What fillers and excipients are in your medicines and nutritional supplements?

Consumers want more clear-content labeling on medicines, foods, and supplements. A recent study published in the BMJ-British Medical Journal shows that vegetarians and those on restricted diets unwittingly eating animal gelatin in medications. Animal gelatin can come from cows or pigs. Vegetarian coatings and capsule shells can come from sea vegetables or other plant-based origins.

How do the patients accept inadvertent prescription of gelatin-containing oral medication? A significant proportion of vegetarians and other patients with dietary preferences borne out of cultural/religious practices are unwittingly consuming animal gelatin in prescribed medicines, reveals research published online in Postgraduate Medical Journal.

The findings prompt the authors to call for more comprehensive labeling of drug content and for vegetarian alternatives to animal gelatin to be used in manufacture. The active component of a medicine accounts for relatively little of the content; most is made up of "excipients," which include binders/fillers, disintegrants, lubricants, sweeteners, and coating agents.

Gelatin in capsules

Gelatin is a commonly used coating agent, but is also used as a thickener in liquid and semisolid medicines, particularly in generic (non-branded) medicines. The researchers surveyed 500 patients being treated for urinary/urological disorders in Manchester, a culturally diverse city in the north west of England.

Previous research has shown that many specialist urology drugs contain gelatin, while roughly one in four Mancunians is of non-white ethnicity. The researchers wanted to know about the prevalence of dietary restrictions; the willingness to take medicines containing animal content; the preparedness to ask about the content of drugs; and the proportion refusing to take drugs they knew contained ingredients derived from animals.

Two hundred patients stated they were not supposed to eat animal products. More than half (283; 56.5%) were taking medicines, 75 of whom were taking a total of 87 different drugs.

Most (88%; 176) of the 200 patients following a restricted diet said they would prefer to take medicines containing only vegetable products. Only one in 10 said this didn't matter to them.

Vegetable products or animal-derived gelatin in your medicines?

Among the 176 with a stated preference, more than half (100; just under 57%) said they would take a drug containing an animal product, if no other alternative was available. But the remainder (43%) said they would not knowingly do so.

Yet only one in five of those with a stated preference would have asked their doctor or pharmacist if the drug's content flouted their dietary requirements/beliefs. And half of the 49 men, who had been prescribed medicines containing gelatin, were taking these drugs in contravention of their stated dietary preference.

"We already know that doctors are fairly ignorant about the issue of excipients in medication," write the authors, who conclude that their findings pose ethical quandaries for the entire profession, according to the news release, "Vegetarians and those on restricted diets unwittingly eating animal gelatin in meds."

Around 10 million people were prescribed specialist urinary/urological drugs in 2009 in the UK, but this category of drugs accounts for only the 14th commonest class of prescription, they say. "[Gelatin content] is almost certainly a much bigger issue for the 860 million non-urological preparations prescribed in the UK each year, whose excipient content is not easily identified," they caution.

Clearer content labeling, the adoption of a vegetarian symbol as is done for foodstuffs, and changes in the manufacturing process could all help patients make informed choices as well as promoting best practice in medical care, they suggest.

You may be eating all those binders (excipients) in your vitamins and other nutritional supplements here in the USA

Excipients are binders, fillers, flowing agents, and various types of 'glues' that hold your vitamin pill or other nutritional supplement together or in the case of capsules, act as a filler or flowing agent to keep the capsule contents from caking or hardening. These fillers are non-nutritive binders or flowing agents used to fill up a capsule or pill.

Some of these fillers are questionable as to what they do to your body. For example, magnesium stearate found in most vitamins is just a flowing agent that according to studies may be affecting your immune system. See the studies, A Dangerous Ingredient in Your Supplements, Life Extension Position Paper, Magnesium Stearate - Medicalinsider and What Is Magnesium Stearate - Expert Health Advice & Information. Also see, Magnesium Stearate Side Effects.

Magnesium stearate is formed by adding a magnesium ion to stearic acid. The compound has lubricating properties, which is why it's often used in the making of supplements, as it allows the machinery to run faster and smoother, and prevents the pills or capsules from sticking to each other.

See the article, "Does your supplement contain this potentially hazardous ingredient?" Dr. Mercola's article reports, "Stearic acid has been linked to suppression of T cells. The filler also stimulates your gut to form a biofilm, which can prevent proper absorption of nutrients in your digestive tract."

