What's in this pill?

Q The label on the vitamins I bought has a list of "inactive" ingredients. Why are they there? Can they hurt me?

A When you buy a supplement, you buy it for the active ingredient--the vitamin, mineral, antioxidant or herb. But you're also likely to get an inactive ingredient or two--whether you want to or not.

Inactive ingredients--called excipients in the industry--are necessary to make the raw material of vitamin C into a pill or put echinacea into a capsule. They provide bulk, ease of manufacturing, timed release in the body, a slippery coating so the pill is easy to swallow, a sweetness so chewable tablets are palatable, or coloring or bleaching to make supplements more attractive. In short, excipients make the delivery of active ingredients possible. And by the Food Drug and Administration's definition, that's all they are intended to do.

However, some supplement experts caution consumers about two of the most common excipients. Lactose, for instance, can be problematic for those who are lactose intolerant, says Al Czap, publisher of the peer-reviewed journal Alternative Medicine Review and founder of Thorne Research, a Sandpoint, Idaho-based company that produces supplements distributed through naturopaths; and physicians.

Czap is also none too fond of another common excipient, magnesium stearate, frequently used in high-volume manufacturing processes to speed the flow of ingredients through the machinery. Czap believes magnesium stearate impedes the body's absorption of the supplement's active ingredients.

But others in the field dismiss that idea. "Magnesium stearate--it's nothing of any consequence," maintains Earl Mindell, R.Ph., Ph.D., author of The Vitamin Bible (Warner Books, 1991).

How does a consumer decipher a label full of inactive ingredients? Fortunately, some manufacturers make it easy by stating outright that the supplement is free of sugars, salt, artificial colors, preservatives or lactose. But not all suppliers do this, and there's no single source that will answer all your questions.

"On some of these labels, the ingredients read like a page from your organic chemistry textbook," commiserates Burton Kallman, Ph.D., consulting scientist for the National Nutritional Foods Association, based in Newport Beach, Calif. In fact, Kallman routinely relies on his reference books to explain, for instance, the role of excipients benzoic acid (a rosemary extract used as an antioxidant and preservative) and titanium dioxide (a natural whitening agent).

For the average consumer scanning the shelves, Mindell simply advises looking for inactive ingredients that derive from natural sources; avoiding preservatives that you'd naturally shun in foods and steering clear of the FD&C colors, often an indicator that other synthetics are present. To investigate further, call The National College of Naturopathic Medicine information line ([503] 255-7355) weekdays between 1 p.m. and 4 p.m. Pacific time. Or contact the manufacturer directly; some offer help lines. Check the label for a phone number or write to the address on the bottle.

Overall, Mindell believes there are worse things to worry about than a supplement's inactive ingredients. "I wish we were so astute about cigarettes and alcohol," he says. "If cigarette and alcohol manufacturers had to list their ingredients the way supplement manufacturers do, we'd be a lot healthier."

RELATED ARTICLE: Is Your Supplement Vegetarian?

Vegetarians and vegans may want to investigate the excipients used in their supplements. Excipients come from a variety of sources, not all of which are plant-based. Gelatin, for instance, which is used to make capsules is an animal-based product. However, a vegetarian version is available that uses carbohydrate gum and glycerin in a base of naturally derived antioxidants--just look for the word "Vegicap" on the label. Lactose, which is used as a binder, comes from milk; cellulose, another binder, comes from plants. The lubricant magnesium stearate may be manufactured from plant or animal sources. If the label doesn't indicate that the Supplement is free of animal ingredients, call the manufacturer for a definitive answer.

RELATED ARTICLE: Take Five

Five categories of excipients go into making your vitamin or supplement. The categories are:

* Binders. Materials that promote cohesion, like dextrose or polyethylene glycol.

* Lubricants. Typically fatty acids, or stearates, which speed manufacturing.

* Disintegrators. Agents like cellulose or sodium lauryl sulfate that promote the breakup of the tablet in the body.

* Coloring and flavoring agents. Substances such as sugar, chlorophyll and the FD&C colors used to make the product more palatable.

* Diluents. Fillers, such as starch or sodium chloride (salt), which increase the bulk of a product.

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