Therapeutic Nutrition and Supplements in Practice

The best way to get started, is to get started. THERAPEUTIC NUTRITION AND SUPPLEMENTATION IN PRACTICE

Instructor: Josh Gitalis, Ba(Hons), CNP, RNCP/ROHP Contact: [email protected] (Put “TNSP” as the subject) Website: www.joshgitalis.com

Optional texts (recommended): • Staying Healthy with Nutrition (Elson Haas) • Encyclopedia of Natural Medicine (Michael Murray and Joseph Pizzorno)

Certification exam • Final open book exam: passing mark is 80%

Table of Contents Pages

Elemental Composition of the Body 1 Slope of Health 2 Nutrient Summary Chart 3-4 Risk of Dying 5 Vitamins and Mineral Supplement Ranges and Indications 6-24 Dietary Reference Intakes 25-39 Vitamin D Dosing 40-41 Vitamin D Disease Incidence Prevention 42 Antioxidant Network 43 Pediatric Dosing 44 Essential Fatty Acids 45-50 Glandulars 51-53 Amino Acids 54-57 Enzyme Therapy 58-65 Accessory Nutrients 66-75 Contraindications of Therapeutic Supplements 76-80 Nutrient Depletions Caused By Pharmaceuticals 81 Herbs 82-90 Mushrooms 91-101 Bee Medicine 102-109 Juicing 110-112 Therapeutic Foods 113-123 Therapeutic Superfoods 125-129 References 130

Elemental Composition of The Human Body (70 Kg)

Macrominerals Key Function Grams Oxygen Cell and tissue respiration, water 43,000 Carbon Protoplasm 12,000 Hydrogen Water, tissue 6,300 Nitrogen Protein tissue 2,000 Calcium Bone and teeth 1,100 Phosphorus Bone and teeth 750 Potassium Intracellular electrolyte 225 Sulfur Amino acids, hair, and skin 150 Chloride Electrolyte 100 Sodium Extracellular electrolyte 90 Magnesium Metabolic electrolyte 35 Silicon Connective tissue 30

Micorminerals Mg Iron Hemoglobin, oxygen carrier 4,200 Fluoride Bones and teeth 2,600 Zinc Metallo-enzymes 2,400 Strontium Bone integrity 320 Copper Enzyme cofactor 90 Cobalt Vitamin B12 core 20 Vanadium Lipid metabolism 20 Iodine Thyroid hormone 15 Tin Unknown 15 Selenium Enzyme, antioxidant, detoxification 15 Manganese Metallo-enzymes 13 Nickel Unknown 11 Molybdenum Enzyme cofactor 8 Chromium Glucose tolerance factor 6

This chart is adapted from a paper entitled “Essential trace Elements, An Overview”, by Dewitt Hunter and is based on percent body weights and parts per million (ppm) in this text. 1 ppm = 1 mcg. (microgram) per gram, 1000 mcg. = 1 mg. (milligram), 1000 mg = 1 g. (gram)

1 The Slope of Health Life Blood tests normal

Heredity Medical (effect) (inherited factors) Physical signs and symptoms of body out of balance - pain, fatigue, headaches, etc.

Poor diet + lifestyle OTC drugs to suppress symptoms

Vitamin + mineral deficiency Diagnosis of a disease/condition

Lifestyle (cause) Artificial food additives Surgery to remove dysfunctional body part or stronger meds to further suppress symptoms Pesticides and chemical exposure

Cancer, tumors, and growths Environmental pollution More surgery, chemotherapy, Digestive problems and internal toxicity and/or radiation

Personal Health Assessment Suppressive medications Where am I on The Slope of Health? How did I get there? End stage How long will it take for me to climb back? What do you think it takes to get up the slope back to health? Copyright2 © 2013 NUTRIENT SUMMARY CHART

Note: All RDA values are for an adult male

Nutrient RDA Maintenance Therapeutic Vitamin A 3000 IU/day 2500-5000 IU/day 50,000-100,000 IU/day Beta-carotene 10,000 IU/day 25,000 IU/day 300,000 IU/day >1 year 1000 IU/day <1 yr 1000 IU/ 25 lbs of body Vitamin D 600 IU/day 10,000 IU/day 50,000 IU/week weight/day Adults 5000-10,000 IU/day Vitamin E 22.5 IU 400 IU 400-3200 IU/day Vitamin K 90-120 mcg/day 150-500 mcg/day 150-500 mcg/day Vitamin C 90 mg/day 2-9 g/day 2-75 g/day in divided doses Thiamin 1.2 mg/day 10 mg/day 50 mg - 8 g/day Riboflavin 1.3 mg/day 5-10 mg/day Up to 400 mg/day • Niacinamide 25 mg/kg of body for Diabetes • Flushing Niacin 100 mg increased over 4-6 Niacin 16 mg/day 25-50 mg/day wks to 1.5-3 g daily in divided doses • Inositol Hexaniacinate 500 mg TID for 2 wks then increase to 1000 mg Pyridoxine 1.3 mg/day 10-15 mg/day 50-1000 mg/day Biotin 30 mcg/day 30-100 mcg/day Up to 3000 mcg/day Pantothenic Acid 5 mg 25-100 mg/day 250 mg – 2 g/day Cobalamin 2.4 mcg/day 100 mcg/day Up to 60 mg/day Folic Acid 400 mcg/day 400 mcg/day 5-20 mg/day Choline 425-550 mg/day 425-550 mg/day 350-10,000 mg/day as phosphatidylcholine Inositol None 100-2000 mcg/day 100-2000 mcg/day Calcium 1000 mg/day 1000-1200 mg/day or lower 12 mg/2.2 lbs of body weight/day or to bowel Magnesium 310-420 mg/day 6 mg/2.2 lbs of body weight/day tolerance Potassium None 1.9-5.6 g/day 1.9-5.6 g/day Zinc 8-11 mg/day 15-20 mg/day 30-150 mg/day Boron None 3-9 mg/day 3-9 mg/day Chromium 25-35 mcg/day 200 mcg/day 1000 mcg/day Copper 900 mcg/day 1.5-3 mg/day 1.5-3 mg/day Iodine 150 mcg/day 500 mcg – 100 mg/day 500 mcg – 100 mg/day 60-90 mg/day Iron 8-18 mg/day iron succinate/fumarate Manganese 1.8-2.3 mg/day 2-5 mg/day 5-200 mg/day Molybdenum 45 mcg/day 45-500 mcg/day 45-500 mcg/day Children 1.5 mcg/lb of body Children 1.5 mcg/lb of body weight Selenium 55 mcg/day weight Adults 50-200 mcg/day Adults 50-200 mcg/day Silicon None 2-20 mg/day Up to 120 mg/day Vanadium None 50-100 mcg/day Up to 2.4 mg/day 1-2 tbsp flax oil/day EFAs None 2 g omega-3 fish oil/day 6 g omega-3 fish oil/day

3 Nutrient Therapeutic Nutrient Therapeutic 1 cap/day, increase every 2 days until Adrenal Glycine 4-8 g/day stimulatory effect, then decrease by 1 Liver 2 g/day Proline 2 g/day Pancreas 2 g/day L-Glutamine 5-40 g/day Spleen 1.5 g/day Tyrosine 500 mg – 2 g/day Thymus 800 mg/day Carnitine 1.5-4 g/day in divided doses Pituitary 270 mg/day Taurine 1.5-6 g/day Kidney 3 g/day Bovine Colostrum 1 tsp – 2 tbsp /day Ovary/Uterus 600 mg/day Coenzyme Q10 50-1000 mg/day Heart 600 mg/day Proanthocyanins 150-300 mg/day as GSE or PBE Lung 400 mg/day Quercetin 200-8000 mg/day Green tea Brain 600 mg/day 240-320 mg/day polyphenols Lysine 1000 mg TID (500 mg non-acute) Rutin 1-3 g/day Phenylalanine 1-3 g/day Glucosamine 500 mg TID Tryptophan 1-3 g/day Lipoic Acid 20-600 mg/day R-type Sleep 0.1-3 mg before bed Arginine 500 mg – 4 g/day Melatonin Anticancer up to 50 mg/day 250-750 mg/day with 3x the amount Cysteine of vitamin C

Nutrient Maintenance Therapeutic Phosphatidylserine 600 mg/day Probiotics 10-25 billion/day 50 billion - 1 trillion /day • Depression, Osteoarthritis 400 mg 3-4x/day S-Adenosylmethionine • Fibromyalgia 200-400 mg BID Osteoarthritis 200 mg BID (SAM) • Liver disorders 200-400 2-3 x/day • Migraines 200-400 BID Policosanol 20 mg/day Fibre 38 g/day Work up from 1 to 15 g/day (Including dietary fibre) Curcumin 20-600mg of Curcumin, 240mg of Theracurmin Lecithin 10-25 g/day Hydrochloric Acid 700 mg – 5 g /meal HCl

4 Risk of Dying Compared to Being Killed on a Boeing 747 Flight (See separate table for units of risk used) Relative risk

0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 10,000 11,000 Associated with medical injury in acute hospitals only 10,348 Smoking 6,303 Preventable medical injury - (Acute Hospitals - NZ/AUS/USA adj) 4,085 Preventable medical injury - (Acute Hospitals only Minister's est) 3,268 1,000

of Risk Preventable adverse drug reaction - acute hospitals (NZ adj) 1,716

Less than 1 per Cardiovascular disease 1,290 Very High Level

Adverse drug reaction (all) 980 Adverse effects of pharmaceutical drugs - all (USA adj) 756 Lung cancer 492 Motorcycle accidents 471 Cerebrovascular disease 462 Breast cancer 311 Alcohol related (Liver disease + direct) 277 Firearms - total 270 Ultralight aircraft 235 Prostate cancer 233 High Level of Risk 1:1,000 to 1:10,000 Diabetes 183 Horse riding 163 Higher level of risk - safety Suicide 157 Farm work 115

Traffic accidents 97 All Terrain Vehicles 69 Workplace accidents 56 Accidental falls 55 Snowmobiles 54 Accidental Poisoning - Medicines 46 War operations 39 Influenza 24 Air - corporate/private/clubs (Per hour Canada) 23 Suicide - Pharmaceutical drugs 19

1:10,000 - 1:100,000 Food (est - USA/Aus) 19 Moderate Level of Risk Homicide 15 Drowning - accidental (male) 15 Pedestrians 13

School bus accidents 10 Firearms - accidental 9 Air accidents (All Canada - Per flight) 9 Choking on food/other objects 8 Risk (1 fatality per x Units of Exposure to Fire 8 Food - Highly preventable (est - USA/Aus) 8 Water transport 7 Pedal cyclist 6 Avalanche 5 Forces of nature 4 Low Level of Risk Railway (total) 4 1:100,000 to 1:1,000,000 Tuberculosis 3 Sport & recreation 2 Menningitis 1.7

Boeing 747 (#flights- worldwide) 1.0 Acceptable risk for cancer (food additives) 1.0 Railway -- Pedestrian 0.96 Electrocution 0.86 Airbus A300 (#flights - worldwide) 0.68 Commercial airliners (per hour - Canada) 0.57 Air accidents (all passengers - Canada) 0.37 Lightning 0.25 1:1,000,000 - 1:10,000,000 Bee/wasp/hornet sting 0.06 Natural healthcare & therapeutic products 0.014 De Minimus Level of Risk Meteorite 0.000006 Ultra Safe to Very Low Level of Risk Greater than

1:10,000,000 Sources: Extensive search of many Canadian Government, quasi government and NGO websites, documents, databases and research outputs © R Law 2004

Vitamin and Mineral Supplement Ranges and Indications

Basic supplementation Maintenance in healthy person or base for therapeutic program 1. Multi-vitamin and mineral without Fe (unless confirmed Fe deficiency) 2. Essential Fatty Acids or Balanced Oil Blend 3. Vitamin D 4. Probiotics

Adult Male 1. Multi-vitamin and mineral without Fe (unless confirmed Fe deficiency) 2. Essential Fatty Acids or Balanced Oil Blend 3. Vitamin D 4. Probiotics

Women of childbearing age 1. Multi-vitamin and mineral without Fe (unless confirmed Fe deficiency or heavy menstrual flow) a. If trying to conceive: at least 1mg Folate (MTHF Form) b. Pregnant women should not exceed 10,000 iu of vitamin A 2. Essential Fatty Acids or Balanced Oil Blend 3. Vitamin D 4. Probiotics 5. Iodine (confirm requirement with testing)

Children 1. Multi-vitamin and mineral without Fe (unless confirmed Fe deficiency) a. Can use adult multi. Adjust for body weight. 2. Essential Fatty Acids or Balanced Oil Blend 3. Vitamin D 4. Probiotics

Vitamins

Vitamin A and Carotenes Food Sources • Vitamin A sources: liver, kidney, butter, whole milk • Provitamin A sources: dark leafy greens (collards, spinach), yellow-orange vegetables (carrots, sweet potatoes, yams, squash)

Symptoms • Hyperkeratosis, night blindness (xerophthalmia), increased rate of infection

Beneficial effects • Development and maintenance of epithelial tissue • Reproduction

• Immune – primary non-specific host defense o Induces antitumor o Enhanced WBC o Increased antibody response

Principal uses • Eye health • Immune enhancer • Skin disorders • Cancer prevention

Conditions • Measles • Respiratory illness • AIDS

Dosage • Maintenance vitamin A: 2500-5000 I.U. per day • Therapeutic vitamin A: up to 50,000-100,000 I.U. (for 1-2 days) • Maintenance beta-carotene: 25,000 I.U. per day • Therapeutic beta-carotene: up to 300,000 I.U.

Absorption • Vitamin A 80-90% - similar at higher dosages • Beta-carotene 40-60% and decreases as dosage increases

Vitamin D Food sources • Cod liver oil, mackerel, salmon, herring, butter, and egg yolks

Beneficial effects • Bone health • Cancer prevention: especially breast and colon

Dosage (Check levels every 2-3 months) • Under age of 1: 1000 I.U. per day • Over the age of 1: 1000 I.U for every 25 lbs. of body weight per day • Adolescents/Adults: 5000-10,000 I.U. per day • Above 125 lbs. therapeutic: 10,000 iu /day 50,000 iu /week (check blood in 8 weeks) (Reference for dosages: www.vitamindcouncil.org)

Vitamin E Food Sources • Polyunsaturated vegetable oils, seeds, nuts, whole grains, asparagus, avocados, berries, green leafy vegetables, and tomatoes.

At risk of deficiency • Fat Malabsorption syndromes: celiac, IBD, cystic fibrosis, gastrointestinal surgeries

Deficiency signs and symptoms • Nerve damage, muscle weakness, poor coordination, involuntary movement of the eyes, breaking of red blood cells leading to anemia (hemolytic anemia)

Principal uses • As an antioxidant: heart disease, strokes, and cancer • Diabetes • Fibrocystic breast disease (FBD) • Menopausal symptoms • Tardive dyskinesia

Dosage • Therapeutic: 400-3200 I.U. per day

Forms • Synthetic: l-alpha-tocopherol • Natural: d-alpha-tocopherol • Natural forms showing vitamin E activity: o d-alpha-tocopherol o d-beta-tocopherol o d-gamma-tocopherol o d-delta-tocopherol o d-alpha- tocotrienol o d-beta- tocotrienol o d-gamma- tocotrienol o d-delta-tocotrienol

Vitamin K Food sources: • Kale, green tea, turnip greens, spinach, broccoli, natto

Beneficial effects • Clotting • Bone health • Stimulates hemoglobin and red blood cell formation • Reduces excessive menstrual flow

Dosage • Maintenance: 150-500 mcg per day

Forms • K1 (phylloquinone): natural from plants • K2 (menaquinone): produced by bacteria in the gut • K3 (menadione): synthetic

Vitamin C Sources • Acerola, sweet red pepper, kale, parsley, collard leaves

Sensitivity to air • Freshly sliced cucumbers, if left standing, lose 49% of their vitamin C within 3 hours • Cantaloupe uncovered in refrigerator loses 35% in 24 hours.

Deficiency symptoms • Bleeding gums, poor wound healing, bruise easily, susceptibility to infection, hysteria, and depression

Beneficial Effects • Manufacture of collagen (proline to hydroxyproline) • Antioxidant – regenerates vitamin E • Manufacture of neurotransmitters and hormones, carnitine • Absorption and manufacture of nutritional factors (i.e. Fe) • Supports adrenals

Forms • Ascorbic acid – least expensive • Buffered – use Na, Mg, Ca, K. Easier on some people’s stomach’s • Ester-C – long chain of vitamin C • With bioflavonoids – amounts equal or greater to vitamin C increase absorption

Conditions it supports • Asthma and allergies • Cardiovascular disease • Cancer • Cataracts • Common cold • Diabetes • Parkinson’s disease • Wound healing

Dosage • Maintenance: 2-9g per day • Therapeutic: 2-75g per day in divided doses (can take to bowel tolerance)

What is rebound scurvy? If you are taking high dose vitamin C for a long period of time and then stop abruptly, one can develop mild symptoms of scurvy. This can be easily avoided by slowly tapering off the dosage from a therapeutic level to a maintenance level.

Thiamin (B1) Sources • Brewer’s yeast, wheat germ, sunflower seeds, pine nuts, brazil nuts

Deficiency symptoms • Beriberi, fatigue, depression, pins and needles, numbness, constipation

Beneficial effects • Part of key enzyme thiamin pyrophosphate (TPP) essential for energy production, carbohydrate metabolism, and nerve cell function

Uses • Psychosis – 30% admitted to mental wards are B1 deficient • Alzheimer’s – thiamine mimics acetylcholine which is deficient in Alzheimer’s • Epilepsy

Form • Thiamine (HCl) • Benfotiamine (fat-soluble, active form)

Dosage • Therapeutic: 50mg – 8g per day (thiamine), 600mg (benfotiamine)

Riboflavin (B2) Sources • Brewer’s yeast, calf liver, almonds, wheat germ, wild rice, mushrooms

Deficiency symptoms • Cracking of lips and corner of mouth, inflamed tongue, sensitivity to light, cataract, disorders of mucous membranes, anemia, seborrheic dermatitis

Beneficial effects • Production of energy in key enzymes FMN and FAD • Regenerating glutathione

Uses • Migraine headaches • Cataracts • Sickle cell anemia

Forms • Riboflavin • Riboflavin-5-phosphate (active)

Dosages • Maintenance: 5-10mg per day • Therapeutic: up to 400mg per day

Niacin (B3) Sources • Brewer’s yeast, rice/wheat bran, sesame seeds, sunflower seeds, brown rice

Deficiency symptoms • Pellagra (dermatitis, dementia, diarrhea)

Beneficial effects • Production of energy in key enzymes NAD and NADP • Regulation of blood sugar, antioxidant mechanisms, and detoxification reactions

Uses • Decreasing cholesterol • Raynaud’s phenomenon • Intermittent claudication • Diabetes and diabetes prevention • Arthritis (niacinamide)

Forms • Niacin, nicotinic acid, nicotinate – flushing form • Niacinamide, nicotinamide – non-flushing form • Inositol hexaniacinate – non-flushing

Note: avoid the use of “time-release” niacin as it can be toxic to the liver.

Dosages • Maintenance: 25-50 mg daily • Therapeutic: o Niacinamide: 25mg per kg of body per day for Diabetes o Flushing-niacin: 100mg increased over 4-6 weeks to 1.5-3g daily in divided doses o Inositol hexaniacinate: 500mg 3x/day for 2 weeks and then increase to 1000mg.

Pyridoxine (B6) Sources • Brewer’s yeast, sunflower seeds, wheat germ, walnuts, lentils, lima beans

Deficiency symptoms • Depression, convulsions, glucose intolerance, anemia, impaired nerve function cracking of the lips and tongue, eczema

Beneficial effects • Healthy pregnancy • Immune system • Mucous membranes • Skin • Red blood cells

Uses • Asthma • Autism • Cardiovascular disease • Carpal tunnel syndrome • Depression • Diabetes • Epilepsy • Immune enhancement • Kidney stones • Morning sickness • Osteoporosis • Premenstrual syndrome

Forms • Pyridoxine hydrochloride • Pyridoxal-5-phosphate (most active) (B2 and Mg catalyze this conversion in the body)

Dosages • Maintenance: 10-15 mg daily • Therapeutic: 50-1000 mg daily

Biotin Sources • Brewer’s yeast, beef liver, rice bran/germ, walnuts, barely, pecans

Deficiency symptoms • Dry scaly skin, nausea, anorexia, seborrhea, alopecia

Beneficial effects • Metabolism of sugar, fat, and amino acids, and cell growth and replication

Uses • Nail and hair health • Seborrheic dermatitis • Diabetes Forms • Biotin • Biocytin (complex from brewer’s yeast composed of 65.6% biotin)

Dosages • Maintenance: 30-100 mcg daily • Therapeutic: up to 3000 mcg daily

Pantothenic Acid (B5) Sources • Brewer’s yeast, calf liver, mushrooms, split peas, pecans, oatmeal

Deficiency symptoms • Numbness and foot pain, fatigue

Beneficial effects • Utilization of fats and carbohydrates in energy production • Manufacture of adrenal hormones • Manufacture of red blood cells

Uses • Adrenal support • Rheumatoid arthritis • High cholesterol (Pantethine) • Diabetes

Forms • Pantothenic acid (calcium pantothenate) • Pantethine (most active)

Dosages • Therapeutic: 250 mg – 2 g daily

Cobalamin (B12) Sources • Lamb/beef/chicken liver, sardines, trout, salmon, eggs, cheese

Deficiency symptoms • Pernicious anemia, numbness, tingling, depression, diarrhea, smooth-beefy-red tongue,

Beneficial effects • Energy metabolism • Immune function • Nerve function Uses • AIDS • Impaired mental function in the elderly • Asthma with sulfite sensitivity • Depression • Diabetes • Low sperm count • Multiple sclerosis • Tinnitus (noise-induced)

Forms • Cyanocobalamin • Methylcobalamin (active form)

Dosages • Maintenance: 100mcg daily • Therapeutic: up to 60 mg daily (Reference: AOR website)

Folic Acid Sources • Brewer’s yeast, blackeye pees (and most legumes), asparagus, walnuts, spinach, kale

Deficiency symptoms • Poor growth, diarrhea, anemia, gingivitis, abnormal pap smear, depression, insomnia, irritability, forgetfulness, loss of appetite, fatigue, shortness of breath, atherosclerosis, osteoporosis

Beneficial effects • Manufacture of DNA and neurotransmitters • Homocysteine metabolism (along with B6 and B12)

Uses • Neural tube defects, atherosclerosis, osteoporosis, cervical dysplasia, and depression, Crohn’s, colitis, ulcers

Forms • Folic acid (folate) • Folinic acid (5-methyl-tetra-hydrofolate or 5MTHF) (most active)

Dosages • Maintenance: 400mcg daily • Therapeutic: 5-20mg daily

Cautions • Folic acid supplementation can mask a B12 deficiency and therefore should always be combined. If folic acid is given and there is an underlying B12 deficiency, permanent nerve damage can result. • Folic acid (the non-methylated form) can promote the growth of certain cancers

Choline Sources • Eggs, beef liver, cauliflower, orange, potato,

Deficiency symptoms • Liver dysfunction,

Beneficial effects • Lipotropic agent • Improve memory • Liver detoxification

Uses • Liver disorders • Elevated cholesterol • Alzheimer’s disease • Bipolar depression

Forms • Choline bitartrate/citrate/chloride • Phosphatidylcholine (soy lecithin contains 2.3g per 1.5 tbsp)

Dosages • Therapeutic: 350-10,000mg daily (as phosphatidylcholine)

Inositol Sources • Citrus, whole grains, nuts, seeds, legumes

Deficiency symptoms • None have been discovered

Beneficial effects • Lipotropic agent

• Nerve, brain, and muscle function

Uses • Liver disorders • Depression • Panic disorders • Diabetes

Forms • Inositol monophosphate • Phosphatidylinositol (lecithin contains 1.4 g per 1.5 tbsp)

Dosages • Therapeutic: 100mg-2000mg daily, up to 12g to restore serotonin sensitivity

Minerals Calcium Sources • Kelp, dairy, carob, collard leaves, kale, almonds

Deficiency symptoms • Rickets, osteomalacia, muscle spasm, cramps, high blood pressure, osteoporosis, colon cancer

Beneficial effects • Builds healthy bones and teeth • Protective factor against high blood pressure and colon cancer

Uses • Osteoporosis • High blood pressure • Pregnancy

Forms • Dolomite, oyster shell (might contain high lead content) • Calcium carbonate • Calcium citrate/gluconate/lactate/aspartate/orotate/fumarate/malate/succinate • Microcrystalline Hydroxyapatite Complex (most absorbable)

Dosages • Maintenance: 1000-1200 mg daily

Magnesium Sources • Kelp, wheat bran/germ, cacao, almonds, cashews, buckwheat

Deficiency symptoms • Fatigue, mental confusion, irritability, weakness, heart disturbances, problems in nerve conduction and muscle contraction, muscle cramps, loss of appetite, insomnia, susceptible to stress Beneficial effects • Energy production • Protein formation • Cellular replication • Involved in 300+ enzymatic reactions (mostly for energy production) • Activates Na/K pump • Blocks calcium influx

Uses • Asthma • Cardiovascular disease and heart conditions • Diabetes • Fibromyalgia • Glaucoma • Hearing loss • Hypoglycemia • Kidney stones • Migraine • Osteoporosis • PMS and dysmenorrhea

Forms • Magnesium oxide, carbonate, gluconate, sulfate, chloride (least absorbable) • Magnesium aspartate, malate, succinate, fumarate, citrate (more absorbable) • Magnesium bisglycinate (most absorbable) • Magnesium Taurate (specific for cardiovascular)

Dosages • Maintenance: 6mg per 2.2 pounds body weight daily • Therapeutic: 12mg per 2.2 pounds body weight daily or to bowel tolerance

Potassium Sources • Apple, avocado, banana, cantaloupe, chicken, flounder

Deficiency symptoms • Muscle weakness, fatigue, mental confusion, irritability, weakness, heart disturbances

Beneficial effects • Water balance and distribution • Acid-base balance • Muscle and nerve cell function • Heart function • Kidney and adrenal function

Uses • Potassium depletion • High blood pressure

Forms • Potassium chloride, bicarbonate, aspartate, citrate, etc.

Dosages • Maintenance: 1.9-5.6 g daily • Note: Doses higher than 99mg are only available by prescription. The best way to increase potassium intake is by consuming fruits and vegetables that have many more times the amount of potassium than any pill.

Zinc Sources • Oysters (usually high in heavy metals), pumpkin seeds, ginger, pecans, split peas

Deficiency symptoms • Skin changes, diarrhea, hair loss, mental disturbances, recurrent infections, poor wound healing, decreased sense of taste/smell, acne, eczema, and psoriasis.

Beneficial effects • Immune function • Wound healing • Sensory function • Sexual function • Skin health

Uses • Pregnancy • Immune function • Male sexual function, male pattern baldness • Rheumatoid arthritis and inflammatory conditions • Acne • Macular degeneration • Alzheimer’s disease • Wilson’s disease • Mental Health, autism, anorexia • Decreased sense of taste

Forms • Zinc sulfate (less absorbable) • Zinc picolinate, acetate, citrate, glycerate, monomethionine, glycinate (more absorbable) • Zinc Carnosine (specific for gastrointestinal healing) Dosages • Maintenance: 15-20 mg daily • Therapeutic: 30-150 mg daily (note: taking high-dose zinc for too long can suppress the immune system)

Boron Sources • Dried fruit (esp. raisins and prunes), nuts, dark green leaky vegetables, applesauce, grape juice

Deficiency symptoms • Bone loss

Beneficial effects • Converts vitamin D into the active form • Reduces body calcium loss

Uses • Treatment and prevention of osteoporosis and arthritis

Forms • Sodium borate • Boron citrate

Dosages • Maintenance: 3-9 mg daily http://www.lef.org/abstracts/codex/boron_index.htm http://www.nal.usda.gov/ttic/tektran/data/000009/61/0000096130.html www.supplementwatch.com

Chromium Sources • Brewer’s yeast, calf liver, rye, green pepper, apple, butter

Deficiency symptoms • Elevated blood glucose and insulin

Beneficial effects • Increased glucose tolerance • Weight loss

Uses • Hypoglycemia • Diabetes • Elevated blood cholesterol and triglycerides • Promotion of weight loss • Acne Forms • Chromium picolinate

Dosages • Maintenance: 200 mcg daily • Therapeutic: 1000mcg

Copper Sources • Brazil nuts, almonds, hazelnuts, walnuts, pecans, split peas, buckwheat

Deficiency symptoms • Anemia, ruptured blood vessels, osteoporosis, bone and joint abnormalities.

Beneficial effects • Aids in the scavenging of free radicals • Collagen and elastin crosslinking • Energy production • Neurotransmitter conversion • Melanin formation • Facilitated Fe absorption • Blood clotting

Uses • Prevention of cardiovascular disease • Arthritis

Forms • Copper citrate, malate, sulfate, picolinate, gluconate

Dosages • Maintenance: 1.5-3 mg daily

Iodine Sources • Seaweeds (esp. kelp), seafood, iodized salt, sea salt

Deficiency symptoms • Goiter, cretinism, intellectual disability, growth retardation, hypothyroidism, miscarriage

Beneficial effects • Manufacture of thyroid hormone • Modulate effects of estrogen on breast tissue

Uses • Fibrocystic breast disease • Goiter • Hypothyroidism

Forms • Iodine (elemental) – functions outside the thyroid (i.e. breast, prostate) • Iodide (complexed to sodium or potassium) – stronger effect on thyroid, skin • Lugol’s iodine – contains iodine and iodide

Dosages • Maintenance: 500mcg – 100mg daily • Therapeutic: 500 mcg – 100mg daily • Note: supplementing selenium with high-dose iodine protect against thyroid damage.

Iron Sources • Kelp, brewer’s yeast, blackstrap molasses, pumpkin seeds, beef liver

Deficiency symptoms • Anemia, excessive menstrual loss, learning disabilities, impaired immune function, decreased energy levels.

Beneficial effects • Component of red blood cells • Energy production • DNA synthesis

Uses • Anemia • Pregnancy • Restless leg syndrome

Forms • Ferrous Gluconate (Floradix) • Ferric pyrophosphate (AOR)

• Iron Citrate (Thorne, Sisu) • Iron sulfate (least absorbable)

Dosages • Therapeutic: 60-90 mg of Iron succinate/fumarate daily

Manganese Sources • Pecans, brazil nuts, almonds, barley, rye, split peas

Deficiency symptoms • Impaired growth, skeletal abnormalities, defects in carbohydrate and fat metabolism.

Beneficial effects • Blood sugar control • Energy metabolism • Thyroid hormone function • Part of super-oxide dismutase

Uses • Strains, sprains, inflammation • Epilepsy • Diabetes

Forms • Manganese sulfate, chloride (less absorbable) • Manganese picolinate, gluconate, citrate other chelates (more absorbable) • Note: Minimal research available on the absorbability of Mn.

