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[blog updated April 2019]

You walk into any pharmacy or health food store and you see hundreds of bottles of vitamins and supplements. You think to yourself which should I buy that will improve my health? You may spend time considering which brand of vitamin to choose, the dosage and, of course, the cost. But what you should take into careful consideration in the form and route of the vitamins and supplements you are going to take.

Important fact: the vitamins and supplements that are consumed orally in pill form and that are swallowed in most cases only about 30% are absorbed by your body.

Why is that? Simple physiology. In medical physiology class, we learn in our first year about the liver’s function in detoxifying any substance we ingest. It’s called the First pass effect. It’s there to protect us from any harmful toxins. However, in doing so, it also takes out of the body’s intestinal circulation a portion of any other ingredients, including vitamins and minerals that we ingest.

Gastrointestinal System
The body has many ways to absorb vitamins and nutrients other than the gastrointestinal system. These different routes can be a lot more potent than swallowing a desired vitamin or mineral. You have to be careful in dosing in these cases because you can be getting a more powerful amount of the ingredient because you are bypassing the liver’s detoxification system.

For example, the skin is a way that topical medicine or nutrients can quickly get into your bloodstream. So don’t think just because you are using a “simple cortisone cream over the counter” that it isn’t getting directly into your bloodstream – not just your skin. The problem from an immunological view (my specialty) is that using topical ingredients on the skin can make some people susceptible to developing an allergic reaction when they ingest the ingredient or medicine late. This is the reason there is no topical penicillin. It was discovered in early research that using penicillin topically can make certain individuals more likely to develop an allergic reaction to oral or injected penicillin.

Nasal sprays are another way to get medicines or vitamins into the body directly but the nose is a very sensitive area – and using these substances would be too irritating on a regular basis. Again, remember if you are using a decongestant nasal spray (like Afrin) it is going directly into the bloodstream. That’s why the manufacturers caution patients with heart conditions or high blood pressure to be aware.

The sublingual area – the space below your tongue is an excellent area to get in vitamins, supplements, and even certain medications. My expertise is in sublingual immunotherapy for patients with allergies and Candida, but I also recommend taking supplements sublingually. The reason is that again, it bypasses the liver and you get maximum absorption. This is my preferred route of vitamin ingestion.

Intravenous and intramuscular vitamin/mineral injections are also excellent ways to achieve high doses of absorption for patients, especially those with chronic health conditions and leaky gut syndrome.

Dr. Mitchell’s Vitamin and Mineral Recommendations

Healthy Young Individuals:

In some cases, a healthy young person might not need any vitamins or supplements if he or she is eating super healthy. But almost all could still benefit from a few key vitamins:

Bluebonnet Liquid Vitamin D3 DropsAmerican Health Ester-C, EffervescentVitamin C
Chronic Medical Conditions: Leaky Gut, Candida, Autoimmune diseases (Celiac or B12 deficiency)
  • These patients can benefit tremendously from a boost of injectable vitamins and minerals depending on the severity of their condition, especially Vitamin C because it is too difficult to achieve oral dosing without side effects like gastritis or diarrhea.
  • At-home patients would benefit from continuing to try and maintain good levels of vitamins and minerals with these sublingual products:
  • Activated Methyl B12 and 5 MTHF lozenges that dissolve on the tongue (Seeking Health | Active B12 Lozenge with L-5 MTHF | Vitamin B12 Supplement | Methylfolate | 60 Lozenges is a brand I use).
  • Vitamin C as mentioned above.
  • Vitamin D3 sublingual drops 2-4,000 units depending on your vitamin D3 level(Bluebonnet)

Dr. Dean Mitchell

So, remember next time you are thinking of spending your money on supplements that will benefit your health – don’t just consider what type of vitamin you are buying, but the way you are going to take it!

– Dr. Dean Mitchell, M.D.
Mitchell Medical Group, NYC

About the Author – Dr. Dean Mitchell, M.D.

Dr. Dean Mitchell, M.D.

Dr. Dean Mitchell, M.D. is a Board Certified Allergist and Immunologist based out of NYC. He graduated from the Sackler School of Medicine and completed training at the Robert Cooke Allergy Institute in New York City. He is also a Clinical Assistant Professor at Touro College of Osteopathic Medicine, a fellow of the American Academy of Allergy, Asthma, and Immunology, and the author of Dr. Dean Mitchell’s Allergy and Asthma Solution: The Ultimate Program for Reversing Your Symptoms One Drop at a Time. Dr. Dean Mitchell, M.D. has also been featured in The New York Times, The Huffington Post, Fitness Magazine, Dr. Oz and News NY 1. Dr. Mitchell also hosts the podcast The Smartest Doctor in the Room – a combination of a lively, personal and in-depth interview with top healthcare specialists.

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