Newsletter 2007 - Supplement Research Update Newsletter 2007

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

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

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

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

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

SUPPLEMENT RESEARCH UPDATE
Vol. 4, Issue 15 -- December 10, 2007

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Ginkgo biloba extends life?
I thought you might be interested in hearing about a French study that found that older people who take Ginkgo biloba may be living longer. Surprisingly, this same study did not find ginkgo biloba reduced the risk of cognitive decline. Dr. Jean-Francois Dartigues at the University of Bordeaux followed a group of 3,500 men and women 65 and older for over a period of 13 years. Those who used ginkgo lived a little longer than those who did not take the supplement. Ginkgo biloba extract has been sold in France for more than three decades. At the start of the study, 6 percent of the participants were taking Ginkgo biloba extract, The researchers found that while the effect of the herb on mortality risk remained significant, it had no effect on the likelihood of developing dementia. Journal of the American Geriatrics Society, March 2007. See http://www.raysahelian.com/ginkgo.html
   Comments: I can't say for sure that taking ginkgo will help you live longer. It is possible that the individuals who began taking ginkgo biloba may have been more health conscious to begin with and paid more attention to their overall diet which was the real factor for life extension. Or, the reason ginkgo blioba was not found to be helpful in reducing dementia is perhaps those who started the ginkgo may have had a family history of dementia or were already starting to notice some form of cognitive decline. Nevertheless, gingko biloba is a good supplement and I can't imagine taking 20 mg or 60 mg of the extract with breakfast a few times a week would pose any danger. I don't think it is necessary to take a ginkgo supplement every day. Mind Power Rx has 30 mg of ginkgo biloba extract per capsule. Those who are taking blood thinning medicines such as Coumadin should be careful since ginkgo has mild blood thinning properties.
   I don't think one herb or nutrient alone can be counted on to prevent dementia or treat cognitive decline. The brain is too complicated and needs many different nutrients. I prefer a mind boosting supplement that has a number of different vitamins, nutrients, and herbs combined in small amounts.

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

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

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

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

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

Regarding the new FDA guidance proposals on alternative medicine, see http://www.raysahelian.com/alternativemedicine.html and scroll down to the bottom of the page
 

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SUPPLEMENT RESEARCH UPDATE
Vol. 4, Issue 6 -- April 17, 2007
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Some of the most common questions my research staff and I are asked relate to how often a supplement should be taken, whether it is safe to use for prolonged periods, and whether a particular supplement can be taken the same day as another. It is very difficult to give answers that would apply to everyone since there are so many factors that influence your need or response to supplements. These factors include your age, sex, overall health status, activity level, climate you live in, diet, types of fluids consumed, alcohol or caffeine use, body weight, whether you are currently on prescription medicines, quality of the herbal products, your sensitivity and tolerance, whether the herbs are whole herb or extracts, whether the supplements are taken with food or on an empty stomach, the time of day they are used, and the dosage of the supplements. However, since may people who email us are frustrated that their doctors have no clue, I will provide some general guidelines that you can adapt to your own unique situation. There's not enough space to cover all the supplements in one newsletter, therefore I will begin with the letter A, and in subsequent newsletters proceed further along the alphabet.
   One point I would like to emphasize: When you take a supplement you have never been exposed to before, do your best to try it a on day when you are not using other supplements or medicines. This way you can better tell what kind of effect this new pill has on you. Also, if you are sensitive to herbs or supplements, at first use a portion of a capsule or tablet to avoid any potential harmful effects, particularly if you are taking pharmaceutical medicines or are taking hormones.

Should you take Garlic supplements?
Garlic supplements are one of the best selling natural products around. But small amounts of garlic supplements given to patients with high cholesterol levels have not shown any dramatic improvement in cholesterol levels. These results have prompted certain skeptics of nutritional supplements to dismiss garlic as a beneficial herb. This is premature. I am not convinced garlic is beneficial in lowering the level of cholesterol, but it has many other health benefits. Based on the studies that I have read, garlic may help lower blood pressure, has antimicrobial activity, and could have anti-cancer potential. Plus, it tastes great. I prefer to eat raw garlic and I personally don't take a garlic supplement. I suspect some of the benefits of raw garlic are reduced when garlic is cooked or processed and packaged in pill form. For more info, see http://www.raysahelian.com/garlic.html

Should you have a Mammogram in your forties?
According to The American College of Physicians, which represents 120,000 internists, mammograms may not be necessary for women in their forties. The American College of Physicians based its recommendations on a comprehensive review of mammography research that concluded that the benefit is less clear for women in their 40s than for those 50 and older, and that screening carries significant risks, including unnecessary biopsies, exposure to radiation, surgery and chemotherapy. Women who are told their mammogram shows a possible cancer that turns out to be a false alarm are likely to suffer anxiety for a long time.
   My comments: I tend to agree that mammograms should be reserved to women over 50, except perhaps in women who have a very strong family history of a mother or sisters who had breast cancer at a young age. There are cases where some women are alive today because they had a routine mammogram done in their 40s and a cancer was picked up early and treated appropriately. However, we cannot let such infrequent cases mar our judgment regarding the overall benefit versus risk of millions of American women in their 40s subjected to mammograms that may lead to unnecessary worry, biopsies, surgeries, false positives, and perhaps not extend life span even if diagnosed earlier than usual. See http://www.raysahelian.com/breastcancer.html

Niacin overdose
Niacin pills in high doses are sometimes taken by people to pass a urine drug test. However this method does not work and could produce severe side effects. University of Pennsylvania doctors discuss four individuals who took several niacin pills to try to beat their impending drug screening tests. Emergency room doctors discovered these individuals had liver toxicity, heart palpitations, skin reactions, nausea, dizziness and vomiting. See http://www.raysahelian.com/niacin.html
   My comments: Many people think vitamins are harmless, but this report clearly illustrates very high dosages of even simple B vitamins can have unpleasant consequences.

