Fish oil has been touted as the miracle supplement for the last few years. In fact research has demonstrated that fish oil is beneficial to control the inflammation of arthritis. There are many studies that describe the cardiovascular benefits of fish oil, and recently the mood balancing benefits of fish oil in mildly depressed patients have been studied. Many physicians recommend that patients begin getting their steady dose of fish oil in-utero by recommending fish oil to pregnant moms so the developing child will have the raw materials to form a healthy nervous system and brain. Although the scientific facts are indisputable regarding the health benefits of fish oil it is what the manufacturer does not put on the label that can make your fish oil very unhealthy. Unfortunately industrialization has polluted our waterways. Toxic chemicals and carcinogenic substances are rampant in our water supplies and oceans. Fish store these toxic wastes in their fat tissue.

A recent test by environmentalists showed a very disturbing trend. Many commercially available fish oils were very high in PCB’s. PCBs are industrial chemicals that were banned back in the 1970s because they cause cancer and birth defects. Quality manufacturers have been aware of this trend for decades. The process of molecular distillation removes PCB’s, heavy metals, and other toxic chemicals from the fat of the fish oil leaving only the healthy omega 3 rich oil behind. It is a process that adds to the cost of the fish oil, but as the research shows it is a necessary step. If your fish oil does not say “Molecularly Distilled” on the label then it most certainly contains pollutants that you would not want to put in your body. Lipid peroxides form in fats when they go rancid. That is the “fishy smell” associated with fish that is not fresh. Lipid peroxides cause inflammation and stress to the cardiovascular system.

If your fish oil has not been “stabilized” with antioxidants then it will taste “fishy” and cause oxidative stress in your body. If you want the benefits of fish oil without any stress to your body then you should be certain that your fish oil is molecularly distilled and antioxidant stabilized for freshness. I only recommend one fish oil Norway’s Purest Fish Oil. I recommend it because it is molecularly distilled, and antioxidant stabilized. I am also given independent 3rd party tested lab results to prove it with every batch I order. That is the quality my patients depend on.

Omega-3 Deficiency May Be A Marker For Bipolar And Depressed Patients
Sobczak S, Honig A, Christophe A, et al. Lower high-density lipoprotein cholesterol and increased omega-6 polyunsaturated fatty acids in first-degree relatives of bipolar patients. Psychol Med. 2004;34(1):103-12

Anti-inflammatory and Cardioprotective Effects of Omega-3 fatty acids
Micallef MA, Garg ML. Anti-inflammatory and cardioprotective effects of n-3 polyunsaturated fatty acids and plant sterols in hyperlipidemic individuals. Atherosclerosis. 2009;204(2):476-82.

Reports safety, and importance of dose and duration of fish oil supplementation for arthritis
Kremer JM. n-3 Fatty acid supplements in rheumatoid arthritis. Am J Clin Nutr.,2000;71(1):349S-351S.
pbhealthcenter.com/Norway

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The role of folic acid and vitamin B12 in memory and cognition is pretty well established. Research appearing in the American Journal of Clinical Nutrition (2007; 86(5): 1384-1391) looked at 1,648 subjects over the age of 65 over a 10-year period. During the 10-year course of the study mental function and vitamin B12 levels were tested at least three times. High vitamin B12 levels were associated with slower rates of mental decline. An earlier study appearing in the American Journal of Clinical Nutrition (1996;63:306-14), also found that high levels of B6 were associated with better memory.


Research appearing in Clinical Biochemistry (2007; 40(9-10) 604-608) found a connection between low levels of folic acid and vitamin B12, and depression in 66 subjects over the age of 60. Also, the depressed subjects tended to have higher homocysteine levels.


It is commonly assumed that people who need B12 must have injections. Actually, if the dosage is high enough, oral supplementation can be very effective. A review of research appearing in Family Practice News (November 15, 2004:59) shows that taking vitamin B12 orally may be as effective as getting by injection. The article reviewed four earlier studies that compared oral B12 supplementation with injections and placebos in patients with documented B12 deficiency. The studies showed taking a high dose orally (between one and two milligrams per day) is as effective as B12 injections. Lower doses were not as effective, in fact at 10 mcg per day, oral B12 supplementation is no more effective than placebo. Doctors in Sweden use oral B12 therapy instead of injections and have been getting good results for over 30 years.


There is not a lot of research on the connection between niacin and memory. Although in the severe niacin deficiency disease, pellagra, there are mental symptoms. Symptoms in the central nervous system can include memory impairment, disorientation, confusion, and confabulation (excitement, depression, mania and delirium). Some patients may become paranoid.


