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Description: In This Issue: Better Weight Management, Women's Health, Lyme Disease and CAM Innovations

w w www.naturalpractitionermag.com May 2015 w. N Na ew Vis tu i ra W t O lP eb u ra ct si r iti te on er M ag .c o m A VRM Media Publication Go to www.naturalpractitionermag.com davinci for info about this advertiser Go to www.naturalpractitionermag.com americasfinest for info about this advertiser TABLE OF CONTENTS May 2015 VOLUME 4 NO. 3 16 FEATURES 16 Better Weight Management Multi-pronged and holistic approaches help tackle the complexities of weight loss. 20 29 COLUMNS 4 Editor s Note 8 Practitioner Corner 38 Product Focus Thyroid Health 20 The Dangers of Lingering Lyme Lyme disease can be a challenging adversary for physician and patients alike. 24 What Women Need Supplement manufacturers toss the onesize-fits-all and opt for condition specific products for women. DEPARTMENTS 8 Health News 40 Monograph Vitamin D 47 Practitioner Chat 49 IHS Wrap-up 50 Natural Health Studies 54 Natural Marketplace 55 Bookshelf 56 Conferences & Events 56 Advertiser Index 29 CAM Innovations Research-based articles from manufacturers and suppliers on the proven health benefits of their products. Visit NaturalPractitionerMag.com FreeProductInfo for FREE Product Information or Samples from All Natural Practitioner Advertisers FREE Subscription (Print Digital or BOTH) FREE E-newsletter Visit NaturalPractitionerMag.com Copyright 2015. Natural Practitioner (ISSN 2331-2580) Volume 4 Number 3 May 2015. Natural Practitioner is published monthly (except for bimonthly January February March April June July and September October) by Vitamin Retailer Magazine Inc. 431 Cranbury Road Suite C East Brunswick NJ 08816 USA Phone (732) 432-9600 Fax (732) 432-9288. All rights reserved including the right to reproduce in whole or in part. Not responsible for unsolicited material. Opinions expressed in by-lined articles or advertisements are not necessarily those of Natural Practitioner or its owners. Publisher is not liable for advertiser product claims or representations. Advertisers assume total responsibility for the contents of their advertisements. No portion of this magazine is intended to diagnose treat cure or prevent any disease. Printed in U.S.A. Basic annual subscription rate is 50.00. POSTMASTER Send address changes to Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246. Subscription Customer Service Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246 USA Phone (818) 286-3169 Fax (800) 869-0040 nprcs magserv.com www.naturalpractitionermag.com. Back Issues & Single Copies For order information contact (732) 432-9600 or info naturalpractitionermag.com. December issue is 25.00. All other issues are 10.00 each. 2 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 Go to www.naturalpractitionermag.com xlear for info about this advertiser EDITOR S NOTE Supplements and Cancer Risk o you recommend supplements to your patients If so the news that taking too many supplements actually increases the risk of cancer likely stopped you in your tracks and possibly even made you reconsider the health benefits of supplements vs. the risk factors for your patients and what this could mean for your practice long-term. For years supplements have been touted for their health benefits including those thought to have anti-cancer properties such as curcurmin and boswellic acids which are well-established dietary botanicals with potent anti-cancer properties. In fact a new study actually suggests that there is a synergistic benefit to taking both together as stated by Ajay Goel PhD director of epigenetics cancer prevention and cancer genomics Baylor Research Institute Baylor University Medical Center in Dallas TX who authored a related study. But on the other side of the argument sits Dr. Tim Byers director for cancer prevention and control at the University of Colorado Cancer Center who last month conducted a meta-analysis of two decades worth of research including 12 trials that involved more than 300 000 people and found a number of the supplements tested actually made individuals more likely to develop certain types of cancer. Dr. Byers findings suggest that while eating certain fruits and vegetables can reduce an individual s risk for cancer taking supplements that provide the same vitamins and minerals as those fruits and vegetables not only failed to provide similar protection but actually increased a person s cancer risk. This of course is not the first time this has been suggested. Past studies have pointed to an increased cancer risk for patients who took high doses of dietary supplements. In a 2011 study for example researchers found that taking highdose vitamin E supplements was linked to a 17 percent increase in cancer risk over a seven to D 12-year period. Other similar studies have linked women s increased risk of breast cancer to high intake of folic-acid supplements. But not so fast. Did the meta-analysis method used by Dr. Byers do justice to the evidence at hand Not according to Natural Products Association (NPA) Senior Vice President of Scientific and Regulatory Affairs Corey Hilmas MD PhD and former Chief of the Dietary Supplement Regulation Implementation Branch within the Division of Dietary Supplement Programs at the Food and Drug Administration (FDA) who questioned the research that linked supplement intake with an increased risk of cancer. In his argument Dr. Hilmas points out that dietary supplements are designed to supplement the diet because consumers do not eat enough of the critical phytochemicals and constituents found in fresh fruits vegetables and other foods including fish on a daily basis. Dietary supplements should be taken as part of a healthy lifestyle and after consulting with one s health care provider. So perhaps this is where Dr. Byers and his meta-analysis goes awry. Should the study compare the health benefits of eating fruits and vegetables to gain the needed nutrients to taking comparable dietary supplements or should it look at both with the need for a healthy lifestyle a must There are some other questions surrounding Dr. Byers methods according to Dr. Hilmas like why the 12 cherry-picked trials for the meta-analysis failed to include other studies that may have evaluated negative outcomes in a long-term prospective study. NPA says it welcomes the opportunity to review the finalized manuscript once it is published and reminds consumers that they should remain confident that their dietary supplements are safe and effective and can contribute to one s overall health and wellness. This of course should also hold true for both your practice and your patients. PUBLISHER DANIEL MCSWEENEY EDITORIAL DIRECTOR DanM VRMmedia.com ASSOCIATE PUBLISHER RUSS FIELDS RussF VRMmedia.com ADVERTISING ROY KIEFFER SALES MANAGER RoyK VRMmedia.com ADVERTISING GARY PFAFF SALES ASSOCIATE GaryP VRMmedia.com INDEPENDENT GLENN DULBERG SALES REPRESENTATIVE GlennD VRMmedia.com EDITOR-IN-CHIEF DANIEL BREEMAN DanielB VRMmedia.com MANAGING EDITOR SHARI BARBANEL ShariB VRMmedia.com ASSISTANT EDITOR CRISTINA GOODWIN CristinaG VRMmedia.com CONTRIBUTING EDITOR JANET POVEROMO JanetP VRMmedia.com ART DIRECTOR ROBERT CERTO PRODUCTION MANAGER RobertC VRMmedia.com PRODUCTION ASSISTANT BRYAN ZAK GRAPHIC ARTIST BryanZ VRMmedia.com CIRCULATION MANAGER ROSIE BRODSKY Rosie StarkServices.com VRM MEDIA 431 Cranbury Road Ste. C East Brunswick NJ 08816 PHONE (732) 432-9600 FAX (732) 432-9288 E-MAIL info VRMmedia.com WEBSITE www.naturalpractitionermag.com PRESIDENT DANIEL MCSWEENEY DanM VRMmedia.com MISSION STATEMENT Natural Practitioner magazine provides alternative complementary and integrative health care professionals information about natural products market trends industry news health research and other content designed to benefit their practices and improve their business results. Subscription Customer Service To order a subscription or manage your account please contact us at Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246 USA Phone (818) 286-3169 Fax (800) 869-0040 nprcs magserv.com www.naturalpractitionermag.com Back Issues See the Table of Contents page for price and order information. Connect With Us www.twitter.com vitaminretailer www.facebook.com naturalpractitioner www.linkedin.com www.instagram.com www.pinterest.com company vrm-media vitaminretailermagazine vrm_media 4 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 Go to www.naturalpractitionermag.com probioticsinternational for info about this advertiser Meet Natural Practitioner s Editorial Advisory Board Adam Killpartrick DC Dr. Adam Killpartrick earned his degree from Palmer College of Chiropractic in Davenport IA. His primary practice focus has been a synergistic blend of NUCCA (upper cervical chiropractic) with Cranial Release Technique for which he has attained lead instructor status. Dr. Killpartrick furthered his education in clinical nutrition functional diagnostics and lifestyle medicine and has since successfully integrated this blend of specialized chiropractic care and functional medicine into his New Hampshire private practice. This practical experience led him to clinical consulting for numerous nutritional supplement companies. He is currently the chief scientific officer for DaVinci Laboratories. In its search to provide readers with insight and perspective that will help them build and better their practices Natural Practitioner has culled together an Editorial Advisory Board of authoritative practitioners willing to do just that. You will see our Board members present in key editorial as well as each authoring their own column Practitioner Corner throughout the year that highlights their expertise and professional experiences. They will also lend us their perspective on trends and topics that Natural Practitioner will be covering in issues to come. Natural Practitioner s Editorial Advisory Board is comprised of Walter J. Crinnion ND After receiving his naturopathic medicine degree from Bastyr University in 1982 Dr. Walter J. Crinnion opened a family practice and began specializing in allergies and treating chronic health problems caused by environmental chemical overload leading him to open Healing Naturally the most comprehensive cleansing facility for chemically poisoned individuals in North America in 1985. A frequent lecturer he has published several articles in peer-reviewed journals in addition to his book Clean Green and Lean. Dr. Crinnion has been on the board of directors of the American Association of Naturopathic Physicians and is a two-time recipient of their award for in-office research. Having taught at Bastyr the National College of Naturopathic Medicine and the University of Bridgeport School of Naturopathic Medicine he is currently a professor at the Southwest College of Naturopathic Medicine and the chair of its Environmental Medicine Department. Holly Lucille ND Dr. Holly Lucille is a nationally recognized licensed naturopathic physician lecturer educator and author of Creating and Maintaining Balance A Women s Guide to Safe Natural Hormone Health. Her private practice Healing from Within Healthcare focuses on comprehensive naturopathic medicine and individualized care. Outside of her practice Dr. Lucille holds a position on the American Association of Naturopathic Physicians board of directors and is on the faculty of the Global Medicine Education Foundation. She is the past president of the California Naturopathic Doctors Association where she spearheaded a lobbying effort to have naturopathic doctors licensed in the state of California. A graduate from the Southwest College of Naturopathic Medicine Dr. Lucilles commitment to naturopathic medicine has been recognized with the Daphne Blayden Award and more recently the SCNM Legacy Award. Jared M. Skowron ND Dr. Jared M. Skowron is a national expert in natural medicine for children. Author of the best-selling 100 Natural Remedies For Your Child his lifes work is dedicated to the optimal health of children. A faculty member at University of Bridgeport and founder of their Pediatric & Autism Clinic Dr. Skowron has helped thousands of children fulfill their optimal potential. He is vice president of the Pediatric Association of Naturopathic Physicians and his expertise is in pediatrics autism ADHD and acute and chronic EENT conditions. Shailinder Sodhi ND Growing up near the Himalayas Dr. Shailinder Sodhi developed an early interest in ayurvedic plants and herbs and received his BAMS (bachelor in ayurvedic medicine and surgery) degree from Dayanand Ayurvedic College in Jalandhar India in 1985. In 1993 he received a naturopathic medicine degree from Bastyr University as well as a degree in diagnostic ultrasound from Bellevue College. Dr. Sodhi practices naturopathic medicine along with his wife Dr. Anju Sodhi and his brother Dr. Virender Sodhi at the Ayurvedic and Naturopathic Medical Clinic in Bellevue WA which he established in 1989. In addition Dr. Sodhi serves as president of Ayush Herbs Inc. a manufacturer of high-quality ayurvedic herbal formulas is an adjunct faculty member at Bastyr and has been published in several natural health magazines. Jacob Teitelbaum MD A recognized authority on chronic fatigue syndrome (CFS) and fibromyalgia Dr. Jacob Teitelbaum is medical director of the Fibromyalgia and Fatigue Centers nationally and does phone consultations with CFS fibromyalgia patients worldwide. He is the author of the popular iPhone application Cures A-Z and author of the best-selling book From Fatigued to Fantastic (3rd revised edition Avery Penguin Group) and Pain Free 1-23--A Proven Program for Eliminating Chronic Pain Now (McGraw-Hill). His newest book is Beat Sugar Addiction NOW (Fairwinds Press 2010). Dr. Teitelbaum does frequent media appearances including Good Morning America CNN Fox News Channel the Dr. Oz Show and Oprah & Friends. Amber Lynn Vitse BA LMT CN Amber Lynn Vitse BA LMT CN majored in economics with postgraduate work in medical sciences and additional certifications in bodywork and nutrition. She is the founder and principal of AmberLynnVitale an independent producer and presenter of unique media content designed to educate the public and the medical establishment on current health trends and ethical and legislative concerns. A leading edge provider and educator of Fusion Bodyworks she practices an integrated modality of ayurvedic medicine yoga advanced bodywork and holistic nutrition. Vitse uses her 17 years of experience in integrative medical practices to provide consultation on marketing to the consumer mindset. She recently joined the Garden of Life team as their Northeast Educator. Deborah Waddell Dipl Ac LAc Nationally licensed through the National Commission of Chinese and Oriental Medicine (NCCAOM) Deborah Waddell has served on the faculty of The Eastern School of Acupuncture she is a member of the American Pregnancy Association and is currently obtaining her Plant Based Nutrition Certification from Cornell University. The founder of Skylands Acupuncture & Wellness Center specializing in pain facial rejuvenation womens health and fertility optimization Waddell also educates her patients and the community through seminars on the virtues of a plant-based diet for optimal and preventive health. Through the use of acupuncture Chinese herbal formulas dietary therapy and mind-body techniques she has helped women realize their dream of having a family naturally. 6 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 Go to www.naturalpractitionermag.com kyowa for info about this advertiser HEALTH INDUSTRY NEWS AHPA Testimony Outlines Adequacy of Current FDA Framework for Homeopathic Drug Regulation T he Food and Drug Administration s (FDA) current regulation of homeopathic drugs provides sufficient substantial oversight of these products according to testimony presented by the American Herbal Product Association (AHPA) at a public hearing held by FDA on April 20-21. The hearing Homeopathic Product Regulation Evaluating FDA s Regulatory Framework After a Quarter-Century was held to gather input on appropriate regulatory policy for homeopathic medicines. AHPA s testimony presented by Will Woodlee partner at Kleinfeld Kaplan and Becker LLP highlighted several points that demonstrate the adequacy of FDA s current regulatory framework for homeopathic medicines in protecting public health and ensuring consumer access to safe products. Woodlee stressed that under the existing framework companies are required to register their facilities and to list their drug products with FDA which along with other investigative and surveillance tools provides the agency with the means to identify manufacturers marketers and products as candidates for education administrative action or enforcement action as necessary or appropriate. The current regulatory framework also provides FDA with sufficient information on adverse events associated with over-thecounter (OTC) homeopathic drug products to allow the agency to protect the public health according to AHPA s testimony. Manufacturers are required to maintain records of all adverse events reported to them and must maintain records and reports regarding complaints. When required firms must investigate those complaints and upon request make their files available during FDA inspections. Woodlee also noted that FDA s existing regulatory framework for homeopathic drug products appropriately reflects the small safety risk inherent to these highly diluted products. In addition AHPA is not aware of any data indicating that consumers perceive appropriately marketed OTC homeopathic drug products as substitutes for prescription drugs and AHPA believes FDA currently has adequate enforcement authority to address any OTC homeopathic drug products that are inappropriately marketed for non-OTC indications or without adequate directions for use. For more information visit www.ahpa.org or www.fda.gov. USP Congratulates Dr. Tieraona Low Dog Recipient of the AHPA Herbal Insight Award T he United States Pharmacopeial Convention (USP) congratulates Dr. Tieraona Low Dog recipient of the American Herbal Products Association (AHPA) Herbal Insight Award. The award recognizes substantive positive contributions to the herbal products industry. In naming Dr. Low Dog AHPA noted her contributions in the area of botanical supplements and their uses. Dr. Low Dog is an internationally recognized expert in the field of dietary supplements herbal medicine women s health and natural medicine. In addition to her work as a clinician and educator at the Arizona Center for Integrative Medicine Dr. Low Dog has been involved in national health policy and regulatory issues for more than a decade. In 2000 she was appointed by President Bill Clinton to serve on the White House Commission of Complementary and Alternative Medicine and she recently completed her three-year term as a member of the Advisory Council for the National Institutes of Health National Center for Complementary and Alternative Medicine (NCCAM). Dr. Low Dog served as the elected Chair of the USP Dietary Supplements Information Expert Committee from 2005 to 2010. And now serves as the Chair of the USP Dietary Supplements Admission Evaluation Subcommittee. The public health impact of Dr. Low Dog s contributions are outstanding said Gabriel Giancaspro vice president foods dietary supplements and herbal medicines at USP. In addition to her expertise in the scientific evaluation of complementary and alternative medicine we appreciate her spirit of volunteerism and her commitment to USP s public health mission. Under her guidance and objective leadership the committee advanced advisories for appropriate use of dietary supplements made major revisions to the admission criteria and safety evaluation of dietary supplements for USP monograph development and led the development of more than 40 families of supplement monographs. The Herbal Insight Award joins a long list of distinctive honors awarded to Dr. Low Dog including the Martina de la Cruz medal for her work with indigenous medicines (1998) Time magazine s Innovator in Complementary and Alternative Medicine (2001) the Burt Kallman Scientific Award (2007) and NPR s People s Pharmacy award (2007). Dr. Low Dog has propagated the responsible use of herbal medicine and dietary supplements for integrative women s health with more than 30 publications to her credit. Her volunteerism is also reflected in her serving on the editorial advisory boards of Journal of Society for Integrative Oncology American Family Physician Association of Reproductive Health Professionals and contributions to the journal Alternative and Complementary Therapies. An internationally known speaker on topics ranging from the responsible use of herbal medicine and dietary supplements to integrative approaches to women s health Dr. Low Dog also serves on the editorial advisory boards of Menopause and Explore journals Prevention magazine and the American Botanical Council. For more information visit www.usp.org. 8 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 Go to www.naturalpractitionermag.com mitoq for info about this advertiser HEALTH INDUSTRY NEWS SharePractice Now Builds Global Medical Consensus on the Web S harePractice recently announced that physicians can now access the popular iOS platform through the web. The new web browser version of the integrative medicine app will allow doctors who use a desktop computer or iPad while seeing patients to consult SharePractice in their workflow at the point of care without having to reach for their iPhone. Now any desktop connection is all a doctor needs to quickly leverage the real-time consensus of the global medical community to make better treatment decisions. SharePractice will be as valuable to medicine as Facebook is to your social life. Doctors will not be able to practice without it said Dr. Aaron Blackledge an early adopter and physician in San Francisco CA. Web-based access is the next logical progression for this gamechanging product to ensure broader access and integration into doctors workflows. While other clinical references focus solely on allopathic drugs and evidencebased research SharePractice sees this as the starting line. The company spent the first stages of its development building a comprehensive medical ontology that maps treatments to diagnoses and gives the product data parity with other reference tools. SharePractice s unique offering is that verified clinicians rate and review all of these treatments based on their professional experience. And since verified users can add their own treatments and protocols for review SharePractice has become the only evidence-based crowdsourced repository for the integration of conventional and non-conventional treatments. Until now doctors have collaborated via phone text message email or forums. The problem is that all of these valuable opinions are lost since they are not structured for quick use at the point of care. By structuring doctors opinions within a clinical reference SharePractice is bringing social validation to some of the world s most critical decisions. With the announcement of the new web app SharePractice is pushing further into every doctor s tool kit. All over the world patients are roughly the same but medical education varies dramatically. We see this as a significant opportunity for physicians to join together in a manner that is constructive for themselves their patients and all of humanity. Better medicine means a better world. SharePractice is completely free for use by licensed clinicians residents and medical students. The company monetizes by selling anonymized sentiment analysis to treatment companies payers and providers who take an active interest in how their products are used and perceived by the professionals who know them best. For more information visit www.sharepractice.com. Go to www.naturalpractitionermag.com emerson for info about this advertiser 10 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 Go to Go to www.naturalpractitionermag.com albion for info aboutaboutadvertiser naturalpractitionermag.com probioticsinternational for info this this advertiser HEALTH INDUSTRY NEWS NCNM to Offer Undergrad Degrees T he National College of Natural Medicine (NCNM Portland OR) will begin offering undergraduate programs--a Bachelor of Science in Integrative Health Sciences and a Bachelor of Science in Nutrition. NCNM received approval to begin both programs in fall 2016 from the Northwest Commission on Colleges and Universities the regional accreditation agency for post-secondary educational institutions recognized by the U.S. Department of Education. The new undergraduate degrees offered by the new School of Undergraduate & Part-Time Studies will join the medical school s rapidly expanding roster of post-graduate programs which include the Schools of Naturopathic Medicine Classical Chinese Medicine and Research & Graduate Studies. Both undergrad offerings are two-year premed and pre-health degree completion programs which focus on integrative medicine or nutrition respectively. The increasing interest in natural and integrative medicine as well as the critical need to strengthen the health care workforce in the U.S. has heightened the importance of adequately preparing students for professions in the health and wellness fields. As integrative medicine expands into hospitals and clinics throughout the country it becomes ever more necessary for NCNM and other educational institutions to provide accessible pathways for future students in graduate and doctoral medical programs. These new undergraduate degrees are designed to help them develop the critical thinking and associated skills required for future graduate medical training. The programs are designed for students who have previously completed two years of college course work such as community college students who want to complete their undergrad degree transfer students from a traditional four-year college or university or students who have previously withdrawn from a bachelor s program and want to continue. The new educational offerings will appeal to students interested in careers in integrative medicine such as naturopathic medicine Chinese medicine and acupuncture chiropractic medicine herbal medicine nutrition holistic nursing and holistic dentistry. These unique undergraduate programs have been developed to meet the demand for access to healthcare or research careers. THE GO TO RESOURCE FOR ALTERNATIVE & INTEGRATIVE HEALTHCARE PROFESSIONALS NP s Upcoming Issue Highlights June July August 5 29 15 ad closing Bone Health Company Profiles AANP Show Issue 7 13 15 ad closing Our 2015 Media Planner Is Now Available At NaturalPractitionerMag.com 2015-Media-Planner Contact One of Our Ad Specialists Today Russ Fields at 732-432-9600 ext. 102 e-Mail RussF VRMmedia.com Roy Kieffer at 719-358-9838 e-Mail RoyK VRMmedia.com Gary Pfaff at 732-432-9600 ext. 107 e-Mail GaryP VRMmedia.com In speaking about the programmatic changes at the nearly 60-year-old institution NCNM President David J. Schleich PhD said It has long been on our agenda to develop pre-professional programs to better prepare students for the academic demands of medical school and graduate programs. Both undergrad programs blend traditional healing knowledge with contemporary science and evidence-based medicine. To accomplish these goals each program consists of three threads that are integrated throughout the curriculum a core thread (integrative health sciences or nutrition) a hard sciences thread (such as genetics immunology or physics) and a social sciences thread (such as ethics cultural competency or self-reflection). The Integrative Health Sciences degree features a variety of complementary and integrative medical topics such as herbal medicine whole-food nutrition and mind-body medicine. The Nutrition degree focuses on topics such as whole-foods nutrition and the connection between diet and disease. Both programs feature a capstone project in which students are required to draw on all aspects of the curriculum to develop a final project research paper or complete an internship. Dr. Schleich noted that NCNM s growth has been rapid as it actively rolls out new programs. In just a few short years NCNM has grown from a two-program college into the exemplary medical college it is today with seven diverse doctoral and master s program offerings within our three distinct schools of medical education. And now we