How To Take Supplements Wisely and Safely
The following suggestions are based on my several decades of personal and professional experience. Other nutrition experts and doctors are likely to have different viewpoints. Unless otherwise noted, I am referring to the dosage of one capsule of the products available at the Physician Formulas website. I will cover additional supplements in upcoming issues. In many cases it may be a good idea to take a week off from a particular supplement every 2 or 3 months or so, unless your doctor is recommending the supplement to treat a particular medical condition. The lower the dosage of the supplements you take, the more of them can be combined. For more details on each supplements, visit http://www.raysahelian.com.

Acai is a berry from the Amazon forest which has many compounds with antioxidant properties. One capsule can be taken a few days a week, and an acai berry supplement seems to be safe taken with other supplements. No side effects have yet been reported to us with acai supplement intake.

Acerola cherries have one of the highest contents of vitamin C of any fruit. Acerola appears to be safe to take on a daily basis and we are not aware of side effects. Acerola seems to be okay when mixed with other supplements.
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Acetyl-l-Carnitine 300 mg is a potent mind booster and antioxidant. Most people find one capsule is the right dose while some people may find the occasional use of 2 capsules helpful. Acetylcarnitine increases alertness and focus. It would be best not to take a capsule with other brain boosting supplements due to possible overstimulation. One option is to alternate the use of acetylcarnitine one day with Mind Power Rx the next day, or alternate with other brain supplements such as DMAE, choline, ginkgo, etc. Doses above 500 mg may, in some people, lead to overstimulation, insomnia, and nausea. For long term use one capsule 3 times a week with a week off each month is a good option. Acetylcarnitne can be taken with small doses of other supplements such as vitamins E and C, and it can be used together with fish oils. Many products on the market have acetylcarnitine together with alpha lipoic acid and are promoted for antiaging purposes. Be careful using high amounts of these combinations since they can keep you awake at night, and shallow sleep is certainly not helpful for longevity purposes. I would not recommend taking more than 10 to 30 mg of R lipoic acid or 20 to 60 mg of regular alpha lipoic acid when combined with 300 mg of acetylcarnitine.

Acetyl-L-Cysteine is a potent antioxidant. So potent that it is used in hospitals by the intravenous route to protect the liver from Tylenol (acetaminophen) overdose. Acetylcysteine can be used a few times a week. If you take daily acetaminophen for arthritis pain or other reasons, discuss with your doctor whether acetylcysteine could be helpful to you. Acetylcysteine can be taken together with other antioxidants such as vitamins C and E, and alpha lipoic acid, however you would need to lower your dose of the other antioxidants. For long term use, 3 times a week is appropriate.

Agaricus is a mushroom extract that may have antitumor activity, however recent reports suggest it may have side effects if taken daily, hence use it no more than 3 times a week and take a week off each month. There are several mushroom extracts sold for immune enhancement or anti-cancer potential. These include AHCC, cordyceps, maitake, and others. It is impossible to predict how these various mushroom extracts will influence your immune system if you take them together.

AHCC is a mushroom extract used in cancer treatment. If you have certain types of cancer, discuss with your doctor if AHCC is appropriate for you. Your dosage and length of time of use could vary depending on the type of condition your doctor is treating you for. No one has yet emailed us regarding side effects they have experienced with AHCC.

Aloe-Vera taken orally may be helpful in gastric mucosal healing or perhaps in inflammatory bowel conditions and the dosage and frequency of use depends on the condition being treated. I have not come across much research regarding the health benefit of aloe vera when ingested orally as a supplement. For long term use (unless for the treatment of a medical condition), take only a few times a week or month. Aloe vera can probably be combined with other supplements.

Email question
Q. When is the best time to take 5-HTP and what is the ideal dosage? I have mild anxiety and depression and I find 5-HTP helps me a great deal at 50 mg a few hours before bedtime, but I don't know whether taking it at another time of day or a higher dosage would offer more benefit.
   A. It is very difficult to predict in any individual person the dose of 5-HTP that will be most effective, the timing of the 5-HTP and the interaction of 5-HTP with other supplements or medicines. The best way to find out is through methodical trial and error trying various dosages at different times. Also to keep in mind is that the dosage and timing need may change after several days as the effects of the 5-HTP accumulate or the depression improves. The use of 5-HTP for depression or anxiety is tricky. Some people may find 5-HTP helps them more when taken in the evening whereas others prefer to take a 5-HTP supplement in the morning or midday. If you have daytime anxiety associated with low mood, 5-HTP could be helpful for you taken during the day.
   If you are not sure how to begin using 5-HTP, open a capsule by pulling on both sides and mix half the contents with water and take it on an empty stomach a few hours before bed. The next day try the other half again in the evening. Base your future dosage on this initial trial. If you have not noticed much, increase your dosage to the full capsule of 50 mg. Some people may require another full capsule during the day. For long term use I prefer not taking more than 100 mg a day. It's also a good idea to take a day or two off a week, and a full week off every couple of months. Some people have found lower amounts of 5-HTP helpful when taken under the tongue.

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SUPPLEMENT RESEARCH UPDATE
Vol. 4, Issue 5 -- March 30, 2007
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A natural cure for toenail fungus infection? I can't believe that I have come across an effective, inexpensive, and safe treatment for a condition for which modern medicine has no good solutions. There are millions of people in the US who suffer from toe nail fungus infection, and many more who have athlete's foot. Most have tried all kinds of over the counter and prescription anti-fungal creams to no avail. Some people have even taken dangerous, liver-damaging oral anti-fungal prescription drugs for several months with little benefit. If you suffer from a fungal toe nail infection, you are in luck, as I will explain below.
   Earlier this month I attended the largest Natural Products expo in the country held each March in Anaheim, CA. This expo draws tens of thousands of people in the natural product industry and there were more than 3000 booths in the showroom. I walked around to see what new items or ingredients were hot this year. It seemed there wasn't too much difference from the year before. The major promoted products included acai berry, cacao, mangosteen, goji berry, pomegranate, fish oils, and hoodia.

