A Closer Look at Supplements and Your Health

September 18, 2013

Craig Peterson, N.D. MSA LAc.Naturopathic Resident

Cancer Treatment Centers of America®

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Disclaimer

• All material provided today is for informational and educational purposes only, and is not intended to provide you with medical advice.

• This presentation is not a substitute for medical care nor is it a substitute for consultation with a healthcare professional. Please discuss all medical and nutrition questions with your health care provider.

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Principles of Naturopathic Medicine

• The Healing Power of Nature

• Identify and Treat the Cause(s)

• First Do No Harm

• Doctor as Teacher

• Treat the Whole Person

• Prevention

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What is a Naturopathic Physician?

• Licensed naturopathic physician (ND)

― 4 year, doctoral-level Naturopathic Medical school; federally accredited

― Same 2 year basic sciences as an MD with additional training in Clinical Nutrition, Homeopathic Medicine, Botanical Medicine, Psychology, and Counseling

― Trained to use prescription drugs

― Perform minor surgeries – removing cysts, stitching up superficial wounds. Do not practice major surgery.

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Naturopathic Medicine - Licensure

http://www.aanmc.org/images/LicensureMapBig_UpdateJune2013.jpg

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Main Topics • Supplements 101

• Vitamin B12 o What is it?o What are the benefits?o When is it indicated?

• Managing Side Effectso How to utilize supplements to ease side effects?

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Supplements - Overview

• Definition

• Purpose

• Categories– Vitamins– Minerals– Herbs

• Cautions

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Supplements - Definition

Dietary Supplement Health and Education Act (DSHEA)

Dietary supplement:– Intended to supplement the diet– Contains one or more dietary ingredients (including

vitamins, minerals, herbs or other botanicals, amino acids, and certain other substances) or their constituents

– Intended to be taken by mouth, in forms such as tablet, capsule, powder, softgel, gelcap, or liquid

– Labeled as being a dietary supplement

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Federal Regulation

• The regulations for dietary supplements are not the same as those for prescription or over-the-counter drugs.

• Manufacturers of dietary supplements are responsible for ensuring that their products are safe and that the label information is truthful and not misleading.

• However, a manufacturer of a dietary supplement

does not have to provide the FDA with data that demonstrate the safety of the product before it is marketed.

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Purpose of Dietary Supplements

• Added to the diet to boost overall health & energy

• Provide immune system support and reduce the risks of illness and age-related conditions

• Improve performance in athletic and mental activities

• Support the healing process during illness and disease

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Categories of Dietary Supplements

• Vitamins

• Minerals

• Herbal/ Botanical

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Vitamins

• Vitamins are micronutrients – substances the body uses in small amounts

• The body requires vitamins to support its basic biochemical functions

• Deficiencies over time can lead to illness and disease

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Water & Fat Soluble Vitamins

• Water-soluble vitamins dissolve in water and pass through the body quickly, meaning that the body needs them on a regular basis.

• Fat-soluble vitamins are stored in the body's fatty tissue, meaning that they remain in the body longer.

• Water-soluble vitamins include the B-complex and vitamin C.

• Fat-soluble vitamins include vitamins A, D, E, and K.

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What happened to the alphabet?Where is F-J?

Vitamin A

Vitamin B1

Vitamin B2

Vitamin B3

Vitamin B5

Vitamin B6

Vitamin B7

Vitamin B9

Vitamin B12

Vitamin C

Vitamin D

Vitamin E

Vitamin K

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Minerals

• Minerals are micronutrients and are essential for the proper functioning of the body.

• Cells in the body require minerals as part of their basic make-up and chemical balance.

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Bulk & Trace Minerals

• Minerals can either be bulk minerals, used by the body in larger quantities, or trace minerals, used by the body in minute or trace amounts.

• Bulk minerals include sodium, potassium, calcium, magnesium, and phosphorus.

• Trace minerals include iron, zinc, selenium, iodine, chromium, copper, manganese, and others.

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How Much Vitamin and Mineral is Needed?

• The U.S. government has published recommended dietary allowances (RDAs) for each vitamin and mineral for the general population.

– These figures can be used as guidelines– Individuals may have different needs depending on

gender, age, and health conditions.

• http://ods.od.nih.gov/factsheets/list-VitaminsMinerals/• http://fnic.nal.usda.gov/

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Herbs - Botanical

• Herbal supplements are added to the diet for both nutritional and medicinal purposes.

• Herbs can supplement the diet to aid in overall health or to stimulate healing for specific conditions.

