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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Ame Sans Vie on April 25, 2003, at 11:11:56
Okay, now I've taken supplements in the past before, but I'm not sure I was doing it right... nor if there were other things I could add to improve the results. Right now I'm taking a daily multivitamin (Theragran-M), a B-complex with added vitamin C, vitamin E, picamilon, B-6, l-tyrosine and chromium polynicotinate. I'm sure I should add fish oil back in to my regimen, but what dose? Also, should these supplements be taken with or without food? I know l-tyrosine should be taken on an empty stomach, and the vitamin E and fish oil with food. I also take gamma valerolactone occasionally. I'm sure I should be taking a calcium supplement, as I'm on Atkins (coral calcium?) and probably a potassium supplement, though they don't manufacture them in high enough doses for OTC use. The prescriptions I take are Lexapro (30mg), Tranxene-SD (44.5mg), Neurontin (2400mg), and Soma (700mg). Any insight? The herbal thing (valerian, passion flower, kava, etc.) never seemed to work for me, so I'm not a big fan of those.
Thanks in advance!
Posted by Caleb462 on April 26, 2003, at 1:02:45
In reply to Supplements for a near-beginner?, posted by Ame Sans Vie on April 25, 2003, at 11:11:56
> Okay, now I've taken supplements in the past before, but I'm not sure I was doing it right... nor if there were other things I could add to improve the results. Right now I'm taking a daily multivitamin (Theragran-M), a B-complex with added vitamin C, vitamin E, picamilon, B-6, l-tyrosine and chromium polynicotinate. I'm sure I should add fish oil back in to my regimen, but what dose? Also, should these supplements be taken with or without food? I know l-tyrosine should be taken on an empty stomach, and the vitamin E and fish oil with food. I also take gamma valerolactone occasionally. I'm sure I should be taking a calcium supplement, as I'm on Atkins (coral calcium?) and probably a potassium supplement, though they don't manufacture them in high enough doses for OTC use. The prescriptions I take are Lexapro (30mg), Tranxene-SD (44.5mg), Neurontin (2400mg), and Soma (700mg). Any insight? The herbal thing (valerian, passion flower, kava, etc.) never seemed to work for me, so I'm not a big fan of those.
>
> Thanks in advance!All I'm taking right now is SAM-e 600 mg a day and a B-complex + C tablet every day. I've been doing this for over a week, and I believe it has helped me not want to kill myself - though I am still suffering. I feel a bit more alive than I did 2 weeks ago.
Posted by Viridis on April 26, 2003, at 1:22:19
In reply to Re: Supplements for a near-beginner?, posted by Caleb462 on April 26, 2003, at 1:02:45
For me, prescription meds are best. However, the supplements that actually seem to help me as adjuncts are fish oil and L-theanine (plus good diet and vitamin/mineral supplements at sensible doses). I've found no substitute for the pharmaceuticals, though.
Posted by Larry Hoover on April 26, 2003, at 12:02:38
In reply to Supplements for a near-beginner?, posted by Ame Sans Vie on April 25, 2003, at 11:11:56
> Okay, now I've taken supplements in the past before, but I'm not sure I was doing it right... nor if there were other things I could add to improve the results. Right now I'm taking a daily multivitamin (Theragran-M), a B-complex with added vitamin C, vitamin E, picamilon, B-6, l-tyrosine and chromium polynicotinate. I'm sure I should add fish oil back in to my regimen, but what dose? Also, should these supplements be taken with or without food? I know l-tyrosine should be taken on an empty stomach, and the vitamin E and fish oil with food. I also take gamma valerolactone occasionally. I'm sure I should be taking a calcium supplement, as I'm on Atkins (coral calcium?) and probably a potassium supplement, though they don't manufacture them in high enough doses for OTC use. The prescriptions I take are Lexapro (30mg), Tranxene-SD (44.5mg), Neurontin (2400mg), and Soma (700mg). Any insight? The herbal thing (valerian, passion flower, kava, etc.) never seemed to work for me, so I'm not a big fan of those.
>
> Thanks in advance!When I see abstracts like these, I've got to wonder about the "standard wisdom" that a balanced diet provides all the minerals we need. If you take into account the possibility that mood-disordered populations may require enhanced levels of some nutrients, the "standard wisdom" falls flat on its face.
Exp Gerontol 1993 Jul-Oct;28(4-5):473-83
Does diet provide adequate amounts of calcium, iron, magnesium, and zinc in a well-educated adult population?
Hallfrisch J, Muller DC.
Metabolism Section, National Institute of Aging, Baltimore, Maryland 21224.
