SUPPLEMENT RESEARCH UPDATE 2005

See Newsletter 2006 for the more issues and the latest at Newsletter 2007. The newsletter is still being published as of 2016.

What readers are saying:
I really enjoy your newsletter. thank you so much for your research and presence on our planet.

Great newsletter, very fair, informative, with current, up to date research and information.  What I really enjoy about the newsletter is it's attempt to sort out truth from myth regarding supplements, what works, what does not, and it is all backed by research and study.  Very refreshing, because even today I hear people trying to sell products that cure almost everything.

Dr. Sahelian, I just wanted you to know how much I appreciate your SUPPLEMENT RESEARCH UPDATE Newsletter for its informative, useful, and authentic character.

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SUPPLEMENT RESEARCH UPDATE - by  Ray Sahelian, M.D.
Vol. 2,  Issue 19 -- December 15, 2005
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An estimated 23,000 emergency department visits in the United States every year are attributed to adverse events related to dietary supplements. Such visits commonly involve cardiovascular manifestations from weight-loss or energy products among young adults.

"I'm starting a detox program to clear out toxins from my body," said a friend. "What's your opinion?"
    Recently, several friends and patients have asked my opinion on "detox diets." Others have asked me about "liver or colon cleansing," or fasting. I know many people who have tried various "cleansing" methods including olive oil/lemon juice programs, colon irrigation, water and juice fasts, etc. I even came across some infomercials promoting herbal tablets that supposedly cleanse and rid the body of toxins. Do any of these work? And besides, what do people really mean when they use the words "detox" or "cleanse?" Many people who suffer from depression, fatigue, anxiety, allergies, digestive symptoms, headache, vague aches and pains, etc, think that these symptoms are due to accumulated toxins in their body. Are they right, or are they misdiagnosing the causation of their symptoms?
     At the bottom of the newsletter I elaborate on this issue. 

Cut Ovarian Cancer Risk by Half?
Woman who drink two or more cups of tea every day may cut their risk of ovarian cancer in half. Both black and green teas are rich in antioxidant chemicals called polyphenols, which have been shown to block cancer growth in lab and animal studies. For details, see http://www.raysahelian.com/ovariancancer.html and http://www.raysahelian.com/polyphenols.html

Good News for Those with Chronic Bronchitis or COPD
Japanese researchers at Kagoshima University Hospital found that supplements of omega-3 fatty acids appeared to improve patients' breathing difficulties -- possibly by countering the airway inflammation seen in the disease. Omega-3 polyunsaturated fatty acids are found largely in oily fish, and to a lesser extent in flaxseed, walnuts, soybeans and canola oil. COPD is a group of serious lung diseases that includes emphysema and chronic bronchitis. Half of the 64 patients drank a liquid supplement rich in omega-3 fats each day; the other half drank a supplement containing omega-6 fats, another type of polyunsaturated fat found in many foods, including vegetable oils and meat. After two years, patients in the omega-3 supplement group showed an overall improvement on tests that measured their breathing during a short bout of exercise. See http://www.raysahelian.com/omega3.html

The Cleansing Controversy
Q. My wife and I love your site and info. We would like your opinion about something. We just read a book which mentions a cleansing diet consisting of: 2 Tbsp. lemon or lime juice (organic) 2 Tbsp. genuine, pure, organic maple syrup 1/10 tsp. cayenne pepper 10-12 oz. purified water. The book states this cleansing diet helps purify the liver and:-helps dissolve and eliminate toxins and congestion.-helps cleanse the kidneys and digestive system.-helps purify the glands and cells-helps eliminate unusable waste and hardened material in the joints and muscles.

      A. There is no doubt that we are exposed to countless harmful substances in our environment - hormones, pollutants, pesticides, drugs, oxidants, toxins, and heavy metals. We are exposed to these toxins through food, water, air, and skin. And in many cases it is relatively easy to point the blame to these harmful substances for causing or aggravating certain diseases. For instance, it is clear that many inhaled pollutants can aggravate asthma symptoms. But, many people are eager to blame their symptoms to toxins even if there is no proof that they are the cause. For instance, toxins are certainly not the cause for the majority of cases of fatigue, yet some people who are tired all the time are ready to blame toxins for their condition. And then they undertake drastic steps - for instance a water or juice fast - which in some cases makes them feel even worse. And when they feel worse, they incorrectly think the reason is because toxins are being removed from their body. Most likely the reason is low caloric intake, low protein intake, muscle tissue breakdown, low glycogen stores in the liver, low blood sugar, etc.
     We probably all have toxins accumulated in our system. And what is the best way to deal with them? I believe undertaking several long term measures are a better approach than drastic short term steps (although perhaps a minority of those trying a drastic diet may notice some benefits such as mental clarity or a sense of wellbeing, others may get worse). For instance, rather than fasting for a few days, I prefer reducing caloric intake to perhaps 1000 or 1200 calories a day over a period of 2 to 3 weeks. I am not convinced that any of the so called drastic "detox diets" that recommend a strict regimen of lemon juice, olive oil, apple cider vinegar, cayenne, etc, etc, are beneficial. Through all my years of medical education, I have come to realize that the body does not like going off balance too much and for too long. Our body tries to maintain homeostasis, a balanced state where everything is functioning properly. Fasting, or these drastic detox regimens alter this homeostasis, often in a harmful way. Liver glycogen stores are depleted, alterations occur in the mineral and electrolyte balance in the blood, muscle and bone tissue start breaking down, changes occur in the acid base balance, alterations occur in the fatty acid composition of cells, and immune function may be impaired.
     Eating a very healthy diet, low in calories, is a better option in the long run. Eat more raw, fresh and organic fruits and vegetables, reduce dairy intake, reduce meat products, eat more whole grains, consume fish caught in the wild, drink more varieties of teas, drink fresh vegetables juice, add more herbs to your food, avoid or dramatically reduce sugar and baked goods, use some antioxidant supplements and herbs (there are many to choose from). Also, drink filtered water and wash your fruits and vegetables. See
http://www.raysahelian.com/antioxidant.html  

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SUPPLEMENT RESEARCH UPDATE
Vol. 2,  Issue 18 -- December 1, 2005

Do you drink decaf coffee or regular? "Decaf coffee increases heart disease risk," was the heading of some newspaper articles after a study was published 2 weeks ago. How worried should you be?
    
First, a little background: the 187 study subjects were randomly assigned to one of three groups: noncoffee drinkers, coffee drinkers and decaf drinkers, who drank three to six cups a day for two months. At the end of the study period, there were no significant differences among the three groups in fasting glucose or insulin, total cholesterol, HDL (the good cholesterol) or triglycerides. However, decaf coffee led to a minimal increase in LDL levels (the bad cholesterol).
     Based on this iffy and preliminary result, the news media went on a hype and scare tactic. I personally am not concerned. First, people were asked to drink 3 to 6 cups a day, and even then the effects were minimal. Apparently some antioxidants may be removed along with the caffeine while processing regular coffee to decaf. Those who drink one or two cups of decaf coffee a day should not worry at all. Besides, the sugar, cream, or artificial sweeteners added to the drink are much more likely to be harmful. Those of you who drink more than 3 cups of decaf or regular coffee should consider perhaps substituting herbal teas. Why not expose your body to many other types of beneficial antioxidants in various teas rather than the same ones in coffee? And to avoid the harm from sugar, use stevia to sweeten your teas. For details on the study, see
http://www.raysahelian.com/cholesterol.html


Common Cold Season is Here - Are Zinc Lozenges Safe?
Over the years there has been a great deal of controversy regarding the usefulness of zinc lozenges in the treatment and prevention of the common cold. My personal observations lead me to believe zinc lozenges are one of the most potent natural nutrients in alleviating the severity and length of the common cold. But are they safe?
     To evaluate the safety of zinc gluconate glycine lozenges in elderly individuals with 1 or more health conditions, with or without a cold, a double-blind, placebo-controlled trial enrolled men and women between 60 and 91 years of age, who self-administered 1 zinc lozenge or placebo lozenge every 3 to 4 hours for 6 days. One or more of the following conditions was present in the study population: arthritis, cancer, depression, heart disease, hypertension, lung disease, osteoporosis, prostate disease, and stroke. No significant adverse events were noted. The researchers conclude that zinc lozenges are safe and well tolerated by a geriatric population.

See http://www.raysahelian.com/zinclozenge.html

     My thoughts: If you do use zinc lozenges, make sure they slowly and completely melt in the back of your  mouth and the throat. They are no good if swallowed. The zinc needs to be exposed to the back of the throat, even if it takes several minutes for the lozenge to dissolve. At the earliest onset of a cold, use them as often as every 2 hours, and then reduce the frequency to every 3 to 4 hours for the next day or two.

Ginkgo Good For Vision, Dementia, and Stress
I'm excited to report to you a summary of three new studies regarding the benefits of ginkgo biloba. For details,

     In the first study, ginkgo supplements given to older individuals improved the functioning of the visual system leading to better processing of visual input. In the second study, ginkgo supplements were given to patients with dementia, or mental decline. The herb led to improved quality of life and positive mood. The third study was done in rats. Ginkgo supplements given before a stressful event led to a better ability to adapt to stress and protected the rats from mental deficits.
     My thoughts: There are no accepted standards for how often ginkgo should be used. Just to be safe, a 40 mg extract once daily is a good option, or perhaps twice daily. For a comprehensive brain formula with 30 mg of ginkgo, see Mind Power Rx.

