Episode 5: Inside the Capsule – A behind the scenes look at what goes into your supplements

The content of this podcast has not been evaluated by Health Canada or the FDA. It is educational in nature and should not be taken as medical advice. Always consult a qualified medical professional to see if a diet, lifestyle change, or supplement is right for you. Any supplements mentioned are not intended to diagnose, treat, cure, or prevent any disease. Please note that the opinions of the guests or hosts are their own and may not reflect those of Advanced Orthomolecular Research, Inc.

* * * Intro Music * * *

Hello, and welcome to Supplementing Health, a podcast presented by Advanced Orthomolecular Research. I’m your host, Dr. Paul Hrkal. This show is all about applying evidenced-based and effective dietary lifestyle and natural health product strategies for your optimal health. We are going to feature some very engaging clinicians and experts from the world of functional and naturopathic medicine to help achieve our mission to empower people to lead their best lives naturally.

* * *

[1:12] Dr. Paul Hrkal: Hello, again, and welcome back to Supplementing Health. I’m Dr. Paul Hrkal, your host. Today we have a really, really exciting topic. It’s one that isn’t going to talk about a specific nutrient or herb or intervention.

[1:25] We’re going to dive into actually the nuts and bolts of what goes inside of your capsule. We’ll talk about purity. We’re going to talk about testing. We’re going to talk about possible contaminants. We’re going to get to know about the quality of your supplements. I’m joined here by Todd Frankovic. Todd, welcome to the show.

[1:43] Todd Frankovic: Thank you. Glad to be here.

[1:45] Dr. Paul Hrkal: When we talked about having this episode and getting the listeners a behind-the-scenes look, I know you’re involved with AOR, specifically, as working on both the U.S. business side. But really, I think your claim to fame if we can even term it that way is your understanding of sourcing and raw materials. That’s what we want to pick your brain. Tell us about how you got into the position that you’re in and some of your experiences.

[2:17] Todd Frankovic: Yeah, absolutely. I’ve been in this industry for almost a decade now, and I would say I got myself started in raw material manufacturing. I’ve been on the side of production and sales of raw materials, botanicals, to be more specific. Over time, I started working my way into product development for dietary supplements in the U.S.

[2:50] Over the past five or six years, I’ve been involved in product development and formulation for brands across North America, mostly focusing on greens, whole foods, and a lot of botanical powders and extracts.

[3:12] Dr. Paul Hrkal: So, it sounds like your experience is very much what you’ve gone into. Is there even an education that a person can do to get into this space?

[3:21] Todd Frankovic: You know, it’s tough for education in this space because a lot of it is through experience. But I would say that on the botanical side of it, you could go and have an education to become a botanist. Also, going to school as a nutritionist or an MD would obviously be beneficial.

[3:50] But I would say that a lot of it as far as my concern of what goes into a capsule and the materials that we’re getting and weaving a path through what quality means in a supplement, a lot of that just comes from experience and dealing with manufacturers, and vendors, and retailers, for that matter and seeing what is actually efficacious and what actually is selling in the stores and what customers want.

[4:21] Dr. Paul Hrkal: It’s a fine balance. I’m always struck, obviously, being a clinician and naturopathic doctor myself, but having experience on the industry side with AOR and understanding other natural health products, I’m always struck by the amount of work and the amount of detail and thought, and all the things we’re going to talk about today that goes into a supplement when a lot of people like my patients or customers ultimately often don’t see that, and they take that for granted. So, maybe a good place for us to start is, walk us through the lifecycle of a product, from conception to what’s sitting on somebody’s counter at their homes.

[5:02] Todd Frankovic: I think it all begins now with what ingredients are coming to the market that weren’t there before? An example being, a long time ago, people realized the benefits of turmeric. So, people were taking turmeric as a wholefood material, and they were using it in cooking.

