6 Surprising Health Benefits of Yerba Mate

What are the benefits of Yerba Mate?

Are there any side effects?

Yerba mate is derived from the leaves of the Ilex paraguariensis tree. This is a broadleaf evergreen tree that can reach up to 50 feet in height. This tree is native to Brazil, Uruguay, Argentina, and parts of Paraguay. The leaves are known as “herb” or “yerba” in Spanish.  

The leaves are commercially harvested and contain caffeine, theobromine, and other useful compounds. 

An infusion, or mate, is prepared by steeping the dry leaves and twigs of the tree. This is where the name Yerba mate originates.

This product is consumed by over 1 million people worldwide.1

Yerba mate has become a popular ingredient in teas and energy drinks here in the United States. 

Health Benefits of Yerba Mate

There are many possible health benefits of yerba mate. I have recently started to enjoy this myself. It is just one of the many new herbal products I have added to my diet. 

Here is what I have learned about this tea.

Antioxidant Properties

There are several compounds contained in yerba mate that can act as free radical scavengers. A study published in Mutagenesis in July of 2008, concluded that mate tea might protect against DNA damage and improve DNA repair.2

It is well known that oxidative stress contributes to many disease processes.   

 

 

Diabetes

Yerba mate has been shown to improve serum glucose levels and decrease fat accumulation in diabetic rats.3 

Other rodent studies have shown long-term supplementation with Yerba mate may also improve hepatic steatosis, insulin resistance, and dyslipidemia.4

Heart Disease

The antioxidant compounds present in YM may lower the risk of heart disease. Yerba mate has demonstrated the ability to decrease the size of atherosclerotic lesions in animal models.5

Atherosclerosis or “hardening of the arteries” results in restrictive blood flow caused by a buildup of fats, cholesterol, and other substances. These buildups, or “plaques,” can also dislodge, forming a blood clot that may lead to a stroke or pulmonary embolus.  

Yerba Mate as a Weight Loss Supplement

Obesity leads to increased morbidity and mortality. The accumulation of visceral fat predisposes people to diseases such as atherosclerosis and type 2 diabetes.6

Mice fed a high-fat diet are excellent models to study obesity.7

Yerba mate has been shown to have positive effects on weight loss. Mice models have demonstrated that mate affects food intake, increases energy expenditures, and leads to a higher basal metabolism.8

This study showed mice fed a high-fat diet (HFD) that received Yerba mate had decreased food and water intake. 

Although the body weight in the HFD group increased, the weight gain in the Yerba mate treated group was significantly less than that of the HFD group who didn’t receive the mate.

It should also be noted that Yerba mate appears to have fewer adverse side effects than other natural weight loss supplements.9

Studies using different human groups have found positive effects of satiety and metabolism.10

Antibacterial Activity

An article published in 2018 found that the aqueous extracts of the stems and leaves of Ilex paraguariensis possess significant antibacterial activity. I found it fascinating because bacterial strains resistant to the antibiotics we typically use were not immune to the Yerba mate.11

This finding could lead to more effective antibiotics in the future. Bacterial resistance is a significant problem in healthcare today, so newer antibiotics with less resistance could save many lives.

Yerba Mate as a Performance Enhancer

A study performed on well-trained cyclists found Yerba mate increased fat oxidation at low-exercise intensities and improved performance in short time trials.12

Another study found YM ingestion reduced carbohydrate reliance during exercise and augmented fatty acid oxidation. 

This was true over a wide range of exercise intensities.13

The investigators concluded that the acute ingestion of YM before exercise increased fat metabolism during light and moderate exercise. No adverse effects on maximal performance were noted.

Adverse Effects of Yerba Mate

All medicinal products have precautions, warnings, and side effects associated with them. I generally use the natural medicines database by trc to research the adverse effects of the various nutraceuticals I study.

Yerba mate may increase the risk of various cancers when used in high doses or over a long period.

The other adverse effects are primarily the result of caffeine. Some of these effects include:

  • Hypertension
  • Tachycardia
  • Chest pain
  • Cardiac arrhythmia
  • Nausea
  • Vomiting
  • Gastric irritation
  • Osteoporosis
  • Insomnia
  • Anxiety
  • Agitation
  • Headache
  • Irritability
  • Depressed mood

 

 

I have recently started to enjoy Yerba mate. I only drink this occasionally but wanted to research its benefits. I was surprised to find it had promising antibacterial properties. It may also decrease plaque buildup in blood vessels reducing heart attack risk.

Athletes may benefit from its effect on fatty acid oxidation, improving athletic performance, and we all may benefit from its weight loss effects.

Diabetic patients may benefit from its effect on blood glucose levels but must be careful as many YM products contain added sugar.

According to the natural medicines database, this “tea” received a rating of “possibly safe” when used orally and appropriately over a short period.

As with anything, moderation is key. Consuming large doses of YM or long term exposure may increase cancer risk. To be honest, I believe it would be difficult to consume these quantities.

Most of the other adverse effects come from the caffeine content. If you have difficulty with coffee, this may not be the drink for you.

I have not experienced any side effects from Yerba mate. I enjoy the taste and find it very refreshing.

If you have any questions regarding this blog post, or anything related to medications or natural products, please send me an email. I am happy to get an answer for you,

Until next week, be happy, be healthy, and stay safe!

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Oxidative Stress Reduction Using an Nrf2 Activator Supplement

Oxidative stress is something that we all are exposed to on a daily basis.

  • What causes oxidative stress?
  • Why should I care?
  • How can I help reduce oxidative stress?

Oxidative stress happens when free radical species, also known as reactive oxygen species (ROS) and anti-oxidants, become out of balance within the cells of our body. The ROS’s contain an uneven number of electrons that cause them to react with other molecules. This may lead to chemical reactions leading to oxidation.

We are constantly bombarded with free-radical sources in our environment. Some we can eliminate, but others are part of everyday life. Here are some examples:

  • Ozone
  • Pollution
  • Radiation
  • Cigarette smoke
  • Some pesticides and cleaning agents
  • A poor diet

Remember the last time you cut up an apple. If you leave the apple segments on the cutting board, they will turn brown. This is an example of oxidation. If you soak the apple slices in lemon-lime soda for 10-15 minutes, they will remain their original color. 

Why is this?  

Carbonated drinks contain citric acid, which is an anti-oxidant. Anti-oxidants inhibit oxidative reactions.

What does this have to do with our health? 

Too many free radicals start to cause damage to DNA, proteins, and fatty tissues within the body. This damage is believed to be responsible, in varying degrees, for the onset and progression of many diseases. See the diagram below.

The Nrf2 Pathway

Nrf2 (nuclear factor erythroid 2-related factor 2) is a key modulator of the primary defense mechanism of mammalian cells. 

The primary function of Nrf2 is to activate the anti-oxidant response. This, in turn, fights the harmful effects caused by oxidative stress.1

It is beyond the scope of this article to explain this complex pathway. I have included a diagram obtained from “Frontiers in Pharmacology” for illustrative purposes.

Figure 1. Schematic representation of Nrf2 signaling in homeostasis and a deregulated environment. (A) Oxidative molecules (e.g., ROS and RNS) produced by cellular respiration or neurotransmission activate the protective anti-oxidant pathway by dissociation of the Nrf2/KEAP1 complex. When dissociated from the cytosolic protein KEAP1, Nrf2 translocates to the cell nucleus, triggering the expression of several homeostatic genes with the ARE sequence in their promoters, including GPx, SOD, HO-1, GST, and CAT. When inactivated, Nrf2 is sequestered by KEAP1 and targeted for ubiquitination and proteasomal degradation. (B) Altered homeostasis promotes excessive ROS/RNS production that can activate glial cells (astrocytes and microglia) that release proinflammatory and danger molecules patterns, which disrupts neuronal communication and the nature of glial activities. Green arrows represent activation and truncated red lines, inhibition (abbreviations: ACh, acetylcoline; DA, dopamine; CAT, catalase; Glu, glutamate; GPx, Glutathione Peroxidase; GST, glutathione S-transferase; HO-1, heme oxigenase 1; RNS, reactive nitrogen species; ROS, reactive oxygen species; SOD, superoxide dismutase; Ub, ubiquitin; ATP, adenosine triphosphate).2

Anti-Oxidants from Food Consumption

It is well known that many foods contain varying levels of anti-oxidants. Many studies have found blueberries contain the highest amount of anti-oxidants of all fruits and vegetables.3

Other foods that are high in anti-oxidants include:

  • Strawberries
  • Artichokes
  • Dark Chocolate
  • Goji Berries
  • Kale
  • Raspberries
  • Spinach
  • Beets
  • Beans
  • Red Cabbage
  • Pecans

 

Eating these foods on a regular basis can help protect your body from free radical damage. As stated in previous posts, I recommend eating whole foods whenever possible and avoid fast food and processed foods that contain unhealthy chemicals. Unfortunately, these foods do not provide enough anti-oxidants to keep up with the free radical onslaught experienced by our bodies as we age.  

