Excipients in vitamin supplements: Allergy sufferers should be wary

If you experience itching, rash, gastrointestinal discomfort, or even difficulty breathing when taking vitamin supplements, nine times out of ten, you are not allergic to the vitamin itself. The problem lies in the excipients that you have never paid attention to. When people with allergies choose supplements, they must not only look at the content of active ingredients. They must prioritize the excipients in the ingredient list, otherwise it is easy to get into trouble.

A while ago, I met a friend who is lactose intolerant and allergic to milk protein. He usually avoids a strict diet than anyone else. Even when drinking milk tea, he has to order dairy-free. Following the trend, he bought a popular imported multivitamin. After only two days of taking it, he developed hives on his arms. It was so itchy that he couldn't sleep all night. I went to the hospital to check for allergens. I haven't touched any new foods recently. I finally flipped through the ingredient list of vitamins and saw a small line in the corner that said "Excipients contain lactose."

If you just pick up a bottle of vitamin tablets and look through the ingredients list, you will know that the vitamin C, B complex, and nicotinamide at the top are the active ingredients that everyone is buying. The long list that follows you can’t name are all excipients: fillers and supplements used to compress the powder into tablets. The disintegrating agent used to spread the tablets in the intestines and stomach, the lubricants used to prevent them from sticking to the production machine, the flavoring agents used to mask the strange smell of vitamins, the gelatin in the gummies, the sodium bicarbonate in the effervescent tablets, as well as the pigments added for good looks and preservatives added for long-lasting storage are all included in the excipients. The combined proportion of these things may be higher than the active ingredients, but most people don’t even look at it when they buy it.

Interestingly, there has always been a lot of controversy about supplements and excipients. Most practitioners in the nutritional supplement industry feel there is no need to make a fuss: as long as the excipients are added in compliance with national standards and the dosage is within a safe range, people with normal physiques will have no problem eating them. It can even be said that without these excipients, most vitamin supplements cannot be made at all - if you imagine, B vitamin tablets without flavorings are so bitter that you feel like vomiting after taking them for two seconds. Tablets without disintegrating agents are what you eat and pull out, and cannot be absorbed at all. The excipients themselves are to improve the feeling of use and absorption rate, and are never "harmful ingredients".

But allergist clinicians have a completely different attitude. When I was chatting with a doctor in the allergy department of a local tertiary hospital, he said that every year he encounters more than a dozen patients who come to the hospital due to allergies to supplements and excipients. The American Academy of Allergy, Asthma and Immunology has also issued relevant reports before. Among allergy cases related to nutritional supplements, 1.2% are induced by excipients, among which lactose, gelatin, soy lecithin, and artificial colors are the four most common allergens. For people who have a clear history of food allergy or have a hypersensitive constitution, even if the excipients are added in only a few thousandths of the amount, it is enough to trigger an immune response. In mild cases, it may cause rashes and diarrhea, or in severe cases, it may even induce laryngeal edema, which is no small matter.

A while ago, I met a mother who came for consultation. She said that after eating the DHA gummies for her child, her mouth became red and rashed after eating it twice. She thought it was a seafood allergy, but it turned out that the problem was caused by the porcine gelatin added to the gummies. Her child was already mildly allergic to pork protein. Who would have thought that animal gelatin could be added to DHA gummies? There are also the vitamin C effervescent tablets that everyone often buys, which taste sour and sweet like orange soda. They contain artificial flavors, aspartame, and sodium benzoate, which are a real minefield for patients with phenylketonuria or people who are sensitive to preservatives. I once had a client who was allergic to gluten. After taking vitamins for half a month, he suffered from irritable bowel syndrome and diarrhea. Finally, he discovered that the filler in the supplements was wheat starch, which contained trace amounts of gluten.

Of course, there is no need to talk about the excipients. If you are not allergic and do not have any clear food allergens, there is no need to dig into the details of the excipient list. Regular products are safe if added in compliance with regulations, so there is no need to be overly anxious.

If you really have high allergies or have clear allergens, be careful when buying supplements: don’t just look at the content of active ingredients advertised on the details page. First, turn to the ingredient list on the back of the package and look for the allergen tip at the bottom. Regular products will have ingredients that may cause allergies marked, such as "contains soy, dairy, and gluten." If your allergens happen to be met, just change it. If you are really unsure, break off half a pill and try it when you take it for the first time. Observe for 24 hours if there is no discomfort before eating it normally. You can avoid 90% of pitfalls.