Tuesday, September 12, 2017

Breaking Down the Evaluation Criteria (or lack thereof) of a Popular Online Guide for Multivitamins


Recently it was brought to my attention that a self-proclaimed resource for evaluating multivitamins, a source I will leave nameless in print but that the reader is free to ask me about, gave a not-so-good evaluation of some products that I passionately believe in, but glowing recommendations for products that might be considered questionable.  So I wanted to respond by evaluating the "evaluators."

Perhaps I should start by showing the faulty evaluation method in the multivitamin that they ranked at the top of their list, which I will leave nameless for this post.  Most doctors by now know that if a form of a certain nutrient isn't listed, it's probably the cheap, junky stuff.  The reader should take note of several important micronutrients listed in their #1 ranking that do not have the forms listed: iron, magnesium, vitamin E, B6, B12, calcium, etc.  Nearly 100% of the time, when a product line does not list the forms, it is most likely the cheapest and least-effective forms on the planet.  In evaluating any vitamin supplement, it is vital to consider the forms of the ingredients -- ones that are clinically-proven to be effective. (BTW: listing a source, such as algae, is not the same as listing the FORM.)  It is equally important to look at the company's commitment to full disclosure on the labels.  

Secondly, the product in question lists an enzyme blend on their label.  Those who are in-the-know understand that enzymes mixed into a multivitamin is a dead ringer that the product line doesn't know what they're doing.  You cannot add enzymes in with a laundry list of other ingredients like this and have any enzymes left by the time the product is brought to market.  Enzymes gobble things up.  That's what enzymes do.  The enzymes thus denature themselves when they start that process so that in no time there's nothing left.  In doing so they also diminish the levels of many other ingredients in the product.  If a third-party laboratory assay was performed to measure the amount of live enzymes this product, I would be willing to bet that they aren't there. Most likely the company in question does not perform third-party or even in-house assays since the FDA does not require them, and since doing so would most likely show that the product in question has no live enzymes as the label claims.  

In this same product there is also CoQ10 listed on the label.  The consumer should be aware that CoQ10 is very unstable and denatures very easily when combined with several other ingredients.  Even if it was stable, the fact that it's in a powder/capsule form diminishes its effectiveness, since research shows that oil-based CoQ10 is 3-FOLD more bioavailable than dry forms.  

And THIS is the product that this self-proclaimed evaluator of quality multivitamins ranks number one???  

Additionally, here's some very inaccurate statements made about Cyanocobalamin (B12) on the site, and my short response:

  • "Most manufacturers go with the synthetic cyanocobalamin form because it is cheaper to make and has a longer shelf life."  
    • WRONG - Cyanocobalamin is used because it is the most clinically validated, with reams of data involving MILLIONS of patients. 
  • "Unfortunately, it cannot be readily absorbed by the body."
    • WRONG AGAIN.  The research shows the exact opposite.
  • "It also contains trace amounts of cyanide..."
    • "INFINITELY WRONG.  Who is writing this stuff, anyway?  B12 in any form does not contain cyanide.  The "cyano" part of cyanocobalamin has nothing to do with cyanide.   
  • "...making it slightly toxic [wrong] if taken over a long period of time [wrong]...."
When writing content on health-related topics, it really helps to consult the research first.  

(By the way, our multi/phytonutrient blend contains the methylcobalamin form of B12, but not because it's better than cyano.  This was only in response to doctor requests who didn't want to continue answering questions having to do with this unfortunate misunderstanding of this topic.  Having this form of B12 in the product makes these questions go away.  Both forms are very good, but the idea that cyano is an inferior form is categorically false. Feel free to ask me for references.)  

In looking closely at the quality assessment criteria of the site in question
, it becomes obvious 
that it is based on the number 
of nutrients 
and the amounts, 
which is 
a subjective label review
, not objective.
 
Can one define and determine quality based on a label review of ingredients?
​ ​
Absolutely not!  
It is a qualitative opinion of the individuals and not one of particular value to a practitioner or consumer in trying to determine which supplement to purchase. 

Does the author include an understanding of herb manufacture as a measure of quality? 
No.  
Do
 they provide a quality assessment of the listed actives in the standardized herb proving they survive manufacture so that they can provide clinical value to the consumer
?
  No.  
Do they reference any bioactive profiles to prove the herbs are alive, effective, and that the active constituents are maintained at high levels?  Nope.  

And what about 
clinical proof
?
 Did the 
website's 
author include published clinical validation as part of their quality analysis? No.  And why not?  Here's an article showing the importance of this kind of evaluation:


I'm not certain, but the site in question might be related in some way to the book, Comparative Guide to Nutritional Supplements.  The criteria looks very similar.  That book has been around for many years. The author is a former board member for a multilevel supplement company. While everyone has to read for themselves and draw their own opinions, close scrutiny of the book -- as well as the website in question -- suggests the authors (along with a small committee) decided for themselves what nutrients and at what levels should be found in what a 'quality' supplement is, in THEIR OPINION. Then, in essence, they said, "Let’s compare and see who gets closest." One has to decide if this is really a marker of quality. Or, for our phytonutrient/multivitamin blend as an example, is quality ORACfn a much better measurement of phytonutrient 'freshness' and activity? Is COMET assaying a measure of quality? Is peer-journal publication a mark of multivitamin quality

I have not even gotten to GMP, third-party gluten-free certification, GMO status, and on-and-on. Everyone just has to answer for themselves what true quality is, I guess. Is it, "We think quality is specific ingredients at these specific levels," or the kind of standards found in the published research?  

