In Defense of Vitamins and Supplements!	
	
June 02, 2006 - There was recently a panel conference of the National Institutes of Health which concluded that Americans may be taking too many vitamin supplements without any clear benefit. Although I would agree that certainly not every vitamin study or vitamin out of hundreds of thousands has shown benefit, there have been countless numbers of studies in the last decade that provide convincing evidence for the overall merit of quality vitamin/multi-nutrient supplementation. This week's newsletter is going to be a primer concerning some of the more notable human studies that have been published in peer-review prominent and reputable medical journals in the last decade regarding the benefits of supplementation. I do agree many mass market vitamins are worthless but high quality supplements with the correct nutrients, form and levels are truly life-saving and enhancing based on the evidence. Get ready for an eye-opening newsletter. 
The first nutrient I would like to discuss is selenium, a micro-mineral that until the 1970s was not even known to be essential to life. In December 1996, the journal JAMA published the results of a multi-center, double-blinded, randomized, placebo-controlled cancer-prevention trial. Seven clinics throughout the United States participated with 1312 patients. Patients were randomized to receive either 200 mcg a day of selenomethionine or placebo. Patients were treated on average for 4.5 years. It was found that in the selenium-treated group there was an overall reduction in the incidence of cancer of 37% with a reduction in overall cancer mortality of 50%. There was a decrease incidence in lung cancer of 38%, colorectal cancer of 46% and a 63% reduction in prostate cancer. If this had been a drug, I am confident that the FDA would have fast-tracked it and approved it as a preventative medicine for cancer. But being that it was just a simple mineral, medical academia looked at it as merely a curiosity to be further investigated. There was a subsequent study published in 1998 in the Journal of the National Cancer Institute measuring selenium concentrations in the toenails of over 50,000 physicians who were followed for more than a decade. It was found that those men with the highest concentrations of selenium reduced their risk of advanced prostate cancer by about two-thirds. Sadly the typical multivitamin contains the wrong form and only 20 mcg per day. I strongly recommend people read the labels of the supplements they take and make sure 200 mcg of selenomethionine is included.
The next essential nutrients that I would like to discuss are omega-3 fatty acids EPA & DHA, with the best source being molecularly distilled fish oil. For those of you who are regular readers of this newsletter, you know how strongly I feel about the amazing benefits of fish oil. For the NIH panel not to indicate the importance of this in their recent news release is quite sad. In the April 2005 edition of the Archives of Internal Medicine, there was a review article published regarding the benefits of lipid-lowering drugs such as the statins and various diets. I had previously written about this study. Just to recap, almost 11,000 clinical trials that were done in the last 40 years were reviewed. Of these almost 11,000 studies, 97 were randomized and controlled with reliable mortality data. These 97 trials involved over 275,000 people. When they looked at these studies that utilized the statin drugs, such as Zocor, Lipitor and others, it was found that overall mortality was decreased by 13%. However, when they reviewed the studies using omega-3 fatty acids (placebo-controlled) they found that this nutrient decreased mortality by 23%, almost twice as powerful as the statin drugs and obviously without any side effects or the outrageously high cost of statin drugs. In fact, for those that would like to understand and solve our health care crisis that is bankrupting America and its citizens, I strongly recommend you read my new book called Natural Cures from a Real Medical Doctor. Clearly the NIH is not going to solve any health care issues with their current advice. Omega-3 fatty acids appear to work their magic by improving heart rhythm and decreasing clotting in the heart, leading to a significant decrease in the incidence in sudden death. The omega-3 fatty acids also have shown benefits in clinical trials as anti-inflammatory agents with great results in arthritis patients. It can also be of benefit in patients with depression. In fact I believe ADHD in children and adults can be helped with a low sugar diet combined with B-complex vitamins and fish oil.
