Newsletter 2007 - Supplement Research Update Newsletter 2007

See Newsletter 2006 back issues.
See Newsletter 2008 issues.

Feedback from readers
Just want you to know that I appreciate the sense of integrity and truthfulness of your articles. Thanks for a year of great newsletters in 2006.

I just want to thank both Dr. Sahelian and his hard working staff for their honesty, integrity and all their hard work promoting natural medicine. I not only love your books and products, but I also love your web site. Please keep up the great work.

I just wanted to say how much I enjoy your newsletters. They are a source of such interesting and important information. Thanks for putting it together for us on a regular basis. I don't know where else I would find such great information in one place. Thanks for your ongoing research and products as well. You do a great job.

The health information from a physician of Dr. Sahelian's stature is priceless.

Your website is a work of art and I commend you for its superior content. I am a teacher in esthetic sciences at a college in Washington state.

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 4, Issue 15 -- December 10, 2007
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The holiday season is here and it is quite likely that some of us will add a few extra pounds over the next few weeks. The winter cold and short daylight hours will keep many people indoors and reduce energy expenditure. Add to this the many family gatherings and dinner parties, the sweets, alcoholic drinks and such, and you may wake up one morning in January and realize the belt buckle needs to be loosened by a notch or two or you have just been expanded to a larger dress size. Many of you will make a New Year's resolution to go on a diet. Unfortunately, most weight loss diets involve a way of eating that is unpleasant or difficult to maintain. That is why most people go off them and gain the weight back rather quickly. Prescription weight loss drugs are not very effective, nor are they safe. Below I discuss recent findings that found these medications to be less than stellar performers regarding permanent weight loss.
   In this issue I discuss new research regarding Crohn's disease, isoflavone treatment for menopause, honey as a cough treatment, and noni for energy boosting.

PRODUCT DISCOUNTS at Physician Formulas -- For the rest of the month of December all the items at Physician Formulas are on sale for an additional 10 percent off on top of the existing discounts, including the bestselling formulas Passion Rx, Diet Rx, Mind Power Rx, Joint Power Rx, Prostate Power Rx, MultiVit Rx, Eyesight Rx, and Veg Rx.. As a newsletter subscriber you are eligible to get this discount. After you add the products to your cart, type the word holiday in the discount code provided and then click update below it. If you have questions, call the customer care representatives at the number listed on the Physician Formulas website.
   Our newest product, Diet Rx, has quickly become our number 2 bestseller within a few weeks. Passion Rx is still number one.

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1. Prebiotics and probiotics for Crohn's disease
Researchers at Nippon Medical School in Tokyo, Japan. used a combination of probiotic and prebiotic supplements in the treatment of active Crohn's disease in ten young Crohn's disease patients who had not benefited from aminosalicylates and prednisolone. Patients were started on both probiotics (75 billion colony forming units daily) and prebiotics (psyllium 10 grams daily). Probiotics were mainly in the form of Bifidobacterium and Lactobacillus bacteria. After about a year, six patients had a complete response, one had a partial response, and three were non-responders. Two patients were able to discontinue their prednisolone therapy, while four patients decreased their dosage. The researchers says. "A high dose of a probiotic and prebiotic combination can be safely and effectively used for the treatment of active Crohn's disease."
   Comments: This was a small study of only 10 people, but it is encouraging and hopefully studies with larger groups of patients will be done soon. The probiotic dosage was quite high, and perhaps lower amounts would also be helpful. I have recently updated the web page on Crohn's disease. See http://www.raysahelian.com/crohnsdisease.html. You will find a link to probiotic and prebiotic web pages.

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2. Isoflavone treatment for menopause symptoms
Soybean have compounds called isoflavones which can influence estrogen receptors in the body.  Scientists at the Karolinska Institute in Sweden looked into the effects of isoflavone treatment in postmenopausal women. Sixty healthy postmenopausal women were randomly assigned into two groups to receive 60 mg isoflavones or placebo daily for 3 months. The women receiving isoflavone supplements had reduced hot flashes and night sweats. There were no side effects. The researchers say, " isoflavones could be used to relieve acute menopausal symptoms."
   Comments: Common isoflavones include genistein and daidzein. Over the years many studies have been conducted to determine the role of various herbs and natural supplements in the treatment or easing of menopausal symptoms. The results have been mixed. There does not appear to be one treatment that helps all women. It may take trial and error to find a natural supplement that helps you, or at least lowers the dosage of estrogen required to reduce hot flashes or other symptoms of menopause. For more info, see http://www.raysahelian.com/isoflavones.html

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3. Obesity drugs - are the risks worth the minor benefits?
Long-term treatment with the anti obesity drugs orlistat (Xenical or over the counter Alli), sibutramine (Meridia) or rimonabant (Acomplia) produces only minor weight loss while increasing the risks for heart disease and other side effects. Although patients taking these anti obesity drugs may lose a few pounds, in a review of long term studies, orlistat reduced weight by 3 kg, sibutramine by 4 kg, and rimonabant by 4.7 kg. Not only are these weight loss drugs expensive, but the side effects counter any potential weight loss benefit.
   Orlistat prevents the absorption of fat. It improves blood pressure and blood sugar control in patients with diabetes but increases gastrointestinal side effects, lowers HDL cholesterol levels, and lowers the absorption of fat soluble vitamins. Some claim that it may increase the risk for colon cancer. Sibutramine is chemically related to amphetamines. It lowers HDL cholesterol and triglyceride levels but raises blood pressure and pulse rate. Rimonabant improves HDL cholesterol and triglyceride levels, as well as blood pressure and blood sugar control in diabetic patients but increases mood disorders, such as depression or anxiety. and increases the risk for suicide.
   Comments: In my opinion, natural supplements for weight loss are much safer and many of them are significantly more effective. Diet Rx is a potent and safe appetite suppressant and, in my opinion, far superior to pharmaceutical diet pills. For more information on weight loss, see http://www.raysahelian.com/weightloss.html

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4.  Noni for energy enhancement
Noni fruit has been used by Polynesians to improve energy levels. Researchers in China gave aged mice Tahitian Noni Juice and then compared them in the forced swim test to with young and aged mice who did not drink the noni juice. The mice drinking noni juice were able to swim longer and had more endurance, similar to the young mice. The researchers conclude, "These results confirm the reported use of noni juice to combat fatigue, improve endurance and increase overall physical performance."
   Comments: Perhaps noni supplements provide the same benefits as noni juice, however we need studies to compare a noni supplement to noni juice to see if there is a difference. One advantage of noni capsules is that they don't have the calories in the form of fructose that noni juice has. See http://www.raysahelian.com/noni.html

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5. Honey for cough in children
Dr. Ian M. Paul of Pennsylvania State University in Hershey compared buckwheat honey, a honey-flavored dextromethorphan preparation (dextromethorphan is found in over the counter cough syrups), and no treatment in 105 children who had sought treatment for nighttime coughs due to colds. Among the three groups, children given honey had the greatest reduction in cough frequency and severity, and the most improved sleep. The dosage was half a teaspoon for two- to five-year-olds, a teaspoon for six- to eleven-year-olds, and two teaspoons for children twelve and older. Archives of Pediatrics and Adolescent Medicine, December 2007.

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Emails
SAM-e antidepressant side effects
Q. I took SAM-e 400mg a day for 2 years and now have had acute anxiety attacks. Since I didn't have any side effects for the first two years, I still didn't attribute the anxiety attack to the SAM-e and thought I was developing generalized anxiety disorder. After several small attacks over the months, I had a huge panic attack 10 months after the first one. I finally figured from reading your info on SAM-e that it might be the culprit. I stopped and have been getting better ever since. My symptoms were dizziness and vertigo, tingling, numbness in extremities followed by panic, racing heart and high blood pressure, lasting three or more hours. During the first attack I was extremely nauseas. Thank you.
   A. SAM-e is a powerful supplement. In low dosages in can help with depression, but higher amounts cause insomnia, anxiety and can lead to panic attacks. See http://www.raysahelian.com/sam-e.html

What herbal extract potency is the best option?
Q. I read in an article on rhodiola extract in Science News which states that in 1989 the then Soviet government standardized the supplement to contain 3% rosavins. I then looked at a couple of rhodiola extract supplements on-line and found that many of them claim to contain 4% rosavins (and something called salidroside, usually at 1%). The rhodiola product available at Physician Formulas web site contains only 0.8% rosavins as well as 0.8% salidrosides. The recommended dosages on the PF site also differs, although they sound more conservative, they may be a more informed and cautious approach. Could you please explain the discrepancies I have found between this rhodiola product and others.
   A. In the past herbs used to be available only as regular powder or leaf form, or as tinctures. Now, many herbs are available in different extract concentrations and potencies. Since human research with these various extract potencies is limited, it is difficult to claim that one extract percentage or potency is better than another. Sometimes if an herbal extract is too concentrated and of too high potency, it can cause more side effects at a lower dosage. Just because one organization or one country has chosen a particular extract percentage as a standard does not mean that particular extract is the best option for you. Different scientists, organizations, and medical doctors can have different viewpoints on this topic. The bottom line is that the ideal extract potency is what works for any particular person rather than what is recommended or chosen by an organization. And the only way for a consumer to tell is to try a particular herb in various dosages and extract potencies to see which amount works best for their unique condition. See http://www.raysahelian.com/rhodiola.html

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 4, Issue 14 -- November 15, 2007
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The more I learn about the influence of omega-3 fatty acids, such as fish oils, on various aspects of health, the more I realize how important these fatty acids are in relation to a number of chronic health conditions such as arthritis, heart disease, high blood pressure, age related vision decline, mental function decline, and certain skin disorders. Even mood is influenced by fish oils. Below I discuss new research regarding the influence of fish oils on depression and also the possibility that glaucoma may be influenced by the types of fats we consume.
   Speaking of diet, many medical conditions are due to overeating. Last month I mentioned to you my newest formulation called Diet Rx for appetite suppression. I don't think there's any formula that I have introduced that has been so appreciated as this diet pill. Just about everyone who has tried it has noticed reduced appetite without any significant side effects. In fact, most people notice better mood balance and more natural energy. Diet Rx has many health benefits. When a person eats less, their blood sugar, cholesterol, and blood pressure are not likely to rise as much. If you have been looking for a natural, effective and safe appetite suppressant, Diet Rx may just be the right formula for you.

