FAQs -

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FAQs

Q. I am age 21 from Glasgow, Scotland. I respect your balanced approach on herbs and supplements. After reading some infos from your website about some herbs that I have been taking for several years I may have found the cause of some problems. You mention taking herbs can cause side effects like : Heart rhythm irregularities, restlessness, anxiety, shallow sleep, sweatiness and some more. After taking certain herbs from around 16-17 daily, I have been experiencing all of the above problems and some more. Symptoms like dull headaches / migraines during morning /afternoon and even evening. Sometimes have to sleep 10-14 hours to dampen it off. Bone / muscle / joint stiffness. Developed anxiety/social anxiety, sweatiness, hot flashes, heart beating really fast, chest tightness, twitching neck / arms / legs, severe facial tightness alot of sleeping problems and some more. Dr.Sahelian is their any advice on how I can bring my body to its natural state ?
   A. High dosages of herbs can give these symptoms. Discuss with your doctor about stopping these pills for a while and have regular habits of exercise, eating well and sleeping. Yoga and hiking can help.

 

Q. Why do you always prescribe such low doses of supplements and medications? At the doses you've prescribed, I usually find no effect whatsoever. Low doses are effective for some people, but everyone is different. You can't possibly prescribe a low dose for everyone and think that it's always going to work.
   A. The doctor has be careful since there are many older people with weak hearts and liver functions who are taking multiple medications. High dosages may work in more people but could also tip some weaker, unstable people with heart problems, endocrine problems, and other medical conditions into emergency rooms or heart rhythm problems. He rather have fewer people benefit than have people suffer serious consequences. Plus, many people who do not respond to initial low dosages will naturally, on their own, increase their dosage. Certain herbs and supplements are very, very potent, just as medicines, and have to be treated with respect.

Q. Hello there Dr. Sahelian and company. I have been trying to make myself more healthy as of late, and I now find myself taking several different tablets and/or capsules to receive different supplements (usually at different times mark you), but I'm concerned about the different types of chemicals that I'm taking in. I don't mean from the herbs/nutrients, but from the tablets and capsules themselves, particularly the tablets. Tablets typically contain all sorts of strange things like "dicalcium phosphate", "silica", "stearate", "crosscarmellose" or whatever in the world that is, as well as gelatin in the case of capsules, etc. So I've been wondering, should I be concerned about these unnatural sounding chemicals accumulating in my body over time (SILICA??!) I'm trying to be as natural as I can. And further, how do tablets and capsules compare to each other? For example, are the contents of capsules present in a more natural or "whole" form than tablets, (seeing that capsules seem to contain the powdered herbs) whereas tablets usually tend to contain extracts? Do capsules provide faster or slower delivery of herbs than tablets? And which ones, capsules or tablets, provide for greater overall bioavailablility of components? Thanks for your consideration.
   A. For practical purposes, the amounts of other ingredients contained in capsules and tablets are so minimal that for almost everyone (unless they have a serious allergy to these compounds) it makes little difference in their health. Most of these additions are safe and harmless. We ingest so much junk in the foods we normally eat, that a few milligrams of these substances are for practical purposes nothing to be concerned about. Gelatin is basically protein and dicalcium and silica are beneficial minerals.

Q. If I should only take half a capsule (and please excuse me if this sounds like a dumb question), how can I accomplish this? What do I do (in the meantime) with the other half of what's in the capsule until I'm ready to take it at a later time (or date)? I know this sound stupid, but since I don't know the answers, please explain this to me: I know how to open a capsule (that's no problem), but my only options I can see are to:
1. Pour half of what's in the capsule to some other temporary container, so I can take the capsule when it's only half full? ---- OR ----
2. To open a capsule, and somehow manage to swallow half of its contents (in their powdery form, or whatever form they are in), saving the remaining half for the next time -- at which time I could swallow the actual capsule itself, now half-full?
   I know, everybody else already knows all this and doesn't need to ask, and I must be the only one who doesn't know how to take half a capsule at a time. There is third (but very impractical) option: to open a capsule and pour half of its contents into the sink, onto the ground, or whatever, and take the now half-full capsule, but then I'd be wasting half of my purchase that way. Honestly, I don't understand this. I sincerely apologize that I have to ask you such stupid questions, but if you would PLEASE answer them, I would be very grateful to you.
   A. It's a very good question and there must be others who don't know so we will be clearer in our explanation on the website.  Basically you can open the capsule by pulling on each end, and then pour about the contents in a glass and add water or a little juice and drink it.  You can then close the capsule by putting the two ends back together and take the other half another day.
 

