Suzanne Munson, MS, is the VP of Product Development and Compliance at Fairhaven Health. She helps us understand how to select the right supplements and even covers nuances for specific vitamins and minerals.
What we Discuss
Which are common supplements for women's health.
How to select the right supplement brand.
Optimal daily dose of common vitamins and minerals
Transcript
Georgie Kovacs: Let’s start with telling us about your background.
Suzanne: my background is in whole foods nutrition. I work now strictly in dietary supplements. My background is in whole foods and cooking. I took an interesting path to get here. My interest in health started just after I graduated from college. I left my small, liberal arts college with a degree in clinical science and economics. I didn’t have a solid idea of what came next but with advice the next logical step was to go to graduate school in politics. I found myself during this journey with a lot of time to read. I picked up a book called “Diet for a Small Planet” by Frances Lappe and also “Diet for a New American” for John Robbins.
Both of those books discuss how our health and our environment and even issues of income equality and food scarcity are impacted by our food system. For me, it was a real “aha!” moment. My politics and economics background were all seen through the lens of food and I was hooked. I learned how to cook brown rice and started diving into nutrition with a plant-based diet. I looked at shifting toward advanced degrees in nutrition. I went to Bastyr University which is one of the leading naturopathic universities in the US. I got a master’s degree in nutrition and started working in the natural product industry. I learned how natural products can be a healthy support for any lifestyle.
Georgie: Tell us a little more about what you do for Fairhaven Health.
Suzanne: at Fairhaven Health, for about 20 years now, we’ve been making products for both men and women’s reproductive health. I’m a key part of product development. We think of things that are going to make women’s lives easier. In other words, what reproductive health issues are women facing, what are they talking to their friends about, what are there not solutions for? That drives our development process. Then, we all work together to develop and test products before they hit the shelves.
Georgie: through my own fertility journey, I saw a lot of interesting behaviors. I thought talking to an expert like yourself would help educate our audience about how supplements play a role. Let’s start with the basics: what is the value of a supplement and how do they differ from vitamins?
Suzanne: a supplement is a general term for a capsule or drink that you ingest that has isolated vitamins and minerals and/or antioxidants or herbal components. A vitamin is something that you can find in food. A supplement is taking those vitamins and giving them another path to get them into your body besides eating them in food.
With my background in whole foods nutrition, I’m definitely a “food first” person. If I’m talking to friends or even customers, the best thing you can do to improve your health is to eat the highest quality diet that fits your lifestyle and that you can afford. Always food first.
The value of supplements comes in when you realize that none of us do the diet part perfectly. We’re busy, some people lack access and there are a variety of additional factors that cause gaps in our intake of the right things. Most people would assess that their quality of food isn’t 100%. This is where supplements can make an impact on our health. Only about 30% of American women rate their diet quality as “very good” or “excellent.” There’s a gap between what we think we should be doing or getting through our food and what we actually are. That gap is where supplements come in.
Related to that is the fact that the nutritional quality of our diets has declined. This includes things we can control, like processed foods, total calories and being plant or animal based, added fats, etc. Additionally, there are factors outside of our control. This includes the nutritional value of food being grown or that is available. Over time, soils have become depleted in vitamins and minerals and that impacts the quality of our food.
For reasons both inside and outside of our control, the quality of our diet isn’t always optimal and that’s where supplements can bring value.
Georgie: so, 200 years ago we didn’t have supplement companies. Would you say that a lot of this has been driven by the quality of food as well as the diet and lifestyle choices we make?
Suzanne: all societal changes impact the way we eat. This hasn’t always been a net positive. If I look back two generations to my maternal grandmother, they lived an urban lifestyle but grew a lot of the food that they ate everyday. I know very few people in my life who are more than a hobby gardener. We don’t depend on our gardens for the food that we eat. We do it for fun or to supplement but we aren’t growing our own food. Even that distance from food in terms of access makes a big difference.
So, 200 years ago, it was a vastly different situation.