PRODUCT DISCOUNTS at Physician Formulas -- For the next few days, the following items are heavily discounted: Eyesight Rx can be used for long term vision support, it can also be used for a quick improvement in vision within a few days. Many, but not all, people notice colors becoming brighter and the act of seeing can be more pleasurable. Objects become sharper and in better focus. Paintings, artwork, or nature becomes more enjoyable to look at. For long term use, take it 2 days on, one day off. Taking one to three fish oil capsules a day may also help with vision.
   Cinnamon 6 is a combination of several herbs to help with blood sugar management; Grape seed extract has compounds called procyanidolic oligomers (PCOs); Indole 3 Carbinol is an extract from cabbage, cauliflower, and brussels sprouts. Indole-3-carbinol is converted in the gut to diindolylmethane (DIM). Rhodiola is used for energy and stamina. Rhodiola extract is also found in Mind Power Rx and Passion Rx. Vitamin C ester is on sale.

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1. What you eat may influence your mood
Many people do not realize the crucial role diet plays in mood disorders. If a patient goes to their doctor and reports feelings of depression, it is quite unlikely that their physician will do a dietary history. Most likely the prescription pad will be taken out and the words Prozac, Zoloft, Paxil, or another antidepressant will be jotted down before you can even spell 'd e p r e s s i o n.' There are many causes for depression, and diet is one cause that is often overlooked. As we understand the complexity of brain biochemistry, scientists are realizing that inflammation in the brain plays a role in depression. Certain chemicals called cytokines cause inflammation in the brain which influences mood. If you ever had low mood or felt depressed during or after a bad case of the flu, then you realized first hand how these cytokines released by the immune system effected your brain. It is interesting to note that this is a typical case of a body-brain influence. The body, in this case the immune system, releases chemicals called cytokines into the bloodstream. These in turn enter brain tissue cause inflammation, leading to low mood. In addition to depressed mood cytokines also cause loss of appetite, altered sleep patterns and fatigue. 
   Fortunately cytokines, and other substances that cause inflammation, are influenced by diet. When you eat lots of fish or foods with omega-3 fatty acids, your body will make fewer inflammatory cytokines. For details, see http://www.raysahelian.com/depression.html and http://www.raysahelian.com/cytokines.html

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2. Fish oil supplementation in pregnancy leads to babies with healthier brains
University of Western Australia researchers gave women fish oil supplements that had 2.2 grams docosahexaenoic acid (DHA) and 1.1 grams eicosapentaenoic acid (EPA) from 20 weeks of gestation until delivery. Compared to the group who receive olive oil, breast milk from women who received fish oil had proportionally higher DHA and EPA levels the first few weeks after delivery. Babies breastfed from mothers who had taken the fish oil supplements were found to have better hand and eye coordination. See http://www.raysahelian.com/fishoils.html

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3. Glaucoma and omega-3 fatty acids
Researchers at the University of Melbourne, Australia wanted to know whether there was an association between dietary omega-3 fatty acid intake and glaucoma. Rats were fed either omega-3-sufficient or omega-3-deficient diets from conception. The omega-3 diet contained safflower, flaxseed, and tuna oils, and the omega-3 deficient diet contained safflower oil only. Animals raised on high omega-3 diets had a decrease in intra ocular pressure when they got older, meaning that the inclusion of tuna oil in their diet reduced their risk of developing glaucoma. See http://www.raysahelian.com/glaucoma.html

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4.  Risk of SSRI and NSAID drug combination
Selective serotonin reuptake inhibitors (SSRIs) -- such as Prozac, Zolofta, Paxil, and others -- and nonsteroidal anti-inflammatory drugs (NSAIDs) -- such as aspririn, ibuprofen, naproxen -- when combined, can interact to increase the risk of upper gastrointestinal bleeding. For more info see  http://www.raysahelian.com/SSRI.html and http://www.raysahelian.com/nsaid.html

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5. Smoking increases risk for psoriasis skin disorder
Nicotine and other toxic substances in cigarette smoke such as peroxynitrite and free radicals of organic compounds, trigger an overly aggressive immune system response. Fortunately, the risk and severity of psoriasis decreases when people quit smoking. See http://www.raysahelian.com/psoriasis.html

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6. Energy drinks side effects
Certain energy drinks increase blood pressure and heart rate, most likely due to the high amount of caffeine in the drinks. For natural energy enhancement, consider MultiVit Rx or for mental enhancement consider Mind Power Rx.

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Emails about Diet Rx
Dr. Sahelian says: I don't know of a dietary supplement formula that has been appreciated as much as Diet Rx. Just about everyone who has tried this product has noticed a sharp decrease in appetite without side effects of any significance. Here are some emails that we have received:

Ever since I started taking Diet Rx, I don't have cravings for ice cream. Ice cream has been my downfall over the past few years and the major cause of the extra few pounds around my waist.

For the past two weeks I have been taking 2 Diet Rx capsules daily. Diet Rx curbs my appetite more than anything else I have ever used. Another important benefit is that I don't experience any of the uncomfortable side effects, such as the jitters, that other supplements with harmful stimulants always do. I feel comfortable using this product because I know that it contains a lot of beneficial ingredients. I just ordered 2 more bottles.

I have been taking Diet Rx for one week now. I have noticed that I do not feel hungry. The biggest difference that I noticed though is no night time snacking. I never go to bed before 2:00am and usually start my evening snacking around 10:00pm I must clarify that what I call a "snack" other people call a meal. I am not fond of sweets so therefore my "snack" is something meaty (pork chop, chicken breast or steak) or a sandwich or two with all the trimmings. I have not even thought about having something to eat in the evenings since starting Diet Rx. I tried a diet pill once before in my life but did not like it because it gave me an awful nervous feeling and fast heart beat. I don't feel anything like that with this diet product.

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Q. Dr. Sahelian, what supplements do you take? First of all thank you for your news letter. I find it very informative and believable. Those qualities set it apart from 95% of the others. Please tell me a good overall regimen to take for optimum antioxidant protection and overall general good health. What do you take?
   A. There is no regular supplement regimen that I take because I am usually experimenting with different herbs or supplements to see what effect they have on me. For instance, while formulating Diet Rx in the last few months, I was trying out different herbs and ingredients one at a time to see if they had appetite suppressing effects. When I am experimenting with a single herb or product, I don't take other supplements during this time. I often revise some of my formulas such as Passion Rx and Eyesight Rx to make them more effective. So I take the new pills, when they are made, to experiment on myself, and I also get feedback from friends, patients, and users of these products.
   If I were to take a regular regimen, I would probably take 1 to 3 fish oil capsules a day, one MultiVit Rx a few times a week, CoQ10 30 or 50 mg a few times a week, alpha lipoic acid 50 mg once or twice a week, and I would also occasionally take Mind Power Rx and Passion Rx. In addition, I may at times take a capsule of mangosteen, resveratrol, curcumin, pomegranate, acai, goji, cranberry, bilberry, artichoke, green tea, asparagus, or another herbal extract (there are many interesting ones). I may also at times try acetyl-l carnitine or carnosine. There are lots of great supplements and it is not easy to determine which to take. As a general rule, I would not advise taking more than 5 to 10 different products a day. It is also a good idea to take a day off each week and a few days off each month unless the supplements are necessary in the treatment of a medical condition. Sometimes I also take Good Night Rx to get a deeper sleep. Since I don't have prostate problems, I rarely take Prostate Power Rx except occasionally for sexual enhancement.

Q. DHEA and pregnenolone side effects. Thank God I found your web site. I have been taking DHEA 30mg daily for 5 years. 2 years ago i developed heart palpitations. Adrenal exhaustion they said. I lived with it. Then i became angry, easily agitated, sleep problems appeared. Two weeks ago I ordered pregnenolone 25mg, and adrenal cortex 250mg, wanting to address the adrenal problem. On the 5th day of taking the new tablets, plus the usual DHEA, i developed extreme dizziness. On the 6th day I was rushed to the hospital by ambulance, placed in cardiac intensive care. ECG showed erratic heart rhythms, they thought my electrolytes were out of whack, and said the electrics of my heart was irregular. They thought i was going to have a heart attack. I have never had high blood pressure, always good cholesterol levels, not overweight, generally very healthy - they were confused because tests all came out normal, and said my symptoms were not typical. After reading your web sight, I now know the new pregnenolone tablets were the straw that broke the camel's back. Your web site is so easy to follow, and packed with vital information. I feel so much better already, and am going to take plenty of hormone holidays. Like everything in life, moderation is the key. P.S. I am a 56 year old female from Australia. Thank you.

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 4, Issue 13 -- October 22, 2007
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My research staff and I get more than forty emails each day and the numbers continue to increase. It's getting hard to keep up with and answer all of them. In this issue I will focus on some interesting questions that we have recently had that would actually be of interest to a large number of supplement users.
   Natural, herbal diet pills have been promoted for a long time. Early in my medical career I was quite skeptical of the claims made by these weight loss pills. Most of the diet pills on the market focus on increasing metabolism for a "fat burning" effect. I am not thrilled with these types of diet pills since they increase body temperature, speed heart rate, and have other unpleasant side effects. Recently hoodia became available as an appetite suppressant and some people have found it to be helpful. Others have been disappointed with hoodia. Many people are also using green tea extract, garcinia cambogia with hydroxytric acid, different forms of fiber such as pectin, psyllium and glucomannan, Other ingredients found in natural diet pills include guggul extract, banaba extract, choline, carnitine, acetylcarnitine, inositol, spirulina, apple cider vinegar, CLA, chitosan, and others.
   After years of research and experimentation, I have developed Diet Rx, a product that includes 24 herbs and nutrients that work synergistically to reduce appetite. I find that herbal combinations work better than single ingredients since each herb and nutrient approaches the whole process of metabolism from its own important angle. Eating less has a number of benefits -- not just feeling better, looking better, and reducing the food budget. By ingesting fewer calories, it is quite likely that cholesterol and blood sugar levels will not rise as much. Below I discuss the best way to use Diet Rx as an appetite suppressant. Diet Rx is new on the market and thus far the reports have been quite positive and no significant or unpleasant side effects have been mentioned.