One study, appearing in the Journal of Neuroscience (2008 November 5;28(45):11500-10) looked at the effect niacinamide (a form of niacin) had on memory in rats. The rats in the study were normal rats and rats specially bred to develop a disease similar to Alzheimer’s disease in humans. Over a period of four months rats were either given niacinamide in their water or a placebo. In the rats bred for the Alzheimer’s-like disease, there was an increase in proteins used to strengthen brain tissue and there was a decrease in material that could lead to plaquing. The specially bred rats who received the nicacinamide performed as well on memory tests as the normal mice, while the untreated rats demonstrated loss of memory.

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Vitamin B12 is a water-soluble vitamin that plays a key function to maintain a healthy nervous system, brain function, formation of red blood cells and DNA.


A deficiency of this vitamin can lead to different forms of anemia (Megaloblastic & Pernicious), vision problems, dementia, muscle weakness, nerve damage, mood disturbances, fatigue, low resistance to infections, psychoses, hypotension, ataxia, fatigue, and incontinence.


Vitamin B-12 is a protein bound food, so most people who eat meat, eggs and dairy products get enough vitamin B-12 in their diet, as long as, they have a strong healthy digestive system, in which their stomach makes enough HCI (hydrochloric acid) to break down the protein to release the B-12 during digestion and the intestinal tract is able to absorb it allowing it to enter into the bloodstream.


A healthy body is able to store in the liver 1-2 years worth of the vitamin, so in non-vegetarians, a deficiency of B-12 is not very common. High levels of vitamin B-12 can occur in people with liver disease such as cirrhosis or hepatitis, with some types of leukemia, and sometimes rarely in obese and diabetic people. People who eat lots of unhealthy fast & junk foods, carbonated beverages, coffee, sweets, have had lots of antibiotics, digestion problems, smokers, vegans, babies of vegans, and the elderly are more prone to vitamin B-12 deficiencies.


The best reliable sources of vitamin B-12 are found mostly in meat (poultry, beef, etc.), free range eggs, dairy products (cheese, whole & 2% milk), fish and shellfish. There are plant sources for vitamin B-12, such as fermented soya products, seaweeds (noni), algae (spirulina), however, studies have shown that this form of B-12 is unavailable to the human body and not able to use it.


Currently, no plant foods can be relied upon to give you enough B-12 to keep you healthy. Vitamin B-12 is frequently combined with folic acid and other vitamins as a supplement.


Always consult with your health care professional to see if supplementation is right for you and how much. It can vary greatly depending on your situation, age, health issues, etc. Strict vegetarians are recommended to supplement their diet with whole food V-12 supplements and fortified food. For most people eating 1-2 free range eggs, a chicken breast a day and whole milk or low fat milk and cheese products will give them enough B-12 per day.

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What are supplements?
Supplements are substances that add to (supplement) the nutrition that we get from food. They may include vitamins, minerals, bioflavonoids, essential fatty acids, probiotics, antioxidants, immune system boosters, and many others. The term now also includes substances that are not primarily nutritional, such as performance-enhancing supplements and “quick fix” energy boosters.


Why do people use supplements?
Some of the main reasons people use supplements are to:
- promote general health,
- aid in healing illness,
- address deficiencies (such as Vitamin D deficiency, now a common problem),
- slow the process of aging,
- enhance athletic performance, and
- combat fatigue.


When is it too much?
People have come into my office with shopping bags and shoeboxes full of supplements. I think it gets to be too much when you are taking handfuls of pills three or four times a day, and when you really can’t afford the supplements you are taking. Advertisers would have you believe that each new supplement on the market is “the answer to health.” The five biggest factors for good health are a diet with five to six servings of fresh fruits and vegetables a day, high quality proteins—like grilled or baked fish, turkey or chicken, and very little white starches, sugars, junk food and processed food; regular exercise; 8 hours of sleep per night; a good social support system; and a positive attitude.


When can supplements adversely affect your health?
Supplements have bad effects especially when they are overused to “jump start” energy that you really don’t have. So-called energy drinks, supplements that contain ephedra, and “uppers” in general are bad for your health and can even cause death.
That said, there were 230 deaths from supplements in the 21 years between 1983 and 2004. (“Essay: Diet Supplements and Safety” by Dan Hurley in the New York Times published January 16, 2007) (http://query.nytimes.com/gst/fullpage.html?res=950DE1DB1030F935A25752C0A9619C8B63)


Deaths from pharmaceuticals in the same period in one year during the same period of time are as follows, according to the National Center for Biotechnology Information of the National Institutes of Health: “A 1998 study of hospitalized patients published in the Journal of the American Medical Association reported that in 1994, adverse drug reactions accounted for more than 2.2 million serious cases and over 100,000 deaths, making adverse drug reactions (ADRs) one of the leading causes of hospitalization and death in the United States. (http://www.ncbi.nlm.nih.gov/About/primer/pharm.html)


What are the most important supplements?
- A good multivitamin/mineral supplement for general health. There are many of these, my favorite for comprehensive ingredients and low cost is NOW Foods Vit-Min 75 Plus ($22.00 for a three month supply!) (I have no financial or any other interest in NOW Foods. I like their supplements because they are responsibly manufactured and very affordable. They are also a local Chicago area company. Their products are easily available online.