Dosages • Maintenance: 2-5 mg daily • Therapeutic: 5- 200 mg daily

Molybdenum Sources • Lentils, split peas, cauliflower, green peas, brewer’s yeast, spinach

Deficiency symptoms • Sulfate toxicity causing increased heart rate, shortness of breath, headache, disorientation, nausea, and vomiting

Beneficial effects • Uric acid formation • Alcohol detoxification • Sulfite detoxification

Uses • Sulfite sensitivity • Cancer prevention • Wilson’s disease

Forms • Sodium molybdate

Dosages • Maintenance: 45-500 mcg daily

Selenium Sources • Wheat germ, brazil nuts, oats, turnips, brown rice, garlic

Deficiency symptoms • Keshan disease, muscle weakness, cancer, heart disease, low immunity

Beneficial effects • Antioxidant • Production of thyroid hormone • Antagonist to heavy metals

Uses • Cancer • Enhancing immunity • Cardiovascular disease • Inflammatory conditions • Cataract formation • Pregnancy

Forms • Selenomethionine

Dosages • Maintenance: 50-200 mcg daily • Children: 1.5 mcg per pound of body weight • Caution: Ingesting more than 1000 mcg of Se can produce toxicity

Silicon Sources • Oatstraw, horsetail, brown millet, oats, brown rice

Deficiency symptoms • Abnormal ligament, tendon, and bone integrity

Beneficial effects • Formation of collagen • Bone calcification

Uses • Strengthen bones, connective tissue, hair, and skin

Forms • Sodium metasilicate

Dosages • Maintenance: 2-20 mg daily • Therapeutic: up to 120 mg daily

Vanadium Sources • Buckwheat, parsley, soybeans, safflower oil, oats

Deficiency symptoms • Elevated cholesterol, diabetes, hypoglycemia

Beneficial effects • Mimics insulin • Cholesterol metabolism • Mineralization of bones and teeth

Uses • Controlling blood sugar

Forms • Vanadium sulfate

Dosages • Maintenance: 50-100 mcg daily • Therapeutic: up to 2.5 mg daily

24 Dietary Reference Intakes Definitions

Estimated Average Requirement (EAR) • The EAR is the median daily intake value that is estimated to meet the requirement of half the healthy individuals in a life-stage and gender group. At this level of intake, the other half of the individuals in the specified group would not have their needs met. • The EAR is based on a specific criterion of adequacy, derived from a careful review of the literature. Reduction of disease risk is considered along with many other health parameters in the selection of that criterion. • The EAR is used to calculate the RDA. It is also used to assess the adequacy of nutrient intakes, and can be used to plan the intake of groups. Recommended Dietary Allowance (RDA) • The RDA is the average daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all (97 to 98 percent) healthy individuals in a particular life-stage and gender group. • The RDA is the goal for usual intake by an individual. Adequate Intake (AI) • If sufficient scientific evidence is not available to establish an EAR on which to base an RDA, an AI is derived instead. • The AI is the recommended average daily nutrient intake level based on observed or experimentally determined approximations or estimates of nutrient intake by a group (or groups) of apparently healthy people who are assumed to be maintaining an adequate nutritional state. • The AI is expected to meet or exceed the needs of most individuals in a specific life-stage and gender group. • When an RDA is not available for a nutrient, the AI can be used as the goal for usual intake by an individual. The AI is not equivalent to an RDA. Tolerable Upper Intake Level (UL) • The UL is the highest average daily nutrient intake level likely to pose no risk of adverse health effects to almost all individuals in a given life-stage and gender group. • The UL is not a recommended level of intake • As intake increases above the UL, the potential risk of adverse effects increases. Estimated Energy Requirement (EER) • An EER is defined as the average dietary energy intake that is predicted to maintain energy balance in healthy, normal weight individuals of a defined age, gender, weight, height, and level of physical activity consistent with good health. In children and pregnant and lactating women, the EER includes the needs associated with growth or secretion of milk at rates consistent with good health. • Relative body weight (i.e. loss, stable, gain) is the preferred indicator of energy adequacy. Acceptable Macronutrient Distribution Range (AMDR) • The AMDR is a range of intake for a particular energy source (protein, fat, or carbohydrate), expressed as a percentage of total energy (kcal), that is associated with reduced risk of chronic disease while providing adequate intakes of essential nutrients.

UPDATED NOVEMBER 2010

25 Dietary Reference Intakes Definitions

Total Fibre • The sum of Dietary Fibre and Functional Fibre. Dietary Fibre • Non-digestible carbohydrates and lignin that are intrinsic and intact in plants. • Dietary fibre includes plant non-starch polysaccharides (e.g. cellulose, pectin, gums, hemicellulose, β- glucans, and fibres contained in oat and wheat bran), plant carbohydrates that are not recovered by alcohol precipitation (e.g. inulin, oligosaccharides, and fructans), lignin, and some resistant starch. Functional Fibre • Isolated non-digestible carbohydrates that have been shown to have beneficial physiological effects in humans. • Functional fibre includes isolated non-digestible plant (e.g. resistant starch, pectin, and gums), animal (e.g. chitin and chitosan), or commercially produced (e.g. resistant starch, polydextrose, polyols, inulin, and indigestible dextrins) carbohydrate. Physical Activity Level (PAL) • The ratio of total energy expenditure to basal energy expenditure. • The Physical Activity Level categories were defined as sedentary (PAL 1.0-1.39), low active (PAL 1.4- 1.59), active (PAL 1.6-1.89), and very active (PAL 1.9-2.5). • Physical Activity Level should not be confused with the physical activity coefficients (PA values) used in the equations to estimate energy requirement. Vitamin E • The requirement for vitamin E is based on the 2R-stereoisomeric forms of alpha-tocopherol only. This includes RRR-alpha-tocopherol, which occurs naturally in foods, and the 2R-stereoisomeric forms (RRR- , RSR- , RRS- , and RSS- forms) that occur in supplements and fortified foods (all racemic alpha-tocopherol). Other forms of vitamin E do not contribute toward meeting the requirement. • Previously, vitamin E activity was reported in alpha-tocopherol equivalents (αTE), which included all forms of vitamin E. Alpha-tocopherol equivalents should be converted to milligrams of alpha- tocopherol. • The UL for vitamin E applies to any isomeric form of supplemental alpha-tocopherol.

REFERENCES: • Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride (1997); • Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); • Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); • Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001); • Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (2002); • Dietary Reference Intakes for Water, Potassium, Chloride, and Sulfate (2004). Available at www.nap.edu

26 Dietary Reference Intakes Abbreviations and Reference Heights and Weights

Abbreviations See definitions and conversion factors for further details. AI Adequate Intake AMDR Acceptable Macronutrient Distribution Range DFE Dietary Folate Equivalent EAR Estimated Average Requirement EER Estimated Energy Requirement g gram IU International Unit kcal kilocalorie kg kilogram m metre mg milligram N/A Not Applicable ND Not Determinable NE Niacin Equivalent PA Physical Activity Coefficient PAL Physical Activity Level RAE Retinol Activity Equivalent RDA Recommended Dietary Allowance RE Retinol Equivalent UL Tolerable Upper Intake Level µg microgram y year

Reference Heights and Weights

Reference Reference Reference Reference Height (m) Weight (kg) Height (inches) Weight (pounds) Infants 2-6 mo 0.62 6 24 13 7-12 mo 0.71 9 28 20 Children 1-3 y 0.86 12 34 27 4-8 y 1.15 20 45 44 Males 9-13 y 1.44 36 57 79 14-18 y 1.74 61 68 134 19-30 y 1.77 70 70 154 Females 9-13 y 1.44 37 57 81 14-18 y 1.63 54 64 119 19-30 y 1.63 57 64 126

Calculated from median height and median body mass index for ages 4 through 19 years from CDC/NCHS growth charts (http://www.cdc.gov/nchs/about/major/nhanes/growthcharts/clinical_charts.htm).

Since there is no evidence that weight should change with ageing if activity is maintained, the reference weights for adults 19-30 years of age apply to all adult age groups.

27 Dietary Reference Intakes Unit Conversion Factors

1 RAE = 1 µg retinol = 3.33 IU retinol Vitamin A For preformed vitamin A, 1 RE = 1 RAE. 1 RAE = 12 µg beta-carotene 1 RAE = 24 µg alpha-carotene Carotenoids 1 RAE = 24 µg beta-cryptoxanthin To calculate RAE from RE of provitamin A carotenoids in foods, divide RE by 2. Vitamin D 1 µg = 40 IU 1 mg alpha-tocopherol = 1.25 mg alpha-tocopherol equivalents (αTE) Vitamin E 1 mg alpha-tocopherol = 1.49 IU d-alpha-tocopherol (natural, RRR form) 1 mg alpha-tocopherol = 2.22 IU dl-alpha-tocopherol (synthetic, all racemic form) 1 DFE = 1 µg food folate Folate 1 DFE = 0.6 µg folic acid from fortified food or from a supplement consumed with food 1 DFE = 0.5 µg folic acid from a supplement taken on an empty stomach Niacin 1 NE = 1 mg niacin 1 NE = 60 mg tryptophan Sodium 1 g sodium = 2.53 g salt Height 1 inch = 0.0254 m Weight 1 pound = 0.454 kg 1000 µg = 1 mg Metric Units 1000 mg = 1 g 1000 g = 1 kg Carbohydrate = 4 kcal /g Energy yield of Protein = 4 kcal /g macronutrients Fat = 9 kcal /g Alcohol = 7 kcal /g

28 Dietary Reference Intakes Equations to estimate energy requirement

Infants and young children Estimated Energy Requirement (kcal/day) = Total Energy Expenditure + Energy Deposition 0-3 months EER = (89 ¯ weight [kg] –100) + 175 4-6 months EER = (89 ¯ weight [kg] –100) + 56 7-12 months EER = (89 ¯ weight [kg] –100) + 22 13-35 months EER = (89 ¯ weight [kg] –100) + 20 Children and Adolescents 3-18 years Estimated Energy Requirement (kcal/day) = Total Energy Expenditure + Energy Deposition Boys 3-8 years EER = 88.5 – (61.9 ¯ age [y]) + PA¯ { (26.7 ¯ weight [kg]) + (903 ¯ height [m]) } + 20 9-18 years EER = 88.5 – (61.9 ¯ age [y]) + PA¯ { (26.7 ¯ weight [kg]) + (903 ¯ height [m]) } + 25 Girls 3-8 years EER = 135.3 – (30.8 ¯ age [y]) + PA¯ { (10.0 ¯ weight [kg]) + (934 ¯ height [m]) } + 20 9-18 years EER = 135.3 – (30.8 ¯ age [y]) + PA¯ { (10.0 ¯ weight [kg]) + (934 ¯ height [m]) } + 25 Adults 19 years and older Estimated Energy Requirement (kcal/day) = Total Energy Expenditure Men EER = 662 – (9.53 ¯ age [y]) + PA¯ { (15.91 ¯ weight [kg]) + (539.6 ¯ height [m]) } Women EER = 354 – (6.91 ¯ age [y]) + PA¯ { (9.36 ¯ weight [kg]) + (726 ¯ height [m]) } Pregnancy Estimated Energy Requirement (kcal/day) = Non-pregnant EER + Pregnancy Energy Deposition 1st trimester EER = Non-pregnant EER + 0 2nd trimester EER = Non-pregnant EER + 340 3rd trimester EER = Non-pregnant EER + 452 Lactation Estimated Energy Requirement (kcal/day) = Non-pregnant EER + Milk Energy Output – Weight Loss 0-6 months postpartum EER = Non-pregnant EER + 500 – 170 7-12 months postpartum EER = Non-pregnant EER + 400 – 0 These equations provide an estimate of energy requirement. Relative body weight (i.e. loss, stable, gain) is the preferred indicator of energy adequacy.

Physical Activity Coefficients (PA values) for use in EER equations Sedentary Low Active Active Very Active

(PAL 1.0-1.39) (PAL 1.4-1.59) (PAL 1.6-1.89) (PAL 1.9-2.5) Typical daily living Typical daily living Typical daily living Typical daily living activities activities activities activities PLUS (e.g., household tasks, PLUS PLUS At least 60 minutes of daily walking to the bus) 30 - 60 minutes of daily At least 60 minutes of moderate activity moderate activity daily moderate activity PLUS (ex. walking at 5-7 km/h) An additional 60 minutes of vigorous activity or 120 minutes of moderate activity Boys 3 - 18 y 1.00 1.13 1.26 1.42 Girls 3 - 18 y 1.00 1.16 1.31 1.56

Men 19 y + 1.00 1.11 1.25 1.48 Women 19 y + 1.00 1.12 1.27 1.45

29 Dietary Reference Intakes Reference Values for Vitamins

Vitamin A 1, 2 Vitamin D ** Vitamin E 5 Vitamin K

Unit µg/day (RAE) IU/day (RAE) µg/day 4 IU/day 4 mg/day µg/day EAR RDA/AI UL 3 EAR RDA/AI UL 3 EAR RDA/AI UL EAR RDA/AI UL EAR RDA/AI UL 6 AI UL 7 Infants 0-6 mo ND 400* 600 ND 1333* 2000 ND 10* 25 ND 400* 1000 ND 4* ND 2.0* ND 7-12 mo ND 500* 600 ND 1667* 2000 ND 10* 38 ND 400* 1500 ND 5* ND 2.5* ND Children 1-3 y 210 300 600 700 1000 2000 10 15 63 400 600 2500 5 6 200 30* ND 4-8 y 275 400 900 917 1333 3000 10 15 75 400 600 3000 6 7 300 55* ND Males 9-13 y 445 600 1700 1483 2000 5667 10 15 100 400 600 4000 9 11 600 60* ND 14-18 y 630 900 2800 2100 3000 9333 10 15 100 400 600 4000 12 15 800 75* ND 19-30 y 625 900 3000 2083 3000 10000 10 15 100 400 600 4000 12 15 1000 120* ND 31-50 y 625 900 3000 2083 3000 10000 10 15 100 400 600 4000 12 15 1000 120* ND 51-70 y 625 900 3000 2083 3000 10000 10 15 100 400 600 4000 12 15 1000 120* ND >70 y 625 900 3000 2083 3000 10000 10 20 100 400 800 4000 12 15 1000 120* ND Females 9-13 y 420 600 1700 1400 2000 5667 10 15 100 400 600 4000 9 11 600 60* ND 14-18 y 485 700 2800 1617 2333 9333 10 15 100 400 600 4000 12 15 800 75* ND 19-30 y 500 700 3000 1667 2333 10000 10 15 100 400 600 4000 12 15 1000 90* ND 31-50 y 500 700 3000 1667 2333 10000 10 15 100 400 600 4000 12 15 1000 90* ND 51-70 y 500 700 3000 1667 2333 10000 10 15 100 400 600 4000 12 15 1000 90* ND >70 y 500 700 3000 1667 2333 10000 10 20 100 400 800 4000 12 15 1000 90* ND Pregnancy < 18 y 530 750 2800 1767 2500 9333 10 15 100 400 600 4000 12 15 800 75* ND 19-30 y 550 770 3000 1833 2567 10000 10 15 100 400 600 4000 12 15 1000 90* ND 31-50 y 550 770 3000 1833 2567 10000 10 15 100 400 600 4000 12 15 1000 90* ND Lactation < 18 y 885 1200 2800 2950 4000 9333 10 15 100 400 600 4000 16 19 800 75* ND 19-30 y 900 1300 3000 3000 4333 10000 10 15 100 400 600 4000 16 19 1000 90* ND 31-50 y 900 1300 3000 3000 4333 10000 10 15 100 400 600 4000 16 19 1000 90* ND

This table presents Estimated Average Requirements (EARs) in italics, Recommended Dietary Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). Tolerable Upper Intake Levels (ULs) are in shaded columns.

** New 2010 values have replaced previous 1997 values. 1 As Retinol Activity Equivalents (RAE). See conversion factors for more details. 2 No DRIs are established for beta-carotene or other carotenoids. However, existing recommendations for consumption of carotenoid-rich fruits and vegetables are supported. 3 UL as preformed vitamin A only. Beta-carotene supplements are advised only to serve as a provitamin A source for individuals at risk of vitamin A deficiency. 4 These reference values assume minimal sun exposure. 5 EAR and RDA/AI as alpha-tocopherol (2R-stereoisomeric forms) only. See conversion factors for more details. 6 The UL for vitamin E applies only to synthetic vitamin E (all isomeric forms) obtained from supplements, fortified foods, or a combination of the two. 7 Due to lack of suitable data, a UL could not be established for vitamin K. This does not mean that there is no potential for adverse effects resulting from high intakes.

NOTE: These are reference values for normal, apparently healthy individuals eating a typical mixed North American diet. An individual may have physiological, health, or lifestyle characteristics that may require tailoring of specific nutrient values.

30 Dietary Reference Intakes Reference Values for Vitamins

Vitamin C 8 Thiamin Riboflavin Niacin 10 Vitamin B6 Unit mg/day mg/day mg/day mg/day (NE) mg/day EAR RDA/AI UL EAR RDA/AI UL 9 EAR RDA/AI UL 9 EAR RDA/AI UL 11 EAR RDA/AI UL Infants 0-6 mo ND 40* ND ND 0.2* ND ND 0.3* ND ND 2* a ND ND 0.1* ND 7-12 mo ND 50* ND ND 0.3* ND ND 0.4* ND ND 4* ND ND 0.3* ND Children 1-3 y 13 15 400 0.4 0.5 ND 0.4 0.5 ND 5 6 10 0.4 0.5 30 4-8 y 22 25 650 0.5 0.6 ND 0.5 0.6 ND 6 8 15 0.5 0.6 40 Males 9-13 y 39 45 1200 0.7 0.9 ND 0.8 0.9 ND 9 12 20 0.8 1.0 60 14-18 y 63 75 1800 1.0 1.2 ND 1.1 1.3 ND 12 16 30 1.1 1.3 80 19-30 y 75 90 2000 1.0 1.2 ND 1.1 1.3 ND 12 16 35 1.1 1.3 100 31-50 y 75 90 2000 1.0 1.2 ND 1.1 1.3 ND 12 16 35 1.1 1.3 100 51-70 y 75 90 2000 1.0 1.2 ND 1.1 1.3 ND 12 16 35 1.4 1.7 100 >70 y 75 90 2000 1.0 1.2 ND 1.1 1.3 ND 12 16 35 1.4 1.7 100 Females 9-13 y 39 45 1200 0.7 0.9 ND 0.8 0.9 ND 9 12 20 0.8 1.0 60 14-18 y 56 65 1800 0.9 1.0 ND 0.9 1.0 ND 11 14 30 1.0 1.2 80 19-30 y 60 75 2000 0.9 1.1 ND 0.9 1.1 ND 11 14 35 1.1 1.3 100 31-50 y 60 75 2000 0.9 1.1 ND 0.9 1.1 ND 11 14 35 1.1 1.3 100 51-70 y 60 75 2000 0.9 1.1 ND 0.9 1.1 ND 11 14 35 1.3 1.5 100 >70 y 60 75 2000 0.9 1.1 ND 0.9 1.1 ND 11 14 35 1.3 1.5 100 Pregnancy < 18 y 66 80 1800 1.2 1.4 ND 1.2 1.4 ND 14 18 30 1.6 1.9 80 19-30 y 70 85 2000 1.2 1.4 ND 1.2 1.4 ND 14 18 35 1.6 1.9 100 31-50 y 70 85 2000 1.2 1.4 ND 1.2 1.4 ND 14 18 35 1.6 1.9 100 Lactation < 18 y 96 115 1800 1.2 1.4 ND 1.3 1.6 ND 13 17 30 1.7 2.0 80 19-30 y 100 120 2000 1.2 1.4 ND 1.3 1.6 ND 13 17 35 1.7 2.0 100 31-50 y 100 120 2000 1.2 1.4 ND 1.3 1.6 ND 13 17 35 1.7 2.0 100

8 Because smoking increases oxidative stress and metabolic turnover of vitamin C, the requirement for smokers is increased by 35 mg/day. 9 Due to lack of suitable data, ULs could not be established for thiamin and riboflavin. This does not mean that there is no potential for adverse effects resulting from high intakes. 10 As Niacin Equivalents (NE). See conversion factors for more details. 11 The UL for niacin applies only to synthetic forms obtained from supplements, fortified foods, or a combination of the two. a As preformed niacin, not NE, for this age group.

31 Dietary Reference Intakes Reference Values for Vitamins

Folate 12 Vitamin B12 Pantothenic Biotin Choline 15

Acid Unit µg/day (DFE) µg/day mg/day µg/day mg/day EAR RDA/AI UL 13 EAR RDA/AI UL 14 AI UL 14 AI UL 14 AI UL Infants 0-6 mo ND 65* ND ND 0.4* ND 1.7* ND 5* ND 125* ND 7-12 mo ND 80* ND ND 0.5* ND 1.8* ND 6* ND 150* ND Children 1-3 y 120 150 300 0.7 0.9 ND 2* ND 8* ND 200* 1000 4-8 y 160 200 400 1.0 1.2 ND 3* ND 12* ND 250* 1000 Males 9-13 y 250 300 600 1.5 1.8 ND 4* ND 20* ND 375* 2000 14-18 y 330 400 800 2.0 2.4 ND 5* ND 25* ND 550* 3000 19-30 y 320 400 1000 2.0 2.4 ND 5* ND 30* ND 550* 3500 31-50 y 320 400 1000 2.0 2.4 ND 5* ND 30* ND 550* 3500 51-70 y 320 400 1000 2.0 2.4 d ND 5* ND 30* ND 550* 3500 >70 y 320 400 1000 2.0 2.4 d ND 5* ND 30* ND 550* 3500 Females 9-13 y 250 300 600 1.5 1.8 ND 4* ND 20* ND 375* 2000 14-18 y 330 400 b 800 2.0 2.4 ND 5* ND 25* ND 400* 3000 19-30 y 320 400 b 1000 2.0 2.4 ND 5* ND 30* ND 425* 3500 31-50 y 320 400 b 1000 2.0 2.4 ND 5* ND 30* ND 425* 3500 51-70 y 320 400 1000 2.0 2.4 d ND 5* ND 30* ND 425* 3500 >70 y 320 400 1000 2.0 2.4 d ND 5* ND 30* ND 425* 3500 Pregnancy < 18 y 520 600 c 800 2.2 2.6 ND 6* ND 30* ND 450* 3000 19-30 y 520 600 c 1000 2.2 2.6 ND 6* ND 30* ND 450* 3500 31-50 y 520 600 c 1000 2.2 2.6 ND 6* ND 30* ND 450* 3500 Lactation < 18 y 450 500 800 2.4 2.8 ND 7* ND 35* ND 550* 3000 19-30 y 450 500 1000 2.4 2.8 ND 7* ND 35* ND 550* 3500 31-50 y 450 500 1000 2.4 2.8 ND 7* ND 35* ND 550* 3500

12 As Dietary Folate Equivalents (DFE). See conversion factors for more details. 13 The UL for folate applies only to synthetic forms obtained from supplements, fortified foods, or a combination of the two. 14 Due to lack of suitable data, ULs could not be established for vitamin B12, pantothenic acid or biotin. This does not mean that there is no potential for adverse effects resulting from high intakes. 15 Although AIs have been set for choline, there are few data to assess whether a dietary supply of choline is needed at all stages of the life cycle, and it may be that the choline requirement can be met by endogenous synthesis at some of these stages. b In view of evidence linking the use of supplements containing folic acid before conception and during early pregnancy with reduced risk of neural tube defects in the fetus, it is recommended that all women capable of becoming pregnant take a supplement containing 400µg of folic acid every day, in addition to the amount of folate found in a healthy diet. c It is assumed that women will continue consuming 400 µg folic acid from supplements until their pregnancy is confirmed and they enter prenatal care. The critical time for formation of the neural tube is shortly after conception. d Because 10 to 30 percent of older people may malabsorb food-bound vitamin B12, it is advisable for those older than 50 years to meet the RDA mainly by consuming foods fortified with vitamin B12 or a supplement containing vitamin B12.

Arsenic 16 Boron Calcium ** Chromium Copper Fluoride Iodine

Unit N/A mg/day mg/day µg/day µg/day mg/day µg/day AI UL 17 AI UL EAR RDA/AI UL AI UL 17 EAR RDA/AI UL AI UL EAR RDA/AI UL Infants 0-6 mo ND ND ND ND ND 200* 1000 0.2* ND ND 200* ND 0.01* 0.7 ND 110* ND 7-12 mo ND ND ND ND ND 260* 1500 5.5* ND ND 220* ND 0.5* 0.9 ND 130* ND Children 1-3 y ND ND ND 3 500 700 2500 11* ND 260 340 1000 0.7* 1.3 65 90 200 4-8 y ND ND ND 6 800 1000 2500 15* ND 340 440 3000 1* 2.2 65 90 300 Males 9-13 y ND ND ND 11 1100 1300 3000 25* ND 540 700 5000 2* 10 73 120 600 14-18 y ND ND ND 17 1100 1300 3000 35* ND 685 890 8000 3* 10 95 150 900 19-30 y ND ND ND 20 800 1000 2500 35* ND 700 900 10000 4* 10 95 150 1100 31-50 y ND ND ND 20 800 1000 2500 35* ND 700 900 10000 4* 10 95 150 1100 51-70 y ND ND ND 20 800 1000 2000 30* ND 700 900 10000 4* 10 95 150 1100 >70 y ND ND ND 20 1000 1200 2000 30* ND 700 900 10000 4* 10 95 150 1100 Females 9-13 y ND ND ND 11 1100 1300 3000 21* ND 540 700 5000 2* 10 73 120 600 14-18 y ND ND ND 17 1100 1300 3000 24* ND 685 890 8000 3* 10 95 150 900 19-30 y ND ND ND 20 800 1000 2500 25* ND 700 900 10000 3* 10 95 150 1100 31-50 y ND ND ND 20 800 1000 2500 25* ND 700 900 10000 3* 10 95 150 1100 51-70 y ND ND ND 20 1000 1200 2000 20* ND 700 900 10000 3* 10 95 150 1100 >70 y ND ND ND 20 1000 1200 2000 20* ND 700 900 10000 3* 10 95 150 1100 Pregnancy < 18 y ND ND ND 17 1100 1300 3000 29* ND 785 1000 8000 3* 10 160 220 900 19-30 y ND ND ND 20 800 1000 2500 30* ND 800 1000 10000 3* 10 160 220 1100 31-50 y ND ND ND 20 800 1000 2500 30* ND 800 1000 10000 3* 10 160 220 1100 Lactation < 18 y ND ND ND 17 1100 1300 3000 44* ND 985 1300 8000 3* 10 209 290 900 19-30 y ND ND ND 20 800 1000 2500 45* ND 1000 1300 10000 3* 10 209 290 1100 31-50 y ND ND ND 20 800 1000 2500 45* ND 1000 1300 10000 3* 10 209 290 1100

** New 2010 values have replaced previous 1997 values. 16 Although a UL was not determined for arsenic, there is no justification for adding arsenic to food or supplements. 17 Due to lack of suitable data, ULs could not be established for arsenic and chromium. This does not mean that there is no potential for adverse effects resulting from high intakes.

33 Dietary Reference Intakes Reference Values for Elements

Iron 18 Magnesium Manganese Molybdenum Nickel Phosphorus Unit mg/day mg/day mg/day µg/day mg/day mg/day EAR RDA/AI UL EAR RDA/AI UL 19 AI UL EAR RDA/AI UL AI UL EAR RDA/AI UL Infants 0-6 mo ND 0.27* 40 ND 30* ND 0.003* ND ND 2* ND ND ND ND 100* ND 7-12 mo 6.9 11 40 ND 75* ND 0.6* ND ND 3* ND ND ND ND 275* ND Children 1-3 y 3.0 7 40 65 80 65 1.2* 2 13 17 300 ND 0.2 380 460 3000 4-8 y 4.1 10 40 110 130 110 1.5* 3 17 22 600 ND 0.3 405 500 3000 Males 9-13 y 5.9 8 40 200 240 350 1.9* 6 26 34 1100 ND 0.6 1055 1250 4000 14-18 y 7.7 11 45 340 410 350 2.2* 9 33 43 1700 ND 1.0 1055 1250 4000 19-30 y 6 8 45 330 400 350 2.3* 11 34 45 2000 ND 1.0 580 700 4000 31-50 y 6 8 45 350 420 350 2.3* 11 34 45 2000 ND 1.0 580 700 4000 51-70 y 6 8 45 350 420 350 2.3* 11 34 45 2000 ND 1.0 580 700 4000 >70 y 6 8 45 350 420 350 2.3* 11 34 45 2000 ND 1.0 580 700 3000 Females 9-13 y 5.7 e 8 e 40 200 240 350 1.6* 6 26 34 1100 ND 0.6 1055 1250 4000 14-18 y 7.9 e 15 e 45 300 360 350 1.6* 9 33 43 1700 ND 1.0 1055 1250 4000 19-30 y 8.1 e 18 e 45 255 310 350 1.8* 11 34 45 2000 ND 1.0 580 700 4000 31-50 y 8.1 e 18 e 45 265 320 350 1.8* 11 34 45 2000 ND 1.0 580 700 4000 51-70 y 5 e 8 e 45 265 320 350 1.8* 11 34 45 2000 ND 1.0 580 700 4000 >70 y 5 e 8 e 45 265 320 350 1.8* 11 34 45 2000 ND 1.0 580 700 3000 Pregnancy < 18 y 23 27 45 335 400 350 2.0* 9 40 50 1700 ND 1.0 1055 1250 3500 19-30 y 22 27 45 290 350 350 2.0* 11 40 50 2000 ND 1.0 580 700 3500 31-50 y 22 27 45 300 360 350 2.0* 11 40 50 2000 ND 1.0 580 700 3500 Lactation < 18 y 7 10 45 300 360 350 2.6* 9 35 50 1700 ND 1.0 1055 1250 4000 19-30 y 6.5 9 45 255 310 350 2.6* 11 36 50 2000 ND 1.0 580 700 4000 31-50 y 6.5 9 45 265 320 350 2.6* 11 36 50 2000 ND 1.0 580 700 4000

18 The requirement for iron is 1.8 times higher for vegetarians due to the lower bioavailability of iron from a vegetarian diet. 19 The UL for magnesium represents intake from a pharmacological agent only and does not include intake from food and water. e For the EAR and RDA, it is assumed that girls younger than 14 years do not menstruate and that girls 14 years and older do menstruate. It is assumed that women 51 years and older are post-menopausal.

