All Posts tagged supplements

When Should You Take Your Supplements?

Sometimes your healthcare provider gives you a nutritional supplement that they say you need and nothing happens.  A classic example is someone who has low levels of vitamin D that doesn’t improve after months of therapy.  One reason for this, according to a small but striking study at the Cleveland Clinic Foundation, is that some vitamin D resistant people are taking vitamin D supplements on an empty stomach or with a small meal, usually breakfast or lunch.

Twenty five people participated in the study, 17 of them were instructed to take the same supplement they had been taking with their largest meal of the day, usually supper. After 2 to 3 months, taking the same vitamin D supplement with the “largest” meal of the day, researchers found that serum vitamin D levels had increased on average by 56.7%.  This magnitude of increase was seen across a wide range of vitamin D dosage.

Vitamin D is fat soluble and generally it is recommended that it be taken with a meal containing fats. However, based on this study, it may be best to take vitamin D with your largest meal of the day, which is likely to contain the most fat.

As people age and their digestive track becomes compromised, the ability to secrete digestive enzymes decreases, especially HCL. Also digesting food takes energy and if someone has been ill for a prolonged period of time their digestive capacity is further reduced. So keep in mind, if you have a weakened immune system you may have difficulty absorbing all nutrients even if they are taken at the largest meal.

Fat soluble vitamins, such as A, D, E, K as well as Coenzyme Q10, must be emulsified by either bile or pancreatic enzymes. But what if your liver is under-performing due to toxic over-load, fatty liver or if the bile is not stored properly and released due to gall-bladder removal? That may also lead to reduced absorption.  You may need to take digestive enzymes with your supplements to help with your nutrient absorption.

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Supplements: How Do You Choose Which Brand to Take

There are hundreds of thousands of vitamin supplements available on today’s market.  You can buy them at health food stores, drug stores, grocery stories, various retailers, through health care professionals, and on the internet.  When choosing a supplement, how do you determine which one to buy?  Do you look at the package details, the manufacturer, the ingredients, and the label claims?  But how do you really know for sure you are getting the best supplement for you?

It can be very confusing to determine which supplement to buy.  Understanding the label will help you know if you are taking a quality supplement.  Look at the ingredients listed on the label.  Do you recognize any of them?  Just like any other food label, the nutrients are listed in a particular order and some manufacturers put the source next to the nutrient.  In a quality, wholesome product you will recognize and be able to pronounce most of the ingredients on the label.

I personally recommend whole food supplements.  Whole food supplements are made by concentrating foods.  When concentrated correctly, the foods supply a multitude of nutrients.  These nutrients work together to provide you with optimal nutrition for good health.  Only whole food ingredients can provide you with all the nutrients contained within the food.  For example, I looked at a supplement a patient brought in the other day and one of its ingredients is dl-alpha tocopherol acetate.  That is a manmade component of the vitamin E complex.  If you were to take a supplement with just dl-alpha tocopherol, you would be missing at least 5 other important nutrients as well as hundreds of other nutrients that occur within the whole vitamin E complex.  These nutrients are only available by consuming a natural, whole food form of vitamin E, such as wheat germ oil, green leafy vegetables, nuts and carrots.

Just like any recipe, the quality of the ingredients you use affects the quality of the final product.  Therefore, it’s good to answer all of the following questions when evaluating a supplement and its effectiveness.

  • Where do the ingredients come from?  Manufacturers who grow many of their ingredients have the unique ability to control the quality of the ingredient from seed to supplement.
  • When are ingredients processed?  When you buy a tomato, you inspect it for quality.  You wouldn’t knowingly buy one that was mushy or bruised.  This same principle holds true for the ingredients in your supplements.  Once they are ready for harvest and are harvested, the ingredients begin to lose their value.  If there is a delay of hours, days, or months from when an ingredient is harvested to when it’s processed, many of its very delicate phytonutrients are lost.
  • Are the ingredient’s vital factors retained?  Each ingredient has its own set of rules in relation to how to best package its vital components.  The manufacturing process needs to retain the vital nutrients within the ingredients.  Too much heat will destroy enzymes and phytonutrients.  The manufacturer should use a low-temperature high-vacuum process to make sure that the ingredient’s nutrients are preserved.

