Buyer Beware # 3: Did Your Vitamin Advisor Discuss Absorption?
The following is a reproduction of a Millennium Health Centre editorial article which appeared in the Seaway News newspaper in Cornwall, Ontario, Canada. The content is shortened to accommodate a newspaper space allotment. As such, it is not academically cited with references. These are available, so please feel free to email your questions.
Dr. Stephen F. Jones B.Comm., N.D.
Doctor of Naturopathic Medicine
Two previous columns cautioning Seaway News readers about quality concerns of many vitamin supplements has generated a great deal of interest and inquiry. As such, this last column will hopefully answer the remaining questions.
The previous columns discussed limitations in the current regulation of natural health products and further itemized many of the 'binders', 'fillers', 'lubricants', 'coatings' and 'colorings' that far too frequently appear in vitamins without the consumer's knowledge.
The last critical topic worthy of review is that of the actual absorption of these (often expensive) vitamins and supplements. Quite directly, it doesn't help the patient if the ingredients listed on the label end up passing right through their body. This does, in fact, happen more often than you might expect.
This decreased absorption occurs due to several key influences. The first are the 'extra' ingredients discussed in past columns. These can directly prevent or reduce the absorption of the medicinal ingredients.
The next is the 'form' of the vitamin. A general rule is that liquid vitamins are better absorbed than capsules and capsules are considerably better absorbed than solid tablets (or 'caplets' as they are now trying to call them). A more important consideration, however, is whether or not the medicinal ingredients are attached to 'carrier' particles to improve absorption (and what 'carrier molecules' are used). As an example, labels which list minerals as being "from elemental" sources (ie. "elemental magnesium") have poorer absorption that minerals attached to certain 'carrier molecules' (depending on the 'carrier' molecule). Minerals in these forms will say such things as 'citrate'/ 'malate' / 'chelate' on the label (ie. 'magnesium citrate') and offer better absorption than the 'elemental'/ 'oxide'/'sulfate' (etc.) forms available. Which form is best, however, depends on the mineral in question. Suffice it to say that the form makes a substantial difference and your advisor should be able to discuss these differences.
To better appreciate this concept, consider calcium. The most common form used in many supplements is called calcium carbonate. That's unfortunate, as studies indicate that, at best, only 10% of the indicated amount will actually be absorbed by the body. Significantly better forms are calcium 'citrate malate' (ie. not just citrate) or 'microcrystalline hydroxyapatite'. Studies show these forms offer the best possible absorption of calcium. Supplement quality, as you can see, becomes very important.
A final consideration regarding absorption is an investigation into the actual functioning of the patient's 'digestive' system. One mere example (as space is limited) includes a patient's level of stomach 'acid' (which can be tested). Insufficient stomach 'acid' (often found in seniors, those under stress and those on medications such as ulcer or 'heartburn' medications) will result in significantly decreased absorption of vitamins like B12 or minerals like calcium (especially in the carbonate or straight 'citrate' forms). As such, the patient should have this consideration tested for and treated accordingly before deciding on what supplement (and what form) to take.
In all, vitamin supplementation is not a simple issue. The patient's individual medical history and current health should be used to determine what vitamins should be used, if any, and what form they should use. Patients should review what they are taking, why they are taking them (if they can recall) and the actual composition of their supplements. Patients should avoid general 'vitamin plans' whereby they take the same vitamins as the 'next guy'. These plans are common in marketing heart health programs, weight loss programs, improved energy etc etc. They do not account for the medical individuality of the patient and often charge considerably more for a supplement.
Best of luck.
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