Helping you buy supplements - Their preparations and forms

The many choices available allow you to find supplements that are safe, effective and convenient. But some 'special' formulations appear to provide little additional benefit and are often not worth the extra expense.

Supplements come in a variety of forms that affect both their ease of use and, in some cases, their rate of absorption. (Each supplement entry lists the available forms for that supplement.)

Tablets:
Easily stored, tablets will usually keep longer than other forms in which supplements are marketed. 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 to break down more quickly in the stomach. Increasingly, supplements are becoming 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 (although this doesn't mean that they are better absorbed by the body - just that they may be absorbed more quickly).

Powders:
People who find pills hard to swallow may prefer to 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 people 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 sold as flavored tablets - are particularly recommended for those who have trouble getting whole pills down.

Lozenges:
A number of supplements are available as lozenges or 'drops' that 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 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.

Special formulations - You will usually pay more for a supplement if the label says 'slow-release' or 'chelated'. Does it provide extra benefits? Hardly ever, according to the available data.

Slow-release formulas:
These formulas contain microcapsules, or have a coating of protein, that gradually breaks down to release the vitamin steadily into the bloodstream over 2-10 hours. 'Sustained-release' is another term for the same process.

There are no reliable studies showing that slow-release formulas are more efficiently utilized by the body than conventional capsules or tablets - in fact, in the case of the fat-soluble vitamins A, D and E, the gel-like substance that delays release may interfere with absorption.

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 evidence that chelated minerals are absorbed any better or faster than non-chelated minerals. In fact, there's no solid proof that any process or addition of ingredients improves the absorption of vitamins or most minerals.

Herbal remedies - You can buy whole herbs and make up your own formulations. But for ease of use, tablets, capsules and the other conveniently packaged forms described here (including forms for external use) are readily available in pharmacies, supermarkets and health-food shops.

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 herb in water and ethyl alcohol. The alcohol extracts and concentrates the herb's active components. (Non-alcoholic concentrations can be made using glycerin.) Tinctures are usually taken in small doses - for example, 20 drops, or 1 ml, three times daily - diluted with water or juice.

Teas, infusions and decoctions:
Less concen­trated than tinctures, teas and infusions are brewed from the fresh or dried flowers, leaves or roots of a herb. These can be bought in bulk or as teabags. Although tea is usually 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. To make decoctions, the tougher parts of a herb (stems or bark) are usually 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 being applied to the skin. (Milder infused' oils can be prepared at home.) Essential herbal oils should never be ingested. The exception is pepper­mint oil: a drop or two on the tongue may be helpful for bad breath, and peppermint oil 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 or heal bruises or wounds. Creams are light oil-and-water mixtures that are partly absorbed by the skin, allow­ing it to breathe while keeping in moisture. Creams can be used for moisturizing dry skin, for cleansing, and for relieving rashes, insect bites or sunburn.

Standardized extracts - 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 producing a herbal supplement, manufacturers can extract the active components from the whole herb. These active ingre­dients - for example, the capsaicin in cayenne peppers - are then concentrated 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. The 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. 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, and that the only way to be sure you're receiving a consistent amount of active ingredients is to take standardized extracts.

Although standardized products are more consis­tent from batch to batch, this 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. Moreover, reliability and consis­tency can be of great value, particularly when a product proves to be beneficial for a specific disorder.