Alternative Migraine Remedy
German researchers report that feverfew extract has potential for migraine headache help. The researchers conducted a study with 170 migraine patients. At the beginning of the trial, migraine frequency was approximately five attacks over a 4-week period. The subjects were then randomly assigned to treatment with feverfew or placebo three times a day for up to 16 weeks. In the feverfew treatment group, migraine frequency declined by two attacks per month. In the placebo patients, the corresponding decrease was only one per month. Analysis of responder rates revealed that feverfew was 3 times more effective than placebo.    
     For more information on headache help, see http://www.raysahelian.com/feverfew.html or http://www.raysahelian.com/headache.html

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SUPPLEMENT RESEARCH UPDATE
Vol. 2,  Issue 17 -- November 15, 2005

Flip-flopping. We heard this term a lot during the last presidential election. But changing an opinion or re-analyzing data can happen in medicine, too. According to a trial published in the November 2005 issue of the journal Stroke, a supplement consisting of folic acid, vitamin B6, and B12, reduced the risk of stroke. The B vitamins lower blood levels of homocysteine -- an amino acid linked to heart disease. In a previous report from the Vitamin Intervention for Stroke Prevention study group, it was reported that the vitamin therapy did not reduce recurrent stroke and cardiac problems. When the scientists re-analyzed the results in a subgroup of 2,155 subjects deemed most likely to respond to treatment, the combined vitamin therapy did appear to reduce stroke and cardiac events by 20%.
     My comments: Sometimes we think results of studies are hard facts that are totally objective, and immune to manipulation or interpretation. However, the study above, and many others, indicate that when we analyze in more detail, and look at subsets of patients, there are groups that do benefit from a particular intervention.  I personally also change my viewpoints - and the information on my website - depending on the results of latest results. That's what science does, it adapts to new information. For more details on this study, see
http://www.raysahelian.com/stroke.html

1. Friendly Bacteria Can Make Your Gut Less Irritable
Good news for those with irritable bowel syndrome (IBS). A beneficial strain of bacteria called Bifidobacterium infantis has been found to stabilize bowel movement frequency in patients with IBS who experience either constipation or diarrhea. To determine the impact of the probiotic on bowel movement frequency, Dr. Quigley, from University Cork College in Ireland assigned 85 female patients with IBS to treatment with the probiotic for 4 weeks and 80 to treatment with a placebo. For patients with very frequent or very few bowel movements, the bacteria had a significant effect in normalizing the frequency. This appears to be a unique finding since other agents tested in IBS have tended to be helpful in either a diarrhea-predominant group or a constipation-predominant group, but not in both. Changes in bowel frequency were accompanied by significant improvement in individual symptoms, such as pain and bloating.
See http://www.raysahelian.com/ibs.html for additional info on this condition. See also http://www.raysahelian.com/probiotics.html

     My thoughts: Even though the researchers looked at bifidobaceterium, alone, it's quite possible other friendly bacterial supplements, such as acidophilus, could be helpful.

2. Passion Flower and Kava Together Help Mice Sleep Better
It s
eems like many people I know have some difficulty getting a deep sleep. Some of the causes include a sedentary daily routine, lack of adequate exposure to sunlight, stimulants such as coffee or high doses of certain supplements, late night TV viewing and bright lights. Many people try to find a natural herb as a sleep aid. There are a few herbs and nutrients that have some relaxation and sleep inducing properties. It's difficult to predict the best choice for each person. Some of the supplements and herbs that could be helpful include 5-HTP, tryptophan, melatonin, hops, passion flower, valerian, and kava. The timing can make a difference. For instance, some herbs initially cause alertness for 2 to 4 hours, followed by sleepiness, kava being an example. In a new study in mice, researchers found that the combination of passion flower and kava was more effective than either herb alone. Whether humans will respond as well to this combination has not been evaluated. For more information on passion flower, see http://www.raysahelian.com/passionflower.html, and for tips on how to sleep better, see http://www.raysahelian.com/sleep.html
     My thoughts: According to new research, while sedative drugs, such as Restoril and Ambien, improve sleep in older people with insomnia, the risks of such therapy outweigh the benefits. The improvements are modest, and the risks include thinking difficulties and daytime fatigue. I think pharmaceutical sleeping pills are okay to use once in a while (a few times a month), but not regularly every night.

3. Aphrodisiac Tongkat Ali has Additional Benefits
One of the most popular herbs for sexual enhancement used in Asia, particularly Malaysia, is tongkat ali. Numerous rodent studies show tongkat ali to have aphrodisiac properties, including a recent one that showed this herb was able to arouse sexually sluggish old rats. But, this herb has additional properties, including anti-malarial and anti-breast tumor activity. A new report published by researchers at the National University in Malaysia indicates certain extracts in tongkat ali can slow the growth of breast cancer cell line MCF-7.
     My thoughts: Tongkat ali is a potent aphrodisiac, sometimes too potent. The reason I say this is that in order to get a quick sexual enhancement, a high dose is needed. But this high dose, even if taken in the morning, can cause insomnia that evening. A high dose can also cause restlessness and increased body temperature. I prefer to enhance sexuality the slow way, by taking a lower amount and being patient for a period of several days. Tongkat ali is found in Passion Rx, and I have tried to formulate this product using an amount of tongkat ali that minimizes the side effects of overstimulation and insomnia. It is too soon to tell whether a small amount of tongkat ali taken most days of the week, such as a quarter of a 400 mg capsule, would be appropriate for those with breast cancer. What happens in a laboratory dish does not necessarily reflect what happens in the whole body when an herb is ingested on a daily basis.
     For more information, see http://www.raysahelian.com/tongkat_ali.html

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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SUPPLEMENT RESEARCH UPDATE
Vol. 2,  Issue 16 -- November 1, 2005

Everybody is talking about the Bird flu. Last week a major weekly magazine called me to find out if I had any ideas on how to prevent or treat Bird flu if it ever occurred in humans in the USA. Since I have not seen any research in this area regarding natural supplements, I told the reporter that I could not say anything for certain. But, it does make sense that any steps one takes towards improving one's immune system could make it less likely to catch this condition or make the symptoms less severe if it ever occurs. I have Top Ten  suggestions on how to keep your immune system at its best at http://www.raysahelian.com/immune.html. But keep in mind: most of us, at this time, are infinitely more likely to catch a cold, another common bug, bronchitis, flu or another infection than to worry about the Avian flu.... at least in the short term foreseeable future.
     There may be some compounds in plants that could have an influence on the Bird flu bug. If I come across any, I will mention it in a subsequent newsletter.

Carnosine helpful in Vegetarians and Diabetic Nephropathy
In recent years carnosine has been getting more respect. This nutrient, made of 2 amino acids, alanine and histadine, is gradually getting a reputation as a powerful natural antioxidant. Unfortunately, carnosine is hardly found in a vegetarian diet. Hence, those who don't eat meat products may benefit from taking this nutrient as a supplement. A recent study also points to carnosine being potentially helpful in diabetic nephropathy (kidney failure) by preventing damage from high sugar levels.
     My comments: Most carnosine capsules are sold in 500 mg. One option is to take carnosine as a supplement two or three times a week, in the morning. This nutrient has a mild mood balancing effect. Another option is to take half a capsule three or four times a week.
See http://www.raysahelian.com/carnosine.html for additional info.

Butterbur for Allergic Rhinitis
Allergic Rhinitis is not an infection. It occurs when the body’s immune system over-responds to specific, non-infectious particles such as plant pollens, molds, dust mites, animal hair, industrial chemicals (including tobacco smoke), foods, medicines, and insect venom. There have been several studies evaluating the role of butterbur in this condition, and most, but not all, show some benefit. In the latest study done in Switzerland, butterbur was shown to be as effective as an antihistamine. See http://www.raysahelian.com/butterbur.html

Bilberry, Cataracts, and Macular Degeneration
Cataracts and macular degeneration are major causes of blindness and decline of visual acuity in the elderly. There is a belief that the loss of vision and damage to rods and cones may be due to free radicals. Hence, there has been a great deal of hope that antioxidant supplementation could be helpful. Bilberry has potent antioxidants called flavonoids. You can tell by the deep blue/purple color that these flavonoids are potent. Scientists in Brazil gave rats with early senile cataract and macular degeneration regular diets and compared them to another group who received additional bilberry extract.  Supplementation with bilberry extract prevented damage and decline in function in the lens and retina. The researchers say, "Long-term supplementation with bilberry extract is effective in prevention of macular degeneration and cataract."
     My comments: Whether the same visual benefits will occur in humans is not known at this time, but bilberry extract looks promising, and occasional use seems appropriate. Some of you history buffs may recall that during World War II, British Royal Air Force pilots mentioned that their night vision was clearer whenever they ate bilberry preserves before starting out on their evening bombing raids.
     There are a number of herbal extracts and supplements that could be beneficial for visual health. For more information, see http://www.raysahelian.com/bilberry.html

Massage Therapy changes Brain Chemistry
You don't always need a supplement to change levels of brain chemicals. Did you know that while you are lying on a massage table slipping your cares away, there are biochemical changes going on? Massage reduces levels of the stress hormone cortisol, and increases levels of brain chemicals serotonin and dopamine. This can lead to a relaxed, balanced, and upbeat mood. See http://www.raysahelian.com/dopamine.html for the abstract of the study.

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SUPPLEMENT RESEARCH UPDATE
Vol. 2,  Issue 15 -- October 17, 2005

Did you know you can search my entire web site, by a keyword search on google or yahoo? For instance, let's say you are searching for the keyword 'vision.' You would go to yahoo or google and type in the following: vision site:raysahelian.com and immediately you will see all the pages that mention the word vision. If you are looking for information on hair, you would type the following: hair site:raysahelian.com. It's that easy. The reason I point this out is because not all the pages on my site are indexed on my home page which has 300 listings. There are actually twice as many pages on the site. It's a lot of work to constantly update the information, but I enjoy it and I hope that I am providing a good service to those who are looking for a complementary approach to improve their health. I must add, though, that you should consult a health care practitioner who knows your medical condition well before making any sudden or significant changes to your supplement or diet regimen.

1. Shed More Tears - Does Diet Influence Dry Eyes?
Twenty years ago, when I was just starting out as an intern in family practice at a hospital in Philadelphia, one of my first patients was a woman in her 60s who complained of having dry eyes. It's interesting that throughout medical school we are taught on how to deal with major health issues such as heart attacks, cancer,  diabetic emergencies, trauma, etc., but we were hardly taught how to deal with common simple complaints encountered in a day to day medical practice. I had no idea what to recommend to this patient. I left the office and went over to consult with the chief of the residency program. He had no solutions except recommending wetting eye drops. Therefore, it was a pleasant surprise when I recently came across a study that pointed to the possibility that diet may play a role in dry eyes.     
     I'm starting to believe quite strongly that quite a number of medical conditions are associated with an overconsumption of omega-6 fatty acids at the expense of omega-3 fatty acids. Many people obtain high amounts of omega-6 fatty acids by eating too many baked goods, vegetable oils (safflower, sunflower, corn, etc.), and margarine. Omega 3 fatty acids are found in flax seeds and flaxseed oil, coldwater fish (primarily salmon, halibut, and tuna), and some in soybeans and walnuts.
     In this study conducted at Harvard School of Public Health, in Boston, the researchers tried to determine the association between the dietary intake and ratio of n–3 and n–6 fatty acids and dry eyes syndrome occurrence. Of the 39876 female health professionals in the Women’s Health Study, 32470 women aged 45–84 years of age who provided information on diet. Of the sample, 1546 (4.7%) of the women reported dry eyes. The ones who had a high dietary intake of omega-3 fatty acids and lower intake of omega-6 fatty acids had a lower incidence of dry eyes. The researchers did not evaluate to see if omega-3 fatty acid supplements improved their condition, and it would be quite interesting to do such a trial 
See http://www.raysahelian.com/dryeyes.html

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

Question of the Month - Why are Dr. Sahelian's dosages sometimes different than dosages used in research studies?
Q. In your 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?
     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.