A Cure for Toenail Fungus - a Major Advance in Natural Medicine
The medical term for nail fungus infection is onychomycosis. At least 5 percent, perhaps up to 10 percent of adults have this frustrating, lingering condition that defies all treatment attempts. I was fortunate enough to come across a natural cure for this condition. What amazes me is that after decades of research by the modern medical establishment, and after billions and billions of dollars spent on studies with anti-fungal medications, the answer has eluded medical researchers. But, an effective and safe treatment for nail fungus infection appears to be quite straightforward. The solution for toenail fungus infection is simply soaking the toes in a solution of magnesium sulfate, also known as Epsom salts. Epsom salts are readily available in most large grocery stores and cost just a few dollars for a 3 pound bag. Soaking alone may not be enough, you have to follow other recommendations.
   I have listed exact steps to take to cure this condition at the web page below. Do not expect a cure within days. It will take at least 2 to 3 months, and perhaps 4 to 6 months if the fungus has spread to many nails and the nail is very thickened or distorted. The soaks are to be done at least once a day, preferably twice a day. There are several other steps that need to be taken to hasten the treatment and make it more effective and therefore you must read this page below. The basic idea regarding treatment of toenail fungus is to keep the toes cool and dry. Fungi love heat and moisture. See www.raysahelian.com/nailfungus.html for specific step by step suggestions. Good luck, and I would be interested to find out your response after a few months. If you have friends or relatives with this condition, let them know of this potential cure, they may be forever grateful to you.

Driving Under the Influence of Sleeping Pills
The Food and Drug Administration is warning consumers that practically all prescription sleeping pills could at times cause sleep-driving such as getting up in the middle of the night and going for a drive — with no subsequent memory of doing so. Other complex sleep-related behaviors have included making phone calls, fixing and eating food, and having sex while still asleep. Ambien isn’t the only insomnia drug that can cause sleep-driving. Others include Butisol sodium; Carbrital; Dalmane; Doral; Halcion; Lunesta; Placidyl; Prosom; Restoril; Rozerem; Seconal; and Sonata.
   Comments: Many people can avoid the use of prescription sleeping pills if they follow the 12 suggestions I have listed on my web page on sleep, http://www.raysahelian.com/sleep.html. You may also consider the occasional use of a natural sleep aid called Good Night Rx. This natural product is not as potent as the pharmaceutical drugs, but it is quite good and has hardly any side effects when used reasonably, such as no more than 3 nights a week.

Probiotic supplements and the immune system
Probiotics, those friendly bacteria found in yogurt and certain other fermented foods, are hardly, if ever, used therapeutically in a hospital setting. Perhaps they should be. Multiple organ dysfunction syndrome (MODS) is a major cause of death in intensive care units. A breakdown in gut barrier function and immune dysfunction are associated with the onset of MODS. In a Canadian study, critically ill patients admitted to the intensive care unit were randomly assigned to receive either placebo or probiotics. The patients responded to probiotics with a significantly larger increase in systemic immunoglobulin IgA and IgG concentrations than in the patients who received placebo. Over the study period, intestinal permeability decreased in most patients. Patients receiving probiotics showed a greater enhancement in immune activity than did patients receiving placebo.

Email questions
We've had a few emails about people being concerned with consumption of soy. Here are a couple:
Q. I appreciate very much your research into various nutrients and making it available to the public; however, concerning your recommendation to take soy. I have seen some websites that say soy is not a healthy food to consume.
Q. In your newsletter you mention using soy protein for building muscle. Recently, however, I read some information about soybeans that caused me to eliminate all soy products from my diet with the exception of soybean oil. Apparently, soybeans are loaded with phytoestrogens which have moderately strong estrogenic activity in the body. While this might be good for a menopausal woman, I don't think it should be introduced into an aging male's body. One article claimed that soybeans were consumed in quantity by Chinese monks as a way of eliminating their libidos! There was also some recent study that showed that consumption of the soybeans (but not the oil) actually reduced the male participants' testosterone levels by 15%! Needless to say, that is the last thing I want happening in my aging body. I have since gone over my diet and also eliminated garbanzo beans (also known as "chick peas") because they too have some of the same estrogen-like isoflavones as found in soybeans.

    A. Based on all the information I have read on soy from multiple research studies and from a number of different sources, the moderate use of soy products as part of an overall healthy diet that has a wide variety of foods appears to offer no harm, and perhaps offer benefits. If soy were so dangerous as some websites make it seem, then why do the Japanese have one of the highest longevity rates in the world even though they consume soy products more than many other countries? Soy, or soy protein, when used in moderation as part of an overall healthy diet which includes a wide variety of foods, is a positive addition to one's diet. Perhaps a very high consumption of soy may have some negative consequences, but this could be true of most foods. A balanced diet with some soy should present no problems. Organic soy products are preferable.

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SUPPLEMENT RESEARCH UPDATE
Vol. 4, Issue 4 -- March 8, 2007
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Those of you who have been reading my newsletters for some time know quite well not to trust the headlines of articles on health topics. Recent headlines that I came across involved the interpretation of a study evaluating the role of antioxidant supplements in life extension. You may have seen some of these headlines, "Vitamins 'could shorten lifespan," "Antioxidants may slightly raise risk of death," and, "Antioxidant vitamins A, C, E, don't lead to longer life." I will dissect the study and the headlines and tell you why this study is worthless and why the researchers should take a sabbatical and go back to school to learn the basics of nutrition and nutritional supplements.
In the first newsletter issue of 2007 I mentioned that I was testing a natural treatment for athlete's foot and toe nail fungal infection. Modern medicine does not have safe and effective treatment options for nail fungus infection. I am about to complete my evaluation (the results thus far look quite promising) and in the next issue of the newsletter I will explain in detail how you can take advantage of a completely safe and inexpensive treatment.

Soy protein as good as whey protein for muscle building
Weight lifters and other athletes often use whey protein supplements and have been less interested in using soy protein thinking that since soy is a vegetable, muscle building would not be as effective as whey protein derived from milk. However, a study in rats indicates that soy and whey protein equally help restore muscle mass after exercise on a treadmill for two hours. After exercise, ingesting protein helps accelerate protein synthesis in muscle tissue.
My comments: In addition to a protein supplement, taking about 2 to 4 grams of creatine also helps with increasing muscle mass. For more information, see http://www.raysahelian.com/soyprotein.html and http://www.raysahelian.com/creatine.html.

