Tag Archive for: absorption

Timing for Enzymes, Prebiotics, and Probiotics

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My digestive system has undergone changes—it doesn’t work like it used to work. Hence, I’ve been paying closer attention to digestive supplements. My voice had been getting raspy, and I had occasional reflux; I was concerned the two were related. I had an endoscopy and found I was correct. They also found a hiatal hernia.

When your body doesn’t work as well as it should, you look for something to help. In this case, digestive enzymes, probiotics, and prebiotics are where you begin.

Digestive Enzymes

These are products that contain pancreatic enzymes that will help digest proteins, fats, dairy, and several kinds of carbohydrates. For them to be most effective, take them just before or as you begin eating, about five to ten minutes before.

Here’s a change in my recommendations from the past: You can take the digestive enzymes up to an hour after you began to eat. They work all through your small intestine, and that takes hours. They’ll catch up to the food you’ve eaten.

Unless you are taking them only because you know that protein gives you excessive gas or you need them to digest a meal with cheese, take them before every meal. Even snacks? Yes, unless you know the specific food. How do you know? Trial and error.

Will using the supplement cause your body to stop making the enzymes naturally? Apparently your body already isn’t making them, so don’t be concerned. The only other thing to work on is the volume of food you eat. Maybe for you, the amount is the issue, not the enzymes you naturally produce. It’s really trial and error.

Prebiotics and Probiotics

The only real research that’s been done on timing of probiotics and the foods that feed them, the prebiotics, was done with models of the digestive system in test tubes. Based on that, the best time to take probiotics with prebiotics is just before or with meals. Personally, I take my probiotics with a fiber prebiotic any time because the right food for the probiotic is going with them. But if it helps you to remember to take them, take them before, during, or after a meal. Just take them and if it’s with some fruit and vegetables, that’s great—more food for them to eat.

The Bottom Line

Your digestive system changes at various stages of life. That’s not a bad thing; it’s normal. Digestive products can help adapt to changes in your gut, as they helped me.

I’ve tried to give you the best approach for maximum benefits from your supplements. While the timing may be important, nothing is as important as taking them consistently. We tend to stop when we feel better; don’t do that! Remember, these are supposed to be made by our body or obtained from the food we eat. Take digestive supplements consistently to get results.

What are you prepared to do today?

        Dr. Chet

Reference: Benef Microbes. 2011 Dec 1;2(4):295-303. doi: 10.3920/BM2011.0022

Timing May Be Everything

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I’ve recently gotten a few questions on the timing of dietary supplements. That means it’s time for a review.

The first category would be multivitamins-multiminerals (MVMM) and other single- or multi-nutrient vitamin-mineral combinations such as calcium plus magnesium and vitamin D. The best time to take them is during or after a meal. The reason is that food has chelators for minerals and nutrients that can help with absorption.

What if you take a MVMM and want extra calcium? It depends on your objective. If you take them separately, you’ll get better absorption of the calcium and other minerals. As I said, there are substances in food that help absorption. But if you want to take them together, some will pass through but most will be absorbed.

The question is maximal absorption versus convenience. It won’t make a major difference, but consider what would be easier for you to remember; if you consistently forget to take them at separate times, you won’t absorb anything!

Consistency. The body adapts to what you do on a consistent basis. Timing for enzymes and microbes on Saturday.

What are you prepared to do today?

        Dr. Chet

When Supplements Aren’t Absorbed

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If you take any type of dietary supplement, you want to make sure that you’re getting the active ingredient whether that’s turmeric, the mineral iron, or omega-3 fatty acids. The problem is that whether in its natural form in food or put into dietary supplements, nutrients can be difficult to absorb. In addition, the same holds true for pharmaceuticals as well. Here are some of the reasons why:

  • Taking supplements with food is important for nutrient absorption. If they’re fat-soluble, they need fat present to be absorbed. That’s problematic if someone takes the supplement without food or is on a low-fat diet.
  • I seem to always talk about increasing fiber in the diet, and we should, but fiber can interfere with the absorption of some nutrients. It may be the increased transit time or some form of mechanical blockage, but it happens.
  • Finally, gut health may also impact the absorption of nutrients. Lack of enzymes, too acidic or too alkaline, or lack of a healthy microbiome can also impact nutrient absorption.

All is not lost; the pharmaceutical and supplement industries have been working on ways to help deliver more active ingredients. I’ll cover those on Saturday.

What are you prepared to do today?

