Supplements for the Brain (and Nerves)

“For Your Peace of Mind…”

Recent research on supplements for memory, cognition and other neurological functions
You may remember (we hope you remember!) the Scarecrow’s petition to the Wizard of Oz for a brain. Be advised–we at NYBC do not stock new brains, so don’t come to us with that request.

However, we do follow the sometimes startling new research on supplements, brain function and related neurological issues. In this department, there’s special cause for concern for people with HIV. According to a Canadian study released in 2010, in a group of 1615 people receiving treatment for HIV during the decade 1998-2008, one fourth had neurological problems, including memory loss, cognitive impairment and peripheral neuropathy. Of course being worried about brain function–and neurological function in general–is not unique to people with HIV. As people age, they are more likely to experience memory loss or forms of dementia such as Alzheimer’s. And the nerve condition called peripheral neuropathy (pain, tingling in the feet and hands) is found not just in people with HIV, but also among the growing population with Type 2 diabetes.

Now, on to what we see as some of the most valuable recent findings about supplements and brain or neurological function:

B vitamins can be considered a foundation because they are needed in so many processes essential to the brain’s operation, from energy supply and healthy blood flow, to the formation of neurotransmitters (=chemical messengers of neurologic information from one cell to another). Furthermore, there is evidence that several groups of people, including those over 60 and those with HIV, have a greater risk for Vitamin B deficiencies. So supplementing with a B complex vitamin is a sensible start to cognitive health. More specifically, there is good research linking deficiency of vitamins B12 and B6 to mood disorders like depression—and depression earlier in life is associated with higher risk of dementia in later life. Last, there is also some evidence that B vitamins may reduce stroke risk in older people.

Omega-3 fatty acids (fish oil) support cognitive health in a variety of ways. In 2008, UCLA researchers reported on a lab study showing that the omega-3 fatty acid DHA, together with exercise, improved cognitive function. This caught our attention, because there is wide agreement that regular exercise strongly supports brain function as we age, and here the suggestion is that omega-3 fatty acids multiply that known benefit. A diet rich in omega-3 fatty acids/fish oil has also been linked to lower risk of depression—another plus. And still more: recent research found that omega-3 fatty acids block the development of retinopathy, a chief cause of blindness as we age. (The retina of the eye is actually part of the brain–it is full of nerve cells essential for vision.) All in all, the neurological benefits of omega-3 fatty acids seem both wide-ranging and quite convincing, so it’s high on our recommended list.

The amino acid acetylcarnitine has shown benefit for brain function in a number of studies with humans. In the last decade, acetylcarnitine has also been investigated for peripheral neuropathy in people with HIV. (Some recommend using it with evening primrose oil and Vitamin C.) A 2008 study found that acetylcarnitine influences a chemical process in the brain that triggers Alzheimer’s, so researchers are continuing to puzzle out how this supplement produces its neurological benefits.

Antioxidants. There’s much suggestive research about how antioxidants counter destructive oxidative processes in the brain, thus blocking memory loss and cognitive decline. For example, a 2003 report found that the antioxidant combination alpha lipoic acid and NAC reversed memory loss in aged laboratory mice. And there’s also been a lot of attention to the combination acetylcarnitine and alpha lipoic acid for memory impairment. Furthermore, other antioxidants such as curcumin are under study for their potential to fight the processes that lead to declining brain function.

Acetylcholine. The first neurotransmitter to be identified, acetylcholine is closely associated with memory, with lower levels linked to memory loss. NYBC currently stocks two combination supplements that support acetylcholine levels in the brain, while also providing other nutrients for neurological function: Neuro Optimizer (Jarrow), which includes acetylcholine enhancers, acetylcarnitine, and alpha lipoic acid; and Think Clearly (SuperNutrition), which includes B vitamins, as well as acetylcholine enhancers and a botanical traditionally used for cognitive support, ginkgo biloba.

Resveratrol. In the past decade, there has been intense scientific interest in this compound, most famously found in red wine. While some research ventures have hoped to find in resveratrol a life-extending supplement (a capacity demonstrated in animal studies), others have focused on its therapeutic value for conditions like diabetes or cognitive decline. For example, Cornell researchers reported in 2009 that resveratrol reduced the kind of plaque formation in animal brains that causes Alzheimer’s. And a year later another lab investigation, this one at Johns Hopkins, found that a moderate dose of the compound protected animal brains from stroke damage.

