There are lots of ways to take medicine. Some cultures like suppositories. Others believe injections are real medicine. Americans overwhelmingly prefer pills, though we also use inhalers, nasal sprays and skin creams to get medicine circulating throughout the body. The biggest problems with oral medications are size and taste. Liquids can sometimes taste terrible. Dextromethorphan (DM) cough medicine is a classic example. Cherry flavor does not help much with palatability. Antibiotics such as clindamycin, metronidazole or penicillin can be bitter and leave an unpleasant aftertaste. Some herbs or dietary supplements may also have a bad flavor or smell. Many people have a hard time swallowing large tablets or capsules. That’s in part why gummy medicines have become so popular.
Can Diarrhea Be a Downside of Gummy Medicines?
A visitor to this website discovered that melatonin gummies created an unexpected complication:
Q. I was taking two melatonin gummies each night to help me sleep. They worked very well. However, within about a week I developed diarrhea that kept getting worse.
After several weeks, I contacted my doctor. She ran a series of blood work, including ulcer tests and at-home colon cancer tests, trying to pinpoint the problem.
I happened to read the melatonin bottle one night and it said, “use as needed,” not nightly. I skipped it a few nights, and my intestinal issues went away. As a test, about a week later I took them again. After two nights, the diarrhea came back. My doctor then told me that the ingredients in some gummies can cause this problem for susceptible people.
A. We agree with your physician that non-sugar sweeteners could be the culprits behind your digestive distress. Manufacturers of gummy supplements like to advertise that they are sugar free. Many of those contain sweeteners such as maltitol, sorbitol or xylitol. These compounds can cause gas, stomach pain and diarrhea.
Many people never bother to read the label on their dietary supplements or vitamin bottles. Even when they do, the long list of chemical names may not raise a warning flag. Non-caloric sweeteners are frequent ingredients.
You may want to look for another form of melatonin supplement instead of gummies. Bland pills are widely available in various shapes and sizes.
You can learn about other strategies for dealing with insomnia in our eGuide to Getting a Good Night’s Sleep. This online resource may be found under the Health eGuides tab.
Gummies and a Spoonful of Sugar:
The most famous song in the movie Mary Poppins was sung by Julie Andrews. The chorus goes:
“A spoonful of sugar helps the medicine go down…in a most delightful way.”
If you have not watched Mary Poppins in awhile, or somehow missed this iconic song, here is a link to refresh your memory.
The Polio Vaccine and Mary Poppins:
There is a fascinating back story to the song A Spoonful of Sugar. The Sherman brothers were writing the music for the Disney film Mary Poppins.
One day, Jeff Sherman came home from school and told his father Robert Sherman about getting the polio vaccine. His father, aware that Jeff was phobic about shots, asked if it hurt. His son responded that they just put the vaccine on a sugar cube that was easy to swallow.
According to the story, Robert immediately called his brother and song-writing partner Richard. Before long, they had composed the song about a spoonful of sugar.
Gummy Medicines Are the Latest Fad:
It took almost 60 years for the supplement industry to embrace the spoonful of sugar concept. Now if you go into pharmacies or health food stores you will find an amazing array of sweet-tasting gummies.
There are multivitamin gummies, B12 energy gummies, elderberry immune support gummies, vitamin C gummies, hemp gummies, cranberry gummies, turmeric gummies and seaweed gummies. And that’s just for starters.
Fentanyl Lollipop:
The FDA approved Actiq in 1998. This “oral transmucosal fentanyl citrate” medication was:
“…indicated for the management for breakthrough pain in cancer patients 16 years of age and older who are already receiving and who are tolerant to around-the-clock opioid therapy for their underlying persistent cancer pain.”
In essence, Actiq is an opioid lollipop.
That’s why the official prescribing information includes this warning:
“Accidental ingestion of even one dose of ACTIQ, especially by children, can result in a fatal overdose of fentanyl. Death has been reported in children who have accidentally ingested ACTIQ. ACTIQ must be kept out of reach of children.”
