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Supplements come in a variety of forms that affect both their ease of use and, in some cases, their rate of absorption.
For most people, tablets and capsules are the most convenient form of supplement to take, but there are other options as well.
Tablets: Easily stored, tablets will generally keep longer than other supplement forms. In addition to the vitamin itself, tablets often contain generally inert additives known as excipients. These compounds bind, preserve, or give bulk to the supplement, and help tablets break down more quickly in the stomach. Increasingly, supplements are available in capsule-shaped, easy-to-swallow tablets called “caplets.”
Capsules: The fat-soluble vitamins A, D, and E are typically packaged in “softgel” capsules. Other vitamins and minerals are processed into powders or liquids and then encapsulated. Like tablets, capsules are easy to use and store. They also tend to have fewer additives than tablets, and there is some evidence that they dissolve more readily (though this doesn’t mean they are better absorbed by the body — just that they may be absorbed more quickly).
Powders: People who find pills hard to swallow can use powders, which can be mixed into juice or water, or stirred into food. (Ground seeds such as psyllium and flaxseed often come in powdered form.) Powders also allow dosages to be adjusted easily. Because they may have fewer binders or additives than tablets or capsules, powders are useful for individuals who are allergic to certain substances. In addition, powders are often cheaper than tablets or capsules.
Liquids: Liquid formulas for oral use are easy to swallow and can be flavored. Many children’s formulas are in liquid form. Some supplements (such as vitamin E) also come in liquids for applying topically to the skin. Eyedrops are another type of liquid.
Chewables: Such supplements — usually packaged as flavored wafers — are particularly recommended for those who have trouble getting pills down. In this book, the most common wafer form is DGL, a licorice preparation. DGL is activated by saliva, so the wafers must be chewed, not simply swallowed.
Lozenges: A number of supplements are available as lozenges or drops that are intended to dissolve gradually in the mouth, either for ease of use or, in the case of zinc lozenges, to help in the treatment of colds and the flu.
Sublingual tablets: A few supplements, such as vitamin B12, are formulated to dissolve under the tongue, providing quick absorption into the bloodstream without interference from stomach acids and digestive enzymes.
You will usually pay more for a supplement if the label says “timed-release” or “chelated.” Does it provide extra benefits? Hardly ever, according to available data, and so paying more for this type of product is generally a waste of money.
Timed-release formulas: These formulas contain microcapsules that gradually break down to release the vitamin steadily into the bloodstream over roughly 2 to 10 hours, depending on the product. (“Sustained-release” is another term that describes the same process.)
There are no reliable studies showing that timed-release formulas are more efficiently utilized by the body than conventional capsules or tablets — in fact, the gel-like substance that acts to delay the release may actually interfere with the absorption of fat-soluble vitamins. And although timed-release versions of niacin may help prevent unpleasant side effects, this formulation (which is commonly used to lower cholesterol) can be harmful, so is not recommended.
Chelated minerals: Chelation is a process in which a mineral is bonded to another substance, or “chelator” — usually an amino acid. This attached substance is supposed to enhance the body’s absorption of the mineral. In most cases, there’s no proof that chelated minerals are absorbed any better or any quicker than nonchelated minerals.
In fact, there is no solid information that any process or added ingredients improve the absorption of vitamins or most minerals. It’s more important that supplements meet standards for dissolving within a set period of time — indicated by the designation “USP” on the label.
Natural sources: Advertising claims imply that the vitamins derived from “natural” sources (such as vitamin E from soybeans) are better than “synthetic” vitamins created chemically in a laboratory. They may state that their natural products are more potent or more efficiently absorbed — and manufacturers generally charge more for natural products. But what is “natural”?
Actually, most supplements, no matter what their source, undergo processing with chemicals in laboratories. Some products labeled “natural” are really synthetic vitamins with plant extracts or minute amounts of naturally derived vitamins mixed in. Hence, “vitamin C from rose hips” may be mostly synthetic. And even the most natural products are refined and processed, and contain some additives. In any case, there’s no difference chemically between natural and synthetic vitamins — nor can your body distinguish between the two.
Some researchers consider natural sources of vitamin E more effective than synthetic versions. But the International Units (IUs) used to measure vitamin E’s potency take this into account, so a capsule designated to provide 400 IUs will have that potency no matter what its source.
Generally, there’s no reason to pay more for supplements advertised as “natural.” The cheapest synthetic vitamin or mineral supplement will give you the same benefit. Of course, the cheapest supplement isn’t always the best. You should check the excipients, or additives, in a supplement to be sure that you aren’t allergic to any — and you may have to pay more for a supplement with fewer of these filler ingredients.
You can purchase whole herbs and make up your own formulations. But for ease of use, tablets, capsules, and the other prepackaged forms described here (including forms for external use) are readily available in drugstores, supermarkets, and health-food stores.
Tablets and capsules: You can avoid the taste of the herb if you take it in tablet or capsule form. Both tablets and capsules are prepared using either a whole herb or an extract containing a high concentration of the herb’s active components. In either form, the constituents are ground into a powder that can be pressed into tablets or encapsulated. Some herbs are available in enteric-coated capsules, which pass through the stomach to the small intestine before dissolving, minimizing potential gastrointestinal discomfort and, for some herbs, enhancing absorption into the bloodstream.
