Club Natural
In the past couple of months Physician Formulas website has added several new items from Club Natural, a vitamin company high quality supplements. Each Club Natural product has the laboratory certificate of analysis to back up its purity and potency. These C of As are provided on the Physician Formulas website with a link from each page. New items added in the past few weeks include acetylcysteine, bilberry, carnitine, carnosine, chrysin, DHEA, glutamine, grape seed extract, hoodia, lutein, MSM, nattokinase, passion flower, phosphatidylserine, tyrosine, and vinpocetine.

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1. Good News on Glucosamine
Initial results of two highly anticipated clinical trials involving the use of glucosamine and/or chondroitin by individuals experiencing pain from osteoarthritis were announced in September, 2005. The good news is that these two studies show strong support for use of both nutrients by osteoarthritis patients to relieve pain. The multi-centered Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) conducted by NIH involved 1,500 osteoarthritis patients who were supplemented with 1,500 mg a day glucosamine hydrochloride and/or 1,200 mg a day chondroitin sulfate. They were compared to other groups who received the prescription pain medication celecoxib (Celebrex™) or placebo. The studies lasted 24 weeks. Preliminary results indicate that both celecoxib and glucosamine - chondroitin combination significantly reduced knee pain compared to placebo. These findings were mirrored by the preliminary results of another multi-centered clinical study, the European-sponsored Glucosamine Unum in Die Efficacy (GUIDE) Trial, which compared the effect of glucosamine sulfate (1,500 mg/day) vs. acetaminophen (3,000 mg/day) or placebo over 24 weeks. Researchers reported that glucosamine sulfate was more effective than acetaminophen, and concluded that glucosamine sulfate might be the preferred symptomatic medication in knee osteoarthritis.
     My comments: With time, we are finding out that the prescription pain medicines for osteoarthritis have potentially serious side effects, and even the non prescription medicines such as naprosyn and acetaminophen are not risk free. Hence, it is great to find alternatives to these medicines. Interestingly, both forms of glucosamine, the sulfate and the hydrochloride, appeared to be effective.

For more info, see http://www.raysahelian.com/glucosamine.html

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Question of the Month - Why are Dr. Sahelian's dosages sometimes different than dosages used in research studies?
Q. In your last newsletter dated September 30, 2005, you wrote:
     Throughout all my years of medical education, whenever we studied the topic of male infertility, there was never a mention of supplements or nutrition having an influence on sperm quality. Fortunately, researchers in Italy had an inkling that supplements could make a difference. They evaluated sixty infertile men between the ages of 20 and 40 who had poor sperm motility or movement. They gave these men the nutrients carnitine, acetylcarnitine, or a combination at a dosage of 3 grams a day. The results showed that the combination of carnitine and acetylcarnitine had the best outcome with improvement noted in sperm motility and velocity.
     Then you added: It would seem reasonable for men who have undergone a medical evaluation for infertility and have not had success with the standard medical approach to try a combination of these two nutrients. The ideal dosage is difficult to know, but a cautious approach would be to alternate taking 200 to 300 mg of acetylcarnitine one day and 200 to 300 mg of carnitine the following day. The dosage can be increased after a month or two if the results are not adequate.
     Your recommendation contradicts the research that you quote directly. Also, you said: Higher doses could lead to overstimulation, restlessness, and insomnia. Where do you get this information from?
     A. I'm glad you asked this question since it is an important one to address. Over my 20 or more years of medical practice, I have come to realize that whenever researchers do a study with a supplement or a drug and pick a particular dosage, it does not mean that the dosage they picked is the ideal amount. You would be surprised how little some researchers know about the practical aspects of taking supplements. More often that not, they do not pick the ideal dosage. In most cases, they choose an amount much higher than needed since most studies are of short duration and the researchers want to measure an effect that occurs fast within days or weeks. They don't spend the time or money to do a study with a lower dose that may take longer to show results.
     Furthermore, many side effects are not noted or missed by researchers. For instance, when I was experimenting with melatonin in the mid 1990s, I realized it caused vivid dreaming, yet, when I reviewed all the previously published melatonin studies in the past three decades, none had mentioned anything about vivid dreams. All the researchers had missed this obvious side effect.
     In my personal and professional experience, I have found that a dosage of acetylcarnitine or carnitine more than 500 mg can cause overstimulation, restlessness and insomnia in many people. Some notice this on as low a dose as 250 mg, whereas others take 1 gram before they feel it. Plus, the effects accumulate with time. So, it is always safer to start with a low dose and gradually build up since we do not know which person is sensitive to these supplements before they are taken. If there has been no effect on fertility after taking the low doses, then, as I mentioned in the newsletter, the dosage can be increased. Over my many years of using supplements, I find the cautious approach to be my preference. For information about the research mentioned,

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SUPPLEMENT RESEARCH UPDATE - by  Ray Sahelian, M.D.
Vol. 2,  Issue 13 -- September 12, 2005
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In the previous issue I mentioned that I had just returned from France where white bread is so commonly consumed. I made the observation that one of the most important dietary changes you can make for long term health is to eat whole, unrefined bread and cereals rather than nutrient- and fiber-poor white bread. Although it is obvious to me and many readers of this newsletter the tremendous health benefits of whole grain bread, it may not be so obvious to others. Just last week, researchers from Finland and the United States found diets high in cereal fiber and whole-grain products slow the progression of plaque build-up in the arteries. Numerous studies have linked increased dietary fiber with a reduced risk of heart disease, stroke, diabetes, cancer... and constipation (I actually took some psyllium powder with me to France since I suspected I would need additional fiber). When you consume whole, multi-grain, unrefined bread and cereals, you are ingesting several substances not found in white bread. These include fiber, additional vitamins and minerals, isoflavonoids, flavonoids, stilbenes, lignans, and many other beneficial compounds.
     Try to find a bread that is made not only from whole wheat, but many other grains and plant products as well. These are called multi-grain breads. Some of these breads will have oats, rye, millet, buckwheat, flax, soy flour, quinoa, amaranth, kamut, barley, and others. Can you see how much healthier it is to eat this form of bread as opposed to refined white bread? It's also possible that excessive consumption of one grain, alone, such as wheat, may lead to allergies, whereas when a wide variety of grains are ingested, the body is not excessively exposed to one allergen in the grain and has less of a tendency to develop an unpleasant reaction to it.

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1. A Natural Approach for Hepatitis C?
Over the years I have read many articles in traditional medical magazines regarding the treatment of viral hepatitis, and I can't recall any of them mentioning the potential of supplements in reducing liver tissue damage. Thus, when I came across the title of this article, "Treatment of chronic hepatitis C virus infection via antioxidants: results of a phase I clinical trial," I became quite interested to find out the result. This study was done at Hebrew University in Jerusalem, Israel.
     In viral hepatitis C, damage to liver tissue from oxidative stress leads to inflammation and death of hepatic cells. Fifty patients with chronic hepatitis C (HCV) were treated orally for 20 weeks with a combination of seven antioxidants given orally (glycyrrhizin (found in licorice), schisandra (a Chinese herb), silymarin (from milk thistle), ascorbic acid (vitamin C), lipoic acid, L-glutathione, and vitamin E), along with four different intravenous preparations (glycyrrhizin, ascorbic acid, L-glutathione, B-complex) twice weekly. Almost half of the patients who received the antioxidants improved. Treatment was well tolerated by all patients. No major bad reactions were noted. The researchers conclude: "These data suggest that multi antioxidative treatment in chronic HCV patients is well tolerated and may have a beneficial effect on necro-inflammatory variables. A combination of antiviral and antioxidative therapies may enhance the overall response rate of these patients."
     My comments: Since there are countless herbs and nutrients that have antioxidant properties, it is possible that many other supplements with antioxidant potential - for instance curcumin, acetylcysteine, grape seed extract, etc - could benefit those with hepatitis C. The ideal dosage, combination, and frequency of use is difficult to know, but starting with small amounts and monitoring liver enzymes every couple of months is a good option. I found this study quite exciting, and I hope future articles written in traditional medical journals mention - even if briefly - that antioxidants should be considered for this condition. Perhaps these supplements can be taken together with standard medical regimens used for HCV, such as interferon.