PRODUCT DISCOUNTS at Physician Formulas -- For the next few days, the following items are heavily discounted: Diet Rx appetite suppressant with 25 herbs and nutrients including green tea extract, hoodia extract, garcinia cambogia extract, ginger, spirulina, cinnamon, pectin fiber, glucomannan, and carnitine. CoQ10 is a nutrient involved in energy metabolism in mitochondria and could be in short supply in those who are vegetarian or on statin cholesterol drugs, the 100 mg dosage is on sale and one capsule with breakfast a few times a week is usually enough; Fish oils are one of our favorite supplements. Fish oils are always popular and a great addition to those whose diets lack adequate intake of fish or omega-3 fatty acids; Chrysin is a potent flavonoid extracted from plants and bee propolis; Tribulus terrestris is an herb commonly appreciated for its sexual enhancement benefits in men and women. Tribulus extract is found in Passion Rx, which is becoming one of the best known natural sexual enhancers on the market.

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1. The best way to use Diet Rx
I formulated Diet Rx with the understanding that different people would require different dosages. Therefore, the number of capsules that are helpful in reducing appetite range from 2 to 4 (in rare instances a person may temporarily require 5 capsules a day). Please discuss with your health care provider whether Diet Rx or any over the counter diet product is appropriate for you before you take the capsules.
   On your first day start with 2 capsules in the morning on an empty stomach about 20 minutes to an hour before breakfast. On subsequent days you can increase your dosage to 3 or 4 capsules depending on your response. The third and fourth capsules may be taken before lunch, or the third capsule can be used before lunch and the fourth in mid to late afternoon. You will find that Diet Rx will give you a slight to moderate energy boost which you can use to take a good 20 minute to an hour walk each day.
   Those who have used Diet Rx report that they feel full eating less food. If you try Diet Rx, I hope you get the same benefits as most of the other users. I have tried Diet Rx this past week and have noticed that I am eating 20 to 30 percent less each day. If you plan to use Diet Rx, try not to mix it with too many other supplements that you are currently taking. It is often a good idea, when you take a supplement you have not used before, to first learn how it makes you feel by itself as opposed to mixing it with a number of other pills.
   If you get hungry between meals, choose a healthy snack as discussed below.

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2. I am interested in losing weight and wanted to know if it is better to eat snacks or not to eat snacks.
I recently came across a study that evaluated this very topic. The study was done at Sahlgrenska Academy, Göteborg University, in Göteborg, Sweden. A total of 140 overweight patients aged 18-60 years were randomized to either eat 3 meals/day (3M) or 3 meals and 3 snacks/day (3+3M). The patients received regular and individualized counseling by dieticians. Both groups decreased energy intake and lost weight, but there was no significant difference in weight loss after 1 year of treatment.
   Comments: It appears that, for practical reasons, eating snacks between meals does not seem to make a large influence on weight loss or gain. If you enjoy snacks, choose healthy ones. See http://www.raysahelian.com/healthysnacks.html for suggestions.

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3. What daily dosage of fish oil do you generally prescribe for depression?
   I don't have a standard amount. I evaluate the whole patient, including their diet and lifestyle patterns. I don't use fish oils by themselves, but depending on the person I will use fish oils in combination with 5-HTP or St. John's wort, or SAM-e, or Mind Power Rx, and other supplements. As a general guideline, though, I will use three to five fish oil capsules daily but this varies with the person and their diet. If someone is eating fish more than three times a week, they would not need as many capsules of fish oils compared to someone who does not eat much fish.

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4. Does Glucosamine influence cholesterol levels?
   A Danish study was conducted in order to determine if glucosamine sulphate influences the fasting blood levels of cholesterol and triglycerides. A group of patients over 40 years of age with joint pain received either 1500 mg per day of glucosamine sulphate or placebo. No significant differences between the glucosamine sulphate group and the placebo group with respect to cholesterol and triglycerides were observed. See http://www.raysahelian.com/glucosamine.html for details.

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5. My question is in regards to CoQ10 daily use. Can a normal healthy person start taking CoQ10 with his or her diet on a regular basis like other multivitamins without any harmful side effects. On the other hand, if your body doesn't need CoQ10 but you are taking, would it hurt your body or do any damage?
   There is no easy answer to this. Some people may benefit from taking CoQ10, others may not. Much depends on a person's diet and metabolism and what other supplements and medicines they are taking. If a person wants to take CoQ10, 30 mg a few times a week could offer benefits without any foreseeable side effects. If high dosages of CoQ10 are used, such as 100 mg a day, side effects could occur including difficulty sleeping or fatigue. However, I can't see any harm in taking 30 mg of CoQ10 a few times a week.

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6. CoQ10 and Lipitor. In a recent question in your newsletter, you wondered whether the questioner would have developed the muscle pain problems from his Lipitor if he'd been taking COQ10. I had been taking 200 Mgs. of COQ10 daily for a couple of years at the time, when I was placed on only 10 mg of Lipitor. I still developed such painful muscles and so much weakness that I could not even walk to the mailbox. So, I am not sure COQ10 would be able to prevent this problem. I figured out quickly what was going on and stopped the Lipitor drug. I recovered totally.

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7. Alpha lipoic acid and heart palpitations. Thank you SO much for the information about alpha lipoic acid on your website. I started taking it preventively for eye, heart and brain health due to some related diseases in my family history. I've been taking 100 mg a day (as per the recommended dose on the bottle) for about a month and started having very odd palpitations in my heart. I thought it was due to stress, although something in my brain said that wasn't the cause. I listened to my inner voice and decided to stop taking the alpha lipoic acid as a test to see if that might be the cause, since I traced the beginning of the heart issues back to about a week after starting the ALA. After just three days of being off the ALA, the heart palpitations stopped. That's when I found your website and the warnings. More people should be aware of the proper doses in which to take this supplement. It has great benefits, to be sure, but not if your heart stops working properly!!
   A. This is very interesting. We have had previous reports of higher dosages of alpha lipoic acid causing heart rhythm problems, but not 100 mg. Did the bottle say R lipoic or regular lipoic?
      Q. As far as I know, it was just plain alpha lipoic acid, 100 mg. That's what the front of the label said. I threw the bottle away, so I can't read the back panel for more details. I'm happy to report that the big "chugging" feelings I was sporadically having in my heart have ceased. Every now and then I have a mild flutter, but that's all and even that seems to be getting less each day. Is this something that usually takes a couple of weeks or more to rectify itself?
         A. Yes, the heart rhythm should return to normal within a week or two if no other causes exist to disturb it.

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 4, Issue 12 -- October 1, 2007
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Last week we got an email that coincided with the release of statistics regarding prescription medication side effects. The email said, "After taking Lipitor [a statin drug used for cholesterol lowering] for  2  years, without forewarning, I experienced very heavy and sore calf muscles in both legs along with a very fatigued feeling all over, particularly my legs and arms. At the ER they suspected peripheral artery disease, but tests ruled that out. The ER doctor told me to stop taking Lipitor. After taking over $30,000 worth of tests, including a complete vascular study with heart catheterization, two neurological studies, and four MRIs, no one had any answers except to wait several months to be accepted into a medical college study plan. In the meantime, I was unable to walk over 150 feet without a 3-wheeled walker. I used a wheel chair for longer adventures. This experience has been very traumatic for me and my family."
   The number of serious side effects to prescription drugs reported to the FDA more than doubled between the years 1998 and 2005. A serious side effect, defined by the FDA, includes death, a birth defect, disability, hospitalization or a life-threatening event or required intervention to prevent harm. In 1998, there were about 35,000 bad adverse effects reported, whereas in 2006, there were about 90,000. The overall relative increase was four times faster than the growth in total U.S. outpatient prescriptions, which grew in the same period from 2.7 billion to 3.8 billion.
   When I get emails such as the above, it reinforces my dedication to provide alternative options to prescription drugs. There are many medical conditions, particularly for the treatment of infections or for pain relief, where only a pharmaceutical drug is helpful and necessary, but there are countless other diseases where natural alternatives are not only safer, but as, or more effective.
   I wonder if the simple use of CoQ10, which has been found to be depleted in those who take statin drugs, could have prevented the Lipitor side effects, or at least reduced the severity. Why aren't doctors learning these basic nutritional principles? (this is a rhetorical question). There are several natural supplements that help lower blood lipid levels and most doctors don't have a clue or have no interest in exploring these natural options.

PRODUCT DISCOUNTS at Physician Formulas -- For the next few days, the following items are heavily discounted: Good Night Rx with kava, valerian, melatonin, 5-HTP, and several other relaxation and sleep inducing herbs and nutrients is ideal for occasional sleepless nights. Tryptophan (120 capsules) is an essential amino acid that converts into 5-HTP and then on to serotonin, influencing relaxation, mood, and sleep; Carnosine has potent antioxidant activity and acts as a neurotransmitter (chemical messenger in the nervous system).  Some people notice a sense of wellbeing after taking it. Bioperine is a pure form of piperine, derived from the fruits of black pepper. Bioperine may promote nutrient absorption. Cordyceps is a mushroom extract involved in the immune system. Goji Berry is used for vitality and its strong antioxidants. Goji berry is getting a lot of attention lately. Cacao powder is basically dark chocolate without the sugar and excess calories - you get all the bioflavonoids and polyphenols and other benefits of dark chocolate.