34 Dietary Reference Intakes Reference Values for Elements

Selenium Silicon 20 Vanadium 22 Zinc 23 Potassium 24 Sodium 25 Chloride 26 Sulfate 27 Unit µg/day N/A mg/day mg/day mg/day mg/day mg/day N/A EAR RDA/AI UL AI UL 21 AI UL EAR RDA/AI UL AI UL 21 AI UL AI UL AI UL 21 Infants 0-6 mo ND 15* 45 ND ND ND ND ND 2* 4 400* ND 120* ND 180* ND ND ND 7-12 mo ND 20* 60 ND ND ND ND 2.5 3 5 700* ND 370* ND 570* ND ND ND Children 1-3 y 17 20 90 ND ND ND ND 2.5 3 7 3000* ND 1000* 1500 1500* 2300 ND ND 4-8 y 23 30 150 ND ND ND ND 4.0 5 12 3800* ND 1200* 1900 1900* 2900 ND ND Males 9-13 y 35 40 280 ND ND ND ND 7.0 8 23 4500* ND 1500* 2200 2300* 3400 ND ND 14-18 y 45 55 400 ND ND ND ND 8.5 11 34 4700* ND 1500* 2300 2300* 3600 ND ND 19-30 y 45 55 400 ND ND ND 1.8 9.4 11 40 4700* ND 1500* 2300 2300* 3600 ND ND 31-50 y 45 55 400 ND ND ND 1.8 9.4 11 40 4700* ND 1500* 2300 2300* 3600 ND ND 51-70 y 45 55 400 ND ND ND 1.8 9.4 11 40 4700* ND 1300* 2300 2000* 3600 ND ND >70 y 45 55 400 ND ND ND 1.8 9.4 11 40 4700* ND 1200* 2300 1800* 3600 ND ND Females 9-13 y 35 40 280 ND ND ND ND 7.0 8 23 4500* ND 1500* 2200 2300* 3400 ND ND 14-18 y 45 55 400 ND ND ND ND 7.3 9 34 4700* ND 1500* 2300 2300* 3600 ND ND 19-30 y 45 55 400 ND ND ND 1.8 6.8 8 40 4700* ND 1500* 2300 2300* 3600 ND ND 31-50 y 45 55 400 ND ND ND 1.8 6.8 8 40 4700* ND 1500* 2300 2300* 3600 ND ND 51-70 y 45 55 400 ND ND ND 1.8 6.8 8 40 4700* ND 1300* 2300 2000* 3600 ND ND >70 y 45 55 400 ND ND ND 1.8 6.8 8 40 4700* ND 1200* 2300 1800* 3600 ND ND Pregnancy < 18 y 49 60 400 ND ND ND ND 10.5 12 34 4700* ND 1500* 2300 2300* 3600 ND ND 19-30 y 49 60 400 ND ND ND ND 9.5 11 40 4700* ND 1500* 2300 2300* 3600 ND ND 31-50 y 49 60 400 ND ND ND ND 9.5 11 40 4700* ND 1500* 2300 2300* 3600 ND ND Lactation < 18 y 59 70 400 ND ND ND ND 10.9 13 34 5100* ND 1500* 2300 2300* 3600 ND ND 19-30 y 59 70 400 ND ND ND ND 10.4 12 40 5100* ND 1500* 2300 2300* 3600 ND ND 31-50 y 59 70 400 ND ND ND ND 10.4 12 40 5100* ND 1500* 2300 2300* 3600 ND ND

20 Although silicon has not been shown to cause adverse effects in humans, there is no justification for adding silicon to supplements. 21 Due to lack of suitable data, ULs could not be established for silicon, potassium, and sulfate. This does not mean that there is no potential for adverse effects resulting from high intakes. 22 Although vanadium in food has not been shown to cause adverse effects in humans, there is no justification for adding vanadium to food and vanadium supplements should be used with caution. The UL is based on adverse effects in laboratory animals and this data could be used to set a UL for adults but not children and adolescents. 23 The requirement for zinc may be as much as 50 percent greater for vegetarians, particularly for strict vegetarians whose major food staples are grains and legumes, due to the lower bioavailability of zinc from a vegetarian diet. 24 The beneficial effects of potassium appear to be mainly from the forms of potassium found naturally in foods such as fruits and vegetables. Supplemental potassium should only be provided under medical supervision because of the well-documented potential for toxicity. 25 Grams of sodium ¯ 2.53 = grams of salt. 26 Sodium and chloride are normally found in foods together as sodium chloride (table salt). For this reason, the AI and UL for chloride are set at a level equivalent on a molar basis to those for sodium, since almost all dietary chloride comes with sodium added during processing or consumption of foods. 27 An AI for sulfate was not established because sulfate requirements are met when dietary intakes contain recommended levels of sulfur amino acids (protein).

Carbohydrate Total Protein 29 Total Fat Linoleic Acid α-linolenic Total Fibre 31 Total Water 33 (Digestible) (n-6) Acid (n-3) Unit g/day g/kg/day g/day 30 g/day g/day g/day g/day Litres/day EAR RDA/AI UL 28 EAR RDA/AI RDA/AI UL 28 AI UL 28 AI UL 28 AI UL 28 AI 32 UL 28 AI UL 28 Infants 0-6 mo ND 60* ND ND 1.52* 9.1* ND 31* ND 4.4* ND 0.5* ND ND ND 0.7* ND 7-12 mo ND 95* ND 1.0 1.2 11.0 ND 30* ND 4.6* ND 0.5* ND ND ND 0.8* ND Children 1-3 y 100 130 ND 0.87 1.05 13 ND ND ND 7* ND 0.7* ND 19* ND 1.3* ND 4-8 y 100 130 ND 0.76 0.95 19 ND ND ND 10* ND 0.9* ND 25* ND 1.7* ND Males 9-13 y 100 130 ND 0.76 0.95 34 ND ND ND 12* ND 1.2* ND 31* ND 2.4* ND 14-18 y 100 130 ND 0.73 0.85 52 ND ND ND 16* ND 1.6* ND 38* ND 3.3* ND 19-30 y 100 130 ND 0.66 0.80 56 ND ND ND 17* ND 1.6* ND 38* ND 3.7* ND 31-50 y 100 130 ND 0.66 0.80 56 ND ND ND 17* ND 1.6* ND 38* ND 3.7* ND 51-70 y 100 130 ND 0.66 0.80 56 ND ND ND 14* ND 1.6* ND 30* ND 3.7* ND >70 y 100 130 ND 0.66 0.80 56 ND ND ND 14* ND 1.6* ND 30* ND 3.7* ND Females 9-13 y 100 130 ND 0.76 0.95 34 ND ND ND 10* ND 1.0* ND 26* ND 2.1* ND 14-18 y 100 130 ND 0.71 0.85 46 ND ND ND 11* ND 1.1* ND 26* ND 2.3* ND 19-30 y 100 130 ND 0.66 0.80 46 ND ND ND 12* ND 1.1* ND 25* ND 2.7* ND 31-50 y 100 130 ND 0.66 0.80 46 ND ND ND 12* ND 1.1* ND 25* ND 2.7* ND 51-70 y 100 130 ND 0.66 0.80 46 ND ND ND 11* ND 1.1* ND 21* ND 2.7* ND >70 y 100 130 ND 0.66 0.80 46 ND ND ND 11* ND 1.1* ND 21* ND 2.7* ND Pregnancy < 18 y 135 175 ND 0.88 f 1.1f 71f ND ND ND 13* ND 1.4* ND 28* ND 3.0* ND 19-30 y 135 175 ND 0.88 f 1.1f 71f ND ND ND 13* ND 1.4* ND 28* ND 3.0* ND 31-50 y 135 175 ND 0.88 f 1.1f 71f ND ND ND 13* ND 1.4* ND 28* ND 3.0* ND Lactation < 18 y 160 210 ND 1.05 1.3 71 ND ND ND 13* ND 1.3* ND 29* ND 3.8* ND 19-30 y 160 210 ND 1.05 1.3 71 ND ND ND 13* ND 1.3* ND 29* ND 3.8* ND 31-50 y 160 210 ND 1.05 1.3 71 ND ND ND 13* ND 1.3* ND 29* ND 3.8* ND

28 Although a UL was not set for any of the macronutrients, the absence of definitive data does not signify that people can tolerate chronic intakes of these substances at high levels. 29 Available evidence does not support recommending a separate protein requirement for vegetarians who consume complimentary mixtures of plant proteins, as these can provide the same quality of protein as that from animal proteins. 30 Recommendations for total protein are determined as the amount needed per kg body weight multiplied by the reference weight. 31 Total fibre is defined as the sum of dietary fibre and functional fibre. See definitions for further details. 32 The AI for total fibre is based on 14 g/1000 kcal multiplied by the median usual daily energy intake from the Continuing Survey of Food Intakes by Individuals (CSFII 1994-1996, 1998). 33 Total water includes drinking water, water in beverages, and water that is part of food. f The EAR and RDA for pregnancy are only for the second half of pregnancy. For the first half of pregnancy, protein requirements are the same as those of the nonpregnant woman.

36 Dietary Reference Intakes Reference Values for Macronutrients

Acceptable Macronutrient Distribution Ranges (AMDR) n-6 polyunsaturated n-3 polyunsaturated Total Carbohydrate Total Protein Total Fat fatty acids fatty acids (linoleic acid) (α-linolenic acid) Males & Females 34 Percent of Energy Percent of Energy Percent of Energy Percent of Energy Percent of Energy 35 1-3 years 45 – 65 % 5 – 20 % 30 – 40 % 5 – 10 % 0.6 – 1.2 % 4-18 years 45 – 65 % 10 – 30 % 25 – 35 % 5 – 10 % 0.6 – 1.2 % 19 years and over 45 – 65 % 10 – 35 % 20 – 35 % 5 – 10 % 0.6 – 1.2 %

34 Includes pregnant and lactating women. 35 Up to 10% of the AMDR can be consumed as eicosapentaenoic acid (EPA) and/or docosahexaenoic acid (DHA).

Additional Macronutrient Recommendations

Saturated fatty acids Trans fatty acids As low as possible while consuming a nutritionally adequate diet Dietary cholesterol

Added sugars g Limit to no more than 25% of total energy A UL was not set for saturated fatty acids, trans fatty acids, dietary cholesterol, or added sugars. g Added sugars are defined as sugars and syrups that are added to foods during processing or preparation. Although there were insufficient data to set a UL for added sugars, this maximal intake level is suggested to prevent the displacement of foods that are major sources of essential micronutrients.

Protein Quality Scoring Pattern (age 1 year and older) Recommended pattern Amino Acid mg/g protein Physical Activity Recommendation Histidine 18 Isoleucine 25 To prevent weight gain and accrue additional health benefits of physical Leucine 55 activity, 60 minutes of daily moderate intensity activity is Lysine 51 Methionine + Cysteine 25 recommended in addition to the activities required by a sedentary lifestyle. Phenylalanine + Tyrosine 47 This amount of physical activity leads to an “active” lifestyle. Threonine 27 Tryptophan 7 Valine 32 Reference amino acid pattern for use in evaluating the quality of food proteins using the protein digestibility corrected amino acid score (PDCAAS). Based on Estimated Average Requirements for both indispensable amino acids and for total protein for 1-3 year olds. 37 Measures and Conversions

Metric Measures: Avoirdupois Weight: 1 kilogram (kg) = 1000 grams 16 ounces = 1 pound 1 gram (gm) = 1000 milligrams 7,000 grains = 1 pound 1 milligram (mg) = 1000 micrograms 453.6 grams = 1 pound 1 gram = 1/1000 (.001) kilogram 1 ounce = 437.5 grains 1 milligram = 1/1000 (.001) gram 1 ounce = 28.35 grams 1 microgram (mcg or = 1/1000 (.001) of a µcg) milligram 1000 grams = 1 kilogram

1000 milligram = 1 gram

1000 microgram = 1 milligram

Household Measures: Conversion Factors: = 15.4 grains 1 teaspoon (tsp) = 5 cc 1 gram (15.43) = .0648 grams (64.8 = 1.33 fluid dram 1 grain mgs) 1 ounce by = 5 ml = 31.1 grams weight = 1 ounce by 1 Tablespoon (T) = 15 cc 31.1 grams weight = ½ fluid ounce 1 fluid ounce = 29.57 cc

= 15 ml 1 fluid ounce = 480 minims

½ pint (US Pint) = 240 cc

= 8 fluid ounces

= 1 cup

1 Tablespoon = 3 teaspoons

Liquid Measure:

1 drop# = 1 minim

1 ml = 1 cc

1 minim = 0.062 cc

16 minims = 1.0 cc

75 minims = 1 teaspoon

38 4 cc = 1 fluid dram

30 cc = 1 fluid ounce

1 fluid ounce = 2 Tablespoons

= 6 teaspoons

= 8 fluid drams

30 ml = 1 fluid ounce

1 Tablespoon = l5 ml

1 teaspoon = 5 ml

= approximately 480 1 fluid ounce drops# (1 drop = 1 minum; 480 minums = 1 fluid ounce)

# drops may vary depending on fluid viscosity, temperature, size of dropper opening, and other factors.

SOURCES: Grand Forks Human Nutrition Research Center. www.gfhnrc.ars.usda.gov/News/nws9912a.htm Online Conversions. www.onlineconversion.com Medical Economics. PDR for Nutritional Supplements. First Edition, 2001 Melvyn Werbach. Textbook of Nutritional Medicine, Third Line Press, 1999 Richard Maurer. Practitioner’s Guide to Plant Based Digestive Enzymes. Original Internist, 2003 United Nations University. Food and Nutrition Bulletin, Volume 15, number 2, www.unu.edu

Measurements of Nutrient Potency

Vitamin A Conversions: 1 IU = 0.3 mcg all-trans retinal = 0.3 mcg retinol = 0.344 mcg retinyl acetate = 0.55 mcg retinyl palmitate = 0.6 mcg Beta-Carotene 1 mcg Retinol = 3.34 IU of vitamin A activity 1 mg of all-trans Beta-Carotene = 1667 IU of Vitamin A activity 1 mcg Beta-Carotene = 1.67 IU of Vitamin A activity 1 mcg dietary Beta-Carotene = 0.167 mcg retinal Retinol Equivalents (RE) = the Vitamin A activity in foods 1 RE = 1 mcg all-trans retinal = 1 mcg retinal = 3.33 IU Retinol 1 RE = 6 mcg all-trans Beta-Carotene = 6 mcg Beta-Carotene 1 RE = 12 mcg other provitamin A carotenoids

Vitamin D Conversion: 1 IU = 0.025 mcg of cholecalciferol (Vitamin D3) 1 mcg Vitamin D (cholecalciferol) = 40 IU 1 mcg 25-hydroxyvitamin D = 80 IU 1 mcg 1,25-dihydroxyvitamin D = 200 IU

Vitamin E Conversion: 1 IU = 0.67 mg of d-alpha-tocopherol or 0.45 dl-alpha-tocopherol 1 mg = 1.49 IU d-alpha-tocopherol (natural vitamin E; RRR-alpha-tocopherol) 1 mg = 1.10 dl-alpha-tocopherol (synthetic vitamin E; all-rac-alpha-tocopherol)

39 40 41 42 The Antioxidant Network

Clark's Rule.

(weight of child (lb)) x (adult dose) = Child’s dose 150

Young's Rule.

(age of child (yr)) x (adult dose) = Child’s dose age + 12

PEDIATRIC DOSE CALCULATION BASED ON BODY WEIGHT This is a more reliable method of pediatric dose calculation than the preceding dosage rules because it bases the dosage on a given amount of drug per pound or kilogram of body weight.

NOTE: Round off all body weights in kilograms to the nearest whole number. (2.2 lbs per kilogram)

Example: The parenteral dose of erythromycin injection is 10 mg/kg/24 hours. Calculate the daily dose of this drug for a 44-pound child.

(1) Step 1. Convert 44 pounds to kilograms.

44 pounds = 20 kilograms 2.2

(2) Step 2. Multiply the client's weight by the dose.

20 kg x 10 mg/kg = 200 mg/24 hrs (answer)

44 Essential Fatty Acids

EFAs There are over 60 conditions that have been shown to benefit from EFAs. Due to their extensive role in every cell they’re critical for optimal health. We will focus on a few key conditions where the use of therapeutic EFA supplementation is warranted.

• Cardiovascular disease, high cholesterol, high blood pressure • Allergic and inflammatory conditions • Autoimmune diseases • Cancer • Inflammatory Bowel Disease

Dosages • Therapeutic: 1-4 tbsp flax oil or 5 g of omega-3 from fish oil daily • Note: Numerous studies regarding the impact of omega 3s on cardiovascular and cognitive function show beneficial results with dosages of 3 grams per day up to 20 grams per day. Caution is recommended with hypocoagubility.

Omega-3 (n-3) Fatty Acids Many edible plants produce this 18-carbon polyunsaturated fatty acid, but because of the small amounts of fresh vegetables consumed by many people, it is one of the least abundant of the essential fatty acids in most diets. It is found in relatively high amounts

45 in flax, hemp, canola seed, soybean, and walnut oils and in dark green leaves. It must be supplied by such foods, since human tissues lack the necessary enzymes forits formation. Dietary insufficiencies and imbalances of alpha-linolenic acid (ALA) and its counterpart, gamma-linolenic acid (GLA), play a central role in many disease processes. The wide range of symptoms and disease associations is due to the function of this fatty acid in critical cell processes of membrane integrity and eicosanoid local hormone production. The hormone function uses the 20-carbon fatty acid eicosapentaenoic acid (EPA, see later), which can be produced from ALA by elongation and desaturation. This conversion depends strongly on zinc status. Inadequate conversion of ALA into EPA is a sensitive biochemical marker of zinc in sufficiency and is indicated by low EPA and docosahexaenoic acid (DHA) in the presence of normal ALA.5 Correction of low body pools of ALA requires dietary changes or the use of dietary supplements containing ALA. Table 17-2 lists food sources of ALA. The origin of ALA deficiency disorders can be seen by inspecting the ALA content of corn, safflower, and peanut oils that are so predominant in modern diets.

Eicosapentaenoic Acid (20:5ω3) Insufficiencies of EPA are likely the most prevalent fatty acid abnormality affecting the health of individuals in Western societies. Low levels in plasma or erythrocytes are indicative of insufficiency. Arthritis, heart disease, and accelerated aging result from direct or indirect effects of inflammatory responses that may be modulated by raising EPA levels. Supplementation with EPA-rich fish oils aids in the prevention of cardiac arrhythmias.6 Significant reduction in total cholesterol and triglyceride has been achieved with a combination of garlic concentrate (900 mg/day) and fish oil supplementation.7 EPA is the parent of the 3-series prostanoids and leukotrienes, which moderate the proinflammatory effects of the 2-series derived from arachidonic acid (AA). Although EPA can be produced from the essential fatty acid (EFA) ALA, dietary intake of this fatty acid is generally poor. The conversion also requires the action of the delta-6 desaturase enzyme, which may be low due to inadequate zinc, magnesium, or vitamins B3, B6, and C.8 Such enzyme impairment would be indicated if EPA is low and ALA is normal or high. High levels of saturated, monounsaturated, and trans-fatty acids and cholesterol also

46 slow the conversion of ALA to EPA (as well as GLA to dihomogammalinolenic acid [DGLA]). Fish oils are rich sources of EPA, as shown in Table 17-3. Dietary supplementation of EPA is an important part of nutritional support in patients with compromised immune responses, including postoperative and trauma cases.9 Fish oil supplementation lowers triglycerides without effect on glycemic control in type 2 diabetes.10 All such clinical presentations should be monitored by evaluation of fatty acid profiles to ensure that balance is restored and maintained.

Docosapentaenoic Acid (22:5ω3), Docosahexaenoic Acid (22:6ω3) Growth and development of the central nervous system in particular depend on the presence of an adequate amount of the long-chain, highly unsaturated fatty acids docosapentaenoic acid (DPA) and DHA.11,12 Attention deficit hyperactivity disorder and failures in development of the visual system in EFA deficiencies are two examples of this dependency.13 DHA is an important member of the long-chain fatty acids (C22-C26), which characteristically occur in glycosphingolipids, particularly those in the brain. Since this fatty acid is so important in early development, it is worth noting that the levels in breast milk are correlated with the mother's intake of fish oils, which are rich sources of DHA and DPA.14 Plasma DHA levels should be checked as early as possible in pregnancy. The finding of low DHA in plasma or erythrocytes also justifies the use of supplemental DHA for depression.15

Omega-6 (n-6) Fatty Acids

Linoleic Acid (18:2ω6) Linoleic acid (LA) is by far the most abundant polyunsaturated fatty acid (PUFA) in most human tissues. It is one of the essential fatty acids because it contains a double bond at the omega-6 position that is beyond the reach of the human desaturase enzyme. Low levels indicate dietary insufficiency, which leads to various symptoms. Some of these symptoms result from a lack of LA in membranes, where it has a role in structural integrity. Most, however, are from failure to produce the 1-series and 3-series local hormones known as prostanoids. LA is the starting point for this pathway. Normal neonatal status of this fatty acid can be marginal, if not insufficient.16 Fetal linoleic and cervonic acids (DHA) are correlated with maternal red blood count levels.17 However, since dietary sources (especially corn oil) are abundant, LA may be found to be above normal in some adults. Excessive LA can contribute to an overproduction of the proinflammatory 2-series local hormones derived from AA.

Dietary fatty acids can strongly inhibit intestinal microbial growth. Compared with other fatty acids, LA caused growth inhibition of Helicobacter pylori, the bacterium thought to cause gastric ulcer.18

Gamma-Linolenic Acid (18:3ω6) GLA is the precursor of DGLA, the parent of the 1-series prostanoids, that can go on to form AA, the parent of the 2-series prostanoids. GLA is found in hemp, borage, blackcurrant, and evening primrose oils. It can be produced in human tissues by the action of desaturase enzymes on LA. Use of 1.4 g/day in the form of borage seed oil

47 resulted in a clinically important reduction in the signs and symptoms of rheumatoid arthritis19. In cases of cancer, it is especially important that low levels of GLA should not be supplemented without added omega-3 fatty acids because omega-6 fatty acids can enhance tumor formation and growth, while omega-3 fatty acids inhibit tumors.20 GLA corrects most of the biologic effects of zinc deficiency, indicating that the requirement of the delta-5 desaturase enzyme for zinc is a first-order essential function of zinc.21

Dihomogammalinolenic Acid (18:3ω6) Diets low in the EFA LA are almost universally also low in DGLA. The 1-series prostanoids and leukotrienes are derived from DGLA, so an insufficiency of this fatty acid impairs a wide range of cellular functions and tissue responses. The 1-series compounds act like the 3-series derived from ALA to moderate the proinflammatory 2- series. In tumor response, however, they are unique in being promoters of growth where the 3-series are inhibitors. When testing reveals low levels of DGLA, supplementation with borage or evening primrose oils should be considered, but if a history of tumor formation is known, ALA sources (blackcurrant) should always be considered as well. See the earlier EPA discussion for other factors affecting the desaturase enzyme required for conversion of GLA into DGLA.

Arachidonic Acid (18:4ω6) Because of the prevalence of corn and corn oil products in feed for cattle and hogs, diets high in these red meats are rich in AA. AA is a 20-carbon or eicosanoate fatty acid that serves as a substrate for the cyclooxygenase and lipoxygenase enzymes, leading to the production of the 2-series prostanoids and leukotrienes. Several of these products have potent proinflammatory and thrombogenic activity. High AA also promotes gallstone formation by stimulating mucin production in the gallbladder mucosa.22 Elevated AA is a frequent finding in profiles of fatty acids in plasma or erythrocytes. Such findings should trigger counseling regarding dietary AA reduction and appropriate supplementation to restore n-3/n-6 balance.

49 Table 93-4. Signs and symptoms associated with fatty acid abnormalities

Signs and symptoms Fatty acid Action association Emaciation, weakness, disorientation Caloric deprivation Add sources of balanced omega-3 and omega-6 fatty acids Reduced growth, renal dysplasia, reproductive Classic essential fatty Add good quality deficiency, scaly skin acid deficiency fats and oils Eczema-like skin eruptions, loss of hair, liver Linoleic acid Add corn or degeneration, behavioral disturbances, kidney insufficiency safflower oils degeneration, increased thirst, frequent infections, poor wound healing, sterility (male) or miscarriage (female), arthralgia, cardiovascular disease, growth retardation Growth retardation, weakness, impairment of Alpha- or gamma- Add flax, primrose, vision, learning disability, poor coordination, linolenic acid borage, or black tingling in arms/legs, behavioral changes, mental insufficiency currant oils disturbances, low metabolic rate, high blood pressure, immune dysfunction Depression, anxiety, learning and behavioral Long-chain PUFA- Add fish oils, avoid disorders, age-related eye disorders dependent hydrogenated oils neuromembrane function Cardiovascular disease risk Prostanoid balance Add omega-3 PUFAs Cancer Low stearic to oleic Use omega-6 ratio PUFAs with caution Rheumatoid arthritis Low GLA and Add primrose oil DGLA

Deficiency of vitamin B12 or carnitine, or both Increased odd- Add B12 or numbered FAs carnitine, or both Myelinated nerve degeneration Increased long-chain Add high-erucate FAs canola or mustard oils Fatty liver Saturated and omega- Restrict alcohol, 9 accumulation in add lecithin, liver increase methionine Accelerated aging High PUFA intake Add vitamins E and without increased C, Se, Mn, and Zn antioxidants Murray, Michael T., Pizzorno Jr., Joseph E. Textbook of Natural Medicine. Elsevier Ltd. 2006.

DGLA, Dihomogamma-linolenic acid; FAs, fatty acids; GLA, gamma-linolenic acid; PUFA,

polyunsaturated fatty acid.

50 Glandulars

Adrenal Uses • Angina • Asthma • Autoimmune disease • Cancer • Cardiovascular disease • Common cold • Diabetes (type II) • Depression • Headaches • Hypertension • Immune suppression • Irritable bowel syndrome • Menstrual irregularities • Premenstrual tension syndrome • Rheumatoid arthritis • Ulcerative colitis • Ulcers

Forms • Whole gland: use when low adrenal function presenting as fatigue, inability to cope with stress, and reduced resistance. • Cortex: use when allergy and inflammation present (asthma, eczema, psoriasis, rheumatoid arthritis, etc.) Dosage • Begin with one capsule per day and increase by one capsule every two days until there is a slight stimulatory effect. Decrease by one capsule for daily requirement. • Caution: some people are more sensitive to adrenal glandulars and should not take them after lunch.

Liver • Contain iron • Uses: chronic hepatitis, improve fat utilization, promote tissue regeneration, prevent liver damage Dosage • Therapeutic: 2 g daily (may vary depending on the product used) • Contraindications: hemochromatosis

Pancreas Uses • Digestive disturbances • Pancreatic insufficiency

51 • Cystic fibrosis • Food allergies • Autoimmune disorders • Sports injuries • Viral infections • Cancer

Spleen Uses • Celiac disease • Dermatitis herpetiformis • Ulcerative colitis • Rheumatoid arthritis • Glomerulonephritis • Lupus • Vasculitis • Thrombocytopenia • AIDS

Dosage • Therapeutic: 1.5 g daily

Thymus Uses • Prevention of recurrent respiratory infections in children • AIDS • Hepatitis B • Cancer (esp. post chemotherapy) • Allergies: asthma, hay fever, food allergies • Autoimmune disorders

Dosage • Therapeutic: 800 mg daily

Thyroid Uses • Hypothyroid

Dosage • Therapeutic: Dosage should be determined based on the manufacturers recommendations and by monitoring the basal body temperature.

Pituitary Uses • Pituitary hypofunction

52 • Dysfunctional HPA axis

Dosage • Therapeutic: 270 mg daily

Kidney Uses • Detoxification • Urinary tract infections • Incontinence • Poor kidney function

Dosage • Therapeutic: 3 g daily

Ovary/Uterus Uses • Hormone balance • Reproductive health

Dosage • Therapeutic: 600mg of each daily

Heart Uses • Cardiovascular support

Dosage • Therapeutic: 600 mg daily

Lung Uses • Smokers • Asthma • Prone to pneumonia

Dosage • Therapeutic: 400 mg daily

Brain Uses • Mental health, Concussion

Dosage • Therapeutic: 600 mg daily

53 Amino Acids

Amino Acids commonly Used in Clinical Practice Amino Acid Uses L-tryptophan (or as 5-HTP) Sleep, anxiety L-lysine Herpes simplex treatment and prevention DL-phenylalanine Pain L-carnitine Weight loss, cardiovascular disease, chronic fatigue L-arginine/L-ornithine Bodybuilding, cancer L-cysteine Oxidative stress, detoxification L-taurine Depression, convulsions, detoxification L-glutamine Alcohol and sugar cravings and addictions, intestinal support L-tyrosine Depression and fatigue, thyroid hormone Isoleucine, leucine, valine (Branched chain Bodybuilding amino acids) Elson Haas, Staying Healthy With Nutrition

Lysine Functions • Absorption of calcium • Promotion of bone growth • Formation of collagen • Prevention of cold sores (herpes type 1) o 1000 mg TID when there’s an infection o 500 mg once/day as prevention

Methionine • Sulphur-containing

Functions • Skin and nail health (from Sulphur) • Lipotropic agent (along with choline and inositol) • Prevents fatigue • Allergy (reduces histamine release)

Phenylalanine • Precursor to tyrosine, epinephrine, norepinephrine, dopamine

Uses • Depression • Bipolar • Musculoskeletal pain

54 Dosage • 1–3 g daily

Tryptophan • Precursor to serotonin: mood, sleep

Dosage • 1–3 g daily

Arginine Uses • Stimulates growth hormone – bodybuilding and growth • Improves sperm count • Aids collagen formation • Lowers cholesterol • Regulate blood pressure • Decrease male impotence • Contraindication: diabetics should be careful with arginine due to its effect on blood sugar and insulin.

Dosage • 500 mg- 4 g daily

Cysteine (Cystine = 2 cysteine) • Sulphur containing • Metabolite of homocysteine • Needed to form glutathione (glycine and glutamic acid also needed) • Acetylated form = N-acetyl-cysteine • Rate limiting for glutathione • Used for Tylenol (acetaminophen) toxicity

Dosage • N-Acetyl-Cysteine 250mg-750mg daily (Take with 3 times the amount of vitamin C to prevent crystallization)

Glutathione • 2 enzymes made from glutathione: 1. Glutathione peroxidase (GPO) a. 8 molecules of GSH and 4 Se atoms b. convert reactive oxygen molecules (peroxides) 2. Glutathione-s-tranfersase (GST) a. Family of enzymes b. Similar function to GPO • Note: there is a lack of evidence indicating that glutathione is absorbed intact across the gut lining.

Glycine • Spares glucose by improving glycogen storage • Assists in liver detoxification

Dosage • 4-8 g daily

Proline • Collagen formation – bone, skin and cartilage

Dosage • 2 g daily

L-Glutamine • Metabolite of glutamic acid • Penetrates the BBB and can be used as brain fuel. Useful in decreasing alcohol cravings 500 mg QID • Also reduces cravings for sugar and carbohydrates • Helps heal ulcers • Digestive healing

Dosage • 5-40 g daily

Tyrosine • The precursor is phenylalanine • Precursor to epinephrine, norepinephrine, dopamine, thyroxine and melanin, enkephalins.