introduce our newest academic enterprise the School of Undergraduate & Part-Time Studies he said. Just in the last few years alone we ve added master s degrees in integrative medicine research nutrition global health and most recently a new program in integrative mental health Schleich observed. Our enrollment has increased 33 percent since 2007. With the addition of undergraduate programming NCNM will continue to attract the best and brightest to build on the legacy first established six decades ago by naturopathic doctors who ensured the future of natural medicine by founding NCNM. For more information visit www.ncnm.edu academic-programs undergraduate-programs.php. 12 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 HEALTH INDUSTRY NEWS Cyrex Laboratories Launches Revolutionary Panel To Measure Reactivity to 180 Food Antigens yrex Laboratories (Phoenix AZ) has launched its innovative Array 10 a multiple food immune reactivity screen. Array 10 is the most innovative immune reactivity food panel on the market. The result of 30 years of scientific development Array 10 features 10 advanced proprietary technologies by Cyrex. First unlike other labs Array 10 tests 180 cooked raw and modified foods. Array 10 is unique to Cyrex in that it tests for immune reactivity to foods the way in which foods are most likely consumed (cooked raw or modified). The reasoning behind testing for reactivity to cooked modified and raw foods is once a food is heated to 118 degrees or more the protein structure and therefore its antigenicity may change. This real-world approach to testing minimizes the risk of missing reactivity to some of the most common foods. Additional proprietary technologies fea- C tured in Array 10 include combined food protein reactivity lectins and agglutins isolation technology amplified antigenics proteins and peptides hidden meat glue crossreactive pan-antigen isolates gum large molecule reactivity tissue-bound artificial food coloring reactivity oil protein isolation and dual antibody detection. There are so many ways that Array 10 is beneficial to patients. According to the American Autoimmune Related Disease Association over 50 million Americans have been diagnosed with an autoimmune disorder. It s time we start paying attention to what we are putting into our bodies and how our bodies react to our diets said Dr. Aristo Vojdani pioneer of ELISA testing and chief scientific advisor for Cyrex Laboratories. In addition to genes environmental triggers such as toxic chemicals infectious agents and food proteomes all play a significant role in autoimmune dis- ease. Array 10 provides a comprehensive look at immune reactivity to a wide range of foods through a simple blood test. It is a great tool for doctors to use with those who already have an autoimmune disorder and with those who are interested in living a healthier lifestyle through a wellness strategy. Array 10 and all of Cyrex s Arrays are available to consumers exclusively through an order from a physician or other licensed healthcare professional. Array 10 is recommended for patients who are experiencing unexplained symptoms that are gastrointestinal neurological dermatological or behavioral in nature. In addition the test is recommended for those who are suspected of having increased intestinal permeability which is the gateway for environmentally induced autoimmune disorders. For more information visit www.cyrexlabs.com. Emerson Ecologics Announces First Annual Conference for Integrative Health Care Practitioners E merson Ecologics (Manchester NH) has announced its first annual conference IGNITE The Business of Better Medicine. The conference will provide integrative health care practitioners with the necessary business knowledge to develop a thriving and fulfilling practice. Scheduled for November 13-15 2015 at the Omni La Costa Resort and Spa in San Diego CA the conference will be a one-ofa-kind get it done event where attendees can expect to accomplish key projects and leave with an action plan in hand. Highlights of the event include keynote presentations from Jeffrey S. Bland PhD FACN CNS and Tieraona Low Dog MD as well as hands-on workshops led by industry experts. The conference workshops are designed to address key business challenges related to clinic operations sales and marketing and patient compliance with a focus on providing valuable and actionable takeaways. In addition representatives from Emerson s most trusted professional brands will be onsite guaranteeing that attendees walk away with a broad community of supportive peers partners and experts. Most practitioners including myself have struggled to balance their passion for patient care with the stress of building a business said Dr. Jaclyn Chasse medical director for Emerson Ecologics. I am so excited to be working with Emerson to deliver the business knowledge not taught in medical school but equally important to creating a successful practice. The conference will build on the success of Emerson s IGNITE series of practice growth webinars and events. Designed to deliver the personalized business advice that practitioners have come to expect from IGNITE the event will feature an expanded range of topics and experts including Mastering Sales & Marketing - Miriam Zacharias MS LPSN Enhancing Patient Compliance - Dan Kalish DC Leveraging Technology - Peter Osborne DC CCN Optimizing Clinic Operations Leandra Fishman Practice Management Consultant Often practitioners don t realize how closely their clinical success is tied to the success of their business said Dr. Dan Kalish founder of the Kalish Institute. The heart of building a client base and thriving referral network revolves around the relationships you develop with your patients as well as the communication skills required to provide them with an optimal treatment plan and health outcome. At Emerson we are passionate about advancing integrative medicine and we know that the clinical and business success of our practitioners is vital to accomplish this added Dr. Chasse. We are thrilled to launch this transformative conference to help our customers succeed and reach more patients. For more information or to register for the conference visit www.eeignite.com. 14 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 Go to www.naturalpractitionermag.com fairhaven for info about this advertiser T he percentage of U.S. adults who are obese continued to trend upward in 2014 reaching 27.7 percent. This is up more than two percentage points since 2008 and is the highest obesity rate Gallup and Healthways have measured in seven years of tracking it. More Americans who were previously overweight have now moved into the obese category while the percentage who are at normal weight has remained stable since 2013. For practitioners the challenge of helping patients reach their weight-loss goals can be viewed as a driving force to aid in the battle of the bulge. The best chance of long-term success may be achieved with a multi-pronged approach to weight management that can be tailored to each individual according to Emily Gonzalez ND senior scientific development associate with Floridabased Life Extension. Addressing Life Extension s nine pillars of weight loss including restoring insulin sensitivity and a youthful hormone balance increasing physical activity restoring resting energy expenditure rate and brain serotonin levels promoting healthy adipocyte signaling and of course eating in order to live a long and healthy life is a holistic approach to weight management that can benefit many individuals struggling with extra body weight Dr. Gonzalez said. Leonid Ber MD from Illinois-based Protocol For Life Balance suggested similar advice The 16 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 most holistic approach to weight management is the one that recognizes the complexity of the interaction between nature and nurture and takes into consideration genetic predispositions epigenetic expressions interplay between the hormones regulating hunger and satiety as well as behavioral aspects such as exercise and dietary choices along with their hedonic value he said. Clinicians no longer think of weight management as a pill or a surgical procedure solution that could produce longstanding results alone. For Beth Baldwin-Lien ND medical affairs & education with Vital Nutrients in Connecticut natural approaches for weight management include eating a whole food diet regular physical activity and balancing calorie intake with calorie expenditure. When tailoring recommendations for an individual patient she said a practitioner will first assess for and address underlying medical reasons for weight gain such as insulin resistance hypothyroidism or elevated cortisol levels and review any medications that may impede weight-loss efforts. Functional medicine physicians often include assessment of endocrine-disrupting environmental toxins as a part of a weight-loss approach. Shifting Approaches From a clinician s perspective the most significant evolution happening with dietary supplements is in the way they are being used--as a part of comprehensive nutritional and behavioral intervention protocol custom-fit to the patient s needs Dr. Ber noted. This is the most important distinction between individual consumers who clearly lean toward a supplement-only-solution and natural practitioners who wholeheartedly embrace a holistic approach. As overweight obesity has become one of the most important public health issues facing our country said Dr. Gonzalez innovative products and ingredients with research to support their use for healthy weight management are an important part of the overall approach to combat this epidemic. Keeping abreast of the research to find these innovative ingredients and bring them to the consumer is one of the ways that Life Extension stays in the forefront of helping people find optimal health as they age. Weight-Loss Ingredient Research Regarding recent research on weight loss Life Extension s Dr. Gonzalez pointed to a 2014 study in Nutrition which showed that young to middle-aged obese men and women taking 500 mg twice daily of a specialized peptide complex from Saccharomyces cerevisiae reduced their energy intake decreased their waist circumference and lost body fat (while preserving lean body mass) in a 10-week period compared to placebo.1 In 2010 Satiereal a proprietary saffron extract was shown to reduce body weight and snacking frequency in healthy mildly overweight women in a placebo-controlled double-blind study without caloric restriction.2 And Beanblock a standardized extract of the Italian Borlotto bean was associated with a reduction in body weight waist circumference and oxidative stress in healthy overweight subjects over a 12-week period in a 2014 pilot study.3 Natural Recommendations There is a wide array of nutritional products to support healthy weight management. Some of the most innovative include products that contain a specialized peptide complex from Saccharomyces cerevisiae that may modulate appetite-regulating hormones in the brain via their effect on neuropeptide Y and decrease the activity of enzymes responsible for the manufacturing of fat from excess energy in foods Dr. Gonzalez noted. Products that contain a specialized extract of saffron may reduce the desire to snack by targeting some of the emotional factors that may cause someone to eat more when they re trying to eat less. And a novel Italian Borlotto bean extract has been shown to help support normal levels of the gut hormones that control appetite and satiety as well as modulate alpha-amylase the enzyme that converts dietary starch into simple sugars. Dr. Ber added that perhaps the most useful framework for classifying nutrients relevant to weight management would be dividing them into modalities affecting central and peripheral mechanisms and a combination thereof. Getting to know your patient inside and out should allow you to concentrate on the pathways in need of most repairs. Weight-Loss Products Used for healthy body weight Dr. Ber noted that MCT or medium-chain triglycerides from coconut oil are glycerol esters of fatty acids with the number of carbon atoms between eight and 12. Unlike longer chain fatty acids they require little or no enzymatic breakdown and are easily absorbed and transported into the liver where they are rapidly used for energy production rather than being stored as fat he explained. Metabolically speaking they are processed more like carbohydrates but without the requirement of insulin and with no effect on blood sugar and triglycerides. Because MCT bypass peripheral tissues it makes them less susceptible to hormone-sensitive lipase and to being deposited into adipose tissue. The best clinical outcomes in body weight and composition have been shown in moderately overweight individuals where MCT (about 10 g day) isocalorically replaced long-chain triglycerides in a fat-balanced diet reaching statistically significant difference in body weight at eight to 12 weeks as compared to placebo. Another noteworthy dietary ingredient used in a Protocol for Life Balance product is commonly known as 7-Keto a naturally occurring metabolite of dehydroepiandrosterone (DHEA) but unlike DHEA it does not result in formation of androgenic or estrogenic hormones Dr. Ber stated. 7-Keto has a unique mode of action via optimizing the rate of mitochondrial substrate oxidation and support of triiodothyronine (T3) levels. Typical clinically validated amount of 7-Keto is 200 mg day. It results in statistically significant uptick in the normal energy expenditure and is strongly recommended when combined with a personalized diet and exercise regimen. Dr. Baldwin-Lien recommended Vita Nutrient s 7-KETO DHEA Vital Clear protein powders multi nutrients vitamin D and berberine. 7-Keto also known as 3-acetyl-7-oxo dehydroepiandrosterone or 7-oxo DHEA is a naturally occurring metabolite of DHEA which cannot be converted back to DHEA in the body she explained. Like DHEA 7Keto production declines with age. 7-Keto may enhance the activity of thermogenic enzymes that support the body s ability to utilize fat for energy. Studies suggest that 7Keto may provide non-stimulatory support in improving RMR (resting metabolic rate) and promoting weight loss when combined with exercise and a calorie restricted diet. Vital Nutrients 7-Keto DHEA is derived from a plant source that has been purified to match the substance naturally produced in the body. Vital Clear is a high-quality source of naturally pure macro- and micronutrients. Vital Clear is comprised of rice and pea protein vitamins minerals trace elements amino acids herbs and essential fatty acids. A full range of vitamins minerals and trace elements support all the body s systems. Optimal nutrient levels combine with cinnamon and glucomannan to maintain healthy blood sugar levels. The unique blend of botanicals and amino acids promote normal detoxification while simultaneously suppressing inflammation. MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 17 In addition Life Extension s weight-loss products include Waist-Line Control Optimized Saffron with Satiereal Advanced Natural Appetite Suppress and Advanced Anti-Adipocyte Formula. Lifestyle When combined with diet exercise and lifestyle strategies Dr. Baldwin-Lien said nutritional supplements could help Increase resting metabolic rate Attain quick wins to increase feelings of self-efficacy Promote satiety Fill nutritional gaps in SAD (standard American diet) low-calorie or restrictive diets Support healthy blood sugar insulin sensitivity and cortisol levels Aid in detoxification of accumulated environmental toxins that may be impeding fat loss and or mobilized during fat loss Decrease inflammation to improve pain exercise tolerance and lower diabetes risk Her other recommendations are Eat breakfast (including protein) within one hour of waking to avoid cortisol surge and compensatory overeating later in the day Eat every three hours during the day Focus on whole foods lean proteins high-fiber low-glycemic index vegetables fruits and whole grains omega-3 monounsaturated fats Avoid high-glycemic index foods and caloric drinks Correct portion distortion occasionally weigh measure servings as a reality check eat off of smaller plates box up half of a restaurant meal to take home Gonzalez explained. This is particularly important in the weight management category as there have been issues with drugs such as sibutramine and fluoxetine showing up in weight management supplements. 4 Dr. Ber agreed Safety and quality of dietary supplements have been undermined by some of the unsavory flight-by-night players in the industry he noted as documented by a steady flow of warning letters being issued by the FDA identifying adulterated weight-loss products often containing undeclared drug ingredients. When it comes to dietary supplements know your manufacturer have a relationship with your brand this step is as important as the intervention choices you make for your patients. References 1 Jung EY Cho MK Hong YH et al. Yeast hydrolysate can reduce body weight and abdominal fat accumulation in obese adults. Nutrition. 2014 Jan 30(1) 25-32. 2 Gout B Bourges C Paineau-Dubreuil S. Satiereal a Crocus sativus L extract reduces snacking and increases satiety in a randomized placebocontrolled study of mildly overweight healthy women. Nutr Res. 2010 May 30(5) 305-13. 3 Luzzi R Belcaro G Hu S et al. Beanblock (standardized dry extract of Phaseolus vulgaris) in mildly overweight subjects a pilot study. Eur Rev Med Pharmacol Sci. 2014 Oct 18(20) 3120-5. 4 Dunn JD Gryniewicz-Ruzicka CM Mans DJ et al. Qualitative screening for adulterants in weight-loss supplements by ion mobility spectrometry. J Pharm Biomed Anal. 2012 Dec 71 18-26. Safety One of the most scrutinized categories of nutritional supplements is weight loss. In fact recently the FDA (U.S. Food and Drug Administration) has warned consumers to avoid any weight-loss pills that contain BMPEA. BMPEA or beta-methylphenethylamine is something of a super caffeine but FDA researchers are concerned that the substance may be more closely related to amphetamine. Quality is always important when it comes to dietary supplements Dr. Gonzalez said adding that Life Extension meets the highest standards of good practices for quality assurance and control as certified by NSF International an organization that provides third-party GMP (good manufacturing practice) certification programs. This means that the label accurately reflects exactly what is in each product and does not contain any traces of drugs or other adulterants Dr. The percentage of U.S. adults who are obese continued to trend upward in 2014 reaching 27.7 percent. A holistic approach to weight management is the one that recognizes the complexity of the interaction between nature and nurture and takes into consideration genetic predispositions epigenetic expressions interplay between the hormones regulating hunger and satiety as well as behavioral aspects. When it comes to dietary supplements know your manufacturer and have a relationship with your brand. Healthy Take Aways FOR MORE INFORMATION Life Extension (800) 226-2370 www.lef.org Protocol For Life Balance (877) 776-8610 www.protocolforlife.com Vital Nutrients (888) 328-9992 www.vitalnutrients.net 18 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 Go to www.naturalpractitionermag.com rainbowlight for info about this advertiser O ften misdiagnosed and with no definite guidelines or vaccine for treatment Lyme disease can be a dangerous and lingering infection. And while a vaccine is currently under development if left untreated Lyme disease can allow the bacteria to travel through the bloodstream and attach to various body tissues leading to swelling of the joints and even heart and nervous system complications. Lyme disease is more common than once thought and more prevalent during the warmer months of the year. According the Centers for Disease Control and Prevention (CDC) approximately 300 000 Americans each year are diagnosed with Lyme disease and that number is on the rise. It comes from a bacterium called Borrelia burgdorferi and is most commonly spread by deer ticks in North America and Europe. Lyme disease is often identified as a bull seye-shaped rash called erythema migrans that can appear within a few days of infection can appears in more than one location on the body and affects approximately 70 to 80 percent of those with the disease. Symptoms include joint pain and flu-like signs including fever headache and general fatigue. More severe symptoms can include nerve damage including memory loss difficultly concentrating and changes in mood or sleep habits. Natural Medicines (formerly Natural Standard) identifies three separate stages of Lyme disease each with different symptoms 1. Localized early disease stage This is the onset of the disease where the bite site expands slowly in size over several days and is usually not painful. However many individuals do not realize they have been bitten by a tick. 2. Secondary stage Symptoms and evidence of a more widespread infection usually begin to develop. 3. Third stage Approximately 20 percent of people with Lyme disease go into remission after stage two but most move into this third stage which finds the individual struggling with conditions that involve the heart nervous system and joints and can linger for weeks months or even years. Diagnosis and Treatment Options One of the biggest concerns with Lyme disease is that many who contract the disease may not even know that they have it at least at first. It can mask itself as any number of illnesses or conditions from simple flu-like symptoms to more serious concerns such as chronic fatigue syndrome (CFS) autoimmune conditions or even fibromyalgia. In his book Why Can t I Get Better Solving the Mystery of Lyme & Chronic Disease author Richard I. Horowitz MD refers to Lyme disease at the Great Imitator and points out the inaccurate testing combined with a fierce ongoing debate that questions chronic infection makes it difficult for suffers to find effective care. It is important to understand that numerous infections trigger a secondary chronic fatigue syndrome fibromyalgia with Lyme simply being one of these said Jacob Teitelbaum MD director of the Practitioners Alliance Network and a leading expert on effective treatments for fibromyalgia and CFS. Antibiotics can be helpful for Lyme and are best used in conjunction with other treatments that augment immunity and treat the overall fibromyalgia. Supplements that are especially helpful include ribose topical comfrey and BCM-95 curcumin. Antibiotics and natural remedies are best used together. The good news for patients regarding Lyme disease is that most make a full recovery if the infection is treated promptly and properly. Without swift diagnosis and treatment however the disease can continue to 20 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 progress and affect multiple parts of the body. On very rare occasions Lyme disease can even lead to death which is why both physicians and patients alike must heed the warning signs of the disease and act quickly to put it in its place. Lyme disease is a very difficult infection to treat and can have effects on a patient for many years to come said Chris Oswald DC CNS. Currently our understanding of chronic Lyme disease infections needs growth but one of the most important things associated with better outcomes is rapid identification and prophylactic treatment of the potential infection. When it comes to the chronic effects of Lyme disease I tend to focus on the effects of post-infectious inflammation. A large priority of mine is to improve the function of the eicosanoid pathway with high dose EPA and DHA. This will promote the formation of SPMs to help with the final resolution of inflammation and help to support balance within the immune system. Once the levels of inflammatory molecules have fallen there is less pain associated with joint destruction and the body can start to mount an appropriate immune response and heal tissue that had been damaged due to the effects of the infection. One such product is ProOmega from California-based Nordic Naturals which provides high levels of the omega-3 fats EPA and DHA and has been shown to support healthy glucose and lipid levels bronchial health and the body s ability to respond to stress. The first line of defense against Lyme disease is usually a three or four-week dose of antibiotics to help combat the infection. Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) are also usually recommended for pain and inflammation but can cause additional side effects such as nausea. Natural remedies can also play a large supporting role here as can exercise and physical activity to help improve range of motion. I want to emphasize that the standard medical approach of antibiotics in the treatment of acute Lyme s disease is appropriate said Michael T. Murray ND. During this time natural products can be used as supportive care. Foremost in this goal is the use of a probiotic supplement to prevent the side effects of antibiotics on the intestinal flora. A good dosage during this time would be 12- 24 billion live bacteria daily. Beyond that my recommendation would be to focus on general supplementation recommendations to support the immune system such as taking a high potency multiple vitamin and mineral formula extra vitamin D to provide an intake of 2 000 to 5 000 IU daily and the use of immune supportive botanicals or mushroom extracts. New Jersey-based Mushroom Wisdom offers its Super Reishi supplement that contains both hot water and alcohol concentrated extracts to provide the maximum range of beneficial constituents of the mushroom. It is also enhanced with the company s proprietary Maitake D-Fraction for added immune support. Immune inflammation liver and stress support seem to be major areas of concern when dealing with or recovering the Lyme disease said Donna Noonan president of the company. The specific immune-related research substantiates that certain mushrooms may be able to help accelerate the healing process while other general support benefits may help rebuild and strengthen the body. While no mushroom supplement is intended to treat or cure any disease I believe that certain mushroom supplements should be considered as one of the supportive components of any natural or integrative plan. Boosting the immune system to help combat Lyme is of utmost importance and along with the herbs from the herbal Lyme protocol (devised by master herbalist Stephen Buhner) such as Japanese knotweed and cat s claw I would use probiotics as well as correct for nutrient deficiencies especially zinc vitamins A C and D and selenium said Frank Aieta ND. I also get great results with the use of medicinal mushroom extracts specifically Shitake Reishi Coriolus versicolor Agaricus blazei Maitake and cordyceps. Prevention of course is the ideal counterpunch to Lyme disease according to Terry Shirvani ND director of product innovation at Texas-based Progressive Laboratories Inc. Prevention is generally much easier said Dr. Shirvani. In regards to antibiotics the danger must outweigh the adverse effects. In other words the patient s condition must be serious enough to warrant the potentially huge impact on the gut and immune system. There is a tradeoff here. The health care practitioner and patient must consider this thoughtfully. A Lyme disease vaccine is under developments but not yet available. As an alternative to antibiotics--or as an adjunct--Dr. Shirvani also recommends a number of natural antimicrobial and immune supporting ingredients including several mushroom extracts and beta-glucan. Mary s Story A Lyme Survivor For Mary Holt HHP owner NPS natural & organic product brokerage in Chicago IL it all started one evening in 2008 when as she puts it she was lucky enough to find the tiny brown tick attached to her leg. The bull s eye was already four inches in diameter and the eye itself was the size of a nickel. The itching was already maddening. I called three friends (doctors) who helped me immediately. My advice is that if you have tick bite or see a ring or bulls eye see a doctor immediately and a health care professional (ND DO clinical herbalist homeopathic physician etc.) Antibiotics can help if administered early and in some case can eliminate the disease Holt said. But she also warned that prescribing long-term antibiotics may not be the best course of action for physicians because they don t generally know much about natural medicines. I feel a combination works best in most cases. She also cautioned against the long-term effects antibiotics can have to the immune system. Holt s recipe for recovery once she was certain she had Lyme disease was to seek the advice of three physicians and seek answers in homeopathic medicine naturopathic medicine and from a clinical herbalist. All three immediately gave me advice and recommended remedies that I bought and used. Her road to recovery from Lyme s disease included applying jojoba and oxygen salve to the rash taking a homeopathic remedy for heavy metal detox and the Borrelia Bulgaria bacteria three times daily for six months and an assortment of liquid-form organic herbs that included goldenseal cat s claw cilantro olive leaf cordyseps chlorella and teasel root. There were also herbs added for immune support. And of course a clean diet was essential. Find doctors that are willing to work with you more than one may be needed she advised. Talk to them about how you feel and what you re willing to do to recover. MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 21 absorption provides support for healthy inflammatory response may be clinically beneficial. Immune Support and Inflammation Building a strong foundation with a comprehensive multivitamin and probiotic along with fish oil can also be beneficial in combating the effects of Lyme disease according to Adam Killpartrick DC chief scientific officer for Vermont-based DaVinci Laboratories. CoQ10 in the form of ubiquinol is also something to consider as part of a foundational protocol Dr. Killpartrick said. Beyond foundational support liquid bound curcumin which ensures As mentioned previously support for the immune system has been cited as one of the goals of Lyme disease treatment along with reducing inflammation to allow for joint pain relief. According to Natural Medicines most individuals with advanced Lyme disease experience attacks of arthritis involving one or only a few joints usually the larger joints such as the knees. In some cases neurological problems can exist. My favorite options for helping those suffering with Lyme disease revolve around the idea of supporting both healthy eicosanoid modulation and optimal immune function Dr. Oswald said. Eicosanoid modulation carries tremendous importance as it has an impact on both healthy inflammation and healthy immune function. This pathway uses the fatty acids available within cell membranes to create many different molecules that interact with immune function inflammation and the resolution of inflammation. I view supporting healthy immune function as a twofold process. Support can be had directly with medicinal mushrooms such as Coriolus versicolor Ganoderma lucidum or Grifola frondosa or indirectly through supporting the healthy function of systems which can impact overall immune function. An infection such as Lyme especially once it has become chronic can become a major endogenous stressor on the body. I am a big fan of the use of adaptogenic herbs to aid in supporting healthy signaling mechanisms with in the HPA axis. Dr. Murray holds that in the treatment of chronic Lyme disease it s not so much about boosting the immune system as it is about helping restore proper immune system function. Another promising supplement to consider for Lyme is propolis according the Mark Kaylor MH CN PhD a natural products industry consultant and formulator. The primary reason to consider including propolis in any anti-Lyme program would be its direct anti-microbial actions against a vast array of microbes Dr. Kaylor said. Brazilian Green Propolis can reduce the parasitic load by improving macrophage activation as well as by acting directly on the microbes. Advanced Cell Training At Advanced Cell Training (ACT) in East Greenwich RI the goal is a simple one for those suffering from Lyme disease. The non-invasive cellular behavior modification program is designed to restore proper bodily function at the cellular level in order to restore homeostatis. In the case of Lyme disease its using the training to help bring the immune system back in balance without the use of machines herbs supplements or prescription drugs. We approach Lyme disease as we do any other chronic illness said ACT Executive Director Paul Callahan. Just as autoimmune issues and allergies are an overreaction of the immune system Lyme disease is an under-reaction of the immune system. It is our goal to teach our clients how to train their body at the cellular level to perform just like those people who were bitten by deer ticks and did not get sick. We believe the true underlying cause of Lyme disease is not the exposure rather it is the immune system s failure to recognize and destroy the pathogen. ACT employs focus intent and practice to raise awareness in the body to substitute good cellular behavior for its current bad habits according to Callahan who also pointed out that antibiotics have limitations when it comes to treating chronic Lyme disease. The process takes approximately three hours once a week and can be done from home by phone or over the internet. For more information on the program visit www.advancedcelltraining.com Inflammation appears to go hand-in-hand with immune support when it comes to battling Lyme disease. While immune system support appears to be vital tackling inflammation can also go a long way toward patient relief. Inflammation is another obstacle when treating Lyme disease Dr. Aieta said. My favorite anti-inflammatory is curcumin. Not only is it a great anti-inflammatory but it balances the immune system and can normalize stress response in the body. Using a bioidentical vectorized highlyabsorbed omega-3 along with special forms of curcumin and boswellia help dramatically with inflammation added Dr. Teitelbaum. Diet & Exercise Of course reducing inflammation also has a lot to do with eating a proper diet getting regular exercise and making smart and healthy lifestyle choices. Diet can be a big instigator of and contributor to inflammation--especially the standard American diet (SAD) Dr. Shirvani said. Limiting or eliminating highly processed foods laden with refined sugar salt unhealthy fats and artificial ingredients is a good start. I recommend a Paleolithic or Mediterranean-type diet to help reduce inflammation. There is much that can be done with diet and supplementation in regard to reducing chronic inflammation Dr. Murray added. The diet should be on that is free of allergens focuses on whole foods with an emphasis on plant foods and provides the right types of fats. In terms of additional supplements to help with persistent symptoms with Lyme disease I would recommend a good high potency proteolytic enzyme and a highly absorbable curcumin product. Exercise too helps reduce inflammation. But after the onset of Lyme symptoms such as joint pain should patients be instructed to continue with regular physical activity Fibromyalgia secondary to Lyme disease is associated with exercise intolerance and too much exercise can leave the person bedridden for several days warned Dr. Teitelbaum. On the other hand deconditioning is devastating in this illness so some exercise is critical. Because of this I recommend a walking program along with (Continued on page 28) WWW.NATURALPRACTITIONERMAG.COM MAY 2015 22 NATURAL PRACTITIONER Go to www.naturalpractitionermag.com symco for info about this advertiser Women Need What Supplement manufacturers toss the one-size-fits-all and opt for condition-specific products for women. By Cristina Goodwin A ccording to the Health Resources and Services Administration as of 2011 there are more than 150 million females in the U.S. representing more than half of the population. And in terms of supplementation in relation to women s health a national 2007 survey from ADM World found that one-third of women have tried natural supplements to relieve menopausal symptoms. In addition the Centers for Disease Control and Prevention (CDC) reported that between 2005-2008 56.9 percent of women in the U.S. admitted to supplement use. Beyond One-Size-Fits-All Women s health is in a state of rapidly growing awareness and increasing knowl- edge. The concept of personalized health care has finally become very pervasive in a women s health said Joseph Collins RN ND clinical advisor for Pennsylvania-based Douglas Laboratories. We have moved from the one-size-fitsall model of care to a new standard that honestly looks at the unique needs of each woman. One of the greatest factors that contribute to the growth in personalized health care is that forward thinking wellness organization started investing resources to support personalized health care long before personalized health care became a buzzword. Going back 10 years Dr. Collins and his team found that while many dietary supplement manufactures were advertising their one-size-fits-all menopause formu- las Douglas Laboratories foresaw the need for personalized care and supported a group of products that could be mixed or matched based on the unique hormonal needs of each menopause aged women he said. Now we see these formulations and other formulations in that group being used to give personalized care to women. Female consumers are not only searching for condition-specific vitamins and minerals but also products that are gender-specific and can seamlessly be added into their daily lives. In recent years I have noticed that the focus on women s health has gradually inclined towards preventive lifestyle. We are looking at more and more women participating in high intensity endurance sports as well as 24 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 heightened awareness on the need to increase physical activity to reduce the mortality rate said Bryan See regional product manager for New Jersey-based ExcelVite Inc. However women are also busy homemakers or involved in stressful careers that demand high energy throughout the day. Although there are quite many fitness and energy sustenance products or supplements in the market there is a need to look at designing such products specifically for women as this is going to be a potential market. Specific Needs When looking at the dietary supplement industry women s products have been categorized to fit specific needs. Like men women go through different stages in life as they age and of course not all woman have the same lifestyles or health issues so manufacturers need to take that into consideration when creating products. However women of all races ethnicities religions and sizes do have three things in common. They produce large amounts of estrogen are born with the physical ability to conceive and go through menopause later in life. Whether a lifetime event or a hormonal imbalance supplementation is highly encouraged to support women s health for example practitioners should recommend vitamin E to support a healthy gut microbiota during pregnancy. The best supplements for any woman are the one s she personally needs Dr. Collins explained. Again we are talking about personalized woman s health care. Does she need a multi-nutrient with iron Does she need enteric-coated fish oil What probiotic is best These are all questions that need to be addressed separately. Hormone Imbalances One of the more complex issues to tackle is hormonal imbalance in women. Many consumers may think of teenage PMS (premenstrual syndrome) when the word hormones arise but in fact there is more chemical changes going on when a women s menstrual cycle runs it s course forever. In fact researchers are finding that women are having more hormonal imbalances and menopause-related symptoms. Reasons may be due to a number of environmental factors including hormone-disrupting chemicals chronic stress starchy diets birth control and antidepressants. Hormones can disrupt ones growth and development metabolism sexual function reproduction and mood. General symptoms include fatigue skin issues opsoclonus-myoclonus syndrome (OMS) endometriosis infertility polycystic ovary syndrome (PCOS) among others. Douglas Laboratories s Dr. Collins said that the company trademarked its woman s heath products as Hormone Specific Formulations which address specific hormones in woman. The Hormone Specific Formulations were designed to give women personalized care. The company begins with EstroMend ProgestoMend TestoGain and Testo Quench for Women. While TestoGain helps restore a healthy balance of testosterone TestoQuench helps secrete excess testosterone. Although we look at testosterone as a man s hormone research found that 10 percent of women in fact have problems with excessive testosterone. DIM Enhanced is another formulation for woman and helps promote healthy detoxification of estrogens. In addition Collins recommends Corvalen and Ubiquinol QH for energy at the cellular level or AdrenoMend for enhanced results. Hormone-specific products provide positive results when used as a supplement to over-the-counter (OTC) aids however hormone deficiency is not the only health concern women come across in their life. There are needs to be addressed when woman age as well as when they start to try to conceive. Aging According to See in regards to supplementation women have different needs at different stages of their lives. Women at older age[s] would be looking out for supplements that address age-related needs such as heart and cognitive health as well as anti-aging. Tocotrienol has been shown to provide neuroprotection cardioprotection and inside out skin benefits he explained. Tocotrienols and tocopherols are both members of the vitamin E family and have similar structures however they differ in a way. See noted that tocotrienol has an unsaturated side chain and exhibited numerous unique and additional biological activities which are not shown by tocopherol. As such tocotrienol has been touted as the super vitamin E. Excelvite address symptoms for older women with different health issues than younger woman. The company s EVNol is a natural full-spectrum tocotrienol complex that is extracted and concentrated from virgin crude palm oil through a mild Does PMS Mean No Hot Flashes recent study reported by Sciencedaily.com published in Menopause the journal of The North American Menopause Society (NAMS) found that women who have premenstrual syndrome (PMS) before menopause does not mean they will be faced with hot flashes afterward although they may suffer from other side affects such as memory and concentration. Researches at the Helsinki University Central Hospital and Folkhalsan Research Institute in Helsinki Finland conducted a study using 120 healthy postmenopausal women who had not taken hormones to help PMS in addition the group was asked to keep a diary to document every time they have a hot flash. The study found that almost 90 percent of the women recalled having PMS and half of them had such bad side effects it affected their work home or social life. Additionally 40 percent of the participants said that their PMS was moderate to sever. However the study showed that hot flashes and their severity had no relationship to PMS. The symptoms were however linked with depression poor sleep feeling less attractive and especially with memory and concentration problems after menopause the society noted. Women who are troubled by PMS can be reassured that it doesn t mean bothersome hot flashes are inevitable later said NAMS Executive Director Margery Gass MD. A MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 25 Women Need What extraction process which ensures maximum preservation of phytonutrients. It contains predominantly full spectrum tocotrienols and other phytonutrients such as alpha-tocopherol plant squalene phytosterols co-enzyme Q10 (CoQ10) and mixed carotenoids that are naturally extracted together with tocotrienols. ExcelVite s product was created with EVNol SupraBio a patented self-emulsifying delivery system specifically designed to provide consistent and enhanced oral absorption of tocotrienols. In addition it contains a mixture of oil and food emulsifiers at an optimum ratio that will selfemulsify in the gastrointestinal tract. There physiological processes generate conditions essential for optimal absorption of each tocotrienols into the plasma. This novel delivery system results in a rapid and consistent absorption of tocotrienols independent of dietary fat or food intake. Clinical study on healthy human volunteers confirmed the efficacy of SupraBio system which increases the rate and absorption of each individual tocotrienols by an average of 250 percent See noted. In addition the largest human clinical study for tocotrienol published in the journal STROKE involved 121 subjects and found that EVNol SupraBio supplementation for two years at 200 mg twice daily slows down the development of white matter lesions (WMLs) in human brain. WMLs are closely related to vascular events of the brain and are indications of fragile brain vascular network and an independent prognostic measure of future stroke risk. Tocotrienols can also help maintain healthy level of blood cholesterol since its ability to signal the degrada- FAMILY OF PUBLICATIONS www.VitaminRetailer.com 1995 Branch Out and Join VRM Media s www.GlutenFreeRetailer.com 20 Y ars Celebratingellence e of Exc 2015 www.NaturalPractitionerMag.com www.NIEmagazine.com www.FitnessTrainerMag.com tion of the rate-limiting liver enzyme (HMG CoA-reductase) involved in cholesterol reduction according to See. In a human trial involving EVNol SupraBio it was shown that it might reduce arterial stiffness in healthy adults after two months when taking oral supplementation of 50 mg of d-mixed-tocotrienols twice daily. Since arterial stiffness is an independent risk factor of cardiovascular disease it is conceivable that improvement in arterial compliance (reduced arterial stiffness) may reduce the risk of CVD (cardiovascular disease). ExcelVite manufactures the ingredient that has been put in Carlson Labs Tocomin SupraBio (containing EVNol SupraBio) Doctor s Best Tocotrienols (containing EVNol SupraBio) Life Extension Super-Absorbable Tocotrienols with EVNol SupraBio Jarrow Formulas TOCO-SORB with EVNol SupraBio Healthy Origins Tocomin SupraBio 50 mg (Tocotrienol Complex) VitaCost Tocomin Suprabio and Allergy Research Group Tocomin SupraBio Tocotrienols. Dr. Nicholas Perricone dermatologist at the Yale Medical Center published the New York Times best seller The Wrinkle Cure discussing the use of tocotrienols in cream to promote skin health and prevent aging. Alpha-tocotrienol has been shown that it is 40 to 60 percent more potent than that of alpha-tocopherol which is regular vitamin E in preventing lipid peroxidation. According to See the higher recycling efficiency from chromanoxyl radicals can uniform distribution in the cell membrane and better interact with lipid radicals. The overall result he said is that tocotrienols are more efficient than tocopherols in scavenging and quenching the free radicals. Pregnancy Pregnancy is a part of a woman s human nature. But according to the CDC there are 6.7 million (10.9 percent) women ages 15-44 with impaired fecundity the impaired ability to become pregnant or carry a baby. Suzanne Munson MS vice president of product development and compliance at Washington-based Fairhaven Health LLC the main cause of Contact One of Our Ad Specialists Today Russ Fields at 732-432-9600 ext. 102 or e-Mail RussF VRMmedia.com Roy Kieffer at 719-358-9838 or e-Mail RoyK VRMmedia.com Gary Pfaff at 732-432-9600 ext. 107 or e-Mail GaryP VRMmedia.com 26 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 female fertility issues is due to ovarian dysfunction that can lead to the complete absence of ovulation infrequent ovulation or impaired egg quality. There have been primary areas of research on PCOS (polycystic ovary syndrome) and reproductive toxicology and found that environmental factors can contribute to decreased fertility. Because PCOS is now the leading cause of female infertility and the causes of PCOS are not well understood researchers are motivated to learn more about the condition she explained. Similarly the area of reproductive toxicology is growing rapidly as connections continue to be made between exposure to environmental toxins and risk of fertility issues. Nutrient deficiencies can also negatively impact egg quality and menstrual cycle regularity therefore there is a large market for vitamin mineral and herbal supplementation to support female fertility. Munson lists different supplements available for women. These include Vitex Agnus-castus CoQ10 L-arginine myo-inositol vitamin D folic acid and iron. Vitex Agnus-castus promotes hormonal balance and menstrual cycle regularity by decreasing prolactin levels in the body as well as level hormones that lead to healthy pregnancy. CoQ10 helps the energy production of living cells in the egg and prevents oxidative stress. L-arginine works as an amino acid to boost fertility by promoting blood flow to the uterus ovaries and vagina while also increasing the production of cervical mucus enhancing the libido and improving sensation from sexual stimulation which all play a part in improving the chances of conception. Myo-inositol a member of the vitamin B complex can improve insulin sensitivity to help support fertility promote hormonal balance ovulation and regular menstrual cycles. Another vitamin vitamin D has been recommended to women of childbearing age especially when trying to conceive since science found that vitamin deficiency has been associated with impaired fertility endometriosis and polycystic ovary syndrome. Part of the vitamin D family folic acid helps pregnancy and fetal development by decreasing the risk of neural tube birth defects like spina bifida and has shown to reduce other birth defects like congenital heart conditions. Lastly Munson found that iron may also be beneficial when pregnant because it helps the blood cells carry oxygen in a woman and their developing baby. It may also support energy a healthy growth and strong teeth and bones. Fairhaven Health provides practitioners with a variety of fertility supplements to offer their patients. FertilAid for Women is the company s dietary supplement containing a full prenatal vitamin with herbs (including Vitex) known to promote hormonal balance and cycle regularity. FertileCM helps to promote the production of fertile quality cervical fluid. OvaBoost is a dietary supplement targeting egg quality and include melatonin folate myo-insitol and a blend of antioxidants intended to promote egg quality. FertiliTea is another product in an herbal medicinal tea form to promote hormonal balance and overall reproductive health. Lastly FertileDetox is a dietary supplement helping to support the body s detoxification systems. In addition to vitamins and minerals probiotics have been shown to provide support for pregnant and nursing woman. Incredible advances have been made and countless hours in research and clinical trials have demonstrated that the gut plays a very powerful role in transforming woman s health explained Natasha Trenev president and founder of Natren Inc. the original probiotic company in Westlake Village CA. Research shows that probiotics are important for the infant s gut microbiota and the factors from Mom that contribute to a unique blueprint that Mom passes to the baby during pregnancy delivery nursing and growth she continued. Seventy percent of the immune system is found in the digestive tract and with friendly bacteria like probiotics the human body is able to promote healthy proper digestion. Supplementing with probiotics for woman s health is no secret in fact more and more medical practitioners are becoming familiar with the abundance of probiotic research and they re recommending probiotics to their patients too Trenev said. Perhaps one of the most exciting areas of probiotic research at the moment pertains to infant gut health. According to Trenev there has been ongoing institutional and product research to support this area of health and wellness. For example an article published in Pediatric Research in January 2015 out of a group at the University of California Davis just named Bifidobacteria infantis the champion colonizer of the infant gut since it supports the digestion and consumption of any human milk oligosaccharide structure. In addition it may also be used as an anti-inflammatory in premature intestinal cells and it has been shown to decrease intestinal permeability. Together these properties protect the baby from exposure to potentially harmful items that pass through the delicate infant gut. Natren has always been very careful and very selective with the particular genus species and strains of bacteria we use as probiotics and research like this proves the importance of really understanding what bacteria we utilize to achieve the right probiotic effect she said. Natren offers other products that are designed specifically for women including Gynatren a dual-action probiotic health system designed for feminine health needs which uses the probiotic Lactobacillus acidophilus NAS super strain. This probiotic is a naturally occurring human strain already found in a woman s digestive urinary and vaginal tracts. The company also offers Healthy Start System a beginner s probiotic kit and the company s flagship probiotic Healthy Trinity which has been benefiting women for more than 20 years. In addition the company has recently added a vegan option to its Life Start line for infants toddlers and expectant or nursing mothers this entire Life Start line is based on the probiotic bacteria Bifidobactierum infantis. California-based Nordic Naturals also offers products MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 27 Women Need make breast milk during nursing. Also EPA and DHA have been shown to prevent pre-term labor and delivery lower the risk of preeclampsia and increase the child s birth weight. According to the Association in a 2006 national survey over two-thirds of pregnant women and new mothers said that they had not received any information from their health care provider about the benefits that omega-3 could provide during the pregnancy and in postpartum time. One-third of women have tried natural supplements to relieve menopausal symptoms. 