Standard advice from dietitians, nutritionists, and physicians is that if one eats a well-balanced diet containing a variety of foods, supplements are not necessary. Little information is available, especially in those over 75, to determine whether actual diets do provide adequate amounts of these minerals. The participants of the Baltimore Longitudinal Study of Aging provide seven-day records which include vitamin and mineral supplement intakes. Median daily dietary intakes from diet in all 564 subjects and from diet plus supplements in those who use them were analyzed by age group and gender. More women than men took supplements. Median intakes of calcium from diet were below the recommended dietary allowance (RDA) for unsupplemented women and for supplemented women over 60. Approximately 25% of women under 50 and 10% of women over 50 consumed less than two thirds of the RDA for iron from diet. For both men and women, all groups had median diet intakes below the RDA for magnesium. Forty percent of men and about half of women consumed less than two thirds of the RDA. These results indicate that many people in this well-educated, presumably well-nourished population did not consume adequate amounts of calcium, iron, magnesium, and zinc from diet. More women than men are at risk. Even those taking supplements did not consume adequate levels of some minerals.
J Am Diet Assoc 1986 Jul;86(7):876-91
Mineral content of foods and total diets: the Selected Minerals in Foods Survey, 1982 to 1984.
Pennington JA, Young BE, Wilson DB, Johnson RD, Vanderveen JE.
The 234 foods of the FDA's Total Diet Study were collected four times per year form mid-1982 to mid-1984 and analyzed for 11 essential minerals. Daily intakes of the minerals were estimated for eight age-sex groups of the U.S. population. Levels of calcium, magnesium, iron, zinc, copper, and manganese were low (less than 80% of the RDA or below the low end of the Estimated Safe and Adequate Daily Dietary Intake range) for some or all age-sex groups. Those most at risk of low intakes were young children, teenage girls, adult women, and older women. Non-discretionary sodium intake exceeded the upper Estimated Safe and Adequate Daily Dietary Intake range for two age-sex groups, and iodine was considerably above the RDA for all age-sex groups. Levels of potassium, phosphorus, and selenium were adequate for all groups.
Really, supplement recommendations may vary substantially between individuals, in that symptoms associated with certain nutrients may indicate a requirement for substantial increases in baseline intakes.Some nutrients, like fish oil, will benefit most anyone, due to the broad dietary imbalance in omega-6:omega-3 ratios seen in most "civilized" countries. About fish oil: take as much as you can tolerate.
Increase your mineral intake. Zinc inhibits copper uptake, but your body stores both, so you may want to alternate one mineral per week. Magnesium will likely enhance the mood stabilization effects and encourage sound sleep.
There are so many possible unique characteristics to consider. What are your symptoms?
Lar
Posted by Ame Sans Vie on April 26, 2003, at 13:01:16
In reply to Re: Supplements for a near-beginner?, posted by Larry Hoover on April 26, 2003, at 12:02:38
Thanks for the abstracts, that is interesting to think that most of us are really starving ourselves from the inside out by neglecting these small (but important) details.
As for my symptoms, they're entirely under control with my prescribed medications, though I hope that my meds could work in tandem with my supplements to provide a better long-term result. My major psychological complaint would be my social anxiety (mostly psychological anxiety, few physical symptoms, coupled with total avoidance of anxiety-provoking situations). I also have a bit of a low mood all the time (dysthymia) and a rather flat emotional panorama (schizoid personality disorder). Physically, I really can only complain about my fibromyalgia, which is characterized by constant, unrelenting pain all over my body, in the muscles. Lesser symptoms would be chemical sensitivity (light, caffeine, aspartame), nonrestorative sleep, and horrible morning stiffness. Could glucosamine/chondroitin be of any help here? What about SAM-e? Is it safe to take with an SSRI (Lexapro)? Finally, I have hypertension, which I just discovered recently.
I've thought about trying magnesium, but am completely unsure how to go about it. What form of magnesium is best, or is there one? What doses have people found the most effective?
I know I need to supplement with calcium, but once again, what form? Is that coral calcium stuff just a gimmick, or does it actually possess some qualities the other supplements do not?
I'm definitely going to start the fish oil again, but I think I may have heard that higher doses thin your blood... I wonder if this could be dangerous?
Really, aside from using these supplements to help manage symptoms, I'm also trying to decide which ones I should take for the rest of my life to promote good health in general. The whole subject just overwhelms me though, and I just know I'd end up taking 80 pills a day to cover all the bases if I left it up to myself, lol. Thanks for the help!
Posted by Larry Hoover on April 26, 2003, at 14:40:07
In reply to Re: Supplements for a near-beginner?, posted by Ame Sans Vie on April 26, 2003, at 13:01:16
> Thanks for the abstracts, that is interesting to think that most of us are really starving ourselves from the inside out by neglecting these small (but important) details.
