't get a false sense of security or the illusion of control from a supplement.”
Burch recommended that pharmacists stock “high-quality multivitamins—not ‘one-a-day’ vitamins.” She recommends offering brands that are labeled “pharmaceutical grade or professional grade,” and contain activated nutrients like methylcobalamin instead of cyanocobalamin. Some of her preferred brands include Xymogen, Ortho Molecular, and Thorne.
In terms of probiotics, Burch recommended Enterobiotic SBO by Natural Creations. “I have been using it with great results for over 20 years, long before many others were on the market. It contains 14 organisms including Saccharomyces boulardii which has an antagonistic effect against Candida albicans. It also contains fructo-oligosaccharides, a prebiotic which helps feed good bacteria in the gut.” Burch noted it has worked well for her patients, and local gastroenterologists recommend it as well.
Burch also suggested stocking a high-quality chelated magnesium. The advantage of chelated magnesium, she explained, is to help with absorption and delivery to the tissue.
“Magnesium oxide is a common magnesium patients pick up at the pharmacy, but it cannot be absorbed, so it causes diarrhea. When using magnesium for leg cramps or headache, we need to get the magnesium into the tissue, so the chelated form does this best.”
Both Smoller and Burch emphasized that, as the most accessible and trusted health professionals, pharmacists can use their drug and supplement expertise to help patients find the right products.