Archive for the ‘Supplements’ Category

About Supplement Quality

Posted on: February 9th, 2015 by Richard Malik No Comments

A recent New York Times article reports that the New York State attorney general’s office recently tested herbal supplements from “GNC, Target, Walgreens and Walmart — and found that four out of five of the products did not contain any of the herbs on their labels.”

Supplement Quality in the New York Times

Supplement Quality in the New York Times

Unfortunately, this and other kinds of funny business is all to common in the supplement industry. It exemplifies why it is important to get supplements manufactured under good quality control and quality assurance. What makes it difficult to know if your supplements are good quality is that there are many factors involved. Information on supplement labels and manufacturer claims can be, at best, less relevant than consumers assume and, at worst, downright deceiving. Acronyms, like GMP, mean less than most consumers suspect.

Ensuring supplement quality requires extensive testing on every batch of raw materials and final product produced:

  • every batch of raw materials used and every batch of final product must be tested for authenticity, potency and stability (shelf life).
  • all raw materials need to be tested for microbiological and heavy metals contamination,
  • herbs must be tested for contamination with herbicides, pesticides, fungicides
  • herbal extracts must be tested for contamination with chemical solvent residues (because herbal extracts are frequently made with solvents that are carcinogens or toxic in other ways to humans)
  • oils must be tested for rancidity
  • fish oils must be tested for PCBs and dioxins
  • perhaps most importantly – all testing must be done by high-quality, third party laboratories (i.e. not by the manufacturer or the raw material supplier)

Obviously, all of these tests to ensure supplement quality become expensive. How can a supplement sold for the cheapest price do all this testing? They can’t; they don’t.

To defray costs, many companies don’t test raw materials or finished products; others only test some batches. Some supplement companies buy their own machine for analysis. These approaches work well for the company’s bottom line but compromise value and even consumer safety.

Ensuring supplement quality is expensive and takes a lot of effort on the part of the manufacturer. I spend a lot of time and energy to make sure that my supplement recommendations are the safest and best quality possible to maximize effectiveness.

Be well,

Richard Malik, ND

Naturopathic Medicine in Salisbury, CT

Naturopathic Medicine in Manchester Center, VT

Staying Healthy This Winter

Posted on: November 20th, 2011 by doctor No Comments

Between colds, flus and the winter blahs, winter can be a tough season.  Here are some  natural steps to ensure a healthy winter season for you and your family.

  • Get your rest – sleep is a nutrient that is important for health and happiness.
  • Use a humidifier – dry winter air contributes to the increased rate of respiratory tract infections.
  • Eat plenty of vegetables, including fruits (yes, fruits are vegetables).  Vegetable soups,  roasted vegetables, and bean dishes are very warming in winter months.  Fruits always make a healthy snack or dessert.
  • Make sure you are getting enough vitamin D – up to 2,500 IU daily for children 1 year or older and up to 4,000 IU daily for anyone 9 years or older.  This almost always requires supplementation since we get no vitamin D from sunlight in winter months and a glass of milk has only 100 IU.
  • Omega-3 essential fatty acids are so important for healthy immune function and mood – they also help prevent cracked lips and dry hands.  If you like fish, great sources that are low in mercury and other environmental toxins include sardines, Alaskan salmon, herring, cod, and mackerel.  If you don’t like fish, taking fish oil capsules will do the trick – just make sure your brand is tested for rancidity, heavy metals, and environmental toxins.
  • Stay active – getting outside when the sun is out can have a remarkable affect on our health in the winter months.
  • I know, I know it is not fair to bring up during the holidays, but sugary sweets slow down the function of white blood cells that devour bacteria and can have negative affects on mood.  Refined carbohydrates like sugar (white, brown, sugar cane crystals, dehydrated cane juice, etc.) corn syrup, honey, and maple syrup are all culprits.  For homemade sweets, stevia extract is a wonderful, healthy, natural sugar substitute.  Apple pie, anyone?