Georgie: I appreciate your background on supplements and the role food plays. I think back to my own journey over the past 10 years. Trying to have a child transformed my relationship with food. It does start with what you eat. I used to have a relationship with food that was about limiting cookies or avoiding unhealthy foods. Now, through knowledge and various shifts, I view food as a way to nourish myself. It’s shifted. If I’m in the mood for a piece of chocolate, I don’t feel resistance or avoidance. Instead, I’m satisfied and enjoy a treat. It’s much healthier and a hard place to get to. I don’t have a perfect diet. But I think if we can all get to a place of transitioning our relationship with food in some way it can make a big difference in health.
Back to supplements, because we do need them, what are some of the most common supplements that are required by regular people given the deficiencies in our diet and other factors?
Suzanne: when we talk about deficiencies in our diet and what that means for our vitamin and mineral status, it’s important to point out that we’re not talking about stark vitamin deficiencies. Thank goodness, that’s relatively rare in the U.S. I’ve never known someone who developed scurvy or rickets. What we’re talking about here is an intake of a suboptimal amount of these vitamins and minerals. The goal of supplements is to reach a more optimal state of health.
We’re not getting everything that we need to obtain optimal health. The vitamins that most people can use more of through supplements are:
B vitamins: often referred to as a complex; B1, B2, B3. They work together to support energy production and cell division and so are crucial to everything that happens in your body. Because they’re water soluble, your body uses them quickly and excretes them out. Renewing them through supplements can be crucial.
D vitamins: more and more is coming out about vitamin D for pregnancy wellness and infant development but also for fertility. Research is showing more suboptimal levels of vitamin D in women, especially in northern climates. Even in sunnier climates, the prevalence of sunscreen reduces the amount of vitamin D people get.
Trace minerals: these are minerals that you just need little bits of. Copper, manganese, iodine, etc. These are co-factors in a lot of your body’s processes. If you don’t get enough of these, it can be impactful on your overall health.
Georgie: that’s really helpful and that was a recent learning for me about vitamin D and sunscreen impacting the amount of vitamin D that you get.
Are these supplements that you mentioned in prenatal or multivitamins? Or do you find that these need to be taken separately to get the right amounts?
Suzanne: a pretty standard prenatal vitamin would have some amount of B vitamins, some amount of vitamin D and maybe some trace minerals. Most multivitamins would do that too. We luckily have plenty of resources and great vitamins.
Georgie: I ask because in my fertility journey I was the person who did the research and, if I found something that seemed like it would help me, I added it to my regimen. I was probably spending hundreds of dollars a month on supplements. Unfortunately, with the way the healthcare system has evolved and you have your seven minute appointment with a doctor, no one monitored that unless I brought it up. The naturopaths and acupuncturists who I talked to better understood it.
What would you say about those who are trying to figure out the right dosage and regimen for themselves so they don’t fall victim to adding everything to the list?
Suzanne: that’s a really interesting point. It happens frequently. There are pros and cons to the approach of introducing individual ingredients. A good example is, if you Google “women’s fertility,” one of the things that will come up is CoQ10. Many women will take this to support their fertility in addition to a prenatal vitamin. And then they get told they should be taking more vitamin D. Then they get told about another ingredient that’s helpful for fertility. Before long, you’re facing 10 bottles of supplements every morning. That’s one way to do it.
At Fairhaven Health we take a different approach. We try to make it more convenient, providing all-in-one solutions. Our prenatal vitamins cover all of the diet deficiencies and we add in the targeted fertility ingredients. If we lived in a healthcare environment where we could get an hour appointment every week or every two weeks with a healthcare practitioner that could decide through testing or some other means how much of these individual ingredients we should be taking, I’d feel better about that approach. For instance, adjusting vitamin D in the winter or CoQ10 testing. But nobody gets that kind of care these days. So, choosing a high quality supplement that can meet the desire for a convenient and affordable solution in one bottle is the best way to go.
Georgie: I’ve been having conversations with practitioners that I work with for my own health. I took pictures of every single supplement and said, I can’t do this anymore, what should I do? One piece of feedback was, you have too many B vitamins so stop those. Another piece of feedback was that I should only take colostrum when I was under a lot of stress. Another was to take a quadruple dose of monolaurin three times a day. It was these interesting off-label approaches to dosing. What is your thinking around that? How would you even know how to decide for yourself what to do?