For the full abstract, see http://ww.raysahelian.com/hepatitis.html

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Question of the Month - Which Supplements to Take on a Regular Basis
Q. I have read a lot of books regarding vitamins and supplements, I wanted to start on a vitamin and supplement program; however, I don't know which one i should buy. Right now, I am in my 40s, excellent health and am using the MultiVit Rx and I think it's great. I would like to know if combining the MultiVit Rx with other supplements such as curcumin, garlic, reishi mushroom, and milk thistle together is ok? I don't know if having vitamin C, vitamin E, combined with curcumin and garlic in regular diet including a lot of veggies and raw foods will be fine for optimal health and cancer prevention? How can one know how much is the right dose? Seems like many supplements and vitamins, herbs etc...all have their own good properties...how can a person with normal health know where to start? Many thanks.

     A. Over the years many readers have asked what I take or what is the appropriate supplement regimen to take on a regular basis. There is no one answer that will be appropriate for everyone and it is very difficult, even with a complete physical exam and blood studies, to know what supplements, in what dosages, and in what combinations are ideal. There is such a wide range of differences in response and need between people, and this also changes within each person with time. What works for one person may cause side effects in another. There are as many regimens are there are people on this planet. Each person is unique due to age, weight, sex, medical condition, diet, exercise or activity level, temperature and climate, sleep patterns, hormonal status, other supplements consumed, digestion, absorption, metabolism, liver and kidney function, mood and mental function, other medicines taken, etc, etc.
     As a general rule, most people are fine taking a multivitamin and mineral supplement that has the basic B vitamins, C, E, selenium, etc. I personally take one capsule of MutiVit Rx most days of the week, one or two fish oils capsules most days of the week, half or one teaspoon of psyllium daily with a meal for extra fiber. In addition, I also take the following, but not on a regular basis, for instance 1, 2 or 3 days a week: Eyesight Rx half a tablet, curcumin, R alpha lipoic acid, CoQ10, acetyl-l-carnitine, Mind Power Rx, mangosteen, and Prostate Power Rx. I try not to mix too many supplements together, but limit them to a total of 4 to 8 capsules a day. I prefer not to take a particular supplement too many days in a row. Occasionally I take ashwagandha, bee propolis, carnosine, quercetin, milk thistle, beta sitosterol, genistein, grape seed extract, pomegranate, TMG, SAM-e, spirulina, and acetyl-cysteine. Once or twice a week I take melatonin or hops in the evening for sleep. I also drink various herbal teas in the morning and use stevia to sweeten them. At least once a month I take a break for 2 or 3 days from everything.
     Some of the time, though, I am experimenting with individual herbs and nutrients by themselves to see what effect they have on me in order to find new effective herbs and nutrients to constantly improve the products I have formulated, such as Passion Rx, Eyesight Rx, Mind Power Rx, and others. During these times I don't take any other supplements since I don't want the results to be influenced.
     Supplementation is not an exact science, and no two doctors or nutrition experts will agree on the same recommendations. Some doctors even think no supplements are needed. I personally like the overall vitality enhancement that these pills make me feel, hence even though it is not proven that taking supplements will make me live longer, I like the way they make me feel more vibrant and alive.
     There is a wide range of possibilities to explore, and ultimately it becomes a personal decision, trial and error, along with consultation with a health care provider, based on likes and dislikes and how you feel when you take these supplements, and your overall medical condition.

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1. Saw Palmetto, PSA, and Hair
Over the years I have been asked whether saw palmetto, the herb used for prostate enlargement, has an influence on PSA test results or on hair growth. PSA is the blood test that is often recommended to monitor prostate tumor growth. Recently medical science has questioned the reliability of PSA testing as a screening tool for cancer detection. Although there is a lot of controversy and varied opinions, it appears PSA testing is not as accurate a tool as we previously thought.
     Saw palmetto has been thought of as an herb that could potentially influence hair growth. Let me explain.
One of the causes of prostate enlargement is testosterone being converted into DHT (dihydrotestosterone). Excess DHT in prostate tissue is thought to lead to prostate growth, and excess DHT in hair tissue leads to hair thinning in men and women. Could we kill two birds with one stone by the use of saw palmetto? In recent years scientists have found that saw palmetto inhibits the enzyme 5-alpha-reductase in prostate tissue. This enzyme converts testosterone to DHT. Interestingly, there are two major forms of this enzyme, called types I and II. In humans, Type I 5 alpha-reductase is predominant in the sebaceous glands of most regions of skin, including scalp. The Type II 5 alpha-reductase isozyme is primarily found in prostate, seminal vesicles, epididymides and less so in hair follicles. At this time we don't have much research as to whether saw palmetto blocks the conversion of testosterone to DHT in hair tissue to a degree adequate enough to prevent or restore hair loss. My personal opinion, based on the early research, is that I suspect even if saw palmetto has a mild effect, it is not nearly as potent as the drug finasteride - an alpha reductase blocker - used for prostate enlargement (as Proscar) and hair regrowth (as Propecia). I do not know if there is an additive effect to finasteride if saw palmetto is taken along with it. There was a small study a few years ago that showed a potential benefit for hair growth in male pattern baldness when saw palmetto was combined with beta sitosterol. More research is certainly needed before we can come to any conclusions.
     Bottom line, the jury is still out regarding the role of herbs and nutrients in hair growth, and we have little idea, even if they work, what dosages would be appropriate for long term use. For more info, see http://ww.raysahelian.com/saw.html or http://www.raysahelian.com/hair.html

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2. Vinpocetine and Stroke
Could a simple herbal extract have an influence on stroke recovery? Vinpocetine is an alkaloid found in the periwinkle plant. It was introduced into clinical practice in Europe more than two decades ago for its role in cerebrovascular disorders and related symptoms. Experiments with vinpocetine indicate that it can dilate blood vessels, enhance circulation in the brain, improve oxygen utilization, make red blood cells more pliable, and inhibit aggregation of platelets. Vinpocetine even has antioxidant properties.
     A double-blind study was conducted to test the effects of vinpocetine on patients suffering from multiple cerebral infarcts. Twenty-six patients with multiple cerebral infarctions, aged between 50 and 83 years were examined, 14 of whom received vinpocetine and 12 placebo. Three months later, the vinpocetine patients did not show any significant worsening in symptoms, while the placebo group did. Several previous studies have indicated that vinpocetine may have beneficial effects in stroke prevention or therapy.
     My comments: I would like to see more studies before wholeheartedly recommending vinpocetine for stroke prevention or treatment. However, the results are intriguing enough that doctors who treat stroke patients should review this literature and decide whether some of their patients could benefit from vinpocetine. As to the dosage, it is difficult to know the long term amounts that are helpful. My guess is 2 to 5 mg once or twice a day should be fine for most people. Vinpocetine is usually found in 10 mg amounts, so breaking a tablet in half, a third, or smaller portions is an option.