Eczema development in child and mother's diet
A woman's dietary choices during pregnancy could well influence the odds that her child will develop an allergy. Dr. Joachim Heinrich, of GSF-Institute of Epidemiology, Neuherberg, Germany evaluated the associations between a mother's diet during the last few weeks of pregnancy and allergy and eczema in the infant at age 2 years. Data from 2,641 children were analyzed. Overall, 17 percent of all children had eczema at age 2. Positive associations were observed between high maternal intakes of margarine and vegetable oils during the last few weeks of pregnancy and eczema during the first 2 years in the offspring. On the other hand, eating a lot of fish late in pregnancy

 seemed to offer some protection against eczema in the children. For more info on allergy and eczema, see http://www.raysahelian.com/allergy.html and http://www.raysahelian.com/eczema.html

Danger: Relying on nutritional information through headlines may be hazardous to your health
A study published in The Journal of the American Medical Association claims that taking antioxidant supplements such as beta carotene and vitamin E can shorten lifespan. This study is worthless.
Researchers first included 68 studies involving 232,606 people and found no significant effect on mortality -- neither good nor bad -- linked to taking certain antioxidants. When they eliminated the "lower-quality" studies and looked only at the most trustworthy ones, they actually found a higher risk of death for people taking vitamins: 4 percent for those taking vitamin E, 7 percent for beta carotene and 16 percent for vitamin A.
   My comments: Who determined which studies were "lower quality?" It is possible that another group of researchers may have had a different opinion on what constitutes lower or higher quality. I can already sense a bias. Donald Berry, chairman of the department of biostatistics at the University of Texas M.D. Anderson Cancer Center, said of this study "There are so many choices you can make when you're doing these analyses." >
Final findings were based on an analysis of 47 studies involving 180,938 people who were randomly assigned to get real vitamins or dummy pills. Some involved very high doses far exceeding the recommended daily amount of the vitamins; others involved normal or low doses.
   My comments: The pooled studies were too diverse to make any sense. The trials ranged from a three-month study of 109 elderly nursing home residents to a 12-year study of 22,071 male doctors. And the vitamin dosages varied significantly from study to study. What if I analyzed various studies on the benefit or harm of drinking wine and pooled studies that included the health effect of one glass of wine a day and other studies where people drank a bottle of wine a day. It's possible that those who drink one glass of wine may live longer while those who drink a bottle of wine a day may die sooner due to liver damage. But when the results of the one drink and the full bottle studies are pooled, the statistical analyses could indicate that drinking wine shortens lifespan. Meir Stampfer, professor of nutrition and epidemiology at the Harvard School of Public Health, agrees with my viewpoint. Dr. Stamfer said the studies were too diverse to pool together because they looked at various combinations and doses of antioxidants tested in different groups of people. "This study does not advance our understanding, and could easily lead to misinterpretation of the data," said Stampfer.
   The study's senior author, Dr. Christian Gluud of Copenhagen University Hospital, said, "The main message is that prevention by beta carotene, vitamin A and vitamin E cannot be recommended. These three antioxidant supplements may increase mortality."
   My comments: Dr. Christian Gluud should take a sabbatical from interpreting research results from nutritional supplement studies and go back to school to take a course in nutrition 101. I can, without hesitation, say that this doctor is ignorant. Firstly, Dr. Gluud, does not seem to recognize that different dosages of supplements can have different effects. There is also no mention that most people who took vitamin E in the past, and also currently, take a synthetic version of one form of vitamin E, dl-alpha tocopherol, whereas there are several forms of natural vitamin E. It is possible that high doses of synthetic vitamin E may not be helpful, whereas low doses of a natural vitamin E complex including alpha, delta, and gamma tocopherol could be beneficial. This is also true of beta carotene. There are many forms of carotenoids, and taking a high dose of a single carotenoid, such as beta carotene by itself, is not the answer.
  
   Bottom line: There is no proof at this time that taking vitamins will help you live longer, nor is there good evidence that they will shorten lifespan. In order for us to know how vitamins influence longevity, several well controlled studies have to be done on individual vitamins in varying dosages for at least a 20 to 30 year period while keeping dietary intake similar in all the study participants. This is not practical and not likely to be done soon. For the time being if you do plan to take antioxidant supplements, take products that have a wide range of nutrients in low amounts as opposed to just 2 or 3 in high dosages. I am not convinced that taking megadoses of a single form of synthetic vitamin E or single carotenoid is a good option. One good daily formula with lots of different nutrients and antioxidants in small amounts is MultiVit Rx which can be taken at one, two, three, or four capsules a day depending on your preference. See http://www.raysahelian.com/antioxidant.html for more info on antioxidants.

Questions from Newsletter Subscribers
Q. Is 50 years of age too early to start taking vinpocetine and ginkgo biloba together as an anti-aging supplement?
A. There is no human research that proves taking supplements will lead to longer lifespan. My personal belief is that we will eventually find certain natural pills will have antiaging benefit, but we are not there yet in terms of certainty. It is possible that high doses of certain supplements could actually be harmful. Therefore, for the time being, supplements should be mostly taken for the benefit they provide in terms of mood, energy, wellbeing, mental enhancement, sexual enhancement or the treatment of certain medical conditions as opposed to primarily focusing on the hope that they may have anti-aging potential. One caution: If your sleep is disturbed because the supplements you are taking are too stimulating, then I can't see how this would help with longevity. The suggestion would be to take fewer supplements or to lower the dosages.

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SUPPLEMENT RESEARCH UPDATE
Vol. 4, Issue 3 -- Feb 19, 2007
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Does the type of food you eat influence how alert or sleepy you are? If you are in your energetic teens and 20s, it may not affect you as much, but as we get older we are more apt to notice the effects. In youth, our brain chemicals are on full speed and whether we have pasta or protein for lunch may not influence how energetic we are the rest of the afternoon. But, as we get older, we are likely to notice the food-mood or food-sleepiness influence. Have you ever had a large lunch consisting of mostly pasta, such as spaghetti, and then had an irresistible urge to take a nap? I have long suspected, based on my personal observations, that the type of food we eat before bed influences sleep onset. Now, a new study confirms previous research that carbohydrates eaten before bed induce sleep. More details below.
   In this issue I want to mention and discuss side effects that can occur from the misuse of certain supplements. Although most supplements are safe, some are much more potent than people realize and can cause problems when high dosages are taken or when they are taken daily for prolonged periods. Over the past few weeks we have had several emails with such accounts, and I want to share a couple of them with you so that you have a more in depth understanding on how to use supplements effectively while minimizing adverse events.

