01.31.08
Compound of milk thistle (silymarin) has a significant anti-cancer effect
Milk thistle, or silymarin, has long been used as a botanical treatment for liver disease. In 2007, researchers at the University of California, Irvine, published a study showing that a biologically active component of milk thistle has significant effect against liver cancer cells (see brief summary below).
Compound of milk thistle (silymarin) has a significant anti-cancer effect
Dr. Ke-Qin Hu and his research team at the University of California, Irvine recently published a study showing the significant anti-cancer effects of silibinin, a major biologically active compound of milk thistle (aka silymarin). Milk thistle has a long tradition of use as a remedy for liver diseases, is generally safe and well-tolerated, and is also known to protect the liver from drug or alcohol-related injury. (Silibinin is purified from milk thistle, with a defined chemical structure and molecular weight.)
Dr. Hu is an experienced research scientist and physician in the field of hepatology. He has published over 70 scientific journal articles, many focused on viral hepatitis B and C, cirrhosis, and liver cancer.
Dr. Hu and his research team found that silibilin can significantly reduce the growth of several human hepatoma cell lines. These findings suggest that silibinin can be used to prevent the development of liver cancer, one of the most common cancers worldwide.
Citation:
Lah JJ, Cui W, Hu KQ. Effects and mechanisms of silibinin on human hepatoma cell lines.
World J Gastroenterol 2007; 13(40): 5299-5305
NAC (N-acetylcysteine) – Clinical Summary from Sloan Kettering Memorial Cancer Center’s Integrative Medicine website
NAC (N-acetylcysteine) has been much studied as a dietary supplement, and is more widely used in Europe than in the US, especially for conditions such as chronic bronchitis or as an antidote to acetaminophen poisoning. Its usefulness for people with HIV has been investigated (sometimes contentiously) by many reseachers in the past two decades. One way to bring the discussion up to date, while also giving the broadest overview of NAC’s applications and potential applications, is to refer to the entry found on the Sloan Kettering Memorial Cancer Center’s Integrative Medicine website–an online resource well worth consulting. (Note: references for this summary are found on the SKMCC website, which is reviewed frequently–this clinical summary, accessed 1/31/2008, was updated within the last two months.)
Clinical Summary
Endogenous antioxidant and precursor to intracellular glutathione. N-acetylcysteine (NAC) is used to prevent exacerbations of chronic bronchitis, treat drug-induced hepatotoxicity, and prevent and treat conditions of oxidative stress and reduced glutathione levels, such as HIV/AIDS, cancer, and toxicity from chemo- or radiotherapy. NAC increases plasma levels of cysteine and glutathione and has antioxidant, nucleophilic, mucolytic, and possibly chemopreventative properties. Animal models suggest anti-carcinogenic, antimetastatic, and antiangiogenic activities. Oral bioavailability is low. Studies in smokers and patients with history of adenomatous colonic polyps show an inhibition of cancer biomarker development, although NAC did not inhibit formation of secondary head and neck or lung tumors in a EUROSCAN trial. 400-1200 mg/day NAC reduces the number of acute exacerbations in patients with chronic bronchopulmonary disease, but little clinical effect on lung function is seen in patients with cystic fibrosis. NAC raises GSH and cysteine levels in HIV+ patients, but shows no effect in Lou Gehrig’s disease. Human studies evaluating the role of NAC in the prevention of chemo- or radiotherapy induced toxicities are inconclusive. Gastrointestinal side effects are most often reported.
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And here’s a study, limited in its goals, but with an interesting specific finding about using NAC at the start of antiretroviral treatment in HIV:
The effect of N-acetylcysteine supplementation upon viral load, CD4, CD8, total lymphocyte count and hematocrit in individuals undergoing antiretroviral treatment
Spada C, Treitinger A, Reis M, et al. Clin Chem Lab Med 2002;40:452-455.
Individuals infected with the human immunodeficiency virus (HIV-1) present with decreased CD4, a progressive increase in viral load, compromised cell immune defense, and hematologic alterations. The aim of this study was to assess the serum viral load, CD4, CD8, lymphocyte count and hematocrit at the beginning of antiretroviral therapy in individuals who were supplemented with N-acetylcysteine (NAC). Twenty volunteers participated in this double-blind, placebo-controlled 180-day study. Ten participants received 600 mg of NAC per day (NAC group) and the other ten serving as a control group received placebo. The above mentioned parameters were determined before treatment, and after 60, 120 and 180 days. In NAC-treated patients hematocrit remained stable and an increase in CD4 cell count took place earlier than that in the control group.