The advice in Dr. Mercola's article also notes how to identify high quality multi-vitamin supplements. See the site, Food Additives ~ CSPI's Food Safety. For other information, also see, The Report on Carcinogens from the U.S Department of Health and Human Services. Although Magnesium Stearate isn't causing any cancer, in some cases it may contain formaldehyde which recently has been listed as a carcinogen by the U.S. Dept. of Health and Human Services. The point is not so much what a filler does, but what else it contains.

Can some fillers stimulate your intestines to prevent proper absorption?

For example, if a particular filler can stimulate your intestines to prevent proper absorption of nutrients in some cases, you want to find out whether it does or doesn't have that ability on your body, since people have different genes influencing immunity. People are concerned whether their vitamins are synthetic or natural. If their B vitamins, for example, are synthetic, the question is whether the synthetic B vitamins are derived from coal tar. You want natural sources for your vitamin B supplements, for example, made from proprietary probiotic fermentation.

Your form of vitamins, for example, vitamin B complex products, should be ready for use by each of your cells, if you even take vitamins or other supplements in the first place. The question for many is whether to buy live-source vitamin B complex usually advertised in journals that go to doctors interested in alternative and functional medicine.

Many people still buy vitamins in supermarkets in the inner aisles among the food or first-aid products rather than in the natural food aisles or in health food stores or from online research labs that are known and supported by medical doctors who are knowledgeable about what's in supplements and how are the supplements made.

For example how many doctors know that weight control may rely on what type of bacteria is in your gut? See the December 27, 2012 Sacramento Bee article, "Weight control could be a gut thing," by Drs. Kay Judge and Maxine Barish-Wreden.

The article focused on discussing how microbes, specifically bacteria in your gut may also contribute to your obesity issues. Such bacteria constitute their own organ system called the microbiome. As your diet focuses more on highly processed grains instead of whole grains or other foods, an imbalance could occur creating inflammation and endotoxins that contribute to changes in hormones, which in turn lead to obesity and various types of weight gain.

The obesity-linked bacteria is known as 'enterobacter'

What helps are foods such as garlic, leeks, and onions that contain prebiotics that specialize in restoring gut health and the good bacteria you need. Sometimes supplements help such as prebiotics and probiotics.

The goal is to restore gut health by reducing the harmful bacteria in your gut and keeping a balance with the good bacteria that don't change your hormones so that you become obese. But more research is needed on probiotics and prebiotics to see whether managing weight issues is about balancing the but bacteria. Another health-related article in the news for Sacramento is, Integrative Medicine: Holistic holiday stress reduction.

Also see another Sacramento Bee news article about health, "Doctors took money, wrote treatment guidelines"-- December 26, 2012. According to that article, doctors with financial ties to drug companies have heavily influenced treatment guidelines that recommend the most lucrative drugs in American medicine, an analysis by the Milwaukee Journal Sentinel and MedPage Today has found. Check out the news stories.

Know how excipients work in your body

As for excipients, at least you should be aware of them and which types of supplements have them listed on the labels. You may want to know what else is in a particular type of excipient in your supplements that also contains a carcinogen such as formaldehyde or other ingredient on the list of known carcinogens, since many people take daily supplements such as vitamins for many decades.

For example, a vitamin may contain harmless fillers, but the question is what else is in the fillers or with what were they processed which might vary from hexanes to formaldehyde or other substances. You don't want hexanes giving you vertigo symptoms, for example.

Check out the May 23, 2009 article, "Soy Protein Used in "Natural" Foods Bathed in Toxic Solvent Hexane," by Mike Adams. The article reports, "Much of the "natural" soy protein used in foods today is bathed in a toxic, explosive chemical solvent known as hexane. Also see the article, "Are the hexanes in your supplements giving you vertigo?"

Here's a list of some excipients you may find in your supplements such as vitamins and other nutritional extracts, powders, crystals, capsules, and pills

Maltodextrin

Cellulose starch

Silicon dioxide

Dicalcium phosphate Polysorbate 80

Titanium dioxide Pharmaceutical glaze Microcrystalline cellulose

Sodium benzoate

Natural flavors

Methacrylic

copolymer

Triethyl citrate

Crosscarmellose

Polyethylene glycol 3350