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1. Beta-glucan, a natural fiber, reduces cholesterol
Scientists at the University of Minnesota, Medical School, Department of Family Medicine and Community Health, in Minneapolis, MN, did a 10-week controlled study to determine the benefits of beta glucan for cholesterol management. Beta-glucan extract at 3 and 5 g doses was given two times a day with meals in the form of a ready-to-eat cereal and a reduced-calorie fruit juice beverage. After 6 weeks of treatment, the mean LDL- Cholesterol levels fell by about 15 % in 5 gram group and 9 % in the 3 g group. Similar results were observed for total cholesterol. HDL-Cholesterol levels were unchanged by treatment.
   My comments: Here is one example of a cheap and safe alternative to cholesterol lowering drugs. There are many others that doctor should learn about. See http://www.raysahelian.com/betaglucan.html for details. Another great fiber worth mentioning is psyllium.

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2. Resveratrol and prostate cancer
Researchers at the University of Alabama at Birmingham's Department of Pharmacology and Toxicology, gave male mice, on a daily basis, the powerful antioxidant resveratrol, the equivalent of that found in a bottle of red wine. They discovered that the mice were significantly less likely to develop prostate cancer. Mice which were fed resveratrol, but still got cancer, developed less serious tumors. Last year this same team found that female mice given resveratrol had a significantly reduced risk of developing breast cancer.
   My comments: Red wine has about 2 to 3 milligrams of resveratrol per liter (a liter is almost 34 ounces). Most resveratrol supplements on the market have about 10 mg per capsule. For the time being, taking one or two resveratrol supplements a week is fine if you are consuming many other antioxidants on a daily basis. However, if you hardly take any antioxidant supplements, then you can take the resveratrol more frequently.

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3. Thiamine deficiency in diabetics
Patients with diabetes may become deficient in thiamine, also known as vitamin B1. Dr. Paul Thornalley and colleagues at the University of Warwick, U.K., believe that the thiamine deficiency is not necessarily due to a shortage in the diet, but rather an increased rate of loss of the vitamin from the body. In their study, diabetics had 76% less thiamine in the blood than those without diabetes. Renal clearance of thiamine was increased 24-fold in type 1 diabetics and by 16-fold in type 2 diabetics. The thiamine deficiency could lead to blood vessel problems, increasing the risk for hardening of the arteries.
   My comments: It seems appropriate for patients with diabetes to take at least 2 to 3 times the RDA for thiamine, and perhaps the other B vitamins.

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4. Post breast cancer nutritional treatment
Many women who undergo chemotherapy, surgery, and/or radiation therapy for breast cancer are placed on tamoxifen with the hope that this drug will reduce recurrence of the breast cancer. There are certain blood studies that can help doctors monitor breast cancer recurrence or relapse. Two of these breast cancer tumor markers are carcinoembryonic antigen (CEA) and carbohydrate antigen 15-3 (CA 15-3). Researchers from Government Royapettah Hospital, in Tamilnadu, India, randomized 84 breast cancer patients to receive a daily supplement of 100 mg coenzyme Q10 ( CoQ10 ), 10 mg riboflavin and 50 mg niacin per day along with 10 mg tamoxifen twice a day. Serum CEA and CA 15-3 levels were elevated in untreated breast cancer patients and their tumor marker levels significantly reduced upon tamoxifen therapy for more than 1 year. Patients supplemented with coenzyme Q10, riboflavin and niacin for 90 days  along with tamoxifen had significantly reduced CEA and CA 15-3 levels. The authors says. "This study suggests supplementing with CoQ10, riboflavin, and niacin to breast cancer patients along with tamoxifen reduces the serum tumor marker level and thereby reduces the risk of cancer recurrence and metastases."
   My comments: "I am not sure why the scientists chose these three particular supplements (and in these particular dosages) to add to the tamoxifen regimen. But the important point is that there appears to be nutritional factors that could reduce the risk for recurrence. You will find some of these supplements listed on this page: http://www.raysahelian.com/breastcancer.html. Perhaps a multivitamin could serve as a substitute for the niacin and riboflavin. Some women may do fine with 50 mg of CoQ10, others may need 100 mg.

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Emails from readers
Q. Are there natural alternatives to testosterone prescription medicine use. My recent test showed I have low testosterone levels.
   A. I personally am of the opinion that the whole person has to be taken into account when considering hormone treatment as opposed to solely relying on blood studies. If a person feels fine even though a blood study shows a low testosterone hormone level, this does not necessary mean replacement is necessary. How do we know testosterone replacement will improve health in the long run? What if testosterone replacement therapy results in various short term and long term side effects? Even if testosterone is replaced, how do we know the ideal dosage and form? If a person has a low testosterone level but no major symptoms, it may be better not to interfere for the time being. However, if low testosterone levels are associated with symptoms of low testosterone, such as fatigue, low vitality, low sex drive, low mood, etc., then it may be appropriate to consider testosterone replacement or the use of certain natural supplements that address the particular symptoms of testosterone deficiency.
   Having said this, if the testosterone level is extremely low, then prescription testosterone use may be a good option. Another option is the over the counter hormone DHEA, or perhaps pregnenolone. See http://www.raysahelian.com/testosterone.html

Q. I am having much difficulty finding a mind boosting product that has ingredients that are safe enough to be used by breast cancer survivors. I finished radiation treatments in March of 07. I was taking ginkgo biloba which worked so well for me and I also felt better. Then I discovered that it had estrogenic like effects on the body and I stopped taking them because my cancer was 80% ER positive, and 10% progesterone positive. I am so frustrated. Its as if estrogen receptor positive breast cancer survivors are overlooked when it comes to this.
   A. I have not seen any research to indicate ginkgo biloba causes harm to those with breast cancer. One study concludes, "Ginkgo biloba extract can be considered as a potential alternative to HRT with chemopreventive effects on breast cancer. However, further studies on animals and humans will be required." J Steroid Biochem Mol Biol. 2006 Aug;100(4-5):167-76. Another study says, "In humans, Ginkgo extracts inhibit the formation of radiation-induced (chromosome-damaging) clastogenic factors and ultraviolet light-induced oxidative stress - effects that may also be associated with anticancer activity. Flavonoid and terpenoid constituents of Ginkgo extracts may act in a complementary manner to inhibit several carcinogenesis-related processes, and therefore the total extracts may be required for producing optimal effects." Fundam Clin Pharmacol. 2003 Aug;17(4):405-17.
   Since human studies regarding various herbs and breast cancer are in short supply, it is premature to jump to conclusions regarding the role of a particular herb in being beneficial or harmful for breast cancer survivors. There's much yet that is not known. There are many factors that influence cancer cell growth or inhibition and herbs have dozens or hundreds of compounds in them that influence various stages of cancer growth or inhibition. In most cases, herbs have anti-cancer benefits.

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 4, Issue 11 -- September 1, 2007
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Every 7 years I take a test to maintain my medical board certification. This test is prepared by the American Board of Family Medicine. The last time I took the test I clearly remember a multiple choice question regarding osteoarthritis. The choice of answers disturbed me. The question basically asked the ideal long term treatment for osteoarthritis. The choices were a) The use of aspirin, b) The use of NSAIDs such as naproxen or ibuprofen (Motrin), c) The use of acetaminophen (Tylenol) up to 4 grams a day, and d) Combination of aspirin and other NSAIDs. What disturbed me was that there was no option provided for glucosamine and chondroitin or other natural methods. In fact, throughout the whole test, I hardly remember any questions regarding the use of nutrition or nutritional supplements in the treatment of common medical conditions. Later I found out their "correct" answer was c) Acetaminophen.
   I recently came across a study comparing glucosamine versus acetaminophen that I discuss later.

   Physician Formulas web site has now added 2 new products for children. They now have chewable children's multivitamin, and chewable 100 percent arctic cod liver oil with DHA. See the images on your left.

PRODUCT DISCOUNTS at Physician Formulas -- For the next few days, the following items are heavily discounted: Joint Power Rx with glucosamine, chondroitin, msm, cmo, curcumin, and other nutrients is formulated to support joint health. DHA is an omega-3 fatty acid derived from kelp and suitable for vegetarians who do not wish to take fish oil capsules. Ginseng is well known to increase energy; the Ginseng Revitalizer product has a number of different ginseng species combined together. Ashwagandha is an herb used in Ayurveda for vitality and relaxation and mental clarity. Most people find half a capsule is enough. Broccoli sprouts contain sulforaphane. Lab studies show this compound is a potent inducer of protective enzymes that provide defense against cancer-causing chemicals. Saw palmetto is an herb used for prostate health and also found in Prostate Power Rx.

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1. Delicious stevia drink
It has been a very hot August in Los Angeles. Sometimes I tend to forget to drink enough water. I drink sodas only on rare occasions, and prefer not to drink too many fruit juices due to the high fructose content. And, there's just so much vegetable juice I can tolerate in a day. The majority of flavored drinks on the market have a lot of added sugar. So, how does one ingest more fluids if they find it difficult to drink enough water? How about stevia drinks? I have found my fluid intake increase dramatically since I started adding lime-flavored Stevia Drink packets to a quart of water. The taste is delicious and I can easily drink an additional quart of water a day. I so much enjoy the taste of the lime... and it is calorie free!! I have served this drink to my friends and guests and almost everyone has loved it. You, too, can enjoy this calorie free refreshing drink. See the image on your left. A packet can be added to a quart of water and then you can refrigerate it or add ice to it. Kids are likely to enjoy the refreshing taste. This may reduce their dependence on sodas and sugared lemonade. If you substitute this calorie free drink for sugared sodas, you may actually consume a few hundred calories less a day.