Ginkgo biloba, a botanical derived from Earth’s most ancient tree species, has been widely used for cognitive function. In the late 1990s, two reviews of dozens of ginkgo studies concluded that it could improve symptoms of dementia. However, a long-term trial of ginkgo published in the Journal of the American Medical Association in 2008 found that the supplement did not prevent development of dementia in a group of more than 3000 older people who had normal cognitive function at the start of the research. One possible conclusion: ginkgo may help symptoms of cognitive decline, but doesn’t address underlying causes.

NYBC’s RECOMMENDATIONS: A B complex supplement (like Jarrow’s B-right) and fish oil (like Jarrow’s Max DHA) are foundations for maintaining cognitive health, especially important for people with HIV or people over 60. There is some evidence for acetylcarnitine, alpha lipoic and acetylcholine supplementation for memory impairment and possibly for cognitive decline. Acetylcarnitine and other supplements can be used to address peripheral neuropathy. And stay tuned for emerging research on preserving brain function with compounds like resveratrol, NAC and curcumin.

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“Supplements and Diabetes” and “Diabetes Facts & Figures”

NYBC INFO SHEET ON SUPPLEMENTS STUDIED FOR DIABETES

Below we describe some of the best recent research on supplements as used for the management of diabetes. More extensive information on these supplements, including recommended dosages, can be found on the NYBC website.

Multivitamin/multimineral: Regular use of a multivitamin/multimineral supplement helps people with diabetes maintain good health and reduce infections. Clinical evidence indicates that diabetics have unique nutritional needs, and should take a daily multivitamin to supplement their normal diet.

Note: NYBC stocks Jarrow’s Multi 1-to-3; Douglas Lab’s Added Protection, and SuperNutrition’s family of multivitamins.

Reference: Barringer, et al. Effect of a Multivitamin and Mineral Supplement on Infection and Quality of Life. Annals of Internal Medicine. 3/4/2003.

Omega-3 fatty acids (Fish Oil): Many people with diabetes have high blood pressure and elevated cholesterol, which can increase the risk of heart disease and stroke. Omega-3 fatty acids have shown benefit for cardiovascular health in recent randomized controlled clinical trials. The FDA has also approved a health claim for fish oil: “supporting but not conclusive evidence shows that the consumption of EPA and DHA omega-3 fatty acids from fish oil may reduce the risk of coronary heart disease.”

Note: NYBC stocks Max DHA –Omega-3 Fish Oil Purified by Molecular Distillation (Jarrow); and ProOmega –Nordic Naturals (60 softgels or 180 softgels).

Alpha-Lipoic Acid: Alpha-Lipoic Acid (ALA) has the ability to assist with glucose metabolism, and also promotes healthy nerve function. A recent study concluded that ALA (600mg/day) could be useful in helping to treat the symptoms of diabetes-related neuropathy (= pain, tingling, numbness in feet and hands). A protocol for diabetic neuropathy using ALA, evening primrose oil and Vitamin C has also been proposed.

Note: NYBC stocks ALA (Montiff) 300mg/60.

Reference: Ametov et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: The SYDNEY Trial. Diabetes Care. 2003, 26 (3)

Chromium and Biotin: These two supplements have been proposed as a useful adjunct therapy for poorly controlled diabetes. Chromium is also under investigation for insulin resistance in people with HIV.

Note: NYBC stocks these two supplements from Jarrow.

Reference: Singer, G M, & J Geohas. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus. Diabetes Technol Ther. Dec. 2006.

Bitter Melon: A popular vegetable in Southeast Asia, Bitter Melon (sometimes called Bitter gourd) contains an insulin-like substance that can lower blood sugar in people with Type 2 diabetes. Warning: Bitter Melon may result in hypoglycemia (low blood sugar) if combined with other blood glucose-lowering drugs or supplements.

NYBC stocks Bitter Melon (Zhang).

Reference: “Bitter gourd (Momordica Charantia): A dietary approach to hyperglycemia.” Nutrition Rev. July 2006.

