Supplements in practice - Administration and Excipients

Question 1

Forms of Supplementation

Answer 1

Supplements take many different forms:
* Tablets: Cheaper, easier to produce large quantities. Generally contain more excipients so try to avoid.
* Capsules: Fewer excipients but not efficient for large doses.
* Powders: Good for bigger doses; e.g. glutamine. Not suitable for sticky ingredients, ones that attract moisture, e.g. phosphatidyl serine or fruit powders, where there is a toxicity risk, or where ingredients are unstable.
* Liquids: Excellent absorption but more expensive and less stable. Many, such as fish oils, need antioxidants such as vitamin E added to prevent oxidation.
* Enteric formulations: Excipients, such as shellac (made from resin of female lac bug) or cellulose acetate phthalate (CAP), used to ensure tablets survive stomach acid so that they don’t release contents until the small intestine. Commonly used for good garlic capsules.
* Spore form: Good form to enable probiotics to survive the stomach acid and reactivate in the intestines.
* Chewable formulations: As vitamins and minerals may taste unpleasant, most vitamin and mineral powders are coated before they are compressed into tablets.
* Slow-release formulations: Cheaper slow-release tablets contain hydrogenated fats to hold the tablets together longer – choose a good quality slow release formula.
Excipients = additives used in forming tablets and capsules to bind active ingredients together.
Enteric =‘intestine’; prevent nutrient release before it reaches the small intestine

Question 2

Liposomal

Answer 2

• Liposomal supplements have a protective phospholipid bilayer protecting the active ingredients.
  o High bioavailability and absorption.
  o Increased oral uptake in the mouth.
  o Increased uptake into target cells.
  o Easier to take than large tablets.
  o Suitable for water-and fat-soluble nutrients.
• A study showed taking liposomal B12 showed a 270% increase in absorption after two months.
• Liposomal vitamin C has a significantly higher absorption rate than non-liposomal forms.

Liposome = Greek: lipo (fat) + soma (body). Spherical lipid bilayer, which forms an internal cavity capable of carrying substances such as vitamins.

Question 3

Excipients and Active / Non-active ingredients

Answer 3

The therapeutically-active component in a supplement can be as low as 2% of the total content:
* Nutrients often cannot be manufactured and put into a tablet or capsule without a stabilising agent to keep them active.
* Non-active ingredients do not affect the overall therapeutic action. Although, these ingredients are potentially harmful.
* Excipients and fillers are the ‘glue’ which bind and stabilise.
* Capsule shells: Made from gelatine or from plant cellulose.
* Flow agents: Help formulations flow easily through machinery but no nutritional benefit. Avoid magnesium stearate.
* Binding agents: Help to bind ingredients together to make a tablet; e.g. maltodextrin.
Note: Refer to the table of excipients linked to this lecture

Question 4

Excipient types/functions:

Answer 4

Fillers: Help to fill capsules, particularly when small amounts of an active nutrient is needed e.g. B12 or vitamin D.
* Natural fillers: Lithothamnion calcareum from fossilised seaweed; vegetable powder; new form of rice flour that is inert.
* Emulsifiers: Used to mix oily and watery ingredients together.
* Flavours: Avoid MSG.
* Colours: Riboflavin, beet extract, turmeric.
* Sweeteners: Glycerine.
* Preservatives: Vitamin E, ascorbic acid.
* These excipients, or inactive ingredients are often listed separately. Choose supplements without them / with minimal essential ones.