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SUPPLEMENT RESEARCH UPDATE - by  Ray Sahelian, M.D.
Vol. 2,  Issue 14 -- September 30, 2005

"Green Tea Halts Alzheimer's Disease in Mice," was a headline commonly seen in newspapers and on the internet. Apparently an ingredient in green tea that researchers think might fight cancer may also protect the brain from the memory-destroying Alzheimer’s disease. Scientists injected mice with an antioxidant from green tea called epigallocatechin-3-gallate (EGCG) and said it decreased production of beta-amyloid, a protein that forms the plaques that clog the brains of Alzheimer’s victims. Several months of injections reduced plaque formation by as much as 50 percent.
     I like green tea and think drinking green tea or taking a green tea extract supplement may be beneficial in a number of conditions, including cancer prevention. But whether drinking green tea will halt Alzheimer's disease in humans is to soon to say. If you decided to drink more green tea or take green tea extract supplements to prevent AD after hearing or reading the news, just don't overdo it. Keep in mind that green tea has compounds that have a stimulating effect and so it's best not to drink the tea or take the supplement after early afternoon, otherwise it will influence your sleep. I like to drink a different tea each morning. On my kitchen counter you will find licorice tea, hyssop, mint, lemon balm, green, chamomile, peppermint, fennel, ginger, rosehips; and hops for nighttime. There are lots of other good herbs and nutrients for AD.

The SuperSperm Supplements
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 at the Polytechnic University of Marche, 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. The results showed that the combination of carnitine and acetylcarnitine had the best outcome with improvement noted in sperm motility and velocity. The antioxidant capacity of the sperm fluid also increased.
     My comments: 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, particularly if analysis shows their sperm do not swim well or are slow movers.  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. Higher doses could lead to overstimulation, restlessness, and insomnia. 

For the full abstract, see http://www.raysahelian.com/acetylcarnitine.html or

Two additional recent studies regarding acetylcarnitine:
It appears to be an effective and well-tolerated nutrient for the treatment of chemotherapy-induced peripheral neuropathy.
May help improve visual acuity in those with macular degeneration, particularly when combined with fish oils and CoQ10. For more info, see the link above. Another popular product that supports visual health is Eyesight Rx.

Pomegranate, Osteoarthritis, and Prostate
In the past month it has been widely reported that pomegranate fruit may be beneficial for osteoarthritis. At Case Western Reserve University, researchers found pomegranate extract decreased levels of an inflammatory chemical called interleukin-1b (IL-1b) and it also curbed enzymes that erode cartilage. This was done in a laboratory, not on animals or humans. Other studies show pomegranate to have anti-cancer and antioxidant properties beneficial for those who have high lipid levels. And this week, researchers found that when human prostate cancer cells were injected into mice, feeding the animals pomegranate extract delayed the appearance of tumors. Tumor growth was significantly inhibited and survival was prolonged.
     My comments: Whether drinking pomegranate juice or taking a pomegranate extract supplement reduces symptoms and signs of osteoarthritis in humans or slows prostate cancer is yet to be determined. But, rather than just drinking orange or apple juice (as most Americans do), it would be wise to incorporate other fruit juices in one's diet to broaden exposure to different beneficial flavonoids and carotenoids.
     As to osteoarthritis, there is growing acceptance that supplements such as glucosamine, chondroitin, MSM, and CMO could be beneficial. For details see http://www.raysahelian.com/osteoarthritis.html or http://www.raysahelian.com/pomegranate.html

Question of the Month - Can 5-HTP and Prozac be taken together?
5-HTP or 5-hydroxy-tryptophan is a nutrient that, not long after taken as a supplement, goes to the brain and gets converted into serotonin. The biochemical sequence is as follows: The amino acid tryptophan converts into 5-HTP, which in turn converts into serotonin. At night, serotonin converts into melatonin.
     To put it simply, Prozac, along with its cousins Zoloft, Paxil, and the other SSRIs (selective serotonin reuptake inhibitors) help lessen depression by making more serotonin available in the brain. Even though the mechanism of action of the SSRIs is different than 5-HTP, the end result is that there is more serotonin available in brain tissue, resulting in better mood balance. There is a condition known as serotonin syndrome which results from too much serotonin. Some of the symptoms include confusion, sweating, elevated blood pressure, and rapid heart beat. Serotonin syndrome sometimes occurs when the dosage of the SSRIs are too high, or when they are combined with other medicines that increase serotonin or brain chemical levels. Hence, tryptophan and 5-HTP, if taken in very high doses along with SSRIs, could potentially lead to serotonin syndrome. Having said this, it is possible that the combination of 5-HTP and Prozac could be helpful in some people if the dosage of the Prozac is reduced (let's say by half) and the initial amount of 5-HTP is started very conservatively at half of a 50 mg capsule and symptoms are monitored closely. The dosage of 5-HTP can be gradually increased if needed. Here is an example where the approach of combining a drug and nutrient could be quite useful, as long as one proceeds cautiously, with medical supervision, and temporarily stops the medicines at the first sign of serotonin excess.

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SUPPLEMENT RESEARCH UPDATE
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.

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

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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SUPPLEMENT RESEARCH UPDATE
Vol. 2,  Issue 12 -- August 25, 2005
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Cheese - butter - bread. I admit I had more than my share on my recent trip to France visiting cousins I had not seen for more than 10 years. Fifteen of us rented a country guest house in the Loire Valley. Each day we went to visit castles and tour the beautiful medieval towns. In the evenings, it was fine cuisine and plenty of French baguette - a long narrow loaf of bread used for sandwiches or thick slabs of butter and fromage (cheese). Even though here in America there is a growing awareness of the importance of eating unprocessed bread, the French seem to consume these fiber-less crusty baguettes as if they were officially blessed health food items. One of the most basic health promoting steps you can take is to avoid consuming white bread, but rather choose whole, unrefined, sprouted, multi-grain bread. And if possible, choose breads from different bakeries to get a variety of different grains. I recognize that you can often only find these kinds of whole breads at a health food store, and many of you may live in rural areas with access only to regular giant food stores that don't carry these better options. Perhaps once in a while you can visit a distant town that has a health food store where you can purchase these breads and keep them in the freezer for long term use. By the way, for those who are interested, of the six castles I visited, my favorite was Chenonceau.

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

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.

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
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

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

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

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

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

Question of the Month:
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"?
   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
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. 
   

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

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.

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.

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

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.


Question of the Month:
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?
   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
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
   

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

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

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
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.

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.

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.


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.

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SUPPLEMENT RESEARCH UPDATE
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.

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


What's the difference between fish oil and cod liver oil? There's little mention about cod liver oil anymore.
   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

Emails:
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
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.    

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

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

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

Question of the Month - Sorting out the Sweet Stevia Story
For more information, see http://www.raysahelian.com/stevia.html

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SUPPLEMENT RESEARCH UPDATE
Vol. 2,  Issue 5 -- May 2005
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The more I learn about supplements and their powerful benefits, the more I become convinced of this fact: Medical knowledge does not necessarily advance in an ideal direction for the benefit of humankind. Most of the time it advances in the direction that is most profitable to the people in control of the research funds and in control of advertising and promotion -- whether they are pharmaceutical or nutraceutical companies. I am hopeful, though, as more people recognize the benefits of supplements, the direction of research will shift more towards nutritional and herbal medicine. We all recognize how much modern surgical knowledge and procedures have advanced. But, our current knowledge and clinical use of natural supplements and herbs in modern medicine is as rudimentary as surgical knowledge was a century ago.
      I am quite pleased that the number of subscribers to this newsletter is growing at such a rapid rate -- 4,000 a month. Starting in May  we will begin sending the newsletter twice a month. There's just so much I would like to share with you. I wish to continue to have a growing positive impact on the course of natural medicine by sharing some of my knowledge to a wider audience. Hence, feel free to forward this newsletter to friends who have an interest in these topics.

Can Prostate Cancer Risk be Reduced with Supplements?
I have no doubt that cancer is influenced by diet, perhaps more so than most doctors are willing to admit. But can supplements influence prostate cancer risk?
      Several
trials over the past few years have shown that supplementation with selenium or vitamin E is associated with a reduction of prostate cancer risk. In a new study published recently, researchers wanted to find out whether supplementation with low doses of several antioxidant vitamins and minerals could reduce the occurrence of prostate cancer. The trial comprised 5,141 men randomized to take either a placebo or a supplementation with nutritional doses of vitamin C, vitamin E, beta-carotene, selenium and zinc daily for 8 years. Biochemical markers of prostate cancer risk such as prostate-specific antigen (PSA) and insulin-like growth factors (IGFs) were measured. During the follow-up, 103 cases of prostate cancer were diagnosed. Overall, there was a moderate reduction in prostate cancer rate associated with the supplementation. However, the effect differed significantly between men with normal baseline PSA and those with elevated PSA. Among those with normal PSA, there was a significant reduction in the rate of prostate cancer for men receiving the supplements. The researchers say, "Our findings support the hypothesis that chemoprevention of prostate cancer can be achieved with nutritional doses of antioxidant vitamins and minerals."
     My comments: There are a number of other supplements that have been studied in relation to prostate cancer prevention or treatment, at least in the laboratory or in mice. These include curcumin (from turmeric), lycopene (found in tomatoes), silymarin (in milk thistle), genistein (in soy), and many others. For a full discussion, see http://www.raysahelian.com/prostatecancer.html

Ginger and Pregnancy
Ginger appears to help pregnant women who suffer from morning sickness, without side effects to the unborn child, according to a review of medical literature. In six studies that examined the effects of ginger in reducing nausea and vomiting in expecting mothers, ginger worked better than a placebo, or inactive drug, and as well as Vitamin B6, which has been shown to improve nausea and vomiting in some pregnant women. None of the women who took ginger had problems with their pregnancies, the authors report in the journal Obstetrics & Gynecology. See http://qww.raysahelian.com/ginger.html