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3. Yoga and Cancer
Yoga has been practiced for thousands of years to improve physical and emotional well-being. Nine recent studies conducted with cancer patients and survivors found yoga lead to modest improvements in sleep quality, mood, stress, cancer-related distress, cancer-related symptoms, and overall quality of life. It appears  from the emerging medical literature on yoga and cancer that yoga therapy is helpful for cancer patients.
     My comments: I started yoga 20 years ago and I love it. It makes me feel so relaxed, revitalized, and supple. I heard someone once say, "You're as young as your spine is flexible." Although not completely true, part of staying younger is to have flexibility of tendons and ligaments. No amount of a healthy diet and supplement intake is going to replace the benefits of yoga or other forms of stretching practices. Although I realize how important yoga is, sometimes I don't have the patience to attend a one and half hour class, so I do it at home at 20 minute intervals a few times a week. There are several yoga programs on TV, particularly the public funded channels, and you can tape some and do the yoga postures at your leisure. Or, you can attend a local yoga class.
See http://www.raysahelian.com/yoga.html

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SUPPLEMENT RESEARCH UPDATE - by  Ray Sahelian, M.D.
Vol. 2,  Issue 11 -- August 2, 2005
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It was all over the newspapers and TV and most of you probably heard about it: "Study finds Echinacea not effective for the common cold." A study in the New England Journal of Medicine funded by the National Center for Complementary and Alternative Medicine showed echinacea didn't prevent or treat a cold.
     Long touted as an herb that could stimulate the immune system and reduce the length and severity of the common cold, the latest study adds to growing evidence that echinacea does not do much to stop the sniffles and coughs. Some herbalists and herbal organizations tried to find flaws in the study to disparage the results, for instance the dosage used, the form of echinacea used, etc - and there certainly are minor or major flaws in almost every study. For the time being we should accept these results. I have always had doubts about the effectiveness of echinacea in regards to the common cold. In my opinion, a large dose of Vitamin C at the earliest onset of symptoms and frequent use of zinc lozenges are much more effective. Cold season is approaching in a couple of months, for details, see http://www.raysahelian.com/common.html

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1. Vitamin C and Atrial Fibrillation
I never thought Vitamin C would have anything to do with helping irregular heart rhythms, but apparently it has an effect. Oral Vitamin C cuts the risk of early recurrence of atrial fibrillation after patients undergo electrical cardioversion. Atrail fibrillation is a condition when the upper chambers of the heart, the atria, beat at a fast and irregular manner. Often medicines are used to correct this problem and if not effective, electrical cardioversion is done in a hospital. However, atrial fibrillation sometimes quickly returns after cardioversion.
     To investigate whether Vitamin C reduces atrial fibrillation recurrence, a research team randomized 44 patients who had undergone cardioversion for persistent atrial fibrillation to standard therapy plus oral Vitamin C or standard treatment only. Patients given the vitamin received a 2-gram loading dose 12 hours before cardioversion and 500 mg twice daily for the next 7 days. One (4 percent) of the patients given vitamin C had a relapse of atrial fibrillation, while eight (36 percent) of patients not given the vitamin did. The researchers also found that white blood cell levels and fibrinogen levels fell significantly in the group given Vitamin C, but did not drop in the control patients. Markers of inflammation were also significantly higher among patients who had a recurrence of atrial fibrillation, compared with those on Vitamin C who did not. Vitamin C supplements were able to reduce the inflammation in the atria after the cardioversion. See
http://www.raysahelian.com/atrialfibrillation.html

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2. A Nutritional Supplement for Ulcerative Colitis
Ulcerative colitis is a severe inflammatory disease of the colon that produces bloody diarrhea.  Researchers from the University of Alberta in Edmonton, Canada enrolled 34 patients with active ulcerative colitis who were then treated with a probiotic mixture twice daily for 6 weeks. A variety of standard treatments had been tried on the patients first, with no help. The probiotic mixture contained four strains of Lactobacillus, three strains of Bifidobacterium and one strain of Streptococcus salivarius -- all well-known species of good bacteria. Remission occurred in 53 percent of the patients and an additional 24 percent experienced some degree of improvement in symptoms. A few patients experienced no improvement or worsening of their symptoms. The only apparent side effect from the probiotic mixture was increased bloating. Testing of sampled colonic tissue provided direct evidence that the probiotic bacteria had, in fact, reached the diseased sites of the colon.  In brief, taking a mixture of several probiotic bacteria reduces symptoms in patients with ulcerative colitis that doesn't respond to conventional medications. For more info, see http://www.raysahelian.com/probiotics.html

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3. Reducing the risk of Hip fracture
Vitamin D deficiency is quite common in cases of hip fractures. A look-back study of 548 patients older than 60 years of age who were admitted at South Glasgow University Hospital in Scotland in the previous 4 years, showed that 97 percent of the patients had Vitamin D levels below normal. Dr. Gallacher, lead researcher and consultant endocrinologist at the hospital said: ''Although the numbers were too small to justify extensive subgroup analyses the study appears to demonstrate that vitamin D inadequacy represents a significant correctable risk factor for fragility fracture and perhaps specifically for the hip."
    My comments: Most elderly patients do not get enough Vitamin D through sun exposure, particularly in cold climates with long winters. Vitamin D can be supplemented by taking a multivitamin and mineral complex, through cod liver oil, or through Vitamin D fortified foods. A Vitamin D supplement (preferably natural Vitamin D3) or multivitamin product with 400 to 800 units should be adequate. Sitting by the window or taking walks outside could be helpful. Getting exposed to sunlight or any type of light is also beneficial since it helps reset the circadian clock and helps one achieve a deeper sleep at night. See http://www.raysahelian.com/vitamind.html or http://www.raysahelian.com/osteoporosis.html

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4. The Low Carb fad -- Beginning of the End?
Atkins Nutritionals Inc., the company behind the low-carbohydrate Atkins Diet craze, filed for Chapter 11 bankruptcy protection, blaming slumping demand and increased competition. I had a suspicion that the low carb diet fad was winding down. A year and a half ago I attended the largest supplement show at the convention center in Anaheim, California. Everywhere I turned, there was a booth selling low carb bars, foods, and drinks. A few months ago, at the same show, there were only a fraction of the low carb booths from the year before.
     What kind of diet works for weight loss? It appears that a high protein diet has the best potential to reduce appetite. Actually, one of the reasons a low carb diet seems to work is that people substitute a higher amount of protein in their diet. As to supplements that suppress appetite, 5-HTP is a good one since it converts into serotonin, a brain chemical involved in appetite control. I still don't have a firm opinion regarding hoodia or bitter orange.
See http://www.raysahelian.com/weightloss.html

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Question of the Month:
Hello to Dr. Sahelian and staff. If I may, I'd like to ask a "philosophical" question. I take it that herbs by definition are considered as having some pharmacological properties to them, correct? Can one then also speak of herbs providing some sort of nutrition to the body, meaning providing nutrients to the body, not just acting like a "natural drug"?
     A. This is an excellent question. The answer is both. There are countless substances in the human body, and there are also countless substances in herbs. Some of the substances in herbs act as pharmaceutical agents, just like drugs. It just happens that some herbs have substances in them that are also found in the body and act as nutritional replacement or supplementation. For instance, the herb wolfberry has a high concentration of zeaxanthin, which, along with lutein, are carotenoids found in the retina of the eye. Zeaxanthin and lutein help improve vision. In this case, the zeaxanthin in wolfberry is acting as a nutritional agent. Herbs also contain many vitamins, minerals, amino acids, fatty acids, and flavonoids which have nutritional value. These substances are used by the body for structural repair, hormone synthesis, and enzymatic activity.

