If something in pure form is bad for the stomach (causes nausea etc), why can it help to put it in a pill; doesn’t it all get broken down eventually?
I’ve been tolerating a specific creatine HCL tablet for a long time. I switched to a much less expensive raw salt-texture version that dissolves completely in water, and get nausea from it. Could the reason be akin to why crushing a pill is bad? Or maybe I shouldn’t trust something inexpensive? It says it’s raw, but you could say that water is H2O, and yet just tiny traces of other minerals can be poisonous but not listed on the label…?
Some pills are formulated to get through the stomach to dissolve in the intestines to avoid gastric problems.
What dose are you taking? 3-5 grams is all you need.
FromExamine.com
So at what stage in digestion is a substance actually absorbed and used? Does the stomach break it down only somewhat, so the goal is therefore for a pill to be structured to take time to break down, to comply with the multi-stage digestive process? Could a substance cause damage to the stomach if it’s released too quickly at that stage?
Those all depend on the substance. Most absorption will take place in the intestine, but not all; there are medications made to be absorbed in the esophagus, the stomach or even the mouth.
Ok, so since we don’t really know everything about the how the body processes creatine, then based on more general information, my theory at least holds some water (ohhh!! Pun intended!! Score!!) that the tablet form I like breaks down in a timely way that happens to be good for the creatine absorption process, as opposed to the instant liquid form which maybe isn’t good to be hitting the stomach all at once? even though though in some cases that’s a good thing like liquid vitamins. ?
“The mechanism of creatine absorption in the gastrointestinal tract is unclear…” - but then the authors go on to suggest that active transport systems are involved - not my area of expertise, but I believe this limits absorption to beyond the stomach. They also kinda suggest that the small intestine may be important. I’m sure others more knowledgeable than I will be able to provide a better reading of this.
The paper does say:
"The degradation half-lives for the conversion of creatine to creatinine at pH values 1.4, 3.7 and 6.8 are 55, 7.5 and 40.5 days, respectively. At these rates, less than 0.1g of a 5g dose would be lost in 1 hour. Therefore, the conversion to creatinine in the gastrointestinal tract is probably minimal regardless of transit time " - which I think answers one of your questions. The pH ranges mentioned cover the length of the gut.
Regarding formulations designed to pass through the stomach before release takes place, I could find only a couple, eg:
and they make quite a song a dance about being enteric coated (ie, coated to pass into the intestine before dissolution takes place) so I would have thought this would be obvious from the packaging of whatever you are using. Whether this makes any difference to absorption and adverse events, I have no idea.
Nitroglycerine for angina is absorbed in the mouth, and it’s amazing how fast this is. One of the very common side effects is headache, and for me the headache starts in about ten seconds. Ten seconds!
There’s a Zofran formulation that’s under the tongue for people who can’t hold anything down, works great. Heck, we even inject epinephrine there in rare cases.
There are plenty of medications that are fine to crush.
There are several simple ways of dealing with nausea from medicine that are usually effective. 1. Eat a small meal before taking the medicine. 2. For a liquid like you are describing, spreading out your consumption, i.e. drink a quarter of a glass at a time with an hour or so between each dose. Combining these two methods should help.
…and there are plenty of medications that are definitely not fine.
The entire point sublingual medication is that it can dissolve in the mouth and be absorbed rapidly by the blood vessels under the tongue. This is useful for people who can’t swallow or have damaged livers, and for anyone who needs the medication absorbed quickly. The problem is that not all medications are designed or intended to be absorbed quickly - as many people on this same thread have already mentioned.
Crushing a pill that is normally designed for ingestion is a great way to overdose. Please don’t take medication sublingually unless a doctor prescribes it with the proper dose.