6.7 million (10.9 percent) women age 15-44 have impaired fecundity the impaired ability to become pregnant or carry a baby. Over two-thirds of pregnant women and new mothers said that they had not received any information from their health care provider about the benefits of omega-3. Hormone-specific products provide positive results when used as a supplement to over-the-counter (OTC) aids. What Healthy Take Aways targeting woman who are pregnant trying to conceive or are nursing with Prenatal DHA the Official Omega-3 of the American Pregnancy Association. ProOmega is another product that provides women with omega-3 but in fewer soft gels and has been clinically proven to support a healthy heart. Its ProOmega D is the sister product with the same ingredients as ProOmega but with 1 000 IU of vitamin D. The two most beneficial omega-3s are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Each has unique benefits for example EPA supports the heart immune system and inflammatory response while DHA supports the brain eyes and central nervous system which are important for pregnant and lactating women. It has been found that omega-3 is essential for both neurological and early visual development of the baby as well as helping mothers to Moving Forward There are a million factors that contribute to improving women s health today Treven said from pollution toxins in the food and water antibiotic resistance antibiotics in our meats preservatives genetically modified organisms (GMOs) artificial sweeteners and more. Dr. Collins believes that practitioners need to address biochemical foundations of health with their patients including high grade multiple vitamin-mineral formulation daily intake of fish oil and probiotics. Dr. Collins concluded that he feels the best way to start the conversation is to honestly start with the basic requirements. FOR MORE INFORMATION Douglas Laboratories (800) 245-4440 www.douglaslabs.com ExcelVite Inc. (732) 906-1901 www.excelvite.com Fairhaven Health (800) 367-2837 www.fairhavenhealth.com Natren Inc. (805) 371-4737 www.natren.com Nordic Naturals (800) 662-2544 www.nordicnaturals.com Adjunctive Treatments There are several adjunct therapies that can aid in the treatment of Lyme disease including acupuncture as well as physical therapy and message. I do acupuncture as an adjunctive treatment in most of my Lyme disease patients Dr. Aieta said especially those that are latestage or chronic. I also recommend massage and physical medicine in most cases. Infrared saunas tend to work great to help raise body temperature to fight off the organisms as well as facilitate detoxification. I also recommend the use of IV nutrients such as glutathione vitamin C and magnesium. Dr. Killpartrick recommends Series Therapy a homeopathic approach that may provide effective support through all stages of Lyme along with SilverSol often referred to as Smart Silver which can provide added immune support not found in other formulas. For symptomatic relief on later-stage Lyme when the musculoskeletal system is effected upper cervical chiropractic cranial therapy such as Cranial Release Technique as well as Low Level Laser Therapy have all provided both short and long-term relief in my practice. (Continued from page 22) a low-sugar high-protein diet. Dr. Oswald says the foundation of his patients treatment plans lies in lifestyle and believes that exercise and diet are incredibly importance. At the same time he too warns against overdoing it when it comes to Lyme disease. Exercise plays a huge role but can be very difficult due to common symptoms of musculoskeletal pain. I recommend refraining from aerobic types of exercise and instead focusing on building strength and muscle mass through resistance exercise performed at the highest intensity tolerated. According to the Centers for Disease Control and Prevention (CDC) approximately 300 000 Americans each year are diagnosed with Lyme disease. Symptoms can include joint pain and flu-like signs including fever headache and general fatigue. Lyme disease is often identified as a bull s-eye-shaped rash called erythema migrans that can appear within a few days of infection. Antibiotics are the first line of treatment for Lyme disease but there are natural remedies that can act as supportive measures. Healthy Take Aways FOR MORE INFORMATION DaVinci Laboratories (800) 325-1776 www.davincilabs.com Mushroom Wisdom (800) 747-7418 www.mushroomwisdom.com Nordic Naturals (800) 662-2544 www.nordicnaturals.com Progressive Laboratories (800) 527-9512 www.progressivelabs.com 28 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 2015 CAMInnovations standing of the research and history behind the products available to practitioners and their patients and manufacturers wanting to offer the science that backs the effectiveness of their products. We have featured a similar section annually in Natural Practitioner s sister publication Nutrition Industry Executive magazine since 2002 where it was designed to help manufacturers gain a better understanding of the ingredients and services available that can make their products stand out. Companies and associations have responded to this opportunity with background information about the health concerns their products are intended to address histories of the nutrients behind their products and details of research carried out. In order to bridge the gap between interested practitioners and these companies we ve also provided company addresses phone numbers and website addresses to make obtaining additional information easier. MAY 2015 WWW.NATURALPRACTITIONERMAG.COM T his special section of Natural Practitioner comes in response to the desire for a greater under- Following is an index of companies participating in the 2015 Natural Practitioner CAM Innovations section DaVinci Laboratories ......................................................30 International Nutrition Inc. ...........................................31 Kyowa Hakko USA ..........................................................32 MitoQ Ltd. .......................................................................33 Protocol for Life Balance ................................................34 Rainbow Light Nutritional Systems ................................35 RLC Labs ..........................................................................36 Sovereign Laboratories ....................................................37 NATURAL PRACTITIONER 29 2015 CAMInnovations DaVinci Laboratories 20 New England Dr. Essex Junction VT 05452 Phone (800) 325-1776 Fax (802) 878-0549 Email info davincilabs.com Website www.davincilabs.com Metabolic Multi ith weight management at the crux of many efforts to change a lifestyle finding the right supplement regimen to support the process is an important step. Metabolic Multi from DaVinci Laboratories provides 38 nutrients to support overall metabolic health--including glucose balance insulin sensitivity lipid metabolism free radical scavenging and normal inflammatory responses--giving your patients the opportunity to make the most of their healthy lifestyle choices. Metabolic Multi offers all benefits of a traditional multi but also provides targeted support for various metabolic health factors. One ingredient that stands out GreenSelect Phytosome. GreenSelect Green Tea Phytosome has been extensively studied for its antioxidant activity. In one trial evaluating TRAP an antioxidant parameter a 20 percent increase of antioxidative capacity was observed in volunteers treated with the phytosome.1 The phytosome is known to exhibit superior bioavailability in comparison to the standard GreenSelect extract.2 GreenSelec has also been studied with regard to its potential effects on metabolic syndrome and obesity in conjunction with diet and lifestyle changes. In two clinical trials it exhibited beneficial activity regarding metabolic health markers.3 4 A recently developed oral formulation in the form of coated tablets (Monoselect Camellia) (MonCam) containing highly bioavailable green tea extract (GreenSelect Phytosome) was tested in obese subjects (n 100) of both genders on a hypocaloric diet. Fifty subjects were assigned to the green tea extract plus hypocaloric diet while the other 50 subjects followed the hypocaloric diet only. After 90 days of treatment significant weight loss and decreased body mass index (BMI) were observed in the group taking the herbal extract (14 kg loss in the green tea group compared to a 5 kg loss in the diet-only group). 5 W Metabolic Multi offers all benefits of a traditional multi but also provides targeted support for various metabolic health factors. One ingredient that stands out GreenSelect Phytosome. Metabolic Multi features a second Phytosome ingredient called Meriv Curcumin. This complex has been extensively studied for its healthy inflammatory response support and for its antioxidant activity. Pharmacokinetic studies demonstrate a nearly 30-fold increase in bioavailability as compared to standard curcumin extracts.6 7 In a weight management program a supplement that supports normal inflammatory responses can be valuable. Though researchers are as yet unsure of the exact relationship between chronic inflammation and obesity it is known that metabolic syndrome is accompanied by an inflammatory condition.8 Curcumin has been studied for its potential to support normal insulin resistance. It may provide support for a normal inflammatory response through a mechanism of PPAR-gamma activation.9 Also featured in Metabolic Multi Purple Tea with GHG. This emerging variety of Camellia sinensis grown in Kenya was developed with high levels of anthocyanins. Specifically it contains the polyphenol 1 2-di-Galloyl4 6-Hexahydroxydiphenoyl-D-Glucose (GHG) a compound not found in green black or oolong tea. GHG supports fat metabolism and Purple Tea with GHG has been shown in two small unpublished openlabel human clinical studies to support body composition and weight loss. Research suggests the polyphenols may support lipase activity in the pancreas as well as normal fat absorption.10 11 Other extensively researched ingredients in Metabolic Multi from DaVinci include berberine to support normal insulin sensitivity trans resveratrol to support glucose balance and vitamin D to support healthy expression of NF-Kappa B inflammatory cytokines. The ingredients mentioned here are just six of 38 important ways Metabolic Multi offers support for a weight management protocol. For more information visit www.davincilabs.com. This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose treat cure or prevent any disease. References 1 Pietta P. Simonetti P. Gardana C. Brusamolino A. Morazzoni P. & Bombardelli E. (1998). Relationship between rate and extent of catechin absorption and plasma antioxidant status. Iubmb Life. doi 10.1080 15216549800204442. 2 Pietta P. Simonetti P. Gardana C. Brusamolino A. Morazzoni P. & Bombardelli E. (1998). Relationship between rate and extent of catechin absorption and plasma antioxidant status. Iubmb Life. doi 10.1080 15216549800204442. 3 Greenselect Phytosome for Borderline Metabolic Syndrome. (n.d.). Retrieved from www.hindawi.com journals ecam 2013 869061 . 4 Menghi A. B. Barreca A. Lucarelli M. & Calandrelli A. (0). GreenSelect Phytosome as an Adjunct to a Low-Calorie Diet for Treatment of Obesity A Clinical Trial. 5 Menghi A. B. Barreca A. Lucarelli M. & Calandrelli A. (0). GreenSelect Phytosome as an Adjunct to a Low-Calorie Diet for Treatment of Obesity A Clinical Trial. 6 Cuomo J. et al. J Nat Prod. 2011 Mar 17. 7 Marczylo T.H. et al. Cancer Chemother. Pharmacol. 2007 60 (2) 171-7. 8 Monteiro R. & Azevedo I. (2010). Chronic Inflammation in Obesity and the Metabolic Syndrome. Mediators of Inflammation 2010 289645. doi 10.1155 2010 289645. 9 Mechanism of the Anti-inflammatory Effect of Curcumin PPAR-gamma A... - PubMed - NCBI. (n.d.). Retrieved from www.ncbi.nlm.nih.gov pubmed 18274631 dopt abstr act. 10 Unpublished study. Research and Development Department Oryza Oil and Fat Chemical Company Ltd. 2014 May 12. 11 Unpublished study. Research and Development Department Oryza Oil and Fat Chemical Company Ltd. 2014 March 1. 30 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 2015 CAMInnovations International Nutrition Inc. 11655 Crossroads Cir. Ste. T Middle River MD 21220 Phone (800) 899-3413 (410) 335-2802 Email ask nutrivene.com Website www.nutrivene.com Manufacturer Probiotics International Ltd. Lopen Head Somerset U.K. TA13 5JH. Website www.bio-kult.com Probiotics International Ltd. (Protexin) A Research-based Track Record W ith probiotics on the verge of a dramatic growth curve and probiotic supplement sales potentially reaching 2.5Billion by 2018 (Source NutraIngredients.com) we undoubtedly seem to be in a Gut Era. There are a gut of products entering the marketplace in all shapes and forms ranging from traditional yogurt-based drinks to oats juices and even chocolates and popsicles. And of course dietary supplements continue to be presented in capsules tablets liquid or powder form. Businesses see growth potential and are dumping probiotics into just about anything ingestible. This poses the question as to whether these new food sources are just trendy ideas or if they possess the efficacy necessary to provide a true benefit to the body. Thousands of research articles listed on PubMed show increasing scientific evidence to support the necessary role of probiotics for today s health challenges. Studies seem to show enhanced efficacy and sophistication in areas around digestive disorders immune response and pathogen inhibition. Additional work is being conducted that also looks promising in the fields of cancer prevention and obesity among others. With so much going on in the world of probiotics it is ever more important to have research-backed products from a company that has a proven track-record of trusted clinical trials. Protexin a division of Probiotics International Ltd. manufactures probiotic supplements such as their gold-standard multi-strain probiotic range Bio-Kult. Sold in more than 80 countries worldwide its products are manufactured at their purpose-built state-of-the-art facility in Somerset South West U.K. designed specifically for probiotic research development and production. Impeccable quality and efficacy are of paramount importance to the company. The com- pany s dedicated quality assurance department has accreditations that include cGMP (current good manufacturing practice) issued by the British MHRA and ISO 9001 2008 and the company was gained a Queen s Award for Enterprise in International Trade. Protexin s product innovation and leadership comes from developing its own researchdriven probiotic strains individual to the company. All strains are included in the European Qualified Presumption of Safety (QPS) list. The QPS lists were compiled by the European Food Standards Agency (EFSA) to assess the compiled evidence and confirm the safety and nomenclature of the bacteria used. Recognizing that the potency of many products becomes neutered by the time they reach the gut Protexin s research has driven the company to create a proprietary method that ensures each of their own strains is delivered directly to the intended area of the body. All of Protexin s products are tested to ensure that they meet label claims using independent UKAS accredited laboratories. Working with leading researchers at preiminent universities and institutes Protexin has maintained a reputation for producing leading-edge research-based products. The company is focused on ensuring they are always at the forefront of the latest science which includes in-vitro early stage development concept exploration and human clinical trials. Most recently a newly published trial in the Journal of Pediatrics and Child Health1 revealed that the Protexin seven strain probiotic and prebiotic mixture (symbiotic) found in Bio-Kult Infantis could significantly improve symptoms in infants suffering from colic without any reported side effects. Average daily crying time was reduced by at least half for 82.6 percent of infants in the probiotic group after seven days. Furthermore 39 percent experienced a resolution of symptoms. Dr. Mayur R. Joshi medical advisor for Probiotics International Ltd. (Protexin) manufacturers of Bio-Kult Infantis commented It has long been suggested that altered gut flora is a contributory factor in the development of infantile colic. This trial helps to support that theory and indeed helps to support the use of certain probiotics in the management of colic. The study supports the case for larger trials to see whether probiotics can prevent infant colic (as opposed to treat it) and to ascertain further information such as optimal dosing or whether there is a dose dependent effect at all. Protexin research continues to extend into the company s new product innovation. Line extensions to their portfolio however are dictated solely upon evidence-based results for benefit to the consumer. We are undoubtedly in an exciting period for probiotics with Protexin leading the way. For a copy of Protexin s research booklet which has a selection of the latest and most important probiotic research as well as insights into the company s own research projects contact ask nutrivene.com. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose treat cure or prevent any disease. Reference 1 Kianifar H. Ahanchian H. Grover Z. Jafari S. Noorbakhsh Z. Khakshour A. ... & Kiani M. (2014). Synbiotic in the management of infantile colic A randomized controlled trial. Journal of Paediatrics and Child Health. MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 31 2015 CAMInnovations Kyowa Hakko USA 600 Third Ave. 19th Fl. New York NY 10016 Phone (800) 596-9252 Websites www.kyowa-usa.com www.setriaglutathione.com What is Glutathione G lutathione is a small peptide comprised of three common amino acids and is present in all tissues and body fluids. Often called the master antioxidant glutathione plays many roles in supporting good health including Helping the body detoxify harmful chemicals Supporting the immune system Improving the performance of other antioxidants Sources of Glutathione Glutathione is provided both through the diet and through endogenous synthesis. The best food sources are fresh fruits and vegetables and freshly prepared meats. While maintaining adequate and consistent levels of glutathione is critical to good health it can be difficult to accomplish through diet alone due to poor lifestyle choices and even the natural effects of aging. Increasing Glutathione Blood Levels Through Oral Supplementation Setria is a clinically studied form of glutathione that when taken orally has been shown to replenish the body s reserves.1 A recently published study on Setria Glutathione in the European Journal of Nutrition in May 2014 shows for the first time that daily consumption of glutathione is effective at increasing glutathione blood levels. This long-term randomized double-blinded placebo-controlled study puts to rest the long-standing debate on the efficacy of oral glutathione.1 The study performed on 54 healthy adults (mean age 46 years) showed that blood levels of glutathione increased after one three and six months vs. baseline at doses of both 250 mg day and 1 000 mg day. At six months mean blood glutathione levels along with various immune markers were shown to have increased 3035 percent in the high-dose group and 17-29 percent in the low dose. Natural killer cytotoxicity increased two fold in the high-dose group versus placebo at three months. A reduction in oxidative stress in both glutathione dose groups was indicated by decreases in the oxidized to reduced glutathione ratio in whole blood. Glutathione levels were shown to return to baseline after a one-month washout period.1 Additional research on glutathione shows that Glutathione production decreases with aging beginning in midlife and plunging precipitously after age 60.2 3 Healthy elders have high blood glutathione concentrations.4 Higher glutathione status in older individuals has been correlated with multiple indices of good health--better overall health and vitality higher levels of selfrated health normal cholesterol lower body mass index and normal blood pressure--as compared to older individuals with lower glutathione levels.5 Higher glutathione status has also been correlated with good cardiovascular oral and eye health.6-10 Glutathione levels fluctuate diurnally with lowest levels found in the morning which may present a window of vulnerability.11 Safety There have been no reported adverse reactions to supplemental glutathione taken orally inhaled or used intramuscularly or intravenously.12 Doses of 3 grams have been used experimentally with no adverse effects.13 Setria Glutathione Setria is a unique tri-peptide form of glutathione manufactured from a patented process by Kyowa Hakko Bio Co. Ltd. Kyowa is a world leader in the research and manufacturing of high-quality ingredients for use in dietary supplements functional foods and beverages. Setria Glutathione is an ultra-pure GRAS (generally recognized as safe) ingredient that is also vegetarian and allergen-free. References 1 Richie JP Jr. et al. Randomized controlled trial of oral glutathione supplementation on body stores of glutathione. European Journal of Nutrition. May 2014 1436-6207. doi 10.1007 s00394-014-0706-z. 2 Lang CA et al. J Lab Clin Med. 1992 120(5) 720-25. 3 Van Lieshout EM Peters WH. Carcinogenesis. 1998 Oct 19(10) 1873-5. 4 Lang CA et al. J Lab Clin Med. 2002 140(6) 380-81. 5 Julius M et al. J Clin Epidemiol.1994 47(9) 1021-26. 6 Ashfaq S et al. J Am Coll Cardiol. 2006 Mar 7 47(5) 1005-11. 7 Richie JP et al. Nutr Cancer. 2008 60(4) 474-82. 8 Flagg EW et al. Am J Epidemiol. 1994 139(5) 453-65. 9 Cohen SM et al. Br J Ophthalmol. 1994 Oct 78(10) 791-94. 10 Coral K et al. Eye. 2006 Feb 20(2) 203-7. 11 Blanco RA et al. Am J Clin Nutr. 2007 Oct 86(4) 1016-23. 12 Natural Medicines Comprehensive Database. www.naturaldatabase.com 12.18.2008. 13 Witschi A et al. Eur J Clin Pharmacol. 1992 43(6) 667-69. 32 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 2015 CAMInnovations MitoQ Ltd. Level 2 16 Viaduct Harbour Ave. Auckland New Zealand 1010 Phone 00649 379 8222 Email customerservice mitoq.com Website www.mitoq.com Research Review Mitochondria-targeted Antioxidant MitoQ itochondria as a target for therapeutic intervention is a promising but relatively new area of research. These tiny organelles known as our cellular powerhouse are now identified as being involved in more than 200 diseases and conditions. Mitochondria are interesting to researchers on a number of levels. They are responsible for the majority of free radicals generated in the cell they are primarily responsible for the energy needs of the cell and they play a very important role in cellular signaling and homeostasis.1 Healthy mitochondrial function is critical for the healthy function of the cell organ and body as a whole. MitoQ is a new third generation mitochondria-targeted antioxidant that is derived from CoQ10. With the addition of a positive charge MitoQ targets negatively charged mitochondria some 800 to 1 200 times that of traditional forms of CoQ10 (ubiquinone and ubiquinol) to deliver an antioxidant payload into mitochondria at levels shown to have a meaningful effect.2 Over the past decade MitoQ has been the subject of a significant body of work by researchers looking to evaluate its effect across multiple disease and organ models. M MitoQ is a new third generation mitochondriatargeted antioxidant that is derived from CoQ10. With the addition of a positive charge MitoQ targets negatively charged mitochondria some 800 to 1 200 times that of traditional forms of CoQ10 (ubiquinone and ubiquinol) to deliver an antioxidant payload into mitochondria at levels shown to have a meaningful effect. disease9 Parkinson s disease10 Lou Gehrig s disease11 and multiple sclerosis12 suggest that MitoQ should be evaluated further to assess impact in human versions of these conditions. free radical production destroys nitric oxide (NO) along with the enzyme that produces NO. Researchers found in a mouse model of EDD that in as few as four weeks they could fully reverse EDD restoring dilation to youthful levels.13 Recent research has linked the injury associated to ischemic reperfusion directly to mitochondrial responding to the resupply of blood to cardiac tissue immediately post clot removal suggesting that MitoQ is likely to be of benefit immediately prior to reperfusion.14 Kidney Some 40 million Americans suffer from chronic kidney disease. Mitochondrial production of ROS (reactive oxygen species) is thought to be associated with the cellular damage resulting from chronic exposure to high glucose in long-term diabetic patients. MitoQ was evaluated in a murine model of diabetic nephropathy 15 and suggests that the pathology associated with this condition is related to oxidative stress and the associated changes to tissue with oxidative damage. Lung Inflammation and oxidative stress play critical roles in patients with chronic obstructive pulmonary disease (COPD). Mitochondrial oxidative stress appears to be involved in driving the oxidative stressinduced pathology. The recent study into mouse models of COPD16 shows that MitoQ s effect on mitochondrial function and oxidative stress is a promising approach to supporting that condition. Liver Chronic oxidative stress and mitochondrial dysfunction of the liver has been linked to a number of liver function issues. MitoQ has been evaluated in models of metabolic syndrome3-5 hepatitis C6 and ethanol induced liver damage.7 In each model reducing oxidative stress and correcting mitochondrial dysfunction appears to be of benefit to overall liver function. Cardiovascular System Mitochondria make up to 50 percent of the content of cardiac cells due to their high-energy needs. For this reason mitochondria-targeted compounds like MitoQ are proving to be of interest because of their potential to impact heart health positively. There have been a number of studies with MitoQ in models of cardiovascular disease that suggest this supplement is an important compound for heart health with improvements to heart rate blood pressure cardiac hypertrophy and endothelial function.17 Interestingly mitochondrial oxidative stress is a key component of endothelial dilation dysfunction (EDD) a condition related to age that causes arteries to stiffen. Excessive Summary Many of the conditions that are front and center in the modern world have links to mitochondrial dysfunction and or oxidative stress. MitoQ is a new type of mitochondria-targeted antioxidant that has been extensively researched in human and animal models in a large range of conditions and the results illustrate the benefits of improving mitochondrial function as a strategy to impacting positively on organ health and overall life health-span. For a full list of references visit www.niemagazine.com. Brain Neurodegenerative conditions have strong links to both oxidative stress and mitochondrial dysfunction. While a phase II clinical trial of MitoQ for Parkinson s disease8 did not achieve an outcome animal models of neurodegenerative disorders such as Alzheimer s MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 33 2015 CAMInnovations Protocol for Life Balance 244 Knollwood Ln. Bloomingdale IL 60108 Phone (630) 545-9098 Email info protocolforlife.com Website www.protocolforlife.com Supplementation with SLCP (Solid Lipid Curcumin Particle Longvida) Supports Normal Cognition Optimizes Mood and Has Anti-Fatigue Effect in Healthy Older Volunteers. urcumin and its naturally occurring derivatives (aka curcuminoids) are a distinct group of polyphenols found in the rhizome of spice turmeric. Curcuminoids have been gaining attention as pleiotropic dietary compounds meaning they produce multiple effects and enable numerous mechanisms of action in the body. Some of these beneficial pathways are more obvious than the other. For example scavenging of free radicals by curcumin is expected due to its chemical structure. Other effects are less anticipated such as the role of curcumin in the regulation of normal neurotransmitter systems and neuroplasticity and have not been realized until recently. Another notable feature of curcumin is the discovery that it can directly interact with beta amyloid protein.1 This protein is now understood to be found in pico-molar amounts even in healthy cognitively-intact middle-aged individuals.2 However the interest in curcumin as a brain health optimizing dietary ingredient has been hampered by the challenges in curcumin bioavailability specifically its delivery to the brain. These problems include curcumin s lack of solubility auto-oxidation and most importantly robust metabolism of curcumin while it is being absorbed in the GI (gastrointestinal) tract rendering it less bioactive subject to fast elimination as well as unavailable to the brain tissue. Multiple curcumin delivery systems developed today offer incremental improvements in curcumin bioavailability but the best attempt to-date appears to be patentpending SLCP (Solid Lipid Curcumin Particle LongVida) now available in Cogumin from Protocol For Life Balance. Human bioavail- C ability study with SLCP Longvida confirms that following its supplementation free umetabolized curcumin indeed appears in the plasma of human volunteers at clinically relevant concentrations.3 In the same experiment conventional curcumin supplementation resulted in undetectable levels of unmetabolized curcumin (while biotransformed glucuronated curcumin was present in plasma). This is an important breakthrough in curcumin bioavailability in general and in brain health applications of curcumin in particular. From a clinician s prospective however it is not only important to understand the bioavailability aspects of a dietary ingredient but also to have a confirmation of its effects on the normal body structures and function. So here we have a chance to review the results of a randomized double-blind placebo controlled trial with SLCP LongVida recently published in the Nutrition Journal.4 Sixty healthy adults between the age of 60 and 85 were randomized to take 400 mg of SLCP Longvida (80 mg of curcumin) or placebo for up to four weeks. Various standardized cognitive and mood test panels were performed following acute chronic and acute-on-chronic supplementation. The results are as follows. Just one hour after administration SLCP Longvida significantly improved cognitive performance related to sustained attention and working memory tasks as compared with placebo (Figure 1). After four weeks of supplementation statistically significant improvement compared to placebo were achieved in indicators of calmness contentedness and fatigue both general and fatigue induced by psychological stress. Finally acute-on-chronic cognitive tests revealed statistically significant improvement in already normal alertness as well as the sense of contentedness as compared to placebo. As widely accepted p-value of 0.05 or less was considered statistically significant. The study was the first double-blind placebo controlled clinical trial to examine the effect of bioavailable curcumin on mood and cognition in healthy older population. Particularly unexpected and encouraging were the acute effects of SLCP Longvida supplementation on cognitive behavior related to the working memory measured in the Digit Vigilance and Serial Three Subtractions tests (Figure 1). Age-related decline in normal working memory is a common finding in the aging population and the significance of a dietary ingredient with the ability to positively affect this cognitive biomarker is hard to underestimate. The tentative mechanism behind this curcumin phenomenon is not fully understood although it is likely to be driven by its support of normal levels of neurotransmitters dopamine and serotonin in the CNS.5 Among other findings reduction of mental fatigue was another intriguing outcome while the support of the reduced normal LDL levels was somewhat expected since this effect of curcumin supplementation has been demonstrated before.6 It is noteworthy mentioning that in a previous randomized placebo-controlled clinical trial published 2012 in the Nutrition Journal supplementation with the same amount of SLCP Longvida for four weeks resulted in statistically significant reduction of already normal low levels of circulating beta amyloid protein as compared to pre-supplementation levels (while no changes were observed in the placebo group).7 Taken together these studies suggest that SLCP Longvida merit a strong consideration when designing nutritional protocols aimed at age-related cognition working memory and occasional mental and physical fatigue. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose treat cure or prevent any disease. For a full list of references visit www.niemagazine.com. 34 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 2015 CAMInnovations Rainbow Light Nutritional Systems 100 Avenue Tea Santa Cruz CA 95060 Phone (800) 635-1233 Website www.rainbowlight.com Allergy Rescue A llergy Rescue is part of the Rainbow Light s cutting edge line of integrated health therapies developed to address the top health concerns of consumers. It is formulated to address immune defense associated with the allergy response. Allergies affect one in five Americans and approximately 40 million Americans have indoor outdoor allergies as their primary allergy. The term allergy refers to the immune system inappropriately attacking a substance in the body that is not normally harmful. The immune system has many different tools at its disposal to combat potential disease-causing substances in the body such as bacteria and viruses. The type of immune response that is relevant to the airborne allergy response is the specific (or acquired) defense mechanism whereby each individual obtains the ability to defend against specific pathogens by prior exposure to those pathogens. This response involves the production of antibodies that attack and destroy foreign allergens (or antigens). The cells that produce antibodies are a special type of white blood cell called lymphocytes. The type of lymphocyte that is involved in the production of antibodies is known as the B lymphocyte. B lymphocytes secrete antibodies specific to each pathogen. The antibodies attach onto the allergen and then prepare it for destruction by neutrophils and macrophages which use phagocytosis (cellular eating) to destroy the allergen. Antibodies thus identify the targets for destruction they do not kill the allergens themselves. Meanwhile as the pathogen is being destroyed substances are discharged that stimulate the release of histamines from mast cells. Histamine brings more blood flow to the area along with more phagocytes and is responsible for the swelling heat and inflammation that occur during this process. Although histamine is an Allergies affect one in five Americans and approximately 40 million Americans have indoor outdoor allergies as their primary allergy. The term allergy refers to the immune system inappropriately attacking a substance in the body that is not normally harmful. important step in the immune defense if the B lymphocytes respond in an abnormal way to non-pathogenic substances (such as what happens with airborne allergy sufferers) the histamine response will create chronic symptoms of inflammation in the body. Inappropriate response of the B lymphocytes to allergens therefore leads to excess histamine release and an immediate allergic response. Allergy Rescue is a naturally effective integrative health therapy designed to Inhibit allergic response to indoor outdoor triggers with quercetin vitamin C and bromelain to moderate the release of excess histamine following exposure to environmental irritants. Ease occasional allergy discomforts including runny nose itchy eyes and skin irritations with herbs traditionally targeted to support clear nasal passageways and normal mucous production. Allergy Rescue is a flexible solution you can take 1-3 tablets once or twice daily depending on individual needs. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose treat cure or prevent any disease. References 1 www.aafa.org display.cfm id 9&sub 30. 2 Sharma SC Wilson CW. The cellular interaction of ascorbic acid with histamine cyclic nucleotides and prostaglandins in the immediate hypersensitivity reaction. Int J vitam Nutr Res. 1980 50(2) 163-70. 3 Johnston CS Martin LJ et al. Antihistamine effect of supplemental ascorbic acid and neutrophil chemotaxis. J Am Coll Nutr. 1992 11 172-6. MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 35 2015 CAMInnovations RLC Labs 29455 N. Cave Creek Rd. Ste. 118-629 Cave Creek AZ 85331 Phone (877) 797-7997 Fax (480) 513-1026 Growing Iodine Deficiency in Women of Reproductive Age odine has been well-established as an essential trace element that is necessary for proper thyroid function. Sufficient levels of iodine are especially necessary in women of reproductive age during pregnancy and lactation. The first introduction of iodine for treatment of goiter (enlarged thyroid) was by a Swiss physician Jean-Francois Coindet in 1820.1 The first major exploration on the use of iodine (iodized salt) as a therapy to reduce goiter in U.S. was conducted almost 100 years later by an American pathologist David Marine and his assistant O.P. Kimball in Ohio.2 This led the U.S. to adopt the wide use of iodized salt by mid 1920s. Despite its identification for well over a century iodine deficiency continues to be an endemic problem with nearly two billion individuals (30 percent of the world population) having insufficient iodine intakes.3 An iodine deficiency may result in goiter mental retardation and pregnancy-related problems including miscarriages stillbirth preterm delivery and congenital abnormalities in their babies. In the United States iodine deficiency has actually increased from the 1970s to 1990s and currently approximately onethird of pregnant women are considered to be marginally iodine deficient.4 5 According to the World Health Organization iodine deficiency is the single greatest preventable cause of mental retardation. 6 The vast majority of the current American diet consists of processed foods which are manufactured with non-iodized salt.7 It is this absence of iodized salt typically the common food source of iodine with iodine depletion in our soils I An iodine deficiency may result in goiter mental retardation and pregnancy-related problems including miscarriages stillbirth preterm delivery and congenital abnormalities in their babies. and inadequate diet (of ocean fish and sea vegetables) that continues to propel iodine deficiency. Environmental pollutants such as thiocyantes and nitrates as well as halides (bromine fluorine and chlorine perchlorate) further contribute by competing for absorption and receptor binding of iodine.8 Since the majority of iodine is found in thyroid and (lactating) mammary glands 9 the significance of iodine greatly increases for breast-feeding women. The American Thyroid Association National Academy of Sciences and American Academy of Pediatrics all have recommendations for women having adequate daily iodine intake including through supplements. However most women are not meeting these intake levels and of those who are actually taking any supplements only 15 to 20 percent contain any iodine.10 One of the most beneficial iodine supplemental therapies combatting deficiency has been the traditional Lugol s solution. Lugol s solution first prepared in 1829 by French physician J.G.A. Lugol is a solution of elemental iodine and potassium iodine in water. Dr. Lugol found that using the reduced form of iodine (iodide) greatly increased solubility of iodine in water. This combination of iodide and iodine initially utilized for iodine solution preparation would later show to become more potent form of iodine therapy. Although effective and still widely used there is a precise accuracy of dosing as well as the challenge of liquid administration so in answer to that RLC Labs introduces i-Throid. It is the dry solid version of the traditional liquid solution to keep the weight dose accuracy while the capsule form allows use of minimal inactive ingredients. The result is a clean potent accurate consistent and reliable alternative to other currently available iodine iodide therapy available in the marketplace. References 1 Coindet J.F. D couverte d un nouveau rem de contre le goitre Annales de Chimie 1820 15 49-59. 2 Marine D. Kimball O.P. The prevention of simple goiter in man. A Survey of the incidence and types of thyroid enlargements in the schoolgirls of Akron (Ohio) from the 5th to the 12th grades inclusive the plan of prevention proposed. 1917 J Lab Clin Med 1990 115 (1) 128-136. 3 Bruno de Benoist et al. Iodine deficiency in 2007 Global progress since 2003 Food and Nutrition Bulletin 2008 29(3) 195-202. 4 Perrine CG et al. Some subgroups of reproductive age women in the United States may be at risk for iodine deficiency J Nutr 2010 140(8) 1489-1494. 5 Hollowell JG et al. The prevalence of iodine deficiency in women of reproductive age in the Unites States of America Public Health Nutr 2007 10(12A) 1532-1539. 6 The Lancet Iodine deficiency way to go yet The Lacet 2008 372 (9633) 88. 7 Renner R Dietary Iodine why are so many mothers not getting enough Environ Health Perspect 2010 118 (10) A438-A442. 8 Rogan W Iodine Deficiency Pollutant Chemicals and the Thyroid New Information on an Old Problem Pediatrics 2014 133(6) 1163-1166. 9 Doh n O et al. The sodium iodine symporter (NIS) characterization regulation and medical significance Endocr Rev 2003 24(1) 48-77. 10 Gregory CO et al. Use of supplements with and without iodine in women of childbearing age in the United States Thyroid 2009 19(9) 1019-1020. 36 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 2015 CAMInnovations Sovereign Laboratories 2020 Contractors Rd. Ste. 5 Sedona AZ 86336 Phone (928) 202-4031 Fax (928) 862-4039 Websites www.sovereignlaboratories.com www.colostrumtherapy.com Healing Leaky Gut with Colostrum-LD By Douglas A. Wyatt Director Center for Nutritional Research eaky gut syndrome is often misunderstood and nearly always goes undiagnosed by medical practitioners as evidenced by the epidemic of allergies and autoimmune conditions. When Hippocrates said that all disease begins in the gut he was certainly ahead of his time. After 2 000 years we are just beginning to understand and accept this premise in modern medicine. The rediscovery of bovine colostrum has been a turning point in how chronically ill patients are treated. When we understand and appreciate colostrum for the true gift it is we can utilize it for the healing and prevention of gastrointestinal distress and therefore chronic toxicity and in doing so we will dramatically increase quality of life and reduce unnecessary death and disability. I ve worked with physicians and health practitioners for over two decades in the area of leaky gut and gastrointestinal (GI) health. Early animal and human studies showed that Colostrum-LD was effective against acid and NSAID-induced damage to the lining of the small intestines otherwise known as leaky gut or intestinal permeability. Colostrum-LD not only prevented GI damage but it healed existing damage and was found to increase surface area of the small intestine.1-7 Colostrum-LD also contains powerful modulators of immune response which regulate the cytokine response that causes inflammation in the body. 8 Both physicians and patients have testified to remission and restoration of damaged tissue in arthritis multiple sclerosis fibromyalgia lupus scleroderma Alzheimer s and other autoimmune L conditions. We believe this to be the result of the healing of leaky gut syndrome and the ability of Colostrum-LD s growth factors to help repair damaged tissue and organs as well as the immune factors which modulate inflammation. I recommend physicians put their chronically ill patients--anyone with allergies food sensitivities autoimmune diseases immune problems cancer heart disease etc. on Colostrum-LD as a first mode of treatment. I also suggest a gluten-free diet because gluten coats the villi in the small intestine thereby trapping any pathogens in the infected area of the bowel. Colostrum-LD can t destroy the pathogens if it can t reach them. The bowel needs to be re-seeded with probiotics and again colostrum is needed for the good bacteria to colonize. If a parasitic infection contributed to leaky gut an anti-parasitic cleanse is recommended as colostrum does not destroy all parasites. Due to the pervasive use of antibiotics prescription and over-the-counter pain medications and the growing concern over antibiotic residues in food GMO (genetically modified organism) foods polluted air and water Colostrum-LD has an important role to play. It is the only substance clinically proven to heal and prevent leaky gut syndrome and unless the gut is healed the body is unable to repair itself and potentially reverse chronic conditions. The quality and efficacy of any colostrum supple- ment is critically important. Bovine colostrum for human consumption is essentially worthless if its active components have been destroyed during processing. The quality and thus effectiveness of colostrum depends on four factors--the colostrum source processing methods testing and verification of active components and Liposomal Enhanced Delivery (LD).9 Colostrum-LD is obtained from pasture-fed dairy cows that are certified to be healthy BST BSE and antibioticfree. Colostrum-LD is flash pasteurized and dried with low heat to preserve bioactivity. Every batch of Colostrum-LD is tested for quality efficacy and safety in an U.S. Food and Drug Administration (FDA)-licensed facility. LD (micro-coating of every colostrum particle) is applied to ensure that Colostrum-LD will bypass digestion and its healing components remain bioavailable at the cellular level. References 1 Borissenko M. Malaysia Colostrum Piglet Clinical Trial. Unpublished Research. October 2004. 2 Playford RJ et al. Bovine colostrum is a health food supplement which prevents NSAID induced gut damage. Gut. 1999 44 653-658. 3 Playford RJ et al. Co-administration of the health food supplement bovine colostrum reduces the acute non-steroidal anti-inflammatory drug-induced increase in intestinal permeability. Clinical Science (London). 2001 Jun 100(6) 627-33. 4 Playford RJ et al. Colostrum and milk-derived peptide growth factors for the treatment of gastrointestinal disorders. American Journal of Clinical Nutrition. 2000 72 5-14. 5 Playford RJ et al. Bovine colostrum is a health food supplement which prevents NSAID induced gut damage. Gut. 1999 44 653-658. 6 Playford RJ et al. Co-administration of the health food supplement bovine colostrum reduces the acute non-steroidal anti-inflammatory drug-induced increase in intestinal permeability. Clinical Science (London). 2001 Jun 100(6) 627-33. 7 Playford RJ et al. Colostrum and milk-derived peptide growth factors for the treatment of gastrointestinal disorders. American Journal of Clinical Nutrition. 2000 72 5-14. 8 Keech AM. Peptide Immunotherapy Colostrum A Physicians Reference Guide. AKS Publishing 2010. 9 Chrai SS et al. Liposomes (a Review) Part Two Drug Delivery Systems. BioPharm. 2002 Jan 40-43. MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 37 PRODUCT FOCUS Natural Thyroid Support small butterfly-shaped gland located in the front of the neck the thyroid gland produces thyroid hormones that is vitally important to the human body. According to PubMed Health the thyroid plays a major role in the metabolism growth and maturation of the human body. It helps to regulate many body functions by constantly releasing a steady amount of hormones into the bloodstream. More hormones are produced when the body needs more energy for instance when it is growing or cold or during pregnancy. The thyroid utilizes iodine to make the thyroid hormone which is obtained through food sources such as seafood dairy products and iodized salt. The thyroid is controlled by the pituitary gland a pea-sized gland located in the base of the brain. The pituitary controls the thyroid gland directing it to produce the A By Shari Barbanel correct amount of thyroid hormone. However sometimes the thyroid may produce to few or too many hormones. An overactive thyroid known as hyperthyroidism is a condition that speeds up the metabolism. Hyperthyroidism is often caused by Graves disease (also known as Basedow s disease) which is an autoimmune disease of the thyroid tissue. Some symptoms of hyperthyroidism include weight loss hot flashes hair loss insomnia and restlessness emotional instability and irritability fatigue among others. If not enough of the thyroid hormones are being produced the body s functions slow down. An underactive thyroid also known as hypothyroidism can either be genetic or developed of the course of life. Some symptoms include tiredness sensitivity to cold a slowed metabolism being overweight dry skin and hair depression being overweight and a general loss of energy. There are a number of reasons that a person may develop hypothyroidism. A lack of iodine may be a cause and if the body is not getting enough iodine in the diet it may impair thyroid function. Hashimoto s thyroiditis (also known as Hashimoto s disease) a chronic inflammation of the thyroid can also lead to underactivity of the thyroid. The use of certain medications may also affect the production of thyroid hormones. It is recommended that those who feel they may have an issue with their thyroid visit a health care practitioner. Below is a sampling of thyroid health products available for natural practitioners to offer their patients Thyroid Care EuroMedica s Thyroid Care (suggested price 19.95 60 capsules) provides superior nutritional support for healthy thyroid and immune function. Optimal levels of iodine benefit the thyroid gland and supports healthy metabolism. L-Tyrosine is an important amino acid that is necessary for the body to produce thyroid (as well as noradrenaline and dopamine) hormones. It is impossible to have a well-functioning thyroid without sufficient quantities of tyrosine and iodine either in the diet or through supplementation. For more information call (866) 842-7256 or visit www.euromedicausa.com. Sea Iodine Life Extension offers Sea-Iodine 1 000 mcg (suggested price 8 60 vegetarian capsules). Iodine is found abundantly in sea vegetables and plants. In areas where no marine foods are eaten people have lower iodine levels. Iodine is a health-promoting trace element essential for life. Its primary biological role lies in the production of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). T4 and T3 contain four and three atoms of iodine per molecule respectively. The thyroid gland actively absorbs iodide from the blood to make and release these hormones into the blood. For more information call (800) 544-4440 or visit www.lifeextension.com. Thyroid Support Gaia Herbs Thyroid Support s (suggested price 9.99 60-ct. bottle) unique herbal formula including ashwagandha bladderwrack coleus kelp and schisandra supports normal thyroid hormone production--helping you to maintain optimal weight neuromuscular tone and cardiovascular health. Suggested use of the product is two capsules in the morning and one capsule in the evening between meals. Thyroid Support capsules are made from 100 percent vegan byproduct in Gaia s easily digestible plant-derived and alcohol-free patented liquid phytocaps. This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose treat cure or prevent any disease. Thyroid Plus Thyroid Plus (suggested price 38.62 60 capsules 72.24 120 capsules) from Priority One Nutritional Supplements Inc. supplies essential nutrients to healthy thyroid function along with 65 mg per capsule of whole gland thyroid. Glandular therapy is based on the thought that glandular concentrates support like organs to maintain an already healthy state. This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose treat cure or prevent any disease. For more information call (800) 831-7780 or visit www.gaiaherbs.com. For more information call (800) 443-2039 or visit www.priorityonevitamins.com. (Continued on page 48) WWW.NATURALPRACTITIONERMAG.COM MAY 2015 38 NATURAL PRACTITIONER Go to www.naturalpractitionermag.com rlclabs for info about this advertiser NATURAL MEDICINES MONOGRAPH Vitamin D Based on a systemic review of scientific literature edited and peer-reviewed by contributors to the Natural Medicines Research Collaboration. V itamin D is found in many dietary sources such as fish eggs fortified milk and cod liver oil. The sun also contributes significantly to the daily production of vitamin D and as little as 10 minutes of exposure is thought to be enough to prevent deficiencies. The term vitamin D refers to several different forms of this vitamin. Two forms are important in humans ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Vitamin D2 is synthesized by plants. Vitamin D3 is synthesized by humans in the skin when it is exposed to ultraviolet B (UVB) rays from sunlight. Foods may be fortified with vitamin D2 or D3. History Orally vitamin D is used for preventing osteoporosis muscle weakness enhancing immune function preventing autoimmune diseases multiple sclerosis rheumatoid arthritis chronic obstructive pulmonary disease (COPD) asthma bronchitis and cancer. It is also used orally for rickets premenstrual syndrome (PMS) influenza preventing falls and fractures in people at risk for osteoporosis corticosteroid-induced osteoporosis osteomalacia anticonvulsant-induced osteomalacia renal osteodystrophy osteitis fibrosa in people on dialysis hepatic osteodystrophy and osteogenesis imperfecta. Vitamin D is also used for preventing and treating hypocalcemia and tetany in premature infants bone disorders in people with familial hypophosphatemia hypophosphatemia associated with Fanconi syndrome and hypocalcemia associated with postoperative or idiopathic hypoparathyroidism or pseudohypoparathyroidism. Other uses include plaque-type psoriasis actinic keratosis lupus vulgaris squamous cell carcinomas vitiligo scleroderma myelodysplastic syndrome periodontal disease hypertension hyperlipidemia cardiovascular disease obesity and diabetes. Vitamin D is also used orally to treat severe proximal myopathy associated with vitamin D deficiency or myopathy associated with the use of HMG-CoA reductase inhibitors (statin-induced myopathy) and to maintain bone density in prostatic cancer patients at risk for osteoporosis when treated with luteinizing hormone-releasing hormone analogue (LHRH-a). Topically vitamin D is used as calcitriol or calcipotriene for plaque-type psoriasis. Intravenously vitamin D administered as calcitriol is used for hypocalcemic tetany in premature infants hypocalcemia and hyperparathyroidism in renal dialysis patients and osteitis fibrosa. Intramuscularly vitamin D is administered as ergocalciferol for hepatic osteodystrophy as an injectable source of vitamin D and to treat severe proximal myopathy associated with vitamin D deficiency. Safety Vitamin D is likely safe when used orally or intramuscularly and appropriately. Vitamin D has been safely used in a wide range of doses. When used orally long-term doses should not exceed the tolerable upper intake level of 4 000 IU per day for adults however much higher doses such as 50 000 IU week orally for six to 12 weeks are often needed for the short-term treatment of vitamin D deficiency. Optimal blood levels of 25-hydroxyvitamin D for maintaining bone density is 30100 ng mL. Toxicity usually does not occur until levels exceed 150 ng mL. Vitamin D is possibly unsafe when used orally in excessive doses long-term. Taking doses greater than the tolerable upper intake level of 4 000 IU per day for long periods can increase the risk of hypercalcemia however much higher doses are often needed for short-term treatment of vitamin D deficiency. Optimal blood levels of 25-hydroxyvitamin D for maintaining bone density is 30100 ng mL. Toxicity usually does not occur until levels exceed 150 ng mL. Children Vitamin D is likely safe when used orally and appropriately. When used long-term doses should not exceed the tolerable upper intake level. Infants from 0-6 months should not exceed the UL (upper level) of 1 000 IU daily. 