Q. I like to take Maca root powder, and I generally prefer to take herbs in straight powder form, "straight" meaning mixing the powder with my food, rather than taking them in capsules (I'll take capsules though if I have to). I was wondering though, which is better for absorption and maximizing the use of any herb: straight powder with food, juice, etc., or powders in capsules? I'm thinking that with straight powder, my body doesn't have to go through breaking down the capsule material, and I'll get more nutrients more quickly. But with capsules, I'm wondering if they preserve some of the nutrients from stomach breakdown so they can be delivered to the target organs? Is either thought correct? Which would you recommend for herbs/nutrients genreally, if you had a choice?
   A. Opening the capsules and mixing it with water or a little bit of juice is preferable, but only slightly since stomach acid is able to break through the gelatin capsule quite easily.
 

Q. Have been taking 200 Mg of SAM-e for two weeks and feel much better than I did. You mention that one should not be taking SAM-e long term without a doctor's supervision. My doctor doesn't know anything about SAM-e and I can't find any doctors who are into natural healing. Why do I need a doctor's supervision? What is a doctor actually going to do. If I experience side effects I guess I can figure that out by myself. Is your statement more of legal reasons than necessity?

   A. You ask a very good question. Unfortunately, even though there are highly effective natural substances that can potentially help prevent or treat a number of common medical conditions that are currently being treated by pharmaceutical drugs, most doctors have little knowledge of their existence. I can empathize with you if you live in an area where there are no doctors into natural healing. There are certainly benefits and risks of self diagnosing and medicating. An intelligent and motivated person can learn more about herbs and nutrients than most conventional doctors who have no interest in this topic. So, most consumers are basically left on their own to explore and discover all these fascinating supplements since they can count for very little help -- if not opposition -- from their doctors. As to SAM-e, it is a powerful substance, and as you have found out there are benefits to self-medicating. There are several reasons why I mention that people should be supervised by their doctor. First, legal: In this day of suing at the drop of a hat, it is medico-legally advisable for me to mention "doctor supervision." Second, perhaps as more and more people go to their doctors requesting supervision while taking supplements, more doctors will be encouraged to take an interest in this topic, especially if the feedback from their patients is positive. Perhaps they will start recommending other patients try the natural approaches. Third, it is possible that your doctor may pick up abnormalities on an exam or blood study due to toxicity or misuse of supplements. For instance, SAM-e may in some cases make someone manic, and a doctor may pick up on this behavior. Or, perhaps a blood study may show liver enzyme abnormalities from taking too high doses of certain supplements or herbs for too long.
 

Questions of the month -- When to take breaks and for how long
We've had several questions this month such as:

Q. I read in one of your web pages that you should take a break from supplements, why is that?
Q. Another reader asks: I find that Tongkat ali worked great for a while for libido, but then as I kept taking it, it didn't seem to work as well. Do I need to take a break?


As a rule, I recommend taking a break from taking supplements. Here are my reasons.

Note: The dosage makes a huge difference in how often to take breaks. If your dosage is very low, you can take supplements for prolonged periods with hardly any breaks. If the dosage is high, you would need to take more frequent breaks.

!. Certain fat soluble supplements, for instance Vitamin E, can accumulate in tissues such as fat cells. Some accumulate without harm -- such as beta-carotene leading to orange colored palms (carotenemia) -- but others may continue accumulating and potentially cause harm.
2. Overstimulation can occur. For instance, SAM-e can continue building up in the body and cause restlessness, insomnia and irritability if a high dose is taken over several days or weeks. Many herbs, hormones and supplements can have a stimulatory nature. Some of these include acetyl-l-carnitine, CoQ10, DHEA, DMAE, ginseng, pregnenolone, rhodiola, St. John's wort, tongkat ali, trimethylglycine and tyrosine. Taking too many in too high doses can potentially cause heart rhythm irregularities, restlessness, anxiety, and shallow sleep.
4. We just don't know enough about the long term effects of many supplements and herbs if taken daily for periods of months or years.
5. Some of the supplements may interact with the medicines you may be taking or interact with over the counter drugs or even interact with other supplements.
6. Some herbs and supplements may be beneficial to the immune system in the short term, but when taken daily for many months may potentially be counterproductive. For instance echinacea is helpful in stimulating the immune system.  If taken daily for several months or years, it is possible that in rare cases it may initiate an autoimmune condition.
7. Long term, high dose, daily use of hormones -- such as DHEA and pregnenolone -- may potentially stimulate tumor growth. Taking "hormone holidays" is likely to
significantly reduce the risk.
8. Tolerance can develop. For instance, melatonin and tryptophan may not work as well for sleep if taken every night and you may need a higher dose for the same effect. Certain libido herbs may work by stimulating testosterone release or release of other substances in the brain and body and the body may need a break for a few days to replenish these substances so that the herbs can be effective again. Another form of tolerance is that you may get used to the feelings that the supplements provide and not realize how well you are feeling with them until you take a break for a few days.
9. Certain herbs and supplements may influence the endocrine system in ways that we do not yet fully understand. These may be beneficial or harmful. We just don't know enough about them yet.
10. There may be impurities in the products or the binders and fillers that could be tolerated by the liver or other organs if consumed occasionally, but toxic if consumed daily for prolonged periods.
 

