Supplement Analysis
The patient was taking 13 different products daily:
- a low-potency multivitamin/multimineral supplement;
- vitamin E, 400 IU;
- vitamin C, 500 mg (two daily);
- vitamin B12, 2,000 mcg;
- oyster shell calcium, 500 mg;
- calcium citrate, 600 mg;
- glucosamine and chondroitin, 500/400 with MSM;
- omega-3 fatty acids, 1,000 mg soft-gel, containing 180 mg of EPA and 120 mg DHA;
- flaxseed oil, 1,000 mg;
- coenzyme Q10, 100 mg;
- grapeseed extract, 50 mg (two daily);
- lutein, 18 mg; and
- calcium-magnesium-vitamin D, low potency - 100 mg, 50 mg, 20 IU.
Diet Analysis
The patient's overall diet was much better than that of the average American. However, analysis revealed insufficient vitamin D levels. Her fiber intake slightly exceeded current recommendations, but for a person with blood lipid elevations, I felt it was inadequate, based on recent research.1
Exercise
The patient walked four days per week (30-40 minutes each day, leisurely pace).
Recommendations
Supplements:
- I sold her a three-pill-a-day multivitamin/multimineral formula containing high amounts of vitamin D and enough vitamin C, vitamin E, vitamin B12, and calcium that she could save money by replacing her multi, C, E, B12 oyster shell calcium and the low potency cal-mag-D formula with this single product.
- I advised her to discontinue the separate multi, vitamin C, vitamin E, vitamin B12 and oyster shell calcium, low-potency cal-mag, and flaxseed oil supplements.
- I sold her red yeast extract and recommended 600 mg two times a day.
- I sold her an inositol hexanicotinate/guggul extract formula containing 500mg of non-flush niacin and 37.5mg guggulsterones per tablet. Rx 1 w/ breakfast, 1 w/dinner.
- I advised her to change brands of glucosamine and chondroitin to one of the two leading national brands that has passed all the independent potency and purity testing. Rx three pills a day to total 1,500 mg glucosamine and 1,200 mg chondroitin, to be taken at once, with or without food.
- I advised her to change brands of fish oil to a product that contains 300 mg of EPA and 200 mg of DHA per 1,000 mg capsule; and take three per day with meals.
- I recommended that she continue taking 100 mg of coenzyme Q10 per day; 50 mg of grapeseed extract, two times per day; and 600 mg of calcium citrate daily.
Dietary:
- Replace her usual morning meal (soy flakes with soy milk) with a high-fiber cereal, giving her an extra 6-8 gm of fiber per day.
- Substitute a third piece of fresh fruit, such as an orange (she already ate a banana for breakfast and an apple with lunch) for her late-night snack of tortilla chips.
- Add a half-cup of beans (black, white, kidney, garbanzo, pinto) to her dinner salad.
Exercise:
- Increase her walking from four days to six days per week, and increase her pace from leisurely to brisk.
Table 1: Fasting Blood Test Comparisons Mg/dl | ||
| Substance | Two days before first appointment | 30 days later |
| total cholesterol | 249 | 140 |
| LDL | 149 | 70 |
| HDL | 46 | 56 |
| triglycerides | 272 | 72 |
Results
- The patient stated after one month that she had less joint pain.
- We have not yet tested the patient's bone density with the extra exercise and extra vitamin D.
- See Table 1 for laboratory values.
Clinical Comments
This extraordinary response illustrates the power of diet and supplements. Even more interesting was a recent trial in which guggulsterones actually raised LDL cholesterol.2 This report crossed my desk the day after she returned for her follow-up visit. Whether guggul will be proven effective by itself remains to be seen. In this case, it didn't interfere with the other interventions that do lower blood lipids. (see Table 2.) Regarding the flax oil, as people age, it is harder for the body to convert it to omega-3 fatty acids. Thus, substituting high-potency preformed omega-3 for her low-potency omega-3 and flax oil also may have contributed to her lipid reductions.
Table 2: Strategies Employed to Lower Blood Lipids | ||
| Supplements | Diet | Exercise |
red yeast extract | increase fiber | increase frequency |
non-flush niacin | decrease fat | increase intensity |
References
- Jenkins DJA, Kendall WC, Marchie A, et al. Effects of dietary portfolio of cholesterol-lowering foods vs. lovastation on srum lipids and C-reactive protein. JAMA. 2003;290(4)502-510.
- Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for the treatment of hypercholesterolemia. JAMA. 2003;290 (6)765-772.
G. Douglas Andersen, DC, DACBSP, CCN
Brea, California
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