40 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 Infants aged 6-12 months should not exceed the UL of 1 500 IU daily. Children aged 1-3 years should not exceed the UL of 2 500 IU daily. Children aged 4-8 years should not exceed the UL of 3 000 IU daily. Children aged 9 years and older should not exceed the UL of 4 000 IU daily however much higher doses are often needed for the short-term treatment of vitamin D deficiency. Some research shows that giving vitamin D 14 000 IU week for a year in children aged 10-17 is safe. It is possibly unsafe when used orally in excessive doses long-term. Taking doses greater than the tolerable upper intake level long-term can increase the risk of hypercalcemia. Infants from 0-6 months should not exceed the UL of 1 000 IU daily. Infants aged 6-12 months should not exceed the UL of 1500 IU daily. Children aged 1-3 years should not exceed the UL of 2 500 IU daily. Children aged 4-8 years should not exceed the UL of 3 000 IU daily. Children aged 9 years and older should not exceed the UL of 4 000 IU daily however much higher doses are often needed for the short-term treatment of vitamin D deficiency. Some research shows that giving vitamin D 14 000 IU week for a year in children aged 10-17 is safe. Pregnancy Vitamin D is likely safe when used orally and appropriately. Vitamin D is safe when used in doses below the tolerable upper intake level of 4 000 IU per day. It is possibly unsafe when used orally in excessive amounts. Tell patients not to use doses above the tolerable upper intake level of 4 000 IU per day. Hypercalcemia during pregnancy due to excessive vitamin D intake can lead to several adverse effects in the fetus including suppression of parathyroid hormone hypocalcemia tetany seizures aortic valve stenosis retinopathy and mental and or physical retardation in the infant. Lactation Vitamin D is likely safe when used orally and appropriately. Vitamin D is safe when used in doses below the tolerable upper intake level of 4 000 IU per day. It is possibly unsafe when used orally in excessive amounts. Tell patients not to use doses above the tolerable upper intake level of 4 000 IU per day. Effectiveness Effective Familial hypophosphatemia. Taking calcitriol or dihydrotachysterol orally in combination with phosphate supplements is effective for treating bone disorders in people with familial hypophosphatemia. Fanconi syndrome. Taking ergocalciferol orally is effective for treating hypophosphatemia associated with Fanconi syndrome. Hypoparathyroidism. Taking dihydrotachysterol or calcitriol orally is effective for increasing serum calcium concentrations in people with hypoparathyroidism or pseudohypoparathyroidism. Ergocalciferol is effective in high doses for increasing serum calcium concentrations in people with hypoparathyroidism or pseudohypoparathyroidism. Taking vitamin D or calcitriol postoperatively is also effective for preventing hypocalcemia in people with hypoparathyroidism due to thyroidectomy. Osteomalacia. Taking cholecalciferol is effective for treating osteomalacia. Oral calcifediol is effective for treating osteomalacia secondary to liver disease and anticonvulsant-induced osteomalacia. Ergocalciferol is effective for osteomalacia due to malabsorption syndromes and corticosteroid-induced osteomalacia. Psoriasis. Applying vitamin D or calcipotriene topically effectively treats plaquetype psoriasis in some patients including those with chronic plaque psoriasis. Applying topical vitamin D or its analogues in combination with topical corticosteroids seems to be more effective for treating psoriasis than either agent used alone. Also applying a specific combination product containing calcipotriene and betamethasone can reduce psoriasis severity compared to pretreatment and the combination seems to be more effective than topical vitamin D analogues alone. Renal osteodystrophy. Taking calcifediol orally manages hypocalcemia and prevents renal osteodystrophy in patients with chronic renal failure undergoing dialysis. However vitamin D and vitamin D analogues do not appear to reduce the risk of death bone pain or parathyroidectomy in patients with chronic renal failure undergoing dialysis. Rickets. Vitamin D is effective for preventing and treating rickets. Calcitriol should be used in patients with renal failure. Vitamin D deficiency. Vitamin D is effective for preventing and treating vitamin D deficiency using a wide range of doses. Optimal blood levels of 25-hydroxyvitamin D for maintaining bone density is 30-100 ng mL. Toxicity usually does not occur until levels exceed 150 ng mL. Dosing & Administration Adult Oral General Vitamin D is included in most multivitamins usually in strengths from 50 IU to 1 000 IU as soft gels capsules tablets and liquids. According to research ergocalciferol and cholecalciferol are considered equivalent however some evidence indicates that ergocalciferol is less potent than cholecalciferol. Since 2000 discrepancies have arisen regarding the benefits of vitamin D and how much is sufficient. A clinical review has suggested an upper limit of a dose of vitamin D to be more than or equal to 250 mcg daily based on the lack of observed toxicity in adult trials. The Institute of Medicine (IOM) has reviewed and updated the Dietary Reference Intakes (DRIs). The IOM found that there is strong evidence to support the use of vitamin D with calcium for bone health but that it was lacking for other health conditions. The new recommended daily allowance as set in 2010 is based on age as follows for those 1-70 years of age 600 IU daily for those 71 years and older 800 IU daily and for pregnant and lactating women 600 IU daily. The IOM further recommended that serum 25D levels of 20 ng mL is adequate and levels 50 ng mL could have potential adverse effects. This level can be achieved through substantial daily skin exposure to sunlight. Anticonvulsant-induced osteomalacia In human research vitamin D2 2 000 IU daily plus calcium lactate 390 mg daily for three months improved well-being and increased bone mineral content when used in combination with antiepileptic agents. Atopic eczema 1 600 IU of cholecalciferol either with or without 600 IU synthetic allrac-alpha-tocopherol has been taken daily for 60 days. Autoimmune diseases 0.25-2 mcg of alfacalcidol has been taken once or twice daily and 0.5 mcg of 1-alfa-OH D3 has been taken daily for up to 12 months. Cancer prevention According to observational studies individuals with 1 000 IU of oral vitamin D daily had a lower incidence of colon cancer. 100 000 IU of vitamin D3 has been taken every four months 1 100 IU of vitamin D has been taken daily and 400 IU of vitamin D3 or 1 100 mg of vitamin D plus 1 400-1 500 mg of calcium daily has been taken for 4-7 years. 400-1 100 IU of vitamin D has been taken daily for four years. Cancer treatment 10 mcg of doxercalciferol has been taken daily for 28 days or 45 mcg calcitriol has been taken weekly for three weeks out of every four weeks. 400 IU and 1 100 IU of vitamin D has been taken daily for 4-7 years. Cardiovascular disease According to a review moderate or high doses of vitamin D of approximately 1 000 IU daily reduced cardiovascular disease (CVD) risk. According to another review supplementation of vitamin D2 or D3 of approximately 528 IU daily raised MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 41 NATURAL MEDICINES MONOGRAPH serum 25D levels and found an association with decreased systolic blood pressure and risk for CVD-related deaths however no beneficial effect was found on blood pressure myocardial infarction or mortality for postmenopausal women. In most studies in a review 320-2 000 IU of vitamin D3 has been taken daily for 1.4-84 months or 200-800 IU of vitamin D2 has been taken daily for five months 100 000 IU of vitamin D2 or D3 three times yearly for up to three years has also been used and in one study participants received a single injection of 300 000 IU of vitamin D2 followed by 1 g of vitamin D2 800 IU of vitamin D3 plus 1 g of calcium daily for 12 months. 400 IU of vitamin D with calcium has been taken at an unspecified frequency for seven years. In a systematic review participants in some of the included studies received 800 IU of vitamin D daily for eight weeks. In a systematic review dosing included 2.5 mg of vitamin D every four months for five years 10-25 mcg of vitamin D daily for 17 years with or without 1 000 mg of calcium. Cognition According to a review supplementation of vitamin D2 or D3 of approximately 528 IU daily raised serum 25D levels and found an association with improved cognition. 9 000 IU of vitamin D2 has been taken daily for eight-40 weeks. Cystic fibrosis According to published guidelines if individuals with cystic fibrosis had a minimal 25-hydroxyvitamin D concentration of 30 ng mL vitamin D supplementation was recommended. A recommendation regarding whether oil- or powder-based formulas were more effective was lacking. Calcitriol doxercalciferol or paricalcitol under the guidance of an expert in vitamin D therapy was recommended. For adults the committee recommended that CF patients be treated with 800-2 000 IU of vitamin D3 daily which could be increased to a maximum of 10 000 IU daily if serum levels of 25-hydroxyvitamin D were persistently 30 ng mL. Dental caries Vi-delta Liquid emulsion and Ostelin were both reported as having been taken a vitamin D mixture in milk was also used. Fall prevention According to a systematic review high doses of vitamin D were found to have a greater benefit than lower doses at preventing nonvertebral and hip fractures. In systematic reviews and meta-analyses 2002 000 IU daily of vitamin D2 or vitamin D3 has been taken often in combination with calcium for up to 62 months. 100 000 IU of vitamin D2 has been taken up to every three months for up to five years. Single doses of 300 000 IU and 500 000 IU of vitamin D have been taken. In a systematic review dose information was limited and was 700 IU 0.50 mcg or 600 000 IU administered daily or weekly for a treatment duration of eight weeks to three years some trials administered vitamin D in combination with calcium. 1 100-15 000 IU has been taken weekly for 324 months. According to a review for optimal blood levels of 75-100 nmol L for improving lower muscular strength and bone density important in fall prevention 800-1000 IU of vitamin D daily is suggested. Vitamin D 100 IU has been taken daily in combination with calcium or 300 000 IU and 500 000 IU of vitamin D have been taken yearly without calcium for one-four years. 1 mcg of 1-alpha hydroxycholecalciferol have been taken daily for 36 weeks and 0.25 mcg of calcitriol has been taken daily for three years. According to a review 800-5 000 IU daily improved musculoskeletal health and reduced the risk of falls and fractures in the elderly. daily for two years. 200-800 IU of vitamin D has been taken daily for an average of 3.5 years in combination with calcium. According to a systematic review calcitriol 0.25-1 mcg daily or vitamin D 800 IU daily in combination with 1.2 g calcium has been used for an unknown duration however some studies were conducted for up to three years. 400-800 IU has been taken in combination with calcium at an unspecified frequency or 400-500 000 IU has been taken at an unspecified frequency once every four months or once a year without calcium for two to seven years. According to a review for optimal blood levels of 75-100 nmol L for improving lower muscular strength and bone density important in fracture prevention 800-1 000 IU of vitamin D daily is suggested. According to a review 800-5 000 IU daily improved musculoskeletal health and reduced the risk of falls and fractures in the elderly. According to a review 10-20 mcg of vitamin D3 has been taken daily other doses have included vitamin D2 2 500 mcg by mouth every four months or 12 500 mcg of vitamin D3 once annually for three to five years. Hyperlipidemia 300-3 332 IU has been taken daily for 42 days to three years and single doses have ranged from 100 000 to 200 000 IU D3 cholecalciferol calcitriol ergocalciferol and alpha-calcidiol were used and calcium was given in some studies. In a systematic review the following doses were used 7.5-1 250 mcg of vitamin D daily for 15 weeks to five years calcitriol 0.5 mcg daily or 1.5-2.25 mcg twice weekly for two to three months or 1 mg of alphacalcidol daily for four to six months. Hypertension According to a clinical review vitamin D 400-8 571 IU daily for various durations showed no effect on hypertension. 0.75-1 mcg of 25D 200-2 900 IU of D3 or 1 800 IU of D2 daily have been taken. Hypocalcemia According to secondary sources calcitriol has been used in an initial oral dose of 0.25 mcg daily dosing may be increased by 0.25 mcg daily at four to eightweek intervals in patients with hypocalcemia from chronic dialysis. Hypocalcemia due to hyperparathyroidism In a systematic review 0.5 or 1.0 mcg of calcitriol 0.5 g of vitamin D and 400 IU of vitamin D have been taken once to twice daily with oral calcium carbonate in some studies and up to postoperative day 14 in some studies. Hypoparathyroidism According to secondary sources dihydrotachysterol has been used in an oral initial dose of 750 mcg to 2.5 mg daily for several days for the treatment of hypoparathyroidism. A maintenance dose is typically 200 mcg to 1 mg daily. Ergocalciferol has also been used in an oral dose of 50 000 to 200 000 IU daily concomitantly with calcium Fertility 400-50 000 IU of vitamin D has been taken weekly or every two weeks alone or with calcium. Elocalcitol has been used for three months. Fertility 400-50 000 IU of vitamin D has been taken weekly or every two weeks alone or with calcium. Elocalcitol has been used for three months. Fibromyalgia 50 000 IU of vitamin D has been taken once weekly for three months. Fracture prevention 800 IU of vitamin D3 has been taken daily. 400-1 100 IU has also been taken daily. 100 000 IU of oral vitamin D2 has been taken every four months for 36 months or 10-20 mcg of oral vitamin D3 has been taken daily for 24 months. 400-1 000 IU has been taken daily. 400-1 370 IU has been taken daily with a follow-up of 7-60 months or 300-1 000 IU of vitamin D plus 500-1 200 mg of calcium have been taken daily for a follow-up of one to seven years. According to a systematic review doses of 400 IU daily to 5 000 IU have been taken twice weekly in combination with calcium and alpha-calcidiol has been taken. 1-alpha-hydroxyvitamin D 0.25 mcg has been taken daily for six months and calcitriol 0.25 mcg has been taken twice 42 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 lactate 4 g six times daily. Immunomodulation The following doses have been taken 40 IU of vitamin D3 given daily for 20 years to 100 000 IU of vitamin D3 given bimonthly for 12 months and 10 000 IU daily. Inflammatory bowel disease 0.5 mcg of alfacalcidol has been taken daily and compared with cholecalciferol 1 000 IU daily or cholecalciferol 1 200 IU has been taken daily with 1 200 mg of calcium and compared with 1 200 mg of calcium alone for 12 months. Kidney disease 1-9 mcg of vitamin D has been taken once daily or weekly over a four to 24-week period. 400-100 000 IU has been taken daily to monthly over a follow up period of six months to two years. Mood disorders In human research 400800 IU daily or 100 000 IU weekly of vitamin D for up to one month improved symptoms of depression associated with seasonal affective disorder. In obese patients 20 000-40 000 IU of vitamin D per week for one year was found to improve symptoms of depression. Mortality reduction 10 mcg to 500 000 IU has been taken with frequencies varying from daily to every third or fourth month to once yearly. In a systematic review the following doses were reported cholecalciferol 3001 8000 000 IU ergocalciferol 200-300 000 IU alfacalcidol 1 mcg calcitriol 0.5 mcg and 2 mcg and if in combination with calcium a calcium dose of 300-1 600 mg was taken and the frequency of vitamin D supplementation varied from daily to yearly with a duration of treatment of one day to seven years. 400 IU and 100 000 IU of vitamin D have been taken daily with or without calcium for two to seven years. Multiple sclerosis (MS) In human research high-dose vitamin D was found to be safe and showed evidence of immunomodulatory effects. In clinical research 5 000 IU of vitamin D3 daily reduced the number of relapses in patients with MS. In a safety study progressive weekly increases of vitamin D3 per week plus 1 200 mg of calcium were found to be safe in individuals with multiple sclerosis. Muscle strength In a systematic review ergocalciferol has been taken at doses of 1 000-600 000 IU calciferol has been taken at doses of 20-300 000 IU and cholecalciferol has been taken at doses of 400-150 000 IU if in combination with calcium 800-1 100 mg was taken. The treatment was daily in some studies and the duration was two to 36 months. In a systematic review doses of vitamin D were 400-150 000 IU of D3 1 000600 000 IU of D2 and 0.25 mcg of calcitriol. In a systematic review participants in some of the included studies received 700-1 000 IU of vitamin D daily for two months to two years. Muscle weakness pain 100 000 IU of calciferol has been taken daily for 12 months in patients with rheumatoid arthritis. Osteoporosis In postmenopausal African American women 2 000 IU daily of oral vitamin D3 was sufficient to raise 25-hydroxyvitamin D concentrations to more than 50 nmol L but higher doses may also be required. In women residing in sunny areas 400 IU daily was not sufficient enough to achieve optimal 25-hydroxyvitamin D concentrations for bone health. For chronic supplementation to protect against bone loss a daily dosage of at least 800 IU seems required. Higher dosages may be needed to correct established vitamin D deficiency a repeat 25D assay after four to six months may help to assess the treatment response and to adjust the subsequent vitamin D dosage. According to a clinical review vitamin D 400-1 200 IU daily with calcium or intermittently 100 000 IU every four months with or without calcium may reduce the risk of falls and fall-related fractures in the elderly. 300-7 000 IU daily and 400-5 714 IU of vitamin D3 and 5 00010 000 IU of vitamin D2 daily have been taken. 100 IU daily to 1000 000 IU weekly and 50 000 IU of vitamin D weekly along with 1 500 mg of calcium daily and 800 IU of vitamin D have been used. Vitamin D supplementation of 4002 000 IU daily as vitamin D alone combined with calcium or within a multivitamin has been used. Osteoporosis Weight-based calcitriol has been taken for two years or 800 IU of vitamin D has been taken or 1 600 IU has been taken with or without 1 g of calcium for six months. Osteoporosis 200800 IU has been taken daily occasionally in combination with calcium for up to 24 months. Calcitriol and alfacalcidol daily were the recommendations in the individual trials. Parasitic infections In patients with Schistosoma haematobium infection 40 IU of vitamin D daily for five days resulted in some positive effects on levels of activated eosinophils and Schistosoma-specific antibodies. Physical performance In elderly subjects vitamin D 400 IU plus 800 mg of calcium daily improved gait speed body sway and muscle strength. According to post hoc analysis in older adults 8 400 IU of vitamin D3 weekly for 16 weeks reduced mediolateral sway and was well tolerated. Pregnancy nutritional supplement 400600 000 IU has been taken as a daily dose from week 12 week 27 or during the third trimester or a single dose at either the seventh or eighth month of gestation. 400-4 000 IU of vitamin D has been taken daily for the third trimester or starting the 12th week of pregnancy other doses were 120 000-600 000 IU of vitamin D monthly at the fifth seventh and or eighth months or the 27th week of gestation. 400-4 000 IU daily a single dose of 200 000 IU or two doses of 600 000 IU has been taken with supplementation starting anywhere between 12 and 27 weeks of gestation. 800-1 200 IU has been taken daily starting at weeks 20-32 of pregnancy and continued until the end of pregnancy other doses have included a single dose of 200 000 IU at 27-28 weeks of pregnancy or 600 000 IU MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 43 NATURAL MEDICINES MONOGRAPH given once in the seventh month and once in the eighth month of pregnancy. A single dose of 1 500-6 000 IU has been taken in both the second and third trimester. Prevention of respiratory tract infections 400-2 000 IU of vitamin D has been taken daily for up to three years. 4 000 IU has been taken daily for one year. An initial dose of 200 000 IU of vitamin D3 has been taken followed by 200 000 IU one month later and 100 000 IU monthly. Respiratory infections According to a clinical review doses of 2 000 IU kg of body weight for three days may be beneficial in treating viral respiratory infections. Rheumatoid arthritis In human research patients with active rheumatoid arthritis stabilized on methotrexate and receiving vitamin D 50 000 IU weekly for 12 weeks showed a moderate improvement in efficacy outcomes. Tuberculosis (TB) A single dose of 10 000 IU daily of vitamin D2 to purified protein derivative-positive contacts of active TB cases improved immunologic control of bacille Calmette-Gu rin in the peripheral blood. Four daily doses of 2.5 mg of vitamin D has been taken on day seven of usual tuberculosis treatment followed by supplementation on days 14 28 and 42. In a second study in this review 1 000 IU of vitamin D was taken daily for eight weeks in addition to usual tuberculosis therapy and a third study administered vitamin D at 0.25 mg daily for six weeks. Type 2 diabetes Calcitriol 1-alpha-calcidiol cholecalciferol doxecalciferol and ergocalciferol have been used at doses of 400-200 000 IU for cholecalciferol 0.25 mcg and 0.75 mcg for 1-alphacalcidiol 1 mcg and 1.5 mg for calcitriol 1 and 2 mcg for paricalcitol and 100 000 IU for ergocalciferol for seven days to seven years. 0.75-2 mcg of alpha-calcidol 11.5 mcg of 1 25-dihydroxyvitamin D3 0.75 mcg daily of 1-hydroxyvitamin D3 and 400100 000 IU of vitamin D3 have been taken daily or weekly as a single dose for up to seven years. 400-8 751 IU has been taken daily for six weeks to nine years. According to a clinical review vitamin D 400-5 714 IU daily for two months to seven years showed no effect on glycemia. Viral infection In human research 800 IU of vitamin D daily for two years followed by 2 000 IU of vitamin D daily for 12 months produced a lower rate of self-reported upper respiratory tract infection. Vitamin D deficiency According to a clinical review treatment of vitamin D deficiency in healthy individuals or those with serious illness should be individualized to maintain 25-hydroxyvitamin D levels in the normal range. To achieve an optimal vitamin D status of 75 nmol L research suggests an intake for all adults of 1 000 IU or more daily. Weekly doses of 8 400 IU of vitamin D3 have also been shown to raise 25D levels. According to a clinical review 50 000 IU daily for six weeks lacked evidence of toxicity. Doses of 300 000 IU of oral vitamin D3 three times per year have also been shown to be effective for vitamin D insufficiency and well tolerated. more over several weeks is needed for treatment of vitamin D deficiency. Topical Psoriasis Calcipotriene is a synthetic form of vitamin D3 and is used for psoriasis. Experts recommend applying the ointment twice daily to control the excess production of skin cells in psoriasis. In clinical trials topical vitamin D analogs have been used alone or with topical steroids for three to 52 weeks. Topical calcipotriol 50 mg g tacalcitol 4 mg g calcitriol 3 mg g or the two compound formulation ointment containing calcipotriol with betamethasone dipropionate have been applied once or twice daily for four to 12 weeks. Senile warts In human research in the elderly topical vitamin D3 ointments for three to 12 months reduced senile warts. Vitiligo In human research calcipotriol ointment alone twice daily showed marked improvement in repigmentation in patients with vitiligo betamethasone dipropionate in the morning and calcipotriol in the evening also showed marked repigmentation. Vitamin D analogs such as calcipotriol or tacalcitol have been used alone or combined with phototherapy or topical steroids and applied topically twice per week to twice daily for six weeks to 18 months. Intravenous Intramuscular Cardiovascular disease A single injection of 300 000 IU of vitamin D2 has been followed by 1g of vitamin D2 800 IU of vitamin D3 plus 1g of calcium daily for 12 months. Fall prevention 300 000-600 000 IU of vitamin D2 has been given intramuscularly once annually for up to 62 months. In a systematic review the following doses were reported a single intramuscular injection containing 300 000-600 000 IU of vitamin D or 300 000 IU of vitamin D annually for three years. Fracture prevention 300 000 IU of intramuscular vitamin D2 has been given every 12 months for 36 months. According to a review vitamin D2 7 500 mcg has been given intramuscularly every 12 months. Hyperlipidemia Calcitriol has been administered intravenously at a dose of 1 mcg twice weekly for eight weeks. Kidney disease 0.04 mcg kg to 4 mcg of vitamin D has been administered intravenously once or three times weekly over a four to 12-week period. Muscle strength In a systematic review doses of vitamin D were 400-150 000 IU of D3 1 000-600 000 IU of D2 or 0.25 mcg of calcitriol. Vitamin D deficiency In human research 300 000 IU of an intramuscular bolus dose of vitamin D2 or D3 administered three times Rheumatoid arthritis In human research patients with active rheumatoid arthritis stabilized on methotrexate and receiving vitamin D 50 000 IU weekly for 12 weeks showed a moderate improvement in efficacy outcomes. According to clinical research in the United States Canada and Japan elderly patients living in long-term care facilities at risk for vitamin D deficiency should receive a minimum of 800 IU daily in combination with calcium. Doses of 400 IU daily have not been found sufficient enough to improve bone health in sunny areas. In women with secondary hyperparathyroidism and hypovitaminosis D cholecalciferol 300 000 IU every three months was more effective than 1 000 IU daily in correcting vitamin D deficiency. In rheumatology patients with severe vitamin D deficiency a single oral dose of 300 000 IU of vitamin D3 has been used. In a separate guideline supplementation at suggested daily intake and tolerable upper limit levels was recommended however age and clinical circumstance were to play a role in the level. The guideline recommended measuring serum 25-hydroxyvitamin D levels and both vitamin D2 and vitamin D3 were recommended. The authors suggested that screening of individuals not at risk for deficiency lacks supportive evidence as does the need for prescription of vitamin D for cardiovascular protection. According to a review a cumulative dose of 600 000 IU or 44 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 per year was well tolerated and effective for vitamin D insufficiency. According to a clinical review higher doses of single injections of 600 000 IU of vitamin D were sufficient to raise levels with no evidence of toxicity and may also be beneficial for the prevention of vitamin D deficiency during the winter season. A single intramuscular injection of 600 000 IU of cholecalciferol vitamin D3 has been given. Children Oral General Since 2000 discrepancies have arisen regarding the benefits of vitamin D and how much to take. IOM has reviewed and updated the DRIs. In 2008 the American Academy of Pediatrics (AAP) increased its recommended daily intake of vitamin D in infants children and adolescents to 400 IU. Exclusively breastfed infants who do not consume less than 1 L of vitamin D-fortified milk daily will likely need supplementation to reach 400 IU of vitamin D daily. Although the AAP advises against keeping children in direct sunlight exposure this may increase the risk of vitamin D deficiency. However the IOM found that there is strong evidence to support the use of vitamin D with calcium for bone health but that it was lacking for other health conditions. The new recommended daily allowance as set in 2010 is based on age as follows for those 1-70 years of age 600 IU daily for infants aged 0-12 months the upper level intake is 1 000 IU daily. Other research confirms these recommendations. According to a review for their first 12 months infants at low risk of vitamin D deficiency should be supplemented with 400 IU daily. Anticonvulsant-induced osteomalacia In human research vitamin D2 2 000 IU daily plus calcium Sandoz 500 mg for three months improved well-being and increased bone mineral content in children aged 7-14 years when used in combination with phenytoin. Atopic eczema 1 600 IU of cholecalciferol either with or without 600 IU of synthetic allrac-alpha-tocopherol has been taken daily for 60 days or 1 000 IU of ergocalciferol has been taken daily for one month. Cystic fibrosis (CF) According to published guidelines if individuals with cystic fibrosis had a minimal 25-hydroxyvitamin D concentration of 30 ng mL vitamin D supplementation was recommended. A recommendation regarding whether oil- or powder-based formulas were more effective was lacking. Calcitriol doxercalciferol or paricalcitol under the guidance of an expert in vitamin D therapy was recommended. For infants with CF the committee recommended treatment consisting of 400-500 IU of vitamin D daily from birth to 12 months. If serum 25-hydroxyvitamin D levels in infants became 10 ng mL it was suggested that the infants be assessed for rickets by an expert in vitamin D therapy. If serum levels of 25-hydroxyvitamin D became 20 ng mL or if they were persistently 30 ng mL it was recommended that the dose be increased to 2 000 IU daily. If this dosing lacked an appropriate effect the committee recommended that the infant consult an expert in vitamin D therapy. Children with CF who were aged 1-10 years were advised to be treated with 800-1 000 IU of vitamin D daily which could be increased to a maximum of 4 000 IU daily if the serum levels of 25hydroxyvitamin D were persistently 30 ng mL. For children aged 10 years the committee recommended that CF patients be treated with 800-2 000 IU of vitamin D3 daily which could be increased to a maximum of 10 000 IU daily if serum levels of 25-hydroxyvitamin D were persistently 30 ng mL. Immunomodulation In a systematic review participants in some of the included studies received 2 000 IU of vitamin D daily during the first year of life. Osteoporosis Weight-based calcitriol has been taken for two years or 800 IU of vitamin D has been taken or 1 600 IU has been taken with or without 1 g of calcium for six months. Osteoporosis 0.25 mcg of calcitriol has been taken in combination with 500 mg of elemental calcium daily for nine months and alfacalcidol has been taken daily for six months. Prevention of respiratory tract infections 1 200 IU of vitamin D has been taken daily for three months to three years. 