A rough guideline regarding breaks:
There are no clear and exact ways to take breaks. Some people like to use a supplement every other day or 2 days on, 2 days off, 5 days on and off on the weekends or a week to ten days off each month. Each person is unique and has different needs, so no blanket statements can be made that would apply to everyone. However, I can give some guidelines on which herbs and supplements can be safely taken with few breaks and which supplements are best taken infrequently. These guidelines only apply to supplements that are being taken for health enhancement purposes and do not apply for supplements taken to treat a particular health condition while under medical supervision. Please note that these are my opinions, other doctors or nutrition experts may have completely different viewpoints.
 

Supplements that can be taken almost every day
The B vitamins (less than 50 mg daily of B1, B2, B6), Vitamin C (less than 1,000 mg), Vitamin E (less than 200 units a day), Vitamin D (less than 600 units), Vitamin A (less than 15,000 units); most minerals such as calcium and magnesium; carotenoids, flavonoids, fish oils, green tea, probiotics, psyllium, stevia; herbs used as spices such as basil, curcumin, fennel, ginger; most herbs and supplements used for joint health such as glucosamine and chondroitin; most herbs  used for prostate health such as saw palmetto and pygeum; most herbs used for menopause support such as black cohosh, chaste berry and red clover. Products from Physician Formulas that fall into this category include Prostate Power Rx and Joint Power Rx.

Supplements that should have more breaks. For instance taking off 2 to 4 days a week or at least a week to 10 days off each month:
5-HTP, acetyl-l-carnitine, arginine, ashwagandha, bacopa, carnitine, choline, CoQ10, creatine, cordyceps, damiana, deer antler velvet, galantamine, ginkgo biloba, ginseng, huperzine, horny goat weed, hyssop, licorice, maca, melatonin, milk thistle, mucuna pruriens, reishi, rhodiola, St. John's wort, tribulus, tryptophan, valerian, vinpocetine and herbs that influence the immune system (such as echinacea, elderberry, andrographis, astragalus); Products by Physician Formulas that fall into this category include Passion Rx and Mind Power Rx.
 

Supplements to be used cautiously or sparingly
Hormones such as DHEA and pregnenolone (take no more than 5 or 10 mg); kava (until we learn more), Yohimbe (has many side effects, particularly on high doses).
 

Others
There are some herbs and nutrients that I have not mentioned above mostly since I don't know much about their long term use. These include AHCC, beta-glucan, graviola, Lyprinol, mangosteen, nattokinase, and serrapeptase..

It has been shown that an agent when administered in its isolated form may have significantly different effects and side effects than the same agent applied as a constituent in naturally occurring multi-component mixtures.
 

Q. What do you think of multivitamin/multimineral/herbal formulas -so-called "ultra" formulas for men or some such- that seem to have "a little of everything" where the herbs are concerned (while having high potencies of the vitamins and minerals), so that they have very small quantities of the herbs they claim to contain? Is it reasonable to expect any sort of benefit from the herbal combinations, albeit much more slowly, if say the formula is used over a very extended period of time?
   A. the benefits in most cases are likely to be minimal and of little significance compared to eating healthy organic fruits and vegetables.

More FAQs

As trytophan is so expensive now, I wanted to try taking 5htp for some of my tryptophan dose. How big a dose of 5htp is equivalent to a gram of tryptophan? As 5htp comes in 100 mg caps, the equivalent dose must be much smaller, right? It's difficult to give a precise conversion since each person is different in their metabolism, but a factor of 10 seems reasonable. I was just wondering if you had a opinion on the "vegetable complex" type supplements that I have seen almost everywhere supplements are sold. To my understanding, they typically consist of freeze-dried concentrates of many different types of vegetables and sometimes fruits. I know that something like this would never be a real substitue for fresh vegetables in a proper diet, but I
wanted to know if they would even be worth taking at all. I'm not sure how freeze-dried concentrates even compare to fresh vegetables in content and potency. Could taking one or two of these types of capsules a day amount to any sort of benefit for someone (I'm a college student) who has a hard time consuming a wide variety of fresh vegetables? I guess I'm basically asking if taking these in a reasonable amount would be much better than taking nothing at all. Anyway, thank you for your help, and I highly enjoyed your book, Mind Boosters, as well as your website.You ask a good question. These supplements certainly do not seem to have the potential to cause harm, and there is a possibility they could be a healthy thing to take, although there are so many products with so many varieties and potencies that it is difficult to give a blanket statement.
 