Uses • Low sex drive • Parkinson’ s disease • Drug abuse • Weight loss • Depression • Stimulates growth hormone • Mild appetite suppressant • Hypothyroidism

Dosage • 500mg-2g daily

56 Carnitine • Carnitine shuttle to burn LCFA in the mitochondria • Helps heart muscle burn energy Possible Uses • Alcohol abuse • Cardiovascular issues • Diabetes • Elevated cholesterol/triglycerides • Fatigue • Hypothyroidism • Immune suppression • Liver disease • Male infertility • Muscle diseases • Overweight • Pregnancy

Dosage • Therapeutic: 1.5 – 4 g daily in divided doses

Taurine • Functions in such electrically active tissues as the brain and heart to help stabilize cell membranes. • Cardiovascular issues

Dosage • Therapeutic: 1.5 – 6 g daily in divided doses

57 Enzyme Therapy

Clinical Applications of Enzyme Combinations

• Soft tissue injuries96,97 • Sprained ankle97-99 • Reabsorption of hematomas96,100 • Sports medicine101-107 • Meniscectomy (preoperative and postoperative therapy)108,109 • Traumatology110 • Prevention of posttraumatic and postoperative swelling111 • Pancreatitis112 • Surgery96,113 • Lower extremity bypass surgery114 • Operative dentistry115 • Proctology116 • Sinusitis117-120 • Acute and chronic bronchitis121-123 • Cystitis and lower urinary tract infections117,124,125 • Prostatitis117,124,126 • Pelvic inflammatory disease127,128 • Postthrombotic syndrome129-133 • Pathologic venous processes129,134-138 • Occlusive arterial disease139 • Lymphedema140-145 • Soft tissue rheumatism (nonarticular rheumatoid syndrome)146,147 • Rheumatoid arthritis (chronic polyarthritis)117,122,131,142,148,149,150-163 • Ankylosing spondylitis (Bekhterev's disease)97,152,153,156 • Degenerative rheumatic joint disease104,117 • Monoarticular, activated osteoarthrosis104,123,164,165 • Multiple sclerosis121,166-170 • HIV infections171-175 • Fibrocystic breast disease144,176 • Ulcerative colitis and Crohn's disease117,122,177-178

Hydrochloric Acid Contraindications: stomach or duodenal ulcers

Hypochlorydria (low stomach acid) has been associated with many common health problems. Stomach acid is used to begin the process of protein digestion. A normal stomach acid level is a pH of 1.5 to 3.0. As we age, the parietal cells in the stomach lining produce less hydrochloric acid In fact, half of people over the age of sixty have

58 hypochlorydria, and by age eighty-five, 80-percent of the healthy people tested had low stomach acid.

Hydrochloric acid is the beginning of the whole digestive cascade and is thus crucial for healthy digestion. It is important to have adequate acidity levels in order to absorb minerals and certain vitamins from food. Without sufficient stomach acid mineral deficiencies can result. In fact, common drugs that cut off stomach (proton pump inhibitors) have related side effects such as hip fracture and bone wasting due to mineral loss.

Another consequence of low stomach acid is bacteria overgrowth. People who have poor digestive capacity are more prone to infection from candida albicans, H. Pylori, parasites, and any other pathogenic organisms.

Hydrochloric Acid Supplementation: Patient Instructions Purpose The purpose of this self-test is to estimate the amount of supplemental hydrochloric acid (HCl) you need to reestablish adequate stomach acid. Adequate stomach acid is critical for initiating digestion and protecting the intestinal tract from microbial pathogens.

Directions 1. Begin by taking 1 HCl capsule (at least 600mg) at your next large meal. At every meal after that of the same size, take 1 more capsule (1 capsule at the next meal, 2 at the meal after that, then 3 at the next meal, and so on). 2. Continue to increase the dose until you reach 7 capsules or you feel a warmth in your stomach, whichever occurs first. A feeling of warmth in the stomach means that you have taken too many capsules for a meal of that size. Take 1 less capsule the next time. However, it is a good idea to try the larger dose again at another meal to make sure that it was the HCl that caused the warmth and not something else. 3. After you have determined the largest dose that you can take at your large meals without feeling any warmth, maintain that dose at all meals of similar size. Take fewer capsules with smaller meals. 4. When taking several capsules, it is best to take them throughout the meal rather than all at once. 5. As your stomach begins to regain the ability to produce the amount of HCl needed to properly digest your food, you will notice the warm feeling again. This is the time to start decreasing the dose level. 6. Every 3 days, decrease by 1 capsule per meal. If the warmth continues, decrease more rapidly. If maldigestion symptoms return, add capsules back until digestion improves again.

Reference Murray, M. Pizzorno, J. Textbook of Natural Medicine. 2005.

59 Systemic Enzyme Support (i.e. Wobenzyme) An Overview by Wald M, M.D.1, Honzíková M, M.D.2, Lysíková M, M.D., Ph.D.2, Masinovský Z, Ph.D.2 1Department of Surgery, 2nd Medical Faculty, Charles University, Prague, Czech Republic 2Department of Enzyme Therapy, Society of General Medicine, J.E. Purkyne Czech Medical Association, Prague, Czech Republic

Introduction A large number of conditions are primarily inflammatory in nature and may be significantly complicated by the presence of secondary forms of inflammation. Regardless of whether the cause of the problem is due to bacterial, viral or auto-immune influences, the result may be an ongoing situation with significant clinical and laboratory manifestations of the inflammatory process.

Dietary supplements designed to provide Systemic Enzyme Support (SES) can play an important role in helping to maintain normal inflammatory processes within the body and thereby help support and speed healing. This is not only beneficial for the patient, but for healthcare in general as ultimately it may help to reduce the costs associated with maintaining health.

Most healthcare professionals select treatments based on what they believe will be effective over a long period of time as well as what will bring a specific patient the fewest risks in connection with treatment. One of the major benefits of using systemic enzyme support is the relatively small amount of undesirable effects combined with good tolerance and efficacy.

Systemic enzyme support was for a long time regarded as a purely empirical treatment method. Due to the rapid development of immunology, biochemistry and molecular biology in the last few decades, systemic enzyme support has undergone significant development, as it has been shown that behind the empirically supported clinical results are a complex set of regulatory processes, which previously were unknown. Today, scientists have a better understanding with respect to the mechanisms by which Systemic Enzyme Support may be exerting its desired effects. Specifically, the effect of proteolytic enzymes (proteases) on the cytokine network and their action at the level of the cell membrane both in terms of cellular adhesion as well as modulation of cellular receptors has been described. One of the main pioneers in the clinical use of the systemic proteases was Professor Max Wolf, who worked in New York in the 1930s not only as a sought- after physician but also as a researcher at Fordham University. At the present time, with regard to the historically best known pharmacological and clinical effects, proteases are placed in the international ATC classification in the M09AB group – anti-inflammatory enzymes.

Systemic Enzyme Support – definition Hydrolytic enzymes have been used widely for decades and a range of scientific publications have recently demonstrated their importance in supporting numerous areas of health. At the present time proteases are indicated for parenteral application in malfunctions of blood coagulation (urokinase), to affect fibrotic processes (hyaluronidase) or in treatment of malignant hemotological conditions (asparaginase).

60 The aim of oral application of enzymes may be either substitution of digestive enzymes in external secretory insufficiency of the pancreas or use of their systemic effects (proteases). So, Systemic Enzyme Support can be defined as a modality which uses oral administration of exogenous hydrolytic (mainly proteolytic) enzymes of animal origin (trypsin, chymotrypsin) and plant origin (bromelain, papain) in the form of enteric-coated tablets for supporting healthy and normal inflammatory processes in the body. As a result, systemic enzyme support can help maintain a healthy immune system, healthy blood flow and circulation, healthy joint function, as well as help to reduce muscle pain after exercising. Systemic enzymes can exert a positive effect on rheological properties of blood as a result of their fibrinolytic properties. Data have also shown that administering systemic enzymes together with certain antibiotics is able to improve the tissue availability of the antibiotics.

Proteases The main component of products designed for systemic enzyme support are proteolytic (i.e. protein splitting) enzymes of animal or plant origin. These are endopeptidases which hydrolyze peptide bonds in certain protein (peptide) chain locations on the basis of a more or less specific affinity to particular amino acid elements of these chains. Trypsin is a pancreatic endopeptidase, which splits peptide bonds formed by the carboxylic group of the amino acids such as lysine or arginine. It is obtained from the pancreas of pigs by repeated refining and subsequent activation of the proenzyme trypsinogen.

Chymotrypsin is a pancreatic endopeptidase, which hydrolytically splits peptide bonds formed by carboxylic groups of the amino acids tyrosine, phenylalanine and tryptophan. Chymotrypsin is obtained by extraction and chromatographic purification from the pancreas of cattle and subsequent activation of the proenzyme chymotrypsinogen.

Bromelain is an endopeptidase obtained from pineapples. Bromelain hydrolytically splits peptide bonds formed by the amino acids lysine, alanine, tyrosine and glycine. Bromelain is a family of individual macromolecules and is not a single enzyme.

Papain is a mixture of proteolytic enzymes separated from the fruit of the tropical Carica papaya, which is a member of the melon family. Papain splits polypeptides, particularly between the bonds of arginine, phenylalanine and lysine.

These proteases are typically combined in preparations for oral administration. The reason for these combinations is an assumption that the effects of individual enzymes will complement each other resulting in the multiplication of the final therapeutic efficacy. Another reason for these combinations is the assumption of an increase in the resorption of individual proteases by the intestinal mucous membrane when administered together with other proteases.

Most of the combined systemic enzyme support preparations currently used usually contain rutin (rutoside) in addition to two or more proteases. Rutin belongs to the group of bioflavonoids and can help to reduce the permeability of veins and capillaries.

Resorption of enzymatically active macromolecules and their pharmacokinetics The basic condition of the systemic effect of proteases administered orally is their absorption in an enzymatically active form. The coated tablet ensures that the content will resist the acid gastric juices and not break down until it has reached the mucosa of the small intestine with a pH of about 7. After absorption, certain parts of the proteolytic enzymes pass into the blood stream and the lymph where their enzymatic activity allows them to bind to natural antiproteases of which the most important are alpha-2- macroglobulin (a-2-M) and alpha-1-antitrypsin (a-1-AT).

Many effects of SES are based on a-2-M-protease complex. The complex formation starts with the hydrolysis of the specific peptide bond in a-2-M by a protease. It causes a very deep conformational change of the entire a-2-M molecule. The protease becomes trapped in the a-2-M molecule in a way that prohibits many of its potential proteolytic abilities, however, some smaller or less protected substrates can still reach the reaction center and thus it does retain some catalytic activity. In the complex, a-2-M masks the protease macromolecule’s antigenic determinants, so the enzyme has no allergenic effect on the organism. By its interaction with a protease, a-2-M is transformed into an “active” form (so called “fast form”) which has new properties in relation to many physiologically active molecules, especially, to a broad spectrum of substances which participate in the immune response.

Protease-antiprotease complexes are transported into tissues, where the proteases can be released (from a-1-AT, but not from a-2-M) and operate for a short time as free enzymes or have a relatively long-term effect as entire complexes. In these complexes, the proteases are captured by the liver and the pancreas where 90 % of them are eliminated in bile and excreted in stools. The biological half-life for elimination of enzymes after their resorption is relatively long (6 hours for bromelain and 12-20 hours for trypsin). The biological availability of enzymes in terms of systemic effects is relatively low after oral administration, i.e. around 1% of the total dose administered. This explains the necessity to administer proteolytic enzymes in large doses.

Bromelain and trypsin and similarly other proteases that are administered for systemic effects are resorbed from the intestine as active molecules. Penetration by the enzyme through the wall of the intestine in an active state has also been demonstrated for other enzymes (horse-radish peroxydase, 40 kDa; botulotoxin, 150 kDa). At the present time the generally accepted opinion is that even molecules with a weight of more than 1000 kDa can also penetrate the intestinal barrier to a limited extent.

Currently a number of mechanisms for the transfer of macromolecules through the intestine wall are described. In the upper part of the small intestine, persorption is regarded as the main mechanism. This is linked with continuous desquamation of dying enterocytes, which causes the short-term increase in permeability of the intestinal barrier. In addition, absorption by M-cells (microfold cells) accumulated in the intestinal mucosa over the Payer’s plaques takes part in the transfer in the ileum. Another mechanism is the receptor-mediated endocytosis linked with internalisation and recycling of the receptor.

62 In addition to transcellular paths, paracellular transfer through tight junctions also appears to be another possibility.

Mechanisms of the effect of proteases after oral application The systemic effect of proteases is realized in the organism either by way of direct proteolysis of physiologically important molecules of a protein nature or indirectly by affecting the properties of important regulatory molecules (e.g. a-2-M or proteinase- activated receptors, PARs).

1. Direct proteolytic effects

2. Effect on adhesion molecules

3. Effect on cytokines operating locally and systemically

4. Effect by means of protease-activated receptors

5. Effect on AGEs by exogenous proteases

6. Immunomodulation by means of intestinal bacteria

Pharmacodynamic effects of SES The effects of proteases administered orally are highly interconnected and can be derived from the mechanisms stated above.

The ability of systemic enzymes to support normal inflammatory processes is a crucial and a highly complex one. The action of proteases on normal inflammatory processes works in a number of ways, which helps to explain the wide spectrum of potential health issues for which systemic enzymes can help to support.

In instances involving occurrences such trauma, burns, haematoma, etc., a combination of proteolytic enzymes works mainly by improving blood rheology and by breakdown of tissue detritus. Specifically, deposits of proteins escaped from the arterial or venous lumen are cleaved and degraded by proteolytic enzymes. Small thrombi created in the periphery of the “vascular bed” can be reduced which promotes the supply of immunocompetent cells and oxygen necessary to rebalance normal inflammatory processes.

In addition to the aforementioned, in situations of ongoing imbalances of the inflammatory system, proteases can help to eliminate immunocomplexes, alter the expression of adhesion molecules, and normalize the cytokine network, and overall haemostasis.

The extent of interaction of proteolytic enzymes with key inflammation reaction mechanisms ranges from supporting the bodies normal inflammatory reaction to helping decrease on overactive system. In contrast to conventional medical products, proteases

63 therefore optimize the physiological course of inflammation and help maintain a balanced process.

The effect on rheological blood and lymph properties, which leads to their decreased viscosity and improved fluidity, is caused by interactions with the fibrinogen/fibrin system and the ability to activate plasminogen into plasmin and increase the levels of anti-thrombine III. Restriction of aggregation and adhesion of thrombocytes and reduction in aggregation and improvement of the flexibility of erythrocytes has also been described.

Improvement of microcirculation by affecting the rheological properties of body fluids is also regarded as one of the factors contributing to the beneficial effects of systemic enzymes. Other important factors which play a part in this effect are all the mechanisms which lead to normalizing an immune response reaction and minimizing secondary damage.

The immunomodulatory effect of systemic enzymes is mediated through affecting the expression of adhesion molecules, interventions in the cytokine network and impact on protease-activated receptors. The effect on various cellular components of the immune system (macrophages, granulocytes, NK cells, T lymphocytes) and the impact on production and elimination of immunocomplexes have also been demonstrated. It has been shown that some individual proteases and also combined preparations increase the concentration of antibiotics, chemotherapeutic drugs and certain other medical products in the blood and tissues.

Certain relatively recent papers refer to the ability of proteases to reduce the level of LDL–cholesterol. The mechanism underlying the increased elimination of LDL- cholesterol may be the ability of a-2-M-protease complexes to activate common receptors specific for LDL and a-2-M on the membranes of phagocytic cells, in particular the phagocyte system of the liver and the spleen.

References Biziulevicius GA. Where do the immunostimulatory effects of oral proteolytic enzymes (‘systemic enzyme therapy’) come from? Microbial proteolysis as a possible starting point. Med Hypotheses 2006;67(6):1386-8. Castell JV, Friedrich G, Kuhn CS, et al. Intestinal absorption of undegraded proteins in men: presence of bromelain in plasma after oral intake. Am J Physiol 1997;273:139-46. Donath F, Roots I, Mai I, et al. Dose-related bioavailability of bromelain and trypsin after repeated oral administration. Eur J Clin Pharmacol 1997;52(Suppl):146. Dosenko VE, Zaharova VP, Byts YV. Systemic enzyme therapy in experimental atherosclerosis. Int J Immunother 2001;XVII(2/3/4):51S-58S. Emancipator SN, Chintalacharuvu SR, Urankar Nagy N, et al. Oral enzymes in different animal models of glomerulonephritis. Int J Immunother 1997;XIII(3/4):97-110. Ernst E. Oral therapy with proteolytic enzymes: Effects on hemorheological parameters. Perfusion 1994;12:440-1. Gaspani L, Limiroli E, Ferrario P, Bianchi M. In vivo and in vitro effects of bromelain on PGE(2) and SP concentrations in the inflammatory exudate in rats. Pharmacology. 2002 May;65(2):83-6. Gläser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17(1):37-41. Guideliness for ATC classification and DDD assignment. WHO Collaborating Centre for Drug Statistics Methodology. Oslo 1998 Hale LP, Greer PK, Sempowski GD. Bromelain treatment alters leukocyte expression of cell surface molecules involved in cellular adhesion and activation. Clin Immunol 2002;104(2):183-90. Hale LP, Haynes BF. Bromelain treatment of human T cells removes CD44, CD45RA, E2/MIC2, CD6, CD7, CD8, and Leu 8/LAM1 surface molecules and markedly enhances CD2-mediated T cell activation. J Immunol 1992;149(12):3809-16. Heidland A, Sebekova K, Paczek L, et al. Renal fibrosis: Role of impaired proteolysis and potential therapeutic strategies. Kidney Int 1997;52(62):32-5. Heidland A, Sebekova K, Schinzel R: Advanced glycation end products and the progresive course of renal disease. American Journal

64 of Kidney Disease 2001; Vol 38, (Suppl 1), S100-S106 Heumann D, Vischer TL. Immunomodulation by alfa2-macroglobulin-proteinase complexes: the effect on the human T lymphocyte response. Eur J Immunol 1988;18:755-60. James K. Interactions between cytokines and alfa2-macroglobulin. Immunol Today 1990;11:163-6. Kolac C, Streichhan P, Lehr CM. Oral bioavailability of proteolytic enzymes. Eur J Pharm Biopharm 1996;42(4):222-32. Korzo TM, Repina MA. Contemporary approaches to correction of hemostasis disorders in pregnancy complicated by gestosis. Prakt Med 2003, 3: 58-61 Koshkin VM, Kirienko AI. Systemic enzyme therapy in the treatment of acute thrombosis of superficial veins in the lower extremities and postthrombophlebitic disease. Int J Immunother 2001;XVII(2/3/4):121-4. Kovalenko VN, Kornienko TM, Gulaja NM. Evaluation of dyslipidemia correction methods in patients with ischemic heart disease based on one month treatment by systemic enzyme therapy compared with simvastatin. Zapor Med Zh 2004;4:52-5. Kunze R, Ransberger K, Stauder G, Gebauer F. Proteolytic enzymes modulate the C1q-binding capacity of fixed immunocomplexes in vitro. Eur J Inf Immunol Dis 1996;1:1:17-29. Lauer D, Müller R, Cott Ch, et al. Modulation of growth factor binding properties of a2-macroglobulin by enzyme therapy. Cancer Chemother Pharmacol 2001;47(Suppl.): 4S-9S. Lauer D, Reichenbach A, Birkenmeier G. Alpha 2-macroglobulin-mediated degradation of amyloid beta 1-42: a mechanism to enhance amyloid beta catabolism. Exp Neurol 2001;167(2):385-92. Lehmann PV. Immunomodulation by proteolytic enzymes. Nephrol Dial Transplant. 1996 Jun;11(6):952-5 Leskovar P. AIDS: Neuartige therapiekonzepte. Dtsch Zeitschr Onkol 1990;22:26 Luerti M, Vignali ML. Influence of bromelain on penetration of antibiotics in uterus, salpinx and ovary. Drug Exp Clin Res 1978;4(1):45-8. Manhart N, Akomeah R, Bergmeister H, et al. Administration of proteolytic enzymes bromelain and trypsin diminish the number of CD4+ cells and the interferon-y response in Peyer ́s patches and spleen in endotoxemic balb/c mice. Cell Immunol 2002;215:113-9. Maurer HR. Bromelain: biochemistry, pharmacology and medical use. Cell Mol Life Sci 2001;58:1234-45. McLean PG, Aston D, Sarkar D, Ahluwalia A. Protease-activated receptor-2 activation causes EDHF-like coronary vasodilation: selective preservation in ischemia/reperfusion injury: involvement of lipoxygenase products, VR1 receptors, and C-fibers. Circ Res. 2002 Mar 8;90(4):465-72. Metzig C, Grabowska E, Eckert K, et al. Bromelain proteases reduce human platelet aggregation in vitro, adhesion to bovine endothelial cells and thrombus formation in rat vessels in vivo. In Vivo 1999;13(1):7-12.. Munzig E, Eckert K, Harrach T, et al. Bromelain protease F9 reduces the CD44 mediated adhesion of human peripheral blood lymphocytes to human umbilical vein endothelial cells. FEBS Lett 1994;351:215-8. Neumayer C, Fugl A, Nanobashvili J, Blumer R, Punz A, Gruber H, Polterauer P, Huk I. Combined enzymatic and antioxidative treatment reduces ischemia-reperfusion injury in rabbit skeletal muscle. J Surg Res 2006;133(2):150-8. Österreicher J, Škopek J, Navrátil L, Knížek J, Šebková V, Macela A. Enteral administration of proteinase mixture delays and/or ihibits inflammation development in irradiated rat lungs. Int J Immunotherapy 2001;XVII(2/3/4):41-49. Pandya NM, Jain SM, Santani DD. Pathophysiological actions of protease activated receptors (PARs). Pharmazie. 2007 Mar;62(3):163-9. Roep BO, Engel NK, Halteren AGS, et al. Modulation of autoimmunity to beta-cell antigens by proteases. Diabetologia 2002;45:686- 92. Rose B, Herder C, Loffler H, Meierhoff G, Schloot NC, Walz M, Martin S. Dose-dependent induction of IL-6 by plant-derived proteases in vitro. Clin Exp Immunol 2006;143(1):85-92. Steffen C, Menzel J. Basic studies on enzyme therapy of immune complex diseases. Wien Klin Wochenschr 1985;12:97(8):376-85. Stopper H, Schnizel R, Sebeková K, Heidland A. Genotoxicity of advanced glycation end products in mammalian cells. Cancer Letters 2003;190:115-56. Sukhikh GT, Loginova NS, Faizullin LZ, et al. The use of Wobenzym® to facilitate interferon synthesis in the treatment of chronic urogenital chlamydiosis. Int J Immunother 1997;XIII(3/4):131-3. Sy MS, Liu D, Kogerman P, et al. Potential of targeting cell surface CD44 proteins with proteinases in preventing tumor growth and metastasis. Int J Immunother 1997;XIII(3/4):105-9. Targoni OS, Tary-Lehmann M, Lehmann PV. Prevention of murine EAE by oral hydrolytic enzyme treatment. J Autoimmun 1999;12:191-8. Tinozzi S, Venegoni A. Effect of bromelain on serum and tissue levels of amoxycilin. Drug Exp Clin Res 1978;1:39-44. Veremeenko KN, Dosenko VE, Kizim AI, Terzov AI. The mechanisms of the curative action of systemic enzyme therapy. Lik Sprava 2000;(2):3-11. Veremeenko KN, Kizim AI, Kikot YuV, Savtchuk EM, Terzov KA. Effect of polyenzyme preparations on fibrinolytic system. Lab Diagn 2002;1:10-2. Wood GR, Ziska T, Morgenstern E, et al. Sequential effects of an oral enzyme combination with rutosid in different in vitro and in vivo models of inflammation. Int J Immunother 1997;XIII(3/4):139-45. Xiang G, Schinzel R, Simm A, Sebekova K, Heidland A: Advanced glycation end products impair protein turnover in LLC-PK1: Amelioration by trypsin. Kidney International 2001; Vol 59; (Suppl. 78):53-57 Xiang G, Schinzel R, Simm A, Münch G, Sebekova K, Kasper M, Niwa T, Schmitz Ch, Heidland A: Advanced glycation end products (AGEs)-induced expresion of TGF-β1is suppressed by a protease in the tubule cell line LLC-PK1. Nephrology Dialysis Transplantation 2001; 16:1562-1567 Závadová E., Österreicher J., Šebková V., Wald M. Reduction of transforming growth factor beta (TGF-beta) in rats with postradiation lung fibrosis after rectal administration of proteolytic enzymes. Clinical Cancer Research 2001; 7:766.

65 Accessory nutrients

Bovine Colostrum What is Colostrum? Colostrum is the first collection of a thick creamy liquid, without blood or infection, produced by the mammary gland of a parturient mother shortly after birth, usually within thefirst 6 hours. Colostrum is very important part of breast milk and lays down the immune system and confers growth factors and other protective factors for the young ones in mammals. This is the source of passive immunity achieved by the mother and is transferred to the baby. This is the major source of secretory IgA and gives protection against gastrointestinal infections.

Benefits of Clolustrum Colostrum is known to have benefits such as passive immunization, benefits immunodeficient patients. The feasibility of obtaining surface immunoglobulin suitable for oral use, which may in future be administered to immunodeficient patients with gastrointestinal manifestations, from human colostrum and milk. [3]

Human and bovine colostrum have many similarities barring that bovine colostrum can be obtained in large quantity, so bovine colostrum may be as beneficial as human colostrum on various disorders in human beings. [2]

Lactoferrin (LF) exhibits antibacterial, antifungal, antiviral, antiparasitice, and antitumoral activities. It is protective with regard to intestinal epithelium, promotes bone growth, and accelerates the recovery of immune system function in immunocompromised animals. Lactoferrin (LF) was tried in the treatment of hepatitis C infection and the intestinal form of graft-versus-host disease (GvHD). [5]

A proline-rich polypeptide (PRP) demonstrated a variety of immunotropic functions, including the promotion of T-cell maturation and inhibition of autoimmune disorders. PRP, in the form of chewable tablets (Colostrinin) was recently found to improve or stabilize the health status of Alzheimer's disease patients. [5]

Casein and casein-derived peptides showed protective activities in enamel demineralization and as caries-preventing agents. The protein hydrolyzates were also protective in diabetic animals, reduced tumor growth, had antihypertensive activity and diminished colicky symptoms in infants.

Glycomacropeptide (GMP), a peptide derived from kappa-casein, exhibited various antibacterial and antithrombotic activities.

Alpha-lactalbumin (LA) demonstrated antiviral, antitumoral and anti-stress properties. LA-enriched diets were anxiolytic, lowered blood pressure in rats, prevented diarrhea, and led to a better weight gain in malnourished children.

66 HAMLET, a complex of LA and oleic acid, was effective in patients with cutaneous papillomas. Lysozyme found application in infant formulas, the treatment of periodentitis, and the prevention of tooth decay. Milk enriched in lysozyme was used in feeding premature infants suffering from concomitant diseases. Interesting, antibacterial properties were exhibited by lactoperoxidase. Both lysozyme and lactoperoxidase required cooperative action with LF in combating bacteria. [5]

Uses • AIDS • Crohn’s Disease • Allergies • Depression • Arthritis • Fibromyalgia • Asthma • Influenza • Attention Deficit Disorder • Multiple Sclerosis • Bacterial infections • Parasites • Chronic Fatigue Syndrome • Rheumatoid Arthritis • Candida

REFERENCE [1] Xu LB et al, Bovine immune colostrum against 17 strains of diarrhea bacteria and in vitro and in vivo effects of its specific IgG.Vaccine. 2005 Nov 15. [2] Thapa BR.Health factors in colostrum.Indian J Pediatr. 2005 Jul;72(7):579-81. [3] Carbonare CB et al, Secretory immunoglobulin A obtained from pooled human colostrum and milk for oral passive immunization. Pediatr Allergy Immunol. 2005 Nov;16(7):574-81 [4] Aydin S, Aydin S, Ozkan Y, Kumru S.. Ghrelin is present in human colostrum, transitional and mature milk.Peptides. 2005 Sep 24; . [5] Zimecki M, Artym J.Therapeutic properties of proteins and peptides from colostrum and milkPostepy Hig Med Dosw (Online). 2005 Jun 30;59:309-23.

Prevention of influenza episodes with colostrum compared with vaccination in healthy and high-risk cardiovascular subjects: the epidemiologic study in San Valentino. (Clin Appl Thromb Hemost. 2007 Apr;13(2):130-6.)

The efficacy of a 2-month treatment with oral colostrum in the prevention of flu episodes compared with antiinfluenza vaccination was evaluated. Groups included healthy subjects without prophylaxis and those receiving both vaccination and colostrum. After 3 months of follow-up, the number of days with flu was 3 times higher in the non-colostrum subjects. The colostrum group had 13 episodes versus 14 in the colostrum + vaccination group, 41 in the group without prophylaxis, and 57 in nontreated subjects. Part 2 of the study had a similar protocol with 65 very high-risk cardiovascular subjects, all of whom had prophylaxis. The incidence of complications and hospital admission was higher in the group that received only a vaccination compared with the colostrum groups. Colostrum, both in healthy subjects and high-risk cardiovascular patients, is at least 3 times more effective than vaccination to prevent flu and is very cost-effective.

Coenzyme Q10 • Involved in the manufacture of ATP in the mitochondria • CoQ10 is one of the top six pharmaceutical agents used in Japan

67 Food Sources • Ubiquinone – called this because it is every plant and animal cell

Beneficial Effects • AO activity limited to protection against lipid peroxidation

Uses • Congestive heart failure • High blood pressure • Cardiomyopathy • Mitral valve prolapse • Coronary artery bypass surgery angina • Periodontal disease • Immune deficiency • Cancer • Weight-loss aid • Muscular dystrophy • Athletes – performance enhancing

Forms • Ubiquinone (oxidized) • Ubiquinol (reduced) • As we age the conversion from ubiquinone to Ubiquinol declines

Dosage • 50-1000 mg per day • 2 mg per kg body weight

Flavanoids • Over 4000+ • Various colors

PCO (Proanthocyanins) • Increase intracellular vitamin C • Decrease capillary permeability and fragility • Scavenge oxidants and free radicals • Inhibit the destruction of collagen

Uses • Venous and capillary disorder • CVD

Quercetin • Inhibits both the manufacture a release of histamine • Vitamin C-sparing

68 • Decreases accumulation of sorbitol • Enhances insulin secretion • Protects pancreatic beta cells • Inhibits platelet aggregation • Anti-viral, anti-tumor

Uses • Allergies • IBD • Cancer

Green tea polyphenols • Antioxidant • Anti-carcinogenic • Anti- cancer (specifically stomach, small intestine, pancreas, colon, lungs, breast, prostate)

Uses • Prevention of cancer

Rutin Uses • Reducing capillary fragility, easy bruising, swelling and bruising from sport injuries and nosebleeds • Venous insufficiency

Forms • Grape seed extract – 92-95% PCO • Pine bark extracts – 80-85% PCO • Quercetin with bromelain enhances absorption

Dosage • PCO – 150-300mg per day (as GSE or PBE) • Quercetin – 200-8000 mg per day • Enzymatically Modified Isoquercetin (EMIQ) 30-100 mg/day • Green tea polyphenols – 240-320 mg polyphenols • Rutin – 1-3g per day

Glucosamine • Made up of a glucose and an amine • Stimulates manufacture of glycosaminoglycans • Incorporates Sulphur into cartilage

Food Sources • None

Beneficial Effects • Stimulates the repair and maintenance of joint tissue

Uses • Osteoarthritis

Forms • N-acetylglucosamine (NAC) (least absorbable) • Glucosamine Hydrochloride (less absorbable) • Glucosamine Sulfate (most absorbable)

Dosage • Glucosamine Sulfate – 500mg 3x/day

Lipoic acid • Anti-oxidant Food Sources • Liver, yeast

Beneficial Effects • Metabolism of glucose • Antioxidant network

Uses • Diabetes • AIDS • Liver cirrhosis • Heart disease • Cataracts • Heavy-metal toxicity • Detoxification support

Forms • Alpha lipoic acid (50/50 synthetic/natural) • R-Lipoic Acid (Natural)

Dosage • 20-600 mg per day

Note: monitor blood sugar

Melatonin • Controls the circadian rhythms of the body

70 Beneficial Effects • Regulate body rhythms • Antioxidant • Anticancer

Uses • Jet lag • Insomnia • Adjunct cancer therapy • Depression

Forms • Sublingual form will optimize absorption

Dosage • For sedative effect 0.1-3 mg 30 minutes before bed • For anticancer up to 50 mg daily

Phosphatidylserine • Major phospholipid in the brain • Determines integrity and fluidity of cell membrane • Requires SAM, folic acid, and B12 (methyl donors)

Food Sources • Trace amounts in soy lecithin

Beneficial Effects • Improves memory • Builds nervous system

Uses • Depression • Impaired mental function in elderly (Alzheimer’s, dementia, Parkinson’s) • Decreasing cortisol

Dosage • 600 mg daily

Probiotics Food Sources • Kefir, yoghurt, sauerkraut, kimchi, miso, tempeh, kombucha, pickles

Beneficial Effects • Constipation • Lactose intolerance

71 • Prevention and treatment of gastrointestinal tract (GIT) infections • Flatulence • Diarrhea: infantile, antibiotic-associated, traveler's • Inflammatory bowel disease • Irritable bowel syndrome • Intestinal hyperpermeability • Treatment of hypercholesterolemia • Prevention and treatment of vaginal infections • Prevention and treatment of urinary tract infections • Treatment of hepatic encephalopathy • Prevention of alcohol-induced liver disease • Stimulation of gastrointestinal and systemic immunity • Prevention of cancer • Prevention of atopic disease • Alleviation of atopic eczema • Treatment of food allergies • Recolonization of GIT and vagina after antibiotic use • Stabilization of GIT flora • Post antibiotic therapy • Yeast infections • Urinary tract infections • Cancer prevention

Dosage • Maintenance: 10-25 billion viable cells daily • Therapeutic 50-1 trillion viable cells daily

S-Adenosylmethionine (SAM) Beneficial Effects • Important for methylation

Uses • Depression • Osteoarthritis • Fibromyalgia • Liver disorders • Migraine headaches

Dosage • Depression – 400 mg 3-4x/day. (Because SAM can cause nausea and GI disturbances in some people, it should be started at a dosage of 200 mg twice daily for the first day, increased to 400 mg twice daily on day three, 400 mg three times daily on day ten, and finally to the full dosage of 400 mg four times daily after 20 days if needed.

