The Common Form Of Nutrients In Vitamin & Mineral Supplements May Still Leave Your Body Undernourished.
Dec 01 2016
According to the US Department of Agriculture (USDA) nutritional deficiencies are rampant in over-fed/undernourished America. Just a sampling from the USDA list of essential nutrients that are not consumed in sufficient amounts by a percentage of the population includes vitamin E (86.4%), folic acid (40.3%), magnesium (57%), potassium (92.4%), vitamin C (42%), zinc (29.2%). [Knowledge of Health]
The Recommended Daily Allowance for essential nutrients is generally too low and the above figures don’t even approach the massive nutrient shortages in the population at large.
For example, virtually every human being on earth is deficient in vitamin C when one considers humans internally synthesized their own vitamin C in the liver before a gene mutation halted that antioxidant mechanism many generations ago. [Medical Hypotheses 1977]
In winter months in North America the only people likely to have reliably sufficient vitamin D levels are those who take dietary supplements.
The answer to the problem of undernutrition is not always a better diet, though that helps. Nutrient gaps in the diet can be made up for with dietary supplements. Non-users of vitamin/mineral supplements are 2.5 times more likely to have a nutrient deficiency compared to those who adhere to a daily regimen of supplements. [DSM.com]
While public health authorities promote consumption of more fruits and vegetables, the public health initiative to eat 5-servings a day of plant foods fell flat in regard to mortality reduction [British Medical Journal 2010] and the current unproven recommendation to consume 9-13 servings of plant foods a day is largely unachievable and impractical. [LewRockwell.com]
Without enrichment of the diet many Americans do not achieve recommended nutrient intake levels. [Journal Nutrition 2011] Sadly, only 1 in 4 supplement users enriched their diet on recommendation of a health care provider. [JAMA Internal Medicine 2013]
Even more disconcerting, physicians are often quick to dismiss dietary supplements, saying they have been shown to be ineffective in published studies. But a major problem in societies with a large population of older adults is malabsorption of nutrients. The age-related decline in stomach acid and bile acid secretion is associated with ineffectiveness of dietary supplements. Provision of supplemental acid (betaine) and bile factors (taurine, vitamin C) may be necessary across the board in the senior adult population. All of the water soluble nutrients (vitamin C, iron, calcium, magnesium, B vitamins) require acid for absorption and all of the fat soluble nutrients (vitamins A,D,E,K and carotenoids lutein, lycopene and beta carotene) require bile acid.
Largely due to the decline in stomach acid secretion with advancing age (a prevalent condition called hypochlorhydria), one study showed that even after taking a multivitamin up to 8% were still deficient in vitamin B1 (thiamin), 33% deficient in niacin, 39% deficient in vitamin B6 (pyridoxine), 13% in folic acid and 18% in vitamin B12. [Geriatric Nutrition 1990]
The digestive tract of over half of the US population is infected with Helicobacter pylori, a bacterium that shuts off the cells that secrete acid necessary for nutrient absorption. [Minerva Gastroenterologica Dietologica 2011]
It is impossible to treat all the cases of H. pylori in the population at large with antibiotics, which would likely result in many cases of antioxidant resistant forms of this pathogen. So only the cases that cause gastric ulcers are treated.
Here again, dietary supplements that inhibit the growth of H. pylori would be in order for population at large – such as allicin from garlic, vitamin C, aloe vera gel, vitamin D and zinc carnosine. [Letters Applied Microbiology 2014; Indian Journal Pharmacology 2011;Biotechnology Progress 2004; Scientific Reports 2015; Clinical Review Allergy Immunology 2012; Canadian Journal Gastroenterology 2002]
Betaine (aka trimethylglycine) supplementation is considered a way to re-acidify the gastric tract when taken with food (produces internal pH of less than 3.0) to improve absorption of nutrients from both food and supplements. [Geriatric Nutrition 1990; Betaine: Chemistry, Analysis, Function, Effects, V Preedy, Royal Society Chemistry 2015; Molecular Pharmaceutics 2013]
A universal digestive aid to improve nutrient absorption from foods and supplements by re-acidification with betaine and improvement of bile flow (vitamin C, taurine, rice bran IP6) along with allicin from garlic to inhibit H pylori growth has been formulated and commercialized by this author. [Garligest.com]
Another answer to the problem of malabsorption is the selection of better-absorbed forms of supplemental vitamins and minerals. Most multivitamins are comprised of the most economical forms of vitamins and minerals for reasons of affordability. But these often are not the most readily absorbed or metabolized forms of nutrients.