Q. Can you tell me the safety of adrenal cortex supplements (Adrenal Cortex Tissue (Bovine)  250 mg, 2-4 per day? Is there any harm in taking this for an extended time? Can taking this inhibit that part of the body from working on its own if the medicine is stopped? Could this have an effect on hair loss? It seems when I stop it, I start losing quite more than the usual amount of hair.
   A. We have not looked into supplements from animal tissues since we don't know what they have in them and each source would have a different composition. Therefore this is an area we don't know much about and we don't study.

 

Q. I am a customer of yours, I purchase my supplements through your group. I won't bore you with my life details but I was diagnosed as suffering from depression(post traumatic) and anxiety due to major issues I had when I was a child and through my adolescence. I take 5-HTP and GABA which seems to be ok but I am never sure of the correct dosage. I take 3 of each 3 times a day. Is this correct? Or is there one supplement that does the function of both of these. My current issue is that I am now having terrible mood swings 3 days and 3 days after my period. I am guessing this is PMT or hormone related I am 40 years old. Do you have a recommendation of something I can take to combat this. I cant bear the feeling of sadness during these days, all I do is cry and I am sure my husband thinks I am going crazy. It's bizarre day 4 I just snap out of it as though nothing was ever wrong. I can't live like this as I am a senior executive with a huge firm. I live in Bordeaux France so here Natural Therapies are not so practiced, your comments would be very much appreciated.
   A. We normally do not give personal recommendations but I spoke with Dr. Sahelian and he offered some suggestions. (He has visited France and has cousins who live in Paris.) 5-HTP and GABA are good choices to be used during those times. It is difficult to know how each person responds but sometime in the future you may wish to try St. Johns wort or small doses of 100 or 200 mg SAMe. Dr. Sahelian also recommends more walking and exercise and also if you have an opportunity to do Yoga, it is very helpful. As to diet, it is good to have balanced meals with protein and vegetables, and less sugar and refined carbohydrates, no caffeine.
 

Q. Hi, Passion Rx seems like a great product. My wife and I (we are in our mid- and late-40s) are trying it for the first time. A few questions: 1. Can Passion Rx cause mild insomnia? For example, if a low dose (1/2 capsule) is taken for two days, then 1 to 2 capsules are taken on the day of planned activity, it is possible that it could be harder to fall asleep on the third night? My wife and I both work in professional, white-collar environments where clear thinking and job performance are essential. Reading the section, "Positive Side Effects" I see the benefits of Passion Rx are compatible with such work environments. However, is it possible with a higher dose (1 to 2 capsules per day) that one might become "distracted with desire" while at work? Or would you suggest this is unlikely (I realize everyone may respond differently) ? Keep up the great work, Dr. Sahelian (my father is a physician, a retired internist). I have a dog-eared and underlined copy of Mind Boosters that has been my bible for the past 3 years. I am particularly interested in your discussion of feedback inhibition* -- one reason, I assume, why taking "vitamin holidays" is important. For example, in Mind Boosters, feedback inhibition is discussed specifically regarding NAC and glutathione. Is it reasonable to suspect that feedback inhibition might develop with long-term supplementation of most (or many) nutrients? Your frequent references to taking time off from a supplement would seem to support this. In any case, I have appreciated and put to good use the idea that, where supplements are concerned, sometimes less is more. Thanks again.   
   A. 1. Yes, Passion Rx can cause insomnia, and this is dose dependent. The higher the dose, the more insomnia. The slow libido approach of 1/3 or 1/2 of a capsule taken 2 or 3 mornings in a row does not cause the insomnia and is effective in boosting libido and performance, and a full capsule or two may not be needed. I use 1/3 of a capsule 2 mornings in a row. We will have another batch of Passion Rx in September which we think will cause much less insomnia, and less body heat, since we decreased the dose of some herbs that are responsible and added other herbs that do not cause the excess alertness.
 2. It is possible of being distracted, but sometimes people don't notice the sexual effects unless they are being intimate. Each person is different. In case users find it distracting, they could take Passion Rx on Fridays, Saturdays and Sundays.