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SUPPLEMENT RESEARCH UPDATE - by  Ray Sahelian, M.D.
Vol. 2,  Issue 10 -- July 20, 2005
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According to the latest data from the federal government's Agency for Healthcare Research, Americans spent a total of $151 billion on outpatient prescriptions in 2002 — $65 billion more than what was spent in 1996. And this figure does not include any over-the-counter drugs prescribed in hospitals, nursing homes or other institutions. The top-ten list of costliest drugs, with a combined price tag of nearly $30 billion, was led by Lipitor, the cholesterol-lowering drug, at a cost of $6 billion. Cholesterol competitors Zocor and Pravachol also made the top ten, as did anti-ulcer drugs Prevacid and Prilosec, along with the anti-depressants Paxil and Zoloft.
     It's interesting that the medical conditions that the above drugs treat - high cholesterol, ulcers, and depression - can be strongly influenced by diet and lifestyle factors. And at least in the case of cholesterol and most particularly mood, natural supplements can have a significant influence. I wonder how many billions of dollars our economy could save if more people were made aware of alternatives. 
   

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1. Eat Less for Better Sex?
Have you heard of Metabolic Syndrome or Syndrome X? Symptoms of metabolic syndrome include a large waistline, high blood pressure, raised insulin levels, excess body weight and abnormal cholesterol levels -- at the rate Americans are growing, this may eventually describe most of us. If someone has three or more symptoms they have the syndrome and a higher risk of coming down with life-threatening illnesses.  In a new study, 100 men with metabolic syndrome were compared with matched male controls who did not have the syndrome (they are called the control group). Patients with metabolic syndrome had an increased prevalence of erectile dysfunction at 26% versus 13% for the control group. The syndrome X group also had a higher level of C-reactive protein, a marker of inflammation. Erectile dysfunction, which occurs in up to 30 million men in the United States, affects up to 50% of males between 40 and 80 years of age. As the C reactive protein level rises, it starts affecting the endothelium, the lining in blood vessels responsible for maintaining healthy dilation of blood vessels. Many patients with erectile dysfunction seem to have a vascular mechanism that is similar to that seen in atherosclerosis. For suggestions on eating healthier,  see http://www.raysahelian.com/erectiledysfunction.html

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2. Creatine for those with COPD
Normally we think of creatine as a bodybuilding supplement, so it surprised me when I came across the title of this article, "Creatine supplementation beneficial in patients with COPD." COPD is short for chronic obstructive pulmonary disease, a condition that comes after years of smoking, repeated infections or other types of damage to lung tissue. A study done in England showed patients with chronic obstructive pulmonary disease who took creatine supplements gained fat-free mass, had increased peripheral muscle strength and endurance, and improved health status. However, whole body exercise capacity was not improved. One of the researchers commented, "Creatine, which is used by many healthy athletes, led to COPD patients putting on muscle bulk, gaining muscle strength and endurance, and feeling better...(and) it may make their quality of life better. Creatine therefore may be potentially useful to a large number of patients with this disease."
     My comments: A cautious approach would be to take 2 or 3 grams of creatine a day (about half a teaspoon) mixed with a couple of ounces of juice. Creatine can also build muscle mass in most everyone, particularly if a small amount of exercise is performed anytime during the day.

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3. Magnesium : The Anti-Arrhythmia Mineral
Arrhythmia means that the heart beat is off it's normal beating pattern. There are numerous types of arrhythmias, some of little significance, while others can be life threatening. Atrial fibrillation is a type of arrhythmia where the atria, the upper chambers of the heart, beat irregularly. In a recent issue of the journal Heart, statisticians reviewed existing studies on the role of the mineral magnesium in atrial fibrillation. In this meta-analysis of randomized, controlled trials involving the use of magnesium on atrial fibrillation after cardiac surgery, 20 randomized trials with a total of 2,490 patients were identified. It was found that magnesium supplementation reduced the percentage of patients who developed postoperative atrial fibrillation from 28% in the control group to 18% in the treatment group. Magnesium had a mild to modest effect in reducing the rate of atrial fibrillation. For additional suggestions on how to minimize heart palpitations or arrhythmias, see http://www.raysahelian.com/arrhythmia.html. You will find that some supplements, such as fish oils, may help, whereas others could contribute to heart palpitations when misused, particularly the hormones DHEA and pregnenolone.

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4. Folic Acid and Colon Cancer
Folic acid is a B vitamin normally found in many multivitamin supplements and sometimes fortified in foods. The daily requirement is about 400 micrograms. In a study of 31 patients with confirmed colorectal adenoma, subjects participated in a randomized, double-blind, placebo-controlled study. Seven male and 8 female subjects (average age 64 years) received folic acid at 400 mcg/day while 8 male and 8 female subjects of a similar age group received placebo. Folic acid supplementation increased serum and erythrocyte folate levels by 81% and 57%, respectively, and reduced plasma homocysteine levels by 12%. Erythrocyte means red blood cell. Folic acid supplementation resulted in increases in DNA methylation of 31% in leukocytes (white blood cells) and 25% in colonic mucosa. Methylation is a process whereas certain supplements, such as folic acid, Vitamins B6 or B12, or certain nutrients such as TMG or SAM-e donate a methyl group. It is believed that as we age, our body's ability to methylate decreases, which may lead to health problems, including high homocysteine levels and cancer. This study showed that DNA hypomethylation can be corrected by physiological levels of folic acid intake. Folic acid supplements are known to raise blood levels of betaine, also known as TMG. For more information on the health benefits of methyl donors, see http://www.raysahelian.com/methyl.html or to lower homocysteine, see http://www.raysahelian.com/homocysteine.html

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The Food and Spice Corner
Once in a while I wish to share with you some foods or spices that I really enjoy and also have a health benefit. Have you heard of Zaatar? If you have ever visited a Middle Eastern restaurant, you may have been served this herbal mix as an appetizer. Zaatar is popular in the Middle East. It is a combination of several herbs, most commonly Thyme, Oregano, Sumac, and Sesame seeds. Zaatar comes as an herbal mix that is soaked in olive oil and then spread on any kind of bread - preferably whole, multi grain bread - for a delicious snack. You can also sprinkle it on a variety of dishes, such as an omelet or soup, to add zest and spice. Warning: it can be deliciously addictive. Zaatar is now available at Physician Formulas web site.  See http:www.raysahelian.com/zaatar.html for more info.