Activating the Nrf2 Pathway

It is not surprising that several companies have attempted to create a product capable of activating the Nrf-2 pathway. 

The product ProtandimTM, by LifeVantageTM, has been extensively studied. This product has been shown to provide a synergistic interaction with the Nrf2 pathway. Each ingredient of ProtandimTM has anti-oxidant properties, but when combined, the effect is much more pronounced.4

Think of ProtandimTM as a nutritional product capable of activating your body to be more efficient at neutralizing free radicals. 

Our body becomes less able to fight oxidative stress as we age. This product has the following benefits.

  • Reduces oxidative stress by an average of 40% in thirty days.
  • Helps to regulate survival genes.
  • Produces enzymes capable of neutralizing more than one million free radicals.
  • Supports the body’s natural ability to repair and rejuvenate its own cells.
  • Helps the body detoxify genes.

ProtandimTM stimulates proteins, causing our bodies to produce protective anti-oxidant enzymes such as superoxide dismutase (SOD), heme oxygenase (HO), and glutathione peroxidase and catalase.

Although many studies have been conducted using ProtandimTM, this product is classified as a nutritional supplement and not a drug.  Therefore, ProtandimTM has not been evaluated by the Food and Drug Administration and is not intended to diagnose, treat, cure, or prevent any disease.

I have been interested in bio-hacking for many years.

The research I have done regarding anti-oxidants has helped determine which products will be offered by Sunshine Nutraceuticals. I have always been open to offering products made by other companies as long as they are safe to consume.

When I learned about ProtandimTM and read the studies, I felt the need to educate as many people as possible. I joined LifeVantageTM as a distributor and only wish I would have learned about this product earlier.

I believe this is a medical breakthrough that many have never heard of. 

Sunshine Nutraceuticals has been an incredible journey that has improved my health and knowledge. We never know what tomorrow will bring. My hope is that you will learn as much as you can about ways to improve your health and happiness.

If you have any questions, feel free to ask me. If you would like to join LifeVantageTM as a distributor, I can help with that as well. Simply send me an email.

 

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Alternatives to ADHD Meds – Dietary Supplements

Are you looking for alternatives to traditional stimulant medications to treat your child’s ADHD?

Is there a more natural way to treat ADHD?

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopment disorder that is associated with the following symptoms. There are two broad groups.

Inattention that negatively impacts social, occupational, and or academic functioning.

Symptoms in this category include:

  • Forgetfulness
  • Distractibility
  • Inability to listen
  • Frequently loses items
  • Trouble organizing
  • Difficulty in maintaining attention
  • Not able to follow instructions or finish tasks
  • Avoids activities that require attention
  • Fails to focus on details or makes careless mistakes on schoolwork

Hyperactivity and impulsivity

symptoms include:

  • Excessive talking
  • Impulsive (doesn’t wait turn and blurts out answers)
  • Runs and climbs when not appropriate to do so
  • Cannot remain seated
  • Fidgets or squirms in seat
  • Constantly on the go
  • Unable to engage in quiet activities

ADHD was estimated to affect 9.4% of children in the US, according to a national parent survey in 2016. 

Of these children, 77% were receiving treatment. This treatment was as follows:

  • 30% treated with medication alone.
  • 15% received only behavioral treatment.
  • 32% received both medication and behavioral treatment.

NSCH 2016: Redesigned as an online and mail survey, estimate includes children 2-17 years of age. 1

Is there a reasonable alternative to stimulants for these children?

Polyunsaturated Fatty Acids (PUFAs)

Omega-3 fatty acids must be obtained through our diet. The following foods are high in this substance:

  • Fish (salmon, trout, sardines, halibut, herring, albacore tuna)
  • Walnuts
  • Flaxseed oil
  • Canola oil

Other foods that contain omega-3 fatty acids are:

  • Clams
  • Shrimp
  • Catfish
  • Cod
  • Spinach

The Western diet consists of a higher quantity of omega-6 fatty acids. Foods that contain omega-6 are poultry, eggs, cereals, nuts, whole-grain bread, and durum wheat.  

Why is this important in ADHD?

One meta-analysis that contained ten trials, including 699 children with ADHD found that PUFA supplementation produced a small but significant improvement compared to a placebo group.2

A significant relationship was also shown between the eicosapentaenoic acid (EPA) dose within the omega-3 supplements, and the efficacy obtained.3

The mechanism of action of the omega-3 in the treatment of ADHD is likely due to its effect on serotonin and dopamine neurotransmission.4

There have been other systemic reviews that have raised questions about the use of omega-3 supplementation in the treatment of ADHD.5

 

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The methods in these reviews were different, which may have led to altered results.

I believe an omega-3 supplement is worth a try. The possible benefits seem to outweigh the risks involved.

Melatonin

Melatonin is a hormone produced by our bodies to regulate circadian rhythm. Adults and children have used melatonin as a sleep aid. 

As a pharmacist, it is the first-line medication for sleep that I recommend. Melatonin has very few side effects and is non-addictive.  

We know that sleep problems are common in children with ADHD. We also know that a lack of sleep can cause symptoms such as hyperarousal, disinhibition, and executive function problems that mimic ADHD symptoms.

The two studies I located showed melatonin was effective for sleep but had no effect on ADHD symptoms.

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Iron

A meta-analysis published in 2012 found that children and adolescents with ADHD had lower serum ferritin levels than healthy controls.

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A small randomized, placebo-controlled study showed children with ADHD, and low serum ferritin levels demonstrated significant improvement when receiving ferrous sulfate (80 mg/day) compared to placebo.

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More studies with a larger sample size are needed before iron can be recommended as a standard treatment of ADHD.

Pycnogenol

Pycnogenol is an extract obtained from the bark of the French maritime pine. Pycnogenol was the subject of the very first post I made to this blog. You can read this post by clicking here!  

Case reports have shown Pycnogenol can improve ADHD symptoms either alone or in combination with psychostimulants.  

A four week randomized, placebo-controlled trial of 61 children found Pycnogenol significantly improved ADHD symptoms according to the Child Attention Problems (CAP) teacher rating scale.

11

A significant improvement was not found using Connor’s Parent and Teacher Ratings, but trends were similar to CAP.

This study also found lower catecholamine levels in the urine of the pycnogenol subjects suggesting a possible effect on catecholamine formation or metabolism.

More studies are needed to determine the safety and efficacy of Pycnogenol in the treatment of ADHD.

Parents are often reluctant to put their children on medications to treat ADHD. At times, this leads to the use of nutritional supplements that are ineffective in the treatment of this disorder.While researching this topic, I discovered supplements such as St. John’s Wort, carnitine, and Gingko Biloba either were ineffective or had minimal evidence to support their use in the treatment of ADHD.

These substances may also produce unwanted side effects.

Zinc can be useful when a deficiency exists, but this is rare in the United States. There have been studies in Israel, Turkey, and Poland demonstrating lower zinc levels in children diagnosed with ADHD. 

Correcting this deficiency of zinc can improve ADHD symptoms.

Magnesium supplementation has been tried, but no randomized, placebo-controlled trials are available to support its use.

Iron supplementation has shown to be effective in one small study. 

Pycnogenol has also shown positive results although more studies are needed to confirm its benefits in the treatment of ADHD.

The most robust evidence available at this time is for omega-3 fatty acid supplementation in the treatment of ADHD and melatonin for sleep-onset insomnia.

