What is the difference between CORvalen and CorvalenM? Both products recommend 5 grams per serving, and both have the same number of servings of D-ribose the principal active ingredient. In addition, CorvalenM contains magnesium and malate, both shown to improve muscle metabolism and relaxation.
How do I know which is best for me? As a general rule, CORvalen is recommended for heart patients and athletic applications. CorvalenM is used more for muscle aches, pain, soreness, and stiffness. But there are many exceptions with each. Ask yourself, Does my diet need additional magnesium? Magnesium is important for over 200 chemical reactions in the body. Some say the American diet contains less and less natural magnesium because more of our food is processed and we drink more bottled water and beverages than a couple of generations ago.
Conversely, too much magnesium leads to loose stools and diarrhea. You can pick up magnesium from several sources vitamin pills and other supplements.
What are the ingredients for each product? CORvalen is 100% D-ribose. Each serving contains 5g of D-ribose. CORvalen M contains D-ribose, malate and magnesium. For each serving of CORvalen M, there is 5g D-ribose, 240mg Malate (or malic acid) and 800mg magnesium gluconate (the same as 40mg elemental magnesium). CORvalen Chewable Wafers each contain 1.67 grams D-ribose. Other ingredients include inulin, cocoa bean powder, mannitol, modified cellulose, safflower oil, coconut powder, stearic acid, silicon dioxide and natural flavors.
What is ribose? D-Ribose is a simple, 5-carbon monosaccharide, or pentose sugar. It is used by all the cells of the body and is an essential compound in energy metabolism. Ribose is also the carbohydrate backbone of genetic material, DNA and RNA, certain vitamins and other important cellular compounds.
Who needs CORvalen? Ribose is an essential ingredient in stimulating natural energy production. Research has shown that ribose promotes cardiovascular health, reduces cardiac stress associated with strenuous activity and helps athletes extend their exercise tolerance and accelerates recovery. Ribose helps hearts and muscles maximize energy recovery. Whether you are a trained athlete, a weekend warrior or are concerned about your cardiovascular health, ribose may help give the energy boost your body needs.
How is ribose made in the body? Most compounds necessary for life are made in the body through a series of complicated pathways. Ribose is no different. In the body, ribose is made from glucose (a simple 6-carbon sugar) through a pathway called the Pentose Phosphate Pathway (PPP). Eventually, adenosine triphosphate (ATP) is produced. ATP is the primary energy molecule in your body’s cells. Though your body makes ribose and ATP naturally, it produces it slowly. As a result, your heart and muscle tissues use their energy faster than they can restore it and the energy pools become depleted.
How does the body derive cellular energy from ribose? The physiologically functional form of ribose, called 5-phosphoribosyl-1-pyrophosphate (PRPP), regulates the metabolic pathway that synthesizes energy compounds in all living tissue. If this compound is not available in sufficient quantity, energy synthesis slows.
How does taking supplemental CORvalen aid in increasing cellular energy? If the cellular energy pool is depleted by disease or exercise, it must be replaced. PRPP is required to turn on the metabolic pathway used by the body to replenish these energy pools. Supplemental ribose bypasses the slow and rate-limiting enzymes in the Pentose Phosphate Pathway, forms PRPP, and quickly begins the process of energy synthesis.
What will CORvalen do for someone concerned about cardiovascular health? Numerous medical studies have shown that energy levels in the heart can be dramatically lowered by exercise or decreased blood flow associated with certain cardiac diseases. Depleted cardiac energy pools may be associated with increased cardiac stress, altered cardiac function, fatigue and decreased exercise tolerance. Ribose is the key nutrient for quickly restoring cardiac energy stores.
What is the recommended daily dosage of CORvalen? Usual dosage: 5g serving twice daily, taken with meals. A third serving may be added with a midday meal as needed.
Alternative dosage: 5g just before and just after exercise or physical activity.
Serving measurement: 5g of CORvalen powder is a rounded teaspoonful. A single dose measuring scoop is provided with each jar.
CORvalen may be dissolved in 2 oz. or more of juice, tea, or coffee or sprinkled over foods of choice (such as hot oatmeal, yogurt, cold cereal). CorvalenM has a more citrus flavor so it is best in juice, water or yogurt. CORvalen and CorvalenM should NOT be mixed into carbonated beverages.
To maximize athletic performance, or to keep energy pools high during strenuous activity, slightly larger doses may be required. CORvalen (D-ribose) should be taken just before and just after exercise or activity. For extended exercise, an additional 1 to 2 grams per hour of exercise or activity may be helpful.
When can I expect to feel results/benefits from taking CORvalen? Individual response varies widely, but relief from fatigue is often felt within the first 10 days of consistent use.
What can I mix with CORvalen? CORvalen may be mixed with water, juice, coffee, tea or sprinkled on cereal or fruit. It has a mild pleasant sweet taste and is very flexible.
Are there any side effects associated with taking ribose? CORvalen may lower blood sugar for 60 to 90 minutes after ingestion. This may cause one to feel very hungry or lightheaded. This can be avoided by taking with meals or with some form of a carbohydrate such as a juice.
What will ribose do for someone who exercises on a regular basis? Scientific research shows that three or four workouts per week may not allow enough rest time between sessions for heart and muscle energy pools to return to normal levels. Taking CORvalen (D-ribose) shortens the time needed by heart and muscle tissue to replace energy that is lost through vigorous exercise. Keeping energy pools full helps to keep hearts and muscles in good physiological condition, increase power and endurance, and reduce fatigue. Recent research has also shown that ribose supplementation during exercise manages free radical formation and lowers cardiac stress associated with hypoxia.
Does CORvalen conflict with any medications? There are no known interactions with drugs or other supplements.
Does ribose work with creatine or other supplements? Ribose can increase the effect of creatine and other energy supplements by keeping the energy pool at full capacity. Creatine works by recycling energy that is already present in the tissue. Another supplement, carnitine, aids in fatty acid metabolism. A third, pyruvate, also helps to recycle energy. Only ribose performs this important metabolic function. Without adequate levels of energy to work with, no other supplement can be fully effective.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Monday, March 9, 2009
Wednesday, February 11, 2009
Microcrystalline Hydroxyapatite Concentrate (MCHC)
Microcrystalline hydroxyapatite concentrate (MCHC) is an excellent source of bioavailable calcium that is important for developing strong bones and teeth, preventing osteoporosis, and assisting with proper function of various body systems such as the heart, nerves, and muscles. MCHC is derived from whole bone and is complete with the minerals and organic factors naturally found in raw bone. In addition to calcium and the organic factors (mostly collagen protein and mucopolysaccharides), MCHC contains phosphorus, magnesium, fluoride, zinc, silicon, manganese, and other trace minerals in the same physiological proportions found in healthy bone. MCHC has been shown to be well-tolerated, even by small children, with no undesirable side effects.
In addition, MCHC has been shown to contain biologically active growth factors. Such growth factors are known to directly stimulate bone cell activity thereby enhancing bone formation.
With the rapid aging of the population, experts agree that prevention is the most effective method of dealing with osteoporosis. Along with regular exercise as well as a healthy diet and lifestyle, MCHC provides comprehensive bone nourishment which aims at preventing the onset of osteoporosis and many other health problems.
Uses
MCHC is available in tablet form. Be sure to drink 6 to 8 cups of water throughout the day to avoid constipation. Studies have shown that 500 mg of MCHC yield approximately 200 mg of elemental calcium and thus, MCHC should be taken according to the following guidelines:
In addition, MCHC has been shown to contain biologically active growth factors. Such growth factors are known to directly stimulate bone cell activity thereby enhancing bone formation.
With the rapid aging of the population, experts agree that prevention is the most effective method of dealing with osteoporosis. Along with regular exercise as well as a healthy diet and lifestyle, MCHC provides comprehensive bone nourishment which aims at preventing the onset of osteoporosis and many other health problems.
Uses
- Excellent source of bioavailable calcium.
- Provides a full complement of minerals that are important for healthy bone formation and metabolism such as phosphorus, fluoride, magnesium, silicon, iron, zinc, copper, and manganese.
