470 Nutritional Support for the Elderly [7 May 2018]

In a recent webinar Dr. Philip Rouchotas ND of the Bolton Naturopathic Clinic in Ontario, shared his nutritional protocol for his elderly patients, especially those with neurodegenerative diseases like Alzheimer’s, MS, and Parkinson’s, and those with mild cognitive impairment or traumatic brain injury. He believes most people over 60, and everyone over 70, will experience rapid and significant benefits from this program.

The base of the program is the Mediterranean Diet (more on this another week) along with physical exercise (aerobic and resistance) and mental exercise (chess, bridge, video games).

Step 1 deals with nutritional deficiencies which are “epidemic” among North American seniors for three main reasons: loss of appetite (they eat less); change in appetite (they prefer saltier, fattier, less nutrient-dense foods); and digestive impairment (they absorb fewer nutrients). Step 1 supplements:
• A good multivitamin with trace minerals and activated B’s
• Whey protein (30g) – prevents muscle loss; halves number of viral infections (colds)
• Creatine (2.5g) – prevents muscle loss (even while in a cast); with Parkinson’s slows requirement for increasing dopamine dose
• Fish Oil (1000-2000mg total EPA + DHA) – a 2:1 ratio works best

After a few months on Step 1 the elderly should have regained some strength and be ready to add a few more products from Step 2 to further improve their health:
• CoQ10 (100mg x2) – improves mitochondrial function, increases energy for muscle and brain function
• Acetyl-L-Carnitine (2g) – cofactor in mitochondria, necessary for burning fat for energy; doubles survival time in ALS patients
• Melatonin (as needed up to 20mg) – nerve cell antioxidant, benefits elderly even if sleep is not an issue
• Ginkgo biloba (120-240mg) – use if meds allow (blood thinners are a contraindication); improves cerebrovascular function (blood flow to the brain)
• Lion’s Mane (1g x2) – prevents cognitive impairment due to amyloid beta plaque; improves brain function in Mild Cognitive Impairment

I appreciate that Dr. Rouchotas’ protocols are backed with multiple human (not just animal) placebo-controlled studies so we can be confident in their safety and effectiveness. I plan to write more about some of these products in future articles.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner. Find this article on my website for links to sources and further reading.

464 Heart Health Protocol [26 March 2018]

A recent webinar by Dr. Philip Rouchotas, a naturopathic doctor practicing in Bolton, Ontario, described his protocol for heart health. This would be particularly beneficial for someone who has had a heart attack or been diagnosed with heart disease.

The base of the protocol is the Mediterranean Diet, with minor modifications. The landmark study published in 1999 found an amazing 56% reduction in all-cause mortality over 4 years compared to the diet recommended at the time by the American Heart Association. It contains plenty of vegetables and fruit, plus olive oil (2 tablespoons per day), and nuts (¼ to ½ cup per day of almonds, walnuts, pistachios). For meat it recommends fish frequently, poultry in moderation, and red meat occasionally.

Exercise: at least 30 minutes of moderate exercise (like walking) 5 times per week. A meta-analysis found that for people with heart disease, exercise reduced all-cause mortality by 24%, along with many other benefits.

Fish oil: 1,000 to 2,000 mg of omega 3 (EPA + DHA) daily. A large study from Italy published in Lancet in 1999 found that in heart attack survivors, 850 mg of omega 3 reduced sudden coronary death by 45% and all-cause mortality by 25%. A 2006 Japanese study found that 1800 mg worked even better.

CoQ10: 200 – 300 mg daily, divided. CoQ10 supports the mitochondria which create the energy which powers our muscles (and the heart is our most important muscle!). A large study in 2014 found that over 2 years 300mg of CoQ10 reduced cardiovascular deaths by 43% and all-cause mortality by 42%. A 2007 meta-analysis found that CoQ10 lowered systolic blood pressure by 16.6 and diastolic by 8.2, making CoQ10 the single most important supplement for blood pressure.

N-Acetyl-Carnitine: 1500-2000 mg daily, divided. This form of the amino acid carnitine also supports our mitochondria. Many human trials show benefits for cardiovascular health including faster healing from a heart attack and improved heart function.

Plant sterols: 1500-2000 mg daily, divided. A meta-analysis found that plant sterols reduced LDL (the “bad” cholesterol) by 10-14%, almost half of the 30% reduction expected from prescription statin drugs.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

403 Humic & Fulvic Acids [16 Jan 2017]

I have a rather unique supplement on my shelves that I wanted to learn more about so chose it for my topic this week. Humic and fulvic acids are organic compounds found in soil, peat, and water sediments. A particularly rich deposit in New Mexico dating from the Cretaceous Period (100mya) is mined to create a supplement for human use.