Garlic and Blood Pressure
An ingredient in garlic appears to prevent a potentially deadly type of high blood pressure affecting the lungs, at least in rats. The garlic ingredient, called allicin, seems to ward off pulmonary hypertension, or high blood pressure in the arteries that bring blood to the lungs. In humans, pulmonary hypertension can lead to potentially fatal complications in the heart and blood vessels. Humans would need to eat two cloves of garlic every day to equal the rats' dose of allicin. Garlic has also been evaluated in regular hypertension.
     My comments: I was in the gym recently and ran into an elderly friend, Jerry, who is 75. He still works out regularly. I asked him how he was doing and he said, "Terrible. My doctor put me on blood pressure pills and I've got no energy left."
     Elevated blood pressure has many causes, and one of them is constriction of arteries. I believe diet has a great influence on blood pressure. Many compounds found in fruits and vegetables -- such as flavonoids --  have blood vessel dilating properties. It's been shown that a diet high in vegetables and fruits can reduce blood pressure. If modern medicine had focused even a tenth of its resources on natural approaches to dealing with hypertension that it spends on finding new antihypertensive drugs, we would be so much more ahead in our knowledge. And patients like Jerry would have better blood pressure control without suffering the vitality-draining side effects of these drugs.
For more information, see http://ww.raysahelian.com/hypertension.html

Lycopene Helpful for Oral Leukoplakia
Leukoplakia is a common, potentially pre-cancerous disease of the mouth characterized by white spots on the mucous membranes of the tongue and inside of the mouth. People with leukoplakia are typically middle-aged and older adults; men are more likely than women to develop the disease. The risk is much higher in smokers and users of smokeless tobacco. Betel nut chewers in Asia are also at high risk.
    In this study, 58 patients with oral leukoplakia were divided into three groups. Group A got 8 mg of lycopene per day, Group B took 4 mg lycopene and Group C was the placebo group. The duration of the therapy was three months. The response rate in Groups A, B, C were 80%, 66% and 12% respectively. Histological evaluation too had similar results. The researchers say, "The observed effect of lycopene suggests that it can be effectively and safely used for the management of oral leukoplakia."

     My comments: Here's another example of a simple nutrient that can be helpful for many people but yet is little known by the medical community.
The standard medical approach to this condition is surgical excision.
For details, see http://ww.raysahelian.com/lycopene.html

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

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

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SUPPLEMENT RESEARCH
Vol. 2,  Issue 4 -- April 2005
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I attended a natural supplement expo in Anaheim, California two weeks ago and the exhibition halls were thriving and full of activity. It's wonderful that the public's interest in natural medicine is growing. I really sense that more people are finding out that in order to have optimal health, they have to take matters into their own hands. Their doctors just don't know it all.

1. Green Tea and Cancer
Researchers at the University of Murcia in Spain and the John Innes Center in Norwich, England have shown that a compound called EGCG in green tea prevents cancer cells from growing by binding to a specific enzyme. They showed for the first time that EGCG, which is present in green tea at relatively high concentrations, inhibits the enzyme dihydrofolate reductase, which is a recognized, established target for anti-cancer drugs. Green tea has about five times as much EGCG as regular tea. Green tea has been suspected to decrease rates of certain cancers but scientists were not sure what compounds were involved or how they worked. Nor had they determined how much green tea a person would have to drink to have a beneficial effect. EGCG is probably just one of a number of anti-cancer mechanisms in green tea. For a full discussion,
see http://www.raysahelian.com/greentea.html

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.


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

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


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

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

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

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

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

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

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

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

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SUPPLEMENT RESEARCH UPDATE
Vol. 2,  Issue 3 -- March 2005
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I never completely trust the results of a single study even though the media often makes a big deal of newly published research. I like to see several trials come to a similar conclusion before I am convinced of the results. Case in point: Two years ago, a study was published in the Journal of the American Medical Association that St. John's Wort did not improve depression. A week ago, another study appeared that St. John's Wort is as good as a pharmaceutical drug in fighting depression. Which results should we trust? See the full discussion below.

St. John's Wort for depression -- Who's right?
Did you see this headline a couple of weeks ago? "Major new study finds proprietary St. John's Wort extract at least as effective as popular prescription anti-depressant." Perhaps you recall another headline from 2 years ago "JAMA study fails to support the efficacy of St. John's Wort in moderately severe major depression." Well, one of these results has to be wrong... right?
     In the latest report, according to a randomized, double-blind clinical study published in the prestigious British Medical Journal, a St. John's Wort extract was at least as effective in treating depression and better tolerated by patients than the widely prescribed anti-depressant paroxetine, known by the product name Paxil (a SSRI similar to Prozac). In the study, 251 patients with moderate to severe forms of depression were divided into two groups: one receiving 900 mg/day of WS(R) 5570 (a proprietary form of St. John's Wort), and the other 20 mg/day of paroxetine, for six weeks. The results: St. John's Wort produced as good an improvement with fewer side effects.
     My comments: In order to know with a greater sense of certainty the effectiveness of a particular herb or medicine, several studies over a period of time have to be evaluated. At this point, the majority of studies testing St. John's wort have found that this herb has mood lifting effects. The dose required varies, ranging from 300 mg to 900 mg a day. Another good mood lifter is SAM-e. Here's another interesting report: Adults taking Prozac, Paxil, and Zoloft are more likely to attempt suicide than those given sugar pills. For more information, see www.raysahelian.com/stjohn.html or www.raysahelian.com/depression.html

Black Cohosh for the treatment of hot flashes in women
Hot flashes cause significant disturbances in postmenopausal women, including women with breast cancer. A pilot study was undertaken to evaluate the effectiveness of black cohosh in reducing hot flashes. Women who reported significant hot flashes (greater than 14 per week) were enrolled. The first week was a no-treatment baseline period, and therapy was given for the subsequent 4 weeks. Patients reported an average of 8 hot flashes per day during the baseline week. The reduction in mean daily hot flash frequency was 50%, while weekly hot flash scores were reduced 56% at completion of the study. Overall, patients reported less trouble with sleeping, less fatigue, and less abnormal sweating. No patients stopped therapy because of adverse effects. Conclusion: black cohosh appeared to reduce hot flashes and had a low toxicity.
     My comments: As with St. John's Wort discussed above, the results of studies evaluating black cohosh in the therapy of menopausal symptoms have not been consistent, but the majority of studies lean towards this herbal extract providing some sort of benefit, but certainly not in any way as powerful as estrogen itself. But estrogen has its risks, and, if needed, should be used at the lowest effective dose and hopefully not for very extended periods.  See www.raysahelian.com/blackcohosh.html

Nutrients that may have positive benefits in Prostate Cancer
A mix of dietary supplements including antioxidants and plant-based estrogens may slow the rise of a PSA, a marker for prostate cancer progression. The study of 37 men with the disease found that 6 weeks on the supplements generally lowered patients' levels of androgens such as testosterone, which stimulates prostate cancer growth. PSA is a protein produced by the prostate gland; rising PSA levels in a man's blood often signals cancer or, in men already diagnosed with the disease, cancer progression. The supplement mixture included a powder-based drink that contained green tea extract, a soy extract supplying estrogen-like compounds called phytoestrogens, and carotenoids such as lycopene. The men in the study, all of whom had prostate cancer and rising PSA levels, used the supplements for 6 weeks; each also used inactive, or placebo, supplements for another 6 weeks. The patients' androgen levels were lower when they were on the supplement compared with when they were taking the placebo. The current findings are in line with studies of the general population that suggest diets rich in antioxidants and phytoestrogens may lower the risk of prostate cancer. Fruits and vegetables are prime antioxidant sources, while phytoestrogens are found in foods such as soybeans and soy products, whole grains and flaxseed. Many phytoestogens found as supplements include beta sitosterol, genistein, and daidzein.
     Two interesting notes: 1. Mortality rates for most men diagnosed with prostate cancer in the United States are not much higher than those in the general population. Most men diagnosed with prostate cancer can expect to live as long as men their age without the disease. 2. The value of prostate specific antigen (PSA) screening tests in reducing prostate cancer mortality is still in question.
    
For more information, see www.raysahelian.com/prostate.html

Short Updates
1.
Does Food Cause Acne? -- spread the word to everyone you know with Acne
Can medical advice be wrong for decades? Certainly, as we have found out in the last few years regarding the risks of synthetic hormone replacement therapy. Doctors for decades had been prescribing Premarin to postmenopausal women, and in the last few years we found out that these hormones actually increase the risk of many medical conditions. Well, it now appears that medical denial regarding the association between food and acne may have been wrong for decades.
     I remember as a teenager going to a dermatologist who emphatically denied that my diet had anything to do with my skin breaking out in pimples. He prescribed antibiotics which made me feel terrible, including nausea and fatigue, and the antibiotics helped very little. For some reason, I had a gut feeling that he was wrong, that diet must have something to do with my skin condition. Interestingly, the search for this relationship eventually led me to change my college major from business to nutrition science, and then on to medical school. This changed the course of my life.
     Well, it took a few decades for me to find out that the consumption of at least one food now appears to either cause acne, or make acne worse. Unfortunately it is a food that many teenagers consume a lot of... milk. And it may not be the lactose, the protein or the fat in milk. It may just be the natural hormones that are present in milk. After all, milk comes from a lactating cow. Foods that I think improve acne are cold water fish and vegetables. For a full discussion of acne and its relation to diet, see
See www.raysahelian.com/acne.html

2. Smoking and Impotence
Smoking raises the risk of impotence, particularly in younger men. Researchers found that among the more than 1,300 men they followed, those who smoked were at greater risk of erectile dysfunction than either former smokers or non-smokers. See www.raysahelian.com/impotence.html for additional causes of impotence.