72 • Osteoarthritis – Start out as above for depression. After 21 days at a dosage of 1200 mg daily, reduce dosage to the maintenance dosage of 200 mg twice daily. • Fibromyalgia – 200-400 mg 2x/day • Liver disorders – 200-400 mg 2-3x/day • Migraine headaches – 200-400 2x/day

Policosanol Uses • Cholesterol lowering • Diabetes • Hypertension • Angina • Intermittent claudication

Dosage • 20 mg per day

Fibre • Indigestible plant components

Food Sources • All plant foods

Beneficial Effects • Decreased intestinal transit time • Delayed gastric emptying = lower blood sugar spike • Increased satiety • Increased pancreatic secretion • Increased stool weight • Gut flora balance • Increased production of short-chained fatty acids • Decreased serum lipids • More soluble bile

Uses • Irritable bowel syndrome • Gastrointestinal issues • Elevated cholesterol • Obesity

Forms • Insoluble (Wheat bran) • Soluble (Oat bran, Psyllium, inulin) • Mucilages (Guar gum, Psyllium, slippery elm) • Pectins (Apples, apricots, orange rind)

73 • Lignins (Flax)

Dosage • Begin with 1 gram and work way up to 15 grams for therapeutic

Curcumin Food Sources • Turmeric

Beneficial Effects • Inhibits leukotriene formation • Inhibits platelet aggregation • Promotion of fibrinolysis • Inhibition of neutrophil inflammatory process • Stabilization of lysosomal membranes

Uses • Any condition involving inflammation

Forms • Standardized extract (95% curcuminoids) • Meriva (phosphatidylcholine complex) • Longvida (Solid Lipid Curcumin Particle) • Theracurmin (reduced particle size, water-soluble)

Dosage • 20-600 mg per day • Up to 240mg of Theracurmin

Lecithin • Source of choline • Emulsifier

Food Sources • Soybeans, egg yolk, sunflower seeds

Beneficial Effects • Lipotropic agent • Keeps cholesterol soluble • Prevents cholesterol from adhering to arterial lining • Dissolves fat (gallstones and kidney stones) • Precursor to anti-inflammatory compounds • Key component of HDL and LDL (make sup 22%) • Keeps PL membrane more fluid • Component of bile

74 • Supports nervous system • Component of acetylcholine

Uses • Cardiovascular disease • Gallstones • Anxiety • Depression • Bipolar • Liver detoxification and damage • Cancer • Memory loss

Forms • Lecithin derived from soybeans (ensure the source is NON-GMO) • Lecithin derived from sunflowers • Egg yolk

Dosage • Up to 10-25 (1.5 – 3.75 tbsp.) grams per day of soy lecithin o 10g = 2.3g of phosphatidylcholine

75 Contraindications and Possible Adverse Effects of Therapeutic Supplements

Contraindications are circumstances in which specific supplements should not be taken. Contraindications for each nutrient are listed below, along with possible adverse reactions that may occur when supplements are taken at high doses. These adverse effects generally occur only at doses in excess of recommended levels -- not at the dosages typically found in ordinary multivitamin/mineral tablets. Special circumstances are also listed where specific supplements should be used only under medical supervision.

The full range of possible supplement/drug interactions is not well understood, and this list does not cover all possible contraindications or adverse effects.

Vitamin A Contraindications Women should not take vitamin A supplements during pregnancy. Dosages greater than 10,000 IU during pregnancy (specifically during the first 7 weeks after conception) have probably been the cause of 1 in 57 cases of birth defects in the United States. Women who may become pregnant should keep doses of vitamin A below 5,000 IU daily.5

Possible Adverse Effects Vitamin A toxicity is by far the most widely reported problem arising from supplement overdoses. Even so, only 200 cases (unrelated to pregnancy) are thought to occur worldwide each year. How much vitamin A causes problems? The answer varies with the individual. Doses of 25,000-50,000 IU daily for several months can be toxic for people with liver problems2, for those taking certain drugs, or for heavy drinkers. Generally, doses over 10,000 IU daily should be taken only under the supervision of a nutrition expert.3

Vitamin B6 (pyridoxine) Contraindications Diabetics should use B6 only under the supervision of a skilled practitioner, since it may affect blood sugar levels. Vitamin B6 may affect the actions of anticonvulsant medications, so epileptics should take it only under skilled supervison.3

Possible Adverse Effects This is a controversial issue, but some people who take high doses of vitamin B6 over a long period of time may experience symptoms such as tingling, numbness, or weakness in the extremities due to nerve damage. But studies indicate that doses smaller than 500 mg per day appear to be safe.1 Doses greater than 50 mg should be spread over the course of the day.5

Vitamin C Contraindications Diabetics should take vitamin C supplements only under supervision, since it may affect blood sugar levels.3 People with genetic iron disorders should consult their physicians before using vitamin C supplements, since it increases the rate of iron absorbtion.1

Possible Adverse Effects Vitamin C is generally regarded as one of the safest vitamins. Too much vitamin C can cause diarrhea.2

Based on early studies, there has been some concern that taking vitamin C might increase the risk of developing kidney stones. But more recent research have found no corroborating evidence of any link between vitamin C and kidney stones.1

Some researchers believe that abruptly ending high-dose vitamin C supplementation can cause "rebound scurvy" (the vitamin C deficiency disease). This is controversial, but it is probably wise to reduce high doses gradually.5

Folic Acid Contraindications Folic acid supplements may reduce the effectiveness of methotrexate (Rheumatrex), colchicine (Colbenemeid), trimethoprim (Trimpex, Bactrim, Septra), pyrimethamine (Daraprim, Fansidor), trimetrexate (Neutrexin) and phenytoin (Dilantin). If you're taking any of those drugs, consult your physician about using folic acid.4 High doses of folic acid may increase seizure activity in epileptics.5 Folic acid can mask symptoms of vitamin B12 deficiency (pernicious anemia).

Possible Adverse Effects People at risk for pernicious anemia should use folic acid supplements only under medical supervision. Risk factors include a family history of the condition, as well as some autoimmune endocrine diseases such as type 1 diabetes, hypoparathyroidism, Addison's disease, hypopituitarism, testicular dysfunction, Graves disease, chronic thyroiditis, myasthenia gravis, secondary amenorrhea, vitiligo, and candidiasis.

Niacin Contraindications Diabetics should use niacin only under supervision, since it may affect blood sugar levels.3 Niacin should be avoided by people with liver disease, gout and peptic ulcers.5 Niacin may affect anticonvulsant medications taken by epileptics and should be used only under medical supervison.3

Possible Adverse Effects Niacin supplementation may causes flushing, nausea, diarrhea, headache and fatigue.4 Niacin in high doses can be toxic to the liver and should be taken only under a physician's supervision. There have been reports that use of time-release niacin has resulted in severe, permanent liver damage.1

Tryptophan Contraindications Tryptophan should not be used by people with asthma. It is converted in the body to serotonin, which causes broncho-constriction in asthmatics.3

Possible Adverse Effects Tryptophan was taken off the market in the United States in 1990 because of evidence that imported supplies contained a contaminant that caused a serious disorder in some users. This effect was not due to tryptophan itself, and its return to market is contingent upon measures that will insure the purity of the supplement.

Lysine Contraindications Lysine may raise levels of cholesterol in the blood. People with high cholesterol should have their levels monitored while taking lysine supplements.3

Calcium Contraindications People with hyperparathyroidism (overactive parathyroid gland) or hypercalcemia due to cancer should only take calcium under the supervision of a physician.5

Possible Adverse Effects High doses of calcium can cause constipation4 and increase the risk of kidney stones and soft-tissue calcification.5

Chromium Contraindications Diabetics should use chromium only under medical supervision, since it affects blood sugar levels.3

Copper Contraindications Diabetics should use copper only under supervision, since it affects blood sugar levels.3

Possible Adverse Effects It is unusual for anyone to be deficient in copper and to require supplements. It is probably safe to take 2-4 mg per day, but doses of 35 mg per day are toxic.4

Vitamin D Possible Adverse Effects Doses larger than 1,000 IU a day should be monitored. High consumption of vitamin D can raise the levels of calcium in the blood to dangerous levels and can result in calcium being deposited into internal organs.5

Vitamin K Contraindications People using anticoagulant drugs such as Warfarin or Coumadin should not take vitamin K.5

78 Iron Possible Adverse Effects Iron supplements are a leading cause of fatal poisonings in children. Adults should keep iron tablets in a locked cabinet out of reach of young children.

Iron deficiency is the most common nutrient deficiency in the United States. The groups at highest risk are infants under two years of age, teenage girls, pregnant women and the elderly. Extreme fatigue is a primary symptom of anemia, the last stage of iron deficiency. However, iron overload can result in heart disease, infection and possibly even cancer.5 Iron supplements, therefore, should only be used when tests show a deficiency exists.4

Magnesium Contraindications People with kidney disease or severe heart disease should not use magnesium supplements except under a physician's supervision.5

Possible Adverse Effects Because healthy kidneys can excrete six grams of magnesium a day, it is difficult to overdose. But toxic levels can result from the abuse of magnesium-containing laxatives. The early signs of toxicity are nausea, vomiting and flushing.4 Even small doses of magnesium can cause diarrhea in some people.

Potassium Contraindications People with kidney disease or severe heart disease should not take potassium supplements except under a physician's supervision.5 People taking certain diuretic drugs may need potassium supplements, but those on heart medications should consult their physician first.

Possible Adverse Effects Potassium (beyond levels found in vitamin/mineral tablets) should not be taken except under supervision. In high doses, potassium may cause abnormal heart rhythms and death.4

Zinc Contraindications People with high cholesterol should use zinc only under supervision, since high doses of zinc may elevate cholesterol levels in some cases.3

Possible Adverse Effects High doses of zinc (100-300 mg daily) can impair immune system function. Taking too much zinc can also lead to severe copper deficiency.2

79 Manganese Contraindications Diabetics should use manganese only under supervision, since it may affect blood sugar levels.3

Selenium Possible Adverse Effects The human body needs only minute amounts of selenium. It may be toxic in amounts greater than 1000 mcg (micrograms) daily. Toxicity can cause hair loss, fatigue, brittle fingernails, muscle discomfort, nausea, poor appetite, weight loss, dermatitis, garlic breath odor, and suppression of immune system function.2

Iodine Possible Adverse Effects Do not use iodine in people with “hot” nodules.

Choline Possible Adverse Effects At high doses (20 grams) choline produces a "fishy" odor.

Fiber Contraindications Fiber supplements in pill form should not be taken by people with esophageal disorders, since they may expand and cause an obstruction.5

Possible Adverse Effects Increasing dietary fiber may cause gas and abdominal discomfort until the body adjusts. Fiber supplements may also interfere with the absorption of drugs, so it's best to separate the two by a couple of hours.5

Omega-6 Fatty Acids Contraindications People with temporal-lobe epilepsy should not use omega-6 fatty acids.3

Probiotics Possible Adverse Effects Mild gastrointestinal symptoms may occur when commencing a probiotics regimen.

References 1. Richard A. Passwater, Ph.D., "Vitamins, Immune Response and Safety: An Interview with Dr. Adrianne Bendich," Whole Foods Magazine. HealthWorld Online. 2. George Lewith, Julian Kenyon and Peter Lewis, Complementary Medicine: An Integrated Approach (Oxford: Oxford University Press, 1996), p. 108-9. 3. Melvyn Werbach, M.D., Healing Through Nutrition: A Natural Approach to Treating 50 Common Illnesses With Diet and Nutrients (New York: Harper Collins Publishers, 1993). 4. Adriane Fugh-Berman, M.D., Alternative Medicine: What Works (Tucson, AZ: Odonian Press, 1996). 5. Michael T. Murray, N.D., Encyclopedia of Nutritional Supplements (Rocklin, CA: Prima Publishing, 1996)

80 81

HERBS

Drug-Herb Comparison

Drug Clinical use Botanical source Atropine Anticholinergic Atropa belladonna Caffeine Central nervous system stimulant Cola nitida Camphor Rubefacient Cinnamomum camphora Cocaine Local anesthetic Erythroxylon coca Codeine Analgesic/antitussive Papaver somniferum Colchicine Antigout Colchicum autumnale Digitoxin Cardiotonic Digitalis purpurea Digoxin Cardiotonic Digitalis lanata Emetine Amebicide/emetic Cephaelis ipecacuanha Ephedrine Sympathomimetic Ephedra sinica Gossypol Male contraceptive Gossypium spp. Hyoscyamine Anticholinergic Hyoscyamus niger Kawain Tranquilizer Piper methysticum Methoxsalen Psoriasis/vitiligo Ammi majus Morphine Analgesic Papaver somniferum Noscapine Antitussive Papaver somniferum Physostigmine Cholinesterase inhibitor Physostigma venenosum Pilocarpine Parasympathomimetic Pilocarpus jaborandi Podophyllotoxin Topical wart remedy Podophyllum peltatum Quabain Cardiotonic Strophanthus gratus Quinine Antimalarial Cinchona ledgeriana Reserpine Antihypertensive Rauwolfia serpentine Scopolamine Sedative Datura metel Sennosides Laxative Cassia spp. Theophylline Bronchodilator Camellia sinensis Tubocurarine Muscle relaxant Chondodendron tomentosum Yohimbine Male erectile dysfunction Pausinystalia yohimbe

Modified from De Smet PA. Drugs 1997;54:801-840.

Preparation of liquids • 1:5 means 5 ml of final preparations is equivalent to 1 gram of dried herb. • Tinctures – Preparations weaker than 1:5 • Extracts – stronger than 1:1 and 1:2

Ethanol Percentage Ethanol Components extracted 25% Water-soluble constituents such as mucilage, tannins, and some glycosides (including some flavanoids and a few saponins) 45-60% Essential oils, alkaloids, most saponins and some glycosides 90% Resins and oleoresins

Single gram equivalents Extract Dosage 1:2 liquid 2 ml 1:1 liquid 1 ml 4:1 soft extract 250 mg 5:1 spray-dried powder 200 mg

Methods of Application 1. Bolus - suppository 2. Douche – used for the treatment of vaginal infections or cleansing 3. Electuary – method of giving young children herbs using honey, maple syrup, and nut butters. 4. Enema – a liquid inserted into the colon. 5. Fomentation (compress) – used to treat external wounds. 6. Capsule/pills – herbs taken as pill. 7. Liniment – extracts rubbed into the skin. 8. Poultice – powdered or macerated herbs applied directly to the skin. 9. Salve – applied to skin and can remain in place. 10. Syrups – use honey or glycerin as vehicle for herb. 11. Tinctures – liquid extracts using alcohol, vinegar, glycerin 12. Infusion – herbs steeped in water. 13. Decoction – herbs simmered for about an hour.

Herbal Actions (http://www.herbalremediesinfo.com/herbal-actions.html) Adaptogen: Substances which put the body into a state of non-specific heightened resistance in order to better resist stress and adapt to extraordinary challenges. Ashwagandha, Cordyceps, American Ginseng, Panax Ginseng, Siberian Ginseng, Gotu Kola, Maca, Reishi, Schizandra, Shiitake, Suma.

Alterative: An herb that will gradually restore the proper function of the body and increase health and vitality. Sometimes referred to as blood purifiers. Alfalfa, Black Cohosh, Blue Flag, Blue Violet, Boneset, Buckthorn, Burdock, Cleavers, Echinacea, Fringetree, Golden Seal, Gotu Kola, Kelp/Bladderwrack, Licorice, Oregon Grape, Pau d'

Arco, Pipsissewa, Poke Root, Prickly Ash, Red Clover, Sarsaparilla, Sheep Sorrel, Stillingia, Tayuya, Wahoo, Wild Indigo, Yarrow, Yellow Dock.

Analgesic/Anodyne: Analgesics or Anodynes are herbs that reduce pain. Chamomile, Chaparral, Dong Quai, Hops, Passion Flower, Reishi, Valerian, Venus' Flytrap.

Anthelmintic: Herbs that work against parasitic worms which may be present in the digestive system. Black Walnut, Helonias, Quassia, Sheep Sorrel, Wormwood.

Antibacterial: Herbs with properties that can inhibit bacterial growth. Blessed Thistle, Cloves, Echinacea, Kelp/Bladderwrack, Licorice, Lomatium, Osha, Pau d' Arco, Reishi, St. John's Wort, Turmeric, Usnea.

Antibilious: Herbs that help the body to remove excess bile. Barberry, Dandelion, Fringetree, Golden Seal, Wild Yam, Wormwood.

Anticatarrhal: Herbs that help the body reduce excess mucous and phlegm. Echinacea, Elderberry, Golden Seal, Marshmallow, Oregon Grape, Poke Root, Uva Ursi, Wild Indigo, Yarrow.

Antiemetic: Herbs that reduce the feeling of nausea and can help to relieve or prevent vomiting. Atractylodes, Barberry, Cloves, Fennel, Oregon Grape.

Anti-inflammatory: These herbs help the body to combat inflammations. Ashwagandha, Bilberry fruit. Blue Violet, Calendula, Cat's Claw, Chamomile, Cleavers, Devil's Claw, Dong Quai, Fo-Ti, Licorice, Lomatium, Reishi, St. John's Wort, Turmeric, Wild Yam, Wormwood.

Antilithic: Herbs that prevent the formation or help remove stones or gravel in the urinary system Sheep Sorrel, Uva Ursi.

Antimicrobial: Herbs that can help the body destroy or resist pathogenic microorganisms. Calendula, Cat's Claw, Cloves, Echinacea, Licorice, Lovage, St. John's Wort, Usnea, Uva Ursi, Wild Indigo, Wormwood.

Antineoplastic: Having the specific action of inhibiting and combating tumor development. Blue Violet, Chaparral, Cleavers, Red Clover, Reishi, Sheep Sorrel, Shiitake, Venus' Flytrap.

Antioxidant: An antioxidant is a substance capable of eliminating hydroxyl free radicals. Bilberry fruit, Cat's Claw, Chaparral, Ginger, Panax Ginseng, Ginkgo, Kelp/Bladderwrack, Schizandra.

Antirheumatic: Herbs used to relieve or protect against rheumatism. Blue Cohosh, Cat's Claw, Chaparral, Celery, Dandelion, Kelp/Bladderwrack, Poke Root, Sarsaparilla, Wild Yam.

Antiseptic: Herbs that can prevent, resist and counteract putrification. Bilberry fruit, Black Walnut, Chamomile, Cloves, Echinacea, Hops, Red Clover, Sheep Sorrel, Uva Ursi, Wild Indigo, Yarrow.

Antispasmodic: Antispasmodics can prevent or ease spasms and cramps in the body. Black Cohosh, Blue Cohosh, Boneset, Chamomile, Cramp bark, Culver's root, Dong Quai, Fennel, Helonias, Licorice, Motherwort, Passion Flower, Red Clover, Skullcap, Stillingia, Valerian, Wild Yam.

Aphrodisiac: Herbs used to stimulate sexual passion. Catuaba, Damiana, Maca, Muira Puama, Schizandra, Suma, Yohimbe.

Aromatic: Herbs that have a strong and often pleasant odor and can stimulate the digestive juices. Angelica, Celery, Chamomile, Cloves, Fennel, Ginger, Valerian.

Astringent: Astringents contract tissue and can reduce secretions and discharges. Bilberry fruit, Blessed Thistle, Calendula, Cleavers, Cramp bark, Golden Seal, Hops, Kola nut, Muira Puama, Pipsissewa, Red root, Sheep Sorrel, Slippery Elm, Squawvine, Stillingia, St. John's Wort, Suma, Turkish Rhubarb, Uva Ursi, Yarrow, Yellow Dock.

Bitter: Herbs that taste bitter act as stimulating tonics for the digestive system. Barberry, Blessed Thistle, Buckthorn, Burdock, Cascara Sagrada, Chamomile, Golden Seal, Osha, Quassia, Wormwood, Globe Artichoke, Gentian, Turmeric.

Cardiac Tonic: Cardiac tonics are herbs that act beneficially on the heart. Cat's Claw, Fo- Ti, Hawthorn, Kelp/Bladderwrack, Motherwort, Reishi.

Carminative: Carminatives are rich in volatile oils and expel gas from the stomach and bowels. Angelica, Celery, Chamomile, Cloves, Fennel, Ginger, Hops, Prickly Ash, Sheep Sorrel, Turmeric, Valerian, Wormwood.

Cathartic: In large doses cathartics purge the bowels and stimulate glandular secretions. Barberry, Blue Flag, Buckthorn, Cascara Sagrada, Culver's root, Turkish Rhubarb.

Cholagogue: Herbs that stimulate the release and secretion of bile from the gall bladder. They also have a laxative effect on the digestive system. Barberry, Blue Flag, Calendula, Culver's root, Dandelion, Fringetree, Golden Seal, Milk Thistle, Oregon Grape, Turmeric, Wahoo, Wild Yam, Yellow Dock.

Demulcent: Herbs that are usually rich in mucilage and can soothe and protect damaged or inflamed tissue. Fenugreek, Licorice, Marshmallow, Slippery Elm.

Depurative: Depuratives are herbs that remove impurities and cleanse the blood. Alfalfa, Black Walnut, Blessed Thistle, Blue Flag, Blue Violet, Buckthorn, Burdock, Culver's

root, Dandelion, Elderberry, Gotu Kola, Oregon Grape, Pau d' Arco, Red Clover, Sarsaparilla, Stillingia, Tayuya, Watercress, Yarrow, Yellow Dock.

Diaphoretic: These herbs will aid the skin in the elimination of toxins through perspiration. Angelica, Blessed Thistle, Black Cohosh, Boneset, Calendula, Chamomile, Culver's root, Elderberry, Fennel, Ginger, Osha, Prickly Ash, Sarsaparilla, Stillingia, Yarrow.

Diuretic: Herbs that increase the flow of urine and help in the removal of toxins from the system. Angelica, Astragalus, Atractylodes, Blue Flag, Blue Violet, Buckthorn, Burdock, Celery, Chaparral, Cleavers, Dandelion, Fringetree, Gotu Kola, Guarana, Hawthorn, Helonias, Kola nut, Marshmallow, Pipsissewa, Sarsaparilla, Saw Palmetto, Sheep Sorrel, Squawvine, Uva Ursi, Wahoo, Yarrow, Yerba Mate.

Emetic: Emetics are herbs that cause vomiting when taken in specific doses (generally high doses). Helonias, Poke Root.

Emmenagogue: Herbs that stimulate and normalize the menstrual flow. Black Cohosh, Blessed Thistle, Blue Cohosh, Calendula, Chamomile, Cramp bark, Fenugreek, Ginger, Golden Seal, Helonias, Motherwort, Squawvine, St. John's Wort, Valerian, Vitex/Chastetree, Wormwood, Yarrow.

Expectorant: Herbs that assist the body in expelling excess mucous from the respiratory system. Angelica, Blue Violet, Fennel, Fenugreek, Golden Seal, Licorice, Marshmallow, Osha, Red Clover, Red root, Reishi, Stillingia, Usnea.

Febrifuge: The febrifuges help the body to bring down fevers. Angelica, Blessed Thistle, Calendula, Prickly Ash, Wild Indigo.

Galactogogue: Herbs that help breast feeding mothers increase the flow of mothers milk. Blessed Thistle, Fennel, Fenugreek, Milk Thistle.

Hepatic: Hepatics strengthen and tone the liver as well as stimulate the flow of bile. Barberry, Blue Flag, Buckthorn, Cascara Sagrada, Celery, Cleavers, Culver's root, Dandelion, Fennel, Fo-Ti, Fringetree, Golden Seal, Milk Thistle, Motherwort, Oregon Grape, Poke Root, Prickly Ash, Turmeric, Wahoo, Wild Indigo, Wild Yam, Wormwood, Yarrow, Yellow Dock.

Hypnotic: Hypnotic herbs will help induce sleep (not a hypnotic trance). Hops, Passion Flower, Skullcap, Valerian.

Hypotensive: Remedies that reduce elevated blood pressure. Astragalus, Cat's Claw, Codonopsis, Hawthorn, Lovage, Lycium, Reishi, Valerian, Yarrow.

Laxative: Herbs that promote the evacuation of the bowels. Barberry, Boneset, Buckthorn, Burdock, Cascara Sagrada, Cleavers, Culver's root, Dandelion, Fringetree, Golden Seal, Licorice, Oregon Grape, Turkish Rhubarb, Wahoo, Yellow Dock.

Mucilage: Mucilaginous herbs contain gelatinous constituents and will often be demulcent. Fenugreek, Marshmallow, Slippery Elm.

Nervine: Herbs that strengthen and tone the nervous system, easing anxiety and stress. Black Cohosh, Blue Cohosh, Catuaba, Chamomile, Cramp bark, Damiana, Guarana, Hops, Lovage, Motherwort, Oat seed, Passion Flower, Red Clover, Skullcap, Tayuya, Valerian, Wormwood.

Nutritive:Herbs that provide nutritional support. Alfalfa, Nettle, Raspberry Leaf, Oat Straw, Seaweeds.

Parasiticide: Herbs that can kill parasites in the digestive tract and on the skin. Black Walnut, Cloves, Quassia, Sheep Sorrel, Wormwood.

Pectoral: Herbs that have a general strengthening and healing effect on the respiratory system. Angelica, Golden Seal, Licorice, Marshmallow.

Purgative: Can produce very strong laxative effects and watery evacuations. Buckthorn, Poke Root, Turkish Rhubarb, Wild Indigo, Yellow Dock.

Rubefacient: Herbs that simulate circulation locally when applied to the skin. Cloves, Fennel, Ginger.

Sedative: Herbs that can strongly quiet the nervous system. American Ginseng, Black Cohosh, Celery, Chamomile, Cramp bark, Dong Quai, Hops, Kava Kava, Motherwort, Passion Flower, Red Clover, Saw Palmetto, Skullcap, St. John's Wort, Valerian, Wild Yam.

Sialagogue: Herbs that stimulate the secretion of saliva from the salivary glands. Blue Flag, Ginger, Prickly Ash, Quassia, Stillingia.

Stimulant: Herbs that quicken and enliven the physiological function of the body. Angelica, Calendula, Cloves, Codonopsis, Dandelion, Fennel, Ginger, Guarana, Kola nut, Muira Puama, Poke Root, Prickly Ash, Red root, Sarsaparilla, Schizandra, Stillingia, Valerian, Watercress, Wild Yam, Wormwood, Yarrow, Yerba Mate.

Stomachic: Herbs that promote digestion and strengthen the stomach. Atractylodes, Chamomile, Cloves, Codonopsis, Fennel, Ginger, Sheep Sorrel, Turkish Rhubarb, Turmeric.

Tonic: The tonic herbs strengthen and tone either specific organs or the whole body through nutritional stimulation. Alfalfa, Angelica, Ashwagandha, Astragalus, Black

Cohosh, Black Walnut, Boneset, Buckthorn, Burdock, Calendula, Cat's Claw, Catuaba, Chamomile, Cleavers, Cordyceps, Culver's root, Damiana, Dandelion, Echinacea, Fenugreek, Fo-Ti, Fringetree, American Ginseng, Panax Ginseng, Siberian Ginseng, Golden Seal, Gotu Kola, Hawthorn, Helonias, Jatoba, Licorice, Lovage, Lycium, Maca, Milk Thistle, Motherwort, Muira Puama, Oat seed, Oregon Grape, Pipsissewa, Poke Root, Prickly Ash, Red Clover, Sarsaparilla, Saw Palmetto, Schizandra, Sheep Sorrel, Skullcap, Squawvine, Suma, Uva Ursi, Watercress, Wild Yam, Wormwood, Yarrow, Yellow Dock, Yerba Mate, Yohimbe.

