If you pop the occasional 5-milligram melatonin tablet every now and then, you’re not alone. According to the Sleep Foundation, just under one-quarter of adults take melatonin as a sleep aid, and a small number of kids and adolescents take melatonin when they can’t sleep, too.
As far as sleep aids go, melatonin is generally considered to be a more natural way to cope with the occasional sleepless night, since it is a hormone we naturally make in our brains anyway. Recently, though, researchers looked at 25 different melatonin gummy brands and found that 22 of them were mislabeled, a sample size that suggests that about 90% of melatonin supplements do not contain the amount of melatonin they claim to include.
Some of the discrepancies in the study findings were unsettling but not totally wild: One brand contained just 74% of the amount of melatonin it said it contained, for example. Other label inconsistencies were more alarming, with one brand containing 347% of the amount of melatonin it said it did, and another containing 31.3 milligrams of CBD but no detectable melatonin at all.
These numbers are scary, especially for parents who may give their kids melatonin to help them sleep from time to time. They also highlight the fact that supplements aren’t approved by the Food and Drug Administration, so supplement makers aren’t required to share the exact amounts of what each supplement contains. That means it can be tough to really figure out exactly how much of certain nutrients are actually in your supplements (if any).
Because most U.S. adults (and one-third of kids) take dietary supplements, we asked doctors to share their best tips for figuring out what’s actually in all those supplements lining the aisles of your local drugstore. Here’s what they had to say:
Make third-party verification labels your best friend.
While the FDA doesn’t approve supplements, third-party verification labels — the most common being U.S. Pharmacopeia (USP) — will let you know that a supplement has had some level of testing.
“USP tests to make sure that the product contains what’s on the label in the same amount and potency and that it does not contain contaminants,” said Dr. Jeff Chen, CEO and Co-founder at Radicle Science. “They also test to make sure that the product will break down and be absorbed in the body. They verify that the product was manufactured under the FDA’s current Good Manufacturing Practices using sanitary and well-controlled procedures and that the supplement will be manufactured with consistent quality from batch to batch.”
There are other third-party verifications and testing companies such as The National Sanitation Foundation (NSF), Clean Label Project and the certified USDA organic label, Chen added, noting that some types of supplements have a specific certification.
“For example, fish oils have International Fish Oil Standards (IFOS), a set of quality standards that analyses purity and accuracy specific to fish oils,” he said.
Check for randomised controlled trials.
If you’re willing to do a little more legwork, it can be helpful to check to see if the supplements you’re thinking of buying have gone through any randomized controlled trials, or RCTs, according to Chen.
“When looking at supplements, I consider only those that are evidence-based and provide a plausible mechanism of action, meaning it makes sense the supplement can function as it claims,” Chen said. “To this end, they must be tested for safety and efficacy, with at least one RCT on the finished product.”
Consumers can look for supplements that say “clinically proven,” but it’s important to review the fine print. You want to look for key terms of a rigorous, gold-standard trial, which include phrases like “placebo,” “blinded” and “randomized” in the explanations. The RCT should also be large-scale, Chen added, meaning it uses a minimum of 200 people to ensure the results are statistically valid and not by chance.
“The trial should ideally be conducted on a relevant population of Americans, inclusive of diverse genders and ethnicities,” he said. “This is because most clinical trials in America have only studied Caucasian males, and many clinical trials are conducted in India, whose population’s genetics, lifestyles and environment do not look like ours.”
Be wary of allergies, and check expiration dates.
Feeling confident about what’s in your supplement is only one piece of the puzzle, said Dr. Dung Trinh, chief medical officer of the Healthy Brain Clinic in California. To make sure your supplements are safe and effective, it’s important to check for allergens and expiration dates as well.
“When shopping for supplements, read the ingredients,” Trinh said. “If you have any allergies or medical conditions, it’s important to check the label for any potential contraindications. You should also make sure you are aware of the recommended dosage and follow it carefully. Taking too much of a supplement can be harmful, and taking too little may not have the desired effect.”
Finally, don’t take expired supplements. “Expired supplements may not be effective and could even be harmful,” he said.
Remember that it’s best to get your nutrients from a healthy, balanced diet.
While dietary supplements can be helpful in making up for any nutritional deficiencies, Trinh said he always tells his patients to look to food first when trying to get the necessary vitamins and minerals.
“In general, I believe that it’s best to get nutrients from a healthy and balanced diet, but there are some situations where supplements may be helpful, such as for individuals who are deficient in certain nutrients, have a medical condition that affects nutrient absorption, or are following a specific dietary pattern that may be lacking in certain nutrients,” Trinh said. “The supplements I recommend to my patients vary depending on their individual needs and health goals.”
And in the case of melatonin, well, it’s always a good idea to practice good sleepy hygiene before turning to it — but if you have to, make sure it’s been sufficiently tested and studied.