The Omega-3 fatty acids are still not as effective as traditional ADHD medications, but they may be beneficial in those with mild symptoms. 

Melatonin is always my first recommendation for patients of all ages for insomnia.

Please feel free to send me an email if you have any questions regarding this post or any other subject regarding medications, diet, fitness, or happiness.  

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Have a great week, and please stay safe out there!

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

4 Remarkable Beetroot Medicinal Uses

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Beets have recently gained popularity for their medicinal uses.  Red beetroot (Beta vulgaris rubra) is a source of nitrate and also contains betalain pigments.  Beetroot ingestion causes an increase in nitric oxide availability and  may lead to a natural treatment for hypertension as well as an improvement in endothelial functioning.  The betalain pigments possess antioxidant, anti-inflammatory and chemo-preventive activity in vitro and in vivo.1

These properties may lead to beetroot’s usefulness in the treatment of diseases occurring due to oxidative stress, inflammation, decreased cognition and altered endothelial function.

Beetroot Capsules for High Blood Pressure

Hypertension is either the primary cause or contributes to more than 1,000 deaths in the United States daily according to the CDC.  High blood pressure increases the risk of stroke, heart attack and heart failure and is also a risk factor for kidney disease.

 

Beetroot is a good source of dietary nitrate which is converted to nitrite and nitric oxide in the body.  Nitric oxide is known to relax and dilate blood vessels which leads to lower blood pressures. 

 

A systemic review and meta-analysis was conducted in 2017 to investigate the efficacy of beetroot juice supplementation on decreasing blood pressure in human subjects.  The results of this analysis is summarized in Table 1.

1To assess statistical heterogeneity, the I2 statistic and Cochran’s Q statistic were used according to specific categories (low = 25%, moderate = 50%, and high = 75%) and significance level (P < 0.10), respectively. *, P for WMD; **, P for Q value. DBP, diastolic blood pressure; SBP, systolic blood pressure; WMD, weighted mean difference.
2Blackcurrant juice (n = 10), low-calorie juice (n = 5), and control diet for NO3 (n = 1).

This study concluded that the hypotensive properties of beetroot are a potentially safe and effective nutritional approach to manage hypertension.  They recommend further clinical studies with larger sample sizes and longer duration to confirm clinical usefulness. 2

Antioxidant Effects of Beetroot

If you have been a reader of my blog, you know how important antioxidant activity is.  Oxidative stress can lead to functional impairment of the cells.  If this occurs over a long period of time, diseases such as cancer may result.  One estimate suggests oxidative stress plays a role in over 200 clinical conditions.3 

Reactive oxygen and nitrogen species (RONS) are molecules capable of oxidation.  These are continuously generated during cellular metabolism.  When aberrant cell metabolism, UV radiation, xenobiotics or increased inflammation lead to more RONS than the cells antioxidant defenses can combat, an imbalance results.  This leads to the condition referred to as oxidative stress.4 

Beetroot is very rich in antioxidant compounds.  The betalain pigments have been shown to protect cellular components from oxidative stress in several studies.5

 

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Beetroot also contains many highly bioactive phenolics, including rutin, epicatechin and caffeic acid that are also known to be potent antioxidants.8

 

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Beetroot as an Anti-Inflammatory

Inflammation is one of the defense systems used by our body.  It causes the release of substances that expand blood vessels increasing blood flow to injured areas helping to speed the healing process.  If inflammation persists for an extended period of time, cell dysfunction may occur.11 

Chronic inflammation has been associated with many clinical disorders including heart disease, cancer, obesity and liver disease.12

 

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We have treated inflammation with non-steroidal anti-inflammatory drugs (NSAIDs) since the 1970’s.15

Like any medication, these agents have side effects especially when used over long time periods.  NSAIDs can cause kidney damage and bleeding issues.  They also interact with several other medication classes.  Furthermore, NSAIDs have been shown to be ineffective for many inflammatory related conditions.16

The focus has been changed from NSAIDs to natural food sources as a potential alternative to combat chronic inflammation.17 

Betalains and beetroot extracts are potent anti-inflammatory agents.  A study by Reddy et al in 2005 found that betanin inhibited cyclooxygenase-2 (COX-2) enzyme activity by 97%.  This effect is comparable to the anti-inflammatory drugs Ibuprofen, Vioxxtm and Celebrextm.  This was the first study to show betanin’s strong anti-inflammatory properties.18  

In 2010, Pietrzkowski et al, found beetroot capsules alleviated inflammation and pain in osteoarthritic patients.19

Beetroot and Cognitive Function

It is well known that cognitive function decreases with age.  This is believed to be due, in part, to a reduction in cerebral blood flow.20

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This reduction in cerebral blood flow has been implicated in dementia and Alzheimer’s disease.23

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It would seem reasonable to conclude that beetroot could improve cerebral blood flow by increasing the availability of nitrous oxide.  We also know that a lower concentration of nitrous oxide can impair cerebral energy metabolism and neuronal activity. This may lead to neurodegeneration and cognitive deficits over time.25

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A study published in 2013 found improvements in systemic and cerebral vascular hemodynamics after ingestion of beetroot juice.  The investigators came to the following conclusion.

The hemodynamic improvements associated with the beetroot juice treatment appear to be consistent with counteracting some of the pathophysiologic cerebral vascular features of hypertension, Alzheimer’s, and other diseases associated with brain hypoperfusion and cognitive deficits.28

 

Beetroot Capsules Dosage

I recommend taking two capsules of Sunshine Nutraceutical’s Beetroot Powder Caps (1300mg) once daily.  Our product is all-natural, non-GMO and 100% organic.  This supplement is vegan and made in the United States.

After researching the benefits of beetroot, I decided to add it to our product line.  I work on a unit that cares for dementia patients so I am always interested in novel treatments for this disease.  Beetroot is high in antioxidants and is a great source of nitrates which are converted to nitrous oxide in the body.  I discussed four medicinal uses of this super food in this post but other possible uses also exist.  The increase in nitrous oxide and blood flow could be helpful in the treatment of erectile dysfunction.  The antioxidant properties may also prove to be beneficial in the treatment of some types of cancers in the future.  Finally, beetroot may be useful in improving exercise tolerance in athletes.  More studies will surely be done in the future regarding the many uses of beetroot. 

Thank you for reading this post.  As always, please contact us with any questions or comments.  Have a great week and be happy and safe.

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Turmeric, Diet, and Boswellia for Arthritis

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

I decided to write a post on arthritis because this is a condition I live with every day. Some days are better than others. I have done plenty of research on arthritis with the hope of improving my quality of life and I will share with you what I have learned about medications, foods, and natural supplements. I hope you never have to deal with this on a personal level but if you do, perhaps what I have learned over the last few years will help relieve some of your pain.  

              This figure represents alterations that occur in the joints during the onset of Oseteoarthritis1

Overview

Osteoarthritis (OA) is the most common joint disorder in the United States.2

 

It is also known as degenerative joint disease or “wear and tear” arthritis. This most often occurs in the joints of the hands, knees and hips. Osteoarthritis affects 32.5 million adults in the United States.3

 

OA is characterized by joint stiffness, swelling, pain and loss of mobility resulting from the breakdown of articular cartilage and synovial inflammation.

 

Here are a few facts about OA:

 

88% of OA patients are 45 or older and 43% are 65 or older. 62% are women and 78% are non-Hispanic Caucasians.4

 

OA patients experience more pain and have more activity limitations than other people in their age group. They are also more prone to fatigue and disability.5

 

One-third of those with arthritis over the age of 45 suffer from anxiety or depression. 

Approximately one million knee and hip replacement surgeries are completed each year due to OA.6

 

By 2040, approximately 11.4% of all adults will have some activity limitations as a result of arthritis.7

 

Risk Factors

                    8

Medications

Like most other ailments, osteoarthritis is initially treated by modifying risk factors. Losing weight, eating healthier foods and exercise are all excellent strategies. It may also help to optimize your workspace, especially if you sit for long periods of time. When these fail, medications may be necessary to relieve pain and inflammation. Most of the medications listed should only be used when symptoms are present since none of these agents have been shown to modify disease progression.