Please do not get us wrong. We are all for helping cancer patients manage breakthrough pain. But we agree with the FDA that gummy medicines must be stored and managed very carefully.
The Pros and Cons of Gummy Medicines:
Compounding pharmacies have adopted the idea that a spoonful of sugar helps the medicine go down. A medication that comes in a large pill can be hard for a child or older person to swallow. The pharmacist can sometimes incorporate it into a gummy bear, a lollipop or hard candy.
Children who have to take medicine on a regular basis for epilepsy, ADHD or a nutrient deficiency may find gummies easier to manage than pills.
As one compounding pharmacy describes it:
“Children typically enjoy gummies, allowing parents to provide the medication without resistance. Gummies are also easy to chew, making the form convenient for children who struggle with swallowing tablets or capsules. In addition, the sweet and appealing taste of gummies can make the experience more enjoyable for children.”
The Risks of Gummy Medicines:
Are there any downsides to the gummy medicines trend? Cases of melatonin overdoses among children have been rising rapidly. That’s because the melatonin gummies are so tasty that children may think of them like candy.
In some cases, the kids ended up in an emergency department after swallowing five or ten gummies. We also worry about acetaminophen-containing gummy medicines.
People tend to take acetaminophen (Tylenol) for granted. The maker of Tylenol has utilized slogans like:
“The brand of pain reliever that doctors recommend more than any other.”
And
“Trust TYLENOL. Hospitals do.”
When acetaminophen comes in pretty colors and tasty flavors, kids might mistake this pain reliever and fever reducer as candy. Too much acetaminophen can lead to liver damage. You can read about acetaminophen overdose at this link.
Gummy Medicines, Dietary Supplements and Herbal Preparations:
We suspect that gummy medicines are not the only problem. Other supplements and herbal remedies may pose a similar challenge if they are made into sweet-tasting gummy candies.
Poison control centers have reported an increase in CBD (cannabidiol)-related cases. There have also been situations in which children consumed THC-containing gummy bears. THC stands for tetrahydrocannabinol, the active compound in marijuana.
ConsumerLab.com tests many dietary supplements for quality and quantity. This organization has reported that some gummy multivitamins are less likely than pills to contain the labeled amount.
Here is what ConsumerLab.com states about “Quality Problems with Gummies:”
“Manufacturing challenges associated with candy-like products likely explain the higher incidence of problems.
“Gummies are notoriously difficult to manufacture because it is hard to measure in the correct amounts of vitamins and minerals (some are simply sprayed on a candy base) and ingredients in a gummy tend to degrade faster, leading manufacturers to put in more than the listed amount (an “on overage”) to help ensure the gummy will continue to provide at least 100% of each listed ingredient throughout its shelf-life, as required by the FDA. However, this results in products with too much of a vitamin when first produced and a range of declining amounts by the time you consume them.”
The FDA may not be paying much attention to gummy manufacturing, whether it’s by compounding pharmacies or the dietary supplement industry. Getting the correct amount in each gummy can be challenging, though.
There’s another problem with sweet-tasting supplements. The manufacturers like to advertise sugar-free gummies. Usually, that means they may contain sweeteners such as xylitol, mannitol, erythritol or maltitol. These sugar alcohols make some people uncomfortable because they can cause gas or diarrhea. The reader who reported diarrhea after taking melatonin gummies is a perfect example.
While one gummy might not pose a problem, overdoing or taking multiple gummies for a variety of herbs or vitamins could lead to digestive distress. Some manufacturers use artificial food dyes to give their products an appealing color.
Final Words:
Although a spoonful of sugar may help the medicine go down, it could also lead to overdoses. Parents need to keep gummy medications and supplements out of the reach of children.
And adults should not think of these products like candy. If one tastes good…why not take two or three? Bad idea! If you have embraced gummy medicines, please use good sense. Do not overdose on a seemingly safe and tasty gummy bear supplement or drug.
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