Tinctures: These concentrated liquids are made by soaking the whole herb or parts of it in water and ethyl alcohol. The alcohol extracts and concentrates the herb’s active components. (Nonalcoholic concentrations can be made using glycerin.) Tinctures are usually taken in small doses — say 20 drops, or 1 ml, three times daily — diluted with water or juice.
Teas, infusions, decoctions: Less concentrated than tinctures, teas and infusions are brewed from fresh or dried flowers, leaves, or roots of an herb; these can be purchased in bulk or in tea bags. Although tea is generally made with boiling water, the herbal teas recommended in this book are prepared as infusions, using hot water on the verge of boiling, which preserves the beneficial oils that can be dissipated by the steam of boiling water. As for decoctions, the tougher parts of an herb (stems or bark) are generally simmered for at least half an hour.
Use these liquid remedies as soon as possible after brewing them, because they start to lose their potency within a few hours of exposure to air. Store them in tightly sealed glass jars in the refrigerator, and they’ll retain some strength for up to three days.
Oils: Oils extracted from herbs can be commercially distilled to form potent concentrations for external use. These so-called essential oils are usually placed in a neutral “carrier” oil, such as almond oil, before use on the skin. (Milder “infused” oils can be prepared at home.) Essential herbal oils should never be ingested. The exception is peppermint oil. A few drops on the tongue are recommended for bad breath, and capsules are beneficial for irritable colon.
Gels, ointments, and creams: Gels and ointments, which are made from fats or oils of aromatic herbs, are applied to the skin to soothe rashes, heal bruises or wounds, and serve other therapeutic purposes. Creams are light oil-and-water mixtures that are partly absorbed by the skin, allowing it to breathe while also keeping in moisture. Creams can be used for moisturizing dry skin, for cleansing, and for relieving rashes, insect bites, or sunburn.
When herbs are recommended in this book, we often suggest you look for “standardized extracts.” Herbalists and manufacturers use this term to describe the consistency of a product. When creating an herbal supplement, manufacturers can extract the active components from the whole herb. These active ingredients — say, the allicin in garlic or the ginsenosides in ginseng — are then concentrated and made into a supplement (tablets, capsules, or tinctures). They are standardized to supply you with a precise amount in each dose.
Sometimes, instead of standardized extracts, manufacturers process the whole, or crude, herb. In this case, the whole herb is simply air- or freeze-dried, made into a powder, and then packaged into a supplement — again a capsule, tablet, tincture, or other form.
Whether a standardized extract or the crude herb is better is an ongoing controversy among herbalists. Supporters of crude herb supplements contend that the whole herb may contain still unidentified active ingredients, and that only through ingesting the entire herb can all the benefits be obtained. On the other hand, advocates of standardized extracts argue that the active ingredients in whole herbs can vary greatly depending on where they’re grown and how the herbs are harvested and processed. Standardization proponents say the only way to be sure you’re receiving a consistent amount of active ingredients is by taking standardized extracts.
Although standardized products are indeed more consistent from batch to batch, this fact doesn’t guarantee that they are more effective than whole-herb products. But in many cases, you would have to use a much greater amount of a whole herb to achieve a similar therapeutic effect. More to the point, reliability and consistency can be of great value, particularly when a product proves to be beneficial for a specific disorder.
When you buy standardized extracts: The amount of an active or main ingredient in a standardized herbal extract is often expressed as a percentage: Milk thistle “standardized to contain 80% silymarin” means that 80% of the extract contains that ingredient. Accordingly, recommendations in this book for most standardized products are given as percentages. For example, a 150 mg dose of milk thistle standardized to contain 80% silymarin contains 120 mg silymarin (150 x .80 = 120). Sometimes, though, a standardized extract product will simply state the actual amount of active ingredient you’re getting (e.g., 120 mg silymarin) rather than listing a percentage.
Multivitamin and mineral formulas are not new products, and many herbs have traditionally been paired with others to enhance their benefits. The most straightforward pairings combine herbs with similar effects, such as valerian and chamomile, which both act as sedatives. Other formulas include herbs that address different symptoms of an ailment, not unlike a combination cold remedy that has one ingredient for congestion, another for sore throat. Still others feature an array of substances touted as antioxidant “cocktails.” And supplement manufacturers have also marketed herbs with vitamins and other nutritional supplements such as amino acids.
Some of these combinations can promote health and may also save you money. In addition, you may find that fewer pills are needed to obtain the desired effect. For example, liver-detoxifying products called lipotropic combinations often include the nutrients choline, inositol, and methionine and the herb milk thistle — all of which, in a blend, assist liver function. These formulas cost less and are more convenient to take than individual supplements.
In some combination products, however, certain ingredients are present in such small quantities that they can’t have any therapeutic effect. They are there simply to promote the product. So it pays to check the label to determine the amount of each ingredient.
The Hype Factor
In an effort to distinguish one brand from another, supplement manufacturers have come up with their own jargon in promoting their products. The following terms commonly appear on supplement labels and in advertisements. Each term implies a superior product, but none has a standard definition agreed upon by experts or by the regulations governing the manufacture and sale of supplements. Pay attention to the specific ingredients and directions on a label rather than the hype of these terms:
Natural (or Naturally Occurring)
Source:Your Guide to Vitamin, Minerals and Herbs (Reader’s Digest)