Let's go on to coenzyme Q10 (CoQ10). This has become an increasingly popular nutrient utilized by people to help improve cardiac function and periodontal disease. In fact, it is approved in Japan for the treatment of heart failure. As a neurologist, I was extremely pleased to see a study published in the October 2002 edition of Archives of Neurology regarding Parkinson's disease. Eighty patients with early Parkinson's disease participated in a double-blinded, randomized, multi-center study. Patients were randomly assigned to receive CoQ10 at doses of 300 mg, 600 mg, 1200 mg a day or placebo. It was found that the higher the dose of CoQ10, the slower the progression of Parkinson's disease. In fact at the highest dosage the progression was reduced by an amazing 50%. The study concluded that CoQ10 was safe and well tolerated and that it appeared to slow the progressive deterioration of function in Parkinson patients. I am aware that there are neurologists in New York using up to 3,000 mg a day of CoQ10 in clinical trials. I routinely recommend this nutrient to my patients with Parkinson's disease since there is no effective FDA approved drug that can slow the progression of Parkinson's disease.
Another disease that I deal with on a regular basis is stroke. It is said that stroke increases the risk of subsequent hip fracture anywhere from two to four times. There has been discussion in the medical literature that elevations in homocysteine are not only a risk factor for stroke, but also for osteoporotic fractures in the elderly. There was a study published in the March 2005 edition of JAMA involving 628 consecutive patients 65 years or older with residual stroke of at least one year's duration. Patients were randomly assigned to receive 5 mg of folic acid along with 1,500 mcg of B12 versus placebo. After two years, those patients treated with the high dose of folic acid and B12 had a reduction in plasma homocysteine level by 38% versus the placebo group that had an increase in homocysteine level of 31%. What was most fascinating was that the number of hip fractures was only 10 in the folic/B12 group and 43 in the placebo group. This result was highly statistically significant with the likelihood that this result could have occurred by chance of less than 1 in a 1,000. Where was the NIH group regarding the results of this study? There have been other studies in the medical literature pointing to the benefits of folic acid in reducing incidence of tumors in the colon, etc. I must reiterate that your typical multivitamin will not provide these results because the level of B vitamins is too low. Read your labels and choose carefully. The NIH should have pointed this out rather than disparaging all vitamins regardless of their formulations.
The NIH panel did mention in passing the AREDS (age-related eye disease study). This was published about five years ago in the medical literature. It was a multi-center study that followed over 3,500 patients with varying degrees of age-related macular degeneration. Groups were assigned to receive placebo, zinc or zinc and anti-oxidants. The anti-oxidant/zinc formulation consisted of 500 mg of vitamin C, 400 units of vitamin E, 15 mg of beta carotene, 80 mg of zinc and 2 mg of copper. It was found that those patients treated with the high dose antioxidants and zinc reduced the risk of developing advanced age-related macular degeneration by about 25%. I must point out the NIH failed to mention the published study on Medline regarding 10 mg lutein, 10 mg lutein plus antioxidants (NSI's OcuPower) or placebo in 90 patients conduced by the U.S. Veteran's Administration. Vitacost/NSI helped fund this study and it is the first published study in humans to show improvement in vision with nutrients whereas the placebo failed. I am not aware of any drug, laser, surgery or medical treatment that can provide the same benefit. The NIH panel spoke primarily of the zinc, although it was clearly the zinc and the antioxidants that had the most benefit. 
Another one of my favorite nutrients is called acetyl-L carnitine (ALCAR). There was a study published many years ago using this nutrient along with alpha lipoic acid. It was found that these nutrients were actually able to regenerate brain cells in aging rats to the point that they were able to function at a much higher level. In the journal Diabetes Care (2005), researchers from Wayne State University evaluated two one-year placebo-controlled trials regarding diabetic peripheral neuropathy. These trials involved the use of acetyl-L carnitine, either 1,500 mg or 3,000 mg a day. Over 1,000 patients were involved in the studies. The two studies were evaluated separately and then combined. Patients underwent biopsy of sural nerves along with other testing to determine efficacy. It was found that those patients treated with ALCAR showed significant improvement in sural nerve fiber number and regenerating nerve fiber clusters. Pain which has the most bothersome symptom showed significant improvement in one study and in the combined cohort. It was concluded that these studies demonstrated that ALCAR treatment is efficacious in alleviating symptoms, particularly pain and improving nerve fiber regeneration in patients with established diabetic neuropathy. Do you know how many drugs are available to help regenerate peripheral nerves in patients with diabetic neuropathy? The answer is ZERO. Where was the NIH panel looking at this nutrient? There have been other recent studies with ALCAR showing benefit for men with impaired sperm motility. I have used ALCAR successfully in my multiple sclerosis patients who suffer with chronic fatigue. There have been double-blinded trials in the medical literature demonstrating efficacy for this problem. There have been studies in the medical literature looking at acetyl-L carnitine in patients with Alzheimer's disease. In one study published in Neurology (September 2000), it was found that patients treated for one year with 1,000 mg three times daily seemed to show stabilization whereas the placebo group showed further decline.