Here is a brief list of optimal form vitamins and minerals that exhibit superior absorption and bioavailability.
Vitamin B1 thiamin
The consumption of the fat-soluble form of vitamin B1 (benfotiamine) is magnanimously superior to that of the water soluble form (thiamin hydrochloride). [Journal Clinical Pharmacology 2014; Annals Nutrition Metabolism 1991] Oral benfotiamine is considered the best suitable form of vitamin B1 largely because of its superior absorption. [International Journal Clinical Pharmacology Therapeutics 1998] Alcohol, sugar, tea and coffee deplete B1.
Vitamin B3 niacin
More consumers of dietary supplements are familiar with non-flush/slow-release niacin to favorably raise HDL “good” cholesterol levels. But science has changed as studies now question the value of raising HDL cholesterol levels altogether. [Medscape.com] Meanwhile, in recent times a coenzyme form of niacin (aka nicotinamide or niacinamide) called nicotinamide adenine dinucleotide has been proposed as an anti-aging pill. MIT researchers recently introduced this niacin-like molecule to quell the ravages of aging. [MIT Technology Review 2015]
But nicotinamide adenine dinucleotide has been available for some time as a dietary supplement and more economical than the highly touted nutraceutical. [Source Naturals] It may be the preferred form of niacin for an aging population.
Vitamin B6 pyridoxine
Pyrodixyl 5-phosphate (P5P) is the active form of vitamin B6. Sugars (glucose from the liver, sucrose or fructose from the diet) deplete P5P. With P5P deficiency, sugars may form glycation end products that can damage chromosomes. [PLoS Genetics 2014]
P5P deficiency is associated with elevated blood sugar levels as well as increased inflammation. [Clinical Nutrition 2011; Journal Nutrition 2012] P5P deficiency may mimic autoimmune disorders like Type 1 diabetes. [Medical Hypotheses 2012; Experimental Biology Medicine 2011] P5P also inhibits diabetic complications (retinopathy, neuropathy). Amino Acids 2012]
Even more startling, elevated levels of vitamin B6 as P5P and vitamin B1 thiamin are associated with a lower over-all mortality rate. [Clinical Nutrition 2012]
Even what appear to be sufficient intake levels of P5P may leave substantial numbers of seemingly well-fed Americans with inadequate B6 blood levels. [American Journal Clinical Nutrition 2008]
Vitamin B9 folic acid/folate
Vitamin B9 is provided as synthetic oxidized folic acid in most multivitamins. Folate (formerly folacin) is the naturally occurring food form of this vitamin. Both forms are used for DNA repair and red blood cell production.
In recent years a scientific argument has arisen over which form of B9 is preferred. Synthetically made folic acid has been demonized to some extent. This is because synthetic B9 can potentially leave unconverted folic acid in the blood circulation. (Folic acid normally converts to tetrahydrofolate within cells.)
Three forms of B9 are available in supplements: synthetic folic acid, folinic acid and food form folate (5-methyltetrahydrofolate, or methyl folate). The latter form of B9 is absorbed even when stomach pH (acid/alkaline balance) is altered. [Clinical Pharmacokinetics 2010]
About 35% of human populations have a genetic flaw that impairs the activation of an enzyme (methylenetetrahydrofolate reductase or MTHFR) required for folic acid metabolism. Individuals with MTHFR mutations may benefit from folate over folic acid. [Psychology Today]
Since such a large percentage of the human population has the MTHFR mutation the active form of folic acid should be consumed. This means consumers should look for folate branded as Metafolin or Quartrefolic or L-form methylfolate. [MTHFR.net]
Vitamin B12 cobalamin
Vitamin B12 deficiency is common among older adults, is often elusive to deal with as B12 blood levels within the “reference range” (the commonly found range) may still not be adequate and its symptoms are so vague and broad as to fool even the best clinician.