- Contains intact organic factors that provide secondary support for healthy bone formation.
In several studies, MCHC has been shown to be highly successful in minimizing bone loss as well as positively affecting bone healing. This includes reducing the incidence of fractures as well as facilitating the healing of fractures.
MCHC is available in tablet form. Be sure to drink 6 to 8 cups of water throughout the day to avoid constipation. Studies have shown that 500 mg of MCHC yield approximately 200 mg of elemental calcium and thus, MCHC should be taken according to the following guidelines:
- Adults ages 19 to 50 need 2,500 mg per day of MCHC (1,000 mg of calcium). After age 50, adults need 3,000 mg per day of MCHC (1,200 mg of calcium).
- Adolescents ages 9 to 18 need 3,250 mg per day of MCHC (1,300 mg of calcium).
- Children ages 6 to 8 need 2,000 mg per day of MCHC (800 mg of calcium); children ages 1 to 5 need 1,250 mg per day of MCHC (500 mg of calcium).
Precautions
Talk with your healthcare provider about your calcium needs if you have any thyroid or kidney problems, or if you have hormone or vitamin deficiencies.
Be especially careful when choosing an MCHC product. It is important to realize that supplements that claim to contain MCHC may vary widely in purity, form, and effectiveness.
The sources of bone extract as well as the processing procedures are of utmost importance in determining the quality of MCHC. Some sources of MCHC may contain high levels of lead and other contaminants, or be tainted with cartilage and tendons. Certain processing procedures, such as high-heat and excessive grinding, can result in a product that is nothing more than bone meal. These products lack the full complement of minerals, organicfactors, and the microcrystalline structures that are characteristic of true MCHC.
Possible Interactions
Some foods, drinks, and medications can cause you to excrete MCHC. These include some soft drinks, aluminum-containing antacids, salt, sugar, saturated fat, caffeine, alcohol, and very high protein and fiber intake.
In addition, excessive amounts of some foods and drinks and regular use of some medications make it hard for your body to get the MCHC it needs. These include alcohol, aspirin, barbiturates, fiber, neomycin, strong sedatives, oxalic acid (found in chocolate, rhubarb, spinach, chard, sweet potatoes, and dried beans), phytic acid (found in grains), and uronic acid (a type of fiber found in fruits and vegetables).
Supporting Research
Epstein O, Kato Y, Dick R, et al. Vitamin D, hydroxyapatite and calcium gluconate in treatment of cortical bone thinning in postmenopausal women with primary biliary cirrhosis. Am J Clin Nutr 1982;36(3):426-30.
Fleming KH, Heimbach JT. Consumption of calcium in the U.S.: food sources and intake levels. J Nutr 1994;124(8 suppl):1426S-30S.
Pines A, Raafat H, Lynn AH, et al. Clinical trial of MCHC in the prevention of osteoporosis due to corticosteroid therapy. Curr Med Res Opin 1984:8(10):734-42.
Riggs BL, Melton LJ 3rd. Involutional osteoporosis. N Eng J Med 1986;314(26):1676-86.
Notelovitz M. Osteoporosis: screening, prevention and management. Fertil Steril 1993;59(4):707-25.
Ruegsegger P, Keller A, Dambacher MA. Comparison of the treatment effects of ossein-hydroxyapatite compound and calcium carbonate in osteoporotic females. Osteo Int 1995;5(1):30-34.
Stepan JJ, Pospichal J, Presl J, et al. Prospective trial of ossein-hydroxyapatite compound in surgically induced postmenopausal women. Bone 1989;10(3):179-85.
Windsor ACM, Misra DP, Loudon JM, et al. The effect of whole-bone extract on 47Ca absorption in the elderly. Age & Ageing 1973;2(4):230-34.
Advanced Nutrition Publications ©2002
Magnesium supplementation and osteoporosis
Although calcium has received most of the attention, there is growing evidence that magnesium is an important factor in maintaining optimal bone health. In fact, experts agree that adequate magnesium intake is necessary for the proper utilization of calcium, which is found in large quantities in bone.
According to researchers, "With this degree of supporting evidence, it is curious that magnesium supplementation has not been examined more frequently in studies of osteoporosis."
Osteoporosis is a reduction in bone mass that leads to an increased risk of bone fractures. In response to the lack of research on magnesium and osteoporosis, researchers reviewed a 2-year study performed on 31 osteoporotic postmenopausal women given magnesium. For the first 6 months, participants were treated with 250 to 750 mg per day of magnesium (depending upon individual tolerance). From month 6 to 24, treatment consisted of 250 mg per day of magnesium. An age-matched group consisting of 23 postmenopausal women with osteoporosis served as controls (untreated) for comparison. Bone mineral density tests were performed on all participants at the beginning of the study, after 1 year of treatment, and at the end of the 2-year study.
Researchers stated that, "At the end of the 2-year study, magnesium therapy [appeared] to have prevented fractures and resulted in a significant increase in bone density."
Researchers also claimed, "The finding that magnesium supplementation actually caused increased bone density rather than a stabilization of existing bone density is noteworthy. This has not been a finding of either calcium or estrogen intervention trials."
J. Sojka and colleagues concluded in Nutrition Reviews that "...magnesium intake should be measured when conducting studies investigating the importance of nutrients on the prevention or treatment of osteoporosis."
Nutr Rev 1995;53(3):71-80.
Advanced Nutrition Publications ©2002
Buy Magnesium Supplement - Quality - Highly Absorbable
According to researchers, "With this degree of supporting evidence, it is curious that magnesium supplementation has not been examined more frequently in studies of osteoporosis."
Osteoporosis is a reduction in bone mass that leads to an increased risk of bone fractures. In response to the lack of research on magnesium and osteoporosis, researchers reviewed a 2-year study performed on 31 osteoporotic postmenopausal women given magnesium. For the first 6 months, participants were treated with 250 to 750 mg per day of magnesium (depending upon individual tolerance). From month 6 to 24, treatment consisted of 250 mg per day of magnesium. An age-matched group consisting of 23 postmenopausal women with osteoporosis served as controls (untreated) for comparison. Bone mineral density tests were performed on all participants at the beginning of the study, after 1 year of treatment, and at the end of the 2-year study.
Researchers stated that, "At the end of the 2-year study, magnesium therapy [appeared] to have prevented fractures and resulted in a significant increase in bone density."
Researchers also claimed, "The finding that magnesium supplementation actually caused increased bone density rather than a stabilization of existing bone density is noteworthy. This has not been a finding of either calcium or estrogen intervention trials."
J. Sojka and colleagues concluded in Nutrition Reviews that "...magnesium intake should be measured when conducting studies investigating the importance of nutrients on the prevention or treatment of osteoporosis."
Nutr Rev 1995;53(3):71-80.
Advanced Nutrition Publications ©2002
Buy Magnesium Supplement - Quality - Highly Absorbable
Friday, January 23, 2009
High PCB exposure tied to diabetes risk
Last Updated: 2008-08-15 11:43:12 -0400 (Reuters Health)
NEW YORK (Reuters Health) - People who have been exposed to high levels of toxic polychlorinated biphenyls (PCBs) may face an elevated risk of type 2 diabetes, a new study shows.
The findings, reported in the journal Diabetes Care, come from a long-term study of Taiwanese adults who, in the 1970s, had been poisoned by cooking oil contaminated with PCB pollutants.
Once used in products ranging from fluorescent lights and appliances to insulation and insecticide, PCBs were banned in the late 1970s as carcinogens and general health hazards. They linger in the environment, however.
In the new study, Dr. Yueliang Leon Guo, from the National Taiwan University in Taipei, and colleagues examined the incidence of type 2 diabetes among 378 Taiwanese "oil disease" victims and 370 of their neighbors who had not been poisoned.
They found that women who had been exposed to the PCB-laced oil were twice as likely as other women to develop type 2 diabetes over 24 years. And women who had been most severely affected by the PCB exposure had a more than five-times higher diabetes risk.
There were no similar risks seen in men, however.