3. More on the Vitamin E controversy
You may recall in previous issues I discussed the shortcomings of the highly publicized Vitamin E study that indicated that high doses of Vitamin E supplements greater than 400 units caused increased mortality. Do you remember I mentioned that the study was partially flawed since the researchers did not differentiate between synthetic Vitamin E supplements versus a combination of several natural Vitamin E compounds such as alpha tocopheral, gamma tocopherol, and others? Well, a new study published in the February 2005 issue of the American Journal of Clinical Nutrition validates my point. In the article entitled "Relation of the tocopherol forms to incident Alzheimer disease and to cognitive change," the researchers conclude "Our results suggest that various tocopherol forms rather than - tocopherol alone may be important in the Vitamin E protective association with Alzheimer disease." I hope future researchers who evaluate the role of Vitamin E supplements in health and disease consider two important aspects: 1. Whether supplements have synthetic or natural vitamin E, and 2. Whether the supplements have only one type of tocopherol such as alpha-tocopherol, or whether the supplements include the whole Vitamin E complex such as alpha, gamma, delta, and others. For more details, see www.raysahelian.com/vitamine.html

Emails from Subscribers:
I recently had a divorce and now having lots of court dates and legal battles with my ex. I've always been a happy person but now could tell I was slowly falling into a depressive state. Within 2 days of taking 200 mg of SAM-e, I noticed a shift in my mood. I believe SAM-e prevented me from sinking deeper into depression.

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SUPPLEMENT RESEARCH UPDATE
Vol. 2,  Issue 2 -- February 2005
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We're in the middle of cold and flu season and I hope, thus far, you have not had the need to take a dolly to Costco to bring home several giant boxes of tissue. I have some suggestions on how to reduce the severity and duration of the common cold. In this issue I also discuss the important connection between tryptophan, serotonin, and melatonin.     

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

Tryptophan taken orally can convert into serotonin and melatonin
Tryptophan is an amino acid available in food. A few years ago tryptophan reappeared on the market as an over the counter supplement. The biochemistry of tryptophan is fascinating and quite important. It has been known for some time that in the body and brain, tryptophan gets converted into 5-hydroxy-tryptophan (5-HTP) which then converts into serotonin, a crucial brain chemical involved in mood, appetite, impulse control and sleep. Serotonin, in turn, is able to convert at night into melatonin.
     To confirm this knowledge, tryptophan was given to a group of rats at 8 am in the morning, and to another group of rats at 8 PM at night. Four hours after administration, researchers measured the blood and brain fluid levels of serotonin and melatonin. During daytime administration, tryptophan raised the levels of serotonin. Interestingly, when tryptophan was given at night, serotonin levels did not increase, but melatonin levels increased significantly. Therefore, the serotonin that was generated by tryptophan administration was being converted into melatonin.
     Another study I came across in the January 2005 issue of the Journal of Pineal Research indicates that 5-HTP is a more potent antioxidant than Vitamin C.
     My comments: First, this study confirms again that levels of 5-HTP, serotonin, and melatonin can be influenced by supplements. Second, it shows that the timing of a supplement can make a difference on how it is metabolized. Since tryptophan, 5-HTP, and melatonin are available as supplements, I have had many questions over the years asking which one is best to take for depression, sleep, anxiety, or appetite control. This is difficult to answer since each person has a different biochemistry and would respond differently. The most reliable way to find out is by trial and error. There's really no practical blood study that can be done to determine which supplement someone will respond to, and in what dosage. As a rule, melatonin is most helpful for sleep and does not have a strong influence on mood or appetite. 5-HTP has a strong influence on mood, appetite and anxiety. Tryptophan has been used for depression and sleep.
For more information, see www.raysahelian.com/tryptophan.html

Short Updates
Probiotic supplements for children -- Many infants and children may be lacking beneficial bacteria, and supplements could potentially help them get fewer infections. Compared with standard formulas, those containing beneficial "probiotic" organisms seem to reduce the number and duration of diarrhea episodes in infants attending childcare centers. Of two types of probiotics tested -- Lactobacillus reuteri and Bifidobacterium lactis -- Lactobacillus may be the better supplement, according to the report in the medical journal Pediatrics. Probiotic supplements
affect the immune response by improving the intestinal microbial balance leading to enhanced antibody production. Another study indicates that children who take probiotic supplements suffer fewer respiratory infections.

See www.raysahelian.com/probiotics.html

Stroke prevention -- Stroke is one of the feared conditions in old age and fortunately much can be done to reduce the risk. For one, how a food is prepared can make a difference. Seniors eating tuna or fish that's been broiled or baked appears to lower stroke risk, but frying the catch of the day may increase it. Investigators found that people aged 65 and older who ordered frequent servings of tuna or other types of broiled or baked fish were up to 30 percent less likely than people who ate fish less than once per month to experience a stroke over a 12-year period. Diet has a strong influence on the fish oils, ginkgo biloba and vinpocetine.
See www.raysahelian.com/stroke.html
for more suggestions on stroke prevention and www.raysahelian.com/diet.html for advice on the ideal diet.

Question of the month -- Fish oil versus Flaxseed oil
Q. What is your opinion on fish oil supplements, and why not just take flaxseed oil since it has omega 3s? How much is needed to take daily?
A. There are several Omega 3 fatty acids. They are named ALA (alpha linolenic acid ), EPA (eicosapentanoic acid) and DHA (docosahexanoic acid).
ALA is found in flaxseed oil whereas EPA and DHA are found in fish oils. ALA is able to convert into EPA and then into DHA, but this takes several enzymatic steps in the body, and not everyone efficiently converts ALA into EPA and DHA, particularly with aging. So, the bottom line, I prefer fish oils to flaxseed oil, although a small amount of flaxseed oil is also good to take. For those of you who don't want to take any fish products, DHA, extracted from algae, is sold by itself.
www.raysahelian.com/dha.html


Emails from Subscribers:
For about nine months I had mixed results using another product that contained Beta-Sitesterol plus a number of minerals such as, Zinc, Copper, Manganese, etc. etc.. I replaced the aforementioned supplement with Prostate Power Rx and within two to three weeks I experienced a truly significant improvement in my condition. Now after about six weeks of use I am a very happy camper. I now only get up during the night ,one or two times as opposed to three, four and sometimes five times. Also, during the day I have very much more control over my need to find a men's room. I highly recommend Prostate Power Rx.

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SUPPLEMENT RESEARCH UPDATE - by  Ray Sahelian, M.D.
Vol. 2,  Issue 1 -- January 2005
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Happy New Year to all of you and I hope 2005 brings you good health, more joy and love, and many other blessings. I am excited to report several interesting research findings with herbs that make me continue wondering when the medical profession will finally take a serious look at all the amazing natural products that are available to help prevent or treat many conditions that modern medicine has not treated adequately with standard drugs.   

Ginkgo Improves Blood Flow to the Eyes
Individuals with diabetes mellitus have problems with circulation and increased clotting tendencies, particularly in small blood vessels. This can sometimes lead to poor vision due to small clots that form in the retina of the eye. In a recent study done in Taiwan, ginkgo biloba was given to type 2 diabetes mellitus patients with eye problems (retinopathy). After taking ginkgo biloba orally for 3 months, the tendency for blood to clot was significantly reduced, red blood cells became more flexible, and blood flow to the retina of the eye was increased. When red blood cells become more flexible, they are able to squeeze through and maneuver easier through tiny blood vessels called capillaries and thus bring more oxygen to tissues and cells.
   My comments: It's difficult to know how much ginkgo to take, but it appears that 40 mg daily is a good option. If you are taking aspirin or other blood thinners, consult with your doctor to make sure you are not thinning your blood too much. Ginkgo is best taken in the morning or midday. Sometimes it can cause shallow sleep if taken late in the evening. For more information, see www.raysahelian.com/ginkgo.html

Hurry for Curry - and Curcumin
I really like Indian cuisine and visit local Indian restaurants in Marina Del Rey quite frequently. So, I was glad to see a study evaluating the benefits of curcumin.
Turmeric (Curcuma longa) is a plant native to south India and Indonesia. It has been used since antiquity as a condiment, as a textile dye, and as a medicine. Curcumin is the substance that gives the spice turmeric its yellow color. Curry powder which is extensively used in Indian cuisine, such as curry chicken, is largely made of turmeric.  
   It now appears that curcumin may be able to break up the "plaques" that mark the brains of Alzheimer's disease patients. Scientists found that curcumin was able to reduce deposits of beta-amyloid proteins in the brains of elderly lab mice that ate curcumin as part of their diets. Furthermore, when the researchers added low doses of curcumin to human beta-amyloid proteins in a test tube, the compound kept the proteins from aggregating and blocked the formation of the amyloid fibers that make up Alzheimer's plaques.
Accumulation of beta-amyloid proteins in the brain is one of the hallmarks of Alzheimer's disease that leads to damage to nerve cells and the resulting loss in memory and cognitive function. Long used as part of traditional Indian medicine, curcumin is known to have some anti-cancer properties, and animal research suggests it might serve as a treatment for multiple sclerosis and cystic fibrosis. Interest in curcumin as an Alzheimer's therapy grew after studies found low rates of the disease among elderly adults in India, where curry spice is a dietary staple. Curcumin is a powerful antioxidant and has anti-inflammatory properties. And since oxidative damage and inflammation mark a number of diseases of aging - such as arthritis and the buildup of plaques in the heart's arteries - curcumin eventually may prove to be useful for a range of age-related conditions.
   My comments: For those who prefer to take a capsule of curcumin rather than cook with curry or turmeric, curcumin supplements are available.
For more information, see www.raysahelian.com/curcumin.html or www.raysahelian.com/alzheimer.html

Butterbur for Migraine Headaches
An extract of the root of a plant called butterbur (Petasites hybridus) reduces the frequency of migraine headaches. An article published in the December 2004 issue of Neurology reports a trial that compared butterbur with an inactive placebo. Researchers compared the effectiveness of two different doses of butterbur extract in about 230 migraine patients. They had experienced two to six attacks per month for the 3 months prior to the study. The number of migraine headache attacks per month was reduced by 45 percent in the group that took 75 milligrams of butterbur twice daily, compared with a reduction of 28 percent in the placebo group during the 16-week trial. A group that took 50 milligrams of butterbur twice daily experienced a 32 percent decrease, not significantly different from placebo. The butterbur extract was well tolerated, the team reports, with burping as the only adverse event occurring more frequently in the active treatment groups. There were no changes in blood pressure, heart rate, or routine laboratory tests.
     My comments: I have personally not used butterbur in my practice, so I don't have first hand experience with it. As with many herbs and medicines, it is likely that some users will find butterbur reduces the severity or frequency of their migraine headache, whereas others may not find it to be helpful. How butterbur interacts with standard pharmaceutical medicines
-- such as beta blockers or triptans -- used for prevention or treatment of migraines is currently not known.
For more information, see www.raysahelian.com/butterbur.html