Just for the record, here's the actual zinc intake status for the most recent analytical period. Take note that "adequate" is defined as obtaining 77% of the appropriate age and gender-matched RDA intake from diet, not 100%.
Table 4. Percentage of the U.S. population with "adequate"1 zinc intake, 1988–1994
Age Total Male FemaleAge Total (S.D.) Male (S.D.) Female (S.D.)
2 mo23 55.6 (0.62) 67.1 (0.78) 44.5 (0.87)
2–11 mo2 96.3 (0.57) 96.9 (0.83) 95.6 (0.86)
1–3 y2 18.9 (1.42) 20.4 (1.73) 17.3 (1.63)
4–6 y 51.5 (2.00) 59.2 (2.59) 43.2 (2.58)
7–10 y 77.1 (1.29) 86.9 (1.64) 66.6 (1.94)
11–18 y3 50.5 (1.43) 61.9 (1.64) 38.7 (2.22)
19–50 y3 60.7 (0.85) 76.7 (1.22) 44.6 (1.22)
51–70 y3 51.1 (1.25) 56.8 (1.73) 46.1 (1.66)
71+ y 42.5 (1.67) 43.9 (1.98) 41.5 (2.19)
Pregnant — — 59.4 (3.91)
Lactating — — 51.5 (9.42)
1 Based on a total zinc intake at or above 77% of the 1989 RDA age/sex-specific value (National Research Coucil 1989) .2 Excludes infants and toddlers who were breast feeding.
3 Excludes pregnant and lactating females.
I have to run. I'll get back to the rest another time. There's a lot you can consider.
Lar
Posted by bluedog on April 27, 2003, at 10:21:06
In reply to Supplements for a near-beginner?, posted by Ame Sans Vie on April 25, 2003, at 11:11:56
I have tried many weird and wacky supplement regimes over the past couple of years but I have finally simplified my regime to the following supplement plan which seems to work very well in tandem with my prescription meds. I suffer from Social Anxiety, Depression and Chronic Fatigue Syndrome (CFS)
Prescription meds:-
Lovan (generic Prozac) 10-20mg per day
Valium (diazepam) 7.5-15mg per day
Supplements:_1. One good Multivitamin tablet per day
2. One good high strength balanced B-Complex tablet per day.
3. Fish Oil (6g per day to give me 1g of EPA per day)
4. Evening Primrose Oil (3g per day to give me 300mg of GLA per day)
5. Alpha Lipoic Acid (200mg per day)
6. Natural Vitamin E (500 IU mixed tocopherals per day)
7. Magnesium Chloride solution (900mg elemental magnesium per day)
8. Co-enzyme Q10 (50mg per day)
9. A Standardised 7.5g Ginkgo Biloba leaf tablet per day
10. Zinc Chloride solution (25mg elemental zinc per day)
11. Selenium solution
12. Glucosamine Sulfate (2000mg per day.
13. One teaspoon of turmeric dissolved in water each day
14. I'm considering adding 6g of Glycine in solution form each day to take with my magnesium solution.I consider ALL of the above supplements as absolutely essential to give my system the support it needs. I know it sounds like a lot of supplements but spread out over the day it's not too bad at all!!! For example the magnesium, zinc, selenium and the glycine solutions can all be mixed in together in one glass when taken. (I tend to purchase my supplements in raw material form if I can from chemical suppliers rather than from the health food stores and this saves me substantial amounts of money).
Hope this helps a little
regards
bluedog
Posted by bluedog on April 28, 2003, at 6:04:23
In reply to Re: Supplements for a near-beginner? » Ame Sans Vie, posted by bluedog on April 27, 2003, at 10:21:06
I forgot to add that I take ALL of my supplements with food Except for my bedtime dose of magnesium:) :)!!!!
regards
bluedog> I have tried many weird and wacky supplement regimes over the past couple of years but I have finally simplified my regime to the following supplement plan which seems to work very well in tandem with my prescription meds. I suffer from Social Anxiety, Depression and Chronic Fatigue Syndrome (CFS)
>
> Prescription meds:-
>
> Lovan (generic Prozac) 10-20mg per day
> Valium (diazepam) 7.5-15mg per day
>
>
> Supplements:_
>
> 1. One good Multivitamin tablet per day
> 2. One good high strength balanced B-Complex tablet per day.