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Question of the Month:
Q. I noticed that you recommend 100 to 300 mg of Acetyl-L-Carnitine on your web site, but in Mind Power Rx, there is only 30 mg of ALC. Same with DMAE, vinpocetine, and other mind nutrients. Why is that?
    A. Most people don't realize that when they are combining multiple supplements, they need to reduce the dose of each one since many of them have an additive effect. ALC may be fine at 300 mg by itself, but if all the other herbs and nutrients in Mind Power Rx are taken at their full daily dose, the results would be quite unpleasant. It could lead to restlessness, anxiety, rapid heart beat, nausea, headache, insomnia, etc. So, I encourage everyone who is taking many supplements to be aware of this fact and make sure you keep dosages to a minimum. That's why, when I formulated Mind Power Rx, I made sure to only include a small amount of each nutrient. High doses can be counterproductive. For instance, if a person thinks they are going to boost their mind by taking high doses of brain supplements, and they sit down to study or try to be effective at work, they may be so energized and restless that it would be difficult to sit still and absorb information, or do the task they planned to accomplish.

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SUPPLEMENT RESEARCH UPDATE - by  Ray Sahelian, M.D.
Vol. 2,  Issue 9 -- June 30, 2005
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Have you had your blood pressure checked lately? High blood pressure can take years off both life expectancy and time lived free of disease. Researchers have found that high blood pressure at the age of 50 shaves about 5 years off men's and women's lives. It also causes them to endure 7 more years with cardiovascular disease compared with their peers who had normal blood pressure in middle-age. It's well known that high blood pressure raises the risk of heart disease, stroke and kidney failure. Although many medicines are available, and some of them are quite helpful in severe cases, it is a good idea to first explore natural options. See http://www.raysahelian.com/hypertension.html
   
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1. Breastfeeding Brings Better Eyesight
Did you know that infants who are breastfed have better vision and have a lower risk for myopia (nearsightedness)? If you have read my book on Mind Boosters or come across some of my other writings on vision, you may have a good guess on which nutrient in mother's milk may be the crucial vision factor. Mother's milk, unlike regular milk or soy formula, has an important fatty acid called DHA, which is also found in fish oils. The retina of the eye is chock full of DHA, and hence fish oils, which contain both EPA and DHA, are helpful in visual health. Years ago when I was writing my book on Mind Boosters I discovered interesting properties of many nutrients that had not been mentioned before in the medical literature. I found out that taking several fish oil capsules a few days in a row provided better clarity of vision and colors were brighter. Hence, it makes sense that infants who drink mother's milk would have healthier retinas and better eyesight.
     I had radial keratotomy done in 1994 to correct myopia. Since then my vision had been about 20/30 and my close vision deteriorated so that I could not read fine print or even regular print in some newspapers. Whenever I take fish oil capsules, I notice an improvement. My search for vision enhancement nutrients and herbs led to the discovery of Eyesight Rx. I find half a tablet 2 days on, one day off, helps me see much clearer and I can read fine print without glasses. I have noticed that my distance and night vision has improved, too.

See http://www.raysahelian.com/eyesight.html
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2. Melatonin - Less is More
MIT scientists confirm that melatonin is an effective sleep aid for older insomniacs and it appears that only a small dose of melatonin (about 0.3 milligrams) is necessary for a restful effect. Taken in that quantity, melatonin not only helps people fall asleep, but also makes it easier for them to return to sleep after waking up during the night. However, the amount in most melatonin products on the market ranges between 1 to 5 mg. At this high dose, tolerance can develop and the melatonin receptors in the brain become unresponsive. Thereafter, melatonin becomes less effective.
     My comments: When I first wrote my book Melatonin: Nature's Sleeping Pill back in 1995, I cautioned users to keep the dosage low. I recommended that people not take more than 1 mg on a regular basis even though the most common dosage on the market at that time was 3 mg and several other books on melatonin had been written touting high doses. It appears now that a third of a mg works better in the long run.  Back in 1995 I had personally noticed tolerance develop within a few days of taking 3 mg nightly - it stopped working. I also experienced some of the side effects of high dose melatonin which include wonderful psychedelic dreams, but also nightmares. In addition, I felt tired and sleepy in the mornings. I now feel comfortable recommending 0.2 to 0.5 mg a few nights a week. Melatonin is best absorbed on an empty stomach. If you can only find the 1 mg product, just take about a third of it. As to the ideal time of use, it can range from 3 to 4 hours before bed to 1 hour before bed. The higher dosages of 1 to 5 mg may be used occasionally for jet lag. Melatonin also has antioxidant properties.

For more info, see http://www.raysahelian.com/melatonin.html

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Interesting Feedback regarding Eyesight Rx
We've had several emails regarding this product and we wanted to mention 3 that were quite interesting.

1. In case you are interested in feedback on Eyesight Rx, I have a condition that is not correctable (congenital nystagmus) so any improvement is welcome. I will tell you my experience so far. The first day I took 2/3 of a tablet and didn't see much of a change but that night I was quite restless. The next day I eliminated the sudafed for sinus and the coffee and I took 2/3 of a pill and I slept fine but not much change. The third day I took 1/2 a pill and started to notice subtle changes in clarity and definition and clearer night vision. I have taken 1/2 a pill for 2 more days and see subtle improvements daily like more definition in grass and trees and colors a little brighter. So far I like the eyesight Rx because I notice the word looks more defined almost more 3D. I was born with albinism and my vision is corrected to 20/80. I went to see a new eye doctor recently who recommended eye vitamins for improving Macular pigment. He was not sure they would improve vision but felt they would prevent further problems. I told him about what I read in Dr. Sahelian's  book - Mind Boosters - about fish oils and DHA and he said it was I good idea but I may need high doses. I take 6 pills a day. It actually helps even though I taste fish every so often.  I have an appointment in August so the doctor can take another picture of my retina to see if the vitamins helped. I will let you know.

2. I have normal vision 20/20 and aged 38. I'm surprised that Eyesight Rx can improve vision even in someone who has good vision to start. I take 1/2 a tablet 2 days on, one day off. Colors are brighter and sharper focus, it just seems so much more fun to look and see, almost like a visual born again. I have tried a higher dose of a full tablet, and even though the vision was better, I had the side effect of insomnia and felt my heart beating faster.

3. I was diagnosed in 1996 with keratoconus (bilateral). I had a corneal transplant in my left eye in 1998. My vision improved to 20/60 with corrective lenses. However it was very difficult and at times impossible to read small, medium, and at times large print. Driving at night was out of the question for me. After taking eyesight Rx I am able to read and respond to my email with less strain than before; as I can now see the monitor and the letters on the key board much clearer. Colors are brighter and lively. I can honestly say my vision has improved and so has my life as a result of taking Eyesight Rx. I noticed the results within the first few hours after melting half a tablet of Eyesight Rx under my tongue.

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SUPPLEMENT RESEARCH UPDATE - by  Ray Sahelian, M.D.
Vol. 2,  Issue 8 -- June 15, 2005
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A month ago I mentioned that even though wonderful advances in surgery, anesthesia, and emergency care have been made by modern medicine -- and we are all extremely appreciative of these advances -- the proper understanding and treatment of chronic conditions with natural herbs and supplements is behind by a century. Well, in at least one case I admit I was off the mark... by a millenium!
     Scientists recently found that Kudzu -- an herb used in China for alcohol cessation -- actually does work. Kudzu was first described in the Chinese materia medica in 200 B.C. and has been used to treat alcohol abuse, drunkenness, and hangover in China for more than a millennium. Modern medicine just now discovered it. Let's see how long mainstream doctors will take to incorporate this herb into clinical practice. I hope it's sometime within this century. I will discuss the kudzu study later.

