DIFFERENT FORMS OF SUPPLEMENTS

Q. I have heard that tablets and capsules are hard to digest and therefore I am not really able to take advantage of their contents. Why are supplements still made in these forms if they are inferior? Are there certain supplements I need to make sure to take in liquid or powder form?

A. There are some common misconceptions about the different forms of supplements available, why they may be most beneficial, and for who. One common misconception is that every supplement is better absorbed if taken in a liquid form. Yes, there are some advantages to liquid, just as there are some drawbacks. Although cost does not always equal quality, there are some advantages to quality name brand or professional brand supplements, one being superior absorption. Nowadays, huge advances have been made in terms of capsule/softgel and tablet quality.

Supplement manufacturer's invest a considerable amount of money and research into the breakdown potential/bioavailability of their supplements, whether it's the forms of the vitamin they are using or the products that they are combining the herbs/vitamins with, you can be sure that quality companies have done their homework and can assure these substances are being absorbed by the average individual. Certain conditions and often age will effect how well any supplement, food or prescription medication is absorbed. More on this in a minute.

Liquids & Powders - The Advantages
One of the main reasons I recommend a liquid or powder as opposed to tablet or capsule is really based on dosage. In some cases the difference in dosage per teaspoon versus per capsule is quite great. For items that often require a high potency to get the most therapeutic benefit, or for supplements that are heavier and difficult to get in a capsule, liquid and powders do have their advantages. For example, I will often recommend a liquid fish oil versus a capsule simply because I think it simplifies things. In my opinion, it is EASIER to take 2 teaspoons of something versus 6 -8 capsules per day. Calcium and Iron are two great examples of supplements that are heavy and can be difficult to fit into capsule from and because of this often contain a less than optimum dosage per cap. Again, in this case, there may be a benefit in terms of simplicity, to take these supplements in liquid or powder form. A scoop of powder mixed into juice, water or milk of your choice, sounds much simpler to me than its equivalent 10 capsules. In this case a powder is also much more cost effective. There is also flexibility with dosing when taking liquid or powders, if you want to take somewhere between 250 and 500 mg of a substance, you simply add another half teaspoon. This is much harder to do with capsules and impossible to do with softgels or tablets.

There are also a few specific cases, in which a liquid form may be better absorbed. This usually effects individuals with severe malabsorption disorders, such as Crohn's, Ulcerative Colitis, Celiac, Cystic fibrosis, etc. I include the elderly in this category, as well. As we age, the efficiency with which out body produces enzymes, as well as the amount of enzymes that are produced by the stomach, pancreas and intestine are significantly compromised. In these individuals, it may prove beneficial to use a liquid. Less breakdown is needed and this may help to ensure that they are absorbing as much as possible from their supplements.

Sometime swallowing a capsule is also impossible or extremely difficult, as in a small child. For these individuals, of course, a liquid, powder or even chewable table may be necessary.

Liquids & Powders - The Disadvantages
As I mentioned, there are also some cons to the liquid and powder supplement options. The topic of standardization comes into play here. One advantage to taking herbs, in particular, in capsule form, is that they are usually standardized to include a specific amount of 'active ingredient' per capsule. Particularly in terms of plant based/herbal medicines, let's use milk thistle as an example, when taking a capsule, softgel or tablet, the manufacturers can tell you exactly how much silymarin is contained in each cap. Liquid supplements cannot be standardized this way. Some ingredients, having a greater density than others, also settle to the bottom of a liquid supplement, making shaking a necessity.

Liquid and powders are also much less convenient to travel with, or bring with you to work, if it is a supplement that you are taking multiple times per day. Powders need to be mixed with a liquid, again adding another awkward element if you are needing something more convenient. In these cases, capsules are much more practical. Liquids, in particular, also have a somewhat shorted shelf life and often need to be kept in the fridge once opened.

Also, if an herb is in a liquid tincture form, it is most commonly in an alcohol base. However minute the amount of alcohol, this may not be appealing to some individuals, ie; parents who are giving these herbs to young children.