> 3. Fish Oil (6g per day to give me 1g of EPA per day)
> 4. Evening Primrose Oil (3g per day to give me 300mg of GLA per day)
> 5. Alpha Lipoic Acid (200mg per day)
> 6. Natural Vitamin E (500 IU mixed tocopherals per day)
> 7. Magnesium Chloride solution (900mg elemental magnesium per day)
> 8. Co-enzyme Q10 (50mg per day)
> 9. A Standardised 7.5g Ginkgo Biloba leaf tablet per day
> 10. Zinc Chloride solution (25mg elemental zinc per day)
> 11. Selenium solution
> 12. Glucosamine Sulfate (2000mg per day.
> 13. One teaspoon of turmeric dissolved in water each day
> 14. I'm considering adding 6g of Glycine in solution form each day to take with my magnesium solution.
>
> I consider ALL of the above supplements as absolutely essential to give my system the support it needs. I know it sounds like a lot of supplements but spread out over the day it's not too bad at all!!! For example the magnesium, zinc, selenium and the glycine solutions can all be mixed in together in one glass when taken. (I tend to purchase my supplements in raw material form if I can from chemical suppliers rather than from the health food stores and this saves me substantial amounts of money).
>
> Hope this helps a little
> regards
> bluedog
>
Posted by Larry Hoover on April 28, 2003, at 10:48:23
In reply to Re: Supplements for a near-beginner?, posted by Ame Sans Vie on April 26, 2003, at 13:01:16
> Thanks for the abstracts, that is interesting to think that most of us are really starving ourselves from the inside out by neglecting these small (but important) details.
For emphasis, I'm repeating this part:
Just for the record, here's the actual zinc intake status for the most recent analytical period. Take note that "adequate" is defined as obtaining 77% of the appropriate age and gender-matched RDA intake from diet, not 100%.
Table 4. Percentage of the U.S. population with "adequate"1 zinc intake, 1988–1994
Age Total Male FemaleAge Total (S.D.) Male (S.D.) Female (S.D.)
2 mo23 55.6 (0.62) 67.1 (0.78) 44.5 (0.87)
2–11 mo2 96.3 (0.57) 96.9 (0.83) 95.6 (0.86)
1–3 y2 18.9 (1.42) 20.4 (1.73) 17.3 (1.63)
4–6 y 51.5 (2.00) 59.2 (2.59) 43.2 (2.58)
7–10 y 77.1 (1.29) 86.9 (1.64) 66.6 (1.94)
11–18 y3 50.5 (1.43) 61.9 (1.64) 38.7 (2.22)
19–50 y3 60.7 (0.85) 76.7 (1.22) 44.6 (1.22)
51–70 y3 51.1 (1.25) 56.8 (1.73) 46.1 (1.66)
71+ y 42.5 (1.67) 43.9 (1.98) 41.5 (2.19)
Pregnant — — 59.4 (3.91)
Lactating — — 51.5 (9.42)1 Based on a total zinc intake at or above 77% of the 1989 RDA age/sex-specific value (National Research Coucil 1989) .
>
> As for my symptoms, they're entirely under control with my prescribed medications, though I hope that my meds could work in tandem with my supplements to provide a better long-term result. My major psychological complaint would be my social anxiety (mostly psychological anxiety, few physical symptoms, coupled with total avoidance of anxiety-provoking situations).Would you say that you have a low startle threshold? Are you sensitive to strong stimuli, e.g. bright light?
Magnesium, fish oil, and phosphatidyl serine will all help with this.
>I also have a bit of a low mood all the time (dysthymia) and a rather flat emotional panorama (schizoid personality disorder).
You said your symptoms are entirely under control. Yes? No? Not meaning any criticism. I'm just not sure if you're pragmatically accepting of less than optimal function.
Selenium has been shown to elevate the mood of normal people, and depressed subjects. The establishment says most people are getting enough, but I say that's bollocks. Just dealing with mercury ingestion may well bind all the available selenium, as selenium forms a covalent bond with mercury and protects against mercury damage. Low thyroid function is associated with chronic selenium deficiency, particularly in that normal circulating levels of thyroid hormones may be present, but activation of T3 may be sub par if selenium stores are low. Selenium is well absorbed from selenium yeast, and less well absorbed from selenium salts.
>Physically, I really can only complain about my fibromyalgia, which is characterized by constant, unrelenting pain all over my body, in the muscles. Lesser symptoms would be chemical sensitivity (light, caffeine, aspartame), nonrestorative sleep, and horrible morning stiffness. Could glucosamine/chondroitin be of any help here?
I well know about fibro.
