Supplements

Vitamins, Minerals, Nutrients, and Other Dietary Supplements

Low Vitamin D Linked to Mobility Limitations and Disability

 

Here’s news that may help older people avoid having to resort to using canes and walkers…

A new study found that people over age 70 who do not get enough vitamin D have a higher risk of developing problems with mobility that can result in disability (compared to those who do get enough D), according to researchers from Wake Forest Baptist Medical Center (WFBMC) in Winston-Salem, North Carolina.

Many studies have looked at how vitamin D can help health, but the new WFBMC study is one of the first to explore how vitamin D is related to “the onset of new mobility limitations or disability in older adults,” nutrition epidemiologist lead author Denise Houston, PhD, RD, lead author of the study, said in a WFBMC news release.

Since vitamin D plays an important role in muscle function, it’s plausible that low levels of vitamin D could be linked to mobility problems.

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Houston’s team followed 2,099 men and women who were participating in the National Institute of Aging’s Health, Aging, and Body Composition (Health ABC) study. All were between 70 and 79 years old when they were enrolled in the study between April of 1997 and June of 1998.  All were Medicare-eligible residents of two major metropolitan areas, Pittsburgh, Pennsylvania, and Memphis, Tennessee and planned to remain in the area for at least three years.

None had a life-threatening illness when the study began, and all were able to perform basic daily living activities, including having no difficulty walking several blocks (one fourth of a mile) or climbing 10 steps without having to stop and rest because of a physical problem.

Participants’ vitamin D level was measured by blood tests at the start of the study.

Their mobility limitations and mobility disability were also tested at the start and then were and rechecked twice a year for six years during annual clinic visits and six-month phone interviews.

The study showed that the 29 percent of participants whose vitamin D blood levels were below 50 nmol/L had a 30 percent higher risk of developing mobility limitations during the time of the study and “almost a two-fold higher risk of mobility disability” compared to those whose vitamin D was measured at 75 nmol/L or higher, Houston noted.

MP900422131[1]

It’s not easy for older people to get enough vitamin D from diet and sunlight. Roughly a third of seniors have low vitamin D levels. Older people may need higher amounts of vitamin D than current guidelines recommend.

 

In addition to the many other health benefits it provides, vitamin D helps muscle function. Could vitamin D supplements prevent – or help to prevent – age-related mobility problems?  We won’t know for sure until definitive trials have been done, but Houston says it’s biologically plausible.

In the meantime, it may be a good idea for older people to get a blood test to see if they’re getting enough vitamin D.

 

For more information:

 

About the research:  Low vitamin D levels linked to mobility difficulties for the elderly, by Stephen Daniells, 31-May-2012, NUTRAIngredients.com

The study abstract:  Low 25-Hydroxyvitamin D Predicts the Onset of Mobility Limitations and Disability in Community-Dwelling Older Adults: The Health ABC Study

The journal in which the study was published: Journal of Gerontology: Medical Sciences

To learn more about the vitamin D blood test: LabTestsOnline.org

© 2012, All rights reserved

(Images: http://office.microsoft.com/en-us/images/?CTT=97)

FDA Issues Alert and Recall of Supplement Reumofan Plus

 

Today we bring you an important news item from the FDA about a supplement that turns out to contain powerful drugs that could be harmful.

 

The FDA issued a warning and recall for Reumofan Plus, a supplement made in Mexico by a company called Riger Naturals. The product is sold in online, at flea markets and in some stores in the US as a remedy for arthritis, muscle pain, osteoporosis, bone cancer and other conditions.

 

Natural dietary supplements should not contain any drugs but the Mexican Ministry of Health found one lot of Reumofan Plus contained dexamethasone, a corticosteroid drug that, like other steroids, relieves inflammation, and suppresses the immune system.

 

The FDA labs analyzed Reumofan Plus and found it also contains diclofenac sodium, a prescription NSAID drug, and a prescription muscle relaxant drug called methocarbamol.  Diclofenac sodium, like other NSAIDS, can increase heart attack and stroke risk and cause digestive system problem, and methocarbamol can cause sedation, dizziness, low blood pressure, and impaired thinking.

 

“Consumers who are currently taking Reumofan Plus or who have recently stopped taking Reumofan Plus should immediately consult a health care professional,” the FDA said in a June 1, 2012, News Release about the recall. The news release includes a photo showing the label on the product bottle and box.