01.29.08
Fish oil lowers triglycerides in people with HIV, according to a 2007 study
Several antiretroviral drugs for people with HIV can cause elevated blood fats, which may increase the risk for cardiovascular disease. One of the therapies that has been tested for managing high cholesterol and triglycerides is fish oil, which has a long history of use to counter cardiovascular disease.
From the March 1, 2007 Journal of Acquired Immune Deficiency Syndromes: French researchers conducted a prospective, double-blind trial to assess the effect of N-3 polyunsaturated fatty acids — better known as omega-3 fatty acids — found in fish oil.The study included 122 HIV positive patients on HAART who still had elevated triglyceride levels (between 2 and 10 g/L) after a 4-week diet. Participants were randomly assigned to receive 2 capsules containing 1 g of fish oil (Maxepa) or else placebo capsules 3 times daily for 8 weeks, followed by an open-label phase during which all participants received fish oil. Ten individuals with baseline triglyceride levels above 10 g/L were not randomized and received open-label fish oil from the outset.
Results
• The median triglyceride level decreased by 25.5% in the fish oil group, while rising by 1% in the placebo group.
•At week 8, the mean triglyceride levels were 3.4 and 4.8 g/L, respectively.• Triglyceride levels normalized in 22.4% of subjects in the fish oil arm compared with 6.5% in the placebo arm (P = 0.013).
• 58.6% and 33.9%, respectively, experienced at least a 20% reduction in triglycerides (P = 0.007).
• Patients in the fish oil group experienced a slight decline in total cholesterol level, compared with a small increase in the placebo arm. • During the open-label phase, the decrease in triglycerides was sustained at week 16 for patients in the fish oil group, while those initially in the placebo group experienced a 21.2% decrease after switching to fish oil.
• The patients with baseline triglyceride levels above 10 g/L experienced a 43.6% decrease by week 8.
• No significant differences in adverse events were observed between the fish oil and placebo arms.
Conclusion “This study demonstrated the efficacy of [polyunsaturated fatty acids] to lower elevated triglyceride levels in treated HIV-infected hypertriglyceridemic patients. [N-3 polyunsaturated fatty acids] have a good safety profile.”“The place of polyunsaturated fatty acids in the armamentarium of treatment of metabolic disorders in HIV-infected patients needs to be further investigated with future prospective studies…”
CITATION: P De Truchis, M Kirstetter, A Perier, and others. Reduction in triglyceride level with N-3 polyunsaturated fatty acids in HIV-infected patients taking potent antiretroviral therapy: a randomized prospective study. JAIDS 44(3): 278-285. March 1, 2007.
EPA (fish oil): from the Physician’s Desk Reference Health site
Thought we’d draw attention to a great online resource for getting the basics on a supplement, and for checking on potential interactions among supplements, drugs, food, alcohol: Physicians’ Desk Reference (PDR) Health.
Below is an excerpt from the entry for EPA (fish oil), which includes the usual warning about interaction with blood-thinnning medications like Coumadin.
See also the entry on fish oil on the NYBC website.
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EPA
What is it?
EPA is an oil that comes from fish. It is used to treat asthma, cancer, arthritis, Lupus, blood clotting, gingivitis (gum disease), high cholesterol, hypertension (high blood pressure), colitis (inflammatory bowel disease), Crohn’s disease, and psoriasis. EPA is also used as an antiinflammatory (help with pain and swelling), to stimulate the immune system, and for cardiovascular health, to help prevent heart disease and stroke. It may also be used to prevent Alzheimer’s disease.
Other names for EPA include: Eicosapentaenoic Acid, Fish Oil, Omega-3 Fatty Acid, Essential Fatty Acid.