Fatigue, sore tongue, burning feet, back aches, numbness in limbs, chronic cough, short-term memory loss are just some of the overt symptoms. Obsessive compulsive disorder is another symptom of B12 deficiency recently reported. [General Hospital Psychiatry 2012]
B12 injections are often ordered but oral supplementation can be just as effective. [Cochrane Database] However, while oral supplementation may normalize B12 blood levels ymptoms may still persist.
The recommended daily allowance (RDA) for B12, 3 micrograms, is a farce as doses 200 times greater than the RDA due to malabsorption may be required to resolve symptoms. [Archives Internal Medicine 2005]
Cyanocobalamin, the most economically available B12 supplement, is not easily converted to methyalcobalamin, the most prevalent form of B12 in the blood circulation. Methylcobalamin is preferred over cyanocobalamin. [VitaminInjections.net]
Recent reports suggest resolution of B12 deficiency symptoms may require supplementation with both co-enzyme forms of B12 (methylcobalamin and adenosylcobalamin). [European Journal Clinical Nutritrion 2015] Both forms of B12 are now emerging in some dietary supplements.
Many senior adults are deficient in vitamin B12 malabsorption induced by a shortage of intrinsic factor. [Handbook Clinical Neurology 2014] Lack of intrinsic factor is necessary for B12 absorption in the small intestine. [Wikipedia; European Journal Pediatrics 1998] Some B12 supplements provide intrinsic factor.
B12 deficiencies may require some trial uses of different forms and doses of B12 to resolve symptoms.
Vitamin E is commonly provided in a single form as d-alpha tocopherol in most multivitamins. However there are four forms of tocopherols and four forms of tocotrienols that comprise the entire family of E vitamins.
There is an association of lower mental impairment in older adults when both tocotrienols and tocopherols are adequately consumed. [Experimental Gerontology 2013; Neurobiology Aging 2012] The brain/nerve protective properties of vitamin E are related to a combination of different forms of vitamin E rather than alpha tocopherol alone. [Journal Alzheimer’s Disease 2010]
Researchers believe the sole provision of vitamin E as alpha tocopherol may nullify its alleged health benefits by alteration of the availability of the other forms of vitamin E. [Critical Review Food Science Nutrition 2010; Journal Nutrition 2003]
Well-designed multivitamins should provide both tocopherols and tocotrienols.
One study showed the incidence of vitamin D deficiency was 56% among D2 users and 25% among D3 users. [Journal Parenteral Enteral Nutrition 2015]
A strong case has been made that vitamin D2 is not suitable for food fortification or supplementation since D2 is not equivalent to vitamin D3’s ability to raise vitamin D blood levels and ability to adhere to vitamin D binding protein. [American Journal Clinical Nutrition 2006]
Chronic inflammation, weakened immunity, hair loss, acne, skin infections, Athlete’s foot, mental depression, atrial fibrillation, herpes virus eruptions, low sperm counts, dental caries, psoriasis, fatigue, diarrhea, poor wound healing, loss of sense of smell and taste, are the price humanity pays for zinc deficiency.
Not only is zinc deficiency highly prevalent, blood plasma zinc levels do not correlate with zinc intake and blood tests are not a reliable way of determining deficiency.
There are many types of zinc supplements (zinc acetate, picolinate, orotate, sulfate, oxide (usually used in topical ointments), gluconate and methionine. Zinc methionine is better absorbed and often provided with a bit of balancing copper. [KnowledgeOfHealth.com]
There is a crying need to restore magnesium to the American diet. Magnesium intake fell from 475-500 mg in 1900 to just 175-225 mg in 2002. [LewRockwell.com]
The most popularly selling form of magnesium in dietary supplements is magnesium oxide because it is more economical. However, it is so poorly absorbed (4% absorption) that it produces no different effect than an inactive placebo pill. [Magnesium Research 2003; Magnesium Research 2001] Magnesium oxide is virtually insoluble in water, which is the likely reason it is so poorly absorbed. [Journal American College Nutrition 1990] It is a shame that mag oxide is even sold as a dietary supplement.
