A good choice for carnitine because of $ value

There are actually many considerations when it comes to choosing a nutritional supplement. Some people can't swallow pills and will need a liquid or powder form. Downsides of liquid forms include poor portability and the fact they will often require additional preservatives and sweeteners.

Absorption is certainly an important factor in choosing a nutritional supplement. The most expensive supplement is the one that doesn't work and one reason for a supplement not working is poor absorption. It makes sense to want to take the best absorbed supplement. Is that going to always be the one that is in liquid form?

All things being equal, I think it makes sense to choose a liquid supplement. However, all things are not equal and there are many factors to consider. Some substances are not available in liquid form. Stability and shelf-life of liquid supplements are often a problem. 

For example, the energy and muscle-building supplement, creatine is not stable in liquid. It rapidly degrades to creatinine and then will do you no good. Creatine can be found in liquid form but these products are worthless. Of course, people making money off these products tell you otherwise. Here is promotional material for one such product:

"Our Serum is a soluble and bioavailable form of creatine

* This means that it is absorbed into the bloodstream and muscles quickly

* It works this quickly because it doesn´t pass through the digestive system.

*100% stable. 2-year shelf life

*Bioavailable

*100% soluble

*Reaches the muscles in minutes."

I wrote the book on creatine

All Lies!

 I recommend creatine in powder form because a fairly large amount is needed. For people who don't like using powders and are not concerned about price, creatine is available in capsules.

Sometimes liquid won't be well tolerated because of taste. Kaprex is a capsule product that was created for reducing the pain and inflammation of osteoarthritis. Believe me, you would not want to "drink" Kaprex. I did.

At a seminar I attended, a presenter from the company that manufactures Kaprex warned that one of her coworkers bit into a Kaprex capsule and related that it was one of the most bitter things he ever tasted. This intrigued me and I had to see for myself how bitter this hops extract was. I punctured a capsule and consumed the contents. WOW! Was that intense! I delayed eating or drinking anything to see how long the bitter sensation would remain on my tongue. I finally got bored of this and had to get the taste out of my mouth - after 4 hours! Some things need to be contained in capsules.

Another example of liquid not being popular is the fact that some people don't like the taste or texture of a liquid fish oil. And then there is the issue of repeating or "fish burps" that sometimes occurs with fish oil.

 Enteric-coated capsules are uniquely able to overcome this problem. Enteric coating slows digestion of the capsule, which is sometimes desirable. If the digestion of the fish oil capsule is delayed until it has travelled further down the digestive tract, it will not "repeat".

A related aspect of tablet technology is controlled or extended-release pills. Ingredients added to the pill, such as forms of cellulose or plant fiber, slow the breakdown of the pill. In this way, the active ingredient is slowly absorbed, leading to sustained blood levels and extended biological effect. Sometimes this is desirable, although in most cases it is not. It is important to use the proper product for the best outcome. For example, extended release niacin produces less flushing- an uncomfortable effect from high dose niacin. High dose niacin is primarily used for improving cholesterol levels and cardiovascular health. 

O.K., so different delivery forms are desirable in different situations. But is liquid the best form to use for optimal absorption? Not always. Tablets and capsules are not as inferior as you might think. A well-made tablet will breakdown in the digestive tract within thirty minutes. The same is true of capsules. Granted, there are some companies that make inferior products that may not be as digestible. The key is to stick with quality manufacturers. If you are not sure of the quality of a company, it is wise to ask the advice of a knowledgeable healthcare professional.

I think it is reasonable to also expect a supplement in powder form to be better absorbed than a tablet. However, a study compared the absorption of 30 mg of iron as micronized dispersible ferric pyrophosphate in powder form versus 27 mg of iron from ferrous fumarate in tablet form. The iron from the tablet was found to be better absorbed than the iron from powder. What is more important than liquid versus powder versus tablet versus capsule is the actual form of the ingredients.

For example, when you take a zinc-containing supplement, it is not simply zinc. It is zinc bound to something else. Some of the zinc supplements available include zinc oxide, zinc acetate, zinc gluconate, zinc carnosine, zinc sulfate, zinc citrate, zinc picolinate, and zinc glycinate.  Sometimes absorption is not the top priority. If someone has gastrointestinal issues, the form of zinc I recommend will be zinc carnosine, which is the most effective for gastrointestinal healing. It has been found to improve symptoms of heartburn, nausea/vomiting, anorexia, belching, abdominal distention, and constipation. I am not aware of zinc carnosine in liquid form but it is available in powder, tablet, and capsule. The best absorbed form of zinc is zinc glycinate. If you compare absorption of a liquid supplement with zinc sulfate versus a tablet or capsule with zinc glycinate, the liquid will lose.

 Zinc oxide is the most poorly absorbed form of zinc. So, why do you find it in nutritional supplements? Because it is cheap and therefore increases the bottom line for the vitamin company. In fairness, zinc oxide has its place: in sunscreen lotion!

Concerns over absorption apply to everyone but even more to people with digestive disorders. A study involving Crohn's disease patients found magnesium glycinate to be absorbed twice as well as magnesium oxide: 23.5% vs. 11.8%. These numbers may seem shockingly low but this is reality. Some unscrupulous supplement marketing may lead to the belief that "Brand X" is 100% absorbed. Nonsense! Absorption rates for different vitamins, minerals, amino acids, fatty acids, and other natural supplements vary but none are totally absorbed. The important thing is to compare the different forms for actual absorption.

Absorption is very important but there are other considerations. For example, I might choose magnesium aspartate for magnesium restoration when an amino acid analysis shows the individual has low levels of aspartate. If the individual has a history of kidney stones, magnesium citrate will be the most protective form. If an organic acid analysis reveals low levels of sulfate, I may recommend a topical magnesium sulfate cream - especially if muscle tension is a problem. 

If you would like guidance in choosing the best nutritional supplements, call my office to set up an appointment.