Fibro has been linked to hypercoagulability of the blood, and particularly, excess tendency to fibrin formation (Fibrin is a component of clots). So, many alternative practitioners (there are no mainstream treatments, at least what I'd call mainstream) recommend interventions which "thin" the blood. Now, nothing you do will actually thin the blood; there is a lot of misconception about this. Your concerns about fish oil thinning the blood are likely unwarranted, and based in misunderstanding of the effect of the long-chain omega-3 PUFAs. Yes, they reduce the tendency to clot, but I would argue that what is taken as normal clotting should better be stated as typical clotting; there is a common tendency to coagulation caused by omega-3 deficiency. There is no evidence of a dose-dependent decrease in clotting with fish-oil intake. Instead, there is a plateau. Fish oil fixes the tendency to clot too readily, and then nothing more happens. Just look at how many people need to take warfarin and heparin and so on. Occlusive stroke, myocardial ischemia and occlusion of heart arteries. That's what commonly happens. So.....fish oil......highly recommended for fibro.
Second, magnesium malate. I don't know why the malate is said to be so effective, but many fibromytes ( a common term for sufferers of fibromyalgia) swear by it. And high doses, too. Some say benefits accrue at greater than 2 grams/day magnesium, which corresponds with about 6 grams of magnesium malate.
The sleep thing may well be solved with temazepam (Restoril). It fixed my non-restorative sleep problem, and I have successfully used it for over two years without loss of efficacy.
What about SAM-e? Is it safe to take with an SSRI (Lexapro)?
I prefer the use of TMG (trimethylglycine, a.k.a. anhydrous betaine or betaine freebase). You can safely use it with an antidepressant, if you're cautious about dose. I find it to be very activating, so I use it sparingly.
>Finally, I have hypertension, which I just discovered recently.
I had borderline or frank hypertension all my life (systolic 135-145, diastolic 90-110). Since I began my fish oil supplementation, my blood pressure has stabilized at around 125 over 78. Other interventions may well have contributed to that, but I focus on the fish oil. My triglycerides went from levels associated with high risk of coronary artery disease to levels considered to be "excellent". My cholesterol is high, but the ratio of HDL/LDL is so good, it is not a risk factor. I think fish oil did all that, but like I said, there may be other interventions which contributed.
> I've thought about trying magnesium, but am completely unsure how to go about it. What form of magnesium is best, or is there one? What doses have people found the most effective?See above.
> I know I need to supplement with calcium, but once again, what form? Is that coral calcium stuff just a gimmick, or does it actually possess some qualities the other supplements do not?Price. Coral calcium is a gimmick, IMHO.
> I'm definitely going to start the fish oil again, but I think I may have heard that higher doses thin your blood... I wonder if this could be dangerous?Not that I know of.
> Really, aside from using these supplements to help manage symptoms, I'm also trying to decide which ones I should take for the rest of my life to promote good health in general. The whole subject just overwhelms me though, and I just know I'd end up taking 80 pills a day to cover all the bases if I left it up to myself, lol. Thanks for the help!Ackk, you don't need 80 pills a day. 75 will probably do it.
No, really, I take a lot of different things, but I don't take them every day. The RDA and RDI concepts are based on seven-day averages. I think your body utilizes nutrients better in pulses, anyway, once you've overcome the malnutrition/malabsorption angle. That's my rational justification for my constitutional inability to do anything in an organized and rigorous manner (i.e. I'm too lazy to bother every day).
Lar
Posted by McPac on April 28, 2003, at 20:06:56
In reply to Re: Supplements for a near-beginner?, posted by Larry Hoover on April 26, 2003, at 12:02:38
"About fish oil: take as much as you can tolerate".
Lar, what do you think of the studies saying that, for depression, 1 gr/EPA per day is best, 2 gr/day is inneffective......I often take studies w/ a grain of salt. I take much more daily myself. Why do you say "take as much as you can tolerate"?
Posted by Larry Hoover on April 28, 2003, at 22:57:35
In reply to Larry, Re: Supplements for a near-beginner?, posted by McPac on April 28, 2003, at 20:06:56
> "About fish oil: take as much as you can tolerate".
>
> Lar, what do you think of the studies saying that, for depression, 1 gr/EPA per day is best, 2 gr/day is inneffective......I often take studies w/ a grain of salt. I take much more daily myself. Why do you say "take as much as you can tolerate"?The study that found that 1 gram/day of EPA was more effective than higher doses used a derivative of just one constituent of fish oil, ethyl eicosapentaenoate, or E-EPA. I don't think that you can generalize that result to fish oil, which contains DHA and other fatty acids, whose effects are probably additive or synergistic with those of the EPA.
The Inuit are thought to average 24 or more grams of long-chain omega-3s per day.
I was thinking in terms of gastro-intestinal tolerance, and concerns about sleep quality, as some people report that they have difficulties in those areas.
Lar
This is the end of the thread.
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