 

Topical NSAIDs – This class is the starting point, especially when few joints are affected. These work well in arthritis occurring in the hands and knees. They have similar efficacy to oral NSAIDs and have a better safety profile.9

 

The drug most utilized in this class is diclofenac gel (Voltarentm.) This medication is only available by prescription.

 

Oral NSAIDs – The next step is to utilize oral NSAIDs. Medications in this class include ibuprofen (Motrintm), naproxen (Alevetm), piroxicam (Feldenetm), and others. 

Caution must be exercised as these agents can cause GI bleeding, kidney disease and cardiovascular complications.  COX-2 inhibitors, such as celecoxib (Celebrextm) may also be used.

 

Duloxetine (Cymbaltatm) – This is an antidepressant medication known as an SNRI (serotonin-norepinephrine reuptake inhibitor.)  These drugs increase the amount of serotonin and norepinephrine available in the brain. My physiatrist (pain specialist) informed me that 90% of his patients responded to duloxetine. It works very well for both nociceptive and neuropathic pain.

 

Glucocorticoid (Steroid) intra-articular injections – Steroid injections are sometimes utilized for OA of the knee. These have a short duration of action (approximately four weeks) and may have adverse effects on the hyaline cartilage.10

 

 

Opiates – Due to the recent changes in opiate use guidelines, these drugs should generally not be used for arthritis. Opiates have many side effects, including increased risk of falls, sedation, nausea and dizziness. They are also habit-forming and may cause hyperalgesia leading to an increased sensitivity to pain. 

Effect of Vitamins and Diet

Arthritis is associated with inflammation, so foods known to decrease inflammation should help relieve pain due to this disease. My recommendation is to stick with the Mediterranean diet as much as possible. This diet has the most evidence to support various health-related benefits.  

 

Many of the foods that help with inflammation are part of the Mediterranean diet. Some examples of these include broccoli, tomatoes, whole grains, nuts, blueberries, avocados and many others. You can learn more about this diet by reading my post at the link below.

 Mediterranean vs Ornish Diet

 

Nightshades – Some people with arthritis believe eating plants from the nightshade family worsen arthritis pain. Nightshades contain solanine, which is a neurotoxin at high doses. Some examples of nightshade foods include white potatoes, eggplant, tomatoes and bell peppers. There is no scientific evidence to support the notion that eating plants from this family makes arthritis symptoms worse. If, however, you notice a negative change when eating these foods, you should avoid them. 

Natural Supplements

Turmeric – The only two nutritional supplements recommended by UpToDatetm at the current time are curcumin, the active ingredient in turmeric, and Boswellia serrata.  Curcumin has been used in Ayurvedic medicine for thousands of years for arthritis, respiratory infections, GI problems and even cancer treatment.   

A review of the efficacy of curcumin in the treatment of osteoarthritis was published in The Journal of Evidenced-Based Complementary & Alternative Medicine in 2017. The conclusion was that curcumin-containing products demonstrated statistically significant improvements in osteoarthritis compared to placebo in four out of five studies.11

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Boswellia serrata – A randomized, double-blind placebo-controlled study of 30 patients with osteoarthritis was published in 2003. The investigators found a statistically significant improvement in knee pain, knee flexion and increased walking distance in patients receiving Boswellia extract compared with placebo. Swelling in the knee joints was also improved. There were no changes that could be seen on x-rays. The Boswellia extract was well tolerated, with the exception of minor GI symptoms. 15

Vitamin K2 – There is some evidence suggesting vitamin K may be important in preventing arthritis. A longitudinal study compared patients with vitamin K deficiency to those who had adequate levels. The vitamin K deficient group had a 56% higher risk of developing knee osteoarthritis than the control group. 16

Vitamin K2 supplementation may also reduce inflammation in rheumatoid arthritis by lowering CRP levels.17

Ashwagandha

Ashwagandha is frequently used to treat both osteoarthritis and rheumatoid arthritis in Ayurvedic medicine.  Several anti-inflammatory pathways may be affected by withanolides, the active ingredients in ashwagandha.18

Arthritis and the Weather

We have all known people who believe they can predict the weather based on their arthritis pain. Scientists have been searching for a link between the weather and arthritis pain for years. Unfortunately, no definitive results have been obtained.

 

Colder weather may cause people to be less active and this may lead to stiffer joints. Lower barometric pressure may cause the nerve endings in joints where cartilage is worn away due to arthritis to be more sensitive, resulting in increased pain.

 

Finally, these changes in barometric pressure could cause expansion and contraction of scar tissue, muscles, and tendons leading to increased pain in these areas. Even though there hasn’t been any scientific proof, my arthritis pain is worse during the winter months. As long as I don’t try to lift heavy items, or cause increased strain on my back, I have very little pain during the summer months.

Arthritis is a painful disease affecting millions of people in the United States alone. It is a common cause of disability and has been linked to anxiety and depression. This condition not only causes pain but can limit physical activity as well. I have experience with this disease myself. 

 

I suffered for years before finally visiting a pain specialist.  Presently, my pain is under control most of the time as I have learned several things over the years that have helped. I try to get up to walk around often, I sit in comfortable chairs, and when my pain flares up, I take a turmeric supplement. 

 

If the pain gets worse, I take naproxen but try to limit its use. I watch what I eat and have found that if I sleep too long the pain is worse. I have also learned some exercises that relieve the pain.  

 

My pain seems to be worse in the winter months which may lead to our family relocating to a warmer climate in the future. Although science has not found a direct link between the weather and arthritis pain, I can feel a difference based on the temperature. When it is cold, my pain is worse!

 

If you have any questions regarding this subject, I would be happy to answer them. Stay safe, stay healthy and follow your dreams!

 

 

 

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Five Amazing Organic Ceylon Cinnamon Benefits

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Cinnamon comes in two varieties. 

  • Cinnamomum zeylanicum (CZ): Also known as Ceylon cinnamon or “true cinnamon.”  This is the version we will be exploring in this post.
  • Cinnamomum aromaticum (CC): Also known as Cinnamon cassia, or “Chinese cinnamon.”

Ceylon cinnamon is a spice is made from the bark of the tropical evergreen tree Cinnamomum verum.  This tree is indigenous to southern India, Madagascar and Sri Lanka with eighty percent of the world’s supply being provided by the latter 1

Almost every part of this tree including the leaves, bark, flowers, roots and fruit has some use either as an ingredient in cooking or a medicinal agent.

Ceylon cinnamon has a lower coumarin content than Chinese cinnamon.2

This is an important difference because coumarins are known to be strong anticoagulants, are carcinogenic and toxic to the liver.  Consuming large quantities of CC over a long period of time could pose health risks whereas CZ does not carry these risks.3

Many studies have been performed demonstrating the benefits of Ceylon cinnamon.  Some of these will be summarized below.

 

Ceylon Cinnamon in Diabetes and Hyperlipidemia

A systemic review and meta-analysis on the use of cinnamon in type 2 diabetes was published in 2013.  This review included ten randomized controlled trials involving 543 patients.  Cinnamon doses ranged from 120 mg per day to 6 grams per day for four to eighteen weeks. 

This review found the consumption of cinnamon to be associated with a statistically significant decrease in:

  • Fasting plasma glucose
  • Total cholesterol
  • LDL-C
  • Triglyceride levels

An increase in HDL-C levels was also significant.  There was not a significant effect on hemoglobin A1c found.  The researchers concluded that “The high degree of heterogeneity may limit the ability to apply these results to patient care, because the preferred dose and duration of therapy are unclear.”4

The fact that cinnamon had a positive effect on five out of six diabetes and blood lipid parameters in this review suggests it may be a positive supplement to add for patients who have hypertriglyceridemia or suffer from type 2 diabetes. 