Now you may be saying, how am I supposed to answer these questions about the supplement I’m taking?  You may not be able to.  However, if you’re taking a certain brand of supplements and only that brand, you may want to do a little research into that company.  For example, I utilize the Standard Process supplements a lot, and if I go to their website I’m able to get these questions answered.  A good supplement company should be willing to disclose information about how it manufactures their vitamins.  Another thing that I like about Standard Process is the company is partnered with MediHerb, an Australian-based company.  You may or may not know that in the United States the FDA does not regulate vitamins or supplements.  I know this is a political issue right now for some, but one thing that FDA regulation does do is it ensures that what the manufacturer says is in that supplement is in the supplement.  Well, in Australia, their supplements are regulated by their version of the FDA.  Therefore, you know that what the label says is correct.

The main thing you need to remember when purchasing a supplement is you want one that’s from a reputable company with the least amount of man-made products.

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The Health Benefits of Acai Berry…From a Skeptical Doctor’s Perspective

Those of you who know me or have read my blog know that I tend to be skeptical of the latest fad in health and nutrition.  For the acai berry, this skepticism was made even worse by weekly spam e-mails touting the virtues of this “miracle” berry.  This skepticism has not rubbed off on my receptionist yet because she recently told me that she went to the health-food store with her sister and got some information about acai berry.  What roused my interest is the store’s employee told my receptionist to “save her money” and buy the green tea instead because it “did the same thing”.  On a side note, I’m always impressed by sales people who value honesty and truth over getting an extra dollar from a sale.  So after a search of Google, I was pleasantly surprised to find that the acai berry may actually have some truth behind its claims.  Acai (pronounced a-sa-ii or ah-sigh-ee, depending on who you talk to) was actually studied by a researcher at Texas A & M University and found to have anti-oxidants that are readily absorbed by the human body.

So what exactly is the acai berry?  The acai berry is a small, round, black-purple berry that’s about 1 inch in diameter.  It looks similar to a grape in size and appearance, but with less pulp.  It is grown on the acai (or aqai) palm which is native to Central and South America from Belize down to Brazil and Peru.  It mainly grows in swamps and floodplains. The acai trees produce two crops of berries each year.  These berries have been consumed for hundreds of years by its native population.  I even read that they make up 42% of the diet of one tribe in the Amazon area of Brazil.

It has only been in recent years that the acai berry has been marketed as a dietary supplement.  It is currently being sold in the form of tablets, juice, smoothies, drink powders and whole fruit.  Marketers of these products claim that it provides increased energy levels, improved sexual performance, improved digestion, detoxification, high fiber content, improved skin appearance, improved heart health, improved sleep, and reduction of cholesterol levels.

As of yet, I haven’t been able to find a whole lot of evidence (aside from the people who market the products) to support most of those claims.  However, it does appear to have a good bit of anti-oxidant properties, it’s low in sugar and high in fiber, and according to the Texas A & M researcher – it tastes like a mixture of red wine and chocolate.  As an anti-oxidant, acai berries help to rid the body of free radicals.  When your cells and body perform their daily functions, oxygen is used in the process and oxidation takes place producing free radicals (think of iron that’s been left to the elements and develops rust through oxidation).  Free radicals are the waste material of these oxidative processes that can have an influence on the forming of cancer, arterial damage, inflammation, and accelerated aging through oxidative damage. They are also caused by a diet high in fried and barbequed foods, pollution, radiation, etc.

Therefore, acai berries are good for helping prevent damage to your body that’s caused by free radicals.  The question that I don’t have answered yet is how the rather expensive acai berries are any different from other good anti-oxidants such as vitamins A, E, and C as well as bioflavonoids, coenzyme Q10, grape seed extract and green tea.  Obviously, the health food store employee my receptionist talked to didn’t think it was that much better, but for me, the jury is still out.