Short Updates
1. Statin drugs, such as Lipitor or Zocor, widely used for lowering cholesterol, may slightly impair brain function and perhaps harm brain cells. Doctors have known for quite some time that these drugs cause muscle tissue damage and lower CoQ10 levels in the blood. How statins interfere with optimal brain function is not clear, but my best guess is due to interference with cholesterol metabolism. Cholesterol is involved in the formation of pregnenolone and other hormones in the brain. These hormones are crucial for memory. There's still so much we don't know about the long term risks of statins. I only recommend their use in cases of very high cholesterol levels where natural remedies have failed. Besides, even though lowering cholesterol is important, too much emphasis has been placed on cholesterol reduction as opposed to reducing the whole inflammatory process that leads to clogging of vessels with plaques.
See www.raysahelian.com/cholesterol.html

2. Are there any safe pain medicines left for osteoarthritis? The last few months have shattered the notion that pharmaceutical arthritis pain medicines are safe for long term use. The Cox-2 inhibitors Vioxx and Celebrex are practically out of the picture; naproxen (sold as Aleve), also might increase the risk of heart attack or stroke; ibuprofen (Motrin) can cause damage to the small intestine; and acetaminophen (Tylenol) is no more effective for arthritis pain than placebo; and besides, long term use may harm the liver. I remember treating several people during my residency years who had come to the hospital with liver damage from acetaminophen toxicity. And do you know what we used to help their liver recover from the toxicity? A natural supplement called Acetycysteine, which is a powerful antioxidant.
     So, what are left that have a good safety record thus far for long term use? Our herbal and nutritional friends -- glucosamine, chondroitin, MSM, and other natural herbs and nutrients.
See www.raysahelian.com/arthritis.html


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SUPPLEMENT RESEARCH UPDATE
Vol. I, Issue 5 -- December 2004
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I hope by now you have recovered from your several thousand calorie Thanksgiving feast. I know I needed a nap after the meal, which can be embarrassing if you are with company.. After dessert I think I dosed off for a while on the sofa. Fortunately it's okay to do that around family members.
     Last month I mentioned the vitamin E study where researchers found that taking more than 400 units a day could potentially shorten lifespan. As I read reports about this -- and the scary hype -- in newspaper articles and listened to medical commentators on TV, I realized again how little the media, and so called experts, know about the topics they are discussing and the information, or misinformation, they are disseminating. I didn't come across any comments regarding the fact that the study did not differentiate between synthetic and natural viamin E, nor did the study discuss one form of vitamin E intake, such as synthetic dl-alpha tocopherol, versus taking a natural complete vitamin E complex that includes several tocopherols, such as alpha, beta, and gamma. This made me even more determined to increase  the number of subscribers to my newsletter so I can have a wider influence regarding interpretation of studies on supplements.
    
Vitamin E and CoQ10 work well together for heart and circulation
One of the early signs of vascular disease is inflammation within the walls of the arteries. This inflammation attracts white blood cells and other types of cells floating in the blood to the damaged inner lining of the arteries, resulting in plaque formation and increased likelihood of clotting. The initial inflammation and subsequent damage can result from a number of factors, including oxidation or free radical damage, high cholesterol, and high homocysteine.
     Researchers gave 21 baboons a high fat, high-cholesterol diet (just like my Thanksgiving meal) daily for 7 weeks and measured the blood level of a substance you will hear of more in the future called CRP, short for C-reactive protein. CRP is a marker for inflammation. The higher the CRP, the more damage to the inner lining of a blood vessel, like the coronary arteries in the heart. At the end of the 7 weeks, they continued with this high fat, high cholesterol diet, but this time they added vitamin E. The addition of vitamin E reduced the level of CRP. Then they added COQ10 on top of the vitamin E for another 2 weeks. They discovered that the levels of CRP dropped even further. The researchers conclude, "Dietary supplementation with vitamin E alone reduces the baseline inflammatory status that is indicated by the CRP concentration in healthy adult baboons. Co-supplementation with CoQ10 significantly enhances this effect of vitamin E."
     Dr. Sahelian says: For those of you with a heart condition or high cholesterol, or a family history of heart disease, it would make sense to take vitamin E complex and CoQ10. Discuss with your doctor if these are appropriate for your condition. A reasonable amount would be 30 to 200 units daily of natural vitamin E complex, or 100 to 300 units two or three times a week since vitamin E is fat soluble and can be stored in fat cells. As to CoQ10, a range of 20 to 60 mg is appropriate, a few times a week. CoQ10 is also fat soluble and is best taken with breakfast. Vitamin E can be taken with any meal.
For more information, see www.raysahelian.com/coq10.html

SAMe better than Prozac?
A couple of issues ago I mentioned the role of SAMe in joint health and how Vioxx, the so called arthritis wonder drug, got kicked out since it was causing an increased risk of heart attacks. This week new research indicates that SAMe, also spelled SAM-e, may give the boot to Prozac and other SSRIs. Actually I'm being a little premature. Researchers at
the Massachusetts General Hospital in Boston found out that SAMe carries quite a punch. When standard medication with selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil and Zoloft, failed to improve depression symptoms in 30 patients, adding the dietary supplement SAMe saved the day. The researchers found that when they added the dietary supplement SAMe to the patients' treatment for six weeks, half saw their symptoms improve and 43 percent had a complete remission. SAMe, short for S-adenosyl-L-methionine, is a substance produced naturally in the body that is involved in a number of biochemical processes including the making of several brain chemicals that relay messages between nerve cells. A larger trial is being conducted with more patients, and the scientists will also test the combination of SAMe together with standard antidepressant therapy.
     My comments: I have personally taken SAMe just to see what it would do, and it is quite a powerful mood lifter. Perhaps I'm sensitive to nutrients, but I notice the effects on 100 mg, sometimes even less. Almost all the tablets on the market are 200 mg. If you plan to take SAMe under medical guidance, here's a few tips your doctor may not know. It's best taken in the morning before breakfast for a quick absorption, or it can be taken with breakfast if you want to slow the effects. I notice within one to two hours being more alert and more motivated to do things, and in a better mood. Many of the clinical studies have used several hundred mgs, but in the long run this can cause side effects. The most common are overstimulation, insomnia, and headache. You can actually feel anxious and restless if you take too much. If you wish to take a small amount, bite off half or a third of a 200 mg tablet and use the rest the next day. You may need to adjust your dose down over the next few days since it can start building up in the system, or you can take a day or two off. Each person is unique in their response.

Short Updates
An FDA advisory panel refused to recommend approval of a new testosterone skin patch to treat low libido in women, saying that its manufacturer, Procter & Gamble, did not provide enough evidence that it is safe for long-term use. The panel voted unanimously that the company did not have sufficient data to show that prolonged exposure to testosterone is safe in women. This is good, since there are natural herbs that work just as well or better to enhance female libido, such as muira puama, tribulus, horny goat weed, and tongkat ali. They may take a few days to fully work. Passion Rx, a combination product with 11 herbs, works within hours. See www.raysahelian.com/female_libido.html

Some vegetarians have metabolic signs indicating a vitamin B-12 deficiency leading to a substantial increase in total homocysteine concentrations. High blood homocysteine levels can damage arteries and make blood clot more easily. Vegetarian may also not get enough CoQ10, Carnitine, Creatine, and omega 3s. See www.raysahelian.com/vegetarian.html for suggestions on which supplements you may need if you are vegan or vegetarian.

Substances in kale, spinach collard greens, broccoli, turnips, and other green vegetables help protect aging eyes from cataracts. These vegetables contain carotenoids such as lutein and zeaxanthin. It's best to take a full range of carotenoids as opposed to just one or two. If you eat a lot of fresh produce, you would not need to take supplements, you're probably getting enough carotenoids. See www.raysahelian.com/carotenoids.html

In a test tube study, several phytoestrogens found in common herbal products were found to be powerful inhibitors of human prostate tumor cells. These were quercetin (
found in onions, apples, berries, tea), genistein (found in soy), epigallocatechin gallate (in green tea), curcumin (in turmeric or curry powder)) and resveratrol (in grapes, red wine). See www.raysahelian.com/phytoestrogens.html

Question of the month
Q. What's you opinion on human growth hormone? Does it have anti-aging activity as some claim?
A. HGH stimulates the growth of muscles and bones and helps regulate metabolism. Human growth hormone can sharply increase the flow of sugar into muscle and fat, stimulate protein production in liver and muscle, and slow the production of fatty tissue. HGH is available as a prescription injectable medicine that costs more than 10,000 dollars a year if injected daily for "anti-aging" purposes. And there is no proof at this time that it helps people live longer, or that it is safe. Some supplement companies are promoting over the counter HGH products. Without going in detail, I can make a blanket statement that none of these have adequate studies to support the claims since it would take years and decades to test something like this. In short, don't waste your money on HGH products. For a more in depth discussion, see www.raysahelian.com/hgh.html

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SUPPLEMENT RESEARCH UPDATE
Vol. I, Issue 4 -- November 2004
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The elections are over and half of you are thrilled while the other half of you are disheartened. The whole process seemed quite exhausting and I'm glad it's over. Now the media can focus on other topics. ABC 20/20 did just that last week when they had a segment on sexual myths and they reported that natural aphrodisiacs do work. I was glad to hear that because ever since I wrote Natural Sex Boosters and formulated Passion Rx, reporters who have interviewed me seemed quite skeptical that herbs actually could be potent sex boosters. I think this mentality is gradually going to change over the next few years... and hopefully put a dent in the profit margins of drug companies.
      This week I turn 47. It's hard to believe since I still think of myself being in my 30s. Time sure passes quickly.  I hope the information in this newsletter and my website helps you stay healthy and happy as long as possible. By the way, if you wish to forward this newsletter to your friends, feel free to do so.