HERE'S AN IMPORTANT QUESTION TO YOUR PATIENTS WHO MIGHT BE USING THE SITE IN QUESTION AS A WAY TO GUIDE THEIR SUPPLEMENT PURCHASES:  

"On what, if any, standards are these scoring systems based?"  

The patient won't be able to tell you, of course, because the site itself can't tell you.  As far as I can tell, again, it's someone's opinion, because they certainly didn't consult the research.  Everybody has an opinion...and a belly-button. "I devised a scoring system..." is not based on fact or objectivity.  Remember that old Wendy's commercial where the old lady demanded, "Where's the beef!?"  That's the same question people should be asking when it comes to research.  Anyone can SAY anything!  I can SAY that our multi grows hair on the heads of 8 out of 10 bald men, and you know what -- if I put that on a website, a lot of people would believe it and buy the product on the basis of that statement.  But where's the beef?  Where's the research to validate my claims?  Without that, the claims on the product are not worth the paper they're printed on.  

Now, if you want research and an objective way to evaluate a multi, it may interest you to know that a study published in 
GLOBAL ADVANCES IN HEALTH AND MEDICINE showed that our phytonutrient/multivitamin blend effected improvements in several health parameters, including cardio markers MPO, LDL, CRP, and PAI-1, as well as the Comet Assay, and an antioxidant level evaluation in the PERSON after taking the product, not just the product itself.  

How come the "evaluators" of this site (and I use that term very loosely) didn't use this kind of criteria?  Good question, Sherlock.

Okay, if I go any further I'm gonna start getting really snarky or start preaching like a Pentecostal evangelist at a tent revival.  So I better quit. 

But here's another very short tidbit I will leave you with:  The site in question denigrates folic acid, yet their #2 recommendation for multis uses straight folic acid. How is it possible that they gave that product the number two ranking, then?  They aren't even consistent with their own standards.  Someone is greasing someone's hand here.  OR, they aren't even really paying attention to what they are saying versus the products they are recommending.  One or the other.  In either case, even a cursory analysis of this site shows they are totally unreliable as a scientific source. 




Friday, July 28, 2017

CONSEQUENCES OF ACID BLOCKING DRUGS, AND NATURAL ALTERNATIVES

The topic of proton pump inhibiting drugs, or PPIs, otherwise known as acid blockers, has been a topic near and dear to my heart recently because my father, who is very medically indoctrinated, has been on a PPI for YEARS, and is now very sick with some of the side effects, such as extreme fatigue, stomach distension, and small intestine bacterial overgrowth, or SIBO.  He was also diagnosed with bladder cancer, and a 2011 study showed that PPIs are linked to cancer, although the form of cancer analyzed in that study was esophageal cancer. 

So in researching this topic for the benefit of my father, I discovered that PPI’s were never intended to be used long term anyway, even by the standards of the drug companies who make them.  Yet my Dad and countless other PPI users have been on them for years. 

If you know even basic physiology, it’s not really rocket science to know that suppressing the stomach acid at all, especially for stretches of years, is a really, really bad idea.  Stomach acid is the first line of defense against pathogenic bacteria, it stimulates peristalsis, it initiates bile secretion, and of course it helps to assimilate important nutrients like B-vitamins, minerals, and protein, just to name a few.

Let’s just consider SIBO for a moment.  If stomach acid is suppressed, it allows some pathogens to survive in the stomach that would otherwise be eliminated, leading to infections of the stomach like H. Pylori.  But then that pathogenic bacteria gets transported into the small intestine, and later the bowel, and can also go systemic, leading to all different kinds of potential maladies related to that circulating bacteria. 

Likewise, suppressing the stomach acid can lead to putrefaction of food in the stomach, leading to halitosis, distension, and more problems with indigestion.

And actually, this is where the whole maddening thing about using acid blockers in the first place needs to be addressed, because the whole idea about acid reflux being a manifestation of too much acid represents a lack of understanding, in some cases, of stomach physiology. 

Think about it.  Our stomachs have these cool little muscles at the top called the esophageal sphincter, which pinches off and blocks the acid from reaching the esophagus.  That muscle is activated by, guess what?  Stomach acid!  If a patient has hypchlorhydria, or low stomach acid, that muscle’s action can be inhibited, and it might not activate like normal, resulting in what little stomach is there reaching the esophagus.  Now, even a little acid in the esophagus is very irritating, and the medical interpretation is, “Oh! You have too much stomach acid.  Let’s block it.”  No, that patient probably has too LITTLE stomach acid, but the manifestation is burning in the chest and throat.

