January 19, 2011
Supplements for anxiety
A while back, we posted a review of holistic M.D. Hyla Cass’ recommendations for avoiding the dependence-inducing benzodiazepines for anxiety. Her prescription was to use supplements instead, and she had some specific recommendations:
In her 2007 book, Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition, Dr. Hyla Cass has an interesting section (pp. 139-140) dealing with supplement alternatives to benzodiazepines and other drugs such as Ambien. (These drugs are generally prescribed as anti-anxiety agents and as sleep aids.)
Of benzodiazepines (the best-known tradenames in this category are Valium, Xanax, Ativan, Klonopin, Librium, Halcion), Dr. Cass writes that a principal problem is that these drugs develop dependence, and so can require steadily increasing dosages as time goes on. (Ideally, she says, they are intended as short-term therapies, but in fact many patients end up being prescribed them for a much longer time.) Withdrawal from these drugs can be quite hazardous, and should be done only under medical surpervision. Moreover, the effect of this class of medications is often a dulling of response, so their use can be associated with accidents.
[...]
She states that in her own practice she has often successfully substituted supplements for these prescription drugs. Among the calming supplements that she has used:5-HTP: 100-200mg at bedtime
Melatonin: 0.5-3.0mg at bedtime
L-theanine: 200mg, one to three times daily, as neededIn Dr. Cass’s view, supplements such as these, sometimes used in combinations, can provide a good alternative to the addictive benzodiazepines and their side effects.
—–
See the following NYBC entries for additional information on the supplements mentioned above:
Melatonin 1mg and Melatonin 3mg
Theanine Serene (includes L-theanine)
NYBC also stocks 5-HTP and the closely related Tryptophan.
If you do decide to take one of the prescription benzodiazepines, Dr. Cass further notes, it is advisable to supplement to offset the key nutrients that these drugs tend to deplete in the body. We note that the Jarrow supplement Bone Up very closely matches the set of depleted supplements listed by Dr. Cass (Calcium, Magnesium, Folic acid, Vitamin D, Vitamin K).
One last note: rather small doses of melatonin may do the trick in terms of helping you to sleep. A 1mg dose may be all that’s necessary.
January 11, 2011
Drugs versus supplements as sleep aids
One of the reasons people turn to supplements is that drugs often have side-effects which make their use, especially over the long term, more damaging than helpful. That may be the case with long-term use of some common over-the-counter drugs to aid sleep.
A 2010 study published in the journal Neurology, for example, looked at drugs called anticholinergics, which block acetylcholine, a nervous system neurotransmitter. They include such common over-the-counter brands as Benadryl, Dramamine, Excedrin PM, Nytol, Sominex, Tylenol PM, and Unisom. They are taken for a variety of common medical conditions including insomnia or allergies. Unfortunately, according to this Indiana University study, over the long term these drugs also produce cognitive impairment. According to the study authors, taking “one anticholinergic significantly increased an individual’s risk of developing mild cognitive impairment and taking two of these drugs doubled this risk.”
Given these risks, it makes sense to consider such alternatives as Melatonin or 5-HTP. While these supplements, like many others, should be taken carefully and according to recommendations, we don’t know of any research suggesting that they produce cognitive impairment over the long run!
December 15, 2010
GABA Hey! Blood Pressure and Sleep
NYBC carries Pressure Optimizer and GABA Soothe to help manage a range of issues. Among them, the data below suggest a benefit for managing borderline hypertension (high blood pressure). A related item in the NYBC catalog, Theanine Serene, also has a fair amount of GABA along with green tea-extract theanine; this combination was designed especially as an anti-anxiety or anti-stress formula.
The second study below looked at a combo of GABA and 5-HTP and found some benefits for helping to get a restful sleep.
Abstract
The anti-hypertensive effect of GABA-rich Chlorella was studied after oral administration for 12 weeks in the subjects with high-normal blood pressure and borderline hypertension in the placebo-controlled, double-blind manner in order to investigate if GABA-rich Chlorella, a dietary supplement, is useful in control of blood pressure. Eighty subjects with Systolic blood pressure (SBP) 130-159 mmHg or diastolic blood pressure (DBP) 85-99 mmHg (40 subjects/group) took the blinded substance of GABA-rich Chlorella (20 mg as gamma-aminobutyric acid) or placebo twice daily for 12 weeks, and had follow-up observation for an additional 4 weeks. Systolic blood pressure in the subjects given GABA-rich Chlorella significantly decreased compared with placebo (p < 0.01). Diastolic blood pressure had the tendency to decrease after intake of GABA-rich Chlorella. Neither adverse events nor abnormal laboratory findings were reported throughout the study period. Reduction of SBP in the subjects with borderline hypertension was higher than those in the subjects with high-normal blood pressure. These results suggest that GABA-rich Chlorella significantly decreased high-normal blood pressure and borderline hypertension, and is a beneficial dietary supplement for prevention of the development of hypertension.