If cold or flu symptoms start, liquid extracts of echinacea root and elderberry taken by mouth help symptoms while reducing the duration of illness.  Goldenseal (warning – a very bitter herb) works great in a neti pot for reducing nasal congestion or by mouth for sore throats.

Be Well,

Richard Malik, ND

Does Vitamin D Improve Depression?

Posted on: May 14th, 2011 by doctor No Comments

A recent study published in the British Journal of Psychiatry finds that vitamin D supplementation does not improve symptoms of in women older than 70.  The researches identified women who had vitamin D deficiency and gave them 500,000 IU of vitamin D one time each year for three to five years.  Hmmm.  This is an unusual vitamin D dosing regimen.

In my experience, providing 5,000 IU vitamin per day, every day, for adult patients is a safe way of maintaining optimal vitamin D status – using less than 4,000 IU does not usually work.  In my clinic, this approach has been a part of a successful program for improving depression in patients with vitamin D insufficiency or deficiency.  This means taking almost 1,800,000 IU of vitamin D per year – much more than what was provided in this study.

According to the Institute of Medicine, 4,000 IU of vitamin D is the upper intake limit for universal safety in people older than 9 years old.  At this level of intake, the annual dosage of vitamin D is 1,460,000 IU – again, much more than the 500,000 IU used in this study.

Honestly, I don’t know if randomized control trials will end up showing that vitamin D supplementation prevents or treats depression.  However, providing one third of the usual annual dose to maintain vitamin D sufficiency is not a very good way to assess the effectiveness of vitamin D for depression.  Providing that dosage all at once makes even less sense.

This is an example of how the results of research and the headlines may not provide an accurate assessment of the question that is trying to be answered.

Be Well,

Richard Malik, ND

Proton Pump Inhibitors and Fracture Risk

Posted on: May 14th, 2011 by doctor No Comments

A recent article in the New York Times reports on research that links long-term Proton Pump Inhibitors (PPIs) with a 30% increased risk of bone fractures.  According to the article, the long-term use of PPIs may decrease absorption of calcium in the intestines.

PPIs reduce the acidity in the stomach in order to reduce symptoms of heartburn.  While this is an effective approach for reducing the burning pain caused by the regurgitation of stomach acid into the esophagus, lowered acidity in the stomach decreases the absorption of some nutrients – including calcium – and increases the chances of getting several types of infection including infections of the digestive tract and lung.

Some forms of calcium do not require stomach acid in order to be absorbed.  These forms include calcium citrate and calcium citrate/malate.  When taking PPIs or other antacid medicines, it is a good idea to supplement calcium intake with these forms of calcium especially if you are at increased risk of osteoporosis or of fracture.

The only drawback of calcium citrate and calcium citrate/malate is that these forms of calcium are very bulky – capsules usually contain only 150mg of calcium.  This means that the usually recommended dosage is 5 to 10 capsules per day.

Ensuring healthy vitamin D status is also very important for calcium absorption.

For more information on addressing osteoporosis, read my previous blog post on osteoporosis.

Other nutrients whose absorption can be decreased by acid lowering medications include magnesium and vitamin B-12.

Be well,

Richard Malik, ND

Simple Steps for Staying Sharp, Stopping Senility

Posted on: December 27th, 2010 by doctor No Comments

Preventing cognitive decline as we age may require only simple measures, according to several recent research articles out of Oxford University, the University of Pittsburgh, and the National Institute of Aging.  Scientists have been looking into the association between preventive lifestyle measures and the size of our brains as we age.

As we age, our brains atrophy; they get smaller over time.  This is a normal process, just like graying hair or skin wrinkling.  However, according to MRI scans, people with senility tend to have more brain atrophy than similarly aged individuals with good cognitive function.  Alzheimer’s Disease produces even faster rates of brain atrophy.

Oxford University researchers recently published study findings indicating that in patients with mild cognitive decline older than 70 years old, daily supplementation for two years with folic acid (800mg), vitamin B-12 (500 micrograms), and vitamin B-6 (20mg) decreases the rate of brain atrophy compared to similar patients taking a placebo.

Research by scientists at the National Institute of Aging found that low folate levels may increase the likelihood of symptoms of depression – especially in women between the ages of 20 and 85 years old.

