How to Choose a Supplement (part 1)

How to Choose a Supplement (part 1)

On June 19, 2002, the Journal of The American Medical Association (JAMA) contained a scientific review article by R.H. Fletcher, MD, MSc, and K.M. Fairfeld, MD, DrPH, which addressed the current debate regarding the use of vitamin supplements and the prevention of chronic disease in adults. After reviewing the body of evidence on this controversial subject, the researchers advised their medical colleagues that the use of vitamin supplements is a prudent intervention in the fight against many chronic degenerative diseases.

The researchers stated that vitamin deficiency syndromes such as scurvy and beriberi are uncommon in Western societies. However, suboptimal intake of some vitamins, even above levels causing classic vitamin deficiency, is a risk factor for chronic diseases. This scenario is common in the general population, especially the elderly.

To many of us this was a breath of fresh air after decades of skepticism from the medical community. But, starting supplements is not simply a matter of rushing down to the mega-mart for brand “X” of vitamins. There are many, many pitfalls in taking supplements.

First of all, 25-50% of supplements are bogus, not even containing the ingredients listed, or so poorly prepared they are not well absorbed. To begin your search, look for a brand that has GMP, USP, or ISO 9000 type of certification. This means that the ingredients listed are truly in the product, and it has been tested for purity and safety.

Next, look for a broad spectrum supplement that includes all the necessary vitamins and minerals, anti-oxidants, and plant nutrients, with a specific list of ingredients. The key is getting the right ingredients in the right amounts. This should include nutrients that support the health of heart, bone, brain, liver, and eyes. It should also provide support for methylation, and defense against glycation, oxidation and inflammation. (more details on these coming in parts 2 to 4).

Avoid the inorganic mineral forms including carbonate, oxide, sulphate and phosphate. Do include mineral forms such as citrate, malate, succinate, aspartate and alpha-ketoglutarate. For example, calcium carbonate is bad, calcium citrate is good. The bad mineral forms are super cheap to make, poorly absorbed, and can even cause lower levels of other minerals. These cheap mineral salts are better laxatives than supplements!

Choose a form of Vitamin E that is the natural d-alpha-tocopherol with at least half gamma-tocopherol or mixed-tocopherols. Many studies have suggested that vitamin E supplementation increases the risk of prostate cancer – these poorly designed studies used only one of the eight forms of vitamin E which we know causes a deficiency in one of those other eight forms, the gamma-tocopherol portion, one of the most important anti-cancer forms of vitamin E.

The best form of Vitamin D, other than sunshine, is D3 or cholecalciferol. We should really check a blood level on Vitamin D to accurately determine the right amount to take.

Avoid potential toxicities. Don’t take more than 5000 IU of Vitamin A unless in the form of beta-carotene which will convert as much as needed to Vitamin A. Don’t supplement iron unless menstruating or directed by a physician.

Last is the issue of purity. Many supplements are contaminated with heavy metals such as mercury or lead. For example, calcium from oyster shells usually contains high levels of heavy metals. Unfortunately, our oceans are laden with these metals, and while good for a hard oyster shell, they are certainly bad for us! So, just because something is “natural” doesn’t guarantee it is good.

Our best nutrition is certainly through diet. We are designed to get 6-8 servings of fresh fruit & vegetables daily. The truth is that 90% of Americans don’t get even 5 servings daily. 90% of us! Even with a lot of effort, this is hard to do. Furthermore, because of synthetic fertilizers and lack of crop rotations, the typical leaf of lettuce doesn’t have the nutrients we think it does. It is a fact that organic gardening produces safer, more nutritious produce.

So, who should take supplements? Not the red wine drinking, berry eating, organic gardening, mostly vegetarian salmon fisherman living in the pristine wilderness! Seriously, we all should.

In the next column, part 2, I’ll cover the role of oxidation.

INSET
Free seminar
Food Allergies and Intestinal Health
Monday, July 9th at 6pm, at the IMC
RSVP at 245-6911 or online at rsvp@imcwc.com.

Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement, thyroid and adrenal disorders, fibromyalgia, weight-loss and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado ( www.imcwc.com).

Weight Loss Supplements

Weight Loss Supplements

“Hey Doc, can you write me a script for the weight loss pill?” I am frequently asked for the synthetic appetite suppressant medication known as phentermine.
While there is a role for prescription medication in weight loss I find many natural supplements work well and are more in tune with our body’s own systems
of appetite and weight management.

In the struggle to maintain weight we can use supplements to help with nutrition, digestive health, metabolism, appetite, cravings and hormone control.

Basics for weight loss

Believe it not, most people that are overweight have some degree of nutrient deficiencies. This is partly due to eating calorie-dense and nutrient-deficient
foods but also due to impaired absorption of nutrients. The first step to remedy this is to avoid sugar, high-glycemic carbohydrates, and processed or
packaged foods. Seek raw, and when able, organic fruits and vegetables. Lean meat such as fish and chicken contain good protein without the inflammatory
fats.