Are you taking too much vitamin E?
Researchers at Johns Hopkins University in Baltimore pooled data from 19 trials of vitamin E supplementation. These included nearly 136,000 subjects who were randomly assigned to take vitamin E or placebo capsules and were followed for more than a year. Overall, vitamin E supplementation did not affect mortality rates. However, the trials testing doses of 400 IU daily or higher showed 39 more deaths occurred per 10,000 people taking high-dose vitamin E than among the same number of people taking a placebo. For low doses of vitamin E -- less than 150 IU daily --  mortality rates were slightly decreased.
     Dr. Sahelian says: I always thought that, for most people, taking more than 100 to 200 units a day of vitamin E was not necessary. The one problem with this study, though, is that it probably did not make a distinction between synthetic vitamin E supplements and natural vitamin E. On a supplement label, natural vitamin E is listed as d-alpha tocopherol. In contrast, synthetic forms of vitamin E are labeled with a dl- prefix.
Also, the study did not account for the d-alpha form of vitamin E versus a natural Vitamin E supplement that includes all the tocopherols and tocotrienols. Even though it is a flawed study, I still think 50 to 200 units a few times a week is quite adequate.

Lipoic acid--a crucial nutrient--are you wasting half your money?
One of my favorite nutrients is alpha lipoic acid. I just call it lipoic acid for short.
Lipoic acid is a powerful natural antioxidant slowly becoming recognized as having some unique properties in the therapy and prevention of a broad range of diseases. In addition to being a powerful antioxidant, alpha lipoic acid helps the body use glucose, hence lipoic acid's potential role in improving blood sugar control, particularly in diabetics. But, did you know almost all the lipoic acid currently sold is actually 50% effective? This is because the conventional lipoic acid available on the market is actually two different molecules, mirror images of each other. These two forms are R and S. Most lipoic acid supplements have both of them in equal amounts. S lipoic acid is basically useless and not used by the body. So, if you buy 100 mg of lipoic acid, you are basically paying for 50 mg. For this reason, I formulated a product for Physician Formulas that has only R-Lipoic acid. The raw material for R-Lipoic acid is much more expensive, but it's worth the extra cost to put natural and pure lipoic acid in your body. When I take lipoic acid in the morning, I notice an improvement in visual clarity that comes on by the afternoon. Although the ideal dose for long term use is not known, my current guess is that 20 to 50 mg a few times a week is sufficient.

Anti-aging action of Cordyceps extract in mice
Cordyceps, one of the better-known traditional Chinese medicines, consists of the dried fungus cordyceps sinensis growing on the larva of the caterpillar. It is commonly used in China for the replenishment of body health. One of the known pharmacological effects is its anti-oxidation activity. Cordyceps is also known as an immune system stimulant. To investigate the anti-aging effect and mechanism of cordyceps, aged mice were treated with cordyceps extract. After six weeks, the scientists found that cordyceps significantly increased their ability to learn, remember, and it improved the activity of their antioxidant systems.
     Dr. Sahelian says: There are many herbs, mushrooms, and supplements that have shown similar properties. I think it's probably a good idea to take cordyceps a few times a month. I generally prefer not to take the same herb or supplement every day and all the time. It's good to take breaks and have variety.
For more information, see www.raysahelian.com/cordyceps.html


Q. How much vitamin B is necessary? Most of the B-complex I see in the stores are 50 and 100 mg tablets.
A. The RDA or daily value for most of the common B vitamins such as B1, B2, and B6 is about 2 mg, yet many supplements on the market have 50 to 100 mg of these B vitamins, which equates to 10 to 50 times the RDA. I really don't think we need that much. As a general rule, I would recommend taking anywhere between 2 to 10 mg a day of these Bs. For more information, see www.raysahelian.com/bvitamin.html

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SUPPLEMENT RESEARCH UPDATE
Vol. I, Issue 3 -- October 2004

I happen to be in a very balanced and relaxed state of mind since I just returned from a week-long bicycle trip in Lancaster County, Pennsylvania, riding the back roads and seeing up close the beautiful Amish and Mennonite farms. I also had a chance to have dinner with an Amish family and visit their farm... I just love their simplicity, humility, honesty and down to earth nature. After the bicycle tour I attended a supplement expo trade show in Washington DC to see what was hot and happening and to do a book signing at my publisher's booth.
    

Acetyl-l-Carnitine versus testosterone for sexual function, mood and energy
Can acetyl-l-carnitine, a natural nutrient, be just as good for aging men as testosterone? In this Italian study, a total of 120 men (age range 60 to 74) were randomized into three groups. Group 1 was given testosterone, the second group was given propionyl-L-carnitine 2 grams a day plus acetyl-L-carnitine 2 grams a day. The third group was given a placebo. Testosterone, carnitines and placebo were given for 6 months. Testosterone and carnitines significantly improved performance on several tests that measure sexual function, mood, and energy. These tests included nocturnal penile tumescence, Depression Melancholia Scale score, and fatigue scale score. Carnitines proved significantly more active than testosterone in improving sexual function. Testosterone significantly increased the prostate volume and testosterone levels; carnitines did not. Carnitines and testosterone proved effective for as long as they were administered. No major side effects were reported within the 6 month study period.
Dr. Sahelian says: As I interpret this study, carnitines appeared to be slightly more effective and safer than testosterone. Both carnitines and testosterone improved male sexual function, mood, and energy levels. However testosterone increases prostate volume which could cause symptoms of prostate enlargement and perhaps prostate cancer in the long run. Even though the study used high doses of carnitines, for long term, life-time use, I don't think most people should exceed 100 to 500 mg a day.

Users of Supplements have reduced Health Care Costs
A new study says that users of dietary supplements have improved health and reduced health care costs by billions of dollars. The study, commissioned by the Dietary Supplement Education Alliance found that the five selected dietary supplements – calcium, folic acid, omega-3 fatty acids, glucosamine and saw palmetto have the potential to positively affect health status and significantly reduce health care costs. Just two of these supplements, calcium and folic acid, if taken regularly, could save Americans $15 billion over a five-year period if taken regularly.
Dr. Sahelian says: I am often asked which supplements one should take on a regular basis. This is hard to answer since, just like a shoe, one size does not fit all. However, vitamins C, E, B complex, fish oils, and psyllium appear to be safe and potentially helpful, along with calcium.
For details, see  www.raysahelian.com/diet.html

Tryptophan and Kava reincarnated
The natural health industry is gradually feeling more confident in promoting two supplements that have a controversial history. Tryptophan was banned in 1990 due to a contaminated batch that caused many health problems while kava was associated a couple of years ago with liver problems. However, it now seems that tryptophan -- which is used for sleep, anxiety, and mood support -- is quietly returning to the market. Kava is also resurfacing with new preparations that do not appear to have the alleged toxicity of some previous high concentration extracts that were marketed in Europe.
Dr. Sahelian says: I think these two supplements still have role to play in helping people with anxiety, mood support and sleep, and their occasional use appears to be safe.
see www.raysahelian.com/kava.html

Vioxx kicked out... more room for SAM-e, MSM, Glucosamine and Chondroitin
As most of you have heard by now, Vioxx, a COX-2 inhibitor used for arthritis, has been pulled off the market due to increased risk for heart attacks and strokes. It appears that more people may now explore safer nutritional options such as glucosamine, chondroitin, MSM, and SAM-e. S-Adenosylmethionine (SAM-e) is a dietary supplement best known in the management of depression, and sometimes used for osteoarthritis symptoms. Studies evaluating SAM-e in the management of osteoarthritis have been limited to non steroidal anti-inflammatory drugs (NSAIDs) for comparison. The present study compared the effectiveness of SAM-e (1200 mg) to a cyclooxygenase-2 (COX-2) inhibitor Celebrex (celecoxib 200 mg) in 56 people with osteoarthritis )OA) of the knee. Celebrex is similar in function to Vioxx. This was a randomized double-blind cross-over trial that lasted for 16 weeks. Subjects were tested for pain, joint function, mood status, and side effects. Results: In the first month, celecoxib showed significantly more reduction in pain than SAM-e. By the second month, there was no significant difference between both groups.
Dr. Sahelian says: SAM-e has a slower onset of action but appears to be as effective as celecoxib in the management of symptoms of knee osteoarthritis. Longer studies are needed to evaluate the long-term effectiveness of SAM-e and the optimal dose to be used. I personally prefer that the maximum daily dose of SAM-e to not exceed 100 mg a day. This means cutting a 200 mg tablet in half or biting off half. Since SAM-e is expensive, the low dose minimizes the cost. High doses of SAM-e can lead to irritability, overstimulation, and insomnia.
For more information about SAM-e, see www.raysahelian.com/sam-e.html

Take your ADHD child on a nature walk
Is attention-deficit hyperactivity disorder partly due to a deficiency of exposure to nature? New research suggests parents may find some relief for their children's ADHD symptoms by going back to nature. A study of 452 parents of children with ADHD found that activities in "green" spaces such as farms, parks and even backyards often seemed to temporarily mellow the children's symptoms. Children were more likely to show improved behavior in the hours after an outdoor, green activity than after activities performed indoors or in concrete-and-steel settings.
For more information about ADHD, see www.raysahelian.com/adhd.html
 

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SUPPLEMENT RESEARCH
Vol. I, Issue 2 -- September 2004

Safety of long term Creatine ingestion
To investigate long-term effects of creatine monohydrate supplementation, 18 professional basketball players of the Spanish Basketball League participated in a longitudinal study. The subjects ingested 5 g creatine monohydrate daily during three competition seasons. Blood was collected five times during each of the three official competition seasons (September 1999-June 2000, September 2000-June 2001 and September 2001-June 2002). Standard clinical examination was performed for 16 blood chemistries. Results: blood studies over a 3 year period did not indicate any major abnormalities.
     Dr. Sahelian says: Daily supplementation with 5 grams of creatine monohydrate 8 months of the year appears to be safe. Still, I would prefer taking an additional one week off each month just to be extra safe.
For more details, see www.raysahelian.com/creatine.html

Maximum daily dose of CoQ10
The safety and tolerability of high dosages of coenzyme Q10 were studied in 17 patients with Parkinson's disease in an open label study. The subjects received an escalating dosage of coenzyme Q10--1200, 1800, 2400, and 3000 mg/day with a stable dosage of vitamin E (alpha-tocopherol) 1200 IU/day. The blood level reached a plateau at the 2400 mg/day dosage and did not increase further at the 3000 mg/day dosage. 

I'm still not comfortable recommeding dosages of CoQ10 above 100 mg a day for prolonged periods until we have at least a 3 year study of high doses given to humans. Another study shows that CoQ!0 and Vitamin E work well together in reducing inflammatory symptoms.