Folic acid, vitamin B-12 and vitamin B-6 status can be measured with a single simple blood test: homocysteine.  There is an inverse relationship between intake of these vitamins and homocysteine levels –  homocysteine goes down with supplementation of these nutrients.  Optimal homocysteine levels are less than 12 nm/L.

In another study, researchers from the University of Pittsburgh found that women and men in their 70’s who walk more than 9 miles per week have better cognitive function than their less active peers.  These patients were monitored for 9 years and their preservation of cognitive function was correlated with slower rates of brain atrophy.

The amounts of folic acid, vitamin B-12 and vitamin B-6 suggested above are non-toxic – adverse effects at these dosages does not commonly occur.  Physical activity, such as walking, not only improves cognitive function but also prevents cardiovascular disease, diabetes, osteoporosis, and enhances mood.  These natural approaches to mental health are affordable and powerful medicine you can use without a prescription.

Vitamin C and the Brain

Posted on: September 5th, 2009 by doctor No Comments

When the body needs a specific nutrient to do a specific job in a specific organ, that nutrient is found in higher concentrations in that organ. Vitamin C is found in high concentrations in many organs including the brain.

Vitamin C is important for many functions in the brain. As an antioxidant, it plays an important role in protecting brain cells from oxidative damage – the kind of damage implicated in Alzheimer’s disease. Vitamin C is also important for neurotransmitter synthesis – improving neurotransmitter levels is the therapeutic goal of many psychiatric medications. Vitamin C can be a basic part of many natural protocols for depression.

Vitamin C can can cause loose stools if taken in too large doses (this can be used to help with constipation). It is commonly used as a basic, supportive therapy for mood concerns like depression or anxiety.

Be Well,

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Natural Swine Flu Recommendations

Posted on: September 2nd, 2009 by doctor No Comments

Centers for Disease Control recommendations for preventing the spread of influenza include:

  1. Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  2. Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners* are also effective.
  3. Avoid touching your eyes, nose or mouth. Germs spread this way.
  4. Try to avoid close contact with sick people.
  5. If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick.
While there is no scientific evidence showing any natural therapies are effective against swine flu, there is good evidence for some therapies against influenza. I thought I would share the recommendations I make to family and friends for the upcoming flu season.
There are no medical studies looking specifically at swine flu and natural therapies because it is a relatively recent medical concern.  However, the natural therapies with the best medical research supporting their use for influenza are Andrographis, Echinacea, Elderberry, and Siberian Ginseng.  For Swine Flu prevention, I recommend:
  1. get your rest
  2. avoid sugar and refined carbohydrates (honey, maple syrup, white flour) as they reduce immune function
  3. humidify your environment – good research indicates that flu season occurs because of less humid air in winter.  However, humidifiers need to be clean to prevent mold problems.
  4. make sure your vitamin D status is optimal (at least 45ng/ml on a 25-OH vitamin D test).  This usually requires 2,500 to 5,000 IU per day, but you should get checked for safety
  5. take your multi-vitamin
Many more people are exposed to swine flu than you might think because their immune systems handle the infection well.  If you start to feel ill, I recommend:
  1. Andrographis and Echinacea are excellent immune stimulating herbs.  I recommend Andrographis Complex by MediHerb
  2. Echinacea, Elderberry, and Pelargonium Herbal Extract (a custom herbal formula I prepare for children and adults)
  3. Other herbs for your specific symptoms (cough, nasal congestion, runny nose, etc.)
  4. Sugar-free zinc lozenges – Zand makes a good product
Be Well,
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Video: Natural Treatments for Depression

Posted on: May 29th, 2009 by doctor No Comments

Click to Watch in a New Window (180 MB)

This video, on depression, is one of the presentations I delivered at the 2008 Kushi Institute Summer Conference.



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Resveratrol Claims Premature and Products Unreliable

Posted on: May 25th, 2009 by doctor No Comments

What is resveratrol and does it support good health or is it effective medicine? It certainly is a popular and strongly advertised supplement.