Carbohydrate meal induces sleep
To investigate the role of carbohydrate in sleep induction, researchers at The University of Sydney in Australia compared the effect of high- and low-glycemic index carbohydrate–based meals ingested several hours before bedtime on sleep quality. Twelve healthy men ate standard, isocaloric (8% of energy as protein, 2% of energy as fat, and 90% of energy as carbohydrate) meals of either low GI or high GI rice 4 hours before their usual bedtime. On another occasion, the men ate the high-GI meal 1 hour before bedtime. The carbohydrate-based high-GI meal resulted in a significant shortening of sleep onset compared with a low-GI meal and was most effective when consumed 4 hours before bedtime. GI is short for glycemic index and you can learn more about it here, http://www.raysahelian.com/glycemicindex.html
   My comments: Those who have difficulty falling sleeping at night may consider eating a higher proportion of carbohydrate while having very little fat and protein. Some options include pasta, potatoes, bread, cereal, and fruit salad. In order to stay alert during the day, a good option is to eat small frequent meals with a higher proportion of protein and fat. If you eat a large meal during the day that consists mostly of carbohydrate, you are likely to have difficulty concentrating or functioning at your best at work or at home. This may also be true of students. If you have a test in the afternoon, avoid a large lunch rich in pasta, potatoes and bread but rather have a smaller meal with a higher proportion of protein such as meat and fish.
For more information, see http://www.raysahelian.com/sleep.html  and http://www.raysahelian.com/carbohydrate.html.
 

SSRI drugs such as Prozac may lead to more bone fractures in older adults
The daily use of a selective serotonin reuptake inhibitor (SSRI) antidepressant drugs such as Prozac, Zoloft, Paxil, and others increases the risk of fractures in adults 50 years of age or older. Doctors who prescribe these drugs to older patients should let them know of the risk and consider whether the benefits outweigh the risks in cases of mild depression. The most common site of fracture is the forearm, followed by ankle and foot.
Comments: Many people have benefited from the use of SSRI drugs. However these medications do have several side effects and doctors have to balance the benefit versus the risks. Natural antidepressants are a good option for those with mild or moderate depression. They also have side effects but they are less serious. Older people taking natural antidepressants should use a third or half of the usual prescribed dose. For more information, see http://www.raysahelian.com/ssri.html, http://www.raysahelian.com/depression.html

Supplement side effects emails
Q. I have been taking 5 HTP for 2 weeks at 50 mg daily, i am on no other meds. After 2 weeks my depression, bad thoughts and general anxiety lifted well, i took my 5-HTP dose at mid day, was eating better, sleeping better, energy in the daytime, i thought i was on my way to recovery then after 16 pills i began to have muscle tremors and faster heart beats in the night and 1 or 2 twitches in the day, Would u say i should have a break for 2 days and reduce the dose or is this just a normal response to serotonin being introduced and i should continue on 50mg or more? My doc has no information about 5 HTP.
   A. We can't give any personal advice, but as a general rule we suggest people take breaks from most supplements since their effects can accumulate over time. Taking breaks minimizes side effects. A very important concept to keep in mind with certain nutrients and herbs is that they can accumulate in the body or their effects may be additive. For instance, if you take a certain supplement at 50 mg, some of it (or its effect on the body and brain) may still be around the next day. So, if you take another 50 mg the next day, you are now getting dosed a higher amount the second day, and even more on the third day. Sooner or later side effects are likely to occur. Just as with medications, supplement dosages need to be constantly adjusted. It is possible to take advantage of the benefits 5-HTP and SAM-e (see below) while minimizing side effects if you do it carefully.

Q. I took 200 mg of SAM-e for depression every day and within 4 days it lifted my mood. But on the fifth day I started feeling jittery, anxious and couldn't sleep well. It seemed to negate the benefits I had the first few days.
   A. This is typical of SAM-e and many supplements. It is quite likely that the initial 200 mg was fine for the first few days, but then the required dosage to lift your mood dropped. But, by exposing yourself to the same initial dosage of 200 mg, it was too much for you. Many people find 100 mg every other day to be good maintenance amount. But there is a wide range of response and each person through trail and error has to find their ideal dosage and how to adjust it on a daily basis.
   Many drug and supplement side effects occur since doctors and consumers do not realize the importance of constant dosage adjustment. Most doctors will put a patient on a standard mg of a drug and do not consider reevaluating the appropriateness of this initial dosage in subsequent weeks, months or even years. Many doctors fail to grasp the importance of the uniqueness of each individual and treat in a robotic manner using the same dosage of a drug for all patients. Furthermore, the dosage required of a natural supplement or a drug can vary over time depending on how the condition changes and many other variables including diet, sleep patterns, physical activity level, season, temperature, etc.

Questions from Newsletter Subscribers
Q. I'm wondering about all of the research about soy being bad. Personally I love soy milk, but I'm constantly told by coworkers that it's not good to drink. I'm wondering if you've read any of the research against soy and what you feel is best.
   A. Soy products are a healthy addition to one's diet when done so in reasonable amounts and as part of a healthy program with a variety of other legumes, cereals, fruits, nuts, vegetables, fish, etc. However, excess soy milk may not be the best option if it ends up providing lots of calories and takes the place of other healthy food options. Furthermore, much of the soy milk sold is sweetened with sugar which is harmful. I think a few ounces of soy milk is healthy to drink, and you could purchase the unsweetened variety and add a few drops of stevia clear liquid to sweeten it without extra calories. See http://www.raysahelian.com/stevia.html

Q. I'm a believer in natural remedies over prescription drugs, however, I have a difficult time explaining why to my husband. How can I convince him that natural supplements are better than pharmaceuticals?
   A. It would be simplistic to make a blanket statement that natural supplements are better than drugs or vice versa. I find natural supplements and dietary intervention to offer great promise in the prevention or treatment of many medical conditions including mood disorders, high blood sugar, high blood pressure, and certain cardiovascular conditions. Natural therapies can make a significant difference in terms of vitality, energy, mind enhancement, vision enhancement, and sexual enhancement. Pharmaceutical drugs offer great advantages in many areas of medicine, two areas that immediately come to mind involve the treatment of infections and pain control, If I had a serious infection, such as pneumonia or meningitis, I would not hesitate for an instant in using antibiotics. For chronic conditions, some people may benefit from a natural approach, others may benefit from a drug while still others may find a combination of a natural approach and a drug is the best option for their disease.

