Media Distortions, as usual…

The news says: Elderly ladies, stop the Ca+D. The title here, for example:
USPSTF Says No to Vitamin D, Calcium for Older Women

The panel said something a bit different–don’t waste your time if the DOSE IS TOO LOW. Will have to get the original article. But it seems to be a tiresome misrepresentation of the data. At least, for those who read the article, they do note first —

“400 IU of vitamin D3 combined with 1,000 mg of calcium carbonate has no effect” BUT then —

“daily intake of 600 IU for vitamin D and 1,200 mg of calcium for women ages 51 to 70 had a clearer net benefit in fracture prevention.

Last month, the USPSTF finding that vitamin D supplements reduce the risk of falls in community-dwelling older people who may be prone to falling.”

Acquiring enough calcium from a healthy diet, getting enough sun and resistance exercise are all the BASIC elements of sustaining good bone health. Supplements have their place for many people. But the media distortions do not help people to make the best decision, especially when they outright distort the recommendation. And indeed many, many people are very low in Vitamin D–as we have discussed frequently here!


NYBC’s BrainPower Multi-Pak – low-cost “Ultramind Solution”

NYBC’s Low-Cost Alternative to the Pricey “Ultramind Solution”

The UltraMind Solution by Dr. Mark Hyman is one of many recent books that attempt to translate the piles of research from the last few decades about nutrition and brain function into useful guidelines for improving and maintaining good mental functioning and psychological well-being.

The Ultramind Solution contends that changing your diet–your “nutritional intake”–can often make a huge difference with conditions like depression, memory impairment, or “brain fog.” Dr. Hyman’s recommendations focus both on weeding out elements that harm 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 from an often-cited US government survey), many people realistically will need to supplement 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 absorption of nutrients).

And yes, you can even go to the ”Ultramind” online store, where you can purchase a kit containing these supplements. The problem is that, at $121.50 for a month’s supply, this package is way overpriced. But never fear—NYBC, as a nonprofit supplements co-op, can offer an alternative that’s a close equivalent (or slightly better), but at only $90 for a month’s supply ($80 if you sign up for a $5 minimum annual membership in the co-op).

Here’s NYBC’s BrainPower Multi-Pak:

    Multivitamin: Added Protection without Iron (Douglas)
    Fish oil: Max DHA (Jarrow)
    Calcium/magnesium/Vitamin D: Ultra Bone Up (Jarrow)
    B: Methyl B-12 (other B vitamins included in the multi)
    Probiotic: Ultra Jarrodophilus

By the way, you can purchase any of these items individually at NYBC if you like. Again–at lower prices than in the “Ultramind” store.

Supplements as alternatives to benzodiazepines

Here’s an update on this topic:

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.)

Dr. Cass is a practicing physician and an expert on integrative (“holistic”) health, and one of her main concerns is to present ways to counter prescription medication side effects, or to identify supplement alternatives to prescription drugs.

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.

Since benzodiazepines deplete needed nutrients, Dr. Cass advises supplementing as follows if you take them:

1000-1200mg Calcium/day, plus 400-600mg/Magnesium
400-800mg Folic acid/day
1000 IU Vitamin D/day
30-100mcg Vitamin K/day

She also 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 needed

In 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 (which, she says, are also characteristic of the newer drug Ambien).


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.

Also note that the Jarrow supplement Bone Up very closely matches the set of supplements recommended by Dr. Cass to offset the nutrients depleted by taking benzodiazepines (Calcium, Magnesium, Folic acid, Vitamin D, Vitamin K).

Raltegrivir (Isentress) and Antacids/Minerals

A recent discussion on the excellent PozHealth listserve has alerted us to a potential problem with the relatively new HIV medication, raltegravir (brand name, Isentress). This drug inhibits an enzyme used by HIV called integrase.

As with many medications, it needs to be absorbed properly by the body after being taken. Some drugs can interact with this, blunting its benefit in lowering viral load to undetectable. In particular, antacids (that often come in the form of calcium carbonate) appear to reduce the drug’s efficacy when they are taken at the same time.