        Dr. Chet

Unusual Questions: Resistant Starch

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Recently an Insider asked what I knew about resistant starch and whether it can help control blood sugar in someone whose blood sugar was higher than normal. Here’s what I found.

Resistant starch (RS) is found in many vegetables and some fruits. It resists digestion and absorption, especially in the small intestine. One of the problems: RS is described on the Internet as not digested and absorbed, but that’s not accurate. It resists digestion and absorption in the small intestine but doesn’t block it completely. Because it doesn’t break down to sugar molecules, RS will not spike blood sugar the way non-resistant starch might.

RS is digested by gut bacteria in a fermentation process. Because the RS feeds healthy bacteria, it produces, among other substances, short-chained fatty acids—fats that can be used for energy without being processed by the liver. The highest amount of RS can be found in beans, grains, potatoes, bananas, and plantains.

However, it’s not quite as simple as that because food preparation happens to be important in this process. I’ll cover that as well as some other research on RS in Saturday’s Memo.

What are you prepared to do today?

        Dr. Chet

How Chromium Conflicts with Levothyroxine

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In the recent series of Memos on thyroid issues, I explained what you need to know about levothyroxine, the medication prescribed for an underactive thyroid gland. New research highlights a key factor in ensuring its effectiveness.

Researchers examined a dietary supplement to see what impact it would have on absorption of levothyroxine. They found that chromium picolinate reduced the absorption of the drug in subjects who took a high level of levothyroxine.

If chromium picolinate, typically used in weight loss supplements, interferes with high levels of the drug, it could impact lower doses even more; less would be available to be absorbed. If not as much of the drug is absorbed, it will not be as effective.

If you’re trying to lose weight, the last thing you want to do is lower your metabolic rate, so what should you do if you take both levothyroxine and chromium? The researchers recommended that people taking the medication be warned to take it at a different time from the supplement; four hours is the time frame. Take your levothyroxine as soon as you get up—that’s when you should be taking it anyway—and begin the supplement with lunch and throughout the rest of the day, depending on how much you take.

What are you prepared to do today?

Dr. Chet

 

Reference: Thyroid. 2007 Aug;17(8):763-5.

 

Bioavailability Ends with Bioactivity

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Here’s where we stand: we’ve digested a nutrient and it’s been absorbed into the bloodstream. How is it going to be used? How do we get the benefit of vitamin C, magnesium, alpha-carotene, or caffeine? Let’s take a look.

Many target cells have receptors that are specific to a nutrient, like a wrench that fits only one size of bolt. For example, when blood sugar rises after pasta is digested and absorbed, insulin is released from the pancreas. Insulin will attach to a specific insulin receptor on the cell membrane, and that will allow a glucose molecule to enter the cell to be used. Cells also have receptors for vitamin C to be absorbed into cells.

That’s fairly straightforward. The next step would be actually performing a function once the nutrient enters the target tissue. Let’s look at caffeine for example. There’s a genetic factor; one version of a gene can process caffeine quickly while a mutation of that gene processes it slowly. I can drink coffee and immediately go to sleep. Others may process it slowly and may not be able to sleep in the evening after a cup of coffee for lunch. Same nutrient, different effects on different people.

In addition, there are numerous enzymes that help make chemicals such as hormones or structures such as cartilage. If enough of an enzyme isn’t being manufactured or it’s blocked from being utilized, that can have an impact on how well a nutrient works. An example would be insulin; if cells are not producing enough receptors, or the receptors are resistant to insulin, blood sugar would rise. That leads to overall insulin resistance, one aspect of being prediabetic.

Another example would be the manufacture of glucosamine. The process requires fructose-6-phosphate and the amino acid glutamine; the first is a result of the breakdown of sugar while the later is the most prevalent protein-building amino acid in the body. The manufacture of glucosamine also requires an enzyme. If a person doesn’t make enough of that enzyme, that affects the production of glucosamine which then impacts the production of other forms of connective tissue such as cartilage, ligaments, and bone.

The Bottom Line

Every day there are new nutrition products introduced that are supposed to be better for you because more nutrients are available, but nutrition just doesn’t work that way. As I’ve tried to show you this week, the problem is that it isn’t quite as simple as what you see in Internet ads. Nutrients have to be digested, absorbed, and used by the body, and things can go wrong at any step along the way. Each individual’s body is unique and comes with its own idiosyncrasies and difficulties, and that’s what makes nutrition so complicated.