[5:31] Eventually, people in North America weren’t using turmeric in cooking, so they ended up trying to extract it, and they extracted it for curcumin. Then as time went on, different patented materials came out that improved the buy availability of it, but how it really starts is going through traditional Chinese medicine, Ayurvedic, vitamin and mineral supplementation, what clinical studies are coming out now for new materials that are coming to market.

[6:15] Right now, a lot of studies are showing that synthetics aren’t always the best option and that there’s something called an entourage effect that a lot of these wholefood products have that synthetics just don’t come with because you don’t have the extra co-nutrients in cofactors that a nutrient is supposed to be within order to be beneficial.

[6:43] So, now, we’re looking at when we’re trying to develop a product. It’s not just what is this one ingredient going to do for the body, but we’re looking at what is this ingredient found within nature, and how can we take that and make a comprehensive product that is going to be beneficial for the whole body and not just specifically one function that may or may not work based on what is with that ingredient. And If it’s with other ingredients, that can help it work better and be safer.

[7:24] Dr. Paul Hrkal: Yeah. In a lot of ways, that makes a lot of intuitive sense because when you think about a lot of these botanical extracts, you mentioned Ayurvedic medicine and traditional Chinese medicine. These medicines, this way of healing was using botanical extracts for many years, and they were using the whole plant, or they were using the root of a plant. You weren’t just getting very specific substance.

[7:47] For example, you mentioned curcumin. Curcumin is one of the most popular natural health products, but it’s a very specific fraction of turmeric. There’s very little curcumin that comes out if you just take it in curry, a bright yellow spice, or even if you mix it in the traditional way with milk, you’re probably getting some of the polysaccharides, which are easier to dissolve instead of in fats, which is what you need to pull out in curcumin and some of the other curcuminoids.

[8:20] That’s a really great example, but a lot of the substances in products are synthetic. How do we draw that balance with using whole foods, and then also wanting some very specific, very pure ingredients, let’s say like an amino acid or B vitamin?

[8:41] Todd Frankovic: That’s actually a good point where there are ingredients like B vitamins where a lot of them—you could get B vitamins from natural organic sources in a supplement. But they’re not in the quantities that are required to supplement your diet.

[9:04] An example being B12, where B12 can degrade in many different ways. In order to get a natural B12, even though you can see natural sources of B12 on the market, usually, the doses are incredibly low and not a studied amount. In order to get the correct clinical amounts of B12, you have to use a synthetic.

[9:39] It’s a matter of there are ingredients where you have to use synthetics in order to get the clinical amount, but then there are other materials like curcumin from turmeric where there are synthetic curcumins. But you know what? Those synthetic curcumins haven’t gotten the safety studies that natural curcumin extracts have.

[10:05] So, because of that, we can tell that the natural form is better, and it’s widely understood that the natural form of curcumin and curcuminoids are better. But at the same time, there are things like the B vitamins and even PEA 10:25 and other ingredients where you just can’t get the clinical doses without using synthetics.

[10:33] So, there is a balance there of supplementing the two together in order to get the correct products, but I guess that’s where the product formulation comes in of what’s the best source of this nutrient or vitamin or mineral at any given time. That’s why products are forever evolving.

[10:50] Dr. Paul Hrkal: Yeah. It’s never static. That’s definitely one thing we can both attest to is that when you’re formulating products, and we’re both involved with that, is that you’re always looking to improve a formulation even if it may be in a class-leading or industry-leading formulation and best-seller. I can think of an experience with AOR recently where we just switched the sources of our B vitamins, for example, to a form that is more ecofriendly. Can you speak about that because AOR’s B complex was one of the best sellers internationally, and we’ve continued to evolve it a number of times in the last couple of years?

[11:30] Todd Frankovic: Yeah. One of the focuses that we have is trying to make a smaller environmental impact. We do evaluate our manufacturers and what they’re doing and what kind of practices they have in place. So, one of the ingredients that recently was having a huge environmental impact was B12.