Other studies have shown no improvement in fasting blood glucose with Ceylon cinnamon compared to placebo or a control group.5

 

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In animal models, the following benefits of cinnamon on diabetes and hyperlipidemia were shown in a study published in Diabetic Medicine in 2012:

  • Attenuation of diabetes associated weight loss
  • Reduction of fasting blood glucose (FBG)
  • Reduction in LDL (bad fat)
  • Increase in HDL (good fat)
  • Reduction in HbA1c
  • Increased circulating insulin levels
  • Beneficial effects against diabetic neuropathy and nephropathy

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Ceylon Cinnamon and Hypertension

Acute intravenous administration of Ceylon cinnamon extract administered to hypertensive rats resulted in a long-lasting decrease in blood pressure.  This study also resulted in a significant decrease in plasma triglycerides (-38.1%), total cholesterol (-32.1%) and LDL-cholesterol (-75.3%).  HDL-cholesterol in this study showed a 58.4% increase.9

Ceylon Cinnamon Antioxidant Properties

Ceylon cinnamon possesses strong antioxidant properties.  This spice is rich in polyphenols.10

 

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A study published in 2005 quantified the antioxidant capacity (TEAC) and phenolic content of 26 common spice extracts from twelve botanical families.  This is important because prior to this study, many different assay methods were used to determine antioxidant capacity.  This study showed a mean TEAC value of 31.7 mmol/100g.  The strongest antioxidant based on radical scavenging activity was clove at 168.7 mmol/100g. 

Cinnamomum zeylanicum had the second highest radical scavenging activity at 107.69 mmol/100g.  This study confirmed the high antioxidant activity of Ceylon cinnamon.14

Antioxidant effects are important because they may reduce the risk of developing many diseases including heart disease and some cancers.  This is accomplished by preventing or limiting the damage caused to cells from free radicals.

Antimicrobial Effects of Ceylon Cinnamon

Ceylon cinnamon has shown antimicrobial activity against many bacterial strains.  CZ oil was beneficial in protecting mice against cryptosporidiosis.15

Another study showed chewing gum containing cinnamic aldehyde and natural flavors from CZ led to significant reductions in salivary anaerobes twenty minutes after gum was chewed.16

There are many more studies and outcomes listed referring to the antimicrobial effects of CZ in the research article “Medicinal properties of ‘true’ cinnamon (Cinnamomum zeylanicum): a systemic review.”

https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/1472-6882-13-275

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It is thought that CZ’s antimicrobial action is due to cinnamaldehyde.18

Anti-Inflammatory Actions of Ceylon Cinnamon

Extracts of cinnamon are known to increase Tristetrapolin mRNA and protein levels.  These have anti-inflammatory effects.  This may be why anti-inflammatory actions have been observed with the use of CZ.19

This effect can help the body fight infection and repair tissue damage.  Studies have shown that Ceylon cinnamon has potent anti-inflammatory properties.  If therapeutic concentrations reach the tissues, this substance may be used in the treatment of age-related inflammatory conditions.20 

A study published in 2012 determined “cinnamic aldehyde may be used in the prevention or treatment of disease where free radical formation is a pathological factor.”21

Ceylon Cinnamon Side Effects

This spice is generally well tolerated and adverse effects are uncommon.  Some side effects reported areHeartburn

  • Nausea
  • Bloating
  • Dyspepsia

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Cinnamon oil can cause burning and contact dermatitis when it comes into contact with the skin.  There has also been a case report of a 7 year-old child developing signs of toxicity (vomiting, dizziness, sedation and loss of consciousness) after ingesting 60 ml of cinnamon oil.23

Ceylon Cinnamon Drug Interactions

Antidiabetic agents:  Ceylon cinnamon can decrease blood sugar so combining it with antidiabetic agents may lead to hypoglycemia.  Frequent monitoring of blood sugars is recommended if combining Ceylon cinnamon with these agents.

Antihypertensives:  Some research has shown Ceylon cinnamon can decrease blood pressure in rat models.  Blood pressure should be monitored when combining Ceylon cinnamon with antihypertensive agents to prevent hypotension.

Cinnamon comes in two different varieties.  Ceylon cinnamon is the preferred type to use for medicinal purposes.  This spice may be useful for several indications.  Cinnamon can lower blood sugar, improve blood lipid levels and reduce blood pressure.  It has also been shown to be effective in preventing and fighting several types of bacterial infections. 

Cinnamon has strong antioxidant properties that may help prevent heart disease and some types of cancer.  It may also be useful in several inflammatory conditions related to the ageing process. 

Ceylon cinnamon is well tolerated when consumed at recommended dosages.  It is important to consume the correct form of cinnamon.  The cinnamon used in cooking (Chinese cinnamon) is not the same as Ceylon cinnamon.  It has many of the same effects but contains high levels of coumarin compounds which may lead to bleeding.  Coumarins are also carcinogenic and toxic to the liver.  Consuming small amounts of Chinese cinnamon in food is safe but you wouldn’t want to consume large quantities for its health benefits.

Sunshine Nutraceuticals has a Ceylon cinnamon supplement available for purchase.  Please let us know if you have any questions regarding this product or any item we offer for sale.  We are always happy to answer any questions regarding happy, healthy living as well.

Have a great week and be safe!  Remember to follow all guidelines regarding COVID-19.  We need to get through this!

 

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Crohn’s Disease Dietary Restrictions and Natural Remedies

Crohn’s disease is an inflammatory bowel disease (IBD) resulting in chronic inflammation of the gastrointestinal tract.  IBD encompasses Crohn’s disease and ulcerative colitis.   Crohn’s disease is associated with distinct granulomas and inflammation which may also affect lymph nodes.1

Ulcerative colitis is a milder disease that is characterized by continuous inflammation affecting the colon.  Both of these conditions lead to extensive epithelial damage.

Inflammatory bowel disease may cause a variety of symptoms including:

  • Loss of appetite
  • Fever
  • Weight loss
  • Diarrhea which may contain blood
  • Abdominal pain and cramping
  • Anemia due to blood loss
  • Urgency to defecate

I thought I would write a post on ways to combat this disease other than the traditional medication therapy. 

Remember, if you suffer from IBD, it is important to visit your physician on a regular basis.  Since bleeding and GI blockages are possible, tests may need to be performed by a professional to keep you as healthy as possible. 

You may require medication depending on how severe your symptoms are.  This disease may also cause a decrease in the absorption of vital vitamins and nutrients the body needs for proper functioning. 

The recommendations in this article should only be considered in combination with the advice of a physician.  I am a strong advocate of yearly check-ups.  Preventative medicine is vital to health.

What Foods Cause Crohn's Disease Flare-ups

Although there is no particular diet that has been scientifically proven to prevent inflammatory bowel disease, there are some trigger foods that may cause flare-ups.  My advice is to keep a food journal and this should help you determine which foods tend to cause problems.  If you find a certain food or food group appearing often before flare-ups, you may consider eliminating that item from your diet.  Some of the possible “problem items” include:

  • Corn, including popcorn
  • Dairy products – if lactose intolerant- consider supplementing with lactase or eliminating
  • Foods that cause increased gas production in the gut (onions, broccoli, cabbage, beans, legumes, lentils, etc.)
  • High fiber foods (chia seeds, avocado, pasta, chickpeas, quinoa, oats, almonds etc.)
  • Fried foods
  • Nuts and seeds, including peanut butter
  • Some raw fruits
  • Coffee and tea
  • Chocolate
  • Fats (butter, mayonnaise, cooking oils)
  • Alcoholic beverages
  • Red meat
  • Pork
  • Spicy foods

As you can see, there are many foods on this list, and others may also cause irritation and flare-ups.  This is why a food journal is essential.  It is worth the effort!

Another strategy is to try an elimination diet.  The way this works is you start by eliminating many foods and if your symptoms improve, you begin to add foods back one at a time.  This can help identify which foods should be avoided in the future. 

There are several elimination diets available today.  The Whole30 is a diet my family and I tried last October.  I have written about this in a separate post if you are interested in the specifics.  I highly recommend trying it.

I was also able to locate a specific diet and cookbook on Amazon written by Patty Catsos, MS, RD, LD.  I have not tried this diet yet, and don’t suffer from IBS, but this book has great reviews.  I do not have any association with this product but will list the link below for your convenience.

https://www.amazon.com/IBS-Elimination-Diet-Cookbook-Low-FODMAP/dp/0451497724

FODMAPs

Fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) are short-chained carbohydrates.  These make their way to the end of the intestinal tract where large amounts of bacteria reside.  The bacteria break these substances down causing the release of gas which may lead to digestive issues in some individuals.  These FODMAPs also draw liquid into the intestines which can lead to diarrhea.  Most individuals with IBS are sensitive to FODMAPs and these substances can lead the flare-ups.  Examples of FODMAPs include:

Lactose – Milk sugar contained in dairy products.