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1. Kudzu Can Curb Alcohol Cravings
Modern Western medicine has few options for those who wish to reduce their cravings for alcohol. Even though the Chinese, Indians and others have studied thousands of herbs for centuries, I find it truly amazing that so much knowledge accumulated by other cultures has hardly been discovered by western scientists.
     Previous trials conducted in the USA have shown that extracts of kudzu reduce alcohol drinking in rats and hamsters. In the present study conducted partly at Harvard Medical School, researchers attempted to evaluate the effectiveness of a kudzu extract in humans. Heavy male and female alcohol drinkers... oops, I meant to say male and female heavy alcohol drinkers were treated with either placebo or a kudzu extract for 7 days and then given an opportunity to drink their preferred brand of beer while in a naturalistic laboratory setting. Results: Kudzu treatment resulted in significant reduction in the number of beers consumed and a decrease in the volume of each sip. There were no reported side effects. The researchers cheered and concluded: "These data suggest that an extract of kudzu plant may be useful in reducing alcohol intake in a naturalistic setting."
     My comments: I personally have not tested kudzu with patients to see how effective it is, and it certainly would help having a couple of more human studies to determine the accuracy of these findings. But, based on kudzu's historical use by the Chinese for alcohol related problems, this herb looks promising.

See http://www.raysahelian.com/kudzu.html
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2. The Mice on the Yellow Spice
Turmeric, a yellow spice used widely in Indian cooking, is back in the news. Curcumin, an active compound found in turmeric, appears to stop the spread of breast cancer tumor cells to the lungs of mice. Tests have already started in people, too, says Bharat Aggarwal of the Department of Experimental Therapeutics at the University of Texas M.D. Anderson Cancer Center in Houston, who led the study. "What's exciting about this agent is that it seems to have both chemopreventive and therapeutic properties.
       Earlier research showed that curcumin, an antioxidant, can help prevent tumors from forming in the laboratory. For their study, Aggarwal and colleagues injected mice with human breast cancer cells -- a batch of cells grown from a patient whose cancer had spread to the lungs. The resulting tumors were allowed to grow, and then surgically removed, to simulate a mastectomy. Then the mice either got no additional treatment; curcumin alone; the cancer drug paclitaxel (sold under the brand name Taxol); or curcumin plus Taxol. Only half the mice in the curcumin-only group and 22 percent of those in the curcumin plus Taxol group had evidence of breast cancer that had spread to the lungs. But 75 percent of animals that got Taxol alone and 95 percent of those that got no treatment developed lung tumors. IN other words, the addition of curcumin lowered the rate of cancer spread. Earlier studies suggest that people who eat diets rich in turmeric have lower rates of breast cancer, prostate cancer, lung cancer and colon cancer.
     My comments: I think we are going to continue hearing a lot more about curcumin and turmeric in the future.
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3. Making Sense of Menopause and Soy
Previous studies on the benefits of soy for relieving menopausal symptoms have produced mixed results. In a new study, a research group used a standardized soy product which contains 160 milligrams of total isoflavones, soy-derived antioxidants. Forty-three postmenopausal women were assigned to the soy product or placebo daily for three months. The average age of the women was 55 years and they had been off hormone replacement therapy for at least six months prior to entering the study. All of the women completed a menopause-specific quality-of-life questionnaire at the beginning of the study and again after 6 weeks and 3 months. Compared with placebo, soy therapy led to a 40-percent reduction in psychosocial complaints involving mood and depression, a 36-percent reduction in hot flashes and night sweats, as well as a 30-percent reduction in other physical symptoms, primarily low energy.
     My comments: Over the years I have read numerous studies regarding the benefits or lack of effectiveness of isoflavones, such as genistein, for menopause symptom relief. Overall, I think the evidence is tilting towards some benefit. At the least, these isoflavones do not have the serious side effects that estrogen has when used for prolonged periods. If isolfavones are not enough to relieve menopausal symptoms, then a small amount of estrogen can be used for brief periods to relieve severe hot flashes and other symptoms.

See http://www.raysahelian.com/menopause.html or http://www.raysahelian.com/isoflavones.html

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Question of the Month

Q. You have a web page on depression at raysahelian.com and you mention several nutrients and herbs that have an influence on mood. How would one know which one to use?
     A. Treating depression is difficult, whether through drugs or supplements. Each person is unique in terms of the causes for the depression and their response to medicines or supplements. However, I can make some generalizations that you can discuss with your doctor. If the depression is associated with low energy and motivation, then SAM-e could be helpful since this nutrient can perk someone up pretty quickly. However, high doses can cause overstimulation and mania. If the depression is associated with restlessness, anxiety and rapid, incessant thoughts, 5-HTP is a good option since it converts into serotonin which has a calming effect. Somewhere between these two effects is St. John's wort which is not as stimulating as SAM-e, but not as calming as 5-HTP. And it's quite likely that as the depression progresses, some people who at first benefited from one supplement may find it is no longer helpful and another supplement is more appropriate. I think part of the reason for the failure of depression treatment lies in the fact that patients or doctors don't adjust the dose or medicine to reflect the biochemical, life circumstance or lifestyle changes that are going on within or outside the individual as the weeks and months go on. Another nutrient that influences mood is tryptophan, however I personally have not taken it for any period of time so I don't have a good personal feel for it. Tryptophan has some aspects that are similar to 5-HTP.

For more information, see http://www.raysahelian.com/depression.html

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SUPPLEMENT RESEARCH UPDATE - by  Ray Sahelian, M.D.
Vol. 2,  Issue 7 -- June 1, 2005
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Recent months have not been the best of times for the pharmaceutical drug industry. Within this past year we have had reports of countless excess deaths from the arthritis drugs Vioxx and Celebrex; reports that Crestor, the statin drug for high cholesterol, causes a high rate of muscle tissue damage and kidney failure; and now the bad news about Viagra, Cialis, and Levitra: there's a possibility that they cause permanent blindness in a very small portion of users. Is it time to look for alternatives?
     My mom's doctor prescribed her the statin drug Lipitor for a slightly elevated cholesterol level. A month ago she reported to him that her muscles were aching all over. He couldn't find a cause. Then she told me about it, and my first thought was the Lipitor. She stopped it, and within four days her muscle aches went away. Atorvastatin, sold by Pfizer Inc. under the brand name Lipitor, is the world's biggest-selling prescription medicine with sales of $10 billion a year. I'm concerned that in the future we may come across more bad side effects from some of the statin drugs. Although they have a role to play in those with very high cholesterol levels, they are being prescribed carelessly to too many people with mild cholesterol elevation. If you need to take statins, ask your doctor if every other day use is an option in order to minimize side effects.