 

The FDA wants to hear from you and your doctor or other health care professional if you’ve used this supplement. Problems that have been reported to the FDA include liver injury, sudden worsening of blood sugar control, weigh gain, swelling, leg cramps, and kidney function problems. If you’ve had any of these or other "adverse events related to this supplement, report them here: MedWatch, the FDA’s  Safety Information and Adverse Event Reporting Program.

 

For more information:

 

Read the Safety Alert here: FDA Safety Alert: Reumofan Plus Recall

Read what the FDA says about other arthritis supplements:  An FDA Guide to Dietary Supplements

 

 

© 2012, All Rights Reserved

Alternative Medicine Wordle

On this Memorial Day (in the US), as we honor those who have fallen in wars and we take a day off from work to reflect on the past and honor their memories, AltMedForYou brings you a lighter topic.

 

Today’s theme for the WordCount 2012 Blogathon challenges bloggers to create a Wordle “word cloud” image composed of words that define the blog or that are used in the blog. Users choose the layout, colors, fonts, and other design elements that best suit the blog.

 

Here’s our AltMedForYou Wordle for today:

 

AltMed-Wordle-4thTry0003

 

 

It’s interesting to see the same image presented vertically, too:

 

AltMed-Wordle-4thTry0001

Supplement Problems: Calcium

(Original article posted May 25, 2011; updated information added on May 26, 2011.)

Yesterday we told you about the concerns that have recently been raised about vitamin E supplements. Today we take a look at the latest on calcium.

 

A new study published in the June 2012 issue of the journal Heart reported that taking high amounts of calcium supplements may increase risk of heart attack and stroke.

Previous research showed calcium was beneficial, especially post-menopausal women and others who are at risk of osteoporosis. Calcium supplements were also to help lower the risk of high blood pressure, type 2 diabetes, and obesity, heart attack, and stroke. No wonder many people say their physicians advised them to take a calcium supplement every day, and others decided on their own that taking calcium would be a good idea.

But now the new study raises serious questions about calcium. 

German researchers analyzed data collected over an 11-year period from 23,980 people aged 35 to 64 who did not have cardiovascular disease when they joined the study between 1994 and 1998.

Participants were asked to take a self-administered “food frequency” test that asked about their consumption of 148 foods over the preceding 12 months. They were also asked about supplement use during a baseline interview and then in periodic follow-up questionnaires.  Analysis of that data told the researchers how much calcium the participants were consuming and in which form (dietary calcium in foods and beverages or calcium supplements such as tablets and chewables).

Next they looked at the cardiovascular disease in the participants. Information obtained by surveying participants and survivors of those who had died was verified through medical and death records. After compensating for other confounding factors that could skew the results, they concluded that dietary calcium did not have a significant impact on heart health risks but calcium supplements actually increased risk of heart attack and stroke.

Why the difference? Calcium in food is consumed in smaller amounts scattered over the course of the day, which means that the calcium in food is absorbed more slowly, a press release about the research explains. Supplements, on the other hand, deliver a bigger dose of calcium all at once and that causes “calcium levels in the blood to soar above normal range.” The researchers think that spike of calcium or “flooding effect” is the key that explains why supplements can be harmful when dietary calcium is not.

The bottom line, the study authors say, is that calcium supplements should be used with caution and patients should be discouraged from taking calcium supplements.

Others who have read the study disagree, according to a report by NutraIngredients-USA. They point out the importance of calcium, especially for elderly people who are at risk of falls and fractures caused by weak bones. And, they note, this single study is not proof that calcium supplements do cause heart attacks, nor does it provide a strong enough reason to disregard the good things calcium can do. Until additional research confirms this study’s findings, it’s way too early to conclude that the possible harm calcium might cause outweighs the benefits studies have shown it provides.

If you’re not sure what to do — and heaven knows, the back-and-forth can be very confusing — ask your doctor to read this study, if he or she hasn’t already done so, and tell you what’s good or bad about it and what he or she recommends for you. Does your doctor think you should continue taking calcium supplements as you have done up to now or does he or she think you should stop taking the supplements?  And if you do stop taking them, ask about food sources of calcium. Which foods does the doctor recommend, in what amounts, and how often should they be consumed?  Be sure to ask about other calcium sources too, such as antacid tablets that contain calcium (like Tums®).

If you don’t have a health care professional to help you with this question, read ConsumerLabs.com’s Review of Calcium Supplements. Cautions and factors to consider if you are concerned are listed toward the end of the review. Or ask knowledgeable staff or nutritionists at your local health store.

Want to read the full text of the Heart article will find it in the June 2012 issue? See:  Calcium and cardiovascular disease. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg), Heart 98:920-925 doi:10.1136/heartjnl-2011-301345

© 2012, All rights reserved

 

Supplement Problems: Vitamin E

 

 

Just when you think you know what supplements you should be taking, research throws a monkey wrench  into the works.