Galactans – Legumes have large quantities of these.

Fructose – This is the sugar contained in fruits and vegetables.  You also find this in many packaged products.

Fructans – These are found in many grains including wheat, spelt, barley and rye.

Polyols – These are sugar alcohols and are also used in processed foods as a sweetener.  Examples include sorbitol, mannitol, xylitol and maltitol.

These substances are resistant to digestion and are passed through the intestinal tract unchanged.  FODMAPs cause an increased hydrogen concentration in the intestines of those with IBS.  They also influence the quantity of methane gas and may cause gastrointestinal symptoms in IBS patients.2

Curcumin for IBS

One of the most effective and popular herbal medicines available is turmeric.  This herb contains curcumin which has many beneficial properties.  Curcumin is known to have a wide range of effects on the gastrointestinal system.  This substance has been shown to inhibit the growth of H. pylori in both mice and on agar plates.3

Curcumin is thought to kill bacteria by inhibiting cell division.4

A study by Niamsa and Sittiwet in 2009, demonstrated the antimicrobial activity of curcumin several commonly encountered pathogenic Gram-negative and Gram-positive bacteria.5

Curcumin has also been shown to regulate the gut microbiota.  This is important because inflammatory bowel disease is partially defined by an altered, pathogenic microbiome.6

 

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One of the changes that occur in the gut is the increase in adherent invasive E. Coli (AIEC) which can promote gut inflammation.9

 

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Curcumin has also been shown to inhibit signaling that initiates the inflammatory process in the intestinal tract.11

A study published in 2006 found the addition of curcumin, 1 gram after breakfast and 1 gram after dinner, plus sulfasalazine or mesalamine was more effective than placebo combined with one of these two medications.  The mesalamine group had a 4.65% relapse rate (2/43), whereas the placebo group had a relapse rate of 20.51% (8/39).  A six month follow-up found eight more patients relapsed in the curcumin group and six additional patients relapsed in the placebo group.12

For additional information on curcumin, please refer to my blog post on turmeric below.

Plantago Ovata

Plantago ovata, also known as Desert Indian wheat or psyllim husk has been used as a medicinal plant.  Psyllium is often used as a bulk forming laxative to support normal bowel movements.  Psyllium is marketed as Metamucil.   We also have this product available in capsule form in the Sunshine Store.  There have been studies showing psyllium to be useful in the treatment of UC.13

Probiotics in Inflammatory Bowel Disease

Probiotics would seem to be helpful in IBD.  Ingesting “good” bacterial should fend off some of the “bad” gas-producing bacteria.  At the present time, the studies show that probiotic supplementation is a promising adjuvant treatment in ulcerative colitis.  It is best to use a combination Probiotic such as Probiotic-40 available below.   There is not enough clinical evidence to support the use of probiotics for Crohn’s disease at the present time.14

Inflammatory bowel disease can be a debilitating illness and may be dangerous in some cases.  This condition may lead to a decrease in the absorption of critical nutrients and can also lead to bleeding and/or intestinal obstructions.  I suggest visiting your physician on a regular basis, keeping a food journal, and consider adding nutritional supplements to your medication regimen.  Your physician can tell you if you are deficient in vitamin B-12 or other necessary vitamins or minerals.  I strongly recommend a turmeric supplement.  This is one of the healthiest natural herbs available today.  Psyllium may also be beneficial but caution should be observed as large fiber loads can increase IBS symptoms in some individuals.  Be sure to check with your physician before starting this or any other supplement. 

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

L-Arginine and Cardiovascular Disease, IVF, PCOS, and More..

What is L-Arginine

L-Arginine is an amino acid made naturally by our bodies and is used in protein biosynthesis.  It is also found in foods such as fish, poultry, red meat, and dairy products. L-Arginine is vital to overall health.  It is associated with the Krebs Cycle and is a part of the urea cycle where it carries nitrogenous waste.   This amino acid also causes vasodilation by its conversion to nitric oxide (NO).1

It is important in maintaining the acid-base balance of the body as the urea cycle is a significant consumer of bicarbonate.

We have recently added this supplement to our product line mostly to be used by athletes.  I will cover this, as well as some uses of L-Arginine in this post. 

L-Arginine and in vitro fertilization (IVF)

In vitro fertilization has become increasingly popular for couples who struggle to become pregnant.  This is often attempted during the later child-bearing years after the woman has failed to become pregnant.  There is some research to suggest L-Arginine can increase the number of oocytes collected in women attempting IVF.  This, however, has yet to be shown to improve the viable pregnancy rate.2

L-Arginine and Polycystic Ovary Syndrome (PCOS)

A small study of eight patients with polycystic ovary syndrome was published in December of 2009.  This study showed that a combination of L-arginine 1600 mg daily combined with N-acetylcysteine 1200 mg daily for a period of six months resulted in moderate improvement of menstrual function and decreased insulin resistance.3

L-Theanine Effects on Cardiovascular Disease and Exercise

L-Arginine may lessen angina symptoms and improve exercise and quality of life in angina patients according to a study published in 2002.4

Another randomized, double-blind cross-over study published in September of 2000, found that, although L-arginine supplementation did not affect exercise-induced changes in QT interval, QT dispersion, or the magnitude of ST segment depression, it significantly improved exercise tolerance.  This is most likely the result of improved peripheral vasomotion.5

Many studies have found L-arginine to be effective and decreasing both systolic and diastolic blood pressure.  This has been shown in healthy individuals, those with pulmonary hypertension, as well as patients with type 2 diabetes.6

 

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L-arginine also appears to have an additive vasodilation effect when combined with angiotensin converting enzyme (ACE) inhibitors and nitrate vasodilators when used for the treatment of hypertension.10

 

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Intermittent claudication associated with peripheral arterial disease symptoms have also been shown to improve with the administration of oral or intravenous L-arginine for short term periods (up to eight weeks). 15

 

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Although this is promising, walking speed, walking distance, or absolute claudication distance does not seem to improve with long-term (up to six months) administration of L-arginine. 18

 

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L-Arginine and Erectile Dysfunction (ED)

L-arginine has shown some promise in the treatment of erectile dysfunction.  A double-blind, placebo-controlled study of 50 men with organic ED showed significant improvement in sexual function in 9/29 (31%) of the treatment group but only 2/17 (11.8%) of the placebo group.  The nine patients in the treatment group that showed improvement all had initially low NOx but this level doubled by the end of the study.20

L-arginine seems to be effective in men with mixed-type impotence when combined with Pycogenol at 1.7 grams daily or when combined with both Pycogenol and aspartic acid when dosed at 0.69 grams daily.21

 

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L-Arginine and Statins

The combination of L-arginine and atorvastatin (Lipitor) has been shown to have a significant positive effect on the progression of atherosclerosis.  A study utilizing rabbits found this combination to achieve a 21% decrease in the total area of lesions and a 44% reduction in the area of abdominal lesions compared to the control group.23

A two-arm, randomized, double-blind study on 33 hypertriglyceridemic patients reported that L-arginine alone had no effect on serum lipids compared to placebo. When combined with simvastatin, however, led to a significantly larger reduction in triglycerides compared to placebo plus simvastatin.  This study also found L-arginine attenuated simvastatin-induced increases in aspartate transaminase and fibrinogen.24

L-Arginine and Body Building

L-arginine is popular with body builders because it helps in the synthesis of proteins.  As muscle mass increases, L-arginine helps signal muscle cells and encourages growth hormone release and the metabolism of fat.  This leads to a more defined, stronger, well-defined physique.  L-arginine can also improve endurance and muscle conditioning due to its vasodilation effects.  This increases blood flow to muscle during workout periods.

L-Arginine Drug Interactions

ACE inhibitors, Angiotensin Receptor Blockers (ARBs) and other antihypertensive agents The combination of L-arginine and ACE inhibitors may lead to increased vasodilation and a larger decrease in blood pressure.  When combined, the risk of hypotension exists. Examples include benazepril, captopril, Ramipril, losartan, valsartan, diltiazem, amlodipine, and many more.