Other studies have found that people with diabetes tend to have relatively higher levels of organic pollutants, such as PCBs, in their blood. In comments to Reuters Health, Guo said that since "everyone" has detectable PCB levels in his or her body, it's possible that exposure to such pollutants has helped feed the widespread rise in diabetes in recent decades.
"The public health implication of these findings can be huge," Guo added, "considering the burden of diabetes and its multiple long-term complications."
.SOURCE: Diabetes Care 2008, August 2008.
NEW YORK (Reuters Health) - People who have been exposed to high levels of toxic polychlorinated biphenyls (PCBs) may face an elevated risk of type 2 diabetes, a new study shows.
The findings, reported in the journal Diabetes Care, come from a long-term study of Taiwanese adults who, in the 1970s, had been poisoned by cooking oil contaminated with PCB pollutants.
Once used in products ranging from fluorescent lights and appliances to insulation and insecticide, PCBs were banned in the late 1970s as carcinogens and general health hazards. They linger in the environment, however.
In the new study, Dr. Yueliang Leon Guo, from the National Taiwan University in Taipei, and colleagues examined the incidence of type 2 diabetes among 378 Taiwanese "oil disease" victims and 370 of their neighbors who had not been poisoned.
They found that women who had been exposed to the PCB-laced oil were twice as likely as other women to develop type 2 diabetes over 24 years. And women who had been most severely affected by the PCB exposure had a more than five-times higher diabetes risk.
There were no similar risks seen in men, however.
Other studies have found that people with diabetes tend to have relatively higher levels of organic pollutants, such as PCBs, in their blood. In comments to Reuters Health, Guo said that since "everyone" has detectable PCB levels in his or her body, it's possible that exposure to such pollutants has helped feed the widespread rise in diabetes in recent decades.
"The public health implication of these findings can be huge," Guo added, "considering the burden of diabetes and its multiple long-term complications."
.SOURCE: Diabetes Care 2008, August 2008.
Saturday, January 10, 2009
Using inositol for promoting brain wellness: an interview with Robert Belmaker, MD
Robert Crayhon: Joining us now to discuss his groundbreaking research on inositol and mental health is psychiatrist and researcher Robert H. Belmaker, MD. Dr. Belmaker, would you please give us your educational background?
Robert Belmaker: I received my Bachelors Degree in 1967 at Harvard University and my MD in 1971 at Duke University. I then started a psychiatric residency at Duke and then went to the National Institutes of Mental Health as a clinical associate from 1972-1974. I then came to Israel in 1974 and completed my psychiatric residency. Eventually, I became director of research at the Jerusalem Mental Health Center in Jerusalem. Later, I became in addition, an associate professor of psychiatry at the Hebrew University School of Medicine in Jerusalem. In 1985 I came to the new medical school in Beersheva at Ben Gurion University to become the Hoffer-Vickar Chair of Psychiatry.
RC: Can you just describe for us briefly, your daily duties?
RB: I am a professor of psychiatry; I am the assistant director of the Beersheva Mental Health Center, so I have administrative duties. Every Monday I have a full clinic day with my own patients. Sometimes with my own 30 patients. Two to three times a week I do rounds on inpatients with the residents as well. So I have clinical, teaching and research duties.
RC: What got you interested in the role of nutrition in brain function as a psychiatrist?
RB: I think it's partly derived from some skepticism about the pharmaceutical companies. It is also derived from the feeling that so much of what we ingest everyday is food, and that chemicals in food must have some effect on our brain, and perhaps some potential therapeutic effects on the brain. But actually the chair of psychiatry that I am incumbent of was endowed by a family that has been famous for their interest in nutrition and psychiatry. I haven't decided to this day whether they found me and endowed the chair, or whether the endowment of the chair influenced my thinking. But, of course, Abram Hoffer, MD, PhD, from Canada has been interested and influential in nutrition and psychiatry for fifty years now. He published in the 1950s about nutrition and psychiatry when it was very unpopular, and he very bravely continued.
RC: Is the connection between nutrition and psychiatry any more popular now in psychiatric circles?
RB: There is an increase in interest in nutrition and psychiatry. However, like the increased interest in nutrition and medicine, it goes with a healthy degree of skepticism. There are a fair number of people who are suspicious -- perhaps sometimes rightly so -- of excessive claims. Often people with severe mental illnesses reject any drug treatment. They do that partly because of their illness in their thinking. Sometimes they use arguments derived from the nutrition literature and don't get proper pharmaceutical treatment. This is a shame, and this makes some psychiatrists in this position skeptical about nutrition. Clearly, however, some patients with heart disease need surgery and sometimes need triple artery by-pass, and other patients with high blood pressure are clearly going to need hypertensive and anti-hypertensive medicine. All cardiologists today know and believe and preach the role of nutrition in preventing heart disease and high blood pressure. So, the two should not be seen as antagonistic. In psychiatry there is no question that the anti-psychotic drugs and the mood stabilizer drugs are effective. But I think perhaps we are a little behind cardiology and some of the papers show that folate supplementation can enhance the ability of lithium to prevent mood disorders and the ability of anti-psychotic drugs to reduce psychosis. These papers are not given as much publicity and as much acceptance as they really deserve. I don't know if it's because they do not have a pharmaceutical company pushing folate -- because it's too cheap -- or whether it's the skepticism that might be a result of excessive claims of the past. Or perhaps it is the skepticism that is coming as an antidote to the fact that some patients refuse pharmaceutical treatment, and only want natural treatment. Often those patients are too sick to be able to make a rational decision.
RC: Dr. Belmaker, do you feel the future of psychiatry is an intelligent integration of pharmaceuticals and nutrients? And, should nutrients be tried first?
RB: I think we have to answer that question empirically. There are going to have to be studies, like the ones we did with inositol. There is no way to know what comes first and what comes second. Certainly in most cases nutrients are milder. If a person finds changing his diet can prevent his headaches, we would like to see him do that before he tries a strong medicine like Valproate to prevent a headache. Ultimately, it has to be an empirical question. We have to do the studies.
RC: What got you interested in inositol?
RB: I had been interested previously in lithium and I am still interested in lithium. As you know, lithium is a very simple compound and a non-patented compound and a cheap compound. Those are some of the things that keep my interest. I have been interested in lithium for 30 years. Lithium has a major effect on inositol and the brain that was discovered by a wonderful man, name of Dr. Berridge from London, a Nobel prize candidate for that work. That work was done on flies, of the salivary gland of the fruit fly. For those people who sometimes make jokes about how animal research is not relevant, here is an example of how something that seems terribly funny, the salivary gland of the fruit fly, has become a major area of scientific research, with many important benefits for humanity. He discovered the whole cycle, the inositol cycle of the cell, and that lithium had an effect on it. So, as a lithium researcher, I read his papers and got interested in inositol. Professor Berridge was very interested in how inos itol can affect cell function. We were really the first to think that one could possibly give inositol as a nutrient in quantities that could get it to the brain.
RC: How does lithium affect inositol's function?
RB: It's a bit complicated, and there are still disagreements about it. Lithium inhibits a key enzyme called inositol mono-phosphatase. Some people say, as a result, inositol levels in some areas in the brain should go down. Other people believe because that enzyme is inhibited, the inositol phosphates actually go up, and we really don't know which of those two things are more important in lithium action.
RC: What is the difference between inositol and myo-inositol? Is there a difference? Is it just two terms for the same thing?
RB: For a biologist they are two terms for the same thing. The only inositol that exists naturally in the body of the human or any other mammal is called myo-inositol. For a chemist, inositol can exist in eight different forms that are mirror images of each other, although it might be hard to imagine how you can have eight different mirror images; but that's because there are eight different places on the inositol molecule that a carbon and a hydroxyl group can have a mirror image. But, only the myo-inositol is present naturally so when I talk about inositol as a medicine or a cell, I can just drop the myo and call it inositol, because that is the only one that we have.
RC: What happens when the human body is given inositol orally?