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SUPPLEMENT RESEARCH UPDATE
Vol. 4, Issue 2 -- Feb 1, 2007
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Back in the early 1980s when I was a student at Thomas Jefferson medical school in Philadelphia, I remember one lecture we had on infertility. The professor reviewed some of the causes of female infertility. He mentioned fallopian tube blockage, endometriosis, ovarian cysts, and ovulation disorders. There was no mention of diet having any influence on infertility. In fact, during all my years in medical school, there was hardly any mention of diet having to do with medical diseases. We now know that our food choices have a significant influence on the incidence of cancer, heart disease, stroke, diabetes... and now perhaps even infertility. More details later.
   I have quite a number of friends who are vegetarian. Many vegetarians may not be getting enough of certain nutrients that are absent or found in very small amounts in a non-meat diet. These include CoQ10, carnitine, creatine, vitamin B12, and others. If you are vegetarian, consider supplementing with my newest formulation Veg Rx. See the link to the left.
   Recently we have had many emails from users of Passion Rx and sexual herbs. Most users -- but not all -- have noticed significant sexual enhancement. Below Il discuss in some detail on how to best take advantage of these sexual herbs and products. Many people expect these herbs to work quickly within an hour, like Viagra. But that's not the way most of them work. Learn the secrets on how to best take advantage of nature's aphrodisiacs.

Zap your sponge germs
I thought this was quite interesting when I came across it this week. Apparently, if you place your kitchen sponge for a couple of minutes in a microwave oven, you can kill almost all the germs that have found a comfortable moist home. Researchers at the University of Florida found that microwaving a kitchen sponge killed or inactivated more than 99 percent of bacteria, viruses or parasites, as well as spores. The day after the news release came out regarding the germ-killing benefit of microwaving, reports came to news stations that people who tried it at home had problems with the sponge burning and ruining their microwave. Apparently the researchers failed to mention that the sponge has to be wet before it is placed in the microwave.
   Comments: I actually placed a semi wet sponge in the microwave for 2 minutes and it survived.... but the germs probably were not as lucky.

Trans fats and fertility
Dr. Jorge E. Chavarro of the Harvard School of Public Health in Boston says the more trans fats a woman eats, the more likely she is to have fertility problems. To maximize fertility, women should avoid foods that list hydrogenated or partially hydrogenated oils. For details of the study, see http://www.raysahelian.com/transfats.html

   Comments: I have little doubt that over time scientists will discover many more medical conditions that are influenced by diet. Diet is only one potential cause of infertility.

Secrets of Herbal Aphrodisiac Use
Most people in the Western world -- along with the media, most doctors and medical researchers -- are not aware of the potent effect of herbs in terms of sexual enhancement. There are quite a number of aphrodisiac herbs that are effective in enhancing sexuality in men and women, but you have to learn how to use them effectively. Herbs work slower than drugs and that may be one reason why some people think they don't work. As Americans we like a pill that gives an immediate effect and if we don't notice an effect within an hour or two we think it is a dud. Most aphrodisiac herbs take a few days for optimal effects, but there are some herbs or combinations that work quicker.
   Although Viagra and its cousins Cialis and Levitra work very well for erectile function, they have little effect on libido and no benefit regarding genital sensation. These drugs don't work that well in women. Herbs generally are not as quick in terms of inducing an erection, but with time they can be as effective as the drugs. Most people prefer the overall sexual enhancement that comes from the herbs in terms of the whole package -- sensation, libido, intensity of orgasms, climaxes, lubrication, and erection. Herbs also have the advantage of causing fewer side effects.

How to Take Passion Rx with Yohimbe, or Individual Sex Herbs, Safely and Efficiently
Take the herbs in the morning at least a half hour before breakfast so they are absorbed well without food in the stomach. Some of the common sexual herbs are horny goat weed, tongkat ali and LJ100, mucuna pruriens, tribulus terrestris, catuaba, muira puama, maca, ashwagandha, and others. It is impossible to predict which one of the herbs or which combination will be effective for you unless you try it. If you buy more than one supplement, learn how each one works by itself before combining.

It is preferable to take these herbs every other day or 2 days on, 2 or more days off. You will likely notice the benefits even on the days you are not taking them since there is often a delayed response. Very important: These herbal products work better when you don't take them every day.

Herbs have side effects, too, although less serious than the drugs. Common side effects from high doses of sex herbs include overstimulation, restlessness, insomnia, increased body temperature, headache, and rapid heart beat. If you get insomnia, skip a dose the next day. If you get insomnia it means the dose of the herb or the herbal product you took was too high, and next time you take it, try half or a third of the initial dose. If you feel increased body temperature, drink a glass or two of cold water.

Be patient. Most herbs take anywhere from 2 to several days to start working, except for a high dose of yohimbe which can work within an hour or two. Keep in mind that if you try to induce sexual enhancement quickly, you are likely to get more side effects. If you wish to minimize adverse effects, take smaller amounts and be patient. The impotence Drugs Viagra, Cialis and Levitra can work within an hour or two but they can potentially induce serious side effects, including vision loss and chest pain.

If you are taking a product for the very first time, Start with a small amount, even if it means opening the capsule and taking a portion.