The main ingredients are humic and fulvic acids. The supplement also contains traces of amino acids, vitamins, minerals, plant enzymes and other organic compounds (organic in the chemical sense meaning that it contains carbon).

Humic and fulvic acids are known to benefit human health in many ways:
• Source of trace minerals in a readily available organic form
• Stimulates mitochondrial production of ATP
• Protects mitochondrial membranes from oxidative damage
• Reduces loss of ATP and CoQ10 levels during heavy exercise
• Acts as prebiotic feeding good bacteria in the gut
• Reduces pain and inflammation
• Improves immunity by increasing T-lymphocytes and neutrophils
• Inhibits viral infections including rhinoviruses, influenza and Herpes simplex
• Increases elimination of toxic heavy metals while improving absorption of nutritional metals like iron and zinc
• Blocks stress hormones
• Increases oxygenation of the blood

Here are how these benefits are experienced by users:
• Relief from joint pain and stiffness
• Reduced soreness and faster recovery from work or sports activity
• Increased energy & stamina
• Improved immunity from colds and flu
• Improved mood, reduced anxiety, increased alertness
• Most people noticed the benefits in 1 or 2 weeks

In over 10 years of research, humic and fulvic acid supplements have been found to be completely safe and do not interfere with any medications.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner. Find this article on my website for links to sources and further reading.

385 Drug Induced Nutrient Depletion [6 Sept 2016]

I first wrote about drug-induced nutrient depletion (DIND) seven years ago in September 2009 (#29). A recent article on the topic in ND Notes (2)2 reminded me of the importance of this topic. The article states that over a thousand commonly prescribed drugs, and many OTC drugs, can deplete us of essential nutrients.

It is estimated that DIND is responsible for up to 30% of drug side effects. Seniors are particularly at risk for DIND – they take more prescription drugs, metabolize the drugs more slowly, and have less efficient digestive systems to start with.

Drugs deplete nutrients in several different ways. Antibiotics change the microflora in the gut which can lower the production and assimilation of several vitamins like K and B12. Some medications block the production in our body of an essential nutrient, such as statins blocking coenzyme Q10. Some, like Ritalin, suppress appetite which reduces the consumption of food (and nutrients); others induce hypoglycemia which causes cravings for sugar. Diuretics increase the excretion of certain minerals like potassium, magnesium and zinc. Ant-acid drugs make the stomach too alkaline to properly digest protein and certain vitamins and minerals. Some weight-loss and cholesterol-lowering drugs bind to, and then excrete, fat in the digestive tract, taking fat soluble vitamins and folic acid with it.

Some DINDs are well known and a prescription often is accompanied with a balancing prescription, like diuretics and potassium. The depletion of CoQ10 with statins resulting in muscle pain is catching on and knowledgeable doctors will recommend supplementation with a prescription. Many others however are missed completely, and too often another drug is prescribed for the side effects of the first, compounding the problem.

There isn’t room here for a comprehensive list of DINDs. Talk to your doctor or pharmacist, get a book like the one by Pelton and LaValle I discussed in 2009, or find a good reference site on the internet. (One I found is by Dr. J. Whitaker).Then look up your drug(s) to see what nutrients you need to be replacing. Maybe those pesky side effects that make you want to flush the pills down the toilet can be easily remedied with appropriate supplementation, allowing you to remain compliant with your meds and, hopefully, healthier.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

323 Statins & Vitamin K2 [15 June 2015]

Back in April 2012 I wrote about the effect of statin (cholesterol lowering) drugs on Co-enzyme Q10 and muscle pain [#159]. Later, in December 2014 [#299] I showed that vitamin D along with CoQ10 relieves statin-induced myalgia (SIM). In the conclusion I wrote “If I was taking a statin drug, in addition to supplementing with Q10, I would make sure my D levels were adequate”. New research indicates that statin users should add K2 to their list of supplements as well.

A recent discovery, discussed by Okuyama et al in the March 2015 Expert Review of Clinical Pharmacology, is that statin drugs inhibit the synthesis of vitamin K2. I have previously discussed [#149] how K2 is essential for directing the calcium from your diet and supplements into your bones instead of your joints and arteries. A 2009 study from Utrecht, Netherlands, had shown that a high intake of K2 reduced the risk of coronary heart disease. It now appears that, ironically, statins, by inhibiting K2 synthesis, could be promoting atherosclerosis, the very condition they are supposed to prevent. The same study (Okuyama et al, 2015) added that statins also inhibit the synthesis of glutathione peroxidase, the essential antioxidant I discussed in two columns in May. Another study published in June 2011 in JAMA concluded that high dose statin therapy increases risk of diabetes compared to moderate dose therapy.