RB: It depends on the dose. The doses that we found are large enough to get inositol into the brain are the dose equivalent of 3 to 6 teaspoons a day. That's 12 to 18 grams. It could be teaspoons in tea or in juice. That's the quantities that we are talking about. In order for these doses to be effective, they need to be taken over a period of three to four weeks. We found those doses to be as beneficial as anti-depressants used in depression, panic disorders and in obsessive-compulsive disorders. We've done one study in normal volunteers, who were given a much larger dose at a single time in the morning in a large cup of juice. They were given 12 grams in one swallow and then every hour they were asked to fill out rating scales as to their tension, mood, feelings of relaxation, feeling of wellbeing, welfare, things that a normal person would write, called a profile of mood scale (the scale for normal mood), and we found that indeed, even a single dose peaking at about six hours reduced tension and increased feelings of well-being. In depressed patients we don't see those effects quite so early. Perhaps because the depression is strong enough to mask them, and in these patients, inositol did not work any faster than standard antidepressants. It only had a significant and beneficial effect after about three weeks.
RC: How does inositol work?
RB: That of course is a very good question. We have done quite a bit of animal work in rats to look at the mechanism and we think that the strongest findings relate to serotonin and particularly the 5HT2 serotonin receptor. In a rat if you drip serotonin on neurons with those receptors, and measure the response, after a while the nerve cell stops responding and if you add inositol it jumps up and starts responding again. So, it seems like cells can get depleted of inositol. Or, specific nerve cells might not have enough to be able to maintain neurotransmission in the serotonergic system. Of course, there are many things we have not investigated, but it could be that some patients have deficiencies in the brain of inositol to the point where their serotonin system cannot respond.
We did do a study with brains donated after death from patients with depression, manic-depression and other mental illnesses, and no illness. These were given to us by the Stanley Research Foundation in Washington DC, which was able to obtain these brains from people who consented before their death to donate their brains. They were diagnosed before their death as suffering from these diseases. We did find a group of patients especially with affective disorder with low, very low inositol levels in the brain.
RC: Is there a way for most people through their diet to get enough inositol? When you are talking about a therapeutic dose in the 12-18 gram range, I am wondering where someone may get a gram of inositol on a daily basis though food.
RB: The usual intake is about a gram a day through food. I think it would be really hard to get 12 grams a day through food, I think that is really a pharmacological dose. Of course, prevention of depression might require a lower dose, and we have been interested. I have a colleague now, a dietitian, whom I have asked to do some surveys of the diet of people who come complaining of depression, to see whether there are different amounts of inositol. We also have a study that will be published in May in the American Journal of Psychiatry on omega-3 fatty acids, another nutrient that we found to be anti-depressant in depressed patients, and on this we were not the first.
RC: Has there been an actual clinical trial of omega-3 fats in depression?
RB: Let me just say one thing about the omega-3s. There is one previous study by Andy Stull of Boston, a Clinical Trial with positive results. What I wanted to say is that the omega-3s also are given in much higher doses than are present in the usual diet, even though there have been reports of a correlation in the usual diet, such that the people who eat more omega-3s get depressed less. It might be with some of these nutrients you need more to correct real depression than you do to prevent it.
RC: Which will bring us back to a lesson taught to us by Abram Hoffer decades ago -- that is exactly the case. If you are missing a nutrient for decades you might need a lot more for the rest of your life to get back to normal. Regarding inositol and the diet, my understanding is that inositol in our food is largely in the form of inositol hexaphosphate, which is in a form of fiber that's hard to absorb. In other words, it might be in the food, but how well we absorb it, I think is perhaps open to question.
RB: I think you are asking a very good question, it's something I am just getting very interested in, and don't have the answer for you.
RC: Let's talk about inositol in some other applications, to say it's effective in depression at doses of 12-18 grams, but you've got to give it three weeks to really see the results?
RB: That's right.
RC: What about agoraphobia?
RB: We tend to call this panic disorder, with or without agoraphobia. Same doses seem to be effective, and also our statistical significant results occurred at three weeks. There was a strong trend before that, but our statistical significant results occurred at about three weeks.
RC: What about obsessive-compulsive disorder and inositol?
RB: In obsessive-compulsive disorder our studies use 18 grams. I can't say it doesn't work less than that, the way it works with depression with 12 grams, but we just haven't tried it. These people tend to be more ill -- and started with 18 grams. We've only seen statistically significant improvement by about six weeks, not before that. It does take longer, which is similar to drug treatment for obsessive-compulsive disorder.
RC: And only with inositol monotherapy, with no other nutrient or drug?
RB: That's right.
RC: Very impressive. Did you arrive at these doses by clinically examining the fact that the 3 and 6 grams doesn't work and then titrating upward to 18 grams?
RB: We arrived at the doses actually first with the pharmacokinetic studies. We tested to see what doses were necessary to get a good rise in inositol in human spinal fluid. Less than 12 grams a day didn't achieve much of a rise. At 12 grams a day, there is a 70% rise in human spinal fluid inositol levels. We have tried some patients in the early days more than now on lower doses, so we had some feeling of what the dose should be. I must say it has not been done in a systematic way because these kinds of controlled trials are expensive. We haven't had the funding that the pharmaceutical companies have. To really work up inositol in the way you are describing with very large trials in multiple doses -- is a one hundred million dollar project. No one would give us this to study a non-patentable compound. We had some grants from NIH and from the Stanley Foundation, but we have not done a good dose response study.
RC: What about SSRI medications and inositol, since they seem to be accentuating the same pathway. What if someone is taking a Zoloft or a Prozac and they ask their physician, "Can I take inositol at the same time?"
RB: We have studied that, and we have not had side effects with it. But, to our surprise and disappointment, we did not see synergism. We would have hoped for synergism, but it seems that inositol works and the SSRIs worked. If you put the two of them together it doesn't work any better than inositol alone or SSRIs alone. So that SSRIs in that sense are an alternative to inositol, or inositol is an alternative to SSRIs. We don't have reason to believe that it is a good addition to a SSRI non-responder, although we have not found it in any way unsafe if someone wants to try.
RC: What if someone wants to transition off of a SSRI? Would inositol be a logical stepping-stone to perhaps a more natural approach to accentuating serotonin metabolism?
RB: It is certainly an option, but we don't have data on that. We have data on people who have been treated in the past with SSRIs successfully and on their next depressive episode they were treated successfully with inositol. But we don't actually have people going from one to the other in the same depressive episode.
RC: Let's talk about inositol and safety. You've used doses of 18 grams in your trials and your practice. Any side effects from these doses?
RB: Well, people will have some loose stools and about the same with some of the SSRIs. I would say about quarter of the patients will move their bowels more frequently. We've had very few people who have to stop the medicine for that reason. We have not seen any significant changes. By now we've have a fairly large number of patients with hematological or chemical parameters. This is a large number of patients for a natural compound, but these are still fewer patients than would be expected, let's say for the FDA. If it were a new SSRI, they would want a considerably larger number of patients.
RC: Is there anyone who should not take inositol?
RB: I think it would make sense for someone who was diabetic to be careful. Someone with severe kidney disease or liver disease to be careful with inositol but I think this is a very general medical consideration.
RC: And that's because inositol has a molecular similarity to glucose and because of this theoretically could raise blood sugar in diabetics?
RB: That's right.
RC: Any other pearls here for nutritional pharmacology research? You spoke about folate and omega-3s, any other information you would like to share with our readers?
RB: Well, I think one of the most exciting things that we've been doing lately is with homocysteine. Homocysteine is the amino acid that's not used in protein synthesis and its been shown to be a risk factor for cardiovascular disease over the last few years. In more recent years it's been proven to be a risk factor for Alzheimer's and cerebral vascular disorders as well. We thought that this might mean that it's a risk factor for mental disorder and we have been surveying homocysteine levels in our patients and have found markedly elevated levels of homocysteine. We have begun a trial of folate, B12 and B6 in schizophrenic patients, because these are known to be homocysteine lowering vitamins that can lower homocysteine levels by up to 50% in combination. Homocysteine has been shown in a test tube to be neurotoxic, so we think we might be able to prevent the clinical deterioration and cognitive deterioration in schizophrenia with homocysteine lowering.
RC: Have you seen lowering homocysteine to be an effective strategy; perhaps in the treatment of depression?
