How to Read a Supplement Label

Start with the front panel: what it says and does not say

• Product name and category: is it a multivitamin, a single nutrient, a herbal extract, a protein powder or a "health drink"?
• Claims: phrases like "boosts immunity", "supports joint health" or "for heart health" are marketing, not proof. Regulators in India (FSSAI) restrict claims that a product treats or prevents disease. Any label promising to remove diabetes, cancer, arthritis, dementia or other illness is a red flag.
• Targets: "for seniors", "50+", "men", "women", which hint at formulation but do not prove suitability.
• Form and quantity: tablets, capsules, powder, liquid, sachets; count or weight.
• Vegetarian or non-vegetarian mark: the green dot or brown dot required on food products in India.

The supplement facts panel

### Serving size and servings per container

The panel says, for example, "serving size: 1 tablet" or "2 capsules", "servings per container: 60". All the amounts listed are per serving. If the serving is two capsules and you take one, you get half. Check how many servings the directions recommend per day.

### Ingredient names and amounts

Each active ingredient is listed with its amount per serving and, usually, the percentage of the recommended daily allowance (RDA or NRV) for adults. Notes:

• Units matter. Look closely: - mg (milligram): one thousandth of a gram. - mcg or µg (microgram): one thousandth of a milligram. 1,000 mcg = 1 mg. Mixing these up gives a thousand-fold error. - IU (international unit): used for some vitamins (A, D, E); conversion depends on the vitamin: for vitamin D, 40 IU = 1 mcg; for vitamin E and A, conversions differ by form. Some labels give both. - CFU: colony-forming units for probiotics. - ml, g, grams for liquids and powders. - Percentage of RDA: gives a quick sense of amount. 100 per cent means about the daily requirement; 500 or 1,000 per cent means a mega-dose. Higher is not better. For some nutrients (such as B vitamins, vitamin C), excess is mostly excreted, but for others (vitamin A, vitamin D, iron, calcium, zinc, selenium), excess can cause harm. An ingredient shown with no percentage has no established RDA, and the dose may be arbitrary. - Daily value "per serving" versus "per day": check which is used.

### Elemental amounts for minerals

Minerals appear in compound form: calcium carbonate, calcium citrate, magnesium oxide, ferrous sulphate, zinc gluconate. The label may give the compound weight or the elemental amount. For example, "calcium carbonate 1,250 mg" provides about 500 mg of elemental calcium; "ferrous sulphate 300 mg" provides about 60 mg elemental iron. Compare the elemental amount to the recommended intake, and confirm with the pharmacist if the label does not state it; see calcium and vitamin D after 60: doses, food and sun and iron and anaemia in older adults.

### Forms of nutrients

Names after the nutrient indicate the form: vitamin D3 (cholecalciferol) versus D2; B12 as cyanocobalamin or methylcobalamin; folate as folic acid or methylfolate; omega-3 as fish oil, krill oil or algae oil, with EPA and DHA amounts listed separately from the total oil. For fish oil, "1,000 mg fish oil" does not mean 1,000 mg of EPA plus DHA; see omega-3 supplements for seniors: evidence and cautions.

### Proprietary blends

A "proprietary blend" lists a total weight and a list of ingredients without individual amounts. You cannot tell how much of each is present, and the most expensive or active ingredient may be a trace. Prefer products that disclose individual amounts.

### Herbal and botanical ingredients

Look for the plant name (Latin name), the part used (root, leaf, seed), the form (extract, powder), the extract ratio and the standardisation (for example, "curcumin 95 per cent"). "Ashwagandha 500 mg" of root powder differs from an extract. Herbal products can interact with medicines; see supplements and medicine interactions: a safety guide.

Other ingredients

Below the active list, "other ingredients" or "excipients" include fillers, binders, coatings, colours, flavours, preservatives and sweeteners. Check for:

• Sugar, maltodextrin, jaggery or artificial sweeteners (important for diabetes).
• Sodium (in effervescent tablets, which can contain large amounts of salt, a concern in heart failure, hypertension and kidney disease).
• Potassium (a concern in kidney disease).
• Allergens: milk (whey, casein), soy, gluten, nuts, shellfish (in glucosamine and krill products), egg, fish.
• Gelatin (animal origin) in capsules, for vegetarians; look for vegetable cellulose capsules.
• Colours and additives that may cause allergies or irritate.
• Lactose in some tablets, relevant for lactose intolerance.
• Caffeine and stimulants in "energy" products.