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2. Alpha lipoic acid improves insulin sensitivity in diabetics
The purpose of this study by researchers at University Hospital of Endocrinology, Medical University, Sofia, Bulgaria, was to determine whether oral administration of alpha lipoic acid improves insulin sensitivity in patients with type 2 diabetes. Twelve patients were treated with oral alpha-lipoic acid, 600 mg twice daily over a period of 4 weeks. Twelve subjects with normal glucose tolerance served as a control group in terms of insulin sensitivity. At the end of the treatment period insulin sensitivity of the diabetic patients significantly increased:
   Comments: The alpha lipoic dosage used was 600 mg twice daily which is quite high. We have had some reports of heart rhythm disturbances with high dosages. When researchers do a study, they tend to use high dosages of a supplement or medication in order to induce a statistically measurable difference within the limited time they have. However, this does not mean that the dosage of a supplement or medication needs to be the same as that used in the studies. I think a dosage of R alpha lipoic acid, which is twice as potent as regular alpha lipoic acid, of 10 to 50 mg a day is quite sufficient for most diabetics. For more information, see http://www.raysahelian.com/lipoic.html

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3. Glucosamine as good as acetaminophen for osteoarthritis pain
Researchers from Madrid, Spain, compared the benefit of glucosamine sulfate versus acetaminophen (Tylenol) on the symptoms of knee osteoarthritis during a 6-month treatment course. Patients were randomly assigned to receive oral glucosamine sulfate 1,500 mg once daily, acetaminophen 3 gm a day, or placebo. There were more responders to glucosamine sulfate (39%) and acetaminophen (33%) than to placebo (21%). The findings of this study indicate that, in the long run, glucosamine sulfate is more effective than placebo and as or more effective than acetaminophen in treating knee osteoarthritis symptoms.
   Comments: Acetaminophen reduces joint pain quicker than glucosamine but it can cause harm to the liver, even at doses of one gram a day. I do not think it is a good drug to be taken long term for a chronic condition such as osteoarthritis. There is a possibility that if glucosamine is combined with chondroitin and other nutrients or herbs it may be more beneficial than by itself. I wonder how many years it will take for the American Board of Family Medicine to include natural supplements as options in their multiple choice questions and answers. For details, see http://www.raysahelian.com/glucosamine.html or http://www.raysahelian.com/osteoarthritis.html

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4. N-Acetylcysteine and cocaine craving
Twenty three cocaine-dependent patients participated in a 4-week study to determine if acetylcysteine supplementation would have an effect on cocaine craving. They received N-acetylcysteine at doses of 1200 mg/day, 2400 mg/day or 3600 mg/day. All three doses were well tolerated. The majority of subjects who completed the study either terminated use of cocaine completely or significantly reduced their use of cocaine during treatment.
   Comments: It is exciting to know that readily available and inexpensive supplements are being tested to determine their potential in reducing drug dependence. There is so much potential in the use of natural supplements for a number of medical conditions. It excites me when I come across such research whose findings can improve the lives of so many people. Longer term studies are needed to determine whether the initial benefits of acetylcysteine supplementation are sustained over time. For long term use, 1,000 mg of acetylcysteine seems reasonable. For more info, see http://www.raysahelian.com/acetylcysteine.html

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Emails from readers
Q. I live in China and bought 3 bottles of Passion RX with Yohimbe recently, which were mailed from the U.S, and started to take it several days ago. Yesterday I read a piece of information in a newspaper that Viagra could reduce the the level of activity of sperm. I wonder if Passion RX also has such kind of side effect, or just vice versa... I read also that Yohimbe has very bad side effects and is forbidden in some countries, but up to now I can see good effect of Passion Rx on me, but no side effect. Can I go on taking it?
   A. The formula of Passion Rx has more than a dozen herbs and is completely different that Viagra which is a drug that blocks the activity of one enzyme. We have not tested Passion Rx on sperm quality but some of the ingredients in Passion Rx, such as maca, have beneficial effects on sperm health. As to yohimbe, I have been careful in putting in only small amounts of the herb in order to minimize side effects but still provide benefits that accrue over several days of use. In the long term, Passion Rx could be taken only 2 or 3 days a week with a complete week off every month or two. Passion Rx is also available without yohimbe.

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 4, Issue 10 -- August 6, 2007
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Ever since I was a child I remember questioning everything told to me by parents, teachers, or anyone that represented authority. At an early age I realized that adults did not have all the right answers. I don't know what made me such a rebel, but it makes sense how this attitude eventually led me to explore alternative medicine.
   Although I grew up eating very healthy as a child, during my teenage years I went overboard eating lots of candy, sweets, cakes, and ice cream. I think this diet, and genetics (my mom had acne), led me in my teenage years to have a moderate, and at times severe, pimple breakouts. I ended up going to several dermatologists who recommended antibiotics. I tried the antibiotics for a few months and all they did was make me sick and tired. I asked these dermatologists if diet had anything to do with acne, and they all said no. (Even now, more than 30 years later, many doctors deny a relationship between diet and acne.) I started questioning the wisdom of these doctors and traditional medical knowledge. I began exploring on my own for natural ways to treat this skin disorder. At age 20, one such path led me to visit a health food stores and search for books dealing with natural ways to deal with skin disorders. I become so interested in natural health that I was spending more time reading health books than books on business, which happened to be my major at Drexel University in Philadelphia. In my fourth year of college I finally switched to nutrition science and, after a superhuman effort cramming biology, physics, biochemistry, organic chemistry, physiology, and calculus within a year, and taking the MCAT medical school admission test, I got accepted at Thomas Jefferson Medical School in Philadelphia. I remember receiving the acceptance letter on a November day, the weather was dry and biting cold. The temperature was in the high 30s or low 40s but for several days I walked around campus with only a tee shirt. I was so euphoric that I did not even notice the frigid cold. Ever since age 20 I have been fascinated with the role of diet in health and disease.
   The reason I have given you this background is to put in perspective and share with you a recent study that indicates diet does have an influence on pimple formation. I also want to make the point that, even on some basic concepts involving the role of diet and disease, modern medicine can be way off the track. Hence, we should not take anything doctors say as the final word, but to keep in mind that in many cases alternatives exist.

PRODUCT DISCOUNTS at Physician Formulas - Until August 25th, all products are on an additional discount of 10 percent, on top of the already discounted price. Once you select and add to the cart the products that you wish to order, type the discount word ' august ' in the discount code space, then click the button that says 'update' below it. This will give you the 10 percent discount. If you are having problems getting the discount, the Physician Formulas website has a phone number at the top of the page you can call to speak with a friendly phone representative.

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1. Acne improved on low glycemic diet
Foods that produce a high glycemic load -- such as sugared drinks, white bread and white potatoes -- cause a quick rise in blood sugar. More complex carbohydrates with fiber, such as unrefined cereals, grains, or beans, lead to a more gradual change and have a low glycemic index. Dr. Robyn N. Smith, from the RMIT University in Melbourne, Australia, evaluated acne symptoms in 43 male patients, between 15 and 25 years, who were randomly assigned to a low glycemic load diet or a normal diet. After 3 months, the low-glycemic diet was associated with a significant reduction in acne compared with the normal diet. In addition, the low-glycemic diet produced greater reductions in body weight and body mass and a greater increase in insulin sensitivity.
      Comments: One reason for the success of this low glycemic acne diet is that it limited the rise in high insulin levels. Chronically high levels of insulin may lead to blockages in skin pores and extra oil building up under the skin. I also think eating lots of fish full of omega-3 EPA and DHA oils is very helpful for acne. Even with the best diet, many teenagers will still be bothered with pimples, but the skin problem is likely to be less severe when a healthier diet is adopted. See http://www.raysahelian.com/acne.html for a full discussion on diet and acne.

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2. Lactobacillus bacteria and antibiotic use
An antibiotic often kills the bad bacteria causing an infection, but antibiotics often also kill the good bacteria in your gut and other places in your body. By killing the good bacteria in the gut, harmful germs can get a foothold and cause diarrhea.
   British researchers wanted to know whether a probiotic drink containing Lactobacillus could help reduce the incidence of diarrhea associated with antibiotic use. Older hospital patients taking antibiotics drank 100 grams of a probiotic preparation twice a day during a course of antibiotics and for one week after the course finished. The placebo group received a sterile milkshake. The results showed that 12 percent of the probiotic group developed diarrhea compared with 34 percent in the placebo group. The researchers conclude, "Consumption of a probiotic drink containing Lactobacillus casei, Lactobacillus bulgaricus, and S thermophilus can reduce the incidence of antibiotic associated diarrhea. This has the potential to decrease morbidity, healthcare costs, and mortality if used routinely in patients aged over 50."
   Comments: When I was a resident working in hospitals I routinely saw patients suffer from diarrhea after being placed on antibiotics. I hope doctors and hospitals begin to add a probiotic supplement or drinks to the regimen of patients placed on antibiotics. So much misery could be reduced. For more info, see http://www.raysahelian.com/lactobacillus.html or http://www.raysahelian.com/probiotics.html

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3. Magnesium and atrial fibrillation
Magnesium, when used intravenously, appears to be helpful in the acute treatment of rapid atrial fibrillation. Dr. Orhan Onalan and colleagues from the University of Toronto reviewed randomized clinical trials on the role of magnesium in the treatment of rapid atrial fibrillation. They compared the effectiveness of magnesium to placebo or antiarrhythmic drugs. Magnesium therapy was much more effective than placebo, and did not have side effects. Dr. Orhan Onalan and colleagues conclude, "intravenous magnesium administration is an effective and safe strategy for the acute management of rapid atrial fibrillation."
    Comments: A recent study shows magnesium deficiency resulting from feeding a diet that has a third of the recommended magnesium intake induces heart rhythm problems, impairs glucose balance, and alters cholesterol metabolism. Doctors often use expensive drugs to control rhythm problems whereas in some cases an inexpensive and safe mineral exists. See http://www.raysahelian.com/atrialfibrillation.html and http://www.raysahelian.com/magnesium.html

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4. Reducing risk for prostate cancer with supplements
Belgian researchers gave supplements of selenium, vitamin E, and soy isoflavonoids to a group of men diagnosed with isolated prostate cancer on biopsy. After six months, the results showed that taking these supplements led to a decrease in the PSA level. A lower PSA level could predict a lower risk of prostate cancer in the future. See http://www.raysahelian.com/prostatecancer.html

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Emails from readers
Q. I just wanted to email you to thank you for your wonderful product, mucuna pruriens. I have had Parkinsonism for the past 5 years and have been struggling for most of that time. When I started taking your product my symptoms have minimized from me taking 5 levadopa/carbidopa pills per day to 2-3. I take mucuna in the morning and am pretty well set until afternoon.
   A. We are always so happy to hear how these natural supplements are actually helping people. Please keep us updated regarding the dosage used, and if any side effects.
   For those of you who are considering using mucuna pruriens, start slow at half a capsule and make sure you have approval by your doctor. The dosage of Parkinson's medicines may be reduced since if you add a full capsule of mucuna to other medicines used for Parkinson's disease, overstimulation or other side effects could occur.