Maybe you’re thinking, “What’s the point if so much can go wrong?” What you have to remember is that most of the time everything works just as it should; not everything related to bioavailability goes wrong in every person. It’s also a matter of degree—maybe absorption will be cut by 50% or activity reduced 10%. I want you to understand why some nutrients won’t work as expected for a particular person, and why claims of better bioavailability aren’t a guarantee.

Yet we’re still here, aren’t we? We’re here because our ancestors survived. To steal a line from “Jurassic Park”: Nature finds a way.

What are you prepared to do today?

Dr. Chet

 

Reference: http://bit.ly/2raDviy

 

Bioavailability Continues with Absorption

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On Tuesday I talked about some of the processing required to get nutrients ready for absorption. The next phase of bioavailability is the absorption of the nutrient from the gut into the bloodstream. Let’s look at what’s involved.

The absorption process occurs via the intestinal epithelial cells and they vary in size and function in the small and large intestine. Some nutrients such as lipids may use a passive process to be absorbed. Sugars, amino acids, and others will use an active process involving transporter enzymes as well as using energy to be absorbed. Vitamin B12 absorption is much more complicated; it requires something called intrinsic factor and then is passed to another protein carrier for absorption.

Here’s where absorption can go wrong. Maybe you don’t produce enough of a transporter enzyme for one or more amino acids. Perhaps you have a condition such as irritable bowel syndrome, and some of the areas where absorption occurs are missing. There are more scenarios related to absorption, but they can all lead to a lack of bioavailability. Then there’s the fact that all our bodies are the tiniest bit different. Because most absorption studies are done with simulations of the digestive system cells, product claims of greater bioavailability can easily differ from what actually goes on in your digestive system.

Let’s say that you have digested and absorbed a nutrient. Does that mean your body will actually be able to utilize the nutrient? That’s the topic of Saturday’s Memo.

What are you prepared to do today?

Dr. Chet

 

Reference: http://bit.ly/2raDviy

 

Bioavailability Begins with Digestion

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Last Saturday’s Memo introduced a new concept: a systems approach to nutrition. One term that gets bounced around a lot related to dietary supplements or different types of food is bioavailability. Claims are made that “this form of our supplement is 10 times more bioavailable than that form.” It sounds so simple, right? It’s not—we’ll spend this week looking at all that’s involved in bioavailability. It begins with the entire digestive system.

Digestion is the process of breaking down a food or nutrient for absorption. There may be plenty of a nutrient consumed, but it has to be broken down into a form that can be absorbed. That begins in the mouth by chewing, and then the action really heats up in the stomach; acids are released to break the food into smaller molecules, if required. After leaving the stomach, the digestive enzymes begin to work on the food to continue the process. If it’s a nutrient from a supplement, it may be absorbed as it is or it may need to be modified biochemically. As the nutrient continues through the small and the large intestine, it may require a modification by bacteria before it can be absorbed.

There are many points in the process that can affect absorption. Does a person’s stomach release enough acid? Does the pancreas make enough digestive enzymes? Is there enough food that provides chelating agents for minerals? Is the microbiome healthy enough to continue the breakdown of the nutrient? You can see how the system can be affected in numerous places. But we’re not done yet. On Thursday, we’ll talk about absorption.

What are you prepared to do today?

Dr. Chet

 

Reference: http://bit.ly/2raDviy

 

The Best Source of Calcium

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Let’s go back to where we began. Is any form of calcium, whether from foods, supplements, or some new-fangled source, any better absorbed than another?

No—not enough that it would make a real difference, anyway. There are two primary forms of calcium available that have lead to this absorption controversy, so let’s take a look at them. In supplement form, calcium carbonate has the most calcium per mg at 40% while calcium citrate has about 20%. That means that fewer milligrams of calcium carbonate are needed to get the amount a person needs to take.

The . . .

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Variances in Calcium Absorption

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On top of the calcium absorption issues discussed in Tuesday’s message, there are a few more factors that have to be considered. In healthy women, gross absorption efficiency spans at least a threefold range, from 15% to 45%, even after adjustment for differences in intake.

Here’s an example. One woman, absorbing at 45% efficiency, extracts 135 mg of the calcium in an 8-ounce serving of milk containing 300 mg of calcium and after subtracting the calcium used in digestion, her net calcium is 100 mg. But another woman absorbing at 15% efficiency extracts only 45 mg and . . .

We're sorry, but this content is available to Members and Insiders only.

If you're already a DrChet.com Member or Insider, click on the Membership Login link on the top menu. Members may upgrade to Insider by going to the Store and clicking Membership; your membership fee will be prorated automatically.