300 IU of vitamin D3 has been given in milk over a three-month period in winter. 1 200 IU of vitamin D3 has been taken. Respiratory tract infections A single dose of 100 000 IU of vitamin D3 has been taken. Rickets According to secondary sources rickets may be treated gradually over several months or in a single day s dose. In one clinical trial a single dose of 600 000 IU of oral vitamin D3 was comparable to a dose of 20 000 IU of oral vitamin D3 daily for 30 days. Gradual dosing may be 125-250 mcg taken daily for two to three months until recovery is well established and alkaline phosphatase blood concentration is close to normal limits. Single-day dosing may be 15 000 mcg of vitamin D taken by mouth divided into four to six doses. Intramuscular injection is also an alternative for single-day dosing. For resistant rickets some authors suggest a higher dose of 12 000-500 000 IU daily. Tuberculosis (TB) 1 000 IU of vitamin D daily in combination with standard TB therapy improved symptom resolution in children. Type 1 diabetes In observational research 2 000 IU daily for a year produced a reduced risk of type 1 diabetes it may be more beneficial to begin supplementation between the age of seven and 12 months vs. birth to six months of age. Viral infection In children 60 000 IU weekly for six weeks prevented the recurrence of viral infection. Vitamin D deficiency In human research oral doses of 2.5 mg of vitamin D every three months as prophylaxis during infancy maintained protection against vitamin D MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 45 NATURAL MEDICINES MONOGRAPH deficiency in high-risk infant populations. In children with chronic kidney disease and vitamin D deficiency 600 000 IU of cholecalciferol was taken. Intravenous Intramuscular Prevention of respiratory tract infections A single parenteral dose of 100 000 IU of vitamin D has been administered. Standardization & Formulation There is no well-known standardization for vitamin D. In a clinical trial Calcichew D3 Forte was used. nolence headache dry mouth metallic taste vertigo tinnitus and ataxia. Kidney function may become impaired and metastatic calcifications may occur particularly affecting the kidneys. Treatment involves stopping the intake of vitamin D or calcium and lowering the calcium levels under strict medical supervision with frequent monitoring of calcium levels. Acidification of urine and corticosteroids may be necessary. To return vitamin D levels to normal the supplement is discontinued. Human reports In a human case report of an 84-year-old man with vitamin D deficiency the prescription was incorrectly filled and he received ergocalciferol 50 000 units daily rather than weekly as it was written. The patient s vitamin D levels rose from 7.0 ng mL to 100 ng mL over a six-month span. He complained of decreased appetite and weight loss and he experienced an elevated international normalized ratio. Vitamin D therapy was discontinued. In human research vitamin D supplementation resulted in hypervitaminosis D in some subjects. In a case report a 42-year-old man who had been taking a vitamin D3 containing supplement for two years was admitted to the hospital. The patient had hypercalcemia and increased serum levels of 25-hydroxyvitamin D and creatinine as well as decreased hemoglobin. The patient was advised to wear sunscreen outdoors and to discontinue the vitamin D3. Blood tests were normal after 30 months. The product used by the patient was found to contain 26-430 times the vitamin D that was listed on the label resulting in the consumption of 156 000-2 604 000 IU of vitamin D3 daily. Although glucocorticoids were not used in this situation the authors indicated that they are useful for short-term management of vitamin D toxicity. The authors also suggest that renal and hematological abnormalities are possible. When examined in a safety study 14 000 IU weekly for eight weeks and 1 400 IU or 14 000 IU weekly for one year lacked toxic effects. According to review long-term daily intakes of 4 000 to 10 000 IU of vitamin D daily lack toxicity and are safe for the healthy adult population. According to a review single large doses of 300 000-500 000 IU of vitamin D should be avoided but the authors suggested that doses of 2 000 IU or lower daily are unlikely to cause harm in young otherwise healthy adults. Cytochrome P450 3A4 Substrates Digoxin (Lanoxin) Diltiazem Heparin Low-molecular weight heparins Thiazide Diuretics and Verapamil. Interactions With Herbs & Supplements Magnesium The protein that transports calcium across the intestinal wall can also bind and transport magnesium. This protein is stimulated by vitamin D which may therefore increase magnesium absorption. In people with low vitamin D and magnesium levels taking vitamin D may improve magnesium status. In people with normal magnesium levels this effect does not seem to be significant possibly because urinary magnesium excretion also increases. Nutrient Depletion Some drugs can affect vitamin D levels including Carbamazepine (Tegretol) Cholestyramine Colestipol (Colestid) Corticosteroids mineral oil Orlistat (Xenical Alli) Phenobarbital Phenytoin (Dilantin) Fosphenytoin (Cerebyx) Rifampin Stimulant laxatives and sunscreens. Interactions with Foods None knows. Interactions with Lab Tests None known. For a full list of references visit www.naturalpractitionermag.com. Natural Medicines Research Collaboration (www.naturalmedicinestherapeuticresearch.com) provides access to the most comprehensive database of high-quality evidence-based systematic reviews on dietary supplements and CAM therapies. This database is a clinical decision support tool that is designed to advise clinicians and researchers on the safety and efficacy of herbs supplements vitamins diets nutrition exercise and complementary practices and modalities. Using a comprehensive methodology reproducible grading scales and the collective expertise of a multi-disciplinary Editorial Board Natural Medicines mission is to provide organizations with access to the highest-quality evidence-based intelligence to make more informed and safer therapeutic decisions. Questions about the database can be directed to (617) 591-3348. Adverse Effects General Vitamin D orally and parenterally is generally well tolerated in recommended doses with the most common adverse effect being gastrointestinal complaints. Vitamin D analogs used for psoriasis are also generally well tolerated. When administered with calcium the combination was well tolerated for up to one year. Adverse effects are lacking in some clinical trials. A review of the potential adverse effects of vitamin D has been published. According to secondary sources one study found a greater likelihood of daytime sleepiness for patients given vitamin D analogs. Vitamin D supplementation may also cause hypercalcemia and hypercalciuria particularly at high doses according to human research. Toxicology According to the European Food Safety Authority (EFSA) safe upper intake levels (ULs) of vitamin D have been established as 25 mg daily up to age 10 years and 50 mg daily for those 11-years-old. IOM released a report on November 30 2010 recommending vitamin D UL of 3 000 IU for those less than nine years old and 4 000 IU for those over nine years old. According to the IOM recommended ULs of vitamin D are 1 000 IU for ages 0-6 months 1 500 IU for ages 7-12 months 2 500 IU for ages 1-3 years 3 000 IU for ages 4-8 years and 4 000 IU for those over age nine. A clinical review has suggested the use of 250 mcg (10 000 IU) of vitamin D3 daily as the UL based on the lack of observed toxicity in adult trials. Vitamin D toxicity can result from regular excess intake of this vitamin and may lead to hypercalcemia and excess bone loss. Individuals at particular risk include those with hyperparathyroidism kidney disease sarcoidosis tuberculosis or histoplasmosis. Chronic hypercalcemia may lead to serious or even life-threatening complications and should be managed by a physician. Early symptoms of hypercalcemia may include nausea vomiting and anorexia followed by polyuria polydipsia weakness fatigue som- Interactions Interactions with Drugs Vitamin D may interact with certain drugs and caution is advised when used in combination with these agents. These include aluminum Atorvastatin (Lipitor) Calcipotriene (Dovonex) Cimetidine (Tagamet) 46 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 PRACTITIONER CHAT M Mark Menolascino MD MS ABIHM ABAARM IFMCP Phone (307) 732-1039 E-mail drmark menoclinic.com Website www.lycored.com www.menoclinic.com ark Menolascino MD MS ABIHM ABAARM IFMCP is the founder and medical director of the Meno Clinic Center for Advanced Medicine in Jackson Hole WY specializing in utilizing nutritional strategies for optimal health and performance. He is also a key medical opinion leader at LycoRed a nutraceutical ingredient supplier and combines multiple disciplines with four board certifications including internal medicine anti-aging medicine functional medicine integrative holistic medicine and a master s degree in psychoneuroimmunology. quality supplements and it worked and she still uses it today. I feel if you are going to recommend supplements you must educate yourself on them. One of the fastest ways to do this is to attend an integrative or functional medicine course to learn about supplements and different options and also meet with sales representatives as this is really is where I seem to learn the most about the unique qualities of each company. As a physician of both conventional and alternative care where does supplementation come into play in your practice What can integrative health care physicians do to help their clients better understand the supplements they take Q Q A Physicians can make brochures that explain to clients why we choose the brands we do list potential interactions or side effect to be concerned about and teach them how to evaluate what they have in their medicine cabinet and when shopping. Studies by Holistic Primary Care have shown that 90 percent of physicians may recommend supplements by name yet only 20 percent will recommend a specific brand. We must first educate practitioners then give them tools to educate the clients. Providing tools from the supplement companies for practitioners to share with clients would be beneficial as well. Do you recommend supplements to your clients A Q A We see chronic conditions and this is where targeted supplementation has the most effect. Usually these clients either failed medication or had side effects and tend to be profoundly nutrient deficient and targeted therapy can have dramatic impacts in a short time. I feel most of us benefit from a high-quality multivitamin vitamin D if deficient and omega-3 as the data is pretty clear to me that most Americans are nutrient deficient and these three have the best data in my opinion. At the end of the day I want Food to be Medicine yet even if we eat the best organic foods it can be impossible to achieve blood and cellular levels needed to reverse illness and treat chronic disease. fillers show up and they pick the highest quality they can find. These are also the consumers seeking out integrative functional MDs or naturopaths as they want nutrition as medicine and are looking for expertise in the field of nutraceuticals. The other group is simply looking for the cheapest price. Not actually understanding the ingredient label consumers will buy the cheapest bargain brand assuming there is no difference. For example many fish oil supplements can be rancid and oxidized upon opening and consumers would never know if it was from industrial harbor grade fish or the desired clean North Sea sardines. When I provide my clients with the professional grade I use within days they can no longer tell they are consuming a supplement with fish oil. Q A How do consumers make sense of conflicting supplement formulations This is very difficult even for me sometimes when I go to the store and look at the dizzying display of lotions and potions. The claims made on some of them are ridiculous but still it can be very difficult to sort through the hype from the hope. In my clinic I stick with the six to 10 medical grade supplement companies that I trust. I have been to several of the facilities I know the owners and developers and have trust in the process. These companies figured out long ago not to compete with grocery store inferior quality but to hold their standards of genus species potency toxicity and microbiological contamination of both the raw ingredients and finished product. For example the professional grade fish oil I recommend has a patented distillation process and on the bottle is a number you can look up on the internet and see that batch gas chromato- Yes I do. I learned at the beginning of my training the difference between grocery store health food store and pharmaceutical grade supplements and this made a huge impact on me. For example I recommended melatonin for sleep to one of my first clients she bought it at the grocery store it did not work and she told me I did not know what I was doing. A month later I gave her the high- When purchasing supplements how important is it that consumers understand ingredient labels We have two groups of consumers--one group does extensive research looks thoroughly at labels looks for the GMP (good manufacturing practice) and NSF-type certification and scrutinizes the other ingredients list which is usually where the binders and Q A MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 47 PRACTITIONER CHAT graph of the constituents so you know it is pure. This is the level that medical grade nutraceutical companies are striving for which will help consumers better understand formulations. What is your best piece of advice for consumers regarding supplement decisions First read the other ingredients list. If there is anything you cannot pronounce then avoid it Many additive fillers and binders including dyes are known toxins but are still found in food and supplements. One of the leading grocery store multivitamins has 46 other ingredients in it as fillers dyes and binders with several know toxins. Also as Hippocrates told us Let food be thy medicine so look to healthy food first and supplements second. The problem is however that our food supplies are so nutrient depleted and our soils are nutrient depleted that it is hard to stay ahead of our stressful lives to maintain optimal support. Most clients who go through intracellular micronutrient testing are low in more than five nutrients and some are low in everything. What can natural products retailers do to help educate their customers As above I like the way companies are doing pre-clinical research on their ingredients controlling the process from seed to supplement and branding their products as certified to a high level of purity activity and quality. I would recommend companies make similar efforts and we really need to police ourselves more to discourage low-quality supplements that flood the market. Retailers should position themselves as leaders in quality provide education scrutinize ingredients and provide the highest quality possible. I also feel some level of education has room to grow as we are educating providers yet we are not doing much to educate our clients. That is why the bombardment of negative press regarding supplements sticks with most people as they have no frame of reference to sort the wheat from the chaff. Q A Q A PRODUCT FOCUS (Continued from page 38) Thyroid Px Restorative Formulations Thyroid Px (suggested price 39.50 75 vegi-capsules) is a balanced blend of minerals and botanicals designed to support the healthy functioning of the thyroid gland while simultaneously maintaining healthy metabolic function. Thyroid Px optimizes thyroid function normal body temperature and general metabolic rate. This formula can help stabilize thyroid peroxidase immunoglobulins which are essential for normal thyroid activity. The powerful antioxidants selenium and zinc as well as the myrrh guggul gum resin help neutralize free radicals that affect iodothryonine-5- monodeiodinase enzyme activity which is involved in the conversion of T4 to the active T3 hormone. For more information call (800) 420-5801 or visit www.restorative.com. Thyroid Metabolism Iodine TMI Thyroid Metabolism Iodine (suggested price 28 for 2-oz. liquid or 60-ct. capsules) from Systemic Formulas Inc. nourishes and supports the thyroid metabolic processes via multi-source iodine and selenium in an herbalomic base. It contains a balanced combination of essential nutrients and herbs and provides the ideal ratio of iodide to iodine along with other essential nutrients needed for proper thyroid function. Some of the herbalomic highlights include schisandra chinensis an adaptogen that helps normalize endocrine gland function helps relieve adrenal stress that in turn affects thyroid T3 production dulse which is rich in selenium a mineral that supports conversion of thyroxine into thyronine and ashwaganda which helps stimulates hormone production in the thyroid gland. For more information call (800) 445-4647 or visit www.systemicformulas.com. WP Thyroid RLC Labs offers WP Thyroid the purest option for hypothyroid treatment. WP Thyroid is a combination of T4 and T3 hormones and also contains thyroid cofactors such as T1 T2 calcitonin and iodine. The clean uncoated tablet was formulated using only two all-natural inactive ingredients inulin (from chicory root) and medium chain triglycerides (from coconut). WP Thyroid does not contain any artificial colors or flavors corn peanut rice gluten soy yeast egg or fish shellfish and is available in eight strengths. For more information call (877) 797-7997 or visit http getrealthyroid.com. Tyrosine and B-Vitamins Vital Nutrients s Tyrosine and B-Vitamins (suggested price 21.70 100 capsules) is a combination which supports healthy adrenal and thyroid function. It affects neurotransmitters and may promote healthy emotional well-being. This combination helps build and support epinephrine norepinephrine and thyroid hormones. It also supports the body s immune system. This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose treat cure or prevent any disease. For more information call (888) 328-9992 or visit www.vitalnutrients.net. 48 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 IHS WRAP UP IHS 2015 Opens the Door for Success treatment differently. In conventional medicine the leading question is what disease does this person have What results from answering that question is how the disease is treated. Instead of focusing on the disease traditional medicine focuses on the patient. Because each individual is different as is their illness--you wouldn t necessarily treat two people with the same illness the exact same way because you have to look at the patient s overall health not just at their disease. The more conventional toplevel specialists a patient has see the more my colleges and I want to help them Dr. Galland said. Dr. Galland also spoke about how clinical disease results from the interaction of mediators triggers and antecedents and that the fundamental diagnostic question is what are the mediators triggers and antecedents and how the effects of sickness in an individual patient because the individuality of each patient is foremost. Disease illness is not caused by mediators antecedents triggers or their effects but rather by the dynamic interaction of all four he explained. According to Dr. Galland finding out as much as possible about a patient and their medical history is vital because it will help you in developing a proper treatment for the patient. In addition to asking patients to describe the effects of their illness especially functional and social disabilities Dr. Galland noted the importance of searching for a precipitating event. Asking a patient When is the last time you felt really well may yield a different answer than How long have you had this problem You don t have to be Einstein to be a good doctor Dr. Galland said. You just need to pay really close attention to detail. Ben Kligler MD MPH n February 19-21 health care professionals gathered at the New York Hilton in New York City for the 2015 Integrative Healthcare Symposium (IHS) to hear industry stakeholders and medical professionals. Attendees came armed and ready to educate themselves about the industry and where it stands today current research and treatments and how practitioners can better incorporate alternative approaches in their practice. IHS 2015 focused on the industry in relation to environmental health nutritional science brain mind and mood as well as integrative nursing. O Patient-centered Care On Thursday morning Leo Galland MD DACP FACN presented Patient-Centered Diagnosis The Heart of Integrative Practice. During the session Dr. Galland spoke about the disease model of illness and the differences between how conventional and traditional medicines approach motivational interviewing as a tool for promoting this change and quick and effective methods of nutrition education for various therapeutic diets. The most important thing is to find the time to talk about nutrition with your patients said Dr. Schehr and it s also the hardest. She also stressed the importance of discovering the boundaries of talking with your patients about food and nutrition and not being afraid to create the space needed for such conversations to happen. Some of the key concepts presented included focusing patients not on what they can t have but what they can have when it comes to food eating with mindfulness (or food awareness) and allowing food to be fun and social. People don t have the confidence that counseling patients on nutrition will lead to chance said Dr. Kligler. We have to help patients overcome the barriers. Considering the role that stress and lifestyle play on a patients health and nutritional habits was also discussed as were dietary modifications and nutritional supplements as part of an overall approach. We can t abstain from food so we need to figure out how to balance that and learn to make it healthy said Dr. Schehr. Most importantly we have to make the time to talk about it with our patients and have an open level of communication with them. Everyday Nutrition On Friday Ben Kligler MD MPH and Jaime Schehr ND RD CDN presented Nutrition In Your Everyday Practice where the pair discussed foundations for proper nutrition during an integrative medical visit how to identify specific strategies that promote successful dietary change the basic principles and skills of Shine Down On the final day of the three-day conference attendees checked in to Effective Treatment of CFS Fatigue & Fibromyalgia with guest speaker Director of the Practitioners Alliance Network (PAN) and author of the Jamie Schehr ND RD CDN (Continued on page 55) NATURAL PRACTITIONER MAY 2015 WWW.NATURALPRACTITIONERMAG.COM 49 NATURAL HEALTH STUDIES High Cholesterol Triglycerides Can Keep Vitamin E From Reaching Body Tissues I n the continuing debate over how much vitamin E is enough a new study has found that high levels of blood lipids such as cholesterol and triglycerides can keep this essential micronutrient tied up in the blood stream and prevent vitamin E from reaching the tissues that need it. The research just published in the American Journal of Clinical Nutrition also suggested that measuring only blood levels may offer a distorted picture of whether or not a person has adequate amounts of this vitamin and that past methods of estimating tissue levels are flawed. Vitamin E is especially important in some places such as artery walls the brain liver eyes and skin but is essential in just about every tissue in the body. A powerful fat-soluble antioxidant it plays important roles in scavenging free radicals and neurologic function. In the diet it s most commonly obtained from cooking oils and some vegetables. Some experts have suggested that recommended levels of vitamin E should be lowered. But because of these absorption issues the recommended level of 15 milligrams per day is about right said Maret Traber the lead author of this study. Inadequate vitamin E intake remains a significant societal problem she said. This research raises particular concern about people who are obese or have metabolic syndrome said Traber who is the Helen P. Rumbel Professor for Micronutrient Research in the College of Public Health and Human Sciences at Oregon State University (OSU) and a principal investigator in OSU s Linus Pauling Institute. People with elevated lipids in their blood plasma are facing increased inflammation as a result Traber said. Almost every tissue in their body is under oxidative attack and needs more vitamin E. But the vitamin E needed to protect these tissues is stuck on the freeway in the circulatory system. It s going round and round instead of getting to the tissues where it s needed. This research was done with 41 men and women including both younger and older adults who obtained vitamin E by eating deuterium-labeled collard greens so the nutrient could be tracked as it moved through the body. Of some interest it did not find a significant difference in absorption based solely on age or gender. But there was a marked difference in how long vitamin E stayed in blood serum based on higher level of lipids in the blood--a more common problem as many people age or gain weight. The study also incorporated a different methodology using a stable isotope instead of radioactive tracers than some previous research to arrive at the estimates of vitamin E that made it to body tissues. Using the stable isotope methodology that these researchers believe is more accurate they concluded that only 24 percent of vitamin E is absorbed into the body instead of previous estimates of 81 percent measured by the use of radioactive vitamin E. In simple terms we believe that less than one third the amount of vitamin E is actually making it to the tissues where it s most needed Traber said. Vitamin E in the blood stream is not completely wasted Traber noted. There it can help protect LDL and HDL cholesterol from oxidation which is good. But that doesn t offset the concern that not enough of this micronutrient may be reaching tissues she said. (Source American Journal of Clinical Nutrition--March 2015) Green Tea May Help Improve MRIs G reen tea s popularity has grown quickly in recent years. Its fans can drink it enjoy its flavor in their ice cream and slather it on their skin with lotions infused with it. Now the tea could have a new unexpected role--to improve the image quality of MRIs. Scientists report in the journal ACS Applied Materials & Interfaces that they successfully used compounds from green tea to help image cancer tumors in mice. Sanjay Mathur and colleagues note that recent research has revealed the potential usefulness of nanoparticles--iron oxide in particular--to make biomedical imaging better. But the nanoparticles have their dis- advantages. They tend to cluster together easily and need help getting to their destinations in the body. To address these issues researchers have recently tried attaching natural nutrients to the nanoparticles. Mathur s team wanted to see if compounds from green tea which research suggests has anticancer and anti-inflammatory properties could play this role. Using a simple one-step process the researchers coated iron-oxide nanoparticles with green-tea compounds called catechins and administered them to mice with cancer. MRIs demonstrated that the novel imaging agents gathered in tumor cells and showed a strong contrast from surround- ing non-tumor cells. The researchers conclude that the catechin-coated nanoparticles are promising candidates for use in MRIs and related applications. (Source ACS Applied Materials & Interfaces--March 2015) 50 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 Roseroot Herb Shows Promise as Potential Depression Treatment Option hodiola rosea (R. rosea) or roseroot may be a beneficial treatment option for major depressive disorder (MDD) according to results of a study in the journal Phytomedicine led by Jun J. Mao MD MSCE associate professor of Family Medicine Community Health and Epidemiology and colleagues at the Perelman School of Medicine of University of Pennsylvania. The proof of concept trial study is the first randomized double-blind placebocontrolled comparison trial of oral R. rosea extract versus the conventional antidepressant therapy sertraline for mild to moderate major depressive