Suzanne: it hits an important question. Sometimes you don’t have the ability to meet with healthcare practitioners who can offer you this level of advice. There are pros and cons to the one-size-fits-all approach that you get from taking an off-the-shelf product. I would advocate for both:
Find the thing that you can do that makes your daily routine easier, find a good multivitamin or prenatal vitamin that you like that covers the bases or a fertility supplement that you like.
Find a healthcare practitioner that can address some of these things in a more individualized, personalized kind of way.
Georgie: there are two ingredients I want to ask about. Folic acid and CoQ10. Let’s talk about folic acid first. I saw a trend at the ASRM conference where manufacturers are switching from folic acid to methylated folate. Maybe you can talk about why that is an important change.
Suzanne: two things for women are FertilAid for women. The conversation around methylfolate was very small and there were no good supplemental forms of methylfolate. The only option we had was folic acid. Over the last two decades we’ve learned more. Sourcing has gotten better and better options are available. For up to 40% of people having some sort of MTHFR mutation, including this in our fertility supplements wasn’t the way to go. Any new product we make has methylfolate in it. Over the last couple of years, we’ve had the chance to transition our FertilAid for women product form folic acid to methyl folate. We always try to stay on the edge of what is the most quality or the best thing for our consumers and that was a change we needed to make.
Georgie: there still seems to be controversy. I spoke to a leader in ASRM who admitted that the data was leaning in that direction but not everyone is 100% convinced. What is the difference?
Suzanne: when you take a supplement that has folic acid, the body goes through a series of biochemical reactions to get it into a form of that vitamin that can be utilized in your cells. The MTHFR mutation impacts one of those biochemical reactions, so it sort of stops that breakdown of folic acid to get it to the active methylfolate that your body can use. By providing the methylated form the same vitamin (B9), it bypasses that biochemical reaction.
I look at it in a two-fold way. From a global health perspective, folic acid has been a huge net positive for the world. By fortifying cereals and breads with folic acid and including folic acid in prenatal vitamins over the last many decades, it has helped us prevent defects in babies.
The net positive is huge.
If you know you have the MTHFR mutation, it is advisable to choose a product that has methylfolate. What we have done, because we’re doing a one-size-fits-all product, we want to safeguard everyone. To make sure that everyone is getting B9 to prevent neural tube defects, we offer a form that everyone can utilize.
Georgie: I love that. It’s understandable that we don’t want to demonize folic acid because it has made a huge impact in a positive way. It was a big part of the prenatal vitamin movement. If people can’t get a hold of methylfolate then of course take the folic acid.
Let’s talk about CoQ10. There are two forms: ubiquinone and ubiquinol. Is there a difference? Some manufacturers don’t even list which form of CoQ10 is in their product. Do you have a perspective we should be aware of?
Suzanne: this subject comes up a lot because CoQ10 is such a popular and important ingredient for both male and female fertility. I may have a different angle on this than other people. Some of this conversation is about marketing and health. In the supplement industry, there has been a movement to push that ubiquinol is better absorbed. There are some patented CoQ10 ingredients that push that. I don’t know if it’s wrong to say that ubiquinol is highly absorbed. What I do know is that those ingredients are very expensive. It’s cost-prohibitive to include a therapeutic amount of CoQ10 in a fertility supplement, for example. That’s the problem. We want to make a product that women can afford and include an amount that will be helpful to them.
The original research on CoQ10 that shows benefits have all used ubiquinone. While we have this data on certain patented ingredients that push a highly absorbable form, you have to reconcile that with the benefits that were shown in the original resource, showing that ubiquinone worked in the body. In the body, ubiquinone switches to ubiquinol and back.
There’s an easy transitioning between one form and another in the body may mean that it doesn’t matter. In other words, either is fine. The question then becomes, how much CoQ10 is there in a product and can I afford it? If your body is looking for ubiquinol for a reaction and you have ubiquinone on board, it can switch it. And vice versa. I’m simplifying the biochemistry quite a bit but it’s important to know that we can make this more complicated because we want to sell a specific product or ingredient.
I take more of a pragmatic approach to that. Looking at the original research, a very strong case can be made that ubiquinone has been shown to have great benefits.