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Drug and Food Interactions:
Do not take omega-3 fish oils such as EPA without talking to your doctor first if you are taking:
Blood thinning medicines (examples: warfarin (Coumadin(R); dicumarol (Dicumarol(R))
01.25.08
Alpha Lipoic Acid – University of Maryland Medical Center Website Entry
This is a brief overview on alpha lipoic acid, a much-studied antioxidant that holds special interest to those with chronic liver disease and/or HIV. If you’re one of those people who like their information in capsule summary form (with further details and references attached), this may be just the ticket to get you started. The full entry can be found on the University of Maryland Medical Center’s website –another in a growing set of mainstream medical information resources that host serious information on “integrative medicine,” including dietary supplements.
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Overview
Alpha-lipoic acid is an antioxidant that is manufactured in the human body. Antioxidants are substances that work by attacking “free radicals,” waste products created when the body turns food into energy. There are also many sources of free radicals in the environment such as ultraviolet rays, radiation, and toxic chemicals in cigarette smoke, car exhaust, and pesticides. Free radicals cause harmful chemical reactions that can damage cells in the body, making it harder for the body to fight off infections. As a result a person becomes more susceptible to long term diseases such as diabetes and liver damage.
Uses
General
Alpha-lipoic acid works together with other antioxidants such as vitamins C and E. It is important for growth, helps to prevent cell damage, and helps the body rid itself of harmful substances.
Diabetes
Several studies suggest that treatment with ALA may help reduce pain, burning, itching, tingling, and numbness in people who have nerve damage (called peripheral neuropathy) caused by diabetes. Alpha-lipoic acid has been used for years for this purpose in Europe. Other studies have shown that alpha-lipoic acid speeds the removal of glucose (sugar) from the blood of people with diabetes and that this antioxidant may prevent kidney damage associated with diabetes in animals.
Liver Disease
Alpha-lipoic acid may prove useful in the treatment of chronic hepatitis because it relieves stress on the liver and helps rid the body of toxins. There have been several case reports of use of alpha-lipoic acid in combination with silymarin (milk thistle) and selenium (a substance with liver-protecting and antioxidant properties) to help treat hepatitis C (a serious type of hepatitis contracted from blood and bodily fluids that does not have an adequate cure or treatment).
It has also been used in conjunction with silymarin to treat Amanita poisoning. Amanita is a highly poisonous mushroom that causes liver damage.
Brain Function and Stroke
Because alpha-lipoic acid can pass easily into the brain, it has protective effects on brain and nerve tissue and shows promise as a treatment for stroke and other brain disorders involving free radical damage. Animals treated with alpha-lipoic acid, for example, suffered less brain damage and had a four times greater survival rate after a stroke than the animals who did not receive this supplement. While animal studies are encouraging, more research is needed to understand whether this benefit applies to people as well.
Other
Additional conditions for which alpha-lipoic acid may prove useful include heart failure, human immunodeficiency virus (HIV), cataracts, and glaucoma. More research is underway in these areas.
UCLA Division of Geriatrics/David Geffen Medical School on “Four Supplements Seniors Should Take”
We took a look at the recent issue of the Healthy Years newsletter (Volume 4G) from the UCLA David Geffen Medical School’s Division of Geriatrics, and were pleasantly surprised to find a good balance of advice ranging from exercise, diet, medication regimens when called for…and a number of on-target recommendations for promoting long-term health with the aid of dietary supplements.
The UCLA newsletter, which is directed especially to people 60 and older, offers several general supplement recommendations to promote healthy aging: a multivitamin/mineral supplement (because diet and digestive capability tend to change as you age); Vitamin D plus calcium for bone health; fish oil supplements to keep triglyceride levels down; glucosamine and chondroitin for moderate to severe arthritis knee pain; and CoQ 10 to help keep blood cholesterol down when taking a statin drug.
A couple of other recommendations emerge for specific conditions: non-smokers with early-stage macular degeneration may want to consider an NIH panel’s advice to supplement with zinc and the antioxidant vitamins C, E, and beta carotene. And niacin and/or a fibrate drug could be beneficial in raising HDL (the so-called “good cholesterol”) levels in a person taking a statin.
Thanks, UCLA Division of Geriatrics! It’s nice to see a general-audience publication from a mainstream medical source include balanced information about supplements, and not just fixate on prescription drugs as the only possible choice for every condition.