PMID: 19811362 [PubMed - indexed for MEDLINE]
Abstract
This study was an outpatient, randomized, double-blind, placebo-controlled trial of a combination amino acid formula (Gabadone) in patients with sleep disorders. Eighteen patients with sleep disorders were randomized to either placebo or active treatment group. Sleep latency and duration of sleep were measured by daily questionnaires. Sleep quality was measured using a visual analog scale. Autonomic nervous system function was measured by heart rate variability analysis using 24-hour electrocardiographic recordings. In the active group, the baseline time to fall asleep was 32.3 minutes, which was reduced to 19.1 after Gabadone administration (P = 0.01, n = 9). In the placebo group, the baseline latency time was 34.8 minutes compared with 33.1 minutes after placebo (P = nonsignificant, n = 9). The difference was statistically significant (P = 0.02). In the active group, the baseline duration of sleep was 5.0 hours (mean), whereas after Gabadone, the duration of sleep increased to 6.83 (P = 0.01, n = 9). In the placebo group, the baseline sleep duration was 7.17 +/- 7.6 compared with 7.11 +/- 3.67 after placebo (P = nonsignificant, n = 9). The difference between the active and placebo groups was significant (P = 0.01). Ease of falling asleep, awakenings, and am grogginess improved. Objective measurement of parasympathetic function as measured by 24-hour heart rate variability improved in the active group compared with placebo. An amino acid preparation containing both GABA and 5-hydroxytryptophan reduced time to fall asleep, decreased sleep latency, increased the duration of sleep, and improved quality of sleep.
PMID: 19417589 [PubMed - indexed for MEDLINE]
September 4, 2010
Chinese herbal combination as sleep aid: HerbSom
NYBC is now stocking HerbSom Capsules (Zhang) a proprietary extract of corydalis root, jujube seeds and schisandra fruit.
Corydalis, known also as jin bu huan, grows in China and has some evidence suggesting it can help people suffering from insomnia to fall asleep.
Jujube seeds, from Zizyphus jujube, has a long use in Chinese medicine for managing insomnia associated with weakness (as defined in that tradition). Subhuti Dharmanand notes “Zizyphus Combination treats weakness fatigue, and distress due to weakness, which causes insomnia.” Zizyphus is the main ingredient of the formula both in terms of the quantity used and its central action for the treatment of deficiency and insomnia, which are the formula’s main indications.
For more information on these herbal components, as well as recommended dosage, see the NYBC entry at
January 13, 2009
Supplement recommendations in “The Ultramind Solution” by Dr. Mark Hyman
NOTE: NOW SEE NYBC’S LOW-COST ALTERNATIVE TO THE ULTRAMIND SOLUTION MULTIVITAMIN PACK–
http://nybc.wordpress.com/2011/04/02/nybcs-brainpower-multi-pak-low-cost-ultramind-solution/
One-third less than the over-priced “Ultramind Solution” supplements!
—
The UltraMind Solution: Fix Your Broken Brain by Healing Your Body First
Mark Hyman, M.D.
This is one of many books published in recent years that seek to translate the enormous body of research findings from the last few decades about nutrition and brain function into simple, useful guidelines for improving and maintaining good mental functioning and psychological well-being. While it’s a popularizing text (Dr. Hyman has even been on Martha Stewart–see link below!), this book does, we feel, accurately register many important trends in our knowledge of nutrition and nutritional supplements and how these factors relate to mental health.
Here’s the statistic that sets off Dr. Hyman’s project: one in three Americans suffer from some kind of “brain dysfunction” (one term in use: “brain fog”), including symptoms such as depression, anxiety, memory loss, attention deficit disorder, autism, and dementia.
“The Ultramind Solution” contends that revising your diet–changing your nutritional intake–can often make a huge difference in these symptoms. Dr. Hyman’s recommendations focus both on weeding out elements that adversely affect the system (too much sugar, poorly chosen carbs, alcohol, cigarettes), and sticking to a menu of what’s good, especially what’s good for brain function: 1) omega fatty acids (found in salmon, sardines, flaxseed); 2) amino acid sources (nuts, lean meats); 3) high-quality carbs (for example, beans, peas, and lentils); 4) phyto-nutrients (plant foods containing antioxidants and other helpful substances, like blueberries, cilantro, etc.).
