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For supplement users trying to optimize health, the alcohol question commonly arises
You just started to do a dietary cleanse, bought oodles of recommended supplements, and on the first day a recognizable liquid hits your tongue. “Alcohol? Could this possibly be alcohol?” you wonder and realize with amazement after looking at the label that indeed, it is alcohol in your dietary supplement. “But why would there be alcohol in a supplement that is intended to improve my health?” the internal dialog continues. Well, it turns out there are many good reasons.
It is not uncommon to find ethanol, also known as ethyl alcohol, or simply alcohol, in liquid herbal supplements, particularly botanical extractions known as tinctures. Ethanol is a recognized ingredient in food and pharmaceutical applications, and is not the same as methanol, which is toxic and not intended for human consumption.
Alcohol is used to extract the active constituents of many botanicals because the active compounds, particularly those found in the resin or essential oil, are more soluble in it.[1] Various ratios of alcohol and water are used to make these traditional botanical preparations, with the ratio being dependent on the water and alcohol solubility of the active constituents. Alcohol also is a natural preservative and inhibits microbial growth.[2] The presence of alcohol additionally may improve the rate and overall absorption of the product; it also may be used for such reasons in liposomal preparations.[3],[4]
Botanical tinctures are not considered alcoholic beverages as was found in a court ruling on October 15, 2001 in favor of the American Herbal Products Association.[5] As a typical serving of a tincture is 20 to 40 drops (1 to 2 mL), the amount of alcohol is negligible. That said, for those who chose to abstain from alcohol fully for medical or other reasons, a wide variety of alternative botanical preparations also exist which may be more appropriate.
The preparation of botanical tinctures
Various ratios of alcohol and water are used to make tinctures, with the ratio being dependent on the water and alcohol solubility of the active constituents.
A tincture is a liquid extraction of the active constituents of a botanical substance in a solution of alcohol and water. The amount of alcohol in a tincture varies depending on what has been shown to be most effective for a particular botanical or part of the plant.[6],[7],[8] For example, if the medicinally active parts of the plant are resins, tannins, or volatile oils, a higher percentage of alcohol is necessary to extract these components.[9],[10] Because alcohol is a solvent, these constituents remain suspended fairly well in a liquid if the proper alcohol-to-water ratio is used (but typically, some shaking is needed).
If the aerial parts (leaves, stems, and flowers) of the plant are used, a lower percentage of alcohol is usually needed as more of the constituents can be extracted in water. Extractions of polysaccharides from mucilaginous plants (such as slippery elm or marshmallow) or mushrooms are best achieved with predominantly water due to their high-water solubility, however they are often still preserved with a low concentration of alcohol if the delivery format is a liquid. The alcohol content of botanical tinctures ranges from roughly 20 to 90%.
Alcohol as an absorption enhancer
Because of the rapid rate of alcohol absorption, effects of botanical products delivered as a tincture may be more rapidly experienced.
Alcohol also may improve the absorption of the same botanical constituents for which it is helpful to extract. As these substances are soluble in alcohol, they remain dissolved in solution and are acted on by digestive secretions throughout the length of the digestive tract much like foods or other liquids would be.
Alcohol is absorbed in small amounts beginning in the oral cavity and stomach and then rapidly in the small intestine.[11],[12] In the small intestine, alcohol diffuses through the epithelial cell lining and into the bloodstream, with levels peaking roughly one hour after consumption.[13] When taken in acutely, alcohol has been demonstrated to slightly increase gastroduodenal permeability,[14] which in theory, also enhances absorption of certain substances contained in tinctures. For some botanical constituents, their combination with alcohol improves absorption because the molecules can be carried directly into the bloodstream along with the alcohol.[15] Because of the rapid rate of absorption, effects of botanical products delivered as a tincture also may be more rapidly experienced.
A natural preservative
Alcohol is a natural preservative and inhibits microbial growth.