disorder. Depression is one of the most common and debilitating psychiatric conditions afflicting more than 19 million Americans each year 70 percent of whom do not fully respond to initial therapy. Costs of conventional antidepressants and their sometimessubstantial side effects often result in a patient discontinuing use prematurely. Others opt to try natural products or supplements instead. All of the study s 57 adult participants enrolled from December 2010 and April R 2013 had a DSM IV Axis 1 diagnosis of MDD meaning they exhibited two or more major depressive episodes depressed mood and or loss of interest or pleasure in life activities for at least two weeks as well as symptoms including significant unintentional weight loss or gain insomnia or sleeping too much fatigue and diminished ability to think or concentrate and recurrent thoughts of death. The participants received 12 weeks of standardized R. rosea extract sertraline or placebo. Changes over time in Hamilton Depression Rating (HAM-D) Beck Depression Inventory (BDI) and Clinical Global Impression (CGI) change scores were measured among groups. Patients who took sertraline were somewhat more likely--as measured by Ham-D scores--to report improvement in their symptoms by week 12 of treatment than those who took R. rosea although these differences were not found to be statistically significant. Patients taking R. rosea had 1.4 times the odds of improvement and patients on sertraline had 1.9 times the odds of improvement versus those on a placebo. However patients on sertraline experienced twice the side effects--most commonly nausea and sexual dysfunction--than those on R. rosea 63 percent versus 30 percent respectively reported side effects. These findings suggest that R. rosea may possess a more favorable risk to benefit ratio for individuals with mild to moderate major depressive disorder. These results are a bit preliminary but suggest that herbal therapy may have the potential to help patients with depression who cannot tolerate conventional antidepressants due to side effects Dr. Mao said. Larger studies will be needed to fully evaluate the benefit and harm of R. rosea as compared to conventional antidepressants. (Source Phytomedicine--March 2015) Zinc Deficiency Linked to Immune System Response Particularly in Older Adults inc an important mineral in human health appears to affect how the immune system responds to stimulation especially inflammation new research from Oregon State University (OSU) shows. Zinc deficiency could play a role in chronic diseases such as cardiovascular disease cancer and diabetes that involve inflammation. Such diseases often show up in older adults who are more at risk for zinc deficiency. When you take away zinc the cells that control inflammation appear to activate and respond differently this causes the cells to promote more inflammation said Emily Ho a professor and director of the Moore Family Center for Whole Grain Foods Nutrition and Preventive Health in the OSU College of Public Health and Human Sciences and lead author of the study. Approximately 12 percent of people in the U.S. do not consume enough zinc in Z their diets. Of those 65 and older closer to 40 percent do not consume enough zinc Ho said. Older adults tend to eat fewer zincrich foods and their bodies do not appear to use or absorb zinc as well making them highly susceptible to zinc deficiency. It s a double-whammy for older individuals said Ho who also is a principal investigator with the Linus Pauling Institute. In the study researchers set out to better understand the relationship between zinc deficiency and inflammation. They conducted experiments that indicated zinc deficiency induced an increase in inflammatory response in cells. The researchers were able to show for the first time that reducing zinc caused improper immune cell activation and dysregulation of a cytokine IL-6 a protein that affects inflammation in the cell Ho said. Researchers also compared zinc levels in living mice young and old. The older mice had low zinc levels that corresponded with increased chronic inflammation and decreased IL-6 methylation which is an epigenetic mechanism that cells use to control gene expression. Decreased IL-6 methylation also was found in human immune cells from elderly people Ho said. Together the studies suggest a potential link between zinc deficiency and increased inflammation that can occur with age she said. We think zinc deficiency is probably a bigger problem than most people realize. Preventing that deficiency is important. Understanding why older adults do not take in zinc as well is an important area for future research Ho said. Additional research also is needed to better understand how zinc works in the body she said. (Source Molecular Nutrition Food Research--March 2015) MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 51 NATURAL HEALTH STUDIES Vitamin D Helps Immune Cells Prevent Atherosclerosis Diabetes ltered signaling through the vitamin D receptor on certain immune cells may play a role in causing the chronic inflammation that leads to cardiometabolic disease the combination of type 2 diabetes and heart disease that is the most common cause of illness and death in Western populations. The research appears in the journal Cell Reports. Because low vitamin D levels are associated with diabetes and heart disease we looked at the connections between vitamin D immune function and these disease states said senior author Carlos BernalMizrachi of the Washington University School of Medicine in St. Louis. The investigators found that when they engineered mice to lack expression of the vitamin D receptor in immune cells called monocytes and macrophages the animals accumulated atherosclerotic plaques in their blood vessels and developed insulin resistance meaning that their liver cells had a diminished ability to respond to insulin and regulate blood glucose levels. A Inactivation of the macrophage vitamin D receptor promotes inflammation of the liver and of the artery walls. It also increases the ability of blood monocytes to adhere and migrate into the vessel wall where they deposit cholesterol and secrete inflammatory mediators to cause diabetes and heart disease explained Dr. Bernal-Mizrachi. This implies that vitamin D will reduce these properties in immune cells to decrease inflammation and reduce the risk of cardiometabolic disease. The research team found that bone marrow transplantation of cells that expressed the vitamin D receptor into mice lacking the vitamin D receptor in monocyte and macrophages improved the animals insulin sensitivity suppressed atherosclerosis and decreased the formation of fat-laden macrophages that accumulate along blood vessel walls. These results suggest that individuals may experience increased inflammation and serious health consequences when their immune cells are exposed to vitamin D deficiency or cannot process vitamin D. Indeed findings from previous studies suggest that individuals with vitamin D deficiency have an increased risk of developing diabetes and that adequate dietary vitamin D in patients with diabetes limits the formation of fat-laden macrophages and decreases atherosclerosis. Our findings provide further mechanistic foundation for multiple interventional trials including our own to evaluate the effects of vitamin D on cardiometabolic disease said Dr. Bernal-Mizrachi. In addition the identification of monocyte cholesterol transport as a mechanism for atherosclerosis in our animal model opens up a new area of research that could identify novel therapies for heart disease. (Source Cell Reports--March 2015) Fitness Level Associated With Lower Risk of Some Cancers Death in Men en with a high fitness level in midlife appear to be at lower risk for lung and colorectal cancer but not prostate cancer and that higher fitness level also may put them at lower risk of death if they are diagnosed with cancer when they re older according to a study published online by JAMA Oncology. While the association between cardiorespiratory fitness (CRF) and cardiovascular disease (CVD) has been well-established the value of CRF as a predictor of primary cancer has gotten less attention according to background in the study. Susan G. Lakoski MD MS of the University of Vermont Burlington and coauthors looked at the association between midlife CRF and incident cancer and survival following a cancer diagnosis at the Medicare age of 65 or older. The study included 13 949 men who had a baseline fitness exam where CRF was assessed in a treadmill test. Fitness levels were assessed between 1971 and 2009 and lung prostate and colorectal cancers were assessed using Medicare data from 1999 to 2009. M During an average 6.5 years of surveillance for the 13 949 men 1 310 of them were diagnosed with prostate cancer 200 with lung cancer and 181 men with colorectal cancer. The authors found that high CRF in midlife was associated with a 55 percent lower risk of lung cancer and a 44 percent lower risk of colorectal cancer compared to men with low CRF. However this same association was not seen between midlife CRF and prostate cancer and authors note the exact reasons for this are unknown although they speculate men with high CRF may be more prone to undergo preventive screenings and therefore have a greater opportunity to be diagnosed with prostate cancer. The study also found that high CRF in midlife was associated with a 32 percent lower risk for cancer death among men who developed lung colorectal or prostate cancer at Medicare age compared with men with low CRF. Further high CRF in midlife was associated with a 68 percent reduction in CVD death compared with low CRF among men who developed cancer. To our knowledge this is the first study to demonstrate that CRF is predictive of site-specific cancer incidence as well as risk of death from cancer or CVD following a cancer diagnosis. These findings provide further support for the effectiveness of CRF assessment in preventive health care settings. Future studies are required to determine the absolute level of CRF necessary to prevent site-specific cancer as well as evaluating the long-term effect of cancer diagnosis and mortality in women the study concluded. (Source JAMA Oncology--March 2015) 52 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 Melatonin Can Help You Get a Good Night s Sleep in a Noisy Environment U sing melatonin could provide more and better quality sleep compared to using an eye mask and earplugs in a simulated noisy and illuminated environment according to research published in open access journal Critical Care. This study was carried out on healthy subjects but could have future implications for intensive care unit (ICU) patients. Melatonin is the hormone secreted by the body to regulate sleep usually in periods of darkness. Synthetically produced melatonin is used to boost the body s own melatonin levels to treat some sleep disorders and sometimes as a means of overcoming jet lag. In ICUs disturbances throughout the night caused by noise and light have been linked to slower recovery. This has led clinicians to investigate ways of reducing sleep disturbances. Researchers from Capital Medical University in Beijing (China) recruited 40 healthy participants to study the effects simulated ICU conditions had on sleep patterns. The research was conducted in the sleep lab of Fuzhou Children s Hospital of Fujian Province in collaboration with Professor Ling Shen. For the first four nights all participants underwent a baseline adjustment period. During this time they slept in a sleep laboratory where on alternating nights a recording from a typical night shift at an ICU was played and light levels were the same as in the hospital. After the first four nights the participants were randomly divided into four equal groups but continued to sleep in the simulated ICU. The first group did not receive any sleep aid. The second were provided with eye masks and earplugs. The third group took 1 mg of fast-release oral melatonin when going to bed. The final group of participants was given a placebo. The participants did not know if they were receiving melatonin or placebo. During the study period all participants melatonin levels were tested hourly by taking blood samples. The quality of sleep was assessed using specialist equipment that measured brain activity eye movement and muscle tension. Anxiety levels and sleep quality were also evaluated by getting participants to self-evaluate the following morning. It was found that all sleep patterns were disturbed by exposure to the simulated ICU environment. This resulted in feelings of anxiety and reduced quality of sleep. Those participants that used either eye masks and earplugs or oral melatonin had improved sleep. Those who took melatonin were found to have decreased awakenings during the night even compared to the eye mask and earplugs group. The quality of the sleep was also found to be much improved for those taking melatonin with reported lower anxiety levels and increased REM sleep--thought to be linked to improved cognitive restoration. As this study was carried out on a small number of healthy subjects over a ninehour period it may not give a full representation of the various sleep disturbances that can occur in an ICU over 24 hours. They say future studies will need to be carried out on a larger group of diverse participants. Consideration would also need to be given for the administration of oral melatonin to critically ill patients who may also be taking other medications. (Source Critical Care--March 2015) How Fatty Acids Can Fight Prostate Cancer W ashington State University (WSU) researchers have found a mechanism by which omega3 fatty acids inhibit the growth and spread of prostate cancer cells. The findings which are at odds with a 2013 study asserting that omega-3s increase the risk of prostate cancer point the way to more effective anti-cancer drugs. Scientists have long known that omega 3s reduce inflammation and have antidiabetic effects and some recently discovered how this happens. But we re the first to show that they work this way in cancer said Kathryn Meier a professor of pharmacy at WSU Spokane. The attention has mostly been on inflammation and diabetes but there has always been an interest in cancer and we were the first to show this mechanism in any cancer cell at all. And we re using prostate cancer which is the most controversial subject in omega-3s. A 2013 study in the Journal of the National Cancer Institute found that men with higher levels of omega-3 fatty acids in their blood had a greater risk of developing prostate cancer. It was not clear if the fatty acids came from food--certain fish seeds and nuts are high in omeg3s--or supplements like fish oil. Working with prostate cell cultures Meier and two students Ze Liu and Mandi Hopkins found the fatty acids bind to a receptor called FFA4 for free fatty acid receptor 4. Rather than stimulating cancer cells the receptor acts as a signal to inhibit growth factors suppress- ing proliferation of the cancer cells. This kind of knowledge could lead us to better treat or prevent cancer because now we know how it works Meier said. The study also found that a drug mimicking the action of omega-3s can work as well or better than fatty acids in suppressing the cancer cells. Meier said it is still unclear if the effect can be obtained by taking dietary supplements like fish oil. Some people don t tolerate fish oil very well she said. Moreover the effect of fish oil could fade as it is digested while data from this study suggest that an omega-3 drug needs to be in a cancer cell all the time to have an effect. (Source Journal of Pharmacology and Experimental Therapeutics--February 2015) MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 53 NATURAL MARKETPLACE NATURAL MARKETPLACE PROVIDES INFORMATION ABOUT NEW PRODUCTS AVAILABLE TO THE NATURAL HEALTH CARE INDUSTRY. ALL STATEMENTS CLAIMS AND PRODUCT INFORMATION ARE PROVIDED BY THE MANUFACTURER. NATURAL PRACTITIONER DOES NOT ENDORSE ANY PRODUCTS INCLUDED IN NATURAL MARKETPLACE OR ATTEMPT TO CORROBORATE ANY CLAIMS MADE BY THE MANUFACTURER. To have a new product included in Natural Marketplace please send a press release and photograph to Natural Practitioner by e-mail to DanielB VRMmedia.com Blurred Lines EL SEGUNDO CA--Invisiblur Perfecting Shield Broad Spectrum SPF 30 PA is Murad Inc. s newest highperformance science-based three-in-one product with a multitasking formula to treat visible signs of aging blur imperfections and protect the skin against UV damage all in the blink of an eye. With advanced technologies and ingredients including Shitake mushrooms peptides and Mucor miehei peptides to reduce the appearance of fine lines and wrinkles black currant rosemary goldenrod and peony root extracts for improved texture for youthful-looking skin soft focus complex to hydrate the skin and leave a blurred matte-like finish barley sunflower and cucumber extracts to help enhance skin s ability to retain moisture and protect skin against environmental aggressors and invisible sunscreen for broad spectrum protection against UV damage (MSRP 65 1-fl. oz.). For more information call (888) 996-8723 or visit www.murad.com. Amyloban 3399 EAST RUTHERFORD NJ--Mushroom Wisdom Amyloban 3399 Breakthrough Brain Function & Memory Support supports healthy nerves and brain from a mushroom called lion s mane. Research has indicated that other active compounds from lion s mane may stimulate the production of nerve growth factor (NGF) within the brain. The suggested dosage is six tablets a day and retail price is 89.95 for 180-ct. For more information call (800) 747-7418 or visit www.mushroomwisdom.com. HLC Baby PITTSBURGH PA--Pharmax has newly released HLC Baby ( 37.90) probiotic formulas to help promote microflora composition. HLC Baby is available in HLC Baby B for breast fed babies and HLC Baby F used as formulas for bottle fed babies and includes more prebiotic fibers from the frutooligosaccharides (FOD). Both formulas consist of 100 billion CFU from human-sourced strains as well as galactooligosaccharides a prebiotic formula found in breast milk that supports the gastrointestinal microflora. For more information call (888) 737-6925 or visit www.seroyal.com. Age Lock PROVO UT--ageLOC R2 is Nu Skin s newest Day and Night formula. ageLOC 2 ( 219.93) Day resets the youthful gene expression related to cellular energy production while ageLOC R2 Night resets youthful expression related to cellular purification. When combined it helps target aging to promote physical vigor mental acuity and sexual health as well as helping to support the body s ability to neutralize and remove cellular waste and metabolic byproducts. For more information call (800) 487-1000 or visit www.nuskin.com. Re-Member ROCKVILLE MD--Tasly Pharmaceuticals launched Re-Memory Plus which helps to support a clearer memory with extracts from all natural chemical-free herbs to help increase cerebral blood flow improve focus concentration and memory. The product can have lasting benefits to a strong cognitive function and is the only pharmaceutical grade brain health product that is approved in 34 countries. For more information call (301) 978-3900 or visit www.taslyus.com. Lipo C ESSEX JUNCTION VT--DaVinci Laboratories Liposomal C offers a powerful dose of vitamin C. A liquid supplement in a liposomal delivery system offering optimal assimilation it has hydrophilic and hydrophobic sides which provides a fat and water portion allowing the vitamin C to absorb in the fat and water-soluble pathways for poper utilization within the body. Liposomal C is known to help patients struggling with GI (gastrointestinal) dysfunction. It is vegetarian and a citrusfree delivery system for optimal assimilation. (The suggested retail price is 33.60 for 10-15-oz.) This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose treat cure or prevent any disease. Spray Ausanil NEW YORK NY--Ausanil Nasal Spray Rapid Relief for Sever Headaches and Migraine quickly provides relief from pain and sever frequent headaches such as migraines cluster headaches and rebound headaches and doesn t contain caffeine and zinc. The suggested retail price is 34.95 for .27-fl.-oz. It is a nonprescription homeopathic nasal spray. In addition it does not interact with other medications does not make you drowsy and has up to 50 doses per a bottle. Please call company for pricing. For more information call (888) 888-4206 or visit www.ausanil.com. For more information call (800) 325-1776 or visit www.davincilabs.com. Detox Lymph EUGENE OR--Hevert Pharmaceuticals released Hevert Detox Lymph for temporary relief of discomfort from the lymphatic system such as swollen lymph nodes and lymphatic edema. In addition it helps relieve lymphatic edema and supports lymphatic system with drainage. The suggested retail price is 24.95. For more information call 541-344-4980 or visit www.hervert.com. 54 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MAY 2015 BOOKSHELF Paths to Healthy Aging Author Dr. Mehrdad Ayati and Arezou Azarani Pages 176 Price 12.99 Publisher CreativeSpace Publishing Contact (843) 789-5000 Dr. Mehrdad Ayati and Arezou Azarani published Paths to Healthy Aging a new book that looks into many agerelated myths. Condensed into five chapters and written in a workbook format the authors offer readers helpful tools to create a healthy joyful and energetic lifestyle. Although backed by evidence and research the book is yet an easy read and covers topics from nutrition to mental and physical health and to medicine. The authors provide questions and action plans to help readers understand mental status and staying physically fit as they age learning the dangers of overmedication and drug cascade syndrome and how to find the right physician you can trust. In addition it provides answers to misconceptions on aging and the journey for the elderly and their loved ones. The authors do not just provide facts and answers but they show their concern for the older generation. The Great Pain Deception Faulty Medical Advice is Making Us Worse Author Steven Ray Ozanich Pages 394 Price 21.95 Publisher Silver Cord Records Inc. Contact www.paindeception.com Steven Ray Ozanich challenges readers to think outside the box to deeper understand pain and diseases. He starts off describing his journey from suffering from sever pain to becoming pain-free after he discovered the work of John E. Sarno MD. He believes that chronic pain fatigue and most diseases have an emotional backbone and that many practitioners have been taught to treat the effects and not the causes. Further today a number of doctors are becoming more open to prescribing many medications which has led to more health problems. The key to good health Ozanich noted is to educate patients on the relationship of the mind and body and potentially healing the patient instead of the symptoms. According to Ozanich pain and illnesses are expressions of our inner-self that have gone unrecognized until we suddenly get something. IHS WRAP UP (Continued from page 49) Smartphone app Cures A-Z Jacob Teitelbaum MD ABIHM ABIM. Dr. Teitelbaum started the conversation by expressing his opinion on natural medicine and standard medicine. I like to use the whole tool kit he said. All doctor s have hammers I m just against it being the only tool. Using Lyme disease as an example Dr. Teitelbaum said you don t know for sure if someone has Lyme disease. Tests aren t helpful so we must look at the symptoms and treatments ourselves. He used this idea as a trend throughout his presentation. In relation to fibromyalgia he started the conversation by asking the medical professionals how they determine if someone is depressed. The answer was ask them. When trying to diagnose fibromyalgia his most important question to ask his patients was if they could get a good night sleep. Dr. Teitelbaum s approach to finding out the answer was to SHINE (sleep hormonal support infections nutrition and exercise.) The patient s answers to whether or not they are suffering from any of these points to his diagnosis. He explained that tests are not effective and that practitioners should not rely on a test performed on different people since everyone is not the same. His example was that if a study was created to determine if a patient had an illness or disease and the results showed to be 99.9 percent affective the test was useless. At the end of the session Dr. Teitelbaum again asked attendees what the most important piece of advice was to take with them when leaving the session and the audience responded Can you get a good night sleep Hold That Date The 2016 Annual IHS annual conference will be once again be held on February 25-27 at the New York Hilton Midtown in New York City. MAY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 55 CONFERENCES AND EVENTS May 29 - June 1 Medicines from the Earth Herb Symposium Black Mountain NC Registration for this spring conference began on April 14 2015 for all natural practitioners medical practitioners physicians and students. Attendees will learn about topics such as omega-3s and mental health early childhood mental health prevention and treatment of skin disorders and more. There will be a variety of herbal experts discussing today s market and new innovations. For more information visit www.botanicalmedicine.org. August 5-8 AANP Annual Conference 2015 Oakland CA The American Association of Naturopathic Physicians (AANP) will host its 30th annual conference and invites naturopathic doctors and students licensed acupuncturists and doctors of osteopathy to register and attend this year s event. Dr. Tori Hudson will lead the event that brings together participants and attendees to interact and network while learning about the most up-to-date information in natural medicine. For more information visit www.naturopathic.org. September 17-20 The 6th Annual Integrative Medicine for Mental Health Conference San Diego CA Taking place at the Hyatt Regency Mission Bay Spa and Marina in San Diego CA this year s Integrative Medicine for Mental Health Conference welcomes psychiatrists naturopathic physicians family physicians chiropractic physicians psychologists nutritionists registered dieticians nurses and nurse practitioners allied mental health professionals and leaders of mental health support groups to join together and learn about the field of integrative medicine in treatment of mental health autism and related disorders. For more information visit www.immh2015.com. September 19-20 Nova Scotia Naturopathic Conference Halifax NS Canada The Nova Scotia Association of Naturopathic Doctors (NSAND) will hold its annual conference at the Best Western Plus Chocolate Lake Hotel in Atlantic Canada where it will be representing licensed naturopathic doctors in the surrounding location. The mission is to improve patient care through high caliber on going educational opportunities for naturopathic and medical doctors on the East Coast as well as offering sponsors the opportunity to showcase new products and services. For more information visit www.nsnc.info. November 12-15 ACAM 2015 Fall Conference Las Vegas NV The American College For Advancement In Medicine (ACAM) will open registration on May 1 2015 for the 2015 ACAM Meeting Integrative Medicine s New Landscape Practical Applications of New Technologies. For more information visit www.acam.com. December 11-13 The American Academy of Anti-Aging Medicine (A4M) Las Vegas NV The American Academy of Anti-Aging Medicine hosts its 23rd annual World Congress covering topics including anti-aging regenerative and aesthetic medicine. The conference invites physicians scientists and members of the public on biomedical sciences breaking technologies and antiaging issues and will learn from physicians health practitioners scientists governmental officials and members of the general public representing more than 110 nations. Attendees will learn advancements in technology helping to detect prevent and treat related diseases and will promote research into methods to retard and optimize the human aging process. For more information visit www.a4m.com. ADVERTISER INDEX ADVERTISER Albion Laboratories Inc. America s Finest Inc. DaVinci Laboratories of Vermont Emerson Ecologics Fairhaven Health LLC Kyowa Hakko USA. MITOQ Probiotics Intl. Ltd. (Bio-Kult) Protocol for Life RLC Labs Symco Inc. Vital Nutrients Inc. 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