Melatonin for Migraines... and Asthma?
Melatonin is a natural hormone secreted by the pineal gland in the brain and is involved in regulating the circadian cycle. There is increasing evidence that melatonin secretion is related to headache disorders, Dr. Mario Peres, of Hospital Israelita Albert Einstein, in Sao Paulo, Brazil note in the medical journal Neurology. "Altered melatonin levels have been found in cluster headache, migraine with and without aura, menstrual migraine, and chronic migraine," the researchers write. The research team tested the effectiveness of melatonin for preventing migraine, with or without aura, in 34 sufferers. The participants were given 3 milligrams of melatonin 30 minutes before bedtime. Among the 32 subjects who completed the study, 25 experienced at least a 50 percent reduction in headache frequency after three months of treatment. Melatonin also decreased headache intensity and duration, and overall use of painkillers and drugs to treat a migraine decreased.

     I find this study to be very interesting but I'm not ready to endorse the long term use of 3 mg without taking breaks, perhaps a week off each month, or 2 days off each week, and maybe trying lower doses such as 1 mg to see if they work just as well. Click the link below for another study that showed melatonin improves sleep in those with asthma.
For more details, see www.raysahelian.com/melatonin.html or www.raysahelian.com/asthma.html

Ulcer relief with Probiotics in Yogurt
Up until recently, peptic ulcer disease was thought to be caused by an imbalance between acid and pepsin secretion, as well as defensive factors such as bicarbonate secretion and gastric mucosal barrier. The isolation of Helicobacter pylori from patients with chronic gastritis and duodenal and gastric ulcers has revolutionized thinking about the causes of ulcers. Current data suggest that persistent infection with Helicobacter pylori may account for peptic ulcer disease. In this study, 59 adult volunteers infected with H. pylori were given Lactobacillus- and Bifidobacterium-containing yogurt (AB-yogurt) twice daily after a meal for 6 weeks. Eleven subjects positive for H. pylori infection were treated with milk placebo as control subjects. H. pylori bacterial loads were determined with use of a breath test, which was performed before and 4 and 8 weeks after the start of AB-yogurt supplementation. Results: Yogurt containing probiotics suppressed H. pylori infection.
     Dr. Sahelian says: When you purchase yogurt, makes sure the label says that it contains these organisms. Or, you may directly supplement with probiotics.
For more details, see www.raysahelian.com/ulcer.html

5-HTP and Vitamin B6
Vitamin B6 (pyridoxine), when given daily to rats, increases production of 5-HTP and serotonin. For those who are not familiar with the biochemistry of serotonin production, here's a quick summary. Tryptophan, an amino acid found in food or available as a supplement, converts into 5-HTP, which in turns converts into serotonin. Vitamin B6 is involved in this process. At night, serotonin is able to convert into melatonin, the sleep hormone.
     Dr. Sahelian says: A daily multivitamin or B complex providing 2 to 10 mg of vitamin B6 should be adequate to allow this biochemical process to proceed properly. For details, see www.raysahelian.com/5-htp.html

Do you have a fertility problem?
Dr. Sahelian says: Those of you with fertility problems may consider the nutrients carnitine and acetyl-l-carnitine. Their combined use has been shown to improve sperm motility.
For more details, see www.raysahelian.com/fertility.html
 

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SUPPLEMENT RESEARCH
Vol. I, Issue 1 -- August 2004

Tell your urologist about this study before he or she works on your prostate
I found it really interesting that an herb could be used before surgery to reduce the complications after the operation. The aim of the study conducted at Clinica Malzoni, Avellino, Italy was to evaluate the efficacy of a pretreatment with saw palmetto to reduce bleeding during transurethral resection of prostate (TURP) in patients with benign prostatic hyperplasia. 108 patients received a pretreatment with a saw palmetto extract (320 mg a day) for at least 8 weeks before the TURP procedure and they were compared to a placebo group. In the placebo group patients did not receive any medical treatment before the intervention. Results: In the group treated with saw palmetto, bleeding during and after the operation was significantly lower than in the control group and the need of transfusion decreased remarkably. Moreover, in the saw palmetto group, the duration of postoperative catheterization lasted 3 days versus the placebo group who needed catherization for 5 days.

Dr. Sahelian comments: Ask your urologist whether it would be okay to take saw palmetto before a TURP procedure. I can't see how if would harm, and there is indication that it could be helpful.
for more information, see www.raysahelian.com/saw.html

Live longer by sipping red wine?
If you haven't already heard about resveratrol (pronounced rez-ver-a-trawl), you will soon. Resveratrol has been in the news a great deal lately. Extensive research from all over the globe contiunes to accumulate about the benefits of this interesting compound. Studies show resveratrol is anti-inflammatory, antioxidant, anti-infective, and it activates the longevity gene. Recent laboratory studies indicate that resveratrol has promising therapeutic activity in various cancers, including breast, prostate, and neuroblastoma. As to its anti-aging potential, resveratrol activates a cell's survival defense enzyme, which prolongs the time cells have to repair their broken DNA. As red wine is a rich source, many sources will reference resveratrol as "red wine polyphenols," "red-wine extract," etc. Unfortunately, there is a great deal of misinformation about resveratrol, keep the following in mind when reviewing articles and marketing information about related products. As resveratrol is found in the skins of grapes, red wine will provide several times more resveratrol than white wine. As resveratrol is vulnerable to fairly rapid destruction by light and oxygen, the fact that wine is stored in air-tight, cool conditions away from sun light protects the resveratrol content. Only immediately after a bottle of wine is opened is the maximum resveratrol potency available.

Dr. Sahelian comments: I'm not much of an alcohol drinker since I've never really appreciated the taste of alcohol as others do. But I've finally been convinced enough about the benefits of resveratrol that I've started drinking an ounce or two of red wine with dinner a couple of times a week. I'm actually starting to like the taste.
for more information, see www.raysahelian.com/resveratrol.html

Glucosamine and MSM work better together for arthritis
We all know the benefits of glucosamine and chondroitin for arthritis. Now it seems there's another nutrient that could be helpful in combination with glucosamine. This nutrient is known as MSM -- which stands for Methylsulfonylmethane. In the June 2004 issue of the journal Clinical Drug Investigations, scientists report that although the individual agents did improve pain and swelling in arthritic joints, the combined therapy was more effective than the single nutrients in reducing symptoms and improving the function of joints. In a clinical trial conducted at Nizam's Institute of Medical Sciences in Hyderabad, India, 118 patients with mild to moderate osteoarthritis were treated three times daily with either 500 milligrams of glucosamine, 500 milligrams of methylsulfonylmethane, a combination of both, or an inactive placebo. After 12 weeks of treatment, the average pain score had fallen from 1.74 to 0.65 in the glucosamine-only group. In MSM-only participants, it fell from 1.53 to 0.74. However, in the combination group, it fell from 1.7 to 0.36.
Dr. Sahelian comments: It would seem reasonable for those with arthritis to take this combination. The dose of glucosamine has been established to be 500 mg 3 times a day. We still don't know enough about MSM to determine whether lesser amounts than 500 mg three times a day would still be effective.

Can an herbal supplement improve your stamina?
Rhodiola rosea, also known as golden or Arctic root, grows in the Arctic regions of eastern Siberia. Rhodiola is a popular plant in traditional medical systems in Eastern Europe and Asia. Russians have drunk rhodiola tea for centuries as an energy booster. Russian and Chinese scientists have researched the benefits of Rhodiola for several decades. The purpose of this study conducted at Katholieke Universiteit Leuven in Belgium. was to two-fold. To investigate the effect of acute and long term 4-week Rhodiola rosea intake on physical capacity, muscle strength, and reaction time. During the acute phase of the study, subjects were given 200-mg of Rhodiola rosea extract and the results compared a few days later when they were given placebo pills. Subjects given rhodiola had sligthly more stamina. The time to exhaustion during exercise was 17.2 minutes compared to 16.8 min on placebo. Also, lung ventilation capacity improved during rhodiola treatment. In a second phase of the study, subjects subjects ingested 200 mg of rhodiola for 4 weeks. The results showed that there was no difference in stamina when compared to placebo.

Dr. Sahelian comments: It appears that Rhodiola rosea intake for a day or two can improve endurance exercise capacity, but long term use does not make much of a difference. Practically speaking, it would make sense to take breaks from use. Perhaps this recommendation could also apply to ginseng and other adaptogens.
For more information, see www.raysahelian.com/rhodiola.html

FAQs
Should diabetics drink more soy and less milk?
Kidney function of people with type 2 diabetes seems to be improved by dietary soy protein. A study of 14 older men with diabetes-related kidney disease found that adding a soy product to their diets reduced the amount of protein in their urine -- an indicator of improved kidney function. It's unclear why soy protein might aid in diabetic kidney disease, but estrogen-like plant compounds called isoflavones could be involved, said one of the researchers Dr. Erdman, a professor of food science at the University of Illinois at Urbana-Champaign. Isoflavones are types of flavonoids found in plants. The main sources for isoflavones are soy products, beans, peas, nuts, grain products, coffee, tea and certain herbs such as red clover. Genistein is one of the best known and studied isoflavones. Compounds in plants that have estrogen-like properties are called phytoestrogens. Most isoflavones have phytoestrogenic properties. For eight weeks, men in the study used an isolated soy protein powder that could be added to a drink or food. For another eight weeks, they used a milk-based protein powder. The goal, Erdman explained, was to have the men replace part of their usual protein intake with the soy or milk protein; however, the patients failed to follow the diet instructions and instead added the protein powders to their normal routine. Yet even with the extra protein intake, the men's excretion of protein in urine fell an average of nearly 10 percent when they consumed the soy product In contrast, protein levels in the urine increased with the milk-based powder. In addition, eight weeks on the soy powder boosted the men's levels of heart-healthy HDL cholesterol by about four percent, while it tended to dip while the men were on the milk protein. Blood tests showed that as the men's isoflavone levels increased, their protein excretion declined. SOURCE: Journal of Nutrition, August 2004.

For more information, see www.raysahelian.com/isoflavones.html

While I would like to think that I am open-minded, I am also somewhat of a skeptic about the claims made about nutritional supplements. The fact that you summarize the research on various supplements, as well as providing journal citations, allows me to placate my scientific mind. Yes, I know that you want to ultimately sell your supplements, and books, but that is fine with me. It is a fair trade for the good that your web-site and e-mails do for me. And no, I wasn't planning to stop using my joint supplement (Glucosamine, Chondroitin & MSM) just because CNN told me to. I know that the knee that I had 'scoped feels better when I am cycling than it used to.