 

Vitamin E is probably best known as an antioxidant supplement that helps to prevent harm that can be caused by free radicals, and helps protect against viral and bacterial infection by boosting immune system strength. It also helps prevent blood clots.

 

Many studies exploring the use of Vitamin E found benefits, including that it helps reduce the risk of Alzheimer’s disease, helps repair the plasma membrane that protects cells in body, helps protect the brain after a stroke, may reduce risk of chronic obstructive pulmonary disease (COPD) when taken long-term. 

 

Most said it was safer to get vitamin E from foods than from taking supplements. There was some concern when  evidence suggested that taking long-term, high doses of vitamin E caused a slight uptick in the risk of death from all causes but, as MayoClinic.com reported, “human research is conflicting,” and their advice said, “Caution is warranted.”

 

Some research in 2002 reported that taking vitamin E with selenium, a mineral, could prevent prostate cancer in men. But in October 2011, further analysis showed the opposite. Instead of reducing risk of prostate cancer, vitamin E increased it. Compared to men who took a placebo, those who took 400 IU of vitamin E each day for seven years had a 17 percent increase in prostate cancer. (Taking E with selenium wasn’t beneficial either.)  “Based on these results and the results of large cardiovascular studies using vitamin E,” study co-chair and Cleveland Clinic physician Eric Klein, MD, said in a National Institutes of Health / National Cancer Institute news release, “the supplements have shown no benefit and some very real risks.”

 

The study, Vitamin E and the Risk of Prostate Cancer, was published in the Journal of the American Medical Association on October 12, 2011, and may be read online at no charge.  (JAMA. 2011;306(14):1549-1556. doi:10.1001/jama.2011.14370)

 

© 2012, All rights reserved

Omega 3 for Alzheimer’s

 

As we’ve been reporting on the pros and cons of taking omega 3 fatty acid (fish oil) supplements, scientists have published yet another study about a promising application for omega 3s.

 

The new study, just published in the medical journal Neurology, suggests that omega 3 fatty acids in food may help delay or, better still, prevent the onset of Alzheimer’s disease and other memory problems.

 

How did they come up with that?

 

First researchers gathered diet data from 1,219 study participants, all aged 65 or older, none of whom had Alzheimer’s disease at the start of the study.

 

Then they collected blood samples from each participant and tested each to see how much beta amyloid they contained. While that’s not a totally accurate reflection of how much beta amyloid is in the brain, given that it’s much easier to measure blood levels than brain levels, at least this gives an indication of how much beta amyloid may be in a person’s system.

 

Beta amyloid, also called amyloid beta, is considered the “hallmark” of Alzheimers. In the brain, this protein is thought to be a key player in the development of Alzheimer’s disease because of its involvement in the formation of plaques (picture scabs or patches) and tangles in the brain that interfere with normal brain function.

 

This can be pretty confusing. If you’d like to see a good, clear, and short explanation of what beta amyloid plaques and tangles are and what they look like, one useful source is the American Health Assistance Foundation’s Alzheimer’s Disease Research page. (Or type “beta amyloid plaques” into a Google search engine and select IMAGES from the top command menu.)

 

As we learn more about how diet affects conditions like Alzheimer’s, we’re finding that certain diets seem to delay the condition — and may even prevent it.

 

For this study, the researchers were interested in ten nutrients, one of which was omega 3s. The report that people whose diets were highest in omega 3s had 20- to 30 percent lower levels of beta amyloid than those whose diets provided only the average amount of omega 3s. The key difference was just one extra gram (1,000 mg) of omega 3s above average intake level.

 

As we’ve previously reported, fatty fish such as salmon, herring, mackerel, and sardines are the best food sources of omega 3s (because they contain the highest amounts of that nutrient) but vegetarians who don’t eat fish can still get omega 3s from nuts and seeds, though in smaller quantities than fish provide. To see how much you get with various types of foods, look at Colorado State University Extension’s fact sheet on Omega 3 Fatty Acids.

 

Now the next step will be – you guessed it – more research. We need to find out if the same thing works for spinal fluid and brain levels of beta amyloid – does a diet rich in omega 3s also reduce beta amyloid in spinal fluid and in the brain?

 

To read the study, see Nutrient intake and plasma β-amyloid.

 

© 2012, all rights reserved

Before you start taking that supplement

 

If you’re thinking of starting to take omega 3 or any new supplement that you haven’t taken before or haven’t taken recently, take time to become an informed consumer.

