Get what you pay for.

Some of my patients don't like paying for prescription medicines but when I talk about alternative nutrition practices to reverse disease and accompanying supplementation, eyes light up, dreams of youth come back, endorphin starts to ooze....then sticker shock!!  I tell them that the 3-4 standard supplements required to control symptoms, regain sleep and make up for some food deficiencies will have to be an investment but should work as good as the rx's they were on with less side effects.  Tough sell for some folks that don't have disposable money, but so is bypass surgery and 6 months of disability.  Desperate folks take the homework shopping list I write up and just hit the aisles of walgreens or walmart thinking a vitamin bottle is a vitamin bottle.  I have been taught to know what active ingredient to look for on the label and percentage.  Problem is the FDA rarely scrutinizes vitamin companies so it is left up to the company making the herb to run expensive checks on percentage of ingredients.  Like asking horny teenagers to behave while you are away?!  Or an alcoholic to stop drinking after 2 glasses?!
I check consumerlab.com for challenged brands when it comes to popular supplements.  They test a good amount of variety but not all supplements.  Their database is growing but I ask patients who are nutrition conscious to pay for the service as it may save money and allow confidence that the pill capsule you take has the ingredient on the label.  Some are reluctant having confidence their local pharmacy is "watching out for local consumers".  I don't agree and New York just called some cheap stores on it.

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This is my answer:

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Caveat Emptor (remember Greg Brady buying his first car?)

Hot Flash

A 19 year old guy come in stating he is having a reaction to a pill.  He took it this morning and about 1 hour later and it got the point of flushing, palpitations, headache, anxiety and now shortness of breath. Previous history is inhaler use for cough after bronchitis treatment about 2 months ago. Only recreational drug was tobacco which he stopped last year cold turkey.  No history of this before and otherwise healthy.
As I was pulled out of another patient room, I enter and notice a red young skinny guy who seemed to be using his shoulders to breath with shaking anxiety.  His physical exam was otherwise normal so I ordered a shot of steroid, high dose benadryl and an IV fluid to make him start peeing.  I gave him reassurance and ask why would a young guy be taking Niacin (then I told him I was given a dose back in 1982 right before I went on stage for Mr Natural New Jersey.....it was supposed to increase "vascularity" to improve the way blood vessels protrude from the skin).  Seems like his mom has a cholesterol issue and the doc said because of my young guys elevated triglycerides he would be fine taking over anything over the counter.  "Redboy" went straight to GNC and bought regular niacin and here we are (should have read consumer labs reviews.)

Niaspan is the prescription form of it and docs prescribe the drug for lowering triglycerides and LDL levels. The theory was if you lover "Bad Cholesterol-LDL" the risk of a heart attack will decrease.  Current thinking is to forget the standard LDL and pay attention to the small, more dense lipids (which require a more expensive blood test called a fractionated lipid panel).  The family of medicines called Statins work to lower LDL but modestly change triglycerides and sometimes lower the good cholesterol (HDL). They have been broadly recommended to prevent high cholesterol in everyone according to studies (some of which are funded by drug manufacturers) The problem is medicines have side effects and I have had patients develop chronic muscle pain for up to 18 months after stopping the statin.  I guess to fight heart disease it's back to exercise, nutrition change and relaxation therapy.  (yes...the Beatles were right-see link)

Here is the reason why nutrition changes FIRST would be important unless there is an urgency in lowering blood levels.  (like an evolving heart attack).  One study (VA HIT) showed by lowering HDL using gemfibrozil the events of coronary heart disease decreased.  So now the buzz words are: raise HDL!!! Gemfibrozil essentially works by not being absorbed from the gut and pulling out cholesterol with your poop. Hey, fiber would do that too right?!?! (see my video on fiber)  Bottom line is sometimes in the midst of massive disease, we need medicines that can produce "massive" side effects. In the decades before disease strikes, over the counter supplements can sometimes cause side effects as well.   Thus it would be prudent to take care of things before you get to advanced disease naturally with lifestyle changes.  The only problem is most people don't feel symptoms at the beginning of bad health.  Eating mostly plants, meditating and taking time off to walk doesn't seem to be inviting to the population who "drives thru" to eat.  Deepak Chopra suggests always keeping life in balance.  Eating industrialized food, sitting all day, always relying on adrenaline (caffeine and sugar) for "energy" is not part of being balanced with the universe.  Fat zebra can't run from lion (unless lion is also fat) so bad zebra health results in not keeping up with the safety of the herd. You can sport your individual stripes but longevity comes when aligned with the universe.  

To V(itamin) or not To V(itamin)....that is the question.