Magnesium deficiency is rampant in America despite plentiful food. The devastatingly broad adverse health effects that can result from a shortage of magnesium profoundly impacts the health of Americans. Naïve efforts to improve magnesium intake without addressing magnesium malabsorption may lead to null studies. [Medical Hypotheses 2001; Disease-A-Month 1988]
When purchasing magnesium supplements, the question is not which magnesium supplement to buy but which one not to buy. Avoid magnesium oxide.
Over $70 million of iron pills are sold annually, most to young anemic females whose monthly menstrual flow results in loss of too much iron.
Iron pills are problematic. They induce nausea and constipation and they pose a hazard for women with young children in the home as kids may ingest them thinking they are candy. The only safe form of iron is carbonyl iron (trade name: Ferronyl). Fast absorption is not desirable. Carbonyl iron is slowly absorbed at the rate at which stomach acid is produced, which limits toxicity. [Blood 1986] Carbonyl iron has never been reported to cause death even with intentional or unintentional overdose. It should be the only form of iron allowed in the home. [Current Opinion Pediatrics 2006; Veterinary Human Toxicology 2002]
Selenium is often provided in dietary supplements as selenite or selenate that is not organically bound to a protein. Organically-bound forms of selenium (examples: selenocysteine, selenomethionine) exhibit superior absorption and bioavailability. and have been found to activate more genes and do not pose the risk of increased oxidation that can damage DNA. [[Biological Trace Element Research 2015;Animal Reproduction Science 2011; Archives Toxicology 2010] One particular brand of organically-bound selenium (trade name: Seleno Excell) provides a full array of the many selenium-containing proteins found in nature, rather than just one form, such as the popular selenium attached to methionine or cysteine (selenomethionine/selenocysteine) and is backed by human studies. [Cypress Systems]
Poor nutrient absorption often negates the benefits of the best diets and supplement regimens. This problem is largely ignored by modern medicine. It is a highly prevalent problem among senior adults. Misdiagnosis of disease that emanates from nutrient malabsorption is likely a massive underlying problem in an era when physicians treat all symptoms as if they are a drug deficiency. Acidification of the digestive tract combined with dietary supplements chosen for optimal absorption should become a strong public health initiative. The frequent use of nutraceuticals to inhibit H pylori growth to reduce antibiotic use should also be a preventive health measure. The reformulation of multivitamins to include optimally absorbed nutrients in an acid base should be considered.
The information provided below should serve as an aid to consumers who seek absorbable dietary supplements. The selected brands have been vetted for quality and price.
SUPERIORLY ABSORBED FORMS OF SUPPLEMENTAL NUTRIENTS
- Vitamin B1 as thiamin: Benfotiamine
- Vitamin B3 as niacinamide: Nicotinamide adenine dinucleotide
- Vitamin B6 as pyridoxine: Pyridoxyl phosphate P5P
- Vitamin B9 as folic acid: Folate (Metafolin, Quartrefolic)
- Vitamin B12 as cynobalamin: Methylcobalamin B12, Methylcobalamin w/intrinsic factor, Adenosylcobalamin, Hydroxocobalamin
- Vitamin D2 (ergocalciferol): Vitamin D3 (cholecalciferol)
- Vitamin E as tocopherol: Vitamin E with tocopherols & tocotrienol
MINERALS, TRACE MINERALS
- Zinc gluconate: Zinc methionine
- Inorganic selenium as selenite, selenite: Organically bound selenium in a natural full array of protein-bound forms
- Iron as ferrous sulfate: Iron as carbonyl iron (Ferronyl)
Magnesium oxide: Magnesium chloride, carbonate, malate, glycinate, gluconate, threonate, others