B Vitamins: These are recommended for those taking Metformin, the most widely prescribed oral diabetic drug in the US. Metformin depletes B12, B6 and folic acid, which in turn leads to a build-up of homocysteine, linked to cardiovascular disease.
NYBC stocks B-right (Jarrow).

Reference: Zhao-Wei Ting, R et al. “Risk factors of vitamin B12 deficiency in patients receiving metformin.” Archives of Internal Medicine, Oct. 9, 2006.

IMPORTANT: Talk to your doctor before you use these or other supplements. Do not discontinue medications you are taking for diabetes/glucose control without first discussing with your healthcare provider any complementary treatments you are considering! As noted above regarding Bitter Melon, there is a risk of dangerous hypoglycemia if multiple blood sugar-lowering agents are used at the same time.

Diabetes Facts and Figures

–Poor diet (processed foods, fast foods, sweetened drinks) and lack of exercise are major factors in recent large increases in Type 2 Diabetes in the US. (The rate of Type 1 Diabetes, which is largely inborn, remains stable.)

–In 2009, 24 million Americans had diabetes. With no changes in diet and exercise rates, the number of US diabetics is projected to double over the next 25 years and the annual costs of treating the disease will rise from $113 billion to $336 billion.

–Minorities are disproportionately affected by diabetes: African-Americans, Hispanics and Native Americans are almost twice as likely as Whites to have diabetes. A main contributing factor for this disparity is limited healthy food choices and an abundance of bad food choices available in minority communities.

–Childhood obesity, closely linked to the development of diabetes, is now considered epidemic in the US, with 40% of US children overweight and 13% obese. The current generation of US children consequently risk having higher rates of cardiovascular disease and other diabetes-related health problems than their parents’ generation.

–The proportion of people with HIV who also have Type 2 Diabetes is increasing. The effects of combination therapies for HIV appear to increase the risk of Type 2 Diabetes; it is estimated that as many as 80% of people with HIV treated with protease inhibitors may develop insulin resistance, a precursor to diabetes (see John G. Ryan, “Increased Risk of Type 2 Diabetes Mellitus with HIV-1 Infection,” in Insulin, Jan. 2010).

–A class of drugs approved by the FDA as second-line treatment of diabetes has shown a dubious safety record. One of them, Avandia, may have caused hundreds of heart attacks per month and as of early 2010 the FDA was considering whether to ask for its withdrawal from the market.

Top search terms bringing visitors to this blog

Dear NYBC Blog Reader,

Thought you might be interested to see some of the most popular search terms that brought people to the New York Buyers’ Club Blog in the past year:

1. “Saccharomyces boulardii C difficile”
2. “glutamine ulcerative colitis”
3. “cholesterol lowering supplements”
4. “B vitamins depression”
5. “HIV Vitamin D”
6. “vitamins for neuropathy”
7. “Tylenol antidote”

And here, in very brief form, is the information these searchers found on the NYBC Blog:

Saccharomyces boulardii, which NYBC stocks in the form of Florastor, appears in a recent study to be the best probiotic for the stubborn gastrointestinal infection C. difficile.

Glutamine has shown effectiveness in reducing symptoms of ulcerative colitis and other gastrointestinal conditions in a number of research studies.

Plant sterols, fish oil, niacin, pantethine have been studied for cholesterol control.

B vitamins strongly affect mood and memory, and addressing a B vitamin deficiency can improve depressive symptoms.

Vitamin D deficiency is widely prevalent among people with HIV, and supplementing with 1000IU/day of D3 plus 1000mg/day of calcium may be a good way to support bone health for people taking HIV meds. Other research has noted the link between Vitamin D deficiency and cardiovascular disease, certain cancers, and susceptibility to cold and flus.

Acetylcarnitine, alpha lipoic acid and evening primrose oil are among the supplements studied for diabetic or HIV-related neuropathy (pain, tingling in feet, hands).

NAC (N-acetylcysteine) is used as the antidote to acetaminophen overdose. Acetaminophen is the active ingredient in Tylenol and is added to many other over-the-counter drugs, so overdose leading to liver damage or liver failure has become common in the US.