How could it be possible for drugs with side effects like these to be so popular (taken by 1 in 4 Americans age 45 and over)? Are the benefits really worth the risks? An investigation into this question was published by Diamond & Ravnskov in the same March 2015 issue of Expert Review of Clinical Pharmacology. They conclude:

“…although statins are effective at reducing cholesterol levels, they failed to substantially improve cardiovascular outcomes… Statin advocates have … [deceptively amplified] the trivial beneficial effects of statins [and] succeeded in minimizing the significance of the numerous adverse effects of statin treatment.”

Please follow the links below, and read these articles for yourself. Then discuss them with your physician and pharmacist. If you decide that statin therapy is still indicated, then consider supplementing with CoQ10, and vitamins D and K2.

Sources:

Okuyama, H et al Expert Rev Clin Pharmacol 2015 Mar:8(2):189-99 Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms [abstract]

Gast, GC et al Nutr Metab Cardiovasc Dis 2009 Sep:19(7):504-10 A high menaquinone intake reduces the incidence of coronary heart disease [abstract]

Diamond DM, Ravnskov U. Expert Rev Clin Pharmacol 2015 Mar:8(2):201-10 How statistical deception created the appearance that statins are safe and effective in primary and secondary prevention of cardiovascular disease.[abstract]

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

305 PQQ – the Newest Vitamin? [9 February 2015]

Lee Know’s book “Life – the Epic Story of our Mitochondria” introduced me to Pyrroloquinoline Quinone (PQQ) and discussed its role as a possible new vitamin.

Like vitamins, we are unable to produce our own PQQ so must get it from our diet. It is an essential enzyme for the production of collagen, the structural protein found in skin, bone and connective tissue. Animals given a PQQ deficient diet develop brittle skin. PPQ’s role as a vitamin however is contested and has not yet been confirmed.

PQQ is a very stable antioxidant that protects our mitochondria from oxidative damage (see #303 Free Radicals & Aging). Beyond that, PQQ is one of a very few things that actually increase mitochondrial biogenesis (production of new mitochondria) – the others being strenuous aerobic exercise, a severely restricted caloric diet, and a few prescription drugs. This property shows great promise for PQQ as an anti-aging supplement.

PQQ protects heart tissue from damage following heart attacks and ischemia-reperfusion injury (oxidative damage that occurs when oxygen deprived tissue is suddenly resupplied with oxygen following bypass or stent surgery).

PQQ also plays a critical role in protecting brain and nerve tissue immediately after a stroke or spinal cord injury. It also protects the brain from toxins including mercury and excitotoxins. No doubt because of the brain’s high demand for energy and PQQs ability to increase mitochondria, supplementation has been found to improve cognitive function. In a controlled clinical trial done in Japan in 2007, 20mg daily of PQQ improved short-term memory, attention, concentration and mental processing. The addition of CoQ10 significantly enhanced this effect.

PQQ is found in small quantities in a few fruits (kiwi, papaya) and vegetables (green pepper, carrots, cabbage) but the highest food source by far is dark chocolate. It’s possible that much of chocolate’s known health benefits comes from its PQQ content. PQQ is now available in Canada as a supplement, either alone or in combination with CoQ10.

Sources:
Lee Know “Life – the Epic Story of our Mitochondria”
Wikipedia Pyrroloquinoline quinone
Life Extension Magazine Generate Fresh Mitochondria with PQQ

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

302 Mitochondria Nutrients [19 Jan 2015]

Last week I wrote about a book by Lee Know, ND, called “Life – the Epic Story of our Mitochondria”. In it I was impressed by the interrelationship among the many nutrients required for mitochondria to function properly and produce the energy our bodies need for health.

The TCA Cycle which converts glucose and fatty acids to acetyl-coA requires vitamins B1, B2, B3 & B5, minerals iron, sulfur, magnesium & manganese, the amino acid cysteine and alpha lipoic acid (ALA). The Electron Transfer Chain (ETC) which converts the acetyl-coA to ATP energy has CoQ10 (#159 Apr 2012) as one of its essential steps. The ETC also requires vitamins B2 & B12 and minerals iron, sulfur, copper & zinc.