Anticoagulants and Antiplatelet DrugsL-arginine may decrease platelet aggregation in humans.  Caution should be exercised when combining L-arginine with medications that increase bleeding risk.  Some examples are warfarin, apixaban, rivaroxaban, enoxaparin, clopidigrel, ticlodipine and others.

Isoproterenol and NitratesL-arginine may lead to increased vasodilation when combined with vasodilators leading to hypotension and dizziness.

Sildenafil (Viagra) – Although not reported in humans, combining L-Arginine with sildenafil may lead to increased vasodilation and dizziness as well.

Potassium-sparing diuretics – There have been some reports of L-arginine causing hyperkalemia in some patients.  Combining L-arginine with these medications may increase the risk of hyperkalemia.  Examples of these medications include amiloride, spironolactone, and triamterene.

Adverse Effects of L-Arginine

L-Arginine is generally well tolerated.  The most common side effects reported for this supplement are:

  • Abdominal pain
  • Bloating
  • Diarrhea
  • Nausea
  • Gout
  • Allergic reactions
  • Exacerbation of airway inflammation in asthmatic patients

L-arginine is an amino acid which helps in the synthesis of proteins.  It also leads to vasodilation and, in doing so, can be beneficial for relieving chest pain.  When combined with a statin, L-arginine leads to a decrease in atherosclerosis which may help prevent heart attacks.  It has also been shown to decrease both systolic and diastolic blood pressures.  Due to its vasodilation properties, L-arginine may help with the symptoms of erectile dysfunction. It may also help with some of the symptoms of polycystic ovary syndrome when combined with N-acetylcysteine.

We recently added L-arginine as a dietary supplement to our product line with the thought of making it available to body builders.  It can increase exercise tolerance and help create a sculpted, muscular body.  As it turns out, many other uses are possible with this substance. 

L-arginine is relatively safe and well tolerated as it is an amino acid found in the human body.  As with any other medication or supplement, allergic reactions are always a possibility.  These reactions are often due to fillers and other substances used to produce the dosage form rather than the active chemical.  Gastrointestinal side effects are always a possibility as well.

If you have any questions about L-arginine or any other medication or supplement, please feel free to send me an email.  I have spent over half of my life working with medications and supplements.   As I have expressed in the past, if I do not know the answer to your question, I will find it.  Have a great week and live a happy, healthy life.  Get plenty of exercise, drink adequate amounts of water, and eat whole foods.  You are worth it.

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

14 Surprising Berberine Uses

The newest supplement available in the Sunshine Store is berberine. We chose to add this product based on the evidence available on its usefulness. As you will learn from this article, berberine may be useful for a variety of health-related conditions. It is one of the few herbal supplements that can have similar effects on the body as prescription medications.

Berberine has been used in Chinese and Ayurvedic medicine for thousands of years. This yellow, bitter alkaloid is found in the roots, bark, and rhizomes of plants such as Oregon grape, goldenseal, European barberry, and tree turmeric, among others.  

What is berberine used for?

Is it safe?

Are there drug interactions?

As mentioned above, berberine has a variety of uses. Some of the most popular are listed below.

Berberine for Diabetes

Berberine has been shown to have a positive effect on diabetes in several studies. 

Some of these effects are listed below.

Taking 500mg of berberine twice daily for three months in patients with type 2 diabetes may reduce glycated hemoglobin (HbA1c), post-prandial glucose (PPG), and fasting plasma glucose (FPG).1

Taking berberine 500mg two to three times daily for two to three months works as well as metformin two to three times a day or rosiglitazone 4mg daily in the regulation of glucose metabolism in type 2 diabetics.

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Berberine for Hypertension

Hypertension is a growing problem. Approximately one million visits to emergency departments listed hypertension as the primary diagnosis in 2016.

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This condition often does not have symptoms associated with it and can go unnoticed for years. 

Hypertension can damage your arteries, heart, kidneys, eyes, and brain. It may lead to stroke, dementia, kidney failure, and blindness.

A meta-analysis showed that combining berberine with amlodipine is more effective at reducing blood pressure than taking amlodipine alone.

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Source: 5

Berberine for Polycystic Ovary Syndrome (PCOS)

There have been studies examining the use of berberine in women with PCOS who were attempting to become pregnant. Although there are mixed results, one study showed that 500mg of oral berberine taken three times daily for three months before IVF increased pregnancy and live birth rate. These results were similar to those obtained when taking oral metformin 500mg three times daily for three months before IVF.

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Berberine for Hyperlipidemia

Meta-analyses show that berberine may reduce total cholesterol (TC), triglycerides (TG), and LDL (bad) cholesterol. 

It can also increase HDL (good) cholesterol levels. It also leads to a more significant reduction in TC and LDL when combined with lipid-lowering medications.

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Berberine may also be useful for the following conditions, although less quality evidence is available to support its use for these.

Congestive heart failure (CHF) – May reduce premature ventricular contractions and lower mortality.

Burns – As an ointment in combination with beta-sitosterol.

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Cholera

Coronary heart disease (CHD) – See hyperlipidemia above.

Diarrhea – May be effective for diarrhea caused by E. coli.

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Glaucoma – As eyedrops in combination with tetrahydrozoline.

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Hepatitis B and C – Berberine decreases triglycerides and blood glucose. It also reduces markers of liver damage, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT).

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Irritable bowel syndrome (IBS) – May reduce the frequency of abdominal pain, diarrhea, and defecation frequency when compared to placebo.

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Symptoms of menopause – When taking berberine along with soy isoflavones, vasomotor symptoms in menopausal women may be decreased when compared to calcium plus vitamin D administration.

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Obesity – Berberine has been shown to decrease weight by 2.3 kg (~5 lbs) in obese patients compared with a control group when ingested for twelve weeks.

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Berberine interactions with Drugs:

Drugs used to treat diabetes – Do not use berberine with antidiabetic medications. There is substantial clinical evidence suggesting this combination increases the risk of hypoglycemia. Berberine should not be used with any drug that lowers blood sugar. 

This includes insulin as well as other oral and injectable diabetes medications.

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Amlodipine and other drugs for high blood pressure – Combining berberine with amlodipine may result in a decrease in both systolic and diastolic blood pressure.

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This effect may also occur with other antihypertensive medications.

Anticoagulants – Since berberine may inhibit platelet aggregation, caution should be used when combining it with antiplatelet or anticoagulant medications. 

The risk of bleeding may be increased.

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Cyclosporine – Do not combine berberine with cyclosporine. This combination may result in an increased level and increased adverse effects of cyclosporine.

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Drugs that may cause sedation – Use caution when combining berberine with medications that produce sedation. 

This combination may lead to an increase in sedative effects. Some examples of sedative agents include.

  • Benzodiazepines
  • Narcotics
  • Barbiturates
  • Sedating antihistamines such as diphenhydramine and hydroxyzine
  • Anticonvulsants

There are other sedating medications, please contact your physician or pharmacist or send me a message to me for clarification.

Medications metabolized by Cytochrome P450 – There are several agents in this category. Below is a shortlist but again, if you have questions about what you are taking, please consult a physician or pharmacist, or simply shoot me an email.

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Ibuprofen (Motrin) – May increase ibuprofen levels.

Losartan (Cozaar) – May decrease therapeutic effects of losartan.

Dextromethorphan (Robitussin DM, Delsym, others) – May increase dextromethorphan levels leading to drowsiness, irritability, and confusion.

Lovastatin (Mevacor) – May increase lovastatin levels.

Sildenafil (Viagra) – May increase sildenafil levels.

Tacrolimus – There has been at least one case report of berberine, causing an increased serum creatinine and tacrolimus level in a 16-year-old patient with idiopathic nephrotic syndrome.

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Patients who take berberine along with tacrolimus should have drug levels checked as tacrolimus dose adjustment may be necessary.

Safety of Berberine in Pregnancy and Lactation

Berberine should NOT be used in pregnant or lactating women. Berberine is believed to cross the placenta and may cause kernicterus and harm the fetus. Berberine may also be secreted into breast milk when taken orally, so it should not be used by breastfeeding mothers.

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Side Effects of Berberine

Although berberine is generally well tolerated, the following side effects were the most commonly reported during research studies.