- A calcium magnesium supplement for bone building, even if you do eat some dairy, it’s rarely enough. My favorite , again, is from NOW Foods—their Calcium Magnesium 500/250—a month’s supply is $12.00. Albuterol, antacids, caffeine, oral contraceptives, and thyroid hormones can reduce calcium absorption.


- A fish oil supplement. Almost no one gets enough Omega 3 essential fatty acids. The dietary ratio of Omega 6 to Omega 3 fatty acids should be about 2 to 1. With all of the processed foods in the US diet, it has reached as much as 17 to 1. A recent study cited on medscape.com showed that giving only 300 milligrams of EPA/DHA, the active ingredient in fish oil, to women who had previously had repeated miscarriages, resulted in healthy pregnancies 83% of the time! Fish oil is also essential for brain health. “If I ran the world” everyone would be taking fish oil, especially women of reproductive age. As a matter of fact, everyone would be taking the supplements listed here!


- Vitamin C We really don’t get enough Vitamin C in our diet. Linus Pauling’s Nobel Prize winning research on vitamin C revealed that most people need between 1500 and 2500 milligrams of vitamin C per day for maintenance. The current “Minimum Daily Requirement” of vitamin C is 60 milligrams. I recommend that most people take 500 milligrams of vitamin C three to five times a day, with at least 8 ounces of water each time. NOW Foods has a good buffered Ester C.


- A good probiotic. Probiotics are the “good bacteria” in the digestive system. We no longer have as many as we should for good health and good digestion because of antibiotics—both those given to us as prescriptions, and those given to animals in factory farming. My favorite probiotic is one that does not have to be refrigerated and that has a dairy free version. It is called PB 8, and is available in most health food stores. Probiotics should always be taken when you are on a prescription of antibiotics, and should be taken at least two hours before or after you take the antibiotic.


- Co-Q 10 Co-Q 10 is a strong antioxidant. Not everyone needs to take it but if you have cancer in your family or have had it yourself, if you have Parkinson’s Disease, or if you have Congestive Heart Failure, you should definitely take it. I have a patient whose Parkinson’s disease reversed enough so that she could play the piano again with a dose of 1200 milligrams of Co-Q 10 daily. I have a Congestive Heart Failure patient who was waiting for a heart transplant and ended up not needing one because her “ejection fraction” went from 13% to 43% just from taking 600 mg. per day of Co-Q 10. Statins and tricylic antidepressants may interfere with Co-Q 10. Costco’s Kirkland brand has a good, affordable, absorbable Co-Q10 supplement.

There are many more specific supplements for specific conditions, but that’s another story for another time. One last cautionary note—in general, avoid supplements from multilevel marketing companies—the prices are most often over-inflated to benefit the people at the top of the pyramid, and the cost of a month’s supply of any single item may range from $35 to more than $100 for a month’s supply. Even with the Co-Q 10, the cost of ALL of the supplements above added together, per month, is less than $75.00. That’s affordable, even in this economy. And now, you won’t need that shoebox or shopping bag.

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Athletes who took probiotic supplements suffered fewer infections and recovered more quickly than those who did not, in a study conducted by the Australian Institute of Sport in Canberra and published in the British Journal of Sports Medicine.

Researchers studied 20 top-level, long-distance endurance runners for two months, assigning them to take either a placebo or a supplement of the probiotic bacterium Lactobacillus fermentum. During that time, the athletes recorded any day on which they experienced symptoms of winter illnesses, including coughs and runny noses.

The researchers added together the total symptom days of both groups, and found that while the placebo group experience symptoms for a total of 72 days, the probiotic group experience only 30 days’ worth of symptoms.

In addition, blood tests revealed that the athletes who were taking probiotics had twice the levels of an immune chemical known as interferon gamma as the athletes in the placebo group.

While researchers do not understand how Probiotics function, particularly since they appear to be effective even in small concentrations, an increasing body of evidence shows that these beneficial bacteria can boost the body’s immune system, among other beneficial health effects. Recent research has also found that probiotic bacteria help regulate metabolism.