RB: We have not looked at that.
RC: What happens when you give a patient a good-sized powder container of inositol and say "Take 6 teaspoons per day, please." Do they look at you and say "why is this doctor giving me a nutrient, and so much of it?"
RB: Well, I explain it. Most of the patients that consent to be on our program are people who are looking for this. That's how they get to us. So we find it very acceptable among patients, compliance is very high.
RC: Does it matter if inositol is taken with food or not?
RB: No it doesn't. It's absorbed very well. We recommend it be taken with some food
Metagenics Cenitol Powder with Inositiol
Robert Belmaker: I received my Bachelors Degree in 1967 at Harvard University and my MD in 1971 at Duke University. I then started a psychiatric residency at Duke and then went to the National Institutes of Mental Health as a clinical associate from 1972-1974. I then came to Israel in 1974 and completed my psychiatric residency. Eventually, I became director of research at the Jerusalem Mental Health Center in Jerusalem. Later, I became in addition, an associate professor of psychiatry at the Hebrew University School of Medicine in Jerusalem. In 1985 I came to the new medical school in Beersheva at Ben Gurion University to become the Hoffer-Vickar Chair of Psychiatry.
RC: Can you just describe for us briefly, your daily duties?
RB: I am a professor of psychiatry; I am the assistant director of the Beersheva Mental Health Center, so I have administrative duties. Every Monday I have a full clinic day with my own patients. Sometimes with my own 30 patients. Two to three times a week I do rounds on inpatients with the residents as well. So I have clinical, teaching and research duties.
RC: What got you interested in the role of nutrition in brain function as a psychiatrist?
RB: I think it's partly derived from some skepticism about the pharmaceutical companies. It is also derived from the feeling that so much of what we ingest everyday is food, and that chemicals in food must have some effect on our brain, and perhaps some potential therapeutic effects on the brain. But actually the chair of psychiatry that I am incumbent of was endowed by a family that has been famous for their interest in nutrition and psychiatry. I haven't decided to this day whether they found me and endowed the chair, or whether the endowment of the chair influenced my thinking. But, of course, Abram Hoffer, MD, PhD, from Canada has been interested and influential in nutrition and psychiatry for fifty years now. He published in the 1950s about nutrition and psychiatry when it was very unpopular, and he very bravely continued.
RC: Is the connection between nutrition and psychiatry any more popular now in psychiatric circles?
RB: There is an increase in interest in nutrition and psychiatry. However, like the increased interest in nutrition and medicine, it goes with a healthy degree of skepticism. There are a fair number of people who are suspicious -- perhaps sometimes rightly so -- of excessive claims. Often people with severe mental illnesses reject any drug treatment. They do that partly because of their illness in their thinking. Sometimes they use arguments derived from the nutrition literature and don't get proper pharmaceutical treatment. This is a shame, and this makes some psychiatrists in this position skeptical about nutrition. Clearly, however, some patients with heart disease need surgery and sometimes need triple artery by-pass, and other patients with high blood pressure are clearly going to need hypertensive and anti-hypertensive medicine. All cardiologists today know and believe and preach the role of nutrition in preventing heart disease and high blood pressure. So, the two should not be seen as antagonistic. In psychiatry there is no question that the anti-psychotic drugs and the mood stabilizer drugs are effective. But I think perhaps we are a little behind cardiology and some of the papers show that folate supplementation can enhance the ability of lithium to prevent mood disorders and the ability of anti-psychotic drugs to reduce psychosis. These papers are not given as much publicity and as much acceptance as they really deserve. I don't know if it's because they do not have a pharmaceutical company pushing folate -- because it's too cheap -- or whether it's the skepticism that might be a result of excessive claims of the past. Or perhaps it is the skepticism that is coming as an antidote to the fact that some patients refuse pharmaceutical treatment, and only want natural treatment. Often those patients are too sick to be able to make a rational decision.
RC: Dr. Belmaker, do you feel the future of psychiatry is an intelligent integration of pharmaceuticals and nutrients? And, should nutrients be tried first?
RB: I think we have to answer that question empirically. There are going to have to be studies, like the ones we did with inositol. There is no way to know what comes first and what comes second. Certainly in most cases nutrients are milder. If a person finds changing his diet can prevent his headaches, we would like to see him do that before he tries a strong medicine like Valproate to prevent a headache. Ultimately, it has to be an empirical question. We have to do the studies.
RC: What got you interested in inositol?
RB: I had been interested previously in lithium and I am still interested in lithium. As you know, lithium is a very simple compound and a non-patented compound and a cheap compound. Those are some of the things that keep my interest. I have been interested in lithium for 30 years. Lithium has a major effect on inositol and the brain that was discovered by a wonderful man, name of Dr. Berridge from London, a Nobel prize candidate for that work. That work was done on flies, of the salivary gland of the fruit fly. For those people who sometimes make jokes about how animal research is not relevant, here is an example of how something that seems terribly funny, the salivary gland of the fruit fly, has become a major area of scientific research, with many important benefits for humanity. He discovered the whole cycle, the inositol cycle of the cell, and that lithium had an effect on it. So, as a lithium researcher, I read his papers and got interested in inositol. Professor Berridge was very interested in how inos itol can affect cell function. We were really the first to think that one could possibly give inositol as a nutrient in quantities that could get it to the brain.
RC: How does lithium affect inositol's function?
RB: It's a bit complicated, and there are still disagreements about it. Lithium inhibits a key enzyme called inositol mono-phosphatase. Some people say, as a result, inositol levels in some areas in the brain should go down. Other people believe because that enzyme is inhibited, the inositol phosphates actually go up, and we really don't know which of those two things are more important in lithium action.
RC: What is the difference between inositol and myo-inositol? Is there a difference? Is it just two terms for the same thing?
RB: For a biologist they are two terms for the same thing. The only inositol that exists naturally in the body of the human or any other mammal is called myo-inositol. For a chemist, inositol can exist in eight different forms that are mirror images of each other, although it might be hard to imagine how you can have eight different mirror images; but that's because there are eight different places on the inositol molecule that a carbon and a hydroxyl group can have a mirror image. But, only the myo-inositol is present naturally so when I talk about inositol as a medicine or a cell, I can just drop the myo and call it inositol, because that is the only one that we have.
RC: What happens when the human body is given inositol orally?
RB: It depends on the dose. The doses that we found are large enough to get inositol into the brain are the dose equivalent of 3 to 6 teaspoons a day. That's 12 to 18 grams. It could be teaspoons in tea or in juice. That's the quantities that we are talking about. In order for these doses to be effective, they need to be taken over a period of three to four weeks. We found those doses to be as beneficial as anti-depressants used in depression, panic disorders and in obsessive-compulsive disorders. We've done one study in normal volunteers, who were given a much larger dose at a single time in the morning in a large cup of juice. They were given 12 grams in one swallow and then every hour they were asked to fill out rating scales as to their tension, mood, feelings of relaxation, feeling of wellbeing, welfare, things that a normal person would write, called a profile of mood scale (the scale for normal mood), and we found that indeed, even a single dose peaking at about six hours reduced tension and increased feelings of well-being. In depressed patients we don't see those effects quite so early. Perhaps because the depression is strong enough to mask them, and in these patients, inositol did not work any faster than standard antidepressants. It only had a significant and beneficial effect after about three weeks.
RC: How does inositol work?
RB: That of course is a very good question. We have done quite a bit of animal work in rats to look at the mechanism and we think that the strongest findings relate to serotonin and particularly the 5HT2 serotonin receptor. In a rat if you drip serotonin on neurons with those receptors, and measure the response, after a while the nerve cell stops responding and if you add inositol it jumps up and starts responding again. So, it seems like cells can get depleted of inositol. Or, specific nerve cells might not have enough to be able to maintain neurotransmission in the serotonergic system. Of course, there are many things we have not investigated, but it could be that some patients have deficiencies in the brain of inositol to the point where their serotonin system cannot respond.