[11:57] The process of creating B12 is very intensive and creates a lot of pollution. A lot of the manufacturers are based out of China. For the longest time, they didn’t have a lot of environmental regulations to stop these factories from creating a large amount of pollution while creating B12.

[12:22] While that was happening, we found a manufacturer in Europe that has a sustainability certificate, and with that, they have a different way of producing their methylcobalamin, which they have coined the term Green Chemistry. With that, it’s creating a lower environmental impact.

[12:46] It’s supporting the manufacturers that are going the extra mile and not just worrying about how low of a price can they sell their ingredient? But actually, caring about the planet and how to make an ingredient that’s required for us to live better, but making it in a way that is as eco-friendly as possible.

[13:09] Dr. Paul Hrkal: That sounds, obviously, really in line with what a lot of people on a political and moral front are really excited about. So I think that’s a really positive step in the evolution of supplements. You can look at it from an environmental sustainability perspective, which is the example you just mentioned.

[13:29] You also mentioned bioavailability. Let’s talk a bit about that because that’s one of the key differentiators that a lot of supplements are known hanging their hat on because, as we know, there’s only a limited amount of nutrients and new innovative ingredients that are coming out.

[13:49] Now, the innovation has gone more toward, not something totally brand new, but more so, how can we make some of the ingredients, and substances, and herbs more effective. Let’s talk a bit about bioavailability and then even the term bioactivity in the way that it works in the body.

[14:09] Todd Frankovic: Absolutely. There are a few different ways that a lot of companies have been moving forward with increasing bioavailability. Just because we’ve been using curcumin as the example so far, over time, we saw turmeric powders get turned into curcumin extracts. We realized, “Wait a second. If curcumin is separated out from the turmeric, it’s not easily absorbed anymore, so because turmeric had that entourage effect when the curcumin was with all the other ingredients that are inside turmeric.

[14:53] Dr. Paul Hrkal: That’s right. Yeah.

[14:55] Todd Frankovic: We saw curcumin extract come to market. We were seeing the results, and barely any of it was being absorbed. One of the first steps people saw was, “Okay. If curcumin is not being absorbed, why is that?” One thing they noticed was that we were separating curcumin from everything else within turmeric. But there were other curcuminoids within that turmeric.

[15:23] So, now, material was being standardized to not just curcumin, but all of the curcuminoids. That helped increase the bioavailability. Then, the next step after that was like, “Okay. This has increased it mildly, but what other ingredients can we include in it that would increase the bioavailability.

[15:43] There have been ingredients like black pepper that have been used with curcuminoids. There are negatives and positives of black peppers, but it’s very clear that it enhances the absorptions of certain molecules, and curcuminoids were one of them. But, once again, there are positives and negatives that come to that.

[16:07] More companies came into the picture and said, “What can we do with these curcuminoids to have a safe delivery system that gets it into the body with more absorption? So, then, companies started coming with, whether it be phytosomes—

[16:31] Dr. Paul Hrkal: Like the fats; like the liposomes, phytosomes.

[16:35] Todd Frankovic: Exactly. Trying to standardize its different standardizations, trying to combine it and hide it with other ingredients, trying to micronize it to make the particle size smaller, to try to squeak through.

[16:53] Dr. Paul Hrkal: Curcumin’s fat solubles, so [16:54], combining it with a very specific fraction of it. That was the long veta curcumin that AOR has been using the past and still does. Right?

[17:03] Todd Frankovic: Exactly. Because curcumin is such a big ingredient, it’s so easy to link it to a lot of the advances within the industry. At this point, I wouldn’t be surprised if there are more than 15 to 20 different patented types of curcumin that all increase bioavailability.

[17:23] I saw one that added povidone to it. Because of the povidone, you saw the big spikes happen in absorption. There are so many different ways, especially with fat solubles, that you can really increase the absorption.

[17:46] It’s a mixture of the quality of the ingredient itself and then what we do with that ingredient because you can’t make a low-quality ingredient more bioavailable than if you come out and use a high-quality extract and combine it with one of these special delivery systems. That’s where that special sauce comes in is where you’re combining a quality system with a quality ingredient.