The research was carried out on athletes, because the strenuous training undergone by marathon runners is known to compromise the immune system, and even minor cold symptoms can seriously setback training regimen. But probiotics specialist Jeremy Nicholson of Imperial College London warned that the results of the current study might not apply to less active people.

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As summer approaches we will once again be bombarded with news about the ill effects of sun exposure to our skin. We are lead to believe that sun exposure must be combated with sunscreen agents, and yet sunscreen may offer little protection to your skin from Melanoma, the deadliest of skin cancers. (Westerdahl J, Ingvar C, Masback A, et al, Int J Cancer. 2000;87:145-50)

Therefore it may seem wise to just avoid the sun all together. However, appropriate sunlight actually prevents cancer. An examination of 506 regions found a close inverse correlation between cancer mortality and levels of ultraviolet B light. The likeliest mechanism for a protective effect of sunlight is vitamin D, which is synthesized by the body in the presence of ultraviolet B. There are 13 malignancies that show this inverse correlation, mostly reproductive and digestive cancers. The strongest inverse correlation is with breast, colon, and ovarian cancer. Other cancers apparently affected by sunlight include tumors of the bladder, uterus, esophagus, rectum, and stomach. (Cancer March 2002; 94:1867-75)

New Research now shows that 600,000 new cases of breast and colon cancer could be prevented worldwide each year by simply by raising vitamin D blood levels. (Cedric F. Garland, Dr. P.H., Sharif B. Mohr, M.P.H., Edward D. Gorham, M.P.H., Ph.D., and Frank C. Garland, Ph.D., of the Division of Epidemiology at the UCSD Department of Family and Preventive Medicine and Moores UCSD Cancer Center; and William B. Grant, Ph.D., of the Sunlight, Nutrition and Health Research Center, San Francisco). Clearly Vitamin D production is an important.

Sunscreen ingredients themselves have come under scrutiny because of their risk in promoting Cancer. A study in the April 2004 Journal of Chromatography found that there was significant penetration into the skin of all sunscreen agents they studied. Additionally, potentially harmful chemicals such as dioxybenzone and oxybenzone, found in some sunscreens, are some of the most powerful free radical generators known to man. Furthermore, authorities have suggested that whereas sunscreen may prevent sunburn, they may fail to actually protect against cancer because most sunscreens only screen out UVB, which makes vitamin D, not the UVA that causes most of the damage.

Visit the Environmental Working Group’s Skin Deep website, or (see table 1. below) for a list of sunscreen ingredients which are of concern.

Remember exposure to the sun allows your body to create an essential substance, Vitamin D. Research now shows that low blood levels of vitamin D are associated with hypertension, (Heartwire, March 2009), migraine headaches, (Medscape Medical News, July 2008), influenza, type 1 and type 2 diabetes, periodontal disease, epilepsy, osteoporosis, heart disease, and osteoarthritis. Low vitamin D levels are also associated with infertility (Journal Article, Hum Reprod, May 2007), PMS, fatigue, seasonal affective disorder, depression (Journal Article, J Midwifery Women’s Health, September 2008), and autoimmune conditions like MS, and Lupus (Journal Article, Curr Opin Rheumatol, September 2008), and rheumatoid arthritis. Vitamin D deficiencies are seen with Crohn’s disease, syndrome X, obesity, and poly cystic ovary disease. Vitamin D has been shown to improve survival in lung cancer patients, reduce falls in the elderly (Journal Article, J Am Geriatr Soc, February 2007), increase athletic performance, and increase cognitive performance in adults. Vitamin D should be a huge part of any protocol in the treatment of any kind of chronic pain, (Medscape Medical News, March 2009). Be careful with Vitamin D however; because it is fat soluble you should only take amounts above the RDA under the supervision of your physician.

So what’s in your beach bag? Few health recommendations have had as damaging an effect as the advice that you should never leave your house without sunscreen. As discussed earlier wearing sunscreen effectively blocks your body’s production of vitamin D, which happens naturally when your skin is exposed to sunlight. In fact, sunscreens reduce vitamin D production by as much as 97.5 to 99.9 percent. Instead of sunscreen limit your sun exposure to about an hour each day and try not to burn your skin when outdoors. Use your clothing to gradually expose your skin to sun during the spring and summer. Strengthen the oxidative capacity of your skin with a diet rich in antioxidants, like Acai, and omega 3-fish oils which have been shown to reduce cancer rates. Search for skin products which are absent of harmful chemicals for those which offer natural UV protection.

Enjoy the benefits of summer, sun exposure and healthy amounts of Vitamin D.
Table 1.