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Natural Treatment of ADHD, Part 4

ADHD can often be successfully treated naturally to the point where the need for medication may be significantly decreased or even eliminated.  Research has shown that improvements can be made with ADHD through diet, nutrition and chiropractic care.  The Center for Science in the Public Interest (a division of the U.S. Dept. of Health and Human Services) has published a report, “Diet, ADHD, and Behavior”, that reviews studies on the effect of diet on behavior (including ADHD) and touches on side effects of the stimulant drugs that have been used to treat behavior disorders in millions of children.  CSPI’s report reviews more than 20 controlled studies of diet and behavior. Most of the studies found that food dyes and, in some cases, other additives and foods provoked symptoms of ADHD or other behavior problems in some children.  They recommend the first avenue of treatment should be the elimination of foods with dyes and additives from a child with ADHD’s diet.  They recommend this be done before any medication is prescribed due to the side effects of the medications as well as Ritalin being a “possible human carcinogen”.  Therefore, if your child is properly diagnosed with ADHD, your first step in treatment should be to change their diet to organic foods with as few food dyes, additives, and preservatives as possible.

Food sensitivities and allergies are starting to be more widely looked at in terms of the treatment of ADHD patients.  In the research of diet and its connection to ADHD, nutritionists commonly find the elimination of foods such as oranges, chocolate, corn, wheat, eggs and milk, may work to improve a child’s mental functioning and, thereby, alleviate, to some degree, the symptoms associated with ADHD.  During an allergic reaction, or food sensitivity reaction, the body releases a chemical known as histamine. Histamine, in physiological terms, works to increase the removal of blood serum from around the brain tissue, thereby reducing adequate blood flow to the tiny capillaries which nourish the brain. When this reaction of histamine occurs within the body, the brain becomes unbalanced and the first indications of complication, from a psychological aspect, involve loss of memory, attention and cognitive function.  Using a diary or journal to log the activities and foods of your child, over a 30 day period, will often provide insight into the natural culprits which may be creating more complex ADHD symptoms; being mindful that food sensitivities, generally, take several hours to appear following consumption. Once the foods are identified, steps can be taken to remove those exposures from the child’s diet and, thereby, remedy the symptoms of ADHD.

Another area that’s getting a lot of research lately is Omega-3 fatty acid supplementation. Dr Basant Puri, a consultant and senior lecturer at Hammersmith Hospital has been using sophisticated imaging techniques to study the role of fatty acids in brain function. He says he has unearthed a wealth of evidence about how supplementation with specific fatty acids can not only help those with ADD/ADHD (attention deficit/ hyperactivity disorder), but also dyslexia and dyspraxia.  “In clinical trials we have seen significant improvements in ADHD symptoms in children administered with fatty acid supplements,” he said.   Typically those who get a benefit enjoy improved attention and concentration, a reduction in anxiety and impulsivity and generally an improvement in self esteem.   Fatty acids are important for the brain growth of all children and particularly so for those with learning conditions.   Dr. Puri recommends that the best results have come from supplementation with a combination of marine and botanical oils rich in a specific fatty acid called Eicosapentaenoic Acid or EPA.   Similarly, a Purdue University study showed that kids low in Omega-3 essential fatty acids are significantly more likely to be hyperactive, have learning disorders, and to display behavioral problems.  Your brain is more than 60% structural fat, just as your muscles are made of protein and your bones are made of calcium. But it’s not just any fat that our brains are made of – it has to be Omega-3 fats, and the typical American diet is low in these types of fats.  We eat man-made trans-fats and excessive amounts of saturated fats and vegetable oils high in Omega-6 fatty acids, all of which interfere which our body’s attempt to utilize the tiny amount of Omega-3 fats that it gets.

Because ADHD can be caused by both biochemical imbalances and brain under-stimulation, chiropractic care is often needed to help stimulate the nervous system and restore normal brain stimulation.  Research has shown not only that the developing brain relies on normal structural integrity and joint movement, but that complex neurochemical communication and pathways involved in helping us to “feel good” are tied into spinal biomechanics.  Children’s nervous systems need the constant stimulation of movement in order to develop and function properly. Abnormal position or movement of the spinal vertebra can develop and this can lead to nerve interference. It is this interference that chiropractors correct.  In the October 2004 issue of the peer-reviewed research publication, the Journal of Manipulative and Physiological Therapeutics (JMPT), a case study shows a child with ADHD who was helped with chiropractic care.  The case study was of a 5 year old boy who had been diagnosed with ADHD at the age of 2.  The child’s pediatrician prescribed Ritalin, Adderall, and Haldol for 3 years.  After 27 visits to a chiropractor, “The patient experienced significant reduction in symptoms. Additionally, the medical doctor concluded that the reduction in symptoms was significant enough to discontinue the medication.”  This case study can be found at the following link:  http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15510091