Capsule, Vegicap, Softgel or Tablet or Caplet... to many options!
In terms of softgels versus capsules, versus tablets or caplets, it all really comes down to what you can afford and what you can swallow, literally. Tablets may be harder for some individuals to swallow, as tend to be fairly big and their surface is not as smooth as a capsule or softgel., but they retain their potency the best of most options. Capsules, gelcaps or vegi-caps, breakdown very easily and are easier to swallow than most tablets. They can also be broken open, so there is some flexibility in terms of dosage. The drawback, as with softgels, is that this form of supplement does tend to be the most expensive and cannot fit as much material, meaning you may need to take a few to get an adequate dosage. Softgels, because they are completely sealed, tend to be very shelf stable, but again more expensive and there is no flexibility in dosage.

As you can see the debate goes far beyond 'absorption' and really becomes more of a personal preference, depending on who is taking the supplement, how much they are taking and what the supplement contains.

Let's Talk Timed Release...
I will also take this opportunity to talk about the 'time released' or sustained release capsule and some more common misconceptions about why and when this may be necessary. First of all, there seems to be a large group of individuals who are uncertain whether this technology is even effective. It is. In a sustained release capsule, the active ingredients are attached to a 'carrier' ingredient that is usually somewhat difficult for the body to break down. You might see non-medicinal ingredients on the bottle, like cellulose/microcrystalline cellulose, povidone, shellac, etc. This substances are eventually eliminated as waste, but in the process of trying to break them down, the medicinal ingredients to which these other ingredients are attached are also absorbed and utilized much slower, giving them a much more sustained release/effect in the body. This is definitely a benefit with certain substances, but not necessary with others. Let's take vitamin C, for example, megadoses of vitamin C have very poor absorption, with smaller doses being absorbed much easier. It is said that 20 mg or less of vitamin C at one time has about 98% absorption, while 1-1.5 g has only 50%. There are a few other factors to mention here, the first is foods high in vitamin C, which have very good absorption rate. There is also some research to suggest that absorption is impacted by need. For those who use higher doses of vitamin C while sick or under stress, you will absorbing more than you would at other times and mage dosing to some degree, may be necessary. This is also something to consider when supplementing with vitamin C.

Melatonin is also a supplement that you will commonly see in a timed release formula. This has less to do with dosage requirements and absorption (as these vary significantly based on individual need), as it has to do with when melatonin is needed and how it works in the body. For the majority of individuals, bedtime is roughly 11 pm. This is also the time we tend to take supplements and prescription medications meant to help us both to fall asleep and stay asleep. The problem with melatonin is that we are taking it to boost our natural stores, which peak roughly 2-4 hours after sleep, if all is working optimally. BUT, if you are taking melatonin, all is most likely NOT working properly. This often means the melatonin you are taking at 11 may help you to fall asleep, but does nothing for the peak levels that should be happening at 3 or 4 in the morning. This is often why so many individuals will find they wake up early and can't fall back to sleep when taking melatonin. A timed release formula allows for a slower release and better chance of maintaining a steady balance of melatonin throughout your sleep, so there is less chance of early waking.

Half life is also something to consider when thinking timed release capsules. Half life is the amount of time it takes for half of the substance in your body to be used. Supplements with a long half life, such as vitamin D, do not need to have a timed release option. Other substances are absorbed and utilized very quickly in the body, such as the antioxidant N-Acetyl cysteine, and therefore a sustained release formula of these supplements may prove helpful in increasing the longevity of their benefit. Do a bit of homework before you head to the healthfood store. Make sure the timed release supplements you are buying (and probably paying a little more for) are formulated this way for a reason. There is not always a benefit or a need for a slow release of active ingredient.

Well, I'm Just Peeing Them Out!!!
Another common misconception about vitamin C and other water soluble vitamins, particularly in higher than RDI amounts, is that we are wasting our money because we are simply peeing them out. The body does get rid of EXCESS water soluble vitamins quite efficiently, but it's important to be clear that if your urine changes colour after a B-vitamin for instance, it does not mean it has not been absorbed or is going to waste. On the contrary, in order to be excreted by the kidneys, these vitamins have to be broken down and absorbed. In this sense, a colour change in the urine is actually conformation that you ARE utilizing these vitamins. Embrace the yellow pee!

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