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1. No more B12 shots!
Great news for needle phobics: Oral supplements of vitamin B12 appear to correct vitamin B12 deficiency as well as B12 injections. However, in order to correct a deficiency, oral doses need to contain several hundred times the recommended daily allowance (RDA) of vitamin B12. Most people develop vitamin B12 deficiency as a result of "malabsorption," in which their bodies become unable to extract vitamin B12 from food. The deficiency typically strikes older people and takes years to develop. In some instances, people who avoid animal products -- such as vegans -- can also develop a deficiency in vitamin B12 as a result of not eating enough B12-rich foods. A vitamin B12 deficiency is typically treated by monthly, often painful, shots. The researchers tested various daily doses of oral vitamin B12 supplements in people aged 70 and older. They found that daily oral doses of 600 to 1000 micrograms of vitamin B12 appeared to correct the deficiency. The current RDA for vitamin B12 is 3 micrograms per day. One milligram equals 1,000 micrograms.
      My comments: Vitamin B12, unlike the other B vitamins, needs a special compound in the stomach called 'intrinsic factor' to be properly absorbed . All the other B vitamins are easily absorbed without much difficulty. It's great to know that oral ingestion of B12 is just as good as a shot. Many B12 supplements do have several hundred times the RDA for this vitamin. B12 supplements are available under several names, including methylcobalamin and dibencozide.
For details, see http://www.raysahelian.com/methylcobalamin.html

2. Preventing Parkinson's Disease
Eating foods rich in Vitamin E may help protect against Parkinson's disease, a chronic disease that affects 1 percent of people over the age of 65 worldwide. In the United States alone at least 500,000 people suffer from the illness. Parkinson's disease occurs when brain cells that produce a chemical called dopamine malfunction and die. Symptoms include tremors, stiffness, slow movement and poor coordination and balance. A review of eight studies that looked into whether Vitamins C and E and beta carotene had an impact on the odds of developing Parkinson's disease showed that a moderate intake of Vitamin E lowered the risk. Neither Vitamin C nor beta carotene seemed to have a protective effect. The researchers said they did not know whether Vitamin E supplements would have any benefits. Foods rich in Vitamin E include nuts, seeds, wheat germ, spinach and other green leafy vegetables.
     My comments: If you plan to take Vitamin E supplements, limit your dose to 200 units a few times a week. Vitamin E is fat soluble and stays in the body; therefore, daily intake is not needed. Also, use natural mixed Vitamin E complex rather than the synthetic dl-alpha tocopherol. It's possible other supplements could be useful in Parkinson's disease. Those with high intake of fresh fruits and vegetables have a lower risk of Parkinson's disease. For more info, see http://www.raysahelian.com/parkinson.html

3. Androgens and Breast Cancer
I am starting to become quite convinced that excess androgens -- such as testosterone, DHEA, and androstenedione -- may raise the risk for breast cancer in women. Androgens are normally present in women, although at much lower levels than in men. Elevated androgen levels have been linked with breast cancer in studies of postmenopausal women, but it was unclear if this also applied to premenopausal women. In a study published in the Journal of the National Cancer Institute, doctors tested blood androgen levels in premenopausal women who were later diagnosed with breast cancer and compared them to androgen levels found in similar women without breast cancer. The likelihood of developing breast cancer increased significantly as levels of testosterone and androstenedione rose.
     My comments: Testosterone is available by prescription and DHEA is sold over the counter. Although I believe androgens could well benefit women who have low androgen levels, their use should be limited to low dosages and brief periods. If androgens are required to be taken for prolonged periods, frequent breaks would reduce the risk of untoward effects. See http://www.raysahelian.com/breastcancer.html
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Question of the Month

Q. What's the difference between fish oil and cod liver oil? There's little mention about cod liver oil anymore.
     A. Fish oil supplements are dietary supplements that contain oil from the fatty flesh of cold water fish such as mackerel, anchovy, and sardines. The active ingredients in fish oil supplements are essential fatty acids known as omega-3 fatty acids. They typically include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Cod liver oil is derived from the liver of cod fish. Cod liver oil contains Vitamins A and D and has a different concentration of EPA and DHA than fish oils. Cod liver oil has a higher ratio of DHA to EPA, while fish oils have a higher ratio of EPA to DHA. But, overall, fish oils have almost twice the amount of total EPA plus DHA than cod liver oil per same size capsule or teaspoon.
      To summarize, cod liver oil has the additional Vitamins A and D, a higher ratio of DHA to EPA, but about half as much total EPA plus DHA than fish oils. Practically speaking, they are both healthy to ingest, but if you want a higher amount of total EPA and DHA, you would go with fish oils.

For more information, see http://www.raysahelian.com/fishoils.html

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Emails from Subscribers:
I'm currently taking Hoodia. I'm 52, 5' 2", with a normal appetite and work in a stressful place where there's food all around me. You can guess what that did. It's too early to record anything significant as to weight loss, but I'll be astonished if it doesn't happen as hoodia is willpower in a bottle! I now eat only when my stomach is growling, only a tiny amount is enough, and have been able to postpone meals and stop snacking completely. Hoodia is much better than the over-the-counter appetite suppressant that they banned a few years back. I start in the morning with 2 hoodia capsules, and may have another in the afternoon if I feel a snack appetite coming on. If night eating starts happening, I'll take another one then, but it hasn't been a problem.

I'm a 360 lbs white male, age 40. I took hoodia pills, 2 a day, for a week and did not notice any effect on appetite or weight loss.

     My comments: We've had feedback from hoodia users regarding appetite control, and the results are mixed. Overall, though, it seems 60% of the feedback has been positive. Some people find 5-HTP or Acetyl-l-Carnitine to also have appetite suppressing qualities. It's really difficult to know who will respond to which supplement, if any. For more info, see http:www.raysahelian.com/hoodia.html or http://www.raysahelian.com/weightloss.html for practical weight loss suggestions.
 

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SUPPLEMENT RESEARCH UPDATE - by  Ray Sahelian, M.D.
Vol. 2,  Issue 6 -- May 2005
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Two weeks ago I started a class at a local university -- my first formal 10 week semester course since I finished medical school! I can't believe I'm in a classroom sitting next to 20 year olds. At 47, I may even be older than the teacher. I happen to be more excited than I've ever been in my whole education career. My mind is like a sponge ready to absorb any new information. The class I'm taking is on Chinese herbal medicine. As some of you may know from my mentions in previous newsletters or having read my books, I experiment almost daily with different herbs and nutrients to see what kind of effect they have on me. In the past few months I started experimenting with Chinese herbs and found some to be quite powerful. Hence, I'm back in school... it's so much fun not to worry about quizzes and exams, but just to learn for the fun of it... and to incorporate some of this knowledge in upcoming herbal formulations. I'll share some of my newfound knowledge with you in the coming newsletters.    

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1. Alpha Lipoic Acid and Multiple Sclerosis
In the last issue of the newsletter I mentioned that nutritional or herbal therapies for medical conditions were a century behind the times compared to the advances we have made in surgery. As most of you know, this is because there is little incentive to do research on supplements since they cannot be patented. So, it's nice and surprising when nutritional research is done in the United States as in the case of scientists from the Department of Veterans Affairs Medical Center, Portland, Oregon, who tried to learn more about the role of Alpha Lipoic Acid in multiple sclerosis.  
     Alpha Lipoic Acid  (ALA) is a powerful antioxidant. Thirty-seven multiple sclerosis subjects were given alpha lipoic acid 1200 mg a day for 14 days. The results were positive. ALA was able to lower levels of two markers for multiple sclerosis called MMP-9 and CAMP-1. The researchers say, "ALA may prove useful in treating multiple sclerosis by inhibiting MMP-9 activity and interfering with T-cell migration into the CNS." MMP-9 is a matrix metalloproteinase substance which is high in multiple sclerosis patients. MMP-9 has been implicated in the pathogenesis of cancer, autoimmune disease, and various pathologic conditions characterized by excessive fibrosis. The fact that ALA was able to reduce it is a positive indication.
     My comments: I'm fascinated by the possibilities of nutritional substances in altering the course of chronic medical conditions for which modern medicine does not have good options. Although this study in no way says ALA will be a cure or long term benefit for those with MS, it does open the door for further exploration. I think the dose of 1200 mg is extremely high, and I would not recommend more than 50 mg a day of R-Alpha Lipoic Acid for long term use.
For more details, see http://www.raysahelian.com/multiplesclerosis.html