01.24.08
Vitamin D3 makes a guest appearance on Martha Stewart (with help from Dr Andrew Weill)
Hope we won’t be regarded as too frivolous if we admit that yesterday evening we turned to our TIVO and took in the day’s Martha Stewart Show, which featured nutrition and integrative medicine guru Dr Andrew Weill. What struck us most about Dr. Weill’s segment was his answer to a question from a female audience member on strategies for preventing osteoporosis. Dr. Weill’s answer: women should start supplementing with calcium and Vitamin D3 by the time they leave adolescence. The benefits to bone health of calcium plus D3, and–just as significantly–new findings on Vitamin D3’s role in reducing cancer rates, are now so well documented that this supplement regimen has become a “no-brainer” even for younger women.
It was nice to see a current view on D3 presented so clearly to a mass audience. (Although we have put some effort into finding and interpreting the latest news on this very interesting vitamin, we are quite aware that this Blog does not reach a public of millions!) But we also reflected, once more, that the new evidence about Vitamin D3 also ought to be of special interest to people with HIV. As highlighted in the media earlier this month, many people with HIV who are entering middle age are facing health issues such as osteoporosis and cancers that are more usually associated with later life. And while there has not been so much research specifically on HIV and D3, the science may already be compelling enough to make this supplement a priority in regimens. After all, we are talking about a very low-cost supplement with negligible risks of side effect. If the results of such supplementation are reduced osteoporosis and reduced cancer risk in people with HIV as they grow older, then it might just be time to take a cue from Martha Stewart and her guest Dr Weill…
01.23.08
FAQ on nutritional supplements
This post runs a little long, but we think it’s worthwhile to put up the FAQ about nutritional supplements recently posted by the New York Buyers’ Club. It answers a lot of (sometimes anxious) queries about supplements, and also gives a quick rundown on some of the top uses of supplements among the NYBC membership.
What are supplements?
A nutritional or dietary supplement (or just plain supplement), as defined by the Dietary Supplement Health and Education Act (DSHEA) of 1994, is “a product (other than tobacco) that is intended to supplement the diet and that contains one or more of the following: vitamins, minerals, herbs or other botanicals, amino acids, or any combination of the above ingredients,” and can be taken in tablet, capsule, powder, or liquid form.
NYBC specializes in supplements for those with HIV, hepatitis C, and other chronic conditions. Our Supplement Fact Sheets contain information on more than 100 supplements commonly used by our Members. Our nonprofit purchasing co-op stocks these supplements on a regular basis, and can also special-order many other supplements on request.
Why take supplements?
There is a great deal of research showing that supplements can help people manage serious chronic conditions such as HIV and hepatitis. Supplements can also be useful in addressing many common health issues, such as high cholesterol, diabetes, depression, arthritis pain, gastrointestinal disorders, etc. (see our short list of specifics below). Some supplements are derived from ancient traditions of use (for example, the botanicals of India’s Ayurvedic tradition), while other items (such as vitamins or amino acids) have been isolated and used as supplements much more recently. The scientific study of supplements has blossomed in recent decades, so we now have better evidence about many of them—even traditional botanicals—than we ever did in the past.
Are supplements considered “medicine”?
While supplements may have medicinal properties, they are not regulated in the same way that prescription drugs are, and are therefore accompanied by the disclaimer: “These statements have not been evaluated by the Food & Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”
The fact that supplements are not regulated in the same way that prescription drugs are naturally gives rise to concerns about purity, efficacy, and safety – so it’s good to have a knowledgeable ally like NYBC on your side! Collectively, we have many years of experience in using supplements, in researching information on them, and in evaluating suppliers to obtain the best quality product.
Are supplements “safe”?
Under current US regulations, supplements are assumed to be safe on the basis of their history of use, or because they are found in the food supply (like the microorganisms in yogurt or the vitamins and minerals in foods). The US Food and Drug Administration is responsible for removing supplements from the market if it finds evidence that they are unsafe, but it’s worth noting that this happens quite rarely. (The removal from the market of ephedra [aka the Chinese herb Ma huang], used at high dosage as a diet pill, is practically the only significant example since 1994). However, while supplements may be “assumed to be safe,” everyone who takes them needs to pay attention to the recommended dosage and any cautions or warnings. If you exceed the recommended dosage of certain supplements, there may be side effects, sometimes serious. Furthermore, a supplement may have negative interactions with other medications you are taking, or a particular supplement may not be a wise choice for you due to other health concerns. That’s why it’s always important to discuss your supplement use with your doctor.
