FAQs -
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Supplement Research Update
newsletter by Ray Sahelian, M.D.
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Index of Vitamins, Herbs, Supplements, and
Medical Topics by Ray Sahelian, M.D.
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:
Supplements that can be taken almost every day
Supplements to be used
cautiously or sparinglyOthers
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. 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.
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.
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.