Georgie: I love that you think practically. As I monitor the women’s healthcare space, sometimes the answer is really simple and we’ve just made it so unnecessarily complex. That’s created a lot of stress.
Suzanne: I know that mine is a controversial opinion. I would always encourage women to do their own research, reach out to people for different opinions and don’t take my word for it necessarily. My opinion is informed but controversial.
Georgie: there are a lot of supplement manufacturers out there. They all have pitches about how they’re different and trusted. I’ve been in the pharmaceutical industry for 20 years. It’s hard even for me to distinguish what's marketing and what’s genuine. Obviously there’s no one good company and everyone else is bad but how does someone ensure they are purchasing a quality product? Especially because the FDA doesn’t regulate the supplement industry the same way as pharmaceuticals.
Suzanne: it’s good to have a general idea about the regulatory framework of dietary supplements. You hear a lot in the news that supplements aren’t regulated. That’s not true. I like the way you said it: they’re not regulated in the same way that pharmaceuticals are regulated. There are FDA regulations on how dietary supplements are manufactured, labeled and promoted. There are regulations on manufacturers and companies like us that formulates products and has them contract manufactured for warehousing and distribution.
The whole manufacturing chain is governed by FDA regulations. With that context, the answer to your first question is that, frankly, it’s really hard to know the good from the bad. The law of the land related to dietary supplements is that GMP manufacturing is required. You see a lot when you’re buying supplements “GMP certified” or “FDA registered.” These are claims without weight behind them. Anyone can say that. Every supplement manufacturer should be GNP certified and subject to FDA audits. That doesn’t always happen but it should.
First, use common sense. How would you make a decision about buying any other product: cosmetics or cleaning products? What would you look for when making those determinations? Have your friends ever taken this product? How long has the company even been around? What is their marketing information like? I like to point this out about Fairhaven health. We really are a healthcare company not a marketing company. Our product line ranges from fertility monitors to supplements to lubricants for vaginal health.
We have a range of products that support female reproductive health. We are not a marketing company. When you see an ad on Instagram for a supplement that is done by an influencer that you know really didn’t take the product or is being paid to take the product, then those companies are more like marketing companies than health companies. Look at the website: do they offer educational information that isn’t just about product promotion? Do they have a range of products?
Those are the things that you should look at when you’re making decisions about which supplements to buy. Another thing that sets some companies apart from others is their customer service team. Can you get someone on the phone? Do they have a way to email them or live chat with them Do you get a real person that doesn’t have a canned answer? Is there individualized support?
Those are elements that help one company stand out from another.
Georgie: those are really helpful tips! I often look at the seal, so to speak, and use practitioners and a network to confirm that. I didn’t even think to look at how things are set up on their website.
Suzanne: just like any other consumer product, the FDA and FTC regulate what supplement companies can say about their product. For instance, as a company in the reproductive health space, we can’t say that our products will cure or prevent PCOS, endometriosis or infertility. If you run across a company that is claiming that their product will cure your migraine or take away PCOS symptoms, you should wonder about the truth of that and the understanding that company has with the laws around their products.
Georgie: it’s interesting to see how marketing practices are changed, even in regard to influencers and social media.
What is one thing you want women to take away about supplements?
Suzanne: when people are looking to make a positive change around their health (whether it’s fertility or weight loss) there is no magic bullet. There is no one thing, whether it be a pill or a supplement, that’s going to get you to your goals without effort. Start with food always.
Develop an exercise habit that you enjoy. Establish baseline, good health practices. And then use supplements to fill in the gaps.
Try and find a company that you feel like you can trust, in terms of quality. You want good formulation (the product to include everything you want) and manufacturing. Reach out and ask a bunch of questions. If they can’t answer you, that might be an indication that it’s not the product you want.
Georgie: what inspires you?
Suzanne: I am really inspired by the farmworkers in every community that bring food into our grocery stores. I have a passion for food justice and farmworker rights. I appreciate all of the men and women who work tirelessly to grow our food.
Resources
Check out these helpful resources:
Learn more about Fertility and Trying to Conceive.
Learn more about the Microbiome.
Learn more about Nutrition.