  • diarrhea
  • constipation
  • abdominal pain
  • abdominal distention
  • vomiting
  • flatulence

Berberine is a substance that has been used in other countries for its health benefits for thousands of years. I became interested in it while reading a book I recently purchased on nutraceutical preparation. This herbal product has the best evidence for its use in diabetes, hyperlipidemia, hypertension, and polycystic ovary syndrome. It can also be effective for several other ailments described above.

 

Berberine should never be used in children or pregnant or breast-feeding mothers. There is some evidence that it may be harmful to the fetus as well as small children. As a pharmacist, I believe in using herbs and medications in pregnancy or children only when absolutely necessary. The risk is just too substantial.

 

Berberine, along with turmeric and ashwagandha, has effects on the body that can rival prescription medications. It can be beneficial for those who have diabetes, PCOS, or obesity. It is generally well-tolerated and is now available in the Sunshine Store for purchase. 

 

Give it a try and let me know what you think.

Always remember to take care of yourself, eat whole foods, drink plenty of water, exercise, and get adequate sleep. These can significantly help in your quest for happiness.

 

 

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Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Abnormal Condition of Dry or Scaly Skin in Older Individuals

What can be done to prevent dry skin as you age?

The skin is the largest organ of the body. It serves as a barrier and protects us from bacteria. 

Skin also helps to regulate body temperature and allows us to respond to heat, cold, and touch. There are three layers that compose the skin.

  • Epidermis – This is the outer layer that serves as a barrier. The epidermis keeps pathogens from entering the body and regulated water being released from the body.
  • Dermis – The layer below the epidermis is called the dermis. This layer contains blood vessels, nerve endings, sweat glands, and hair follicles.
  • Hypodermis – This layer contains fat and connective tissue, and provides cushioning and insulation to the body.

Dermatologists are specialized physicians who diagnose and treat various conditions of the skin. This post will explore dry skin, its causes, treatments, and effects on the aging population.

Effects of Age on the Skin

As we age, our skin becomes thinner. The number of blood vessels, nerve endings, and the amount of connective tissue also decrease. These changes lead to a reduced ability to retain moisture, control body temperature, and sense the environment.

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Pruritis, or itching, is the most common complaint involving the skin in older individuals. Short-term itching, less than six weeks, may protect us, but pruritis lasting more than six weeks can be bothersome. Pruritis can effect the quality of life and, in some cases, patients would rather live a shorter life without symptoms than live longer with pruritis.

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Dry skin (xerosis) is more common in older individuals and those living in colder climates. Heating homes in the winter months leads to decreased humidity that can dry the skin.

Prevention of Dry, Itchy Skin

The best treatment for most anything is prevention. 

Dry, itchy skin is no exception. 

The first step is to monitor the health of the skin regularly. This can be done by scanning the body for problem areas. A physician may also perform skin monitoring during a routine physical exam. 

Some causes of dry skin include:

  • Cold, dry air during the winter months
  • Skin damage from the sun
  • Use of soaps and detergents that damage the skin
  • Excessive immersion in water (taking long baths)
  • Some diseases such as lymphoma, malnutrition, hypothyroidism, eczema, and others
  • Direct exposure to fan heaters

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    One of the best ways to prevent dry to skin is to eat an adequate amount of protein, vitamins, and fatty acids.

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Best Foods to Eat for Healthy Skin

What should you eat to help keep your skin healthy? In general, fresh fruits and vegetables are a good choice because of the vitamins and antioxidants. Below are some great suggestions.

  1. Salmon – Fatty fish, such as salmon, contain omega-3 fatty acids which reduce inflammation and keep the skin moisturized.

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  1. Bell Peppers – Bell peppers are an excellent source of beta-carotene, especially the red and yellow variety. Green bell peppers are picked before they turn color and do not contain as much beta-carotene, which is converted to vitamin A in the body. Bell peppers are also high in vitamin C, which helps keeps the skin healthy by helping form collagen.

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3. Broccoli –

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Probably my favorite vegetable, broccoli, contains many vitamins and minerals necessary for good skin health, including:

  • Vitamin A
  • Vitamin C
  • Zinc

Broccoli, as well as cabbage, cauliflower, and kale, also contains sulforaphane. This substance may protect the skin from the sun’s damage, thus decreasing photoaging.

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  1. Avocados – Packed with healthy fats, this guacamole ingredient can improve skin health by moisturizing and improving flexibility.

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Avocados also contain vitamins C and E, which act as antioxidants. One symptom of vitamin C deficiency is dry, scaly skin. Vitamin C also is needed to make collagen that helps keep skin healthy and strong.

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  1. Tomatoes – Another favorite of mine, tomatoes contain vitamin C, lycopene, and beta-carotene. 

These substances can protect skin from the sun and help prevent wrinkles.

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  1. Soy – Isoflavones are contained in soy. These have been shown to improve skin elasticity and decrease fine wrinkles in at least one study.

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Isoflavones can also protect the skin from the sun’s harmful rays.  

  1. Sweet potatoes – We started eating more sweet potatoes when consuming the Whole30 diet. These are an excellent beta-carotene source that can protect the skin from the sun. Sweet potatoes are a better option than white or yellow potatoes. Give them a try.
  1. Green leafy vegetables – spinach, kale, and collard greens contain vitamins A, C and E. They are also a good source of protein and spinach contains selenium which can protect the skin from UV rays.
  1. Eggs – These are a good source of protein, selenium, zinc, vitamin A and vitamin C.  

10. Healthy oils –  Extra virgin olive oil and fish oil can help with keeping the skin moist and pliable.

Dietary supplements may be necessary if you cannot get enough nutrients from the foods you eat. 

Some of these can be found in the Sunshine Store. The supplements listed below are the same as those contained in the foods above.  

  • Fish Oil
  • Vitamin A
  • Vitamin C
  • Vitamin E
  • Zinc
  • Selenium

Topical Agents for Dry Skin

Daily use of moisturizers that hydrate the skin is important. Some examples of ingredients that can help are:

 

Topical Urea – This is a molecule produced by our body that is naturally found in the skin. It is generated from the metabolism of proteins and other compounds. 

Urea is excreted in the urine and through sweating.

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Urea is one of the best moisturizing agents available to dermatologists today. It has been used safely for over a century and can be utilized for several skin conditions. Urea has different effects on the skin, depending on the concentration employed. At lower concentrations (~10% or less), it acts as a moisturizer, while at concentrations greater than 10%, it has an emollient/keratolytic action. Urea can also enhance the penetration of other molecules through the skin and is used in combination therapies.

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Other skin moisturizers available include glycerin, lactic acid, and petrolatum.

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Other Ways to Help Dry Skin

  • Avoid traditional soaps – regular soap can alkalinize the skin damaging the moisture barrier. Synthetic cleansers such as Dove, Olay, and Cetaphil are preferred.
  • Avoid excessive washing – This can worsen dry skin, especially if very hot water is used. 
  • Avoid aggressive scrubbing and use luke-warm water.
  • Use a Humidifier – Increasing humidity can help decrease skin drying, especially in the winter months.

 

 As we age, our bodies go through many transformations. Energy levels decrease, our kidneys and liver don’t work as well, and we have a higher percentage of body fat. Our skin also changes and becomes thinner, less pliable, and dry. If we don’t care for our skin, it can crack, leading to pain and possible infection.  

 

One of the best things you can do for your body at any age is to eat fresh, whole foods. If you eat a healthy, balanced diet, you are likely to help your skin stay strong and healthy. Always stay hydrated, exercise, and use high-quality moisturizing lotions. 

 

If you live in the northern part of the country where it is cold in the winter, consider using a humidifier to help decrease the effects of dry air on your skin.  

 

Avoid excessive bathing, especially with very hot water, as this may dry your skin. Stick with high-quality synthetic cleansers, and be sure to monitor your skin for dry, scaly areas. If you find problems with your skin, see your doctor. There are medicated creams and lotions available to help relieve the various skin conditions you may be suffering from.

Skin integrity is vital to our overall health. If you have any questions regarding this topic, or any other health or fitness related subject, feel free to contact us. If you have ideas for future blog posts, let me know. My goal is to keep you entertained and informed. Have a great day; be happy, healthy, and keep smiling.

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Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.