The amino acid L-carnitine (#168 June 2012) is essential for moving long chain fatty acids into the mitochondria where they can be burned for energy. Oxygen is essential for efficient production of ATP by oxidative phosphorylation and requires iron in the form of hemoglobin for transport to the cells. Without adequate oxygen ATP is produced anaerobically resulting in the buildup of lactic acid (causing muscle pain including angina) which requires carnitine to clear it.

In addition to its role in the TCA cycle, ALA is necessary for the production of the antioxidant glutathione. Glutathione is the most important antioxidant in the mitochondria (more on this next week). ALA is also essential for regenerating NADH back to NAD+ so the first step in the ETC can be repeated. As I explained in an earlier article on ALA (#89 Nov 2010), only the R(+) isomer of ALA is bioactive.

Creatine holds and donates the phosphorus ion to convert ADP to ATP; when used as a supplement creatine increases endurance in athletes and improves brain and heart function.

A deficiency of any of these nutrients slows the production of ATP energy in the mitochondria causing fatigue and the reduced function of the organ(s) involved. That’s why there is no simple answer to the question “Why do I feel so tired all the time?”

Next week – free radicals and the mitochondrial theory of aging.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

189 Antioxidants & Heart Disease [29 October 2012]

Antioxidants are certain vitamins, minerals and other molecules that protect the body from oxidative stress from highly charged molecules called free radicals, more technically called “reactive oxygen species”. Oxidative stress is believed to be a factor in the development of atherosclerosis – plaque formation in the arteries – and therefore heart disease, but is not generally accepted in North America. A recent study from Israel should increase the popularity of antioxidant therapy as an adjunct for the treatment of vascular heart disease.

The study, published in Nutrition & Metabolism in July 2010, followed 70 adults with at least two of these risk factors: smoking, Type 2 diabetes, hypertension, low HDL cholesterol, or high triglycerides. They were examined after 3 and 6 months. Half of the participants received daily antioxidant supplements containing 1,000mg vitamin C, 400iu vitamin E, 120mg coenzyme Q10, and 200mcg selenium; the other half a placebo. Those taking the antioxidants, but not the control (placebo) group, had the following benefits:
• significant increase in elasticity of both large and small arteries
• significant increase in HDL-cholesterol (the good kind)
• a small decrease in triglycerides
• significant reduction in HbA1C (a measure of long term blood sugar levels)
• reduced blood pressure

Although the study was too small in number of participants and too short in duration to measure risk of heart disease, all of these improvements would be expected to prevent heart attacks and deaths. The authors conclude that the findings of the study “justify investigating the overall clinical impact of antioxidant treatment in [patients with multiple cardiovascular risk factors]”. But if you have some of these risks, you don’t have to wait for more studies before using antioxidants to improve your own health. Ask your doctor or pharmacist if you can add these antioxidants to your current medications.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

159 Coenzyme Q10 [2 April 2012]

On looking over my 150+ Eagle columns, I was surprised to learn that I have not done one on coenzyme Q10. Two of the columns mention it in passing - #19 Cholesterol – Essential for Life (6 July 2009), and #29 Drug-Induced Nutritional Deficiencies (14 Sept 2009). These as well as all 159 columns are accessible through my website (see below).

Coenzyme Q10 is an enzyme essential for the production of ATP in the mitochondria of every cell in our body. ATP is the only fuel that our muscles (including the heart – arguably our most important muscle!) and the brain can use for energy. Other functions of CoQ10 include:
• It works as an antioxidant, protecting lipids and proteins from oxidation.
• It has the ability to regenerate vitamin E.
• It increases survival in patients with congestive heart failure from 25% (with conventional therapy) to 75% (with conventional therapy and coQ10).
• It provides effect relief for some migraine headaches.
• It can lower blood pressure in people with hypertension.
• It shows promise in treating periodontal disease and gingivitis.

Coenzyme Q10 is also known as ubiquinone (from the same root as ubiquitous) because it is found in every cell of the body. Our bodies’ ability to synthesize it decreases with age so supplementation is required to keep it at levels for optimum health. CoQ10 is fat soluble so supplements in an oil based gel cap are better absorbed. Our ability to convert the oxidized ubiquinone form to the active reduced ubiquinol form also decreases with age, so ubiquinol is the preferred form for everyone over 40.

CoQ10 supplementation is especially important for anyone taking a statin drug for cholesterol management. Statins work by blocking a liver enzyme that not only produces cholesterol but also coenzyme Q10 (which probably explains their common side effects of fatigue, muscle pain and weakness).

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.