Finally, Dr. Hyman observes that, since more than 90% of Americans don’t get adequate nutrients from food (a finding of an often-cited US government survey), people realistically will need to supplement at least periodically in several key categories: 1) a multivitamin; 2) fish oil (omega fatty acids); 3) Calcium/Magnesium; 3) Vitamin D; 4) B complex vitamins; 5) probiotics (for good digestion/absorption of nutrients); and 6) occasionally a sleep aid like melatonin to insure a good amount of rest.
Here are some NYBC suggestions for supplementing in the categories recommended by Dr. Hyman:
Multivitamins: Added protection with Iron (Douglas) ; Added Protection without Iron (Douglas) – recommended for those with liver conditions; Opti-Pack – iron-free (SuperNutrition); Super Immune Multivitamin – iron-free (SuperNutrition)
Fish oil: Max DHA (Jarrow); ProOmega (Nordic Naturals) 60 caps; ProOmega (Nordic Naturals) 180 caps;
For Calcium, Magnesium, Vitamin D, NYBC recommends Bone-Up (Jarrow), which provides all three nutrients in the most useful dosages.
B complex vitamins: B-right (Jarrow)
Probiotics: NYBC recommends Jarrodophilus EPS (Jarrow) because it doesn’t require refrigeration. But other probiotics may be useful as well–see the Probiotics entry on the NYBC website.
NYBC also stocks Melatonin in several formats.
See Dr. Hyman on Martha Stewart:
http://www.marthastewart.com/portal/site/mslo/menuitem.3a0656639de62ad593598e10d373a0a0/?vgnextoid=0f545e9ea969e110VgnVCM1000003d370a0aRCRD&vgnextfmt=default
April 10, 2008
Melatonin, best known as sleep aid, now studied as adjunct in some breast cancer treatment regimens
The University of Maryland Medical Center’s Complementary Medicine website provides an assessment of some recent studies on melatonin as an adjunct treatment for breast cancer. Of course melatonin is best known and has been most researched for its effects on sleep and its potential to address sleep disorders. Most of these investigations have focused on people whose circadian rhythms are disrupted by factors such as jet lag or work schedules, but there have also been studies looking at melatonin as a sleep aid for the elderly or for those with HIV (see other “Melatonin” entries on this Blog).
This excerpt from the UMMC article on Melatonin indicates, however, that this supplement may be eliciting additional interest as an auxiliary to certain cancer treatment regimens. We have highlighted the last sentence in this passage, which repeats one of the crucial guides in using supplements: be sure to consult your health care professional.
“Several studies indicate that melatonin levels may be linked with breast cancer risk. For example, women with breast cancer tend to have lower levels of melatonin than those without the disease. In addition, laboratory experiments have found that low levels of melatonin stimulate the growth of certain types of breast cancer cells, while adding melatonin to these cells inhibits their growth. Preliminary laboratory and clinical evidence also suggests that melatonin may enhance the effects of some chemotherapy drugs used to treat breast cancer. In a study that included a small number of women with breast cancer, melatonin (administered 7 days before beginning chemotherapy) prevented the lowering of platelets in the blood. This is a common complication of chemotherapy, known as thrombocytopenia that can lead to bleeding.
In another study of a small group of women whose breast cancer was not improving with tamoxifen (a commonly used chemotherapy medication), adding melatonin caused tumors to modestly shrink in over 28% of the women. People with breast cancer who are considering taking melatonin supplements should consult their doctors before beginning supplementation.“
March 17, 2008
Tryptophan as a sleep aid, antidepressant, and for chronic pain relief
Clinical research has tended to confirm tryptophan’s effectiveness both as a sleep aid and for other conditions typically associated with low levels of the neurotransmitter serotonin. It has shown value as an antidepressant, and as an “enhancer” or “augmenter” of antidepressant drugs. Other promising indications include relief of chronic pain.
For dosing recommendations, see NYBC product entry for Tryptophan
As a sleep aid, Melatonin also has good evidence to support its use. Note that 5-HTP, which is closely related to Tryptophan, has also been studied as an antidepressant.
Citation: Shaw K, Turner J, Del Mar C (2002). “Tryptophan and 5-hydroxytryptophan for depression”. Cochrane database of systematic reviews (Online) (1): CD003198.
Tryptophan for chronic pain: Seltzer S, Dewart D, Pollack RL, Jackson E. The effects of dietary tryptophan on chronic maxillofacial pain and experimental pain tolerance. J Psychiatr Res 1982-83;17(2):185-6.