Here are just a few examples of potentially dangerous supplement-medication interactions (from the National Center for Complementary and Alternative Medicine’s website) – further proof that consulting your physician about supplement use is crucial:
• St. John’s Wort can increase the effects of prescription drugs used to treat depression. It also dangerously interferes with drugs used for HIV, cancer, birth control, and rejection of organ transplants
• Ginseng can increase the stimulant effects of caffeine (as in coffee, tea, and cola). It can also lower blood sugar levels, creating the possibility of problems when used with diabetes drugs
• Ginkgo, taken with anticoagulant or antiplatelet drugs, may increase the risk of bleeding. Ginkgo may also interact with certain psychiatric drugs and with certain drugs that affect blood sugar levels
Of course, doing your own “homework” is also encouraged. Be sure to bring any notes or printouts from your research to share with your healthcare provider. That way, you’ll both be literally on the same page.
Identity, Purity and Potency
Safety is also a matter of product quality. Is the product what it claims to be on the label (that is, is it really fish oil)? This is the product Identity. Does the product contain any unwanted contaminants like heavy metals, insect parts, rodent droppings? All foods and medicinal products face these issues of Purity. And finally, does it have as much of the claimed amount of a substance? For example, if it says 100 mg of niacin, does it have that amount? This is the product’s Potency. These issues are of ongoing concern. NYBC has done everything possible to assure that products meet these standards. Websites such as www.consumerlab.com can help. Also indications of quality such as USP or other labels further add assurance. The good news is that the vast majority of products tested by consumerlab, for example, pass their tests. Still, NYBC believes an appropriately funded agency of the FDA could do more rigorous, routine and comprehensive testing.
What is CAM?
CAM is an acronym for complementary and alternative medicine. The use of supplements is considered CAM. Some prefer the term integrative medicine.
The National Center for Complementary and Alternative Medicine (NCCAM), a division of the US National Institutes of Health, defines CAM as “a group of diverse medical and health care systems, practices and products that are not presently considered to be part of conventional medicine.” NCCAM, like the US Office of Dietary Supplements, came into being after passage of DSHEA, and marks the federal government’s decision to commit funding to research and education about CAM. Over a billion dollars in your tax dollars have been spent by these agencies since their start.
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Using Supplements
What supplements can I use to improve my immune system?
Agents such as a potent multivitamin, NAC (N-acetyl cysteine), alpha lipoic acid and whey can all help offset oxidative stress and nutrient losses caused by HIV as well as the free radical generation and inflammation-related damage that some antiretroviral drugs cause.
For those with HIV, supplementation can be a valuable assist in restoring the body’s immune system, as evidenced by many studies, such as Dr. Jon Kaiser’s HIV Micronutrient Study, which showed a significant increase (26%) in the CD4 counts of the subjects who maintained a supplement regimen in addition to their regular medications. FYI: NYBC offers a “MAC Pack” (Micronutrient – Antioxidant Combination Pack), a product very similar to the one used in the study.
What supplements can be used to improve gut function?
Acidophilus or bifidus, glutamine, whey proteins, Saccharomyces boulardii (Florastor) and a good multi can all be important to offset gastrointestinal problems, whether HIV-related or of other origin.
What supplements can I use to manage my blood fats (cholesterol and triglyceride levels)?
“Bad cholesterol” (LDL) and triglycerides can be reduced with agents such as carnitine, pantethine, and fish oils. Niacin may be an excellent option which can also help increase HDL (“good cholesterol”). For heart health in general, aside from diet and exercise, CoEnzyme Q10 may also be of help (may also be useful in countering statin-related side effects).
What supplements are used to improve mental function and/or mood?
Acetylcarnitine, 5-HTP, tyrosine, ginkgo biloba, fish oils, SAM-e, DHEA, theanine, or St. John’s Wort may help mental function and alleviate depression, though each of these must be taken with some care (and not all together!)
See also: a full dossier on Memory Loss and Other Brain Problems from our Health+HIV section of Recommended Reading on the website www.newyorkbuyersclub.org; also recommended is the NYBC info sheet on Depression and supplements on this blog, under “Depression.”
What supplements can I use to combat fatigue?