Herbs

Herb Uses Artichoke, globe (Cynara Used for gallstones and as a liver and gallbladder/bile scolymus) stimulant, to support liver function, and to reduce high cholesterol. Ashwaganda (Withania An herb commonly used in Ayurvedic medicine. Has somnifera) adaptogenic effects while supporting the thyroid. Lessens the effect of stress. Astragalus (Astragalus Stimulates the immune system. membranaceus) Black Cohosh (Cimicifuga Commonly used to treat menopausal problems. Used as a racemosa) prescription medication in Europe for menopause-related problems. Burdock (Artium lappa) Helps alleviate the pain associated with rheumatism, treat skin disorders such as eczema and psoriasis, and as a diuretic and blood purifier. Cat’s claw (Uncaria Used adjunctively to ease symptoms associated with tomentosa) inflammatory bowel conditions such as Crohn’s, colitis, diverticulitis, and irritable bowel syndrome (IBS). Chamomile (Matricaria Helps alleviate gastrointestinal disturbances. recutita) Cinnamon A sweet, aromatic spice that has been shown to lower blood sugar an increase insulin sensitivity. Cleaver’s (Galium aparine) Used for enlarged or inflamed lymph nodes. Dandelion (Taraxacum Used to support liver function and to stimulate bile flow officinale) (root).Used as a bitter tonic, to stimulate digestion (root and leaf). Used as a diuretic and to support kidney function (leaf). Echinacea (Echinacea Stimulates the immune system and has anti-bacterial, anti- angustifolia/purpurea/palli viral, and anti-cancer effects. da) Gentian (Gentiana lutea) The most bitter herb on the planet. Stimulates digestion and appetite. Great to take before a meal. Ginger (Zingiber officinale) Commonly used as a spice. In higher dosages can act as an anti-inflammatory. Also decreases feelings of nausea and

soothes the digestive tract. Ginkgo (Ginkgo Biloba) Used to treat senile conditions, including Alzheimer’s. Also has strong antioxidant capacity. Ginseng (Panax ginseng There are various types of ginseng but all have an anti- and Eleuthrococcus fatigue, anti-stress effect. They improve physical and senticosus) mental performance. Goldenseal (Hydrastis Used to treat inflammatory conditions of the digestive Canadensis) tract. Very soothing to all mucous membranes. Used to treat infection. Hawthorn (Crataegus Traditionally used to improve heart function in people oxyacantha) with cardiovascular weakness or debility. Horse chestnut (Aesculus Very useful for strengthening the venous system. hippocastanum) Horsetail (Equisetum Traditionally used for cystitis, bladder inflammation and arvense) infections, kidney stones and for its silica content as a tonic to the connective tissues: hair, nails, teeth and bones. Lemon Balm (Melissa Know as a nervine, lemon balm helps to calm the mind officinalis) and body. Licorice (Glycyrrhiza This sweet herb can raise blood pressure and support those glabra) with adrenal fatigue. It is also effectively used to treat ulcers. Marshmallow (Althea Used for irritation of the oral and pharyngeal mucosa and officinalis) associated dry cough, inflammation of the gastric mucosa, peptic and gastric ulcer and enteritis, cystitis and urinary tract infections. Milk Thistle (Silybum The best herb for regenerating the liver cells. Used to treat marianum) liver cirrhosis, hepatitis, and liver disease. Nettle (Urtica dioica) Helps to prevent/treat seasonal allergies. Very high in calcium. Oatstraw (Avena sativa) Traditionally used for depression, debility, stress, nervousness and anxiety and for general prostration from overwork, anxiety and worry, and for addiction withdrawal. Pau D’arco (Tabebuia Very strong anti-fungal properties. Effective against impetiginosa) candida, yeast infections, skin fungus, and to treat cancer. Peppermint (Mentha Stimulate the nervous system but calms and relaxes the piperita) whole digestive tract. Great for relieving symptoms of irritable bowel syndrome (IBS). Rhodiola (Rhodiola rosea) Adaptogen for increasing energy. Russian olympians used this herb to help them recover faster and improve energy. Saw Palmetto (Serenoa Used for the prevention of benign prostate hyperplasia, repens) male pattern baldness, and urinary tract infections. St. John’s wort (Hypericum Very effective as a treatment for mild depression. perforatum) Turmeric (Curcuma longa) Has strong anti-carcinogenic and anti-cancer effects. Also

a useful anti-inflammatory. The active component curcumin, gives turmeric it’s yellow color. Valerian (Valeriana Traditionally used to treat insomnia and for the relief of officinalis) anxiety and nervous tension.

Mushrooms

A Brief Overview of Mushroom Extracts 1. Medicinal mushrooms and mushroom mycelium MUST be extracted with hot water to guarantee bioavailability and to create the potency needed for therapeutic effectiveness. (Hot water extracts are dehydrated then encapsulated). Although hot water extraction is used in 100% of the thousands of independent references, both herbal and medical, 95% of the mushroom supplements available in the U.S. and Canada are ground up mushrooms (un-extracted), mycelium grown on grain (un-extracted), or tinctures. These supplements are 1/30th to 1/50th the strength of a hot water extract and are significantly less potent than the materials used in traditional herbalism or the clinical research. The primary actives, the polysaccharides (beta glucans) are found inside indigestible cell walls (made of chitin). Only hot water extraction can liberate the actives, maintain their structural integrity, and concentrate them to defined and therapeutically useful levels. The good news is that every mushroom label, whether thru inclusion or omission, contains the information needed to determine potency and quality. Hot water extracts (except the Maitake Fractions), will list the polysaccharide (beta glucan) levels, as a percentage, on the label. None of the un-extracted mushroom products or tinctures list polysaccharide/beta glucan levels on their labels. If potency information is missing the supplement should probably be avoided.

2. Mushroom supplements should be taken twice daily, A.M. and P.M., on an empty stomach.

3. There are no references on the use of medicinal mushroom extracts by pregnant women or nursing mothers, and medicinal mushroom extracts not be used in these cases.

4. Mushroom extracts can be taken daily for long periods of time, even years, without negative side effects. For vegetarians, mushroom extracts are one of the only non-animal based immune supplements that can be used long term (as opposed to colostrum based supplements).

5. It takes time for mushroom extracts to work. Cordyceps/Asthma 6 weeks, Reishi/Hepatitis 6-8 weeks. Patients need to know that mushroom extracts do not work overnight.

Mushroom Biology “Mushrooms” or “fruit bodies” represent the fruiting stage of the life cycle. The mushrooms sole purpose is to make spores (mushroom seeds). Mushrooms typically

appear in the fall after increased rainfall and dropping temperatures trigger their formation and growth.

The permanent part of the organism that lives year round, gathering and storing nutrients is called the “mycelium”. Mycelium is an inter-connected network of threadlike tubes growing through soil or wood. Mycelium excretes enzymes that break down organic matter, converting the material to food. This food is transported back through the cell walls of the mycelium and then metabolized or stored for later use.

Mushroom Supplement Descriptions The primary active compounds in medicinal mushrooms and mushroom mycelium are called polysaccharides or beta glucans. These terms are synonymous when used to describe the actives in mushroom supplements. Product labels employ a variety of terms to describe the different types of mushroom supplements. The following list covers most of the descriptions likely to be found.

Un-extracted Mushroom Supplements Mycelium Biomass or Mushroom Mycelium Mycelium grown on grain that is dried, powdered and encapsulated. Levels of actives are not listed on the label. This material is 50 % undigested grain, 50 % mycelium, and contains waste from the metabolized grain.

Mycelium Powder Mycelium grown in liquid or on grain that is dried, powdered and encapsulated. Levels of actives are not listed on the label.

Fruit Body or Mushroom Powder The mushroom fruit body dried, powdered, and encapsulated. Levels of actives are not listed on the label.

Extracted Supplements Hydro-Alcohol Extract/Tincture Liquid products made from mycelium biomass or mushroom fruit bodies that are preserved in alcohol. Levels of actives are not listed on the label. Most tinctures state that thirty drops equal one gram of fresh mushrooms or mycelium. References in Traditional Chinese Medicine (TCM) recommend 4 to 20 grams of dried mushrooms daily, used as a tea. It takes 10 grams of fresh mycelium or fresh mushrooms to create one gram dry.

Although tincturing works well for some cellulose based plants, mushrooms and mushroom mycelium are made from chitin, requiring heat in the extraction. Our chemical analysis of tinctures available in health food stores revealed an average potency of one- half percent polysaccharide content (.5%).

Hot-Water Extracts Hot-water extracts are made from mycelium or mushrooms. The extracts are dehydrated and encapsulated. Levels of actives are listed on the label. This process concentrates the actives to specific and desired amounts. Depending on the species, the levels of actives range from 12% to 38%.

“Extracts” Many encapsulated products calling themselves “extracts” are really a blend of extracts and un-extracted materials. A typical blend contains one part extract to five parts un- extracted material. As with un-extracted supplements and tinctures, blends at this ratio are incapable of delivering therapeutic doses when following label instructions.

Mushrooms are unique, stationary like a plant, yet built from chitin, the same material contained in the shell of a lobster. Understanding the properties of chitin is critical to understanding how to choose an effective, high-quality medicinal mushroom product.

Chitin is indigestible by humans. Yet chitin, which makes up the cell walls of mushrooms and mushroom mycelium, contains the potent immune stimulating compounds common to all medicinal mushrooms, the polysaccharides. Practitioners of Traditional East Asian Medicine and modern clinical researchers both use the same preparation technique to overcome this barrier, hot water.

Chaga Chaga is a mushroom that grows in the forests of Northern Siberia and Northern Canada. Chaga is highly prized in Russian herbalism with the modern clinical research validating many of the health benefits described in the Russian sources.

Chaga is unique among medicinal mushrooms and may be one of the most important anti-aging supplements yet discovered. Like all medicinal mushrooms Chaga contains the non-linear, complex polysaccharides that give the Chaga extracts potent immune supporting properties. However, Chaga also has an extremely high ORAC value (antioxidant properties), similar to that of blueberry extracts.

Chaga also has melanin compounds that nourish the skin and hair. The betulin and betulinic acid compounds, similar to the triterpenes found in Reishi, also have immune supporting properties.

Chaga is a mushroom that must be wild crafted as only those mushrooms harvested from living birch trees will have the full compliment of active compounds Chaga is famous for.

Cordyceps Cordyceps sinensis is a highly valued medicinal mushroom in both Classical Chinese Medicine and modern clinical practice. In China it is called "winter worm, summer grass", and the "caterpillar mushroom". Cordyceps is found in the highlands of China, Tibet, and Nepal, above 10,000 feet.

Cordyceps attracted the attention of the general public and the health profession in 1993 when a group of Chinese runners broke nine world records in the World Outdoor Track and Field Championships in Germany. Afterwards the coach attributed those results to the athletes regular use of a cordyceps based tonic. Because Cordyseps helps increase stamina, energy levels, and endurance, it has become one of the top selling sports supplements amongst the worlds' elite competitive athletes.

Clinically, Cordyceps is used to support immune health.

Clinical Research There has been a significant amount of research done on Cordyceps. Studies have looked at the immuno-modulating and immuno-regulating activities, uses in supporting renal health and respiratory health.* 1,2

Traditional Use and Preparation Cordyceps is sweet and acrid in taste and warm in nature, acting through the lung and kidney channels.3 Cordyceps invigorates the kidneys and protects the lungs.* Cordyceps is also used in cases of occasional fatigue. For most conditions Cordyceps is prepared as a decoction, although when used as a tonic in TCM the fruit bodies are often cooked into a chicken broth.5

Active Constituents Polysaccharides, Adenosine, Cordycepic Acid.

References 20. Zhu, J., et al., The Scientific Rediscovery of an Ancient Chinese Herbal Medicine: Cordyceps sinensis, Part 1. The Journal of Alt and Comp Med. 1998 (4); 3:289-303. 21. Zhu, J., et al., The Scientific Rediscovery of an Ancient Chinese Herbal Medicine: Cordyceps sinensis, Part 2. The Journal of Alt and Comp Med. 1998 (4); 4:429-57. 22. Hobbs, C., Medicinal Mushrooms. Botanica Press. 1995. 23. Xie, Z., Huang, X., Lou, Z., Li, S., Zhou, L., Yuan, S., Yang, Z., Tang, Z., Dictionary of Traditional Chinese Medicine. The Commercial Press Ltd., Hong Kong. 1988. 24. Liu, B., Bau, Y., Fungi Pharmacopoeia. Kiniko Press. 1980. 25. Chen, D., et al. Effects of natural Cordyceps and the cultured mycelia of Cordyceps sinensis on murine immune organs and functions of mononuclear phagocyte system. Abstracts of Chinese Medicine, 1:371. 26. 1985.

Reishi (Lingzhi, Ganoderma) The Reishi mushroom is one of the most revered herbs in Traditional Chinese Medicine (TCM). Now known as Ling zhi in China, there are references to its use in that country as far back as 100 B.C. where it was referred to as the "Herb of Spiritual Potency" and the "Ten-thousand Year Mushroom".

The focus of TCM is on actively promoting good health and the prevention of health problems. Reishi is one of the most highly regarded herbs in TCM for this purpose and the mushroom most often used as a general health tonic.

Modern clinical research also supports many of the uses for this mushroom as described in TCM. It benefits immune health and liver function.1 Reishi mushroom extracts are frequently used by mountain climbers to combat altitude sickness and are contained in many of the performance enhancing herbal formulas used by Chinese athletes.

Traditional Use and Preparation Reishi is mild and warming in nature, with a bitter taste. In TCM it is used to nourish, tonify, remove toxins and disperse accumulation. It is used as a tonic for symptoms of weakness or debility and as a sedative for dizziness and insomnia.4

Active Constituents Triterpenes (Ganoderic Acids), Polysaccharides (1-3 linked proteoglycans extracted from the cell walls).

References 1. Jianzhe, Y., Xiaolan, M., Qiming, M., Yichen, Z., and Huaan, W., Icons of Medicinal Fungi from China. Science Press, Beijing.1987. 2. Chang, H.M., and But, P. Pui-hay. Pharmacology and Applications of Chinese Materia Medica, Vol 1. Singapore: World Scientific.1986. 3. Bastyr 4. Xie, Z., Huang, X., Lou, Z., Li, S., Zhou, L., Yuan, S., Yang, Z., Tang, Z., Dictionary of Traditional Chinese Medicine. The Commercial Press Ltd., Hong Kong.1988. 5. Liu, B., Bau, Y., Fungi Pharmacopoeia. Kiniko Press. 1980. 6. Upton, R., et al. Reishi Mushroom (Ganoderma lucidum) Standards of Analysis, Quality Control, and Therapeutics. American Herbal Pharmacopoeia. p. 9. Sept. 2000. 7. Willard T., Reishi Mushroom, Sylvan Press, p. 143-44. 1990

Lingzhi may possess anti-tumor, immunomodulatory and immunotherapeutic activities, supported by studies on polysaccharides, terpenes, and other bioactive compounds isolated from fruiting bodies and mycelia of this fungus (reviewed by R. R. Paterson[17] and Lindequist et al.[43]). It has also been found to inhibit platelet aggregation, and to lower blood pressure (via inhibition of angiotensin-converting enzyme[44]), cholesterol, and blood sugar.[45]

Laboratory studies have shown anti-neoplastic effects of fungal extracts or isolated compounds against some types of cancer, including epithelial ovarian cancer.[46] In an animal model, Ganoderma has been reported to prevent cancer metastasis,[47] with potency comparable to Lentinan from Shiitake mushrooms.[48]

The mechanisms by which G. lucidum may affect cancer are unknown and they may target different stages of cancer development: inhibition of angiogenesis (formation of new, tumor-induced blood vessels, created to supply nutrients to the tumor) mediated by cytokines, cytoxicity, inhibiting migration of the cancer cells and metastasis, and inducing and enhancing apoptosis of tumor cells.[17] Nevertheless, G. lucidum extracts are already used in commercial pharmaceuticals such as MC-S for suppressing cancer cell proliferation and migration.

Additional studies indicate that ganoderic acid can help to strengthen the liver against liver injury by viruses and other toxic agents in mice, suggesting a potential benefit of this compound in the prevention of liver diseases in humans,[49] and Ganoderma-derived sterols inhibit lanosterol 14α-demethylase activity in the biosynthesis of cholesterol .[50] Ganoderma compounds inhibit 5-alpha reductase activity in the biosynthesis of dihydrotestosterone.[44]

Besides effects on mammalian physiology, Ganoderma is reported to have anti-bacterial and anti-viral activities.[51][52] Ganoderma is reported to exhibit direct anti-viral with the following viruses; HSV-1, HSV-2, influenza virus, vesicular stomatitis. Ganoderma mushrooms are reported to exhibit direct anti-microbial properties with the following organisms; Aspergillus niger, Bacillus cereus, Candida albicans, and Escherichia coli.

Preparation Due to its bitter taste, Lingzhi is traditionally prepared as a hot water extract.[53] Thinly sliced or pulverized lingzhi (either fresh or dried) is added to a pot of boiling water, the water is then brought to a simmer, and the pot is covered; the lingzhi is then simmered for

two hours. The resulting liquid is fairly bitter in taste, with the more active red lingzhi more bitter than the black. The process is sometimes repeated. Alternatively, it can be used as an ingredient in a formula decoction or used to make an extract (in liquid, capsule, or powder form). The more active red forms of lingzhi are far too bitter to be consumed in a soup.

References 43. ^ Lindequist U, Niedermeyer THJ, Jülich WD. (2005). "The pharmacological potential of mushrooms". Evidence-based Complementary and Alternative Medicine 2 (3): 285–299. doi:10.1093/ecam/neh107. PMC 1193547. PMID 16136207. 44. ^ a b Liu J, Kurashiki K, Shimizu K, Kondo R (December 2006). "Structure-activity relationship for inhibition of 5alpha-reductase by triterpenoids isolated from Ganoderma lucidum". Bioorg. Med. Chem. 14 (24): 8654–60. doi:10.1016/j.bmc.2006.08.018. PMID 16962782 45. ^ Chinese Herbal Medicine: Materia Medica, Third Edition by Dan Bensky, Steven Clavey, Erich Stoger, and Andrew Gamble (2004) 46. ^ Zhao S, Ye G, Fu G, Cheng JX, Yang BB, Peng C.,"Ganoderma lucidum exerts anti-tumor effects on ovarian cancer cells and enhances their sensitivity to cisplatin." Int J Oncol. 2011 Mar 8; 47. ^ Lee, SS., Chen, FD., Chang, SC., et al. (1984). In vivo anti-tumor effects of crude extracts from the mycelium of Ganoderma lucidum. J. of Chinese Oncology Society 5(3): 22-28. 48. ^ Suga, T.; Shiio, T.; Maeda, YY.; Chihara, G. (1994). "Anti tumor activity of lenytinan in murine syngeneic and autochthonous hosts and its suppressive effect on 3 methylcholanthrene induced carcinogenesis". Cancer Res. 44: 5132. 49. ^ Li YQ, Wang SF (2006). "Anti-hepatitis B activities of ganoderic acid from Ganoderma lucidum". Biotechnol. Lett. 28 (11): 837–841. doi:10.1007/s10529-006-9007-9. PMID 16786250. 50. ^ Hajjaj H, Macé C, Roberts M, Niederberger P, Fay LB (July 2005). "Effect of 26-oxygenosterols from Ganoderma lucidum and their activity as cholesterol synthesis inhibitors". Appl. Environ. Microbiol. 71 (7): 3653–8. doi:10.1128/AEM.71.7.3653- 3658.2005. PMC 1168986. PMID 16000773. 51. ^ Wang H, Ng TB (January 2006). "Ganodermin, an antifungal protein from fruiting bodies of the medicinal mushroom Ganoderma lucidum". Peptides 27 (1): 27–30. doi:10.1016/j.peptides.2005.06.009. PMID 16039755. 52. ^ Moradali MF, Mostafavi H, Hejaroude GA, Tehrani AS, Abbasi M, Ghods S (2006). "Investigation of potential antibacterial properties of methanol extracts from fungus Ganoderma applanatum". Chemotherapy 52 (5): 241–4. doi:10.1159/000094866. PMID 16899973. 53. ^ Smith, Rowan, and Sullivan (2001), p. 31.

Shitake Modern research has indicated shiitake mushroom may stimulate the immune system,[8] possess antibacterial properties,[9][10][11] reduce platelet aggregation,[12] and possess antiviral properties,[8][13][14][15][16][17] possibly through antiviral agents known as proteinase inhibitors.[18]

Shiitake isolate AHCC Active hexose correlated compound (AHCC) is an α-glucan-rich compound isolated from shiitake.[20] In Japan, AHCC is the second most popular complementary and alternative medicine used by cancer patients.[21] AHCC is a well tolerated compound[20] and is metabolized via the CYP450 2D6 pathway.[22]

In addition, animal research has shown that AHCC may increase the body's resistance to pathogens as shown in experiments with the influenza virus,[23][24] West Nile encephalitis virus,[25] and bacterial infection.[26][27][28] Animal research has shown AHCC may enhance immune function.[29][30] A double-blind, placebo-controlled trial of 21 people supported the idea that AHCC may enhance immune function.[31] Clinical research has shown AHCC may benefit patients with hepatocellular carcinoma.[32][33] A published case study reported AHCC benefited a patient with prostate cancer.[34]

Shiitake lentinan

Lentinan, a compound isolated from shiitake, is used as an intravenous anticancer agent in some countries.[35] Studies have demonstrated lentinan possesses antitumor properties,[36] and human clinical studies have associated lentinan with a higher survival rate, higher quality of life, and lower recurrence of cancer. Clinical research with lentinan includes studies with 78 hepatocellular carcinoma patients,[37] 32 gastric cancer patients,[38] a multi-institutional study of lentinan and gastric cancer,[39] a meta-analysis of lentinan and gastric cancer,[40] 80 colorectal cancer patients,[41] 20 gastric cancer patients,[42] 36 hepatocellular carcinoma patients,[43] and 29 pancreatic cancer patients.[44] The City of Hope National Medical Center is currently conducting clinical trials to determine if a select portion of the shiitake mushroom, which includes lentinan, can inhibit lung cancer.[45] Lentinan is currently used in Australia as part of a commercially available pharmacological blend (MC-S) to suppress cancer cell proliferation and to promote proliferation of peripheral blood lymphocytes.

The Korea Food & Drug Administration approved on January 2000 that the extracts of the mycelium of shiitake mushrooms can protect and help the liver recover from substances such as alcohol. The main chemical for this effect is the beta-glucan. The research showed injecting the extracts of the mycelium in vitro raised the survival rates of liver cells and increased protein synthesis.

References 20. ^ a b Spierings EL, Fujii H, Sun B, Walshe T (December 2007). "A Phase I study of the safety of the nutritional supplement, active hexose correlated compound, AHCC, in healthy volunteers". Journal of Nutritional Science and Vitaminology 53 (6): 536–9. doi:10.3177/jnsv.53.536. PMID 18202543. 21. ^ Hyodo I, Amano N, Eguchi K (April 2005). "Nationwide survey on complementary and alternative medicine in cancer patients in Japan". Journal of Clinical Oncology 23 (12): 2645–54. doi:10.1200/JCO.2005.04.126. PMID 15728227. 22. ^ Mach CM, Fugii H, Wakame K, Smith J (2008). "Evaluation of active hexose correlated compound hepatic metabolism and potential for drug interactions with chemotherapy agents". Journal of the Society for Integrative Oncology 6 (3): 105–9. PMID 19087767. 23. ^ Ritz BW, Nogusa S, Ackerman EA, Gardner EM (November 2006). "Supplementation with active hexose correlated compound increases the innate immune response of young mice to primary influenza infection". The Journal of Nutrition 136 (11): 2868– 73. PMID 17056815. 24. ^ Nogusa S, Gerbino J, Ritz BW (February 2009). "Low-dose supplementation with active hexose correlated compound improves the immune response to acute influenza infection in C57BL/6 mice". Nutrition Research 29 (2): 139–43. doi:10.1016/j.nutres.2009.01.005. PMID 19285605. 25. ^ Wang S, Welte T, Fang H (March 2009). "Oral administration of active hexose correlated compound enhances host resistance to West Nile encephalitis in mice". The Journal of Nutrition 139 (3): 598–602. doi:10.3945/jn.108.100297. PMC 2646222. PMID 19141700. 26. ^ Aviles H, O'Donnell P, Orshal J, Fujii H, Sun B, Sonnenfeld G (April 2008). "Active hexose correlated compound activates immune function to decrease bacterial load in a murine model of intramuscular infection". American Journal of Surgery 195 (4): 537–45. doi:10.1016/j.amjsurg.2007.05.045. PMID 18304499. 27. ^ Ritz BW (September 2008). "Supplementation with active hexose correlated compound increases survival following infectious challenge in mice". Nutrition Reviews 66 (9): 526–31. doi:10.1111/j.1753-4887.2008.00085.x. PMID 18752476. 28. ^ Aviles H, O'Donnell P, Sun B, Sonnenfeld G (December 2006). "Active hexose correlated compound (AHCC) enhances resistance to infection in a mouse model of surgical wound infection". Surgical Infections 7 (6): 527–35. doi:10.1089/sur.2006.7.527. PMID 17233570. 29. ^ Gao Y, Zhang D, Sun B, Fujii H, Kosuna K, Yin Z (October 2006). "Active hexose correlated compound enhances tumor surveillance through regulating both innate and adaptive immune responses". Cancer Immunology, Immunotherapy 55 (10): 1258–66. doi:10.1007/s00262-005-0111-9. PMID 16362410. 30. ^ Aviles H, Belay T, Vance M, Sun B, Sonnenfeld G (October 2004). "Active hexose correlated compound enhances the immune function of mice in the hindlimb-unloading model of spaceflight conditions". Journal of Applied Physiology 97 (4): 1437–44. doi:10.1152/japplphysiol.00259.2004. PMID 15194672. 31. ^ Terakawa N, Matsui Y, Satoi S (2008). "Immunological effect of active hexose correlated compound (AHCC) in healthy volunteers: a double-blind, placebo-controlled trial". Nutrition and Cancer 60 (5): 643–51. doi:10.1080/01635580801993280. PMID 18791928. 32. ^ Cowawintaweewat S, Manoromana S, Sriplung H (March 2006). "Prognostic improvement of patients with advanced liver cancer after active hexose correlated compound (AHCC) treatment". Asian Pacific Journal of Allergy and Immunology 24 (1): 33–45. PMID 16913187. 33. ^ Matsui Y, Uhara J, Satoi S (July 2002). "Improved prognosis of postoperative hepatocellular carcinoma patients when treated

with functional foods: a prospective cohort study". Journal of Hepatology 37 (1): 78–86. doi:10.1016/S0168-8278(02)00091-0. PMID 12076865. 34. ^ Turner J, Chaudhary U (March 2009). "Dramatic prostate-specific antigen response with activated hemicellulose compound in metastatic castration-resistant prostate cancer". Anti-cancer Drugs 20 (3): 215–6. doi:10.1097/CAD.0b013e3283163c26. PMID 19104437. 35. ^ "Lentinian". About herbs. Memorial Sloan–Kettering Cancer Center. 2009. 36. ^ Kim HS, Kacew S, Lee BM (August 1999). "In vitro chemopreventive effects of plant polysaccharides (Aloe barbadensis miller, Lentinus edodes, Ganoderma lucidum and Coriolus versicolor)". Carcinogenesis 20 (8): 1637–40. doi:10.1093/carcin/20.8.1637. PMID 10426820. 37. ^ Yang P, Liang M, Zhang Y, Shen B (August 2008). "Clinical application of a combination therapy of lentinan, multi-electrode RFA and TACE in HCC". Advances in Therapy 25 (8): 787–94. doi:10.1007/s12325-008-0079-x. PMID 18670743. 38. ^ Nimura H, Mitsumori N, Takahashi N (June 2006). "[S-1 combined with lentinan in patients with unresectable or recurrent gastric cancer]" (in Japanese). Gan to Kagaku Ryoho 33 Suppl 1: 106–9. PMID 16897983. 39. ^ Nakano H, Namatame K, Nemoto H, Motohashi H, Nishiyama K, Kumada K (1999). "A multi-institutional prospective study of lentinan in advanced gastric cancer patients with unresectable and recurrent diseases: effect on prolongation of survival and improvement of quality of life. Kanagawa Lentinan Research Group". Hepato-gastroenterology 46 (28): 2662–8. PMID 10522061. 40. ^ Oba K, Kobayashi M, Matsui T, Kodera Y, Sakamoto J (July 2009). "Individual patient based meta-analysis of lentinan for unresectable/recurrent gastric cancer". Anticancer Research 29 (7): 2739–45. PMID 19596954. 41. ^ Hazama S, Watanabe S, Ohashi M (July 2009). "Efficacy of orally administered superfine dispersed lentinan (beta-1,3-glucan) for the treatment of advanced colorectal cancer". Anticancer Research 29 (7): 2611–7. PMID 19596936. 42. ^ Kataoka H, Shimura T, Mizoshita T (2009). "Lentinan with S-1 and paclitaxel for gastric cancer chemotherapy improve patient quality of life". Hepato-gastroenterology 56 (90): 547–50. PMID 19579640. 43. ^ Isoda N, Eguchi Y, Nukaya H (2009). "Clinical efficacy of superfine dispersed lentinan (beta-1,3-glucan) in patients with hepatocellular carcinoma". Hepato-gastroenterology 56 (90): 437–41. PMID 19579616. 44. ^ Shimizu K, Watanabe S, Watanabe S (2009). "Efficacy of oral administered superfine dispersed lentinan for advanced pancreatic cancer". Hepato-gastroenterology 56 (89): 240–4. PMID 19453066. 45. ^ Alicia Di Rado (26 November 2008). "Can a mushroom help fight lung cancer?". ehope (Duarte, California: City of Hope National Medical Center) 7 (11). Retrieved 25 June 2009

Maitake In 2009, a phase I/II human trial, conducted by Memorial Sloan–Kettering Cancer Center, showed Maitake could stimulate the immune systems of breast cancer patients.[1] Small experiments with human cancer patients, have shown Maitake can stimulate immune system cells, like NK cells.[2][3] In vitro research has also shown Maitake can stimulate immune system cells.[4] An in vivo experiment showed that Maitake could stimulate both the innate immune system and adaptive immune system.[5]

In vitro research has shown Maitake can induce apoptosis in cancer cell lines (human prostatic cancer cells, Hep 3B cells, SGC-7901 cells, murine skin carcinoma cells)[6][7][8][9] as well as inhibit the growth of various types of cancer cells (canine cancer cells, bladder cancer cells).[10][11][12] Small studies with human cancer patients, revealed a portion of the Maitake mushroom, known as the "Maitake D-fraction", possess anti-cancer activity.[13][14] In vitro research demonstrated the mushroom has potential anti-metastatic properties.[15] In 1997, the U.S. Food and Drug Administration (FDA) approved an Investigational New Drug Application for a portion of the mushroom.[16]

Research has shown Maitake has a hypoglycemic effect, and may be beneficial for the management of diabetes.[17][18][19][20][21][22] The reason Maitake lowers blood sugar is due to the fact the mushroom naturally contains a alpha glucosidase inhibitor.[23]

Maitake contains antioxidants and may partially inhibit the enzyme cyclooxygenase.[24] An experiment showed that an extract of Maitake inhibited angiogenesis via inhibition of the vascular endothelial growth factor (VEGF).[25] Lys-N is a unique protease found in Maike.[26] Lys-N is used for proteomics experiments due to its protein cleavage specificity.[27]