We did do a study with brains donated after death from patients with depression, manic-depression and other mental illnesses, and no illness. These were given to us by the Stanley Research Foundation in Washington DC, which was able to obtain these brains from people who consented before their death to donate their brains. They were diagnosed before their death as suffering from these diseases. We did find a group of patients especially with affective disorder with low, very low inositol levels in the brain.
RC: Is there a way for most people through their diet to get enough inositol? When you are talking about a therapeutic dose in the 12-18 gram range, I am wondering where someone may get a gram of inositol on a daily basis though food.
RB: The usual intake is about a gram a day through food. I think it would be really hard to get 12 grams a day through food, I think that is really a pharmacological dose. Of course, prevention of depression might require a lower dose, and we have been interested. I have a colleague now, a dietitian, whom I have asked to do some surveys of the diet of people who come complaining of depression, to see whether there are different amounts of inositol. We also have a study that will be published in May in the American Journal of Psychiatry on omega-3 fatty acids, another nutrient that we found to be anti-depressant in depressed patients, and on this we were not the first.
RC: Has there been an actual clinical trial of omega-3 fats in depression?
RB: Let me just say one thing about the omega-3s. There is one previous study by Andy Stull of Boston, a Clinical Trial with positive results. What I wanted to say is that the omega-3s also are given in much higher doses than are present in the usual diet, even though there have been reports of a correlation in the usual diet, such that the people who eat more omega-3s get depressed less. It might be with some of these nutrients you need more to correct real depression than you do to prevent it.
RC: Which will bring us back to a lesson taught to us by Abram Hoffer decades ago -- that is exactly the case. If you are missing a nutrient for decades you might need a lot more for the rest of your life to get back to normal. Regarding inositol and the diet, my understanding is that inositol in our food is largely in the form of inositol hexaphosphate, which is in a form of fiber that's hard to absorb. In other words, it might be in the food, but how well we absorb it, I think is perhaps open to question.
RB: I think you are asking a very good question, it's something I am just getting very interested in, and don't have the answer for you.
RC: Let's talk about inositol in some other applications, to say it's effective in depression at doses of 12-18 grams, but you've got to give it three weeks to really see the results?
RB: That's right.
RC: What about agoraphobia?
RB: We tend to call this panic disorder, with or without agoraphobia. Same doses seem to be effective, and also our statistical significant results occurred at three weeks. There was a strong trend before that, but our statistical significant results occurred at about three weeks.
RC: What about obsessive-compulsive disorder and inositol?
RB: In obsessive-compulsive disorder our studies use 18 grams. I can't say it doesn't work less than that, the way it works with depression with 12 grams, but we just haven't tried it. These people tend to be more ill -- and started with 18 grams. We've only seen statistically significant improvement by about six weeks, not before that. It does take longer, which is similar to drug treatment for obsessive-compulsive disorder.
RC: And only with inositol monotherapy, with no other nutrient or drug?
RB: That's right.
RC: Very impressive. Did you arrive at these doses by clinically examining the fact that the 3 and 6 grams doesn't work and then titrating upward to 18 grams?
RB: We arrived at the doses actually first with the pharmacokinetic studies. We tested to see what doses were necessary to get a good rise in inositol in human spinal fluid. Less than 12 grams a day didn't achieve much of a rise. At 12 grams a day, there is a 70% rise in human spinal fluid inositol levels. We have tried some patients in the early days more than now on lower doses, so we had some feeling of what the dose should be. I must say it has not been done in a systematic way because these kinds of controlled trials are expensive. We haven't had the funding that the pharmaceutical companies have. To really work up inositol in the way you are describing with very large trials in multiple doses -- is a one hundred million dollar project. No one would give us this to study a non-patentable compound. We had some grants from NIH and from the Stanley Foundation, but we have not done a good dose response study.
RC: What about SSRI medications and inositol, since they seem to be accentuating the same pathway. What if someone is taking a Zoloft or a Prozac and they ask their physician, "Can I take inositol at the same time?"
RB: We have studied that, and we have not had side effects with it. But, to our surprise and disappointment, we did not see synergism. We would have hoped for synergism, but it seems that inositol works and the SSRIs worked. If you put the two of them together it doesn't work any better than inositol alone or SSRIs alone. So that SSRIs in that sense are an alternative to inositol, or inositol is an alternative to SSRIs. We don't have reason to believe that it is a good addition to a SSRI non-responder, although we have not found it in any way unsafe if someone wants to try.
RC: What if someone wants to transition off of a SSRI? Would inositol be a logical stepping-stone to perhaps a more natural approach to accentuating serotonin metabolism?
RB: It is certainly an option, but we don't have data on that. We have data on people who have been treated in the past with SSRIs successfully and on their next depressive episode they were treated successfully with inositol. But we don't actually have people going from one to the other in the same depressive episode.
RC: Let's talk about inositol and safety. You've used doses of 18 grams in your trials and your practice. Any side effects from these doses?
RB: Well, people will have some loose stools and about the same with some of the SSRIs. I would say about quarter of the patients will move their bowels more frequently. We've had very few people who have to stop the medicine for that reason. We have not seen any significant changes. By now we've have a fairly large number of patients with hematological or chemical parameters. This is a large number of patients for a natural compound, but these are still fewer patients than would be expected, let's say for the FDA. If it were a new SSRI, they would want a considerably larger number of patients.
RC: Is there anyone who should not take inositol?
RB: I think it would make sense for someone who was diabetic to be careful. Someone with severe kidney disease or liver disease to be careful with inositol but I think this is a very general medical consideration.
RC: And that's because inositol has a molecular similarity to glucose and because of this theoretically could raise blood sugar in diabetics?
RB: That's right.
RC: Any other pearls here for nutritional pharmacology research? You spoke about folate and omega-3s, any other information you would like to share with our readers?
RB: Well, I think one of the most exciting things that we've been doing lately is with homocysteine. Homocysteine is the amino acid that's not used in protein synthesis and its been shown to be a risk factor for cardiovascular disease over the last few years. In more recent years it's been proven to be a risk factor for Alzheimer's and cerebral vascular disorders as well. We thought that this might mean that it's a risk factor for mental disorder and we have been surveying homocysteine levels in our patients and have found markedly elevated levels of homocysteine. We have begun a trial of folate, B12 and B6 in schizophrenic patients, because these are known to be homocysteine lowering vitamins that can lower homocysteine levels by up to 50% in combination. Homocysteine has been shown in a test tube to be neurotoxic, so we think we might be able to prevent the clinical deterioration and cognitive deterioration in schizophrenia with homocysteine lowering.
RC: Have you seen lowering homocysteine to be an effective strategy; perhaps in the treatment of depression?
RB: We have not looked at that.
RC: What happens when you give a patient a good-sized powder container of inositol and say "Take 6 teaspoons per day, please." Do they look at you and say "why is this doctor giving me a nutrient, and so much of it?"
RB: Well, I explain it. Most of the patients that consent to be on our program are people who are looking for this. That's how they get to us. So we find it very acceptable among patients, compliance is very high.
RC: Does it matter if inositol is taken with food or not?
RB: No it doesn't. It's absorbed very well. We recommend it be taken with some food
Metagenics Cenitol Powder with Inositiol
Saturday, December 6, 2008
NUTRITIONAL SUPPORT IN A PATIENT WITH CHRONIC FATIGUE SYNDROME
NUTRITIONAL SUPPORT USING ULTRACLEAR PLUS ® AND ULTRACLEAR SUSTAIN®
IN A PATIENT WITH CHRONIC FATIGUE SYNDROME
Purpose: To show how a targeted nutritional support program featuring UltraClear PLUS medical food for detoxification and UltraClear SUSTAIN medical food for gastrointestinal (GI)
support may be useful in some patients with long-standing chronic fatigue syndrome (CFS).
Patient’s Presentation and History: A 42-year-old Caucasian female presented with CFS,
reporting unremitting fatigue, insomnia, chronic arthralgias and myalgias, post-exertion exhaustion, cognitive dysfunction, cyclical acne, recurrent sinus and strep infections, and
increasing sensitivity to environmental stimuli (e.g., tobacco smoke, perfumes, newsprint). At the time of presentation, she was on disability and unable to work. The patient primarily ate
organic foods, and noted some bloating with wheat and dairy. She had a history of hypothyroidism, mononucleosis, allergies, migraines, 6 weeks of “colitis -like” symptoms after
pesticide exposure, and multiple antibiotic courses.