Passion Rx with yohimbe can be taken as a full capsule. Some people notice the effects within a few hours, but most people find that a good approach is to skip the second day and then take it again the third morning. The effects are often clearly noticed on the third day. Take the fourth day off and take it again the fifth day. Eventually you will find a noticeable enhancement of genital sensation, erection, lubrication, and overall sexual interest. Some people get sexual urges and overall enjoyment similar to what they experienced in their teenage years. The dosage of the current version of regular Passion Rx (without yohimbe) is a third of a capsule.

It is best not to take other supplements, especially those of a stimulant nature, on the days that you are taking sexual herbs since restlessness, insomnia and overstimulation can occur. Avoid using ginseng, St. John's wort, or other similar herbs, Eyesight Rx, hormones, SAM-e, and certain amino acids such as tyrosine. I also suggest you avoid drinking more than a cup of regular coffee and more than an ounce or two of wine.

Use caution if you are taking prescription medicines since sometimes the interactions between herbs and medicines is not predicable. It is best not to use antidepressant drugs the same day as these herbs. SSRI drugs such as Prozac, Paxil, and Zoloft inhibit sexuality. 5-HTP, tryptophan and kava also inhibit sexual drive or decrease genital sensation.

Be extremely cautious using sex herbs if you have thyroid or other endocrine issues, a heart condition, a tendency for high blood pressure or heart rhythm abnormalities. Many of these herbs can stimulate heart contraction and if you are prone to heart problems you may have untoward reactions.

Although initially you may find that a high dose is required for you to notice something, with time a lesser dose becomes just as effective. Your dosage requirement may change with time.

Prostate Power Rx works very well in many people as a sexual enhancer and can be alternated with Passion Rx or other sexual herbs.

If you find one particular product or herb is no longer effective, take a week off and then try another one..

Drink Cloudy Apple Juice
In a head-to-head comparison of apple juices, Polish researchers found that pulpy, non-clarified juice carried more antioxidants - four times the level of polyphenols - than clear apple juice. Unlike cloudy apple juice, the more common clear variety undergoes additional processing to remove any apple solids. Manufacturers typically think the public will favor the more attractive, clear juice over its cloudy cousin, and retailers prefer the clear variety for its longer shelf life. For optimal health, drink a variety of 100 fruit juices as opposed to just one or two. Most people drink apple juice or orange juice almost exclusively whereas there are many additional fruit juice options available. For more info on polyphenols, see http://www.raysahelian.com/polyphenols.html

No Milk or Cream with Tea
Tea improves blood flow and the ability of the arteries to relax but milk reduces this benefit. Proteins called caseins in milk decrease the amount of compounds in tea known as catechins. A comparison was done with the health effects of drinking boiled water and tea with and without milk on 16 healthy women. The function of an artery in the forearm before and two hours after drinking tea was measured. Black tea significantly improved blood flow compared to drinking water but adding milk blunted the effect of the tea. Tests on rats produced similar results. When rodents were exposed to black tea they produced more nitric oxide which promotes dilation of blood vessels. But adding milk blocked the effect. http://www.raysahelian.com/tea.html

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SUPPLEMENT RESEARCH UPDATE
Vol. 4, Issue 1 -- January 8, 2007
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I have made some personal resolutions and one simple one is to take more time to appreciate the food at the table rather than rush through meals. I have started to eat slower, chew slower, be more conscious and aware of taste and texture, and take pauses while being thankful that food is so abundantly available.
There are a number of interesting nutritional topics to cover in 2007 and I will try to include a variety in the upcoming newsletters. I have come across an excellent natural treatment or even a potential cure for athlete's foot and nail fungus growth but will test this a few more weeks before I announce it in a future issue of the newsletter.

CoQ10 Helpful in Heart Failure
CoQ10 supplements appear to be helpful in strengthening the heart. Dr. Romualdo Belardinelli, of Lancisi Heart Institute in Italy studied 23 patients, average age 59 years, with moderate to severe heart failure. They were assigned to four weeks each of CoQ10 supplements or placebo pills, with or without supervised exercise training. The dosage of CoQ10 was 100 mg three times a day. Those taking CoQ10 had improvement in peak exercise capacity. There was an improvement in cardiac function with CoQ10 treatment. Combining exercise training with CoQ10 produced more marked improvements than CoQ10 alone. The researchers conclude that the use of CoQ10 improves several aspects of heart failure without any side effects. For details, see http://www.raysahelian.com/coq10.html
    My comments: Those who have heart failure should discuss with their doctor the use of CoQ10 supplements. I tend to be more cautious on dosages and would prefer keeping the amount of CoQ10, at least initially, to 30 mg or 50 mg once or twice a day. CoQ10 can be taken with breakfast and or lunch. The study went on only for one month, and even though the researchers did not observe side effects on 100 mg three times a day, it is possible that prolonged use of 300 mg a day over several weeks or months could lead to adverse events. We also don't have a good understanding how CoQ10 supplements interact with heart medicines.

Breast Cancer Rates Drop
Fewer women are being diagnosed with breast cancer. Estrogen and progesterone hormone use plummeted after a 2002 study found that hormone replacement therapy after menopause raised the risk of breast cancer, heart disease and other problems. Before that, the regimen was believed to prevent many of these conditions, and doctors prescribed them as little fountains of youth. The decline in new breast cancer cases in 2003 is thought to have come because millions of postmenopausal women stopped hormone replacement therapy in 2002. There appeared to be a 7 percent drop in breast cancer incidence between 2002 and 2003 and most researchers believe it is related to the discontinuation of the hormones.
   My comments: Many of you already know that the estrogen most commonly prescribed for women as hormone replacement therapy after menopause is Premarin derived from the urine of pregnant mares (horses). The progesterone prescribed to women by doctors most often is a synthetic progestin, not actual progesterone made by the body. Some people claim that the use of natural bioidentical hormones would not cause as many problems in women as the use of Premarin or progestins. However I have not seen any long term studies comparing the two regimens and for the time being I will assume that the risk for breast cancer in women with the use of bioidentical hormones is similar until proven otherwise. Lately Suzanne Somers, the TV actress, has been heavily - and somewhat irresponsibly - promoting her book suggesting women use bioidentical hormones to improve their health. I think this is a better option than artificial estrogens and progestins, but there is no evidence that they are safer and before you take high doses of these hormones keep in mind that it is a possibility that future research may show misuse of these bioidentical hormones carries serious risks. There are two natural hormones -- DHEA and pregnenolone -- available over the counter. Be cautious with their use since they can have serious side effects. Hormone supplements are not to be toyed with but be treated with respect, even if they are available without a prescription.