Q. I read with interest your comments in the last two issues of the newsletter about taking too many supplements but I am confused. I can well understand that one, thinking that every supplement that is said to be helpful is and takes it, may make mistakes thinking they are doing good for themselves and end up taking many more supplements than their body can handle. But how is one to tell. The suggestions you provided are so general. How is one to access information that can be applied to an individual based on age, sex, medical conditions, etc.?
   A. There is no easy guide or formula regarding supplementation that applies to everyone. Research in the field of nutritional supplementation is very early and many products are on the market that have hardly been tested in humans. Every doctor, herbalist, nutritionist, or scientist, is likely to have a different opinion on which supplements a person should or should not take and in what dosages. Some health care providers don't believe that any supplements are necessary while others recommend their patients take a dozen or more. I fully recognize the fact that many consumers want precise answers, but you have to accept the fact that no such thing is possible. Life is full of uncertainty. Does anyone know what would happen if you took, for instance, a vitamin E pill every day for 40 years? No. What if you took 20 units compared to 100 units or 400 units. What about if you took a synthetic vitamin E pill or a natural vitamin E complex. How do we know whether it is better to take a curcumin capsule versus resveratrol, grape seed extract, green tea extract, or the hundreds of herbs or nutrients that are available to us? Just consider now the countless possibilities of various combinations of vitamins and herbs in varying dosages. And since many people are taking pharmaceutical medicines in varying dosages and combinations, imagine the endless potential interactions that could occur.
   The reason I am vague in my discussion on this topic is because I want to be scientifically honest. I could easily make a list of several supplements and suggest that everyone should buy these particular products. But that would not be right or honest. You have to accept the fact that science does not have such answers at this time. If you happen to be the type of person who wants exact recommendations, I am sure there are websites or marketers out there that will ask you to fill out a questionnaire and then make recommendations for to you to buy their particular products (in most instances the majority will end up getting the same recommendations). It is up to each person and their health care provider to read all they can about diet, exercise, supplements, and other lifestyle factors and then decide which regimens and products appeal to them. As a general guideline, if you are sensitive to herbs, are female, are older, or taking pharmaceutical medicines, begin with low dosages. One option is to try different supplements by themselves for a week or two to see how they make you feel. Over time, experiment with different ones and then you can find a few that you really like. Once in a while you can try a different one. I actually enjoy the process of trying out different supplements and I pay attention to how they make me feel in terms of mood, energy, wellbeing, clarity of thinking, vitality, vision enhancement, etc. Much, of course, also depends on whether you are treating a particular medical condition such as high blood pressure, arthritis, prostate problems, etc., and this could lead you to particular supplements that specifically address these conditions.

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 4, Issue 9 -- July 1, 2007
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In the last issue of the newsletter I mentioned my friend who had called me for advice regarding the supplements he was taking.  Each day he was swallowing about 30 capsules and tablets, of about 15 different supplements. I told him that I felt uncomfortable with people taking too many supplements and that there was no proof taking so many was a healthy thing to do. I did not say in the last issue what recommendations I had for him. I purposely did not want to be specific since there is no right answer. But, we had many emails from readers of the newsletter that wanted to know what I told him. Since he had about 15 different bottles on his kitchen counter, I mentioned to him that perhaps he could alternate their use and take 5 or 6 different supplements a day rather than 15. This way he could go through all of them every 3 days. I also told him that I had no proof that taking more would not be helpful, and ultimately it is up to him and his health care provider to decide what to take.
   Some people may not need any supplements, others may do fine taking 10 or more different ones. However, as a general rule, there should be a good reason for taking more than 6 to 10 supplements each day (such as treating a medical condition). Think of supplements the same way as the produce section of your grocery store. There are dozens of healthy vegetables and fruits available to you and each one of them has a unique set of vitamins, minerals, carotenoids, flavonoids, and other beneficial substances. However, this does not mean you should eat them all every day. Same with supplements, there are literally hundreds of products that have antioxidant and potential health-benefiting properties. But it is not reasonable to take them all every day.
   One way you can tell if you are taking too many pills is if you notice your heart rate going faster, your body temperature going higher, feeling overstimulated or anxious, having uncontrolled or restless energy, and very importantly, if you find your sleep is disturbed. Many herbs (for instance ginseng, aphrodisiacs, and herbs that increase energy) and nutrients (for instance B vitamins) can cause alertness. You may have trouble falling asleep or perhaps experience shallow sleep. Or, you may wake up in the morning an hour or two earlier than usual. If this happens to you, take a break from these supplements and resume a couple of days later at a lower amount. Also, keep in mind, that the effects accumulate over time. If you take a pill on the first day, some of the effects may last into the next day. So, when you take the same pill the second day, it is already adding on to some of the remnants of the first day.

PRODUCT DISCOUNTS at Physician Formulas - For the next few days, the following supplements are on special discount:  Prostate Power Rx provides saw palmetto, pygeum, stinging nettle, phytosterols and other substances for prostate health. Curcumin, an extract from turmeric, continues to get a lot of press for its many health benefits found in lab studies. To cool off during the hot summer days, consider a no calorie Stevia Drink. All you have to do is open a packet and empty it in cold, iced water for a refreshing drink. Acetylcarnitine is a mind booster and antioxidant, some people notice a mild appetite suppression. Bilberry is an herbal extract used for better vision. Avena sativa is a mild, gentle aphrodisiac. Acidophilus is a probiotic product that supports colon health by altering the intestinal ecology to favor "friendly" flora. Glucosamine is a nutrient used for joint health.

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1. Benefit of Flaxseed
I am a big fan of flaxseeds. I add them to soups and enjoy the crunchy taste. Flaxseeds are helpful for colon health, similar in some ways to psyllium fiber. Flaxseed is rich in omega-3 fatty acids and lignans, a fiber found on the seed coat. Researchers at Duke University Medical Center in North Carolina took a look at the seed's role as a food supplement in 161 men who were scheduled to undergo surgery for prostate cancer. Half of the men added 30 grams of flaxseed (about one ounce) daily to their diets for about 30 days. After the surgery, the researchers looked at the men's tumor cells to see how quickly the cancer had multiplied. The cancer cells in the flaxseed groups were growing about 30 to 40 percent slower than the control group. The flaxseed study was funded by the National Institutes of Health.
   In another study, obese individuals who were given flaxseed had reduced levels of inflammation in their body.
   For more info, see http://www.raysahelian.com/flaxseed.html, or to learn about lignans, http://www.raysahelian.com/lignan.html,

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2. CoQ10 Reverses Muscle Damage from Statin Cholesterol Drugs
Those of you who have read my newsletters for the past 3 years are familiar with my warnings regarding side effects from statin drug use. I have mentioned before that statin drugs cause muscle pain and damage, and CoQ10 could be helpful. A small study published in the May 15th issue of the American Journal of Cardiology supports my viewpoint.  Statin drugs, such as Lipitor and Zocor, lower cholesterol levels, but at the same time they interfere with the making of coenzyme Q10 in the body. Scientists now suspect that CoQ10 deficiency as a result of stating drug use may partly, or fully, contribute to the development of muscle damage. Dr. Giuseppe Caso and colleagues from Stony Brook University, Stony Brook, New York gave 100 mg of CoQ10 for one month to 32 patients using statins. Pain intensity decreased by 40% after a month of CoQ10 treatment whereas patients treated with vitamin E (as placebo) experienced no change in pain intensity. Sixteen of 18 coenzyme Q10-treated patients experienced a decrease in pain.
   My comments: I am not sure 100 mg of CoQ10 is needed in the long run. If 30 mg or 50 mg works for you, then take these lower amounts. Researchers often have a limited time to do a study and use high dosages of a medicine to elicit a response, but that does not mean that same dosage should be used forever. For more info, see www.raysahelian.com/coq10.html or www.raysahelian.com/statins.html

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3. Cinnamon lowers blood sugar
It has been quite a number of years now that researchers have tested the role of cinnamon supplements in blood sugar control. Most studies, but not all, have shown cinnamon to play a positive role. In this latest study done at Malmö University Hospital, University of Lund, in Sweden, the effect of cinnamon was tested on the rate of gastric emptying, the after meal blood glucose response, and satiety in healthy subjects. Healthy subjects ingested 300 grams of rice pudding or 300 grams of rice pudding along with 6 grams of cinnamon. The addition of cinnamon to the rice pudding significantly delayed gastric emptying and lowered the glucose response after the meal.
   My comments: Most cinnamon supplements come in 300 to 500 mg of regular powder, and lower amounts for concentrated extracts. It would seem reasonable to use about 3 grams a day of the regular powder and less of the extracts. This study did not include other supplements. Many people who have diabetes are often taking several other supplements and medicines. It is not clear how the cinnamon addition would interact with these medicines or other products. For this reason perhaps starting with one cinnamon capsule and gradually building up could be a good option. Discuss with your health care provider. For more info, see www.raysahelian.com/diabetes.html and www.raysahelian.com/cinnamon.html