[18:21] Dr. Paul Hrkal: Yeah. There are so many great points that we need to unpack further there. That’s really important to understand is that the evolution of turmeric to these very specific ingredients. I think there’s a point to make that the natural health product world has always felt a little bit inferior to the pharmaceutical world and always influenced by it. So I think the influence of pharma on natural health products is especially I would say in the last decade, has promoted a focus that is really microscopic. How can we get that exact extract of curcumin?

[19:04] Then, as you mentioned, something called the entourage effect where there are other molecules in the herb or maybe even other herbs because that’s how traditionally they were used. They were often mixed up together, especially in traditional and Chinese medicine, which has been around for thousands of years.

[19:19] Licorice, for example, was added into every single one of most formulations because they considered it a synergiser. One particular curcumin that is recent that comes to mind is called curcuphin, which I’m very intrigued by because it uses, not just curcumin, but also other curcuminoids, and it combines it in another herb called fenugreek, and there’s a fibre. That is a great example of what you’re talking about. Right.

[19:50] Todd Frankovic: Yeah, absolutely, and that’s not just curcumin. Every ingredient—there’s animosity from time to time between the pharmaceutical industry and the nutraceutical industry. In my opinion, they both can live in harmony because they both do different things.

[20:13] With nutraceuticals, I really feel like that’s for living better. That’s for taking foods and finding out how can we take these foods and make our bodies run better from them, as opposed to pharmaceuticals, which are about those synthetics and those isolated ingredients. But really, nutraceuticals as a whole.

[20:44] In the U.S., they call them supplements. They’re there to supplement your life and your food. They’re not there to replace your food. I think that supplements and natural health products are there to make us live better, and they can live in a world with pharmaceuticals.

[21:11] Dr. Paul Hrkal: I think a couple of key points that I want to circle back on because like you just said was really jam-packed with things that I think everyone that’s listening would want to know more about. You mentioned black pepper is a bit of a double-edged sword. I would agree, but I’d like to hear your take on it.

[21:29] Todd Frankovic: Black pepper is an ingredient that people saw increase the absorption of curcuminoids, and it increases the absorption of other nutrients. But, at the same time, there seems to be the idea that black pepper can increase the absorption. It’s not targeted, so black pepper can increase the absorption of things that we don’t expect it to enhance the absorption. So this includes toxins, and I think possibly heavy metals and other ingredients. Because it’s not targeted toward curcuminoids or other nutrients, that they’re getting put into the formula with, there is a chance that when it’s taken, it could increase absorption of things that may cause a negative effect.

[22:25] It’s just a matter of more safety studies being done on it, and there are more safety studies coming out on it that show what it doesn’t increase the absorption on. We’re seeing where it can and can’t be used, but my biggest concern with it was that because it enhances the absorption of so many different molecules, we don’t know what negative things that it could be enhancing.

[22:56] Dr. Paul Hrkal: Right. To expand your point a little bit, it inhibits a particular pathway in the liver that is meant to metabolize anything that you consume through your digestive system and including something like turmeric and curcumin, and now that turmeric is bulkier. There’s a molecule added to it, made more water-soluble in preparation to be eliminated.

[23:20] The contention is that if you are inhibiting this pathway that should normally be metabolizing things you’re consuming, well, what other things are you letting in. You mentioned things like solvents, heavy metals, pollutants, other things that your body is being exposed to day in and day out.

[23:37] If you’re taking Bioprene or an extract of black pepper daily, what other things are you possibly doing? I think that is more of a theoretical concern. As you mentioned, the research is not quite there yet.

[23:52] Todd Frankovic: Exactly.

[23:55] Dr. Paul Hrkal: I think this is a huge topic that you mentioned the difference between synthetics and naturals because I know a company like AOR and other really good quality natural health product manufacturers use a combination of natural-sourced ingredients as well as synthetic ingredients.