Many individuals who chose to use natural substances such as botanicals often avoid synthetic substances including preservatives due to attitudes towards health or adverse reactions they may have had.[16] Alcohol acts as a natural preservative for botanical substances found in tinctures and other liquid preparations such as liposomes. This often eliminates the need for other, less natural, preservatives. Tinctures are often quite stable and can have a long shelf-life, up to five years.[17]
When working with integrative practitioners, one typically finds that traditional herbalists rely more on time-honored botanical preparations such as tinctures while medical doctors who have taken training in integrative medicine are more likely to select encapsulated botanical products, particularly those that are standardized extracts, as they usually have more clinical research supporting them. Either way, the power of botanical medicine knows no boundaries, and can be experienced regardless of preparation technique, although dosages may be far different.
Click here to see References
[1] Dog TL. Smart talk on supplements and botanicals: herbal teas versus tinctures; standardized extracts; green tea. Alt Comp Ther. 2009 Jun 1;15(3):101-3.
[2] Meyer BK, et al. Antimicrobial preservative use in parenteral products: past and present. J Pharm Sci. 2007 Dec;96(12):3155-67.
[3] Liu C, et al. Effect of alcohol concentration of Shangtong Tincture on percutaneous absorption of Paeonol. Chinese Trad Patent Med. 1992 Jan 1(10).
[4] Hussain A, et al. Elastic liposomes as novel carriers: recent advances in drug delivery. Int J Nanomedicine. 2017 Jul 17;12:5087-5108.
[5] Natural Products Insider. Herbal tinctures not to be regulated as alcohol [Internet]. Natural Products Insider; 2001 [cited 2020 Dec 20]. Available from: https://www.naturalproductsinsider.com/regulatory/herbal-tinctures-not-be-regulated-alcohol
[6] Singh Khalsa KP. Preparing botanical medicines. J Herbal Pharma. 2008 Jan 1;7(3-4):267-77.
[7] Wendakoon C, et al. Evaluation of selected medicinal plants extracted in different ethanol concentrations for antibacterial activity against human pathogens. Journal of Medicinally Active Plants (JMAP). 2012;1(2):60-8.
[8] Kim SJ, et al. Investigation of antioxidative activity and stability of ethanol extracts of licorice root (Glycyrrhiza glabra). Korean J Food Sci Tech. 2006;38(4):584-8.
[9] Markom M, et al. Extraction of hydrolysable tannins from Phyllanthus niruri Linn.: effects of solvents and extraction methods. Separation Purification Tech. 2007 Jan 1;52(3):487-96.
[10] Tilgner SM. Herbal Medicine from the Heart of the Earth. 2nd Edition. Pleasant Hill, OR : Wise Acres Publishing LLC; 2009.
[11] Cooke AR, Birchall A. Absorption of ethanol from the stomach. Gastroenterology. 1969 Sep;57(3):269-72.
[12] Holt S. Observations on the relation between alcohol absorption and the rate of gastric emptying. Can Med Assoc J. 1981 Feb 1;124(3):267-77.
[13] Paton A. Alcohol in the body. BMJ. 2005 Jan 8;330(7482):85-7.
[14] Keshavarzian A, et al. The differing effects of acute and chronic alcohol on gastric and intestinal permeability. Am J Gastroenterol. 1994 Dec;89(12):2205-11.
[15] Woelkart K, et al. Bioavailability and pharmacokinetics of Echinacea purpurea preparations and their interaction with the immune system. Int J Clin Pharmacol Ther. 2006 Sep;44(9):401-8.
[16] Astin JA. Why patients use alternative medicine: results of a national study. JAMA. 1998 May 20;279(19):1548-53.
[17] Kumadoh DO, Ofori-Kwakye KW. Dosage forms of herbal medicinal products and their stability considerations-an overview. J Crit Rev. 2017;4:1.
The information provided is for educational purposes only. Consult your physician or healthcare provider if you have specific questions before instituting any changes in your daily lifestyle including changes in diet, exercise, and supplement use.
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Dr. Carrie Decker
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