We start all patients in our weight loss programs on a customized multivitamin that provides intensive support for the healthy functioning of the body in
general, but also a blend of herbs and additional nutrients formulated to assist in the assimilation and utilization of foods. Pancreatic enzymes are included to
help break down foods into small nutrient building blocks that are easily absorbed through the intestinal wall.

Probiotics are added to repopulate the “good bacteria” that reside in the intestine. These beneficial bacteria help maintain a proper functioning gut, produce
many vitamins, assist with detoxification, and help break down foods for absorption. They also communicate with the immune system and play a role in
lowering inflammation and keeping us healthy. When we perform a “comprehensive digestive stool analysis” we routinely find low numbers of beneficial
bacteria – a deficit that is due to poor diet, medications, chemicals in our water and food, and even stress.

A dietary fiber supplement is also routinely recommended. Fiber is made up of complex carbohydrates that resist the digestive enzymes, thus pass
unabsorbed through the intestinal tract. “Soluble” fiber, such as pectin or gums, is fermented in the colon, which results in a more acidic environment and
more short chain fatty acids that support the beneficial bacteria and the cells that line the intestine. “Insoluble” fiber, such as cellulose, is not fermented in the
colon and thus provides bulk to stool, binds water and helps soften stools. Most types of dietary fiber contribute substantially to the volume of stomach
contents and help provide a feeling of fullness.

A protein powder supplement is another basic ingredient for weight loss. Many commercial “meal in a shake” products are based on simple protein powders.
Protein helps with energy and muscle building and will help stabilize blood sugar. I recommend 20-30gm in the morning first thing or with breakfast. Many
studies show increased protein intake, especially in the morning, will facilitate weight loss.

Restful sleep is critical to weight loss. During the deep stages of sleep our pituitary gland is very busy controlling production of hormones that build muscle
and burn fat, such as growth hormone and testosterone. Our master metabolic hormone, thyroid, has a spike in production at night. The hunger hormone,
ghrelin, is necessary to get into a good sleep cycle and is suppressed by a good night’s rest. Going to bed with an empty stomach will more likely lead to
good sleep and awakening without ghrelin-induced hunger pangs.

Managing appetite and cravings

Comfort foods, such as chocolate, sugar, or high glycemic carbohydrates will temporarily raise the “feel good” neurotransmitter called serotonin. We screen
for this and recommend serotonin support with a natural precursor called 5-HTP. Getting off the roller coaster of craving / reward with certain foods is critical
to healthy diet and weight.

High cortisol, from stress or inflammation in the body, will cause high blood sugar and weight to accumulate around the belly. We can lower cortisol with
herbs such as magnolia officinalis or phellodendron amurense. Activities that lower cortisol include meditation, deep breathing exercises, yoga, tai chi, or a
leisurely stroll.

There are a few appetite suppressants we recommend for those who struggle with portion size. Garcinia cambogia is made from a tropical Asian fruit and is
known to stimulate the breakdown of stored fat in the body, thus encouraging the glucose from our diet to be used for energy instead of stored as fat. This
also promotes a feeling of fullness.

Leptin is a hormone produced by fat cells. When we are full after a meal or a few pounds heavier leptin secretion goes up and informs our brain we are full.
But with aging and weight gain leptin quits working, so even though leptin levels are high we are resistant to its effects. Another appetite suppressant called
Irvingia gabonensis helps increase leptin sensitivity. Derived from the African bush mango plant, irvingia has been shown in studies to help with weight loss.

Increasing metabolism

Anything that helps get the cellular machinery moving more efficiently can increase metabolism and increase the burning of calories as energy. Many of the
above recommendations that add nutrients and improve gut function will help metabolism. Our anabolic steroid hormones, such as growth hormone and
testosterone, will “turn on” the DNA switches that lead to increases in metabolism, muscle growth, and fat breakdown. A similar steroid hormone called
DHEA may also play an active role in stimulating enzymes that promote fat burning in the body. While this is available over-the-counter I don’t recommend
taking it without a baseline serum test and ongoing monitoring for safe and effective serum levels.

Conjugated linoleic acid, or CLA, is thought to be an effective modulator of metabolism, reducing body fat and increasing muscle mass. Many herbs, such as
green tea extract, are also known to increase metabolism.

Improve blood sugar metabolism with cinnamon, particularly the patented “cinsulin” extracts. Helpful herbs include gymnema silvestre, berberine and
fenugreek. Chromium is a trace element that may work by helping insulin control blood sugar. Seaweed extracts are known to block the breakdown of stored
glucose reserves thus facilitating blood sugar uptake. Cellular energy can be supported with CoEnzyme Q, activated vitamin B3 or Niacinamide, L-Carnitine,
and D-Ribose.

If you are working on weight loss and already eating well and exercising, then adding some targeted supplements that work with natural metabolic systems
may help you reach your weight goals.

INSET

Free Seminar
“Bioidentical Hormone Replacement for WOMEN”
Monday, June 25th, 6pm, at the IMC
RSVP at 245-6911 or online at rsvp@imcwc.com.

Bio
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He
specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He
is founder and medical director of the Integrative Medicine Center of Western Colorado ( www.imcwc.com). Call
(970) 245-6911 for an appointment or more information.