People are coming in totally confused about whether they should take a vitamin supplement or not.  I dont blame them....even the medical community is clueless about nutrition.  It boils down to that,,,,nutrition. Average medical school student spends no time learning about food except cholesterol is bad because Dr Oz said so.  It used to be important in curriculum about 30 years ago but now so much else is squeezed into 4 year that some "non essential" stuff had to be dropped.  No problem....we will save the education for residency.  Oops, no one to teach it to residents except the attending physicians who were trained 20 years ago when nutrition was dropped.   No problem, make it mandatory CME (seminars required 1 time every 7-10 years) training to keep private practice docs updated.  Oops, most docs attend the lectures but stuff the literature under the pile of bills and charts when they get back to the real world.
When doc tells you to eat a balanced diet, you should ask the doc what s/he eats.   When the doc tells you to exercise, you should ask him/her what they do to keep fit.
Dr Klein and associates on the SELECT trial concluded vit E (in alpha tocopherol form) and selenium (in L-methionine selenium form) were associated with an increase in prostate cancer risk for men.  The doses studied were the measurements found in common over the counter vitamins (400IU and 200Mcg respectively).  So the conclusion of Dr Klein is dont take it if you have a history of prostate cancer and he went on to say in an interview....dont take the supplement at all.. The information is good but the they only studied the intake of one type of tocopherol.  Vitamin E in nature comes in 8 forms (my favorite natural sources are almonds, sunflower seeds, kiwi and mangoes).  If you take it there should be a balance of mixed tocopherols and tocotrienols.  The cheapest synthetic  to produce is listed as dl tocopherol - the most abundant form normally found in tissue and blood is d alpha tocopherol.  There is good evidence for Vit E aiding in Alzheimers and Parkinsons disease.  So end of the day, change your nutrition to include a mostly plant based whole food diet.  It you are just starting out a lifestyle change and want to include a supplement or two to provide building blocks to repair the long standing damage accumulated, ok to take a vitamin but you should read labels and empower yourself with the research (google scholar or pubmed) but also know how to interpret the data (www.drweil.com gives Andy's  translation for "layman" of up-to-the-minute research).  The idea will be eventually to get off everything once you have maximized on nutrition and lifestyle.   (in my DrRic 12 Weeks to Change I suggest adding different supplements every few weeks while also self empowering with reading and seeking reliable sources of information to develop your person plan for change)
By the way, as typical for statistical healing, one way to know which supplements you may benefit from (everyone lacks a different level of nutrition) is to get a blood test for every vitamin you are about to take and make sure you "really need it".  Medicare/Medicaid is the insurance of choice for the highest risk people in the US and it Does Not Cover vitamin blood tests.  So I can get substandard blood tests and 'tease out" an opinion from a CBC and CMP (the basic blood all docs order) and say "looks like your blood system is normal so continue current eating pattern".  Kinda like getting an xray of the chest on a tobacco user and saying "all normal-no cancer" so you can continue smoking!!! ......or.......telling an obese person "your annual cholesterol and glucose is normal " so dont change your weight!!!!  My head is spinning from all this dis-empowering research....I'm going hiking....but first I take my "prostate cancer inducer".

 ( ...note: the vit E is lower than the SELECT study but selenium is same  Nice knowing you!!)

Healingwith

 

 

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At this point in the summer, most people have started an exercise program and 50% of you will have some form of muscle ache or strain. The idea for exercise is to be healthy but what do you do when an injury occurs on the way to lifestyle change? If you don’t have a registered dietician in your corner, the information on the web can be confusing. RICE is not just food; Tylenol does nothing but decreases pain, physical therapy can be expensive.

The range of rumored nutrition for healing, spans from high dose antioxidants to anabolic steroid look-alikes. If you are in a hurry, there are safe ways to combine herbal supplements with prescription medicines. If you want to be conservative, there are some supplements you buy cheap and others that are worth their high price tag. With the multitude of prescription medicines most Americans take, you have to be careful about combining botanical, vitamin and drug, (searching the internet for answers can be disastrous!) Learn how DrRic advises his Olympians, college athletes and weekend warriors on getting the most "bang for the buck".

DrRic Saguil worked as Physician for University of Central Florida and Cirque du Soliel -LaNouba. He is also a Yoga Teacher, Outdoor Guide, title holder for Teen Mr Natural New Jersey and Teen Mr East Coast.  He practices Family Medicine at First Health Associates in Arlington Heights.

July 13th (Saturday) 3-4pm

Whole Foods Market Schaumburg

Subject to cancellation so Call (847) 585-5800 to reserve a seat!