 

Do your homework.

  1. Read as much as you can about the supplement – pro and con – before you try it.  Know what conventional medicine says about the supplement as well as what alternative medicine says. You’ll find information in loads of health and nutrition books and magazines, brochures, single-sheet supplement handouts about individual supplements (free at health stores), and similar sources.
  2. Check reputable websites.
  3. Ask staff at your health store. Some health stores make sure all the people who work in their stores, especially those who talk to customers, are well informed and able to answer questions. Many also have nutritionists and other experts available for consultation.
  4. Consult a pharmacist. If you don’t have a pharmacist, go to a large drug store or grocery with in-store pharmacy and ask to speak with a pharmacist.

 

Learn as much as you can about the supplement.

  • Find out what the risks may be.
  • Find out how much to take. You should know both the recommended dose and the “ceiling” or do-not-exceed maximum dose
  • Find out how to take it. Some work best when taken with food; some should not be taken with food. Some may interfere with absorption of other supplements you take (such as iron and calcium, for example); others help your body use the supplement more effectively (such as iron with vitamin C). Some are better at bedtime; others at morning. And so on.
  • If you take any medications, find out if the supplement

 

Write it down.

If you don’t already keep a supplement record start now.  Call it a journal or a diary or a log or give it whatever label you like – just do it. 

Include:

  • Reason?  Say why you are trying this supplement. What do you hope it will do for you?  Many supplements have multiple benefits. If that’s true of the one you’re going to try, list the primary reason first, then note any secondary goals that are important to you. For example, if you were going to start taking Cosamin DS, a glucosamine-chondroitin supplement for joint pain, your Reason entry might say: Reduce hip pain. Move easier. Walk longer.
  • Date?  Date you start taking the supplement. If time (of day) taken matters with this supplement, note both date and time.
  • Dose?  How much are you taking? How often?
  • With?  What other supplements and/or medicines do you take on the same day you take the new. If the supplement is one of those that should be taken with food or on an empty stomach, note “with meal” or “empty stomach” and if it should not be taken at the same time as something else you take, note the times (when you took this supplement and when you took the other supplement or medicine)
  • Changes? Make a note of any changes you notice. Include improvements, even if you are not sure they’re related to the supplement, such as “memory better” … “legs didn’t ache like they usually do after long walk” … “not out of breath now”…  Also note any problems or concerns, such as “1st bloody nose since 4th grade” … “bruise easily” … “rash won’t go away…” “very tired but getting plenty of rest". 

 

You don’t have to make notes in your supplement log every single day, but do update it whenever you make any change or notice anything new. Keep making notes for at least six months.

 

Why so long? Some changes are so gradual or so subtle that they go unnoticed. Some may not show up until you’ve been using the supplement for several weeks or more. Some are like pieces of a jigsaw puzzle in the sense that one individual piece doesn’t show much but when added to other pieces (when you review your notes), patterns emerge or become more apparent.

 

Having a written record will cover any gaps that might creep into memory and also will make it easier to see “the big picture” to assess how this supplement is affecting you.

 

 

© 2012, all rights reserved

Omega 3 – Friend or Foe (part 2)

 

People take fish oil (omega 3) supplements for many reasons.  Most online and print sources I’ve seen including Fish oil, which is on the excellent MedlinePlus Herbs and Supplements website, that heart and cardiovascular health and prevention top the list. “The scientific evidence suggests that fish oil really does lower high triglycerides, and it also seems to help prevent heart disease and stroke when taken in the recommended amounts,” the report says. And that part about “in the recommended amounts” is important because the report also notes that taking too much can raise risk of stroke.

 

Other conditions people take fish oil for, according to MedlinePlus, include:

  • Depression
  • Attention Deficit-Hyperactivity Disorder (ADHD)
  • Alzheimer’s disease and other disorders that involve cognitive, or thinking, problems
  • Dry eyes
  • Glaucoma
  • Age-related macular degeneration (AMD)
  • Menstrual pain
  • Breast pain
  • Pregnancy complications
  • Diabetes
  • Asthma
  • Rheumatoid arthritis (RA)

… and many others

 

With so many ways to use this product, it’s not surprising to read in a February 5, 2012, news release from ConsumerLab.com that fish oil was the most popular supplement. Their survey of supplement users asked more than 10,000 supplement-savvy consumers what supplements they take every day. Fish oil topped the list – it was used by 80.8% of people who took 10 or more supplements daily. 

 

Does it work?