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4. Have you had your share of Flavonoids today?
If your diet has plenty of flavonoids, you are likely helping maintain a healthy brain in old age and lowering your risk for heart disease. Flavonoids are potent antioxidants found in plant-based foods from red wine to tea to vegetables. Dr. Luc Letenneur of INSERM in Bordeaux, France, followed a group of 1,640 older, dementia-free individuals for 10 years, recording information on their diet at the beginning of the study. The men and women who took in the most flavonoids showed significantly better mental performance at the beginning of the study, even after the researchers adjusted the data for the influence of sex, level of education, and age. And those who ranked in the top half for flavonoid consumption showed more favorable progress in their cognitive function over time; for example, after 10 years, men and women in the lowest fourth for flavonoid consumption had lost 2.1 points on a test of cognitive function known as the Mini-Mental State Examination, compared to a 1.2-point loss for the people in the highest fourth for flavonoid intake. See more info on flavonoids at www.raysahelian.com/flavonoids.html

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Emails from readers
Q. Have you done a comparison between chia seeds and flaxseeds? I have just heard of the chia seed. I am a long time user of fresh ground flax seed, but if chia is easier to store, digest etc and is more beneficial than flax seed maybe I should make the switch.
   A. Is an orange healthier than a grapefruit? They are both a good addition to the diet. One option is to use a little bit of both since each seed will provide a different set of nutrients the body can use.

Q. So, what's up with all these energy drinks? If a person drinks one big can a day, is that bad?
   A. There are hundreds of different energy drinks on the market, each with its own different formula. We can't make blanket statements regarding all energy drinks. As a rule, though, we don't think they are necessary since many of them contain lots of sugar and stimulants such as caffeine which are not the best option for sustained all day energy. A healthy diet with plenty of physical activity and deep sleep at night should take care of most cases of low energy. Some of the energy drinks may give you a short boost of energy followed by a drop. See www.raysahelian.com/energy.html

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 4, Issue 8 -- June 1, 2007
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A friend of mine called me recently for advice. He is 53 years old, very healthy, and wanted to know what I thought about his supplement regimen. I asked what he was taking. I was shocked. He started reading the labels, and here's some of the ones I remember him mentioning: curcumin, garlic, cayenne, resveratrol, chrysin, multivitamins, Mind Power Rx, ginseng, zinc tablets, Prostate Power Rx, alpha lipoic acid, lycopene, fish oil, flax seed oil, calcium, vitamin D, and a few others I can't recall. "Do you really take all of these every day?" I asked him. "Yes, every day. I often take 2 or 3 capsules from each bottle. My intent is to take a lot of antioxidants to stay young."
 I'm a strong believer in supplements and truly feel that they are underused by the medical profession. Sometimes people proudly list a dozen supplements they take daily, thinking that the more they ingest, the healthier they will be. I don't think there is any evidence to support this viewpoint. In fact, my interpretation of studies leads me to believe that a certain amount of supplements can be helpful, but after a point they could interfere with optimal health and lead to unexpected or unforeseen health problems.

PRODUCT DISCOUNTS at Physician Formulas - For the next few days, the following supplements are on special discount:  Mind Power Rx - helps improve mental alertness and wakefulness along with boosting mental stamina. Serrapeptase or Serratiopeptidase - is an enzyme isolated from a microorganism in silkworm. N Acetyl cysteine - is a precursor in the body to the antioxidant glutathione, which is produced intracellularly, particularly by the liver. Acerola Powder - is derived from acerola cherries, one of nature's highest sources of vitamin C. Cinnamon extract - has strong antioxidant activity and has the potential to help maintain healthy blood sugar and cholesterol levels. Banaba - has been used in the Philippines for blood sugar control. Mind Boosters - is a best selling book written by Dr. Sahelian regarding the natural supplements that enhance mood, memory, and mind.

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1. Another Reason to Eat Broccoli
Researchers at the University of California, Los Angeles, found in lab studies that diindolymethane (DIM), a compound resulting from digestion of cruciferous vegetables, and genistein, an isoflavone in soy, reduce the production of two proteins needed for breast and ovarian cancer to spread. The UCLA team plans to evaluate the theory in mice.
   Findings of a lab study do not necessarily mean that a person ingesting a DIM or genistein supplement will have benefit in terms of cancer prevention. However, it is intriguing to think that perhaps these supplements, or others, can someday be found to be beneficial in terms of cancer prevention or treatment, either by themselves or combined with other natural supplements or even pharmaceutical medicines. In the meantime those with cancer or a family history of such, could discuss with their doctors whether it would be appropriate for their particular situation to supplement with these nutrients. There are many supplements that have shown to play a role in cancer, and it is difficult to know which one to choose or which combination to take. Each patient with cancer is unique. One option is to have half a dozen different supplements and then take one each day, alternating their use. For instance, one can alternate the use of curcumin, DIM, genistein, mangosteen, graviola, resveratrol, reishi, ashwagandha, or others. I would suggest having a day off each week.  regarding some supplements that have been tested for their role in cancer treatment. For more info, see http://www.raysahelian.com/cancer.html regarding some supplements that have been tested for their role in cancer treatment. Other links of interest, http://www.raysahelian.com/diindolylmethane-dim.html or http://www.raysahelian.com/genistein.html

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2. The ideal aspirin dose
Long-term aspirin therapy at doses greater than 81 mg per day does not enhance the prevention of heart disease but does increase the risk of stomach bleeding. Over 50 million adults in the US are on long-term aspirin therapy for heart disease prevention, yet the optimal daily dose is still a point of controversy. Dr. Charles L. Campbell, from the University of Kentucky in Lexington, and colleagues performed a review of relevant studies. They found that while aspirin doses as high as 1300 mg per day are approved for clinical use, scientific data indicate that doses as low as 30 mg per day provides the full physiologic effect of higher doses.
   My personal opinion is that aspirin, in a dosage of about 81 mg three times a week, should provide enough benefits and at the same time minimize the risk for stomach ulcer or bleeding. I also think fish oils could be beneficial in thinning the blood. Many herbs have mild blood thinning potential. Some of these include garlic, ginger, ginkgo, and green tea extract EGCG. It is possible the need for aspirin could be further reduced by the use of some supplements, but there's still much we need to learn about this before making recommendations. For more info on aspirin, see www.raysahelian.com/aspirin.html

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3. Avandia increases heart attack risk - Wait a while before using a new drug
When I was a medical student and resident I was often excited when a new drug was approved. At the time I was naive and assumed when a drug was approved by governmental agencies, that it was quite certain it was safe or that all potential side effects had been discovered. It wasn't until I gained a little more experience as a doctor that I came to realize that the new drug approval process was not fail-proof. Case in point is the latest furor over Avandia, the diabetes drug that millions of people have taken for blood sugar control. An MSNBC.com article asks, "How can big safety issues go undetected in medicines taken by millions of people for many years, as happened this week with the diabetes pill Avandia and a few years ago with the painkiller Vioxx?" They add, "The roads — and fingers this week — point to the U.S. Food and Drug Administration. From a company’s labs to a consumer’s lips, the chronically understaffed federal agency has the power and duty to keep dangerous products from harming the public."
   There are many people who have benefited from oral medicines used for diabetes, but I think many more could benefit from natural options.

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Emails from readers
Q. I discovered your alpha lipoic acid website just recently as well as the analysis of different supplements I'm interested in. Your work is excellent and very important. I've been browsing the internet for a longtime regarding treatment of diabetes, high blood pressure, and high cholesterol. Started as per numerous and similar advices with alpha lipoic acid with lots of hope. The alpha lipoic acid almost resulted in a syncope (fainting) -- the very first time and the second attempt (I took 250mg both times in a span of 2 months) I had extremely violent tachycardia (rapid heart rate) and very high blood pressure. I also experienced bone and joint pain. As per your analysis of this supplement I realize the dosage was very high. Thank God I found you!! I thought I will die. I thought this will help you to confirm the very similar alpha lipoic acid symptoms your clients vented on your web site. I think one has to experience on himself first with the smallest dosage possible and then make slow adjustments. Thank you very much for your diligent work--you just may have saved my life.

Q. Can't thank you enough for all the information you send. I keep sharing with my friends and now I am passing your website to my customers (I am a hairstylist always trying to promote natural health and natural healing first)...God Bless and have a great week!

Q. My email is in regards to melatonin for my child. My son's pediatrician recommended us giving him (almost 5 years old now) Melatonin nightly because he had a hard time falling asleep. We have given him at least 1 mg every night for several years. Recently we started observing and he started complaining of ''tremors" which looked like he was shivering from being cold. He recently had a 48 hour EEG which was normal. We stopped using the Melatonin and the ''tremors" have disappeared. My child also has had some behavioral problems, requiring discipline and ''time outs'' but since we stopped the Melatonin this has improved. I also saw some information recently that Melatonin affects Human Growth Hormone, my son is very short for his age, in the 3% for his age. I am a very concerned parent. Do you feel that the long term Melatonin use has contributed to his growth problems? The ''tremors?" The discipline issues? His lack of growth? I saw a mention that you don't recommend its use for more than 2 times per week. Do you think there will be any long term problems my child will experience because we used melatonin tremendously more than your recommendation?  
   A. The long term use of melatonin in children and adults has not been evaluated enough to know the consequences. It is possible that the conditions you mention regarding your child's health may be due to melatonin excess. If that is the case, hopefully his body and pineal gland will be able to recover and readjust after stopping the melatonin. It may be a good idea not to use melatonin until he is much older. It is possible that these side effects and problems will reverse with time, however we are not familiar with any child who has been given high doses of melatonin nightly for several years, so we don't have any first hand experience. I can't be sure that these problems are related to melatonin use, but it is a possibility.