So, if you do have a child with ADHD, there are a number of alternatives that you can try before using medications that have numerous side effects and may possibly be carcinogenic.  I hope this series was helpful for you, and if you have any questions or comments, please post them or contact me directly.

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Glucosamine and Chondroitin Sulfate….Garbage or Gold?

Does Glucosamine and Chondroitin Sulfate really work?  I don’t know a week that goes by in my practice where I don’t get a comment from one of my patients about this supplement.  Some of my patients swear by it and others don’t think it’s worth the breath it takes to talk about it.  So I decided to do some research into the subject to help to clarify things with my patients.

The first article I found in my research was performed by the National Center for Complementary and Alternative Medicine (NCCAM)  and was published in the New England Journal of Medicine. This study showed that the supplement helped those individuals with moderate to severe pain from osteoarthritis of the knee, but did little to improve those with mild pain from the knee arthritis. You can click here to see the link:  http://www.nih.gov/news/pr/feb2006/nccam-22.htm.   Another study that was performed in Canada and published in the Arthritis Research & Therapy journal found that glucosamine and chondroitin sulfate improved some of the bony changes that occur in patients with osteoarthritis.  This shows that the supplements have a positive effect on arthritic joints.

 Another article I read on chiroweb.com stated that Glucosamine sulfate has been the subject of more than 300 scientific investigations and over 20 double-blind clinical studies.   The site cited a recent meta-analysis of glucosamine clinical trials in the treatment of osteoarthritis.  In this meta-analysis there were 13 studies that met the inclusion criteria for double-blind, placebo-controlled trials of greater than four weeks’ duration; using global pain score or the Lequesne index joint as the primary outcome measure and considered the trial positive if improvement in the treatment group was equal to or greater than 25 percent compared with the placebo group.  This meta-analysis revealed that glucosamine supplementation reduced the symptoms and signs of osteoarthritis by 40.2 percent on average, compared with the placebo.

Another study that was performed by Reginster, et al., in 1999 and 2001, published in Arthritis and Rheumatology (1999;42, supplement) and Lancet (2001;357). The three-year randomized study by Dr. Reginster was a large analysis that was placebo-controlled, double-blind, and prospective in nature. It involved 212 patients with knee osteoarthritis. Weightbearing and anteroposterior radiographs of each knee were obtained at one and three years, and joint space width was also measured. Symptom and functional status were scored every four months using the Western Ontario and McMaster University Osteoarthritis index. The two groups had comparable baseline status, but after three years there was no further joint space narrowing in the glucosamine group. The placebo group had further joint space narrowing and objective evidence of disease progression. Subject symptoms worsened in the placebo group, but the group taking glucosamine realized a marked reduction in symptoms of osteoarthritis over the three-year period. The authors concluded that glucosamine sulfate supplementation significantly reduced progression of knee osteoarthritis. Patients in the glucosamine group did not experience any untoward side-effects.

So where does all of this information leave us?  There are a number of studies out there showing glucosamine and chondroitin sulfate supplementation helps reduce the progression of osteoarthritis and does not have any of the side effects that the medications for that condition has.  To me, that’s a significant plus when it comes to dealing with a condition that affects so many and has no known cure.  The main things I tell my patients when they’re considering taking any supplement…make sure the supplement is high quality – not all supplements are made the same.  Supplements are not regulated by the FDA in the U.S. so what’s on the label may not be what’s in the pill.  The best thing is to buy your supplements from a reputable company.  Also, most supplements take at least 3 months to make a difference in your body, so give them time.  With glucosamine and chondroitin sulfate we’re looking for it to make changes to an actual joint – that takes time.   If you have any comments of your own about these supplements, we’d love to hear from you.

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