Patient’s Objective Information
· BMI†: 22.8; BP: 120/80
· MSQ* score 129
· Results of HEENT exam: notable allergic shiners, lungs lear to auscultation
· Thyroid palpable, liver non-tender, abdomen soft with diffuse tenderness in right and left upper quadrants
· Along with dry skin, reddened vesicles in various stages of eruption, healing, and scarring noted on anterior arms, forearms, calves, and thighs
· Prescriptive medications and supplements included spironolactone (75 mg/day), desiccated thyroid (120 mg/day), and a variety of nutritional supplements
· Assessment: CFS, multiple chemical sensitivities, possible food allergies, and adrenal fatigue
Plan: In addition to continuing prescriptive medications and discontinuing supplements, the patient was instructed to begin taking:
· UltraClear PLUS medical food, 3 servings daily
· Licorice root extract, ¼ tsp qd
· Extract of 7 mushrooms, 30 drops bid
· Multivitamin/mineral supplement without iron, 2 tablets bid
1 and 3 Week Results
The patient’s laboratory results from week 1 showed altered intestinal permeability and detoxification. After 3 weeks on the program, the patient reported improvements in sleep, cognition, and energy and was instructed to:
· Continue UltraClear PLUS, licorice root, multivitamin/mineral supplement without iron
· Discontinue mushroom extract
· Add elimination diet, fiber supplement (1 scoop tid), glutamine (5 grams tid)
8 and 12 Week Results
The patient’s fatigue, energy, and sleep continued to improve. Prior to the program, she was sleeping 14-16 hr/day, decreasing to 8-10 hr/day after 8 weeks on the program. She was instructed to continue the protocol and add sodium sulfate (20 mg bid) to help manage chemical sensitivities. The patient indicated a 30% to 40% improvement overall after 12 weeks, and said she was better able to withstand chemical exposures. Intestinal permeability and detoxification laboratory values also improved. The patient was instructed to add a supplement to support mitochondrial energy production (2 capsules tid).
20 and 32 Week Results
The patient continued to do well and rated her overall improvement at 50% by the 20th week. She was instructed to:
· Continue the elimination diet, licorice root extract, multivitamin/mineral supplement, and fiber supplement
· Discontinue UltraClear PLUS, mitochondrial support supplement, and glutamine
· Begin taking UltraClear SUSTAIN medical food, 2 scoops bid
· Increase sodium sulfate, 400 mg bid
· Add N-acetylcysteine, 500 mg tid
After 32 weeks, the patient was no longer bedridden and continued to show improvement. She decided to remove mercury amalgams and had two chelation IV therapies. The patient noted that support for detoxification, particularly the sodium sulfate, helped her manage chemical sensitivities.
Conclusion
This case study suggests that a focused nutritional program featuring UltraClear PLUS for detoxification and UltraClear SUSTAIN to support healthy GI function may help address
CFS symptoms—including multiple chemical sensitivities associated with long-term CFS.
CASE STUDY #909
Figure 1
After 32 weeks, the patient’s Medical Symptoms Questionnaire* score decreased from 129 to 18 (reference range: <30>RESULTS
strong86% Improvement in MSQ Score
129
18
0
50
100
150
Before Program After 32 Weeks
MSQ Score 91% Reduction in Intestinal Permeability ("Leaky Gut")
0.338
0.031
0
0.1
0.2
0.3
0.4
Initial Lab Results After 32 Weeks
Lactulose-Mannitol Ratio
2X the Total
Acetaminophen Recovery
40.60%
83.20%
0.00%
20.00%
40.00%
60.00%
80.00%
100.00%
Initial Lab Results
After 32 Weeks
AIMS2: Physical Score
†BMI is the Body Mass Index and can be computed by the weight (kg) divided by the square of the height (m).
*The Medical Symptoms Questionnaire (MSQ) is a clinical tool for the evaluation of general physical symptoms. Total scores above 75 are generally associated with substantial symptomatology and disability; scores below 30 generally indicate few or low intensity symptoms.
© Metagenics, Inc. MET909 4/04
Note: The information provided in this case study describes the results of one patient under the care of a licensed healthcare practitioner and may not be a typical response. UltraClear PLUS medical food and UltraClear SUSTAIN medical food are to be used under the supervision of a physician or other licensed healthcare practitioner.
Case Study: Nutritional Support Using UltraClear PLUS and UltraClear SUSTAIN in a Patient with Chronic Fatigue Syndrome. Metagenics, Inc.; 016CFS1203.
IN A PATIENT WITH CHRONIC FATIGUE SYNDROME
Purpose: To show how a targeted nutritional support program featuring UltraClear PLUS medical food for detoxification and UltraClear SUSTAIN medical food for gastrointestinal (GI)
support may be useful in some patients with long-standing chronic fatigue syndrome (CFS).
Patient’s Presentation and History: A 42-year-old Caucasian female presented with CFS,
reporting unremitting fatigue, insomnia, chronic arthralgias and myalgias, post-exertion exhaustion, cognitive dysfunction, cyclical acne, recurrent sinus and strep infections, and
increasing sensitivity to environmental stimuli (e.g., tobacco smoke, perfumes, newsprint). At the time of presentation, she was on disability and unable to work. The patient primarily ate
organic foods, and noted some bloating with wheat and dairy. She had a history of hypothyroidism, mononucleosis, allergies, migraines, 6 weeks of “colitis -like” symptoms after
pesticide exposure, and multiple antibiotic courses.
Patient’s Objective Information
· BMI†: 22.8; BP: 120/80
· MSQ* score 129
· Results of HEENT exam: notable allergic shiners, lungs lear to auscultation
· Thyroid palpable, liver non-tender, abdomen soft with diffuse tenderness in right and left upper quadrants
· Along with dry skin, reddened vesicles in various stages of eruption, healing, and scarring noted on anterior arms, forearms, calves, and thighs
· Prescriptive medications and supplements included spironolactone (75 mg/day), desiccated thyroid (120 mg/day), and a variety of nutritional supplements
· Assessment: CFS, multiple chemical sensitivities, possible food allergies, and adrenal fatigue
Plan: In addition to continuing prescriptive medications and discontinuing supplements, the patient was instructed to begin taking:
· UltraClear PLUS medical food, 3 servings daily
· Licorice root extract, ¼ tsp qd
· Extract of 7 mushrooms, 30 drops bid
· Multivitamin/mineral supplement without iron, 2 tablets bid
1 and 3 Week Results
The patient’s laboratory results from week 1 showed altered intestinal permeability and detoxification. After 3 weeks on the program, the patient reported improvements in sleep, cognition, and energy and was instructed to:
· Continue UltraClear PLUS, licorice root, multivitamin/mineral supplement without iron
· Discontinue mushroom extract
· Add elimination diet, fiber supplement (1 scoop tid), glutamine (5 grams tid)
8 and 12 Week Results
The patient’s fatigue, energy, and sleep continued to improve. Prior to the program, she was sleeping 14-16 hr/day, decreasing to 8-10 hr/day after 8 weeks on the program. She was instructed to continue the protocol and add sodium sulfate (20 mg bid) to help manage chemical sensitivities. The patient indicated a 30% to 40% improvement overall after 12 weeks, and said she was better able to withstand chemical exposures. Intestinal permeability and detoxification laboratory values also improved. The patient was instructed to add a supplement to support mitochondrial energy production (2 capsules tid).
20 and 32 Week Results
The patient continued to do well and rated her overall improvement at 50% by the 20th week. She was instructed to:
· Continue the elimination diet, licorice root extract, multivitamin/mineral supplement, and fiber supplement
· Discontinue UltraClear PLUS, mitochondrial support supplement, and glutamine
· Begin taking UltraClear SUSTAIN medical food, 2 scoops bid
· Increase sodium sulfate, 400 mg bid
· Add N-acetylcysteine, 500 mg tid
After 32 weeks, the patient was no longer bedridden and continued to show improvement. She decided to remove mercury amalgams and had two chelation IV therapies. The patient noted that support for detoxification, particularly the sodium sulfate, helped her manage chemical sensitivities.