Info sheet on “Supplements studied for diabetes/insulin resistance”

NYBC has prepared an updated version of its info sheet on the topic of supplements that have been studied for diabetes or insulin resistance. Here’s the text below:

SUPPLEMENTS STUDIED FOR DIABETES/INSULIN RESISTANCE

Multivitamin/multimineral: Regular use of a multivitamin/multimineral supplement helps people with diabetes maintain good health and reduce infections. Clinical evidence indicates that diabetics have unique nutritional needs, and should take a daily multivitamin to supplement their normal diet.

Note: NYBC stocks Jarrow’s Multi 1-to-3; Douglas Lab’s Added Protection, and SuperNutrition’s family of multivitamins (such as the Opti-Pack).

Reference: Barringer, et al. Effect of a Multivitamin and Mineral Supplement on Infection and Quality of Life. Annals of Internal Medicine. 3/4/2003.

Omega-3 fatty acids (Fish Oil): Many people with diabetes have high blood pressure and elevated cholesterol, which can increase the risk of heart disease and stroke. Omega-3 fatty acids have shown benefit for cardiovascular health in recent randomized controlled clinical trials. The FDA has also approved a health claim for fish oil: “supporting but not conclusive evidence shows that the consumption of EPA and DHA omega-3 fatty acids from fish oil may reduce the risk of coronary heart disease.”

Note: NYBC stocks Max DHA –Omega-3 Fish Oil Purified by Molecular Distillation (Jarrow); and ProOmega –Nordic Naturals (60 softgels or 180 softgels).

Alpha-Lipoic Acid: Alpha-Lipoic Acid (ALA) has the ability to assist with glucose metabolism, and also promotes healthy nerve function. A recent study concluded that ALA (600mg) could be useful in helping to treat the symptoms of diabetes-related neuropathy (= generally, pain, tingling, numbness in feet and hands).

Note: NYBC stocks ALA (Montiff) 300mg/60.

Reference: Ametov et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: The SYDNEY Trial. Diabetes Care. 2003, 26 (3)

Other supplements studied for diabetes: Chromium and biotin (these two supplements, taken together, are believed to play an active role in balancing insulin production with glucose uptake). Also: evening primrose oil, resveratrol, bitter melon.

Talk to your doctor before you use these or other supplements. Do not discontinue medications you are taking for diabetes/glucose control without first discussing with your healthcare provider any complementary treatments you are considering!

Antioxidants for Diabetic Peripheral Neuropathy

We were interested to read about an antioxidant therapy for Diabetic Peripheral Neuropathy (DPN). It includes alpha lipoic acid, which has been studied quite extensively for diabetes, as well as evening primrose oil (gamma linolenic acid being the active component) and Vitamin C:

…a recommendation for treatment of DPN by use of anti-oxidants, and is based on the research of Stan Angilley. It has been used successfully by many diabetics to reduce or even eliminate DPN. Before starting on this regimen, you should discuss it with your doctor, as you may have other medical issues which would contraindicate its use. It is likely that your doctor will have heard little or nothing about this approach, so we have provided citations to applicable literature below.

The DPN cocktail has three components: Alpha Lipoic Acid (ALA), Gamma Linolenic Acid (GLA) as contained in Evening Primrose Oil (EPO), and Vitamin C.

Read more at:

http://www.diabetes-support.org.uk/joomla/neuropathy-treatment

See www.newyorkbuyersclub.org for more on these supplements.

Evening Primrose Oil: How It’s Used by People with HIV

Evening primrose oil is derived from a plant native to North America. It’s rich in gamma-linolenic acid (GLA), which is normally produced in the body through the breakdown of omega-6 fatty acids, a process that may be disrupted in people with HIV. Thus supplementing with evening primrose oil can add available GLA to the body, which can help maintain many important functions.

Our friends at the Canadian AIDS Information Exchange (CATIE) have prepared a good information sheet detailing the purposes for which people with HIV use evening primrose oil:

Evening Primrose Oil

This CATIE Supplement Sheet includes information on using evening primrose oil to:

–help heal nerve damage (peripheral neuropathy)

–treat skin conditions associated with anti-HIV drugs

–cope with premenstrual syndrome

–reduce cholesterol levels

For more information on this supplement, see also the NYBC entries:

Evening Primrose Oil – Super

Evening Primrose Oil + Gamma Tocopherol