 

Yes, for some things. Research shows omega 3 is effective for reducing high triglycerides. It probably works to prevent heart disease or reduce your risk of dying from heart disease if you already have it. And it may do a better job of reducing heart disease death risk than statin drugs.

 

Maybe, for many things. There’s a long list of conditions that may be helped by omega 3 supplements, and an even longer list of things it may not help, but at this point there’s not enough evidence to give a firm yes or no answer. 

 

We do know that there are some risks, especially if daily intake is higher than 3 grams. Problems it can cause include:

  • Increase risk of bleeding (blood-thinner)
  • Increase risk of infection (inhibits immune system function)
  • Cause side effects affecting the digestive system (heartburn, nausea, loose stools), skin (rash), and others (nosebleeds, bad breath)
  • Interact with medicine and other supplements
  • Contamination risk

 

Bottom line

 

Articles about supplement use usually include a line that tells people they should check with their doctor or other health care professional to make sure it’s safe to take that supplement. We see that line so often that many of us have a tendency to think, “Yeah, yeah, same old, same old” and ignore the advice. But in this case, it’s not just a cover-yourself-against-lawsuit line; it really is important.

 

If someone I knew asked whether I thought he or she should try omega 3 supplements, I’d say “maybe.”  I’d tell that person there is good evidence showing omega 3s can be wonderful for some conditions but there’s also evidence showing they can be risky too, so I would not start taking them without informed guidance from a health professional who is knowledgeable in this field.

 

If the person asking this question doesn’t know a health professional who is informed enough to consult, or doesn’t trust them, I’d suggest that person invest some time in becoming informed himself or herself. 

 

See our guide to starting any new supplement, “Before You Start Taking That Supplement.” 

 

It’s coming up next.

 

 

© 2012, all rights reserved.

Omega 3 – Friend or Foe

Today’s plan was to focus on a different topic. But after seeing several email and online chat comments about omega-3 fatty acids, I’m shifting gears.

Too many intelligent, well read, supplement savvy people have misconceptions about omega 3 fatty acids or fish oils and need to know what to do to stay safe.

Overall, fish oils, which contain omega-3 fatty acids, are great. The American Heart Association (AHA) recommends fish oil, preferably from foods — at least two 3.5-ounce servings 6wice a week. Recommended fish include salmon, canned tuna, sardines, and others.

The AHA’s Fish 101 for tips on which fish to choose and how much omega-3 is in each. The site also provides information on how much mercury the listed fish contain so you can weight the balance between mercury (bad) and omega 3 (good) for fish you’re considering.

 

If you can’t do that – anyone who has priced salmon at the grocery store lately knows it’s a potential budget breaker – or you don’t like any of the fish they recommend, supplements are you next best choice. Check the info on omega-3 fatty acid supplements on the AHA’s Vitamin and Mineral Supplements.

The AHA site recommends omega 3 for high triglycerides (a type of blood fat that should not be high), tachycardia (rapid heart rate – more than 100 beats per minute), and other heart conditions.

As a friend says, “all good, right?”

Maybe. But there’s also a maybe hitch. They AHA doesn’t mention cautions and caveats.

If you recently upped your daily intake of omega 3 and you’re noticing any unusual problems that involve bleeding such as bruising more than normal or more easily than normal or subjunctival hemorrhage (a red blood spot in the white of the eye), check further or ask a qualified medical professional who knows you, knows your medical problems, knows what else you’re taking, and knows the risks and benefits of this supplement.

More to come…

 

© 2012, all rights reserved. 

Restocking Supplements

No news today – just a question and a thought or two to share…

 

The question:  

When it’s time to restock your supplement shelves, where do you shop?

 

And the thought or two:

I used to go to the health store, partly because it was such a charming place filled with knowledgeable people, but as other stores broadened their selection of quality supplements, it became easier and easier to buy from other places, at least for some items.

 

Now I order some things from online retailers (only from those who were recommended by trusted sources have outstanding reputations for honest and fair business practices) mainly for the price and convenience. Delivery is either free or cheap, and there’s no hassle about going out in bad weather, finding a parking space, or carrying things home. Even Amazon.com sells many popular supplements.

 

In fact, I find the only time I go to the health store these days is when I need something that I can’t get anywhere else.

 

But now, looking at the bigger picture, I have to wonder what will become of the brick-and-mortar stores if everybody did that.

 

And what about loyalty to the store that was there for me when I needed them?  

 

It would be interesting to see other views. Where you shop for supplements? What’s good and what’s not so good about it?  Do you feel any obligation to the “home” store?

 

Time for a poll? 

 

© 2012, all rights reserved