1. ^ Deng G, Lin H, Seidman A, et al. (September 2009). "A phase I/II trial of a polysaccharide extract from Grifola frondosa (Maitake mushroom) in breast cancer patients: immunological effects". Journal of Cancer Research and Clinical Oncology 135 (9): 1215–21. doi:10.1007/s00432-009-0562-z. PMID 19253021. 2. ^ Kodama N, Komuta K, Nanba H (2003). "Effect of Maitake (Grifola frondosa) D-Fraction on the activation of NK cells in cancer patients". Journal of Medicinal Food 6 (4): 371–7. doi:10.1089/109662003772519949. PMID 14977447. 3. ^ Kodama N, Komuta K, Sakai N, Nanba H (December 2002). "Effects of D-Fraction, a polysaccharide from Grifola frondosa on tumor growth involve activation of NK cells". Biological & Pharmaceutical Bulletin 25 (12): 1647–50. doi:10.1248/bpb.25.1647. PMID 12499658. 4. ^ Kodama N, Asakawa A, Inui A, Masuda Y, Nanba H (March 2005). "Enhancement of cytotoxicity of NK cells by D-Fraction, a polysaccharide from Grifola frondosa". Oncology Reports 13 (3): 497–502. PMID 15706424. 5. ^ Kodama N, Murata Y, Nanba H (2004). "Administration of a polysaccharide from Grifola frondosa stimulates immune function of normal mice". Journal of Medicinal Food 7 (2): 141–5. doi:10.1089/1096620041224012. PMID 15298759. 6. ^ Fullerton SA, Samadi AA, Tortorelis DG, et al. (2000). "Induction of apoptosis in human prostatic cancer cells with beta-glucan (Maitake mushroom polysaccharide)". Molecular Urology 4 (1): 7–13. PMID 10851301. 7. ^ Lin JT, Liu WH (October 2006). "o-Orsellinaldehyde from the submerged culture of the edible mushroom Grifola frondosa exhibits selective cytotoxic effect against Hep 3B cells through apoptosis". Journal of Agricultural and Food Chemistry 54 (20): 7564–9. doi:10.1021/jf0616762. PMID 17002422. 8. ^ Cui FJ, Li Y, Xu YY, et al. (April 2007). "Induction of apoptosis in SGC-7901 cells by polysaccharide-peptide GFPS1b from the cultured mycelia of Grifola frondosa GF9801". Toxicology in Vitro 21 (3): 417–27. doi:10.1016/j.tiv.2006.10.004. PMID 17150327. 9. ^ Gu YH, Belury MA (March 2005). "Selective induction of apoptosis in murine skin carcinoma cells (CH72) by an ethanol extract of Lentinula edodes". Cancer Letters 220 (1): 21–8. doi:10.1016/j.canlet.2004.06.037. PMID 15737684. 10. ^ Konno S (2004). "Potential growth inhibitory effect of maitake D-fraction on canine cancer cells". Veterinary Therapeutics 5 (4): 263–71. PMID 15719326. 11. ^ Konno S (March 2007). "Effect of various natural products on growth of bladder cancer cells: two promising mushroom extracts". Alternative Medicine Review 12 (1): 63–8. PMID 17397268. 12. ^ Nanba H (September 1995). "Activity of maitake D-fraction to inhibit carcinogenesis and metastasis". Annals of the New York Academy of Sciences 768 (1): 243–5. doi:10.1111/j.1749-6632.1995.tb12130.x. PMID 8526356. 13. ^ Kodama N, Komuta K, Nanba H (June 2002). "Can maitake MD-fraction aid cancer patients?". Alternative Medicine Review 7 (3): 236–9. PMID 12126464. 14. ^ Nanba H, Kubo K (December 1997). "Effect of Maitake D-fraction on cancer prevention". Annals of the New York Academy of Sciences 833 (1 Cancer): 204–7. doi:10.1111/j.1749-6632.1997.tb48611.x. PMID 9616756. 15. ^ Masuda Y, Murata Y, Hayashi M, Nanba H (June 2008). "Inhibitory effect of MD-Fraction on tumor metastasis: involvement of NK cell activation and suppression of intercellular adhesion molecule (ICAM)-1 expression in lung vascular endothelial cells". Biological & Pharmaceutical Bulletin 31 (6): 1104–8. doi:10.1248/bpb.31.1104. PMID 18520039. 16. ^ http://sci.cancerresearchuk.org/labs/med_mush/final_pdfs/chapt7.pdf[dead link] 17. ^ Konno S, Tortorelis DG, Fullerton SA, Samadi AA, Hettiarachchi J, Tazaki H (December 2001). "A possible hypoglycaemic effect of maitake mushroom on Type 2 diabetic patients". Diabetic Medicine 18 (12): 1010. doi:10.1046/j.1464- 5491.2001.00532-5.x. PMID 11903406. 18. ^ Hong L, Xun M, Wutong W (April 2007). "Anti-diabetic effect of an alpha-glucan from fruit body of maitake (Grifola frondosa) on KK-Ay mice". The Journal of Pharmacy and Pharmacology 59 (4): 575–82. doi:10.1211/jpp.59.4.0013. PMID 17430642. 19. ^ Kubo K, Aoki H, Nanba H (August 1994). "Anti-diabetic activity present in the fruit body of Grifola frondosa (Maitake). I". Biological & Pharmaceutical Bulletin 17 (8): 1106–10. PMID 7820117. 20. ^ Lo HC, Hsu TH, Chen CY (2008). "Submerged culture mycelium and broth of Grifola frondosa improve glycemic responses in diabetic rats". The American Journal of Chinese Medicine 36 (2): 265–85. doi:10.1142/S0192415X0800576X. PMID 18457360. 21. ^ Manohar V, Talpur NA, Echard BW, Lieberman S, Preuss HG (January 2002). "Effects of a water-soluble extract of maitake mushroom on circulating glucose/insulin concentrations in KK mice". Diabetes, Obesity & Metabolism 4 (1): 43–8. doi:10.1046/j.1463-1326.2002.00180.x. PMID 11874441. 22. ^ Horio H, Ohtsuru M (February 2001). "Maitake (Grifola frondosa) improve glucose tolerance of experimental diabetic rats". Journal of Nutritional Science and Vitaminology 47 (1): 57–63. PMID 11349892. 23. ^ Matsuur H, Asakawa C, Kurimoto M, Mizutani J (July 2002). "Alpha-glucosidase inhibitor from the seeds of balsam pear (Momordica charantia) and the fruit bodies of Grifola frondosa". Bioscience, Biotechnology, and Biochemistry 66 (7): 1576–8. doi:10.1271/bbb.66.1576. PMID 12224646. 24. ^ Zhang Y, Mills GL, Nair MG (December 2002). "Cyclooxygenase inhibitory and antioxidant compounds from the mycelia of the edible mushroom Grifola frondosa". Journal of Agricultural and Food Chemistry 50 (26): 7581–5. doi:10.1021/jf0257648. PMID 12475274. 25. ^ Lee JS, Park BC, Ko YJ, et al. (December 2008). "Grifola frondosa (maitake mushroom) water extract inhibits vascular endothelial growth factor-induced angiogenesis through inhibition of reactive oxygen species and extracellular signal-regulated

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kinase phosphorylation". Journal of Medicinal Food 11 (4): 643–51. doi:10.1089/jmf.2007.0629. PMID 19053855. 26. ^ Nonaka, T; Y Hashimoto, K Takio (1998-07). "Kinetic characterization of lysine-specific metalloendopeptidases from Grifola frondosa and Pleurotus ostreatus fruiting bodies". Journal of Biochemistry 124 (1): 157–162. ISSN 0021-924X. PMID 9644258. Retrieved 2010-07-01. 27. ^ Taouatas, Nadia; Madalina M Drugan, Albert J R Heck, Shabaz Mohammed (2008-05). "Straightforward ladder sequencing of peptides using a Lys-N metalloendopeptidase". Nat Meth 5 (5): 405–407. doi:10.1038/nmeth.1204. ISSN 1548-7091. PMID 18425140.

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Bee Medicine

Honey Honey is the most important primary product of beekeeping both from a quantitative and an economic point of view. It was also the first bee product used by humankind in ancient times. The history of the use of honey is parallel to the history of man and in virtually every culture evidence can be found of its use as a food source and as a symbol employed in religious, magic and therapeutic ceremonies (Cartland, 1970; Crane, 1980; Zwaeneprel, 1984) an appreciation and reverence it owes among other reasons to its unique position until very recently, as the only concentrated form of sugar available to man in most parts of the world.

Topical applications Topical applications under controlled conditions have shown accelerated wound healing in animals (Bergman et al., 1983, El Banby et al. 1989) and of experimental burn wounds in rats (Burlando, 1978) but also of various types of wounds, including post-operative ones in humans (Cavanagh et al., 1970; Kandil et al., 1987a, b and 1989; Effem, 1988 and Green, 1988). Similar, yet not equal, effects are obtained with the application of purified sucrose and special polysaccharide powders (Chirife et al., 1982). External as well as internal wounds from operations become bacteriologically sterile within a few days and dry out. The simultaneous stimulation of tissue regeneration by honey reduces scarring and healing times. In addition, dressings applied with honey do not stick to the wounds or delicate new skins. In many tropical field hospitals, where antibiotics and other medicines are scarce, honey has been employed successfully for a long time.

Antibacterial activity Antibacterial activity is the easiest to test and is probably the most studied biological activity of honey. In normal honey it is attributed to high sugar concentration and acidity (pH range 3.5 to 5.0). Yet, since also diluted honey has shown antibacterial activity, the active ingredient was attributed to an elusive substance generically termed "inhibin". Much of this activity was later attributed to hydrogen peroxide (H202) an enzymatic by- product during the formation of gluconic acid from glucose. The responsible enzyme, glucose oxidase is basically inactive in concentrated normal honey. Thus, in honey solutions (diluted honey) with the right pH, antibacterial activity is largely due to the presence of hydrogen peroxide. The biological significance of such a mechanism arises from the requirement to protect immature honey (with high moisture content) inside the colony until higher sugar concentrations are achieved.

Both mechanisms can partially explain the sterilizing effect of honey on wounds and some of its efficacy against cold infections, but it does not explain its beneficial effect on burn wounds (Heggers, et al., 1987) and faster wound healing with less scarred tissue. Subralimanyam (1993) has experienced 100% acceptance of skin grafts after storage in honey for up to 12 weeks. Antibacterial activity varies greatly between different types of honey (Dustmann, 1979; Revathy and Banerji, 1980; Jeddar et al., 1985 and Molan et al., 1988). In addition to glucose oxidase, honey seems to contain other mostly unknown substances with antibacterial effects, among which are polyphenols. These other factors

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have been identified in a few cases (Toth et al., 1987; Bogdanov, 1989 and Molan et al., 1989) but as a whole there are few scientific studies on the various claims of the beneficial effects of honey. However, it has been well demonstrated that most of the antibacterial activities of honey are lost after heating or prolonged exposure to sunlight (Dustmann, 1979).

Honey improves nocturnal cough and sleep quality in children and their parents Researchers compared the effects of a single nocturnal dose of buckwheat honey or honey-flavored dextromethorphan (DM) with no treatment on nocturnal cough and sleep difficulty associated with childhood upper respiratory tract infections, in a double-blinded randomized trial of 105 children 2-18 years old. A single dose of buckwheat honey, honey-flavored DM, or no treatment was administered 30 minutes before bedtime. Significant differences in symptom improvement were detected between treatment groups, with honey consistently scoring the best and no treatment scoring the worst. In a comparison of honey, DM, and no treatment, parents rated honey most favorably for symptomatic relief of their child’s nocturnal cough and sleep difficulty caused by upper respiratory tract infection. In this study, DM was not significantly different than no treatment in any outcome (other research has been inconsistent about the difference between DM and placebo).

Paul IM, Beiler J, McMonagle A, et al: Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med 161(12):1140-1146, 2007.

Propolis The term "propolis" comes from two Greek words: "pro," which means 'before," and "polis," which means "city." This ancient term came into being centuries ago when some early Greek student of Nature established the fact that honeybees use propolis to narrow the opening into their "cities," or hives, to keep out unwelcome intruders. Many sources attribute the word to Aristotle (384-322 B.C.). The Greeks also recognized the healing qualities of Propolis, using it for treating wounds as well as "incurable diseases". Hippocrates himself, the father of modern medicine, prescribed Propolis for the healing of sores and ulcers, both internal and external.

Blood Disorders: Chinese researchers found it effective in treating hypertension, arteriosclerosis and coronary disease. European scientist V. Balalykin tells us that Propolis helps the white blood cells engulf and digest bacteria and other waste products in the blood.

Gastro Intestinal Problems: Soviet scientists and doctors have shown that Propolis can prevent ulcer and abscess formation, as well as speeding up the healing process.

Skin Problems : Research in America, Poland and Russia has shown that acne, allergies, herpes and other dermatological disorders have all responded to Propolis therapy.

The “Woman's Friend”: Propolis has become known as the "Woman's Friend”. It has shown to be helpful with painful periods as well as with vaginal infections and sores.

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Propolis contains approximately 55 percent resins and balms, 30 percent wax, 10 percent etheric oils and 5 percent pollen. These basic ingredients have dynamic bacteria destroying power. They do this flawlessly, yet they render no adverse side effects. Unlike chemical medicines such as penicillin, which can produce reactions, propolis will not cause such upset. This has been clinically verified after its use in more than 16,000 situations.

Bee propolis is believed to be rich in amino acids, composite ethers of univalent alcohols and trace elements including iron, copper, manganese, zinc and antibiotics. It has a high vitamin content, especially the valuable bioflavonoids. Propolis is usually chestnut or greenish-brown in color. It gives off a pleasant aroma of poplar buds, honey and vanilla.

Uses • Immune building • Topical anti-inflammatory • Antimicrobial • Common cold • Gastrointestinal infections • Upper respiratory tract infections

A list of microorganisms against which propolis or its extracts have been shown to have a positive effect.

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Bee pollen In ancient Greece, bee pollen was called "Ambrosia", meaning "Food of the Gods".

Bee pollen is one of the richest and most complete foods in nature. It is often used by athletes to give them extra stamina and energy. Bee pollen is rich in vitamins, trace minerals and 19 of 20 amino acids. It has natural interferon and that helps to build the immune system.

Pollen is the male element of the flower. When examined under the microscope, it is seen as a very fine powder, an infinite amount of grains of different forms and designs representing the specific flower from which it comes. This fine powder, containing richly concentrated nutritive and healing properties, forms the ovules, the starting point of the production of fruits, grains, legumes and vegetables. Basically, pollen gathered by the bees is mixed with nectar to make it more solid and of a particular consistency to form the pellets, the form that is carried into the hive. A bee brings two loads of pollen at a

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time in her pollen baskets; that is, two pellets which weigh an average of 20 milligrams (one milligram is one thousandth of a gram; one ounce has 30 grams). It takes a bee approximately one hour to collect an amount that adds up to about four million pollen grains. Therefore, one teaspoon (the customary recommended dose) contains about 1200 pellets; or about 2.5 billion grains of pollen-each of which has all the potency to fertilize and create a fruit, a grain and so forth. Yes, there is power in pollen. But what is in it for you? The composition of pollen, like that of honey and royal jelly, is extremely complex. An analysis shows 9 very richly concentrated amounts of nitrogenous materials known as protein, minerals, amino acids along with a treasure of other non-isolated and different trace elements.

Pollen can be taken by the spoon and let dissolve in the mouth like candy or it can be added to other foods, especially salads, fruits, juices, yogurt, jams and honey.

It is the purest and most complete food available to man and can be taken by people of any age. It is a food of 100% plant origin and is therefore ideal for people on a meatless diet. Just 1 gram of pollen is able to energize and develop fruit in about 100,000 flowers. It is the richest natural food with the smallest volume.

Uses • Nutritive • Increase energy • Athletes • Allergies • Antioxidant support • Menopausal symptoms • Support for chemotherapy and radiation therapy

Minor components of bee collected pollen (Crane, 1990)

Flavonoids At least 8 (flavonoid pattern is characteristic for each pollen type) Carotenoids At least 11 Vitamins C, E, B complex (including, niacin, biotin, pantothenic acid, riboflavin (B2), and pyridoxine (B6)). Minerals Principal minerals: K, Na, Ca, Mg, P, S. Trace elements: A1, B, C1, Cu, I, Fe, Mn, Ni, Si, Ti and Zn Terpenes Free amino acids All Nucleic acids and DNA, RNA and others nucleosides Enzymes More than 100

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Growth regulators Auxins, brassins, gibberellines, kinins and growth inhibitors

Royal Jelly Fountain of Youth Royal jelly is a white, milky substance produced in the glands of worker honeybees to feed the queen bee. All the larvae receive this royal jelly or bees' milk for the first three days of their lives, Afterwards, they are nourished on a diet of honey, pollen and water. This bees' milk is a concentrated super food responsible for turning an ordinary worker bee into a long-lived reproductive dynamo-the queen bee. It is her only food. The queen bee grows 40 to 60% larger than the worker bees and lives five or more years compared to her genetically identical sister whose lifespan is only 40 days.

Uses • Increase fertility • Elevated cholesterol levels • Energy enhancement

A list of some effects of royal jelly on humans.

Applications Description References Premature babies 8-100 mg orally, improvement of general Malossi & Grandi, and those with condition; increase in weight, appetite, red 1956 nutritional blood cells and hemoglobin Prosperi and deficiencies of Ragazzini, 1956 various origins Prosperi et al., 1956 Quadri, 1956 Elderly (70-75 20 mg injected every second day, Destrem, 1956 years), anorexic, improvements on all accounts depressed and low 20 mg taken orally every second day, blood pressure improvements as above Destrem, 1956 patients Psychiatry Improvements of asthenia, nervous breakdown, Telatin, 1956 emotional problems and counteraction of side effects of psychoactive drugs Chronic Mixture or royal jelly, honey and ginseng, Borgia et al., 1984 metabolism improvements in weight gain and psychological conditions, but changes of blood characteristics Stimulating Stimulating effects comparable to that by Martinetti and metabolism proteins, effect assumed to be due to activity of Caracristi, 1956 enzymatic complexes Wound healing 5-30 mg/ml injected into burn blisters, Gimbel et al., 1962 improved regrowth of skin

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Bee’s wax The word wax describes a large variety of substances of plant and animal origin, as well as man-made products, which are mostly petroleum derivatives. However, natural waxes are not single substances, but a mixture of various long-chain fatty acids and a variety of other constituents, depending on their origin. Each wax therefore has unique physical and chemical characteristics, which are exploited in a multitude of applications. In particular, wax from the honeybee has an extremely wide spectrum of useful applications and occupies a very special position among waxes.

Young bees in the hive, after feeding the young brood with royal jelly, take part in the construction of the hive. Engorged with honey and resting suspended for 24 hours together with many other bees in the same position, 8 wax glands on the underside of the abdomens of the young bees secret small wax platelets. These are scraped off by the bee, chewed and masticated into pliable pieces with the addition of saliva and a variety of enzymes. Once chewed, attached to the comb and re-chewed several times, they finally form part of this architectural masterpiece, a comb of hexagonal cells, a 20 g structure, which can support 1000 g of honey. Wax is used to cap the ripened honey and when mixed with some propolis, also protects the brood from infections and desiccation. Together with propolis, wax is also employed for sealing cracks and covering foreign objects in the hive. The wax collected by the beekeeper is that which is used in comb construction. Frame hive beekeeping produces wax almost exclusively from the cap and top part of the honey cells.

For centuries, beeswax was appreciated as the best material for making candles. Before the advent of cheap petroleum-based waxes, tallow (rendered animal fat) was used for cheap candles and for the adulteration of beeswax. Ancient jewelers and artisans knew how to form delicate objects from wax and cast them later in precious metals. Colors of ancient wall paintings and icons contain beeswax, which has remained unchanged for more than 2000 years (Birshtein et al., 1976). The wrappings of Egyptian mummies contained beeswax (Benson et al., 1978) and beeswax has long found use in medicinal practices and in creams and lotions. Of all the primary bee products it has been, and remains, the most versatile and most widely used material.

Bee Venom (Apitherapy) During the last seven decades, over 1700 scientific publications on the composition and various effects of bee venom in animals and humans have been published. An overwhelming proportion comes from Eastern Europe and Asia. Most of them concentrate on demonstrating the site specific, physiological effects of individual components such as membrane destruction, toxicity, or the stimulation or blocking of enzyme reactions. This has largely increased our understanding of the processes occurring after a sting, the physiological effects of isolated venom compounds and the substances responsible for most of the allergic reactions. It has contributed little to verifying the increasing claims of different therapeutic values attributed to honeybee venom, however.

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A study with whole bee venom on dogs (Vick and Brooks, 1972) and rats (Dunn, 1984) showed that melittin and apamine produce increased plasma cortisol. Together with various other arguments, this suggests that many of the curative effects of bee venom may work through stimulation of the body's enzyme and immune system, in a way similar to the common drug cortisone. Cortisone has been used in the treatment of many ailments, but it is also known to have strong, undesirable side-effects. Melittin also appears to have toxic side effects as do some of the other individual compounds in venom. When whole venom is applied however, no side-effects have been shown, other than in allergic patients (Broadman, 1962 and Weeks, 1992 personal communication).

The anti-inflammatory effects of bee venom are perhaps the best studied and the various mechanisms have been repeatedly described in scientific literature (Rekkaand Kourounakis, 1990; Kim, 1989 and others). The neurotoxic venom compounds have shown a potential benefit for epileptic patients (Ziai, 1990). The protective value of bee venom and melittin against the lethal or damaging effects of x-rays has been investigated (Shipman and Cole, 1967 and Ginsberg et al., 1968). Though these and many other results are encouraging, no clinical studies have been carried out to verify the effectiveness using tests accepted by the Western medical establishment. Nevertheless, more and more physicians and healers are experimenting with this benign treatment after they have tested the patient's allergic reactions to bee venom. Recently, after long efforts by the American Apitherapy Society and its members, some interest has been shown by national institutions in several Western European countries and the USA for clinical and large scale tests of bee venom therapy.

A good summary of the scientific studies, with further references can be found in Banks and Shipolini (1986) and Schmidt (1992). Summaries of some of the major specific effects of the various venom compounds that are shorter and more easily understood, can be found in Mraz (1983), Dotimas and Hider (1987), Crane (1990) and Schmidt and Buchmann (1992). The American Apitherapy Society keeps records of scientific as well as anecdotal information on the use of bee venom.

References: Krell, R. Value-Added Products From Beekeeping. 1996. (http://www.fao.org/docrep/w0076e/w0076e00.htm#con) http://secure.herbies-herbs.com

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Juicing 101

Lesson 1: Use pesticide free veggies. It is wise to choose organic whenever possible. However, some vegetables are worse than others. Below are the vegetables that are the most pesticide loaded ones according to the Environmental Working Group.

So it would be wise to only purchase these vegetables if they are organically grown. The worst ones are listed first.

• Celery • Spinach • Kale • Collard Greens • Lettuce • Carrots • Cucumber (not as bad if you peel the skin)

Lesson 2: Get ready to juice! Please note that the order listed below is only intended for those that are new to juicing so you do have a pleasant experience with it. However, if you use ¼ to ½ lemon or lime to the juice you can start experimenting with the more bitter greens early on as the lemon and lime effectively counter their bitterness.

Please note it would be FAR better to use lemon or limes than carrots, beets or apples, which have far more fructose than lemons or limes.

Step 1: If you are new to juicing. I recommend starting out with these vegetables, as they are the easiest to digest and tolerate:

• Celery • Fennel (anise) • Cucumbers

These three aren't as nutrient dense as the dark green vegetables. Once you get used to the 3 vegetables listed above, you can start adding the more nutritionally valuable, but less palatable, vegetables into your juice.

Step 2: When you've acclimatized yourself to juicing, you can start adding these vegetables:

• Red leaf lettuce • Green Leaf lettuce • Romaine lettuce • Endive • Escarole

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• Spinach

Step 3: After you're used to these, then go to the next step: • Cabbage • Chinese Cabbage • Bok Choy

An interesting side note: Cabbage juice is one of the most healing nutrients for ulcer repair as it is a huge source of vitamin U.

Step 4: When you're ready, move on to adding herbs to your juicing. Herbs also make wonderful combinations, and here are two that work exceptionally well:

• Parsley • Cilantro

You need to be cautious with cilantro, as many cannot tolerate it well. If you are new to juicing, hold off on the cilantro. These are more challenging to consume, but they are highly beneficial.

Step 5: The last step: Only use one or two of these leaves, as they are very bitter:

• Kale • Collard Greens • Dandelion Greens • Mustard Greens (bitter)

When purchasing collard greens, find a store that sells the leaves still attached to the main stalk. If they are cut off, the vegetable rapidly loses many of its valuable nutrients.

Lesson 3: Make your juice taste great. If you would like to make your juice taste a bit more palatable, especially in the beginning, you can add these elements:

Lemons and Limes: You can also add a quarter to half a lemon a lime (leaving much of the white rind on).

Cranberries: You can also add some cranberries if you enjoy them. Researchers have discovered that cranberries have five times the antioxidant content of broccoli, which means they may protect against cancer, stroke and heart disease. In addition, they are chock-full of phytonutrients, and can help women avoid urinary tract infections. Limit the cranberries to about 4 ounces per pint of juice.

Fresh ginger: This is an excellent addition if you can tolerate it. It gives your juice a little "kick"! And, as an added boon, researchers have found that ginger can have dramatic

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effects on cardiovascular health, including preventing atherosclerosis, lowering cholesterol levels, and preventing the oxidation of low density lipoprotein (LDL).

Lesson 4: Drink your vegetable juice right away, or store it very carefully. Juicing is a time-consuming process, so you'll probably be thinking to yourself, "I wonder if I can juice first thing in the morning, and then drink it later?" This is not a good idea. Vegetable juice is HIGHLY perishable so it's best to drink all of your juice immediately.

However, if you're careful, you can store it for up to 24 hours with only moderate nutritional decline. This is really helpful if you are bringing your juice to work with you so you can consume it during the day.

How to store your juice:

Put your juice in a glass jar with an airtight lid and fill it to the very top. There should be a minimum amount of air in the jar as the oxygen in air (air is about 20 percent oxygen) will "oxidize" and damage the juice.

Purchase a food vacuum pump like Food Saver with a Ball jar attachment. You can pour your juice into a pint jar and put the lid on and use the Food Saver to suck out the air in the jar to vacuum pack it. This will remove most of the oxygen that will damage the juice.

Immediately store it in the fridge and consume it when you are ready. It is best to drink it as soon as possible and in any case within 24 hours of juicing.

Most people juice in the morning, but if that does not work out well for your schedule, please feel free to choose whatever meal works best for your lifestyle.

Lesson 5: Clean your juicer properly. We all know that if a juicer takes longer than 10 minutes to clean, we'll find excuses not to juice at all. I find that using an old toothbrush works well to clean any metal grater. If you buy a high-quality juicer, the whole process should only take about 5 minutes.

Whatever you do, you need to clean your juicer immediately after you juice to prevent any remnants from contaminating the juicer with mold growth

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Therapeutic Foods

Blueberries and Bilberries Therapeutic uses: memory, mental health, eye health, diabetes, cancer, collagen- stabilizing, capillary stabilizing Best consumed: raw Dosage: 55-115g 3x/day

Packed with antioxidant phytonutrients called anthocyanidins, blueberries neutralize free radical damage to the collagen matrix of cells and tissues that can lead to cataracts, glaucoma, varicose veins, hemorrhoids, peptic ulcers, heart disease and cancer. Anthocyanins, the blue-red pigments found in blueberries, improve the integrity of support structures in the veins and entire vascular system. Anthocyanins have been shown to enhance the effects of vitamin C, improve capillary integrity, and stabilize the collagen matrix (the ground substance of all body tissues). They work their protective magic by preventing free-radical damage, inhibiting enzymes from cleaving the collagen matrix, and directly cross-linking with collagen fibers to form a more stable collagen matrix.

Mateljan, George. The world’s Healthiest Foods. 2007.

Broccoli Sprouts Therapeutic uses: detoxification, cancer Best consumed: raw Dosage: use liberally

Three-day-old broccoli sprouts have the highest amount of sulforaphane in broccoli’s growth cycle. The amount of sulforaphane available from only 5g of three-day-old sprouts is equal to what we would get from 150g of adult broccoli. Sulforaphane has been found to inhibit chemically induced cancers in rats.1,2

1. Fahey, J.W., Y. Zhang & P. Talalay. Broccoli sprouts: An exceptionally rich source of inducers of enzymes that protect against chemical carcinogens. Proc. Natl. Acad. Sci. USA., 1997: 94:10367-72 2. Raloff, J. Anticancer agent sprouts up unexpectedly. Science News, 1997;152:183.

Cabbage (green) Therapeutic uses: digestion, ulcer Best consumed: fresh juice Dosage: 1 liter/day

Cabbage juice has a long history of use for promoting wellness, and research has supported its effectiveness in the treatment of peptic ulcers. Human clinical trials conducted by Dr. Garnett Cheney at Stanford University’s School of Medicine in 1952 demonstrated that fresh cabbage juice (1 liter per day) is highly beneficial in healing peptic ulcers with measurable effects usually seen in less than 7 days.

Since then researchers have discovered that cabbage contains high levels of L-glutamine, which is the preferential fuel for the whole digestive thus aiding in healing.

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Celery Therapeutic uses: decreasing blood pressure Best consumed: fresh juice Dosage: 4-6 stalks/day

Celery is a particularly interesting recommendation for hypertension. It contains 3-n- butyl phthalide, a compound that has been found to lower blood pressure. In animals, a small amount of this compound lowered blood pressure by 12% to 14% and cholesterol by about 7%.1 The equivalent dose in humans can be supplied in about four to six ribs of celery. The research was prompted by the father of one of the researchers, who, after eating a quarter pound of celery daily for 1 week, observed that his blood pressure had dropped from 158/96 to 118/82.

1. Tsi D, Tan BKH. Cardiovascular pharmacology of 3-n-butylphthalide in spontaneously hypertensive rats. Phytother Res 1997;11:576-582.

Cherries Therapeutic uses: gout, connective tissue Best consumed: whole, fresh juice, juice concentrate Dosage: equivalent to 1/2 pound/day

Consuming one-half pound of fresh or canned cherries per day has been shown to be effective in lowering uric acid levels and preventing attacks of gout.30 To assess the physiologic effects of cherry consumption, one study measured plasma urate and antioxidant and inflammatory markers in 10 healthy women who consumed two servings (280 g) of cherries after an overnight fast.31 Blood and urine samples were taken before the cherry dose and at 1.5, 3, and 5 hours afterwards. Plasma urate decreased 5 hours after the cherry consumption by an average of 30 µmol/L. This reduction correlated with an increased urine urate excretion. Plasma C-reactive protein and nitric concentrations decreased slightly after the 3-hour mark.

Cherries, hawthorn berries, blueberries, and other dark red and blue berries are rich sources of anthocyanidins and proanthocyanidins. These compounds are flavonoid molecules, which give these fruits their deep red-blue color, and are remarkable in their ability to prevent collagen destruction.32,33

Anthocyanidins and other flavonoids affect collagen metabolism in many ways:

• They have the unique ability to actually cross-link collagen fibers, resulting in reinforcement of the natural cross-linking of collagen that forms the collagen matrix of connective tissue (e.g., ground substance, cartilage, tendon).32-34 • They prevent free radical damage through their potent antioxidant and free radical scavenging action.32-35 • They inhibit enzymatic cleavage of collagen by enzymes secreted by leukocytes during inflammation.34,35

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• They prevent the release and synthesis of compounds that promote inflammation such as histamine, serine proteases, prostaglandins, and leukotrienes.35

30. Tyler VE, Brady LR, Robbers JE. Pharmacognosy, ed 8. Philadelphia: Lea & Febiger, 1981, pp 480. 31. Jacob RA, Spinozzi GM, Simon VA, et al. Consumption of cherries lowers plasma urate in healthy women. J Nutr 2003;133:1826- 1829. 32. Whitehouse LW, Znamirowski M, Paul CJ. Devil's claw (Harpagophytum procumbens): no evidence for anti-inflammatory activity in the treatment of arthritic disease. Can Med Assoc J 1983;129:249-251. 33. McLeod DW, Revell P, Robinson BV. Investigations of Harpagophytum procumbens (Devil's claw) in the treatment of experimental inflammation and arthritis in the rat. Br J Pharmacol 1979;66:140P-141P. 34. Ball GV, Sorensen LB. Pathogenesis of hyperuricemia in saturinine gout. N Engl J Med 1969;280:1199-1202. 35. Appelboom T, Bennett JC. Gout of the rich and famous. J Rheumatol 1986;13:618-622. .