The claims about resveratrol are substantial; claims of effectiveness include a long list of conditions:
age-related macular degeneration, allergy, Alzheimer’s disease, amyloidosis, amyotrophic lateral sclerosis, atherosclerosis, cerebral ischemia, chronic obstructive pulmonary disease (COPD), cognitive disorders (cognitive impairment), degenerative diseases, diabetic neuropathy, diabetic wound healing, edema, Epstein-Barr virus, hearing loss, Helicobacter pylori infection, herpes simplex virus types 1 and 2, HIV, hormonal imbalances, hypercholesterolemia, ischemia-reperfusion injury prevention, leukemia, medulloblastoma, melanoma, menopausal symptoms, multiple myeloma, multiple sclerosis, nephrotoxicity, neuroblastoma, neuropathy, neuroprotection, pain, pancreatitis, Parkinson’s disease, premature aging, renal impairment (protection), rheumatoid arthritis, seizure, skin disorders, spinal cord injury, stroke.

And… the claimed beneficial actions of resveratrol include: antifungal, anti-inflammatory, antimicrobial, antioxidant, antiplatelet, anti-tumor agent, antiviral, bone density, cancer prevention, chemoprotectant, immunomodulator, lipid lowering effects, lung cancer prevention, vasorelaxant, wound healing.

That is a very long list of claimed benefits! What do we know that resveratrol does for human health? Nothing – at least not yet.

Resveratrol was discovered in red wine and thought to be an explanation for the French paradox (the French have a low rate of coronary heart disease in spite of diet rich in saturated fats). However, the amount of resveratrol found in red wine is very small and the beneficial effects of red wine may be due purely to the alcohol or to the wide array of phytochemical compounds found in red wine.

Since the discovery of resveratrol there have been numerous test tube experiments that show it has anti-inflammatory, anti-oxidant, and anti-cancer activity in the test tube. However, it is not known if these effects extend to humans when it is ingested.

One of the factors that causes researchers to question resveratrol’s beneficial effects in humans is that, although it is well-absorbed, the body quickly metabolizes (changes) resveratrol and excretes it.

Another concern about resveratrol is that its manufacture is not well controlled or standardized – it is difficult to know if what you purchase is the same as what is beneficial in the test tube.

Bottom Line:
Resveratrol may prove to be an effective antioxidant, anti-inflammatory, and anti-cancer agent, but at this time the research is not strong enough to support these claims and resveratrol product variability makes it difficult to rely on for substantial clinical benefit.

Be Well,

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Acai: Scam and Deception

Posted on: May 17th, 2009 by doctor No Comments

I am receiving so many junk mails about the AMAZING effects of Acai products.  In general, I am very skeptical when anything is advertised as a cure-all.  Acai certainly is marketed as an effective therapy for a vast number of health concerns.

Based upon my exposure to research from Acai manufacturers, the primary value of Acai is its high anti-oxidant activity.  ORAC (Oxygen Radical Absorbance Capacity) is one measure of antioxidant activity.

Promotional materials for Acai claim that the ORAC value of Acai is several times higher than other anti-oxidant rich foods.  As with all statistics and marketing, the devil is in the details.

According to one freeze-dried Acai supplement manufacturer, the ORAC value of 100 grams (about 3.3 ounces) of freeze-dried Acai is 5,500 ORAC or about twice that of 100 grams of blueberries.  That is very good.

However, this manufacturers supplement contains 1,000mg (one gram) of freeze-dried Acai per 2 capsules.  This provides an ORAC value of 55!  The ORAC value of one cup of blueberries is between 9,000 and 13,000 or equivalent to 260 servings of Acai freeze-dried supplement.

One $40 (discounted from $50!) of Acai supplement provides sixty 1,000mg servings of Acai.  In other words, $40 provides you with the anti-oxidants activity of 1/4 to 1/3 cup of blueberries.  

Bottom Line:

Anti-oxidants are very important and promote health, however you would get many times more anti-oxidant effect at a small fraction of the cost from eating some blueberries each day.

Be well,

Richard Malik, ND

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