Directions, warnings and interaction notes

• Suggested use: how many, when, with or without food, for how long.
• Warnings: statements such as "consult your doctor if you are on blood thinners, have kidney disease or are about to have surgery" should be taken seriously. Their absence does not prove safety.
• "Not for use in..." conditions.
• Do not exceed the recommended dose.
• Keep out of reach of children, since iron overdose in children can be fatal.
• Not a substitute for a varied diet or medical treatment.
• Storage instructions: cool, dry place; some need refrigeration.
• Taking with food or on an empty stomach, and spacing from other medicines. This is where your pharmacist's advice is valuable.

Legal and quality marks in India

• FSSAI licence or registration number: nutraceuticals and health supplements in India are regulated under food safety rules, and the label should show the manufacturer's FSSAI licence number (14 digits), with a logo. The absence of one is a warning.
• Manufacturer and marketer details: full name and address, customer care contact.
• Batch or lot number, manufacturing date and expiry (use-by) date. Check that they are clearly printed, not stuck on or smudged.
• MRP, net quantity, country of origin.
• Ayurvedic, Siddha and Unani products should carry a manufacturing licence number from the state licensing authority, and the label should list ingredients and the formulation reference.
• Certification marks: GMP, ISO, third-party tests by independent laboratories, and organic or other claims; verify, since logos can be copied.
• Imported products: should carry an Indian importer's details and licence; avoid products with no local contact.
• Barcode and QR codes can help verify authenticity with the maker.

Comparing two products

1. Convert both to the same units and per-day dose. 2. Compare the active amount per day against the recommended amount, not just the percentage. 3. Check the form (some are better absorbed). 4. Compare cost per day or per gram of active ingredient, not per bottle; see care costs in India: budgeting. 5. Prefer simple formulas and disclosed amounts. 6. Check for third-party testing and licence details. 7. Check excipients for your parent's allergies and conditions. 8. Consider pill size and form for swallowing ease; see swallowing problems (dysphagia) in older adults. 9. Ask the pharmacist.

Red flags on a label

• Claims to treat or prevent disease, or to "replace medicine", "detox", "reverse ageing", "completely safe" or "no side effects".
• "Breakthrough", "magical" or "secret formula" language.
• No FSSAI or AYUSH licence, no address, no batch number, or no expiry date.
• Mega-doses (thousands of per cent of the RDA).
• Proprietary blends with no amounts.
• Long lists of herbs in small unknown doses.
• "Doctor recommended" or celebrity endorsement with no names.
• Testimonials and before-and-after photos.
• Prices far below the market or pressure to buy now.
• Misspellings, poor print quality, different fonts, broken seals, which suggest counterfeit; see spotting fake or poor-quality care products.
• Unlisted ingredients or "natural flavours" hiding allergens.
• Products sold with steroid-like effects such as sudden weight gain or energy, which may contain hidden drugs; avoid.

Checking authenticity and storage

• Buy from licensed pharmacies and authorised sellers, not from unverified online sellers or roadside vendors.
• Check the seal, packaging, hologram or QR code on arrival.
• Keep the receipt.
• Store properly: heat and humidity degrade vitamins, make tablets crumble and spoil oils and probiotics; keep bottles tightly closed, away from the kitchen stove, bathroom and direct sun; do not transfer to unlabelled containers.
• Discard expired, discoloured, smelly or damp products, and those whose seal was broken.
• Label your parent's pill organiser and keep the original packs for reference; see pill organiser guide.
• Report adverse reactions to the doctor, and, where available, to the product's maker and the pharmacovigilance system.

When to ask a professional

Ask the pharmacist to read the label with you, convert units, check the elemental amounts and spot interactions. Ask the doctor whether a supplement is needed, in what dose and for how long, and which tests to repeat. Ask a dietician about food sources. Seek urgent help for allergic reactions, bleeding, black stools, severe vomiting, jaundice, palpitations, confusion or severe low sugar after taking a supplement; call 112 if severe.