2. Counteracting Tylenol Toxicity
Regular use of the painkiller acetaminophen is associated with higher rates of liver and kidney toxicity, asthma, and chronic obstructive pulmonary disease and reduced lung function.
     My comments: With hundreds of people each year dying from acetaminophen overdose, thousands more with liver damage or other health problems, why is acetaminophen still available for sale without a prescription whereas regulators have tried to pull away certain nutritional supplements that are far less toxic?
     Those who need to take acetaminophen for a health condition should consider Acetylcysteine, a nutrient that protects the liver from this drug's toxicity.
For more info, see http://www.raysahelian.com/acetylcysteine.html

3. One More Reason to Rationalize My Chocolate Habit
Did I say habit? Let's be honest... I guess addiction is a more accurate description... although there have been times when I have gone without chocolate for prolonged periods. For instance, I once went as long as 72 hours. This was a weekend camping trip in the woods and I had forgotten to pack the chocolate bars. So when I hear good news about cocoa, I begin salivating in anticipation. The title of a recent article caught my eye: "Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons." As I read the article while melting a square of 70% cocoa dark chocolate in my mouth, I started feeling better about my daily intake of a couple of ounces of this tasty treat. As some of you may know, chocolate has important flavonoids (a type of polyphenols). Many flavonoids dilate blood vessels and have antioxidant properties. The objective of the study was to compare the effects of either dark or white chocolate bars on blood pressure and glucose and insulin responses to an oral-glucose-tolerance test in healthy subjects. After a 7 day cocoa-free phase, 15 healthy subjects were randomly assigned to receive for 15 days either 100 grams of dark chocolate bars, which contained approximately 500 mg polyphenols, or 90 grams of white chocolate bars, which has no polyphenols. Results showed that systolic blood pressure was slightly lower after dark than after white chocolate ingestion by about 4 points and insulin sensitivity was enhanced which means blood sugar can enter cells and tissues more easily rather than linger in the bloodstream causing problems.

See  http://www.raysahelian.com/flavonoids.html
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Question of the Month - Sorting out the Sweet Stevia Story

Q. I keep reading contradictory reports in magazines regarding the safety of Stevia, the natural sweetener. In your opinion, is stevia safe?
     A. Stevia is a natural, no calorie sweetener which is extracted from the stevia plant leaf that grows naturally in South America. I have used stevia daily for 10 years with absolutely no adverse effects. I usually take 2 to 4 drops of clear stevia liquid in my morning herbal tea, and I also use stevia to sweeten cocoa in combination with soy milk, cinnamon powder, vanilla extract, and a fruit juice concentrate such as black cherry. I know a number of people who have used stevia daily for several years with no side effects at all.
     I spent long hours at the UCLA medical library while writing The Stevia Cookbook. I evaluated in detail all the published studies on stevia over the past several decades. Based on a thorough evaluation, I am confident to say that stevia, in my opinion, is safe and significantly safer than practically all of the artificial sweeteners currently on the market. Stevia has been given in massive doses to three generations of rodents with no harmful effects noted. Stevia has been used in Japan for more than 3 decades with no adverse reactions reported. It's too bad that more Americans have not heard of this amazing and safe sweetener. I personally prefer the clear liquid extract, although each person has their own preference. There is a wide range of quality among different brands depending on the extraction process.
For more information, see http://www.raysahelian.com/stevia.html

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Email from a Subscriber:
Dear Dr. Sahelian,
I am a psychologist (therapist) and often recommend Mind Power Rx to my clients and close friends. Its a pleasure being in touch with you. I have been hearing great feedback from my friends and clients who are using your Mind Power Rx, which in my opinion provides for all aspects of mind boosting whether it's serotonin, dopamine or acetylcholine related. Big thumbs up in my understanding! (And twice or thrice a week I use it myself as well with great zest and confidence!)
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2. Acetyl-L-Carnitine and Diabetic Neuropathy.
An evaluation from two 52-week randomized placebo-controlled clinical diabetic neuropathy trials testing acetyl-l-carnitine demonstrated that acetyl-l-carnitine treatment is beneficial in alleviating symptoms (particularly pain) and improves nerve fiber regeneration and vibration perception in patients with established diabetic neuropathy. The study was published in Diabetes Care journal. See http://www.raysahelian.com/acetylcarnitine.html

3. Oily fish helps cut inflammation
A diet high in oily fish like salmon, halibut and mackerel may help improve inflammatory conditions such as arthritis.
A key anti-inflammatory fat in humans is found in fish oil. The researchers, from Harvard Medical School, Brigham and Women's Hospital, found the diet worked best when combined with low aspirin doses. The inflammatory response protects the body against infection and injury, but when it goes wrong it can lead to conditions such as arthritis and cardiovascular disease. The Harvard team identified a new class of fats in the human body, called resolvins, which they showed can control inflammation. They do this both by stopping the migration of inflammatory cells to sites of inflammation and the turning on of other inflammatory cells. Resolvins are made from the omega-3 fatty acids, found in high concentration in oily fish. Their production also appears to be stimulated by taking aspirin.
     My comments: If you don't like eating fish, consider taking 2 to 3 fish oil capsules a day. As to aspirin , I think a baby aspirin (about 80 mg) taken 3 or 4 times a week should be safe. See
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Questions of the month -- When to take breaks and for how long
We've had several questions this month such as:

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

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

Zinc Lozenges for the common cold
A recent review article published in the Journal of the American Pharmacy Association concludes: "Clinical trial data support the value of zinc lozenges in reducing the duration and severity of symptoms of the common cold when administered within 24 hours of the onset of common cold symptoms."
     I believe this to be true based on the available research and my personal and professional experience. The proper use of zinc lozenges and vitamin C can shorten the duration and severity of common cold symptoms. Here are a few tips (discuss with your health care provider first):
     At the earliest onset of symptoms (a mild sore throat, funny feeling or tingling in nose, etc.):
1. Immediately take 3 to 5 grams of vitamin C followed by 500 mg every 3 to 4 hours the first day.
2. Allow a zinc lozenge containing 10 to 20 mg of zinc in the form of zinc gluconate, zinc gluconate/glycine, or zinc acetate to dissolve in the back of your mouth. Keep the lozenge in the back of the mouth for at least 5 to 10 minutes or as long as you can. Zinc does not work once it's in the stomach, it works when it is in direct contact with pharyngeal tissues in the throat that have the virus. Therefore, swallowing the lozenge prematurely reduces its effectiveness. After the first lozenge has melted, wait a few minutes and place another lozenge in your mouth. Repeat the zinc lozenge every hour for the next four hours and then reduce the frequency to every two to three hours while awake. If you wake up in the middle of the night, take the zinc lozenge again.
     The second and third days
Take 1,000 mg of vitamin C three times a day and continue the zinc lozenges every three to four hours.
     The fourth day and beyond: I don't think zinc and vitamin C are effective after the initial few days so there's no point in taking them after the third day.  Side effects of excess use of zinc lozenges include nausea and irritated throat or palate.
For more information, see www.raysahelian.com/commoncold.html or www.raysahelian.com/zinclozenge.html

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