[24:13] A lot of people want everything from natural. I think you alluded to it, but I just want to drive home the point, can you do everything natural? My understanding is no because I always tell my patients you have to have therapeutic dosages, but is there a drawback to using synthetic substances?

[24:32] Todd Frankovic: I think it’s a matter of looking at safety data and clinical research. Things like vitamin C are an example, where there’s clinical data for grams worth of vitamin C. But there’s no way that you can get a natural source of vitamin C that’s going to be in the grams-worth and still be able to be taken in a capsule at an affordable price.

[25:05] I think it comes down to, “Yeah. We can get vitamin C from Amla. We can get vitamin C from oranges, sure, and there are other sources of it. But in order to get that therapeutic dose, you really need to have that synthetic. So, it’s a balancing act of seeing every different ingredient, how can it be made?

[25:27] There are certain ingredients like vinpocetine, where, for the most part, there was a synthetic on the market. Eventually, we saw that a natural version was able to come to the market, and the natural version was showing to have better efficacy. The higher-quality brands with the higher-quality supplements have the natural vinpocetine now as opposed to the synthetic, that other brands are trying to sell still.

[26:03] I think it’s a matter of every ingredient is a bit different, and it’s just a matter of, is there a natural? If there’s a natural source that can be harvested in a sustainable way that can produce that ingredient, then sure. Let’s go with the natural. I would agree that in that event, the natural would be a better option.

[26:27] But, in the event like the B12 or the vitamin C where that’s not an option, we have to rely on those synthetics. That’s where science comes in. It shows the safety data and the efficacy of those doses of the synthetic.

[26:47] Dr. Paul Hrkal: As you mentioned, there’s a degree of purity that comes in. There are various degrees of using, let’s say a synthetic amino acid or a mineral that’s synthetic like magnesium glycinate. It’s a mineral with an amino acid. You can have 100% pure, or they use the world chelated in the industry, or you can have it 80% pure, and there could be some other adulteration in it.

[27:11] I really like that you showcase the fact that really good, savvy, responsible natural health product companies are looking to try to find that balancing act between evidence-based ingredients and doses as well as finding a natural source. But in a lot of cases, it’s hard to find both of those.

[27:33] Then, you have to make a choice. Are you going to be evidence-based, or are you going to be food-based? Those often don’t intersect. That’s where a lot of patients come in. I’m on a wholefood melty, and I start looking at there is .00 of a milligram of B12 in that capsule. I’m going to tell them they’re really not going to have any sort of therapeutic effect. They’re probably not going to even absorb much of it.

[28:04] Todd Frankovic: Exactly.

[28:05] Dr. Paul Hrkal: So, it’s a fine balance. Right?

[28:07] Todd Frankovic: Yep. I think the best route is to have a combination of both synthetics and natural. Even if it’s a natural extract, also having a balance of whole food, natural ingredients, but it’s a matter of trusting a brand to formulate a product that’s going to be the most efficacious product as possible, and seeing what that brand stands for. Sometimes, there are brands that say, “We only use natural ingredients.” That’s great, and they do the absolute best they can with natural ingredients.

[28:43] There are some that only use synthetics. But it’s a matter of researching the brand and what they stand for to see: are they more about low prices? Are they more about efficacy? Are they more about being natural? It really depends on what brand you’re going for, and that’s why the brand that you shop with is so important.

[29:02] Dr. Paul Hrkal: I think the one step further of that is the customers need to set their expectations. If their expectations are to have a therapeutic effect, then you’d better be taking a B vitamin that is in line with the research that is going to give you the forms.