Another great nutrient that is in the category of bioflavonoids is green tea. Green tea catechins have been shown in animal and lab studies to inhibit cancer growth. There was a study published in the journal Cancer Research (January 2006) looking at men with high-grade prostate intraepithelial neoplasia. Recent studies have shown that 30% of men with this condition go on to develop prostate cancer within one year. In this study, 60 patients with prostate intraepithelial neoplasia were enrolled in a double-blinded, placebo-controlled trial. Half of the men were given 600 mg of standardized green tea extract daily whereas the other group was given placebo. After one year, only one tumor was diagnosed in the 30 men treated with green tea (incidence of about 3%) whereas 9 cancers were found among the 30 placebo-treated men (incidence of 30%). As a side observation, those men treated with green tea extract also had reduced lower urinary tract symptoms, suggesting that these compounds may also be of value with benign prostate hyperplasia (BPH). Green tea has been used anecdotally for its potential cancer fighting properties. In an article just published in the June 2006 edition of Leukemia Research, researchers out of the Mayo Clinic reported on four patients with low-grade B cell malignancies, three of which had a partial response after taking green tea extract. The researchers cautioned against widespread use of green tea until further clinical trials can be conducted to define optimal dosing, schedule, toxicity and clinical efficacy. This is absurd considering the fact green tea is safe and has been consumed for thousands of years. We are not talking about a new drug that may kill you. Make sure you read the label and look for green tea that has a high percentage of EGCG, the most active component. Another nutrient in the bioflavonoid family is curcumin. This powerful nutrient is also being tested in centers throughout the country, including MD Anderson in Texas, for killing cancer cells.
Lycopene is a nutrient in the carotenoid family. There are approximately 600 carotenoids in nature, the best well-known one being beta carotene. There have been some interesting studies on lycopene regarding cancer and heart disease. In one study, 54 patients with biopsy-proven, metastatic prostatic cancer were randomized to undergo orchidectomy (removal of testicles) alone or orchidectomy plus lycopene supplementation. After six months, both groups showed a significant decrease in the levels of PSA but the group treated with orchidectomy and lycopene showed further decrease. After two years, the changes were noted to be more consistent in the orchidectomy/lycopene group. Approximately 40% of the patients treated with surgery alone had a complete PSA response compared with 78% in the group treated with surgery and lycopene. The researchers concluded that adding lycopene to orchidectomy produced a more reliably consistent decrease in serum PSA level, treating not only the primary tumor, but also diminishing secondary tumors. In another study published in the journal Experimental of Biology Medicine (November 2002), 26 men with newly diagnosed prostate cancer were randomly assigned to receive 30 mg a day of lycopene extract or no supplementation for three weeks before radical prostate surgery. It was found at the time of surgery those men treated with the lycopene had generally smaller tumors compared to those given no therapy. The researchers indicated that this pilot study suggested that lycopene may have beneficial effects in prostate cancer and suggested a larger clinical trial. I would like to point out the primary standardized supplement utilized in many studies is Lyc-O-Mato.
This rather lengthy newsletter was just an introduction into some of the amazing studies on vitamins/nutrients that have been published in recent years. This newsletter, literally, just scratches the surface as I did not cover other important nutrients such as magnesium, vitamin D, calcium, glucosamine/chondroitin, garlic and so on. Recent studies on vitamin D indicate it can help maintain balance and reduce cancer, heart disease and osteoporosis. Current RDA/DV levels of 400 IU per day are too low; scientists are suggesting 700 to 2,000 IU per day is optimal. Glucosamine sulfate and chondroitin sulfate have numerous studies proving their benefits for repairing joints and reversing arthritis in humans. Calcium and magnesium may prevent and reverse osteoporosis and even heart disease. Please read more here >>>