While it seems enticing to simply place a vitamin and mineral patch on your skin for a few hours each day instead of taking oral supplements, there are a few things you should be aware of when it comes to transdermal micronutrient delivery (a.k.a. the patch).
Research is ongoing to understand the potential for patch nutrient delivery in the general population. However, this has not been evaluated in postbariatric surgery patients who are at greater risk for nutrient deficiencies. There is a lack of clinical data evaluating the ability to supplement nutrients through the skin, for both maintenance within the normal serum range or correction of an existing nutrient deficiency.
How does nutrient absorption through the skin work?
You’ve likely heard of soaking in an Epsom salt bath to ease sore muscles. Did you ever think about how this works? The magnesium contained in the salt bath is able to penetrate your skin and can provide comfort to an aching body. Certain nutrients (like magnesium) are able to be absorbed through the skin by pores and then enter the capillary system (bloodstream). Other nutrients cannot be absorbed by the skin partly because their molecular size is too large.
Known nutrients that can’t be absorbed through the skin are vitamins A, K, and B12.[1] Vitamin B12 is one of the most commonly reported nutrient deficiencies after bariatric surgery.[2]
Has transdermal nutrient absorption been studied?
No direct comparisons between transdermal nutrient delivery and oral dosing of nutrients have been completed. Two studies are ongoing directly comparing oral to transdermal delivery of nutrients in postbariatric surgery patients[3] and in general population subjects.[4] However, these results are not yet publically available. Additionally, the ongoing study with postbariatric surgery patients is a short-term study of only three months postoperative. This is not a time when the majority of nutrient deficiencies present after surgery, and the risk for nutrient deficiencies increases as the length of postoperative time passes.
Additional considerations
In addition to large molecular size being a barrier of nutrient absorption, other physiological factors that can affect transdermal absorption must be considered. These can include: skin thickness, anatomic site of the application on the body, skin hydration, skin irritation and sensitivities, age, ethnicity, and race. Transdermal delivery of nutrients may also be poor if the skin is oily, sweaty, or exposed to water.[5],[6]
Maintenance of adequate nutrient status and correction of nutrient deficiencies are critical to avoid long-term health consequences in post bariatric surgery patients. Current oral micronutrient supplement guidelines have been established by numerous professional societies; however, there are no guidelines on recommended nutrient levels of patch delivery after bariatric surgery.
Main takeaways
- Nutrient delivery via a vitamin and mineral patch has not been studied in post bariatric surgery patients and cannot prevent all nutrient deficiencies common in this population
- The risk of nutrient deficiencies increases as you progress from surgery
- Numerous factors can influence the body’s ability to absorb nutrients via the skin including molecular size of the nutrient and individual skin conditions
[1]Bos JD, Meinardi MM. The 500 Dalton rule for the skin penetration of chemical compounds and drugs. Exp Dermatol. 2000;9(3):165-9.
[2]Parrot J, Frank L, Rabena R, et al. ASMBS Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient — 2016 Update: Micronutrients. Surgery for Obesity and Related Diseases. 2016;12:955–959.
[3]NCT02686905 https://clinicaltrials.gov/ct2/show/NCT02686905?term=transdermal+vitamin+D&rank= ëë22.[December 14, 2017].2
[4]NCT02174718
https://clinicaltrials.gov/ct2/show/NCT02174718?term=transdermal+vitamin+D&rank=1 (vitamin D transdermal versus oral in healthy subjects over 6 months – data collection completion anticipated end 2017).[December 14, 2017].
[5]Yang Y, Kalluri H, Banga AK. Effects of chemical and physical enhancement techniques on transdermal delivery of cyanocobalamin (vitamin B12) in vitro. Pharmaceutics. 2011;3(3):474-84.
[6]Modepalli N, Jo S, Repka MA, Murthy SN. Microporation and ‘iron’tophoresis for treating iron deficiency anemia. Pharm Res. 2013;30(3):889-98.