[29:19] You mentioned methylcobalamin earlier, which is a more active form of B12, or if you’re getting just a wholefood-based B12, don’t expect it to raise your B12 levels as quickly, or maybe not at all. Maybe it’s good as a maintenance. I talk to patients all about expectations. It’s also something I think appropriate to point out is that a person is happy to take Advil every other day for their headaches, but then they

Nobody is asking questions about what’s in that capsule or tablet or pill. Yet, when it comes to natural health products, they’re like, “Where’s it coming from?” If it’s from a country they don’t necessarily want, then they’re upset about it. Their expectations are almost incongruent with where the source is from, whether it’s pharma or natural. Right?

[30:14] Todd Frankovic: Yeah. As far as those synthetic ingredients, not all synthetic ingredients are considered the same. There are different qualities. Going back to those B vitamins, like you were saying, where we have the form methylcobalamin, which is the more bioavailable form of B12.

[30:34] It goes the same with other B vitamins, where you have B6. I feel like this is a sure-fire way of seeing if it’s a quality brand. There are different synthetic versions of these B vitamins. I think if you look at a label, you can tell if this brand cares about quality by seeing are they using the active forms of these B vitamins?

[31:01] Like, for B6, pyridoxal phosphate versus pyridoxine HCL or B2 with riboflavin 5-phosphate versus riboflavin. There are different active forms that are available that are still synthetics, but they are more bioavailable and more efficacious than using the lower-quality forms that you still see on the market. They’re still out there. That’s the difference between a multivitamin that might be $10 versus a multivitamin that might be $50 is all those active forms.

[31:39] Dr. Paul Hrkal: And those active forms translate into your getting more out of that capsule. You’re getting faster improvements. Ultimately, what I’ve seen in my practice is that using those active forms, people feel better quicker. Especially when it comes to multiple ingredients products like a B complex or like even a multivitamin, I always joke with my patients, “Have you ever felt better after taking a multi?” Invariably, the answer always is, “No.” The reason is unless you’re majorly depleted, 90% of multivitamins on the market are One A Day, and the amount of the ingredients and the form of the ingredients to keep the price down has kept us as inexpensive and actually not as active as possible.

[32:26] So, you’re not going to expect a therapeutic effect from something that has 20 different ingredients and very microdoses much lower than you really want. One A Day multivitamins, which is what a lot of the research uses and always rains on and says that supplements are not effective, especially multivitamins, I would argue that the whole concept of One A Day multivitamins or even sometimes Two A Day is almost implausible if you understand what goes into a supplement.

[32:59] Todd Frankovic: Exactly. In One a Day, Two a Day multivitamins, you can tell what’s going to be missing from that. The bulky minerals, like the calciums and the magnesiums, are taking a hit in order to reduce the capsule counts. Honestly, you get what you pay for, and how many capsules you’re getting really dictate—if there’s a multivitamin that’s one capsule, and you see a multivitamin next to it that’s five capsules, you are getting less in that one capsule. That’s for sure.

[33:37] Dr. Paul Hrkal: Right. Todd, this has been so enlightening, and I feel like we’re going to have to have you back to chat about all the things that we haven’t had a chance to get into like countries of origin and purity and other types of sourcing. Thank you for sharing that, especially that last point.

[33:54] For everybody that wants a little bit of a summary, how we know what is a high-quality supplement? Take a look at the forms. Ask some questions to the people that you’re buying the supplement from. You can tell a lot about a supplement by the types of vitamins that they’re using.

[34:11] If they’re using a cyanocobalamin B12, that typically is the cheaper, less-active form. If they’re using a high dancel hydroxy or a methyl version, then you probably can tell that the supplement company is a little forward-thinking, they’re evidence-based, and they’re using the most active forms. Thank you so much, Todd, and we’re going to have to have you back very soon.

[34:31] Todd Frankovic: Yeah. Absolutely. Thank you so much.

* * * Outro Music * * *

[34:52] Thank you for listening today. For more information about our guests, past shows, and future topics, please visit aor.ca/podcast. Do you have a topic that you want us to cover? We invite you to engage with us on social media to request a future topic or email us at marketing@aor.ca. We hope you tune in again next week to learn more about supplementing your health.

[End of episode 35:23]