Various conditions can cause fatigue, but in general, B12 (methylcobalamin) and Eleuthero (used to be “Siberian ginseng” – don’t use with high blood pressure!) may all help to improve energy. A good start may also be as simple as a good multivitamin!
For more information about the causes and treatments for fatigue, see our Fatigue Fact Sheet on the NYBC website.
What supplements can I use to stabilize my weight?
For those experiencing weight loss, whey proteins, carnitine and creatine plus CLA may all help – but of course especially in conjunction with a good diet and routine exercise! And we agree with Dr. Jon Kaiser and many others: resistance exercise remains an important component of a successful HIV management plan.
What supplements are used to treat nausea?
NYBC recommends ginger; marijuana, while effective, is not carried by the NYBC, as it is not yet approved for medical use in New York. For detailed information about the causes and treatments for nausea, see Health+HIV section of Recommended Reading on the NYBC website.
What supplements are used to improve liver function?
Liver function can be impaired due to several reasons, including disease, alcohol abuse, and the effects of some cholesterol-lowering drugs (statins).
While making sure there aren’t any interactions with your meds, supplements like milk thistle (Silymarin), NAC, alpha lipoic acid, Hepato-C or Hepato-Detox, Hepatoplex I or II, Ecliptex, SAM-e and Clear Heat are options to consider (again, not all at once!)
What supplements can be used to treat diarrhea?
NYBC suggests supplementing your diet with glutamine and calcium. For more information about the causes and other possible treatments, see our Fact Sheet about diarrhea in Recommended Reading, at www.newyorkbuyersclub.org.
What supplements can combat neuropathy?
Much scientific evidence now points to acetylcarnitine as an effective approach to countering neuropathy (numbness, tingling, or pain, usually in the extremities, which can be caused by HIV, diabetes or by some medications).
01.22.08
Arthritis Supplements reviewed in the journal “American Family Physician”
Our local paper, The New York Times, has just brought us a piece on “Making Sense of Arthritis Supplements” in its Jan. 21, 2008 issue. It’s motivated by a recent medical journal review, and has already attracted a long string of reader comments.
No surprise, given that arthritis is the leading condition for which Americans use alternative therapies, including dietary supplements. At this point there has been a lot of scientific research on supplements for osteoarthritis; the review in the journal “American Family Physician,” which is the starting point for the NYT piece, attempts to help people sort through the studies and come to some conclusions about what the best bets are.
Some of our own thoughts on the topic:
Glucosamine sulfate is the acknowledged front-runner, both for symptom relief and on account of evidence that it may have disease-modifying effects. Especially when side effects of ibuprofen or prescription medications cause concern, there’s reason to think about glucosamine sulfate as an alternative.
In 2005, results were made available for the NIH-sponsored “Glucosamine-Chondroitin Arthritis Intervention Trial” (GAIT), which looked at almost 1600 US patients with moderate-to-severe knee osteoarthritis pain. In the glucosamine-chondroitin combination group, 79.2% had pain relief, as opposed to 69.4% in the celecoxib (tradename you might know: Celebrex) group. The competition to interpret this trial to favor supplements or prescription drugs still rages pretty fiercely–see the comment from Dr Jason Theodosakis following the NYT review. (He was on oversight committee of the GAIT study, and is a well-known proponent of glucosamine.)
There is another supplement, more expensive than glucosamine, that has been extensively researched for osteoarthritis: SAM-e (S-Adenosyl-methionine). Below we simply reproduce the abstract of a frequently-cited review of this supplement, with Conclusion highlighted. (BTW, the caution raised in the NYT review about the stability of this product on the shelf is a point well taken.)
Safety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritis
Soeken KL, Lee WL, Bausell RB, Agelli M, Berman BM.
University of Maryland, School of Nursing, Baltimore, MD.