Cruciferous Vegetables (cabbage, broccoli, cauliflower, Brussels sprouts, bok choy, kale, kohlrabi, turnips, rutabagas, garden sorrel, radish, watercress, and collards) Therapeutic uses: hormonal, liver, cancer Best consumed as: whole, lightly steamed Dosage: 1/2 cup/day

• Cruciferous vegetables contain a photochemical known as Indole-3-Carbinol (I3C). I3C inactivates harmful estrogens and up regulates liver detoxification. • Cruciferous vegetables also contain sulforaphane that also increases phase II liver detoxification activity and protects DNA from damage.

Dandelion Leaf Therapeutic uses: blood pressure, diuretic Best consumed: fresh juice Dosage: 8ml/kg daily

The leaves of dandelion have confirmed diuretic activity. In one study in mice, dandelion exerted a diuretic activity comparable to that of furosemide (Lasix).12 Because dandelion replaces potassium lost through diuresis, it does not have the potential side effects of furosemide, such as hepatic coma and circulatory collapse. The dose given was 8 ml/kg body weight of the aqueous fluid extract of the leaves. This dose produced a 30% loss of body weight in mice and rats in a 30-day period. Much of the weight loss was attributed to the significant diuretic effects.

12. Racz-Kotilla E, Racz G, Solomon A. The action of Taraxacum officinale extracts on the body weight and diuresis of laboratory animals. Planta Med 1974;26:212-217.

Fermented Vegetables (kimchi, sauerkraut, pickles, miso etc.) Therapeutic uses: digestion, dysbiosis, candida Best consumed: fermented raw Dosage: 1-3 servings daily

Fermentation refers to an ancient technique of preparation and preservation in which food is naturally “processed” by microorganisms such as bacteria that break down the carbohydrate and protein in the food. The benefits of consuming these foods are multifactorial mostly due to the good bacteria that are introduced in the gut. Dr. Sonja Pettersen explains: “By maintaining good gut flora, you’ll prevent all kinds of different

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diseases, especially chronic degenerative ones. Probiotics help control inflammation, which is a central feature of so many degenerative diseases, including heart disease. Probiotics help increase NK cells, a powerful immune system weapon. They increase antibodies when we have infections. They improve digestion. They have anticancer properties. And if this weren’t enough, they can increase good cholesterol while decreasing the bad kind.”

Flax Therapeutic uses: digestion, hormones, cancer Best consumed: ground, tea, soaking liquid Dosage: 1-3 tbsp./day (ground), 3 cups/day (liquid)

Flax seeds contain an outer coating known as mucilage that is very soothing to the digestive lining. It has a thick consistency, which is very similar to the mucous your own stomach produces.

Flaxseeds contain lignans. Lignans have been shown to have anti-viral, anti-bacterial, and anti-fungal properties. These properties help to protect our digestive tracts from invading organisms and exert a sparing effect on our immune systems. Lignans also contain two phytoestrogens, known as secoisolariciresinal (SECO) and matairesinol. Like the isoflavones in soy, these are converted by intestinal bacteria to weak estrogens. Flaxseeds contain hundreds of thousands more amounts of SECO than any other food studies so far. Ninety-five percent of the lignans are present in the fiber of the seeds, while less than 5% is present in flaxseed oil.

Garlic Therapeutic uses: antibiotic, immune, blood pressure Best consumed: raw crushed Dosage: 2 cloves/day

Cardiovascular Support In addition to the ability of garlic to help prevent our blood vessels from becoming blocked, this allium vegetable may also be able to help prevent clots from forming inside of our blood vessels. This cardiovascular protection has been linked to one particular disulfide in garlic called ajoene. Ajoene has repeatedly been shown to have anti-clotting properties. It can help prevent certain cells in our blood (called platelets) from becoming too sticky, and by keeping this stickiness in check, it lowers the risk of our platelets clumping together and forming a clot.

Equally impressive about garlic is its ability to lower blood pressure. Researchers have known for about 10 years that the allicin made from alliin in garlic blocks the activity of angiotensin II. A small piece of protein (peptide), angiotensin II helps our blood vessels contract. (When they contract, our blood is forced to pass through a smaller space, and the pressure is increased.) By blocking the activity of angiotensin II, allicin form garlic is

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able to help prevent unwanted contraction of our blood vessels and unwanted increases in blood pressure.

More recently, however, researchers have found that garlic supports our blood pressure in a second and totally different way. Garlic is rich in sulfur-containing molecules called polysulfides. It turns out that these polysulfides, once inside our red blood cells (RBCs), can be further converted by our RBCs into a gas called hydrogen sulfide (H2S). H2S helps control our blood pressure by triggering dilation of our blood vessels. When the space inside our blood vessels expands, our blood pressure gets reduced. (H2S is described as a "gasotransmitter" and placed in the same category as nitric oxide (NO) as a messaging molecule that can help expand and relax our blood vessel walls.) Interestingly, our RBCs do not appear to use processed garlic extracts in the same way that they use polysulfides in food-form garlic.

Antibacterial From a medical history standpoint, the antibacterial and antiviral properties of garlic are perhaps its most legendary feature. This allium vegetable and its constituents have been studied not only for their benefits in controlling infection by bacteria and viruses, but also infection from other microbes including yeasts/fungi and worms. (One particular disulfide in garlic, called ajoene, has been successfully used to help prevent infections with the yeast Candida albicans.) Very recent research has shown the ability of crushed fresh garlic to help prevent infection by the bacterium Pseudomonas aeruginosa in burn patients. Also of special interest has been the ability of garlic to help in the treatment of bacterial infections that are difficult to treat due to the presence of bacteria that have become resistant to prescription antibiotics. However, most of the research on garlic as an antibiotic has involved fresh garlic extracts or powdered garlic products rather than fresh garlic in whole food form.

Overgrowth of the bacterium Helicobacter pylori in the stomach-a key risk factor for stomach ulcer-has been another key area of interest for researchers wanting to explore garlic's antibacterial benefits. Results in this area, however, have been mixed and inconclusive. While garlic may not be able to alter the course of infection itself, there may still be health benefits from garlic in helping to regulate the body's response to that infection.

Anticancer While not as strong as the research evidence for cruciferous vegetables, research on the allium vegetables-including garlic-shows that these vegetables have important anti-cancer properties. Interestingly, high intake of garlic (roughly translated as daily intake of this food) has been found to lower risk of virtually all cancer types except cancer of the prostate and breast cancer. However, moderate intake of garlic (roughly translated as several times per week) has been repeatedly found to lower risk of only two cancer types- colorectal and renal cancer. This difference between "high" versus "moderate" garlic intake may be a real difference that suggests we all need to eat more garlic if we want to maximize its cancer-related benefits. Or it may be a difference that is more related to research complications involving the options given to research participants when

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reporting their food intake. Still, garlic has a consistent track record with respect to general anti-cancer benefits, and there are good research reasons for classifying garlic as an "anti-cancer" food.

The allyl sulfides found in garlic may play a key role in its cancer-prevention benefits. These garlic compounds are able to activate a molecule called nuclear erythroid factor (Nrf2) in the main compartment of cells. The Nrf2 molecule then moves from the main compartment of the cell into the cell nucleus, where it triggers a wide variety of metabolic activities. Under some circumstances, this set of events can prepare a cell for engagement in a strong survival response, and in particular, the kind of response that is needed under conditions of oxidative stress. Under other circumstances, this same set of events can prepare the cell to engage in programmed cell death (apoptosis). When a cell recognizes that it has become too compromised to continue functioning in a healthy manner with other cells, it stops proceeding through its own life cycle and essentially starts to dismantle itself and recycle its parts. It's critical for a cell to determine whether it should continue on or shut itself down, because cells that continue on without the ability to properly function or communicate effectively with other cells are at risk of becoming cancerous. The ability of garlic's allyl sulfides to activate Nrf2 suggests that garlic may be able to help modify these all-critical cell responses and prevent potentially cancerous cells from forming.

Mateljan, George. The world’s Healthiest Foods. 2007.

Grapes Therapeutic uses: cardiovascular, cholesterol, blood pressure, respiratory, mental Best consumed: juice, whole raw, with seeds Dosage: 1 cup daily

Over 100 research studies on grapes (or products made from them, like red wine) have shown many of their health benefits to come from a category of phytonutrients called polyphenols. Three types of polyphenols seem most important with respect to grapes and their health benefits: (1) flavonoids, (2) phenolic acids, and (3) resveratrol. Interestingly, all three types of polyphenols appear to be most concentrated in the skins, stems, and seeds of grapes rather than their juicy middle sections. Flavonoids are phytonutrients that give the vibrant purple color to grapes, grape juice and red wine; the stronger the color, the higher the concentration of flavonoids. These flavonoid compounds include quercitin, as well as a second flavonoid-type compound (falling into the chemical category of stilbenes) called resveratrol. Both compounds appear to decrease the risk of heart disease by:

• Reducing platelet clumping and harmful blood clots • Protecting LDL cholesterol from the free radical damage that initiates LDL's artery-damaging actions

Grapes and products made from grapes, such as wine and grape juice, may protect the French from their high-fat diets. Diets high in saturated fats like butter and lard, and lifestyle habits like smoking are risk factors for heart disease. Yet, French people with

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these habits have a lower risk of heart attack than Americans do. One clue that may help explain this "French paradox" is their frequent consumption of grapes and red wines. Recently, several studies have also identified resveratrol as an excellent candidate for use as a cancer-preventive agent in prostate, lung, liver and breast cancer. Resveratrol has demonstrated striking inhibitory effects on the cellular events involved in cancer initiation, promotion, and progression, and its safety in animal studies of cancer development resulting from exposure to chemical toxins is excellent.

Mateljan, George. The world’s Healthiest Foods. 2007.

Green Tea Therapeutic uses: cancer, cholesterol, hormone balance Best consumed: infusion, extract Dosage: 3 cups daily

Green tea is a great alternative to caffeinated teas and coffee. In contains L-theanine, which has a relaxing effect, counteracting the small amount of caffeine in green tea.

Green tea increases friendly bacteria and decreases the number of disease-causing bacteria. Polyphenols are believed to be the enhancing substance in green tea, which has beneficial effects on serum cholesterol, tumors, and ulcers.

Kelp (and other sea vegetables) Therapeutic uses: thyroid, radiation, fibrocystic breast disease, breast cancer Best consumed: flakes, whole, soups Dosage: use liberally daily

Kelp is a rich source of iodine, a key component in the formation of thyroid hormones T3 (triiodothyronine) and T4 (thyroixine).

As a group, they are known for their ability to detoxify the body. They have been shown to help prevent assimilation of heavy metals such as cadmium as well as other environmental toxins.

Researchers are McGill University studied a compound called sodium alginate that is present in strong quantities in brown algae (arame, hijiki, kombu, and wakame). In their studies, it was found that sodium alginate reduced the uptake of radioactive particles into the bone.1

1. Bowden, Jonny. The 150 Healthiest Foods On Earth. 2007.

Lemons/Limes Therapeutic uses: digestion, cancer Best consumed: juiced, fresh squeezed (rinse mouth with water after) Dosage: 1 tbsp./week grated peel, ½-1 lemon juiced before meals

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In animal studies and laboratory tests with human cells, compounds in citrus fruits, including lemons and limes, called limonoids have been shown to help fight cancers of the mouth, skin, lung, breast, stomach and colon. Now, scientists from the US Agricultural Research Service (ARS) have shown that our bodies can readily absorb and utilize a very long-acting limonoid called limonin that is present is citrus fruits in about the same amount as vitamin C.

Fresh lemon juice and water can be taken before meals to prime the digestive tract. Due to lemon’s acidity outside the body (it is alkaline once absorbed) it brings the pH of the stomach down aiding in the digestion of food. www.Whfoods.com

Mung Beans Therapeutic uses: hormone balance Best consumed: sprouted Dosage: 3 cups/week

A lesser known phytoestrogen is coumesterol, which has a stronger estrogenic effect than the isoflavones and the lignans. Coumesterol is found in high amounts in mung bean sprouts, with lower amounts found in the following seeds: red clover, alfalfa, soybean, yellow pea, green lentil, chick pea, fenugreek, adzuki bean, and fava bean. Mung bean sprouts can be eaten on their own, added to salads, on top of bean dishes, or mixed in juices.

Kaur, Sat Dharam, The Complete Natural Medicine Guide to Breast Cancer. 2003.

Natto Therapeutic uses: blood clotting, cardiovascular, high blood pressure Best consumed: fermented Dosage: 200g/day

Natto is a traditional Japanese food. It’s made from soybeans fermented by the Bacillus natto. It has been consumed for thousands of years due to its health benefits.

Its claim to fame is its richness in an enzyme called nattokinase. Nattokinase is a fibrinolytic enzyme that can help reduce and prevent clots.1

Natto also contains high amounts of vitamin K needed for clotting and bone health.1

1. Bowden, Jonny. The 150 Healthiest Foods On Earth. 2007.

Oats Therapeutic uses: digestion, cardiovascular, nervous system Best consumed: soaked, cooked Dosage: ½ cup/day, or 3 cups of oatstraw tea

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Oats are very soothing externally and have been used in herbal medicine for years as poultices. They are also very soothing internally for digestive upset.

Okra Therapeutic uses: digestion Best consumed: whole cooked, soups, steamed Dosage: ½ cup/day

Contains demulcent properties that are very soothing to the digestive tract. Also very high in organic sodium.

Prunes Therapeutic uses: constipation, cardiovascular, anemia (Fe) Best consumed: whole, juice Dosage: ¼ - 1 cup of the juice daily, 4-5 soaked prunes

In high doses prunes and prune juice can have a laxative effect. They are a safe, nutritious, way to keep the bowels moving, especially in the elderly. They are also the best source of iron in all fruits. One cup of prune juice contains 10mg of iron. One cup of prunes contains 4-6mg of iron

Pumpkin Seeds Therapeutic uses: parasites, prostate, benign prostate hyperplasia Best consumed: raw ground, oil Dosage: ¼ cup daily (maintenance), 7-14 ounces ground daily for children, up to 25 ounces for adults (parasites)

Benign prostatic hypertrophy, or BPH, is a condition that commonly affects men 50 years and older in the United States. BPH involves enlargement of the prostate gland. One of the factors that contribute to BPH is overstimulation of the prostate cells by testosterone and its conversion product, DHT (dihydrotestosterone). Components in pumpkin seed oil appear able to interrupt this triggering of prostate cell multiplication by testosterone and DHT, although the exact mechanism for this effect is still a matter of discussion. Equally open for discussion is the relationship between pumpkin seed oil extracts (which could be purchased in the form of a dietary supplement) and pumpkin seeds themselves. The prostate-helpful components found in the oil extracts are definitely found in the seeds; the only question is whether the amount of seeds eaten for a normal snack would contain enough of these prostate-supportive components. The carotenoids found in pumpkin seeds, and the omega-3 fats found in pumpkin seeds are also being studied for their potential prostate benefits. Men with higher amounts of carotenoids in their diet have less risk for BPH; this is the connection that has led to an interest in pumpkin seed carotenoids.

Zinc is one further nutrient found in pumpkin seeds that might impact prostate function. The fact that pumpkin seeds serve as a good source of zinc may contribute to the role of pumpkin seeds in support of the prostate. However, studies about the relationship

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between zinc and BPH show mixed results, and more research is needed to determine the circumstances under which zinc might be helpful versus harmful.

Pumpkin seeds have been traditionally used as a folk medicine for tapeworms and roundworms. In order to benefit from their therapeutic effect large amounts need to be consumed.1

1. Lipski, Elizabeth. Digestive Wellness. 2004. 2. Whfoods.com

Radish Therapeutic uses: gallstones Best consumed: juiced raw Dosage: 100-400 ml daily

A six-week course of treatment with fresh radish juice is an effective traditional remedy for gallstones. To make the juice, wash and peel the radishes (use the large white variety, not the small red garden radish) and run them through a juice extractor. Start with 3 ½ fl oz (100ml) of juice a day, increasing the quantity slowly to 14 fl oz (400ml) by the end of the first three weeks. Reduce the quantity again after this, cutting it down progressively so that you reach 3 ½ fl oz (100ml) a day again at the end of the second three weeks. Always drink the juice on an empty stomach.

This course of treatment is not suitable for people who have gastric or intestinal disorders.

Treben, Maria. Health from God's Garden. pg.93

Raspberries Therapeutic uses: hormones Best consumed: whole/raw, whole/frozen Dosage: 3 cups/week

Red raspberries contain ellagic acid, which can increase to liver detoxification of estrogen (glucoronidation) by up to 75%.

Kaur, Sat Dharam, The Complete Natural Medicine Guide to Breast Cancer. 2003.

Sardines Therapeutic uses: cardiovascular, nervous system, brain, depression, anxiety, bones Best consumed: canned in olive/sardine oil, cooked from fresh Dosage: 3 cans/week

Sardines are one of the best sources of omega-3 fats. Epidemiological studies in the United States report that a mere ½ gram a day of these fats can significantly decrease cardiovascular risk. Omega-3s help with mood, thinking, circulation, and glucose and insulin metabolism; they lower blood pressure; and they protect against heart disease. They are also loaded with calcium (25-28% of DV).1

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1. Bowden, Jonny. The 150 Healthiest Foods On Earth. 2007.

Slippery Elm Powder Therapeutic uses: digestion Best consumed as: as part of gruel, tea, Dosage: 1-4 tbsp./day

Slippery elm inner bark is very rich in mucilage, a complex mixture of polysaccharides that form a soothing gelatinous fiber when water is added. The pleasant tasting high fiber 'gruel' or porridge made by adding water to the bark was traditionally used as both a food and a medicine by First Nations peoples, and later by European colonists. The mucilage was traditionally used internally for soothing sore throats and tonsillitis, coughs, dryness of the lungs and digestive upsets, and externally for healing wounds and other skin inflammations. Slippery elm tree and root bark were also used as folk remedies for treating many serious degenerative diseases. The bark is particularly recommended for soothing gastric diseases. The viscous fiber has several beneficial effects on digestion:

• Reduces bowel transit time; • Absorbs toxins from the bowel; • Increases fecal bulk and dilutes stool materials thereby reducing stool contact with the intestinal mucosa; and • Enhances beneficial bacteria in the gut and provides an excellent substrate for bacterial fermentation.

Eliminating estrogenic anaerobes from the gut can significantly help the body to regain critical hormone balances that are required for basic health. The bark has noted anti- inflammatory activity and because the mucilage resists hydrolysis and digestion by stomachs acids and enzymes, it therefore maintains it's soothing action throughout the entire digestive system. Slippery elm bark mucilage also helps to moisten the throat, nasal passages, and lungs. Slippery elm bark was also traditionally used for treating abscesses, dysentery, urinary conditions and fever. Poultices were traditionally used to support bone and joint health, reduce swollen glands and stop the spread of infections.

Tomatoes (nightshade) Therapeutic uses: prostate and breast cancer, cardiovascular health Best consumed as: juice, sauce, pureed, cooked Dosage: 500ml juice daily

A meta-analysis of 21 studies published in Cancer Epidemiology Biomarkers and Prevention confirms that eating tomatoes, especially cooked tomatoes, provides protection against prostate cancer.

When the data from all 21 studies was combined, men who ate the highest amounts of raw tomatoes were found to have an 11% reduction in risk for prostate cancer. Those eating the most cooked tomato products fared even better with a 19% reduction in

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prostate cancer risk. Even eating just one 6-ounce serving a day of raw tomato provided some benefit-a reduction in prostate cancer risk of 3%.

Tomatoes are a rich source of the carotene lycopene. In large clinical studies evaluating the relationship between carotene status and heart attack (acute MI), lycopene, but not beta-carotene, was shown to be protective. Lycopene exerts greater antioxidant activity compared with beta-carotene in general but specifically against LDL oxidation.26

26. Weisburger JH. Lycopene and tomato products in health promotion. Exp Biol Med 2002;227:924-927.

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Aloe Vera Therapeutic uses: skin (external and internal), ulcers, IBD, inflammation, radiation, cancer, heart disease, diabetes, constipation Best consumed: inner fillet Dosage: ½ cup daily

The bulk of the aloe leaf is filled with gel, 96% water with the other 4% containing 75 known substances. Applied to wounds, aloe gel is a mild anesthetic, relieving itching, swelling, and pain: it also is antibacterial and antifungal, increases blood flow to wounded areas, and stimulates fibroblasts, the skin cells responsible for wound healing.

An animal-based study in the Journal of the American Podiatric Medical Association found that both oral and topical aloe preparations speed wound healing. Animals were given either aloe (100mg/kg body weight) in their drinking water for two months or 25% aloe vera cream applied directly to wounds for six days.

Aloe had positive effects in both cases. The size of wounds decreased 62% in the animals taking oral aloe compared to a 51% in the control group. Topical aloe produced a 51% decrease in wound size compared to a 33% in the control group.

Aloe vera juice can be effective for treating inflammatory bowel disease, according to a study in the Journal of Alternative Medicine. Ten patients were given two ounces of aloe juice, three times daily, for seven days. After one week, all patients were cured of diarrhea, four had improved bowel regularity, and three reported increased energy.

Aloe turns on the immune system by activating macrophages (white blood cells which "swallow" antigens), causing the release of immune-activating (and anticancer) substances such as interferons, interleukines, and tumor necrosis factor. In addition, aloe promotes the growth of normal (non-cancerous) cells, researchers said.

Cacao Therapeutic uses: depression, anxiety, fatigue, cardiovascular issues, oral health Best consumed: raw, nibs, powder, whole beans, Dosage: 1 cacao bean per 11-17 pounds of body weight.

Cacao contain 4 mood-enhancing chemicals; phenylethylamine, anandamide inhibitors, tryptophan, and serotonin.

Phenylethylamine is a chemical that is released endogenously when we fall in love. It has positive mood enhancing effects and is a mild apatite suppressant.

Anandamide is a cannabinoid endorphin that the human body naturally produces after exercise. Anandamide has only been found in one plant – cacao. Anandamide is known

125 as the “bliss chemical” because it is released while we are feeling great. Cacao contains enzyme inhibitors that decrease our bodies’ ability to breakdown anandamide.

Cacao contains significant amount of tryptophan which is the precursor to the neurotransmitter serotonin. Serotonin is theorized to be the key neurotransmitters in maintaining healthy moods and a happy outlook.

Cacao also contains serotonin. Serotonin is not only beneficial for optimal mood, but it also converts into melatonin. Melatonin is important for sleep and is also an important antioxidant.

Cacao contains the compounds N-caffeoyldopamine and N-coumaroyldopamine and their analogs. These compounds significantly suppress an adhesive molecule, P-selectin, that glues platelets to white blood cells and blood-vessel walls and increases inflammation. Elevated P-selectin levels in the blood have been associated with an elevated danger of cardiovascular clots.

Note: Avoid cacao if you currently or have a history of fibrocystic breast disease.

Goji Berries Therapeutic uses: anti-aging, diabetes, weight loss, immune, vision Best consumed: raw-dries, fresh, tea, powder, blended Dosage: 1 handful per day Note: Goji berries are part of the nightshade family

Traditional Chinese medicine (TCM) has esteemed the Goji berry for centuries. Its virtues were first extolled in print in the first century AD in the classic work, The Divine Husbandman’s Classic. A Chinese legend claims that the use of Goji berry allowed one herbalist to reach the age of 252 years!

Traditional sources praise its value as a tonic for debility and to improve the vision – uses that have been corroborated by 15 centuries of TCM practice. Modern science has substantiated improved eyesight – Goji berry is known to be one of the richest sources of highly bio-available beta-carotene. Goji use in one clinical trial not only confirmed significantly improved visual acuity, but blood levels of vitamin A reached saturation levels in just 34 days!

Modern research has also confirmed its anti-aging properties. At least three separate clinical studies have demonstrated anti-aging effects such as significantly improved immune function, diminished signs of senility, increased antioxidant status, and elevation of hormones to more youthful levels. Some sources suggest that Goji berries stimulate human growth hormone (HGH) production.

At least one TCM formula containing Goji berry has been found effective for normalizing blood sugar levels in diabetics, while another clinical trial found that

126 individuals consuming 30 grams of the berries twice daily experienced significant weight loss.

Goji berries contain more than just beta-carotene; the fruit is also a significant source of essential amino acids, numerous trace elements, vitamins such as B1, B2, B3 and C, and antioxidant and immune stimulating polysaccharides – the same chemicals known to be responsible for the immune-building properties of medicinal mushrooms.

Goji berries contain what scientists are convinced is its active constituent: an immune sugar – similar to the one in echinacea – known as lycium barbarum polysaccharide or LBP for short. A number of clinical trials have been conducted with LBP to determine its effects on health and disease. These confirm its anti-obesity, anti-aging, neuroprotective, vision improving, age-related macular degeneration preventive, anti-diabetes, anti- fatigue, and cancer-preventive properties. As well, it was shown to improve sexual function.

Maca Therapeutic uses: anemia, chronic fatigue, depression, infertility, lack of libido, malnutrition, menopausal discomfort, poor memory, stomach cancer Best consumed: raw, powdered Dosage: 2 tbsp. daily

Native to the highlands of Peru, this remarkable plant has been used by the indigenous peoples there as both a medicine and a marvelously nutritious root vegetable since before the time of the Incas. These days it is gaining dramatically in popularity on the world stage, highly regarded for its effectiveness in toning, strengthening and balancing the body’s vital functions

Researcher Leslie Taylor points out that, "This energizing plant is also referred to as Peruvian ginseng (although maca is not in the same family as ginseng). Maca has been used for centuries in the Andes to enhance fertility in humans and animals… Maca is a wonderful source of natural vital nutrients. The synergy of so many amino acids, vitamins, and minerals in their natural states may increase the assimilation, uptake, and utilization of them in the body."

"Legend has it," says medicine hunter Chris Kilham, "that during the height of the Incan empire, warriors would consume maca before entering into battle. This would make them fiercely strong. But after conquering a city, the Incan soldiers were prohibited from using maca. That was to protect the conquered women."

Kilham goes on to note that, "Macamides and macaenes are the names given to two groups of novel compounds in maca discovered by a team of analytical chemists... Preliminary experiments with animals point to these compounds as likely sex and energy enhancers. In the experiments, sexual activity and stamina increased significantly as the quantities of macamides and macaenes in the diet increased."

127 "In Peruvian herbal medicine today," says Taylor, "maca is reported to be used as an immunostimulant; for anemia, tuberculosis, menstrual disorders, menopause symptoms, stomach cancer, sterility (and other reproductive and sexual disorders); and to enhance memory. Other… herbal medicine uses in the U.S. and abroad include increasing energy, stamina, and endurance in athletes, promoting mental clarity, treating male impotence, and helping with menstrual irregularities, female hormonal imbalances, menopause, and chronic fatigue syndrome."

In a recent double blind placebo-controlled, randomized, parallel trial in men it was concluded that, "treatment with Maca improved sexual desire". Yet another study asserts that, "Maca seems to act as a modulator of sperm count at the reproductive tract level."

Marine phytoplankton Therapeutic uses: children, nervous system, detoxification, energy, athletes, recovery Best consumed: raw, liquid, powder, paste Dosage: a few drops to 2 dopers full (increase gradually)

Marine phytoplankton contains compounds including trace minerals, chlorophyll, omega 3 fats EPA and DHA, carotenoids, and other unidentified pigments. Interestingly, a recent animal study (2003) found that Marine Phytoplankton significantly reduced plasma and liver levels of cholesterol in male rats, demonstrating its potential benefits for cardiovascular health. It was also shown that phytoplankton and its provision of omega 3 fats help support normal fetal brain development in baby rats during late pregnancy and early lactation.

Marine Phytoplankton has been shown to provide the same level of antioxidants as found with cruciferous vegetables. Cruciferous vegetables are amazing health protectors, detoxifiers, and provide a nutrition power house. However, the astounding health benefits reported with Marine Phytoplankton may indicate that this whole food contains unique antioxidant pigments unavailable in other common foods. Alternatively, it may be working at a cellular level to produce a stronger antioxidant effect within the body.

References: Ziccarelli VE, and Basu TK. An in vivo study of the antioxidant potentials of a plant food concentrate. Journal of the American College of Nutrition. Vol.22 (4): 277-282 (2003) Werman MJ et al. Effects of the marine unicellular alga sp. to reduce the plasma and cholesterol levels in male rats fed on diets with cholesterol. Biosci Biotechnol Biochem. 2003 Oct; 67(10): 2266-8 Mokady S and Sukenika A. A marine unicellular alga in diets of pregnant and lactating rats as a source of omega 3 fatty acids for the developing brain of their progeny. J Sci Food Agric. 1995, vol. 68(2): 133-39 Lubian LM et al. Phytoplankton as a source of commercially available pigments. Journal of Applied Psychology. 2000, vol. 12 (3-5): 294-55

Spirulina Therapeutic uses: anemia, muscle wasting, convalescence, inflammation, anemia (B12, and Iron), ADD Best consumed: raw, powder, tablets Dosage: 11-20 grams daily (Therapeutic)

Spirulina’s dark color comes from a rainbow of natural pigments. They harvest sunlight at different wavelengths and protect from too much sun. These pigments offer unusual

128 health benefits and help synthesize many enzymes necessary for regulating body metabolism. They are chlorophyll (green), carotenoids (yellow and orange) and phycocyanin (blue), the dominant color.

Spirulina is the richest Beta Carotene food, with a full spectrum of ten mixed carotenoids. About half are orange carotenes: alpha, beta and gamma and half are yellow xanthophylls. They work synergistically at different sites in our body to enhance antioxidant protection.

Spirulina is a potent source, an astonishing 1% GLA by weight. Eight spirulina tablets contain equivalent GLA to a capsule of primrose oil. About 10 grams of Spirulina provides 131 mg of GLA.

Spirulina contains the highest concentration of protein (by weight) of any food known, between 65 and 71 percent protein, depending upon the variety. Each gram of Spirulina is four times more absorbable than the same gram of protein in beef. It also contains as much iron as red meat.

129 References

Bowden, Jonny. The 150 Healthiest Foods On Earth. Fair Winds 2007. Cass, Hyla. Supplement Your Prescription. Basic Health Publications Inc. 2007. Gates, Donna. The Body Ecology Diet: Tenth Edition. 2010. Haas, Elson. Staying Healthy With Nutrition. Celestial Arts 2006. Kaur, Sat Dharam, The Complete Natural Medicine Guide to Breast Cancer. Robert Rose 2003. Ley, Beth. Colostrum: Nature’s Gift to the Immune System. BL Publications 1997. Light, Luise. What to Eat. McGraw Hill 2006. Lipski, Elizabeth. Digestive Wellness: Third Edition. McGraw Hill 2005. Loomis, Howard F. Enzymes: The Key to Health, Volume 1. Enzyme Formulations Inc. 2007. Mateljan, George. The World’s Healthiest Foods. GMF Publishing 2007. Mills, Simon. Bone, Kerry. Principles and Practice of Phytotherapy. Churchill Livingstone 2009. Murray, Michael T., Pizzorno Jr., Joseph E. Textbook of Natural Medicine: Third Edition. Elsevier Ltd. 2006. Murray, Michael T. Encyclopedia of Nutritional Supplements. Three Rivers Press 1996. Packer, Lester. Colman, Carol. The Antioxidant Miracle. Wiley 1999. Pitchford, Paul. Healing with Whole Foods: Third Edition. North Atlantic Books. 2002. Tierra, Michael. The Way With Herbs. Pocket Books 1998. Wolfe, David. Superfoods. North Atlantic Books 2009.

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