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 4, Issue 7 -- May 6, 2007
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Hormone supplements, when misused, can be harmful and dangerous. We recently had an email that illustrates the point: "i was taking 10 mg of DHEA and 50 mg of pregnenolone together for 2 months and my body felt arthritic. i had a hard time walking. i had a hard time sleeping. Can you tell me what happened?"
   My research staff and I get more than a thousand emails a month from supplement users who ask us questions or tell us their personal experiences with natural products. This gives us a unique perspective on the effects of these over the counter pills on individuals from all walks of life and from all parts of the world.
Breast cancer rates have recently dropped, and many scientists believe that the decreased use of hormone replacement with estrogen and progesterone is a contributing factor. I will later discuss my thoughts on the proper use of prescription and natural hormones.
We have had quite a few emails recently regarding concerns of new FDA guidance proposals on alternative medicine. See the bottom of the newsletter for 2 links that help explain the confusion.

PRODUCT DISCOUNTS at Physician Formulas - For the next few days the following 6 items will be highly discounted: MultiVit Rx, 5-HTP, Chondroitin sulfate, Fenugreek, Ginkgo biloba, and Spirulina. MultiVit Rx has become a very popular multivitamin product. Even though it says to take up to 4 capsules a day, two capsules are often enough. Most users notice enhanced mood, energy, vision and wellbeing. We find a high rate of reorder with this multivitamin supplement. 5-HTP is a supplement that easily converts into serotonin. Chondroitin sulfate is used by those for joint support. Chondroitin is also found in a popular product called Joint Power Rx formulated by Dr. Sahelian. Fenugreek is now being researched for blood sugar control and may influence triglyceride levels; Ginkgo biloba is a mind booster and may have some health improvement benefits; Spirulina has been popular for several years as a functional food.
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1. Ginkgo biloba extends life?
I thought you might be interested in hearing about a French study that found that older people who take Ginkgo biloba may be living longer. Surprisingly, this same study did not find ginkgo biloba reduced the risk of cognitive decline. Dr. Jean-Francois Dartigues at the University of Bordeaux followed a group of 3,500 men and women 65 and older for over a period of 13 years. Those who used ginkgo lived a little longer than those who did not take the supplement. Ginkgo biloba extract has been sold in France for more than three decades. At the start of the study, 6 percent of the participants were taking Ginkgo biloba extract, The researchers found that while the effect of the herb on mortality risk remained significant, it had no effect on the likelihood of developing dementia. Journal of the American Geriatrics Society, March 2007. See http://www.raysahelian.com/ginkgo.html
   Comments: I can't say for sure that taking ginkgo will help you live longer. It is possible that the individuals who began taking ginkgo biloba may have been more health conscious to begin with and paid more attention to their overall diet which was the real factor for life extension. Or, the reason ginkgo blioba was not found to be helpful in reducing dementia is perhaps those who started the ginkgo may have had a family history of dementia or were already starting to notice some form of cognitive decline. Nevertheless, gingko biloba is a good supplement and I can't imagine taking 20 mg or 60 mg of the extract with breakfast a few times a week would pose any danger. I don't think it is necessary to take a ginkgo supplement every day. Mind Power Rx has 30 mg of ginkgo biloba extract per capsule. Those who are taking blood thinning medicines such as Coumadin should be careful since ginkgo has mild blood thinning properties.
   I don't think one herb or nutrient alone can be counted on to prevent dementia or treat cognitive decline. The brain is too complicated and needs many different nutrients. I prefer a mind boosting supplement that has a number of different vitamins, nutrients, and herbs combined in small amounts.

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2. The Ongoing Hormone confusion and debate - and good news about Black Cohosh
Breast cancer rates fell sharply in 2003, and then held steady at the lower rate in 2004. The most likely reason for the sharp fall in rates was that large numbers of women stopped taking hormone therapy for menopause. More doctors are now realizing that the recommendation for estrogen and progestin use after menopause (which has gone on for the past few decades) may not have been such good advice after all. As many of you suspect, doctors, and the medical establishment, are not always right, but hopefully most doctors have a tendency to correct themselves when presented with fresh evidence.
   I would suggest we all accept the fact that it is going to take a long time to find out the answers to the following questions: When is hormone replacement therapy appropriate? Which hormones should be used? What dosages are appropriate? These may seem like simple questions but after decades of research there still is no general agreement in the medical community regarding guidelines to appropriate hormone replacement.
   I am going to provide you with some of my general thoughts that you can use to guide your decisions. First, do not use hormones, whether synthetic or natural, unless you have a good reason to and there are no other good options (such as nutrients and herbs along with exercise, deep sleep, yoga, etc). Second, if you do need to take hormones, use the least amounts that work. Third, whenever possible use natural hormones rather than synthetic or horse-derived. Fourth, reevaluate your need for these hormones, and the dosages that you are using, on a regular basis. Perhaps your required dosage could be reduced over time, or even stopped altogether.
   The beneficial dosages may be a fraction of what doctors normally prescribe or are available over the counter. Perhaps women may do well at half the estrogen and progesterone amount normally prescribed. DHEA and pregnenolone are sold at up to 100 mg a capsule. Any dosage above 5 to 10 mg could be harmful and dangerous. In fact, those who actually benefit from DHEA or pregnenolone may do so at dosages less than 5 mg, perhaps even as low as 1 or 2 mg. I have been telling the natural health industry to limit the amount in each capsule to less than 10 mg, yet there are many companies who still sell 25, 50, and 100 mg pills. They are not doing their customers a good service. See http://www.raysahelian.com/dhea.html and http://www.raysahelian.com/menopause.html
   Interestingly, A new study provides preliminary evidence that black cohosh herb may reduce breast cancer risk.  Dr. Timothy R. Rebbeck of the University of Pennsylvania School of Medicine in Philadelphia compared 949 women with breast cancer to 1,524 healthy controls. Women who reported taking black cohosh were at a lower risk of breast cancer. Previous studies have shown that black cohosh can block cell growth. The herb is also an antioxidant, and has been shown to have anti-estrogen effects as well. International Journal of Cancer, April 1, 2007.
   Comments: It is also possible that those who took black cohosh did not take estrogen or progesterone, and hence, had a lower rate of breast cancer when compared to women who took the hormones.

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3. Forskolin and urinary tract infections
Duke University microbiologist Dr. Soman N. Abraham found that many E. coli bacteria (the ones responsible for a large number of bladder infections) hide in cells lining the bladder, out of reach of antibiotics. However, when the researchers injected forskolin ( an extract from the herb coleus forskohlii) directly into the bladder or intravenously, it appeared to expel the majority of "hiding" E. coli, thus exposing them to the antibiotics. This is important in order to prevent recurrent cystitis when the bacteria come out of hiding and cause another infection shortly after the first one is treated.
   Comments: Whether forskolin supplements taken orally help individuals with bladder infections is not clear at this time. Even if forskolin works in humans, we still need research to find out the ideal dosage, when to take it (before, during, or after antibiotic treatment) and how long to take it for. See http://www.raysahelian.com/forskolin.html

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Email questions and comments
Q. Is coconut oil good for you as some web sites are telling me?
   A. Some websites are making claims for coconut oil that seem to go beyond what the limited research tells us. It is preferable to ingest small amounts of a variety of oils in order to obtain a number of different fatty acids, as opposed to a large amount of one type of oil. In my opinion, fish oils and flax seed oil are some of the healthiest options , but olive oil and small amounts of coconut and other oils can certainly be incorporated in one's diet, but I don't think large amounts are healthy as some websites promote. As much as possible ingest your oils without heating, and if you do use them for cooking, keep the cooking temperature as low as possible. See http://www.raysahelian.com/coconutoil.html

Q. Just a note you might pass on to takers of this Prostate Power Rx supplement: My husband has been taking this for over three years and notices a great difference in the less frequency of going to the bathroom. However, he now sees that it appears to be less effective than when he began taking it in the first place. What he has found out (by accident when he went on a trip and forgot to take the capsules with him) is that if he stops taking them for two weeks every once in a while, and then begins again, the effectiveness of the supplement goes back to its original strength for a period of months. We love your web site!
   A. Another reason to take breaks from supplement use. We really enjoy getting feedback from users of supplements.

Q. Dr. Sahelian, thank you for the Epsom Salt "solution" for toe nail fungus. I have been battling a slight problem with this for almost 2 years. After only 3 weeks I have seen significant improvement. Thank you so much!
   A. You're welcome. Most of the time it takes several months of Epsom salt use for the toe nail fungus to be eliminated or significantly reduced. See http://www.raysahelian.com/nailfungus.html

Regarding the new FDA guidance proposals on alternative medicine, see http://www.raysahelian.com/alternativemedicine.html and scroll down to the bottom of the page
For an excellent review of the whole process of how this became such big news, see http://www.naturalhealthline.com/

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 4, Issue 6 -- April 17, 2007
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Some of the most common questions my research staff and I are asked relate to how often a supplement should be taken, whether it is safe to use for prolonged periods, and whether a particular supplement can be taken the same day as another. It is very difficult to give answers that would apply to everyone since there are so many factors that influence your need or response to supplements. These factors include your age, sex, overall health status, activity level, climate you live in, diet, types of fluids consumed, alcohol or caffeine use, body weight, whether you are currently on prescription medicines, quality of the herbal products, your sensitivity and tolerance, whether the herbs are whole herb or extracts, whether the supplements are taken with food or on an empty stomach, the time of day they are used, and the dosage of the supplements. However, since may people who email us are frustrated that their doctors have no clue, I will provide some general guidelines that you can adapt to your own unique situation. There's not enough space to cover all the supplements in one newsletter, therefore I will begin with the letter A, and in subsequent newsletters proceed further along the alphabe