Tuesday, November 20, 2007

A Critical Eye On "Synergistic" Formulas

When you hear a manufacturer touting a "synergistic" formula, it is often shorthand for "small amounts" of "more things."

I met a physician-turned-manufacturer who lamented the fact that he "could formulate the very best supplements but no one would buy them due to the cost." Instead, he had opted to experiment with "synergistic ingredients" in smaller serving sizes so that he could sell at lower prices.

I was chatting back and forth this week about another physician's so-called synergistic formula for heart health with my friend, Gino Giglio, who regularly routes around interesting health information (and amusing stuff too). Anyway, I got to thinking more about the "synergistic ingredients" theory.

When I first took over Our Health Co-op, I met a "formulator" at one of the original manufacturers, and he was little more than a guy promoted from the mixing and blending floor. I ended the relationship with that manufacturer (and a few others) and built an advisory group of my own -- comprised of people with serious credentials, none of whom had anything to do with manufacturing.

When I was working on the formula for Constant Health, I worked with a team of people, including Dr. Rodier (integrative physician) and two practicing naturopaths at a leading research institution.

Our bias was to include therapeutically-significant servings of individual ingredients and ensure that our 46-ingredient formula didn't have any unintended problems (the antithesis of synergies).

While it would have been great to include probiotics in the formula, I was skeptical, since I know how delicate these live organisms are and how important it is to protect them from air and moisture. I checked with our biochemist, Dr. Patel, and he agreed, leave out the probiotics. One so-called synergy nixed.

It also would have been great to include digestive enzymes in Constant Health, with its focus on supporting a healthy gut. Dr. Patel cautioned against this too, since the enzymes would start to break down the protein and carbohydrates in the formula and diminish efficacy. Another so-called synergy nixed.

However, while examining labels in Wild Oats the other day (Steve is tolerant of this particular form of lollygagging), I noticed that more than a few prominent formulas had enzymes in their protein powders and probiotics in their powder blends (greens and protein formulas).

I'm not sure if the "formulators" for these products don't know any better or just look the other way and cave in to marketing pressures.

I called Dr. Rodier to hear his take on "synergistic formulas." Here's what he said:

"In all of my years of clinical practice, I've never seen anyone feel better from small servings of many things, which is why I don't even recommend multivitamins. The theory of synergy is great, but there's no evidence today for most of these formulas with small amounts of active ingredients."

"In my patients, I see a lot of problems with absorption. I prefer to flood cells with nutrition at levels that have been proven in clinical trials. The worst thing that can happen is the body will excrete whatever it doesn't need."

"The body is very forgiving with extra nutrition. Think about drinking too much water. You pee out what you don't need, but that's far better than rationing your intake of water. I believe in flooding the system with nutrition and letting cells make intelligent choices for themselves about what need."

"I've seen great results with nutritional products based on proven therapeutic amounts. I've never seen that happen with microscopic amounts of lots of ingredients."

Amen. The nursing home where my mom is recuperating from her fall doles out a multivitamin every day, and they think that's a big step forward in her daily nutrition. We bring her Constant Health every day in our yellow-lidded shaker bottles, so my mom is doing better all the time with her daily serving of concentrated nutrition.

Alas, I just can't endorse the trend toward "synergistic formulations," where the supplement facts panel looks more like trendy window dressings than proven amounts of anything scientific.

My two cents. I may have some protests, but that's okay.

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