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Sublingual vitamins:
questions... and more questions

Sublingual vitamins are a class of dietary supplements that are not as common as other types, such as solid vitamins (tablets) or liquid vitamins.

The name clearly identifies how these supplements are delivered to the body. "Sublingual" literally means "under the tongue", indicating how sublingual vitamins are to be taken. They come in a form of very small pills, sometimes called lozenges, which should quickly dissolve under the tongue.

The most common vitamin of this type is sublingual B12, but some other vitamins are also available in this form.

Benefits of sublingual vitamins

According to manufacturers, this kind of vitamins has superior bioavailability, because of the quick absorption through oral tissues directly into bloodstream.

You can find a review of sublingual absorption and all its related problems and questions on the page about spray vitamins.

Spray vitamins, as sublingual vitamins, are claimed to bypass gastrointestinal tract by being absorbed in the mouth through oral mucosa.

Without repeating the entire review, here are the main points about the sublingual absorption:

  • Drugs, or supplements, taken sublingually are absorbed more quickly than they are through swallowing. Of course, a necessary condition is that the substance can be absorbed in the mouth.

  • Sublingual absorption allows for gastrointestinal tract bypass, which may benefit people with particular digestive problems.

  • Fat-soluble vitamins can be absorbed sublingually better than water-soluble ones.

  • There is no scientific proof of better vitamin absorption when vitamins are taken sublingually. Some papers confirm that vitamins are absorbed at the same level when swallowed, or dissolved in the mouth.

In the case of spray vitamins, lacking some solid proof of benefits, I wrote that they are at least as good as liquid vitamins from the perspective of absorption and bioavailability. (You can always just swallow them.)
Liquid vitamins and spray vitamins do not have to be dissolved, like tablets.

What about sublingual vitamins? Do they have any issues related to dissolution?

Because the most important ingredients in vitamin tablets
are not vitamins, let's have a look at the ingredients of typical sublingual vitamins tablets.

What's inside those sublingual vitamins?

Some websites which sell dietary supplements claim that sublingual vitamins do not contain binders, fillers, and other inactive ingredients, which have a general name excipients. The role of these components is to form a tablet, and to assure its proper dissolution.

Some proponents of a natural approach to nutrition do not accept any presence of such components in dietary supplements.
You can check this post, for example.

Just bear in mind that any substance can be poisonous, even ordinary water, or table salt. It all depends on the amount consumed.

Here is the list of common inactive ingredients found in sublingual pills:

  • Mannitol
    Sugar alcohol (sweetener). Mannitol is also used as a sweetener for people with diabetes, and as a sweetener in "breath-freshening" candies, where it adds the cooling effect.

  • Sorbitol
    Sugar alcohol (sweetener). May also be used as thickener.

  • Magnesium stearate
    This is a magnesium salt: a white substance which is not soluble in water. Generally considered safe for human consumption. Primary source is beef. (Vegetarians among us, beware.)
    Often used as a filling agent in medical tablets and capsules
    (No fillers in sublingual pills?)
    Probably the most important use of magnesium stearate is its use as a lubricant, preventing ingredients from sticking to manufacturing equipment during the compression of chemical powders into solid tablets.
    In addition, it can also be used to bind sugar in hard candies (No binders too, huh?)

  • Silica
    Silicone dioxide, solid adsorbent material. “Adsorbent” refers to a material to which other materials will stick. Another binder.

  • Stearic acid
    It is one of the useful types of saturated fatty acids that come from many animal and vegetable fats and oils. It has many uses, including the use in candles and soaps. It is used along with simple sugar or corn syrup as a hardener in candies.

  • Cellulose
    An organic substance, polysaccharide, main material for producing paper.

As you can see, sublingual vitamins are not innocent, and they have their portion of excipients, after all.
Let's just notice, that these pills are very small, and probably contain mostly sugars, so the amount of other inactive components is much smaller than in regular tablets.

Smaller amounts, of course, do not justify inaccurate marketing claims made by distributors of dietary supplements.

Speaking about dietary supplements: While researching the topic of sublingual vitamins, I made an unexpected and odd discovery:

The FDA does not consider sublingual vitamins to be dietary supplements

Here are two documents by the FDA (US Food and Drug Administration), which clearly state that any sublingual product cannot be considered dietary supplement.

Both documents are PDF files and require Acrobat Reader.

Document # 1

A quote from Document # 1:

Therefore, because the term “ingestion” means introduced into the gastrointestinal tract, a product that is absorbed from the mouth prior to ingestion is not subject to regulation as a dietary supplement because it is not “intended for ingestion.”

Document # 2

A quote from Document # 2:

In addition, only products that are intended for ingestion may be lawfully marketed as dietary supplements. Topical products and products intended to enter the body directly through the skin or mucosal tissues, such as transdermal or sublingual products, are not dietary supplements. For these products, both disease and structure/function claims may cause them to be new drugs.

Companies which produce drugs must arrange a series of tests to prove that their medications do actually work. Moreover, the facilities where drugs are manufactured must be registered by the FDA, and must meet FDA standards.

Dietary supplements are not medications; they are not intended to cure any condition, as is stated on every vitamin label. The FDA does not regulate - meaning, does not approve for selling based on the performance - any dietary supplements, as it does when regulating drugs.

So, this finding leaves an open question: What are sublingual vitamins?
Are they drugs or dietary supplements?
Oh, yes - the same question would apply to spray vitamins.

Isn't this strange!

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