OBJECTIVE: We assessed the efficacy of S-adenosylmethionine (SAMe), a dietary supplement now available in the Unites States, compared with that of placebo or nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of osteoarthritis (OA). STUDY DESIGN: This was a meta-analysis of randomized controlled trials. DATA SOURCES: We identified randomized controlled trials of SAMe versus placebo or NSAIDS for the treatment of OA through computerized database searches and reference lists. OUTCOMES MEASURED: The outcomes considered were pain, functional limitation, and adverse effects. RESULTS: Eleven studies that met the inclusion criteria were weighted on the basis of precision and were combined for each outcome variable. When compared with placebo, SAMe is more effective in reducing functional limitation in patients with OA (effect size [ES] =.31; 95% confidence interval [CI],.099-.520), but not in reducing pain (ES =.22; 95% CI, -.247 to.693). This result, however, is based on only 2 studies. SAMe seems to be comparable with NSAIDs (pain: ES =.12; 95% CI, -.029 to.273; functional limitation: ES =.025; 95% CI, -.127 to.176). However, those treated with SAMe were less likely to report adverse effects than those receiving NSAIDs. CONCLUSIONS: SAMe appears to be as effective as NSAIDs in reducing pain and improving functional limitation in patients with OA without the adverse effects often associated with NSAID therapies.
Citation: J Fam Pract. 2002 May;51(5):425-30.
01.18.08
Boston Buyers’ Club members welcomed by NYBC
The New York Buyers’ Club would like to extend a welcome to former members of the Boston Buyers’ Club, a nutritional supplements co-op that recently closed after twelve years of service to the community.
BBC members are invited to make use of the New York Buyers’ Club purchasing co-op and information services by going to
or by calling NYBC toll-free at 800 650-4983 and requesting our information packet for former BBC members.
If you have questions, feel free to email us at contact@newyorkbuyersclub.org
Or you can even reach us by snail mail at:
NYBC
75 Varick Street, Ste. 1404
New York, NY 10013
A role for Vitamin D supplementation in dealing with HIV?
The question in our title stems from this 2006 article by E. Villamor, a researcher in the Department of Nutrition, Harvard School of Public Health. (Our highlighting in the abstract.)
This preliminary review suggests that low levels of Vitamin D are associated with increased mortality in people with HIV, while higher levels of Vitamin D are associated with higher CD4 counts.
Needless to say, we agree with the highlighted calls for further research on this topic.
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A potential role for vitamin D on HIV infection?
E. Villamor, Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
Despite advances in the knowledge of vitamin D’s potent immunomodulatory activity, its role on HIV disease progression is unknown. Decreased concentrations of 1alpha,25-hydroxyvitamin D3, or 1,25(OH)2D, the active form of vitamin D, have been reported among HIV-infected people and attributed to defects in renal hydroxylation and increased utilization. A few studies also described low levels of 25-hydroxyvitamin D3, 25(OH)D, the vitamin obtained from solar synthesis and diet. An inverse association between 1,25(OH)2D concentrations and mortality has been reported from a small cohort of HIV-infected adults, and some cross-sectional studies have indicated positive correlations between 1,25(OH)2D and CD4+ cell counts.
Additional observational studies are needed to confirm the associations between vitamin D status and HIV disease progression. These investigations would provide useful insights on the potential role of vitamin D supplementation to HIV-infected persons and the planning of intervention trials.
Citation: Villamor E. A potential role for vitamin D on HIV infection? Nutr Rev. 2006 May;64(5 Pt 1):226-33
01.17.08
Vitamin D: University of California, Berkeley Wellness Letter asks if you are getting enough, and if testing of Vitamin D levels in the blood should be routine
We were impressed by the lead article on Vitamin D in the February 2008 issue of the University of California, Berkeley’s Wellness Letter (a “newsletter of nutrition, fitness, and self-care”). The Wellness Letter is usually quite conservative about recommending nutritional supplements, but in this case it finds the recent wave of research on Vitamin D promising enough to recommend that people “consider taking 800 to 1000 IU of supplemental D a day.” As the newsletter reports, studies have now gone much beyond the well-known benefit of this vitamin in working with calcium to keep bones strong; recent research has ranged over a much broader field, focusing on Vitamin D’s “potential to reduce risk of everything from some common cancers and multiple sclerosis to diabetes, hypertension, and age-related muscle weakness.”
Although not going so far as to suggest testing blood levels of D for the general population, the Wellness Letter does recommend talking to your doctor about testing, “especially if you are over 60 [...] or have low bone density.”
A further recommendation: “When shopping for a supplement, read the fine print: look for D3 (also called cholecalciferol), which is more potent than D2 (ergocalciferol).”
For other commentary on recent Vitamin D research, see the “Vitamin D” category on this blog.
And you can also read the Vitamin D3 entry on the New York Buyers’ Club website.
