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 Post subject: Vitamins the oral route
PostPosted: Sun Jun 23, 2019 7:20 pm 
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Bogdan Popa, MD:

The Oral Route

When you take a vitamin by mouth, your body has to do a lot of work to move that vitamin into the blood stream. The process is actually fairly complex and quite inefficient.

Water-soluble vitamins, for example, are large molecules. They can’t just pass through from your intestines directly into the blood stream like IV vitamins can. Instead they have to cross your “enterocytes” or “colonocytes”—fancy terms for the layer of cells lining the entire intestinal tract. These cells have phospholipid cell membranes that are impenetrable to water soluble vitamins and nutrients.

Unless you’ve already discovered liposomal vitamins (discussed in another post) which are wrapped in the same phospholipids making up the cell membranes, the “regular” water soluble vitamins actually need special “transporters” to move each individual nutrient across the cells lining the intestinal tract.

One such transporter is called the Sodium-dependent Multi Vitamin Transporter (SMVT). Think of the SMVT (or any other multi-vitamin transporter) like the passport control station at the border between two countries. They allow certain individuals to get through while prohibiting others. In this case the “individuals” are vitamins trying to cross the border to get from the gut into your blood circulation.

Aside from being limited in capacity, the SMVT transporter regulates the absorption of several vitamins and nutrients: Biotin (vitamin B1) important in skin, hair, nails integrity and immune function, pantothenic Acid (vitamin B5) and alpha lipoic acid (ALA – a key antioxidant).

Because it is responsible for the transport of several nutrients this means each of them has to get in line waiting to cross the border into your blood circulation. This means oral vitamins compete with each other for access to the blood stream! The diagram below shows how this works. When you look at it, keep in mind “lumen” means the inside of the gut and “blood” is the circulation side of the border.

There are of course other transporters for other vitamins that perform the same “passport control” function to get that vitamin from the gut into blood circulation.

Thiamine (vitamin B3)— a vitamin important in cardiovascular and neurologic function—uses transporters called Thiamine Transporter 1 and 2 (THTR1 and THTR2—these are shown in the diagram above). These transporters are abundant, but are easily influenced by what we eat and drink. Chronic alcohol consumption, for example, significantly inhibits absorption of vitamin B3 E. Coli infections also cause a significant inhibition of thiamine uptake as well.

Riboflavin (vitamin B2)—vital in the generation of energy (ATP) in mitochondria and for the activation of folate (vitamin B9) into its active form—uses the transporters RFVT-1 and RFVT-3 (also pictured in the diagram above). Chronic alcohol consumption, as well as some medications can significantly inhibit absorption of Vitamin B-2.

I could go on and on here, but you should be getting the picture by now. Oral supplementation is already challenging, because unless you are taking a very special form of supplements (liposomal), it’s going to be hard for these vitamins to cross from your small intestine into your blood stream. This is further complicated by the “transport” stations that are like border crossing from your gut to your blood where vitamins have to line up and vie with one another for priority placement. On top of all this, the transporter molecules themselves can be impacted by a wide range of dietary and lifestyle factors that impact their abundance and, therefore, their usability.

Put simply oral supplements are not very efficient or bioavailable to your body.

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