November 7, 2007
Fatigue, sleep disturbances, low energy, depression: dietary supplements may help address special health concerns for people with HIV
As we were mulling over the recent New York Times piece on the billions of dollars Americans spend each year on sleep aids that are only mildly effective (see today’s other post under “Melatonin”), we thought we’d reprint this article from the NYBC newsletter THE SUPPLEMENT, which appeared earlier this year. It deals with the constellation of health concerns, from fatigue to depression, that often affect people with HIV, and gives an overview of some of the dietary supplements that have been used to address these issues.
——–
Sleeping poorly? Energy low? Feeling down?
Dietary supplements may have something to offer
Sleep disturbances are the third most common complaint among people with HIV seeking medical attention. Everybody knows what it’s like to sleep poorly, then feel cranky and fatigued the next day. But persistent insomnia, followed by chronic fatigue, can become major medical issues for people with HIV (we’re talking about lower CD4 counts and poor medication adherence), so it’s worth reviewing options for dealing with these problems.
A 2005 research presentation suggested that melatonin supplements can improve sleep patterns in people with HIV. Melatonin, a hormone secreted by the pineal gland, has long been studied as a sleep regulator—levels increase in response to darkness, then fall during daytime. It’s also been investigated as an anti-cancer agent, where it has shown the capacity to combat solid tumors. (But melatonin should not be taken by people with cancers affecting immune cells, such as lymphoma or leukemia.)
Good news: a recent trial indicates that low-dose melatonin (0.5 to 1.0 mg) may be perfectly effective as a sleep promoter, making it a very inexpensive option for this purpose.
Fatigue can stem from other causes besides sleep disturbances. Anemia, a shortage of red blood cells, is another leading cause of fatigue among people with HIV, and is especially common among women. (A recent large study found that about 30% of people on HAART had moderate anemia. Women had an 80% greater risk of being anemic than men, and African-Americans had a risk of anemia 2.6 times higher than whites.) It’s important to learn the source of anemia in people with HIV (taking Retrovir, AZT, is a drug-related factor). Treatment options include increasing intake of iron, vitamin B12 and folic acid. Note that NYBC stocks multivitamins with iron for those concerned about their intake of this mineral. You’ll also find folic acid and B12 in our multis, and may want to consider adding a separate vitamin B supplement as well.
While for some people with HIV treating anemia can be a key to helping them overcome fatigue and its frequent companion depression, there are other cases where low energy is not connected to low red blood cell levels, and where the treatment options are therefore different. Particularly in HIV+ men, steroid hormones (testosterone and DHEA) have proven to be useful in combating the fatigue-depression combination. Recent federally-funded research on DHEA showed it to be an effective anti-depressant, with the added interesting feature that it can enhance sex drive (rather than undermining it, as do certain common prescription anti-depressants). And a Columbia University study of DHEA for fatigue and depression in people with HIV has found it to be a successful treatment for some, with the added bonus that, unlike some prescription energy boosters, it doesn’t carry the risk of addiction.
Sleep drugs wildly popular, and expensive, but not terribly effective–what about melatonin as an alternative?
We were amused to see the recent New York Times article about how many billions of dollars Americans spend on popular sleep drugs like Ambien, yet how little effect these medications actually seem to have:
Sleep Drugs Found Only Mildly Effective, but Wildly Popular NYT Oct. 23, 2007
Meanwhile, there have been a number of studies over the years pointing to the dietary supplement melatonin as a useful sleep aid, providing comparable effects to the prescription meds.
For example:
Psychopharmacology (Berl). 1996 Jul;126(2):179-81.
Low dose melatonin improves sleep in healthy middle-aged subjects.
University Department of Psychiatry, Littlemore Hospital, Oxford, UK.
We studied the effects of single evening doses of melatonin (0.3 mg and 1.0 mg orally) on polysomnographically measured sleep in 15 healthy middle-aged volunteers, using a placebo-controlled, double-blind, cross-over design. Compared to placebo, the 1.0 mg dose of melatonin significantly increased Actual Sleep Time, Sleep Efficiency, non-REM Sleep and REM Sleep Latency. These data are consistent with the hypothesis that low dose melatonin has hypnotic effects in humans. It is possible that administered melatonin may have a role to play in the treatment of sleep disorders.
There are also current studies funded by NIH on melatonin for sleep disturbances in the elderly, and in people with Alzheimer’s.
But getting back to the New York Times piece: while the article reported prices of prescription sleep aids in the $2-4 range per dose, the typical melatonin dose can cost just a few cents. See, for example, the Douglas Labs Melatonin stocked by NYBC.