Here’s an example that I think will be helpful and applicable.  One Thanksgiving my older sister was at our house sharing the Thanksgiving meal with us, and afterward she sat down on my couch holding her stomach and moaning.  When I asked what was wrong, she said she had been struggling with indigestion and acid reflux for a long time, and she was having another episode.  So I gave her three tablets of a product containing betaine HCl and pepsin, or stomach acid.  In about 20 minutes she felt so much better that she had to ask me what it was that I gave her.   Sometimes if the problem is mild you can accomplish the same thing with apple cider vinegar.  I have had some success with that approach as well.

Now, having a patient go off a PPI can be tricky, because the parietal cells in the stomach have been suppressed for so long that sometimes it can trigger a strong rebound effect.  So to fight that, I would recommend having a combination powder containing DGL, aloe, and glutamine.  That combination is great in helping to soothe the discomfort associated with acid reflux while the patient is weaning off the drug. 

I also had a practitioner just this past week tell me that she gives magnesium to patients coming off long term PPIs because it helps get peristalsis going again, so I thought that was good insight. 


Feel free to reach out me if you need some product guidance.

Wednesday, July 12, 2017

Weight Control, Glucose Sensitivity, and the other Benefits of B. Lactis B420

As the research on probiotics continues to mushroom, some very compelling applications are being shown that would not have previously been attributed to the microbiome.  

Along those lines, then, there's some very interesting research surrounding a new probiotic strain called, Bifidobacterium Lactis B420.  

Now, before we examine the research on this strain, let's first note that medical science is beginning to make a connection between body weight and gut microbiota.  This was first discovered by accident with fecal implant patients.  Doctors began to notice that recipients of fecal implants would take on the characteristics of the donor in terms of body composition.  So a study was done on mice to try to reproduce this, and indeed they found the same thing in the laboratory.  A fecal sample was taken from an obese person and implanted into a mouse, and the mouse gained weight. 

So enter, then, the research on B. Lactis B420. 

Before we look at the research specific to body weight, let’s first look at the various other benefits of this impressive strain on other health paramters.

Experimental research has indicated that:

  • B420 increased tight junction integrity of epithelial cells, and therefore protected gut epithelial cells from the harmful effects of pathogenic microbes.
  • B420 protected against NSAID-induced GI side effects in a rat model by reducing an NSAID-induced inrease in stomach permeability
  • B420 reduced mucosal dysbiosis, bacterial translocation, expression of major pro-inflammatory cytokines in various tissues, and improved glucose metabolism in mice fed a high fat diet (HFD).
  • In HFD-fed mice, B420 modulated gut microbiota and improved glucose intolerance.  Further, the combination prevented the impairment of intestinal immunity due to metabolic abnormalities induded by the HFD.
  • In a mouse model of diabetes, B420 enhanced concentrations of ileum GLP-1, a protein involved in both insulin secretion and satiety signaling.
  • In an obese mouse model, increases in body weight and fat mass in mice fed with HFD for 12 weeks were significantly reduced if the mice were co-administered B420.  
  • In a diabetes mouse model, mice receiving both HFD and B420 had decreased fat mass compared with mice receiving only HFD.  B420 also improved glucose metabolism in this mouse model.


So this is already a very impressive list of benefits even without the benefits of weight control.  But now let’s turn our attention to that aspect, which is human data.

The goal here was to determine if the B420 could make a change in the incremental body weight that many people experience over time as they age.  The untreated group of overweight individuals gained 3.1% of bodyweight in six months.  The overweight group receiving 10 billion units per day of the B420 probiotic strain, however, did not gain any extra body weight in that same period of time, and they observed no dietary or lifestyle changes.  All they did was add the probiotic.  The probiotic group also showed a slight decrease in waist circumference of 2.4%, AND they ate less, showing improved satiety with the use of the probiotic strain. 

Another very positive benefit was the improvement in short chain fatty acids over that period of time, a huge benefit to gut health. 

Now, as we know, many people tend to gain weight as they age, some a little, and some a lot.  It’s too early to tell if the B420 can legitimately be called a weight LOSS probiotic, but it can certainly be called a weight CONTROL probiotic.  With that in mind, remember that those in the study didn’t change anything about their lifestyles.  So it could be, perhaps, that if this probiotic strain was added to a weight loss plan, it may amplify the effects of the other weight loss efforts….maybe.  Again, there’s not enough information to go on yet to verify that statement, but I think it’s a fairly good assumption that this could be the case. 

I’ll close by saying that weight gain with age is multi-factorial, and can be attributed to shifts in hormones and other factors.  However, we cannot and should not rule out the changes in the microbiome that occur with age as well.  And weight issues aside, there are enough other benefits with this remarkable strain that it should be considered for use with leaky gut and autoimmune patients, those with gut dysbiosis, and even glucose and insulin intolerance. 

References available upon request