Conclusion
This case study suggests that a focused nutritional program featuring UltraClear PLUS for detoxification and UltraClear SUSTAIN to support healthy GI function may help address
CFS symptoms—including multiple chemical sensitivities associated with long-term CFS.
CASE STUDY #909
Figure 1
After 32 weeks, the patient’s Medical Symptoms Questionnaire* score decreased from 129 to 18 (reference range: <30>RESULTS
strong86% Improvement in MSQ Score
129
18
0
50
100
150
Before Program After 32 Weeks
MSQ Score 91% Reduction in Intestinal Permeability ("Leaky Gut")
0.338
0.031
0
0.1
0.2
0.3
0.4
Initial Lab Results After 32 Weeks
Lactulose-Mannitol Ratio
2X the Total
Acetaminophen Recovery
40.60%
83.20%
0.00%
20.00%
40.00%
60.00%
80.00%
100.00%
Initial Lab Results
After 32 Weeks
AIMS2: Physical Score
†BMI is the Body Mass Index and can be computed by the weight (kg) divided by the square of the height (m).
*The Medical Symptoms Questionnaire (MSQ) is a clinical tool for the evaluation of general physical symptoms. Total scores above 75 are generally associated with substantial symptomatology and disability; scores below 30 generally indicate few or low intensity symptoms.
© Metagenics, Inc. MET909 4/04
Note: The information provided in this case study describes the results of one patient under the care of a licensed healthcare practitioner and may not be a typical response. UltraClear PLUS medical food and UltraClear SUSTAIN medical food are to be used under the supervision of a physician or other licensed healthcare practitioner.
Case Study: Nutritional Support Using UltraClear PLUS and UltraClear SUSTAIN in a Patient with Chronic Fatigue Syndrome. Metagenics, Inc.; 016CFS1203.
Fish Oils and Mood Disorder Prevention
Metagenics EPA-DHA Extra Strength® Concentrated and Stabilized Purity-Certified, Omega-3 Fish Oils EPA-DHA Extra Strength is a concentrated source of health-promoting, antioxidant stabilized, omega-3 essential fatty acids from cold water fish. EPA-DHA Extra Strength supports healthy musculoskeletal, cardiovascular, nervous, and immune functions.
Advantages of this premium formula include:
Pharmaceutical-grade fish oil
Purity certified
Low in cholesterol
Fish Oils and Mood Disorder Prevention
In addition to adequate micronutrient intake, fatty acid balance also plays a critical role in mental health. Low fish consumption has been found in multiple studies to be a statistically significant finding in those with depression. For example, this study showed that rates of depression increased more than twofold in women who were rare fish consumers compared with regular fish eaters.1 Research scientists consistently found a reduced level of omega-3 fatty acids in patients with mood disorders and mental illness. There is overwhelming evidence that omega-3 fatty acids are important to mental health.
The two main omega-3 fatty acids in fish oil, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), have important biological functions in the brain. DHA is a major structural component of neuronal membranes, and changing the fatty acid composition of neuronal membranes leads to functional changes in the activity of receptors and other proteins embedded in the membrane phospholipid. EPA has important physiological functions that can affect neuronal activity. Clinical trials have suggested benefits from DHA and EPA treatments in borderline personality disorder, bipolar or manic-depressives, schizophrenia, and attention deficit hyperactivity disorder.
Our bodies have the ability to make these important fats from the short chain omega-3 fats found in leafy greens, walnuts, flax, and hemp, but some people do not fabricate sufficient DHA from the shorter length precursors as well as other people do, predisposing them to neurological problems. These individuals have a greater need to supplement their diets, especially since fish today is so polluted, and farm-raised fish is no longer a dependable source of DHA and EPA. Using a DHA supplement or purified fish oil is cleaner and more dependable.
Documented benefitsThe following interesting observations are found in the scientific literature:
1. Both lower DHA content in mothers’ milk and lower seafood consumption were associated with higher rates of postpartum depression.2
2. Depressed patients have lower levels of DHA in their fatty tissues compared to normals.3
3. Multiple studies indicate that in depression and schizophrenia, one gram a day of the EPA component is more effective than DHA, and a higher dose does not add additional efficacy
4.Depression is related to low levels of these long chain omega-3 fats in the brain, and it is apparent that supplementation with DHA and EPA have beneficial results in patients with mood disorders.
Since studies have shown that EPA is even more effective than DHA for alleviating depression in the short run, and DHA is more important for structural normalcy to maintain long-lasting results, I recommend real fish oil containing both EPA and DHA for those with depression and related mood disorders. About two grams of fish oil usually contains about one gram of active ingredient (EPA + DHA) appropriate for those with mild mood disorders. With major depression, use about 3 grams to achieve the one gram of EPA that has documented clinical efficacy for depression. Look for an oil that gives the most active ingredients (EPA + DHA) per gram of oil.
For more information about these Metagenics products, please call us at: 208-325-9292 or by e-mail at jes@jescollection.com. Web-site: www.jescollection.com or www.jescollection.meta-ehealth.com
Advantages of this premium formula include:
Pharmaceutical-grade fish oil
Purity certified
Low in cholesterol
Fish Oils and Mood Disorder Prevention
In addition to adequate micronutrient intake, fatty acid balance also plays a critical role in mental health. Low fish consumption has been found in multiple studies to be a statistically significant finding in those with depression. For example, this study showed that rates of depression increased more than twofold in women who were rare fish consumers compared with regular fish eaters.1 Research scientists consistently found a reduced level of omega-3 fatty acids in patients with mood disorders and mental illness. There is overwhelming evidence that omega-3 fatty acids are important to mental health.
The two main omega-3 fatty acids in fish oil, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), have important biological functions in the brain. DHA is a major structural component of neuronal membranes, and changing the fatty acid composition of neuronal membranes leads to functional changes in the activity of receptors and other proteins embedded in the membrane phospholipid. EPA has important physiological functions that can affect neuronal activity. Clinical trials have suggested benefits from DHA and EPA treatments in borderline personality disorder, bipolar or manic-depressives, schizophrenia, and attention deficit hyperactivity disorder.
Our bodies have the ability to make these important fats from the short chain omega-3 fats found in leafy greens, walnuts, flax, and hemp, but some people do not fabricate sufficient DHA from the shorter length precursors as well as other people do, predisposing them to neurological problems. These individuals have a greater need to supplement their diets, especially since fish today is so polluted, and farm-raised fish is no longer a dependable source of DHA and EPA. Using a DHA supplement or purified fish oil is cleaner and more dependable.
Documented benefitsThe following interesting observations are found in the scientific literature:
1. Both lower DHA content in mothers’ milk and lower seafood consumption were associated with higher rates of postpartum depression.2
2. Depressed patients have lower levels of DHA in their fatty tissues compared to normals.3
3. Multiple studies indicate that in depression and schizophrenia, one gram a day of the EPA component is more effective than DHA, and a higher dose does not add additional efficacy
4.Depression is related to low levels of these long chain omega-3 fats in the brain, and it is apparent that supplementation with DHA and EPA have beneficial results in patients with mood disorders.
Since studies have shown that EPA is even more effective than DHA for alleviating depression in the short run, and DHA is more important for structural normalcy to maintain long-lasting results, I recommend real fish oil containing both EPA and DHA for those with depression and related mood disorders. About two grams of fish oil usually contains about one gram of active ingredient (EPA + DHA) appropriate for those with mild mood disorders. With major depression, use about 3 grams to achieve the one gram of EPA that has documented clinical efficacy for depression. Look for an oil that gives the most active ingredients (EPA + DHA) per gram of oil.
For more information about these Metagenics products, please call us at: 208-325-9292 or by e-mail at jes@jescollection.com. Web-site: www.jescollection.com or www.jescollection.meta-ehealth.com
Subscribe to:
Posts (Atom)