Ashwagandha for Dyskinesia
Many of you remember seeing the actor Michael J. Fox on TV exhibiting repetitive involuntary movements. The medical term for this kind of involuntary movement is dyskinesia. Involuntary movements can occur in some patients with Parkinson's disease due to the long term use of L-DOPA since this drug can damage nerve cells in the brain involvement with movement. Another form of dyskinesia occurs in those who are given antipsychotic drugs and this type of involuntary movement disorder is called tardive dyskinesia.
   Researchers at Panjab University in Chandigarh, India induced tardive dyskinesia in rats by providing high doses of a drug called reserpine. Treatment with ashwagandha root extract for a period of 4 weeks to reserpine treated animals significantly reduced the senseless chewing movements and tongue protrusions. Rats given reserpine had decreased levels of natural antioxidants in their bran while treatment with ashwagandha restored levels of antioxidants. The researchers say, "The major findings of the present study indicate that oxidative stress might play an important role in the pathophysiology of reserpine-induced abnormal oral movements. In conclusion, Withania somnifera root extract (ashwagandha) could be useful for the treatment of drug-induced dyskinesia."
For more details, see http://www.raysahelian.com/withaniasomnifera.html
   My comments: The involuntary movements that occurs in those with Parkinson's disease placed on L-Dopa are different from antipsychotic induced tardive dyskinesia although both types of dyskinesia may perhaps share a commonality of oxidative damage to nerve cells in the brain. It is possible that a variety of different antioxidants could help reduce the risk of dyskinesia although human research is lacking. If you have antipsychotic drug-induced tardive dyskinesia, ask your doctor to read the research provided. If your doctor agrees to give ashwagandha a try, use half of a capsule of the 500 mg extract to start and gradually increase over time. I have not seen any research regarding the role of ashwagandha in dyskinesia due to long term L-DOPA use in those with Parkinson's disease. We don't know yet how ashwagandha interacts with antipsychotic drugs or drugs used in Parkinson's disease.

Emails from Newsletter Subscribers
Q. I have been taking 500mg a day of tyrosine since June 2006 in combination with 500 mg of Para Thyrolate, and vitamin B (as prescribed by a nutritionist.) Also, I have high blood pressure and have been taking hydrochlorothiazide (water pill) for the past two years. On Friday December 22, 2006 I had a grand mal seizure followed by a second one 5 hours later. I have never had a seizure before in my life and I am 36 years old. The day of the seizure I had been feeling like I was coming down with a cold or flu and barely ate anything all day. I have been reading up on the side effects of L-Tyrosine and realized that I have been experiencing side-effects for quite some time; heart palpitations and what appeared to be mini panic attacks. Has L- Tyrosine ever been documented to cause seizures? At the hospital they ran lots of tests and could not seem to find anything wrong with me so the seizure remains unexplained.
   A. Although we have not come across any published studies regarding the role of l tyrosine on seizure inducement, we can not rule out the possibility, that, in some people, it is possible that high doses of l tyrosine could reduce the threshold for a seizure to occur. This is just speculation since we have not seen actual research blaming l tyrosine supplement use and seizure occurrence. I am not familiar with Para Thyrolate but a search on the internet reveals it is a natural supplement that has " parathyroid concentrate " and " thyroid concentrate." I have no idea how much thyroid hormones are present in this product. High doses of thyroid hormones could also lower seizure threshold. I have come across many individuals who have had heart rhythm problems from the use of high doses of tyrosine. For more information see http://www.raysahelian.com/tyrosine.html.

Q. I am a nutritionist practicing in Chicago and wanted your opinion on vitamin E optimal intake. I came across an editorial in the American Journal of Clinical Nutrition by Maret G Traber who is at the Linus Pauling Institute at Oregon State University in Corvallis, OR. Here is the last paragraph of the editorial: "And so we are left with the good news that the serum concentration of {alpha} - tocopherol is associated with decreased chronic disease risk, but we still do not know how much vitamin E to recommend for consumption to achieve that concentration. It may be that large vitamin E supplements are not necessary to achieve optimal serum {alpha} - tocopherol concentrations, in that the vitamin E recommended dietary allowance of 15 mg per day may yield optimal serum concentrations to achieve significant reductions in chronic disease mortality. However, 15 mg a day may be a vitamin E intake that is achieved only with supplements, given the dietary habits of most Americans and the observation that vitamin E–rich food sources are less popular foods, such as nuts, seeds, and vegetable oils, including olive, sunflower, or safflower oils."
   A. A person's optimal vitamin E supplement requirement is influenced by many factors, particularly diet. I think a daily vitamin E supplement (mixed tocopherols) intake of 10 to 100 units a few times a week is reasonable, and frankly I don't see the need to take megadoses beyond 100 to 200 units a day. For more info, see http://www.raysahelian.com/vitamine.html

Q. After 7 months of various statin protocols I completely stopped in March 06 due to extensive pain in the thighs and calfs and started a daily regiment of 2400mg of Red Yeast Rice. The muscular discomfort has slowly decreased. Last month I added 200mg of CoQ10 to my daily regimen. The lingering muscular discomfort has gone. I credit CoQ10 for the relief. I wish to continue CoQ10 along with the Red Yeast Rice and would appreciate your comments, recommended dosage and frequency.
   A. There is no standard nutritional regimen that will apply to everyone. As a rule, the best option is to use the lowest amount of supplements that work. Personally, I prefer to use less than 60 mg of CoQ10 a day, and there have been cases of muscle aches or muscle tissue damage with red yeast rice hence it is a good idea to use the lowest amount of red yeast rice that works in reducing cholesterol level. http://www.raysahelian.com/redyeastextract.html