One contributor to the list noted that he now takes the drugs separately from any antacids as WELL as his K-PAX. This is prudent. We strongly urge you to separate any multi or other minerals that may inhibit the benefit of this medication by taking them about 4 hours apart.

This is also based on some research, as discussed on the HIV Insite website. They note: “:

”It appears that polyvalent cations (such as magnesium, calcium, and iron) 
bind integrase inhibitors and interfere with their activity against 
integrase. A pharmacokinetic study showed that administration of antacids 
containing divalent cations at the same time as elvitegravir (an 
investigational integrase inhibitor) lowered serum elvitegravir 
concentration by more than 40%. This effect was minimal if antacids were 
taken 4 hours apart from the integrase inhibitor.(5) The interaction of 
raltegravir and antacids has not been studied; pending further 
investigation, antacid medications and other agents with polyvalent cations 
should be used cautiously with (and taken separately from) raltegravir.”

(If you would like to join the POZHealth group, send a blank email to and you will get an email with instructions to follow. It is a terrific group!)

Bone Up & BioSil

NYBC stocks Jarrow Formulas’ Bone Up, which is a comprehensive formula to support bone health. Its essential components are calcium in a form readily usable for bone building in the body, Vitamin D and Vitamin K. By the way, here’s the Health Claim regarding bone health which the FDA allows for Calcium and Vitamin D:

Adequate calcium and vitamin D as part of a healthful diet, along with physical activity, may reduce the risk of osteoporosis later in life.

Jarrow also recommends using Bone Up together with its product BioSil, a bioavailable silicon solution that is helpful in maintaining nails, bones, joints, hair and skin. (Silicon is important for tissue strength and elasticity.)

See the NYBC entries for more information on Bone Up:

and BioSil:

Higher Vitamin D Recommendations

You may have heard reports about a scientific advisory panel that recently called for increasing the recommended dietary allowance (RDA) of Vitamin D and calcium. The same panel also revised upward the “tolerable upper limit,” or highest advisable daily dose, for D and for calcium.

The new guidelines, issued by the Institute of Medicine, are summarized as follows:

Vitamin D; Ages 1-70: 600 international units (IUs) per day. Older than 71:800 IUs. The IOM previously said 200 IUs was adequate for people aged 50 and younger, 400 IU for people aged 51-70, and 600 IUs for people older than 70.

The tolerable upper limit (UL) is 4000 IUs for ages 9 and above (up from 2000 IU in the IOM’s previous guidance).

Calcium: based on age, ranges from 700 to 1300 milligrams (mg) daily with a tolerable upper limit range of 1000-3000 mg.

Note that the recommended daily allowances are basically for the sake of maintaining health. When deficiencies are identified in individuals or groups (such as people with HIV), then higher dosages may be recommended.

See NYBC’s entry on Vitamins and Minerals for further details about multivitamins, Vitamin D, calcium, and other vitamins and minerals:

Tenofovir (Viread, Atripla) and Severe Bone Loss

Sean Strub, founder of POZ, notes on his blog the evidence for severe osteopenia or osteoporosis arising from the use of this drug. And unfortunately, from his own personal experience.

The comprehensive issues arising from ARV clearly require more diligence from physicians HEARING what people using these meds are experiencing, and acting more aggressively to mitigate the problems. This can include encouraging (prescribing??) resistance exercise, use of appropriate mineral supplements and extra Vitamin D.

One case study is reported here–we’re beginning to investigate the issue more closely.
Brim NM, Cu-Uvin S, Hu SL, O’Bell JW. Bone disease and pathologic fractures in a patient with tenofovir-induced Fanconi syndrome. AIDS Read. 2007 Jun;17(6):322-8, C3.
Comment in: * AIDS Read. 2007 Jun;17(6):326-7.

We report the case of an HIV-positive patient with preexisting bone disease who developed tenofovir-induced Fanconi syndrome and subsequently sustained pathologic fractures. We suggest that tenofovir treatment may have contributed to the patient’s pathologic fractures through its effects on phosphorus balance and vitamin D metabolism. This case highlights the importance of monitoring not only for renal impairment but also for bone disease in patients receiving tenofovir treatment, especially given the high prevalence of osteopenia and osteoporosis in HIV-positive patients.