　

Prank call your vitamin company

I always tell my lecture attendees:

-to find out if the vitamin company you buy from is investing money into your health, call the 800 number and ask a question. 
-if they have no 800 number/website, throw them away
-if they have a number but the rep doesnt look up the info or gives you like a 5th grader, throw them away
-if they have a department specifically for hard questions, an frequently asked question database, a nutritionist that answers the phone....that's your company!

I was buying some melatonin replacement and saw extended release oral spray from Source Naturals (great turmeric/pepper combination antiinflammatory capsule btw)  and wondered "if it isnt covered in a slow to digest shell/tablet/capsule....how the heck do individual droplets slowly get released once you spray them into the mouth.  Here is their answer:

Source Naturals NutraSpray Melatonin Timed Release Sublingual employs microscopic lipid spheres to slowly deliver melatonin. As stated in the product description - http://www.thresholdenterprises.com/publications/controlled/100182.pdf - “[a} quick spritz of NUTRASPRAY under the tongue delivers thousands of microscopic lipid spheres, each full of nutrients. These lipospheres are readily absorbed and retained by the mucosal tissue of the mouth. Here they release their nutrients quickly, but steadily, into the bloodstream.” 

Nice answer....I think I'll keep it!  For info on how I use melatonin.....see my slideshare.net lecture DrRic Good Night. http://www.slideshare.net/DrSaguil/get-back-to-sleep-slide-share-edition


....I love Whole Foods Market (John Mackey has changed the paradigm of grocery shopping) and the 365 brand but to give a shout out to a local company, I also like Now Foods from Bloomingdale IL- great nutrition department staffed with folks that field customer calls and they give plant tours!

What's not on the label

 

Had some  rep drop off samples from 5 hour (not sure why they picked my office as it is contradictory to anything natural/healthy).  Before I threw it out, took a look at the label.  I understand how they were able to place the "decaf" word on the headliner but most patients on blood pressure meds, sleep meds, heart meds, add/adhd meds wont read the nutrition panel and can end up with side effects to "natural ingredients".  Yes, if you check the ingredient panel on the second pic, the smallest and last ingredient on the "Energy Blend" is 6mg of Caffeine!  Yes, natural ingredients can be dangerous if used improperly and lifethreatening if used with prescription meds.  Example-tonic water.  Seems harmless but if you take coumadin/warfarin/blood thinner....this can make you bleed uncontrollably or can interact with a common antibiotic for urinary tract infections (cipro).  St Johns Wort is a great botanical that does just as good a job for mild to moderate depression as zoloft but has interactions with several medicines.  Don't be fooled by labels.....manufacturers are trying to get your attention and will stop at nothing. 

Next big problem, Genetically Modified Food industry is pushing not to have consumers know which foods are GMO and which are not.  See the movie Food Inc for details on potential genetic problems with eating large volume GMO products.  So dont ask, dont tell?....at least until you are the first one in your family to be diagnosed with a cancer or an autoimmune disease.

 

Caveat Emptor!

Choosing a Daily Supplement

Unless you eat all organic or maintain a Mediterranean/Okinawan Diet you are probably not getting the same nutrient value from your food that Americans did 4 decades ago.  Soil has lost it's mineral content, pesticides have been added to mass agriculture, antibiotics have altered fish and beef health and science has bypassed gene replication that can place increased stress to your immune system.  So yes, the average American on a standard American diet should be adding supplement to daily diet.  Don't have to go broke with high end, member only vitamin lines (no matter what your distributor says) starting out can be with simple daily over the counter choices.  Personally, I take above the grade supplements depending on what is important during the time of year.  For example, turmeric for when I start a new exercise routine, vit D3 and astragalus for flu season, probiotics and magnesium with detox spring and fall.  But overall, a daily multipak supplement, omega 3 fish oil and vitamin D3 (the fish oil I research the company due to mercury worries). 

Some people stop after 30 days when they don't feel any results.  This is the wrong way, in going with nutrition and exercise to heal, changes are always slow.  We're talking months to years.  When using prescription medicines, you can expect a change in your life quickly since science has researched how to change your body and mind quickly with powerful chemicals.  The caveat is with powerful chemicals, you will have powerful side effects.  You can make the choice but Andy Weil has taught me the intensity of the treatment plan depends on the intensity of the disease presentation.  In life threatening situations you may have to tolerate the potential side effects to survive. 

click to see my tutorials on vitamins, omega 3 fish oil and vit d3 on youtube

Ultimately, proper nutrition is always the base to a healthy lifestyle change.  Speaking from my heart, I can't afford to go total organic so for now, I feel supplements are important while I get to my ultimate level of health.  This includes exercise, meditation, community, family as well as nutrition.  For my average patient who comes in suffering from imbalance/disease manifestation/on medications-I definitely will be putting together a homework shopping list to bring to the local herbal store, Whole Foods Market or Fruitful Yield.