• The medicinal effects of herbs are gaining scientific validation; some pharmaceuticals have been derived directly from plant sources

– Aspirin (found in willow bark), – Codeine (from poppy seeds), – Paclitaxel -Taxol (from the Pacific Yew tree)

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Importance of Supplement Safety

• What to look for?– Authenticity– Purity– Potency

• Supplement Certification Groups– USP (U.S. Pharmacopeial)– NSF (National Science Foundation)– NNFA GMP (National Nutritional Foods Association

Good Manufacturing Practices)

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Key Points

• To use dietary supplements safely, read and follow the label instructions, and recognize that “natural” does not always mean “safe.”

• Some dietary supplements may interact with medications or pose risks if you have medical problems or are going to have surgery.

• Most dietary supplements have not been tested in pregnant women, nursing mothers, or children.

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Vitamin B12

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Vitamin B12 – What is it?

• Water soluble vitamin

• Contains the mineral cobalt– “Cobalamins”– Methylcobalamin and 5-deoxyadenosylcobalamin

• Foods that contain B12– commonly found in fish, shellfish, meat, eggs, and

dairy products.

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Vitamin B12 - What are the benefits?

• Required for proper red blood cell formation and hemoglobin synthesis

• Required for neurological function

• DNA synthesis

• Acts as a cofactor Fat and Protein metabolism

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Vitamin B12 - When is it indicated?

• Pernicious anemia

• Gastrointestinal – Celiac and Crohn’s disease

• Vegetarians

• Cardiovascular disease – Hyperhomocysteinemia

• Dementia and cognitive function

• Fatigue

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Dietary B12 Supplements

• Cyanocobalamin converted to Methylcobalamin + 5-deoxyadenosylcobalamin in the body.

• Supplemental types: ― Oral― Sublingual ― Injection (intramuscular)― Intranasal gel (prescription)

• Absorption is largely limited by intrinsic factor.

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Vitamin B12 - Cautions

• Upper Limit has not been established • Interactions with medications:

– Chloramphenicol (Chloromycetin)– Proton Pump Inhibitors (PPI)

• Omeprazole (Prilosec)• lansoprazole (Prevacid)

– H2 receptor antagonist• Cimetidine (Tagamet)• famotidine (Pepcid)• ranitidine (Zantac)

– Metformin

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How do I utilize nutrients and supplements to help manage side effects?

– Fatigue• B Complex• Astragalus• Ginseng

– Infection• Vitamin C• Elderberry Syrup

This content is for informational and educational purposes only, and is not intended to provide medical advice or to be a substitute for medical care or consultation with a healthcare professional. Please discuss all medical and nutrition questions with your health care provider.

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Managing Side Effects continued…

– Neuropathy• Vitamin B6• L-Glutamine• Alpha lipoic acid• Acetyl L carnitine

– Cardiovascular wellness• Essential Fatty Acids• Coenzyme Q10• L-Carnitine• Hawthorne (Crataegus)

This content is for informational and educational purposes only, and is not intended to provide medical advice or to be a substitute for medical care or consultation with a healthcare professional. Please discuss all medical and nutrition questions with your health care provider.

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Managing Side Effects continued…

– Digestive• Probiotics• L-Glutamine• Slippery elm

– Musculoskeletal• Bromelain• Curcumin• Magnesium• Calcium

This content is for informational and educational purposes only, and is not intended to provide medical advice or to be a substitute for medical care or consultation with a healthcare professional. Please discuss all medical and nutrition questions with your health care provider.

© 2013 Rising Tide

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Anti-Cancer Properties

– Curcumin– Green Tea Extract (EGCG)– Vitamin D3– Resveratrol– Sulforaphanes

This content is for informational and educational purposes only, and is not intended to provide medical advice or to be a substitute for medical care or consultation with a healthcare professional. Please discuss all medical and nutrition questions with your health care provider.

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Avoid in Hematologic Malignancies

• Immune stimulating – Melatonin – Medicinal Mushroom Extract

• Reishi, • Turkey Tail • Shitake

This content is for informational and educational purposes only, and is not intended to provide medical advice or to be a substitute for medical care or consultation with a healthcare professional. Please discuss all medical and nutrition questions with your health care provider.

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• QUESTIONS?

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THANK YOU!

• Wisconsin Naturopathic Physician Association• WNPA• www.wisconsin-nd.org

• Oncology Association of Naturopathic Physician• OncANP• www.oncanp.org

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References

• PubMed• Uptodate• Natural Medicine Comprehensive Database• Natural Standard• http://ods.od.nih.gov/factsheets/list-VitaminsMinerals/• http://fnic.nal.usda.gov/