 3. Each nutrient and each person is different in terms of feedback inhibition (many herbs and nutrients don't have any feedback inhibition at all but could cause side effects if misused) and the human body is so complicated that it is difficult to have a full understanding of this issue at this time.

Q. What do you think of the study released 10-Nov-2003, Orlando, Fl. RE; Jutta Reising, U. of Muenster. The study evaluated 177 cases of M.I. and  Phytosterol blood levels with conclusion that those with higher levels were At increased risk?  Presented at Amer. Heart Assoc. Scientific Sessions (2003 ).
   A. We have not seen this study and could not find it on medline. One has to be careful interpreting the results of one study alone. Many studies on the same topic have to be looked at over a period of time before coming to conclusions.

Additional links

Damiana herb
Danshen herb
Deer antler velvet herb
Deprenyl medicine
Depression treatment
Devils claw herb
DHA/fish oils
DHEA and 7-Keto potential harm
Diabetes alternative options
Diet suggestions
DMAE capsule
DMG sublingual
Dopamine
enhancer

 

Alkyl glucoside
Q. Some weeks ago I received an e-mail which seemed to hype a product previously unknown to me. It was called "AGS" and apparently this stands for alkyl glucoside. My question Do you have information about the use of AGS in treatment of cancer? And if so, could you cite a journal article on the subject?
   A. We are not familiar with alkyl glucoside supplements or information.


Echinacea herb
Energy
Seizure
Epimedium herb
Erectile dysfunction herbal treatment
EstroPause herbal product
Eurycoma herb
Evening primrose supplement
Evodiamine herbal extract
Eyesight herbs

 

Q. What is your opinion of the "chi machines"? real or another fraud? ps. you're terrific! i have used your supplements and pass along information provided in your newsletters constantly!
   A. Chi machines don't make any sense to me but I have not seen any research with them.

Fatigue
Female_libido herb
Fennel herb
Fenugreek herb
Fertility herb
Feverfew herb
Fibroids
Fibromyalgia
Fish oils heart
5-HTP/ 5-hydroxytryptophan
Flavonoids vlood vessel
Flaxseed
Forskolin herbal extract
Fo-ti chinese
Fructus Lycii herb

Q. I use to take Vinpocetine a few years back. I took it for a few months off and on and what i experienced with vinpocetine was great clearity of thinking, very noticeable sharper vision, heightened color perception with good memory and recall and a sense of deeper enlightment (specially when i combined it with acetyl L Carnitine ( 5 mg Vinpocetine and 10 mg ALC) however after a few months i started to catch flu and throat and ear infections easily. I found out later that German commission E has issued a warning against Vinpocetine that it temporarily supresses the immune system and causes apoptosis if taken on the long term. Never the less i did have some fantastic lucid dreams and 2 self initiated and well controlled out of body experiences when i was on vinpocetine. So then i stopped taking it and in a few days my immune system got back in business. Also vinpocetine lessens sex drive if taken for more then two weeks as it increases serotonin in the brain. I tried DMAE but that gives a mild reaction like tingling in my hands and feet and mild anxiety even on a 15 or 20 mg dose, I have used ALC on its own and its fine and fairly better but not as good as Brahmi (Bacopa) but long term or chronic administration of bacopa increases Uric Acid which may cause temporary gout. Although brahmi gives me energy, better vision, clearity of thinking, better and quick understanding of difficult concepts, it causes a strange or very mild restlessness in my mind like Biological Noise or something which i never experienced while i took Vinpocetine. I also get good results with fish oil but cant take it regularly.


Q. Hi, I was on 90 mgs methadone and Duragesic patch 75 mcgs (fentanyl) for about ten years for chronic pain. Then... was put on an illegaly high does of subutex (buprenorphine), 96 mgs/day and over 20 months tapered down to .25 mgs/day and then ceased and have been off totally for ten days. I probably don't need to tell you what I feel like. Do you any recommendations for supplements, etc. that would ease the agony of the withdrawal process? Since subutex is the latest greatest formula for dealing
with opiate wd and as a replacement to methadone maintenance, there is virtually no information available anywhere that deals with the withdrawal from subutex. The forums online tend to be in one of two categories; one,"Gee, what a swell drug. I don't have to steal to feed my smack habit, etc." For those folks it seems very good, or at least a good alternative. The other group is the one I'm in, "Okay I've been on subutex for X years and when I stop taking it or taper down the withdrawal is from hell, and it lasts longer than the usual opiate wds."
 

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