Fortify Your LifeApril 2016
By Kyle Roderick
Your Guide to Vitamins, Minerals, and More
Book Review with Dr. Tieraona Low Dog
“Clearly,” says Tieraona Low Dog, MD, “many Americans are not getting everything they need in their diet as seen by the deficiencies noted by the US Centers for Disease Control data.”
Of Cherokee descent, Dr. Low Dog is an integrative medicine specialist practicing in Pecos, New Mexico. “Many of my patients,” she notes, “benefit from a high-quality multivitamin that is specific for age, gender, and lifestyle.” She also prescribes a wide array of minerals, herbal remedies, and other supplements, especially to older patients.
An internationally recognized authority on integrative medicine and dietary supplements, Dr. Low Dog has chaired two committees on dietary supplements for the US Pharmacopeia and served as adviser to both the White House and the National Institutes of Health. She’s also the author of Fortify Your Life (National Geographic Books), a recently published guide to vitamins, minerals, and other key supplements. Dr. Low Dog says that a major reason that she wrote this book is that, “Very few health care professionals are routinely checking nutrient levels, and even fewer discuss the potential for deficiencies with their patients, with the exception of potassium and diuretic use.”
Drug-Induced Nutrient Deficiencies
Dr. Low Dog and her physician colleagues are seeing various drug-related nutrient-deficiency problems on the rise. For instance, “We are seeing more people having difficulty with absorption of nutrients due to broad use of proton pump inhibitors, or PPIs, which are drugs that inhibit the proton, or acid-producing, pumps in the stomach,” she says. “Sold under such brand names as Prilosec®, Nexium®, and Protonix®, these are used to treat acid reflux and are, in my opinion, overprescribed.”
Dr. Low Dog relates that a person’s level of CoQ10, “which is very important for heart and neurological health, can be depleted by numerous prescription drugs.” These include such widely prescribed drugs as statins and beta-blockers.
“We are also seeing more people having difficulty with absorption of nutrients due to the prevalence of autoimmune disease and the aging population,” says Dr. Low Dog. “Digestive enzymes can be useful in this regard because they stimulate the body’s production and/or release of stomach acid, bile, and pancreatic enzymes.”
Dr. Low Dog points out that bitter foods (arugula, radicchio, endives) and bitter herbs (dandelion root, artichoke leaf, gentian root, angelica) can be added to the diet to enhance the stimulation of stomach acid, bile, and pancreatic enzymes.
“For some people, digestive enzymes may be necessary,” says Dr. Low Dog. “While you can take enzymes that are derived from plants or animal sources, I generally recommend the former. Look for products that provide Food Chemical Codex (FCC) units. In the US, Food Chemical Codex is the national standard for evaluating activity and potency of enzymes.”
As a physician who views public health issues as major influences upon the fate of the nation, “I’m deeply concerned about the mixed messages in the media regarding the current state of nutrition in the US,” says Dr. Low Dog. She objects to the oft-repeated mantra, “If you just eat right, you’ll get everything you need.” As she notes in Fortify Your Life, this is contradicted by unassailable research findings that some of the most widely prescribed drugs in the US deplete the body of vital nutrients.
In Dr. Low Dog’s opinion, the science of drug-nutrient depletions and interactions “are totally off the radar” in US medical school curricula. “Drug companies should be required to list potential nutrient depletions in their commercials and advertisements,” she asserts. “While I am not in favor of direct-to-consumer advertising of drugs, until it is banned, I believe that this should be mandatory.
“We should increase the training for medical doctors, nurse practitioners, pharmacists, registered dietitians, psychologists, and many other health professionals so that we can all be advocates on our patient/client’s behalf,” Dr. Low Dog continues.
Fortify Your Life is filled with the kind of practical and actionable news that everyone can use. For instance, while it’s estimated that 30 million people take Prozac ® and other anti-depressant SSRIs, these drugs have been proven to deplete the body of vital nutrients like iodine, selenium, and vitamin B9 (folate) and hormones like melatonin. “Around 60% of Americans take at least one prescription drug,” Dr. Low Dog notes, “and 15% take five or more every day.” Thus, the risk for drug-induced nutrient depletions in the majority of the population “further increases the risk of nutrient deficiencies.” Fortunately, Fortify Your Life contains a lengthy, detailed, and easy-to-understand Appendix of Drug-Nutrient Depletions and Interactions.
With more than 30 million Americans deficient in vitamin B6, which can cause depression and poor cognition, and roughly the same number of people taking antidepressant medications, “It concerns me that health care providers don’t ever think to check B6 levels,” says Dr. Low Dog. “If we never think about it,” she continues, “we may never look and thus we may remain unaware of the deficiency.
“I do not always order blood tests,” explains Dr. Low Dog, “but I do if I suspect deficiency based upon a thorough history and physical exam.” If a nutrient deficiency is noted, “We make recommendations accordingly and then recheck generally in eight to 12 weeks.”
If the follow-up blood test shows that supplement levels have made little improvement, Dr. Low Dog carefully considers various factors related to the nutrient deficiency in question.
Best Way to Take Supplements
“Are we using the correct form of a nutrient (e.g. pyridoxal-5-phosphate instead of pyridoxine for vitamin B6)?” Dr. Low Dog asks. “Would a liquid or capsule be superior to a tablet? Do we have the partner nutrients that are necessary for activation, use, and transport by the body?”
For instance, she says, “Iron is needed to correct iron deficiency anemia, but you need vitamin A to move the iron into the hemoglobin and vitamin C is necessary to absorb non-heme forms of iron.” Then again, “You need vitamin A to see in dim light at night, but you must have zinc to transport it from the liver (where it is stored) to the retina.” Noting that vitamin D insufficiency is very common in the US population, Dr. Low Dog offers this compelling advice about supplementing with vitamin D: “Taking vitamin D with the dinner meal can increase absorption by 50% more than taking with breakfast (dinner meals generally contain more fat).”
More Health-Enhancing Facts
Noting that immunity begins in the gut, Dr. Low Dog says, “Probiotics and prebiotics, whether in supplement form or in foods, are vitally important in a society where one in three babies are born by C-section and the average 21-year-old [person] has typically taken 17 rounds of antibiotics. We are just in our infancy when it comes to fully realizing the vital importance of the human microbiome and health.”
Fortify Your Life brims with many other potentially health-enhancing facts on often-overlooked benefits of basic nutrients such as magnesium. For instance: “When blood sugars rise, magnesium is excreted in the urine. Up to a third of people with diabetes are deficient in magnesium, further complicating their ability to maintain good blood sugar control: a vicious cycle. Magnesium may also protect us from stroke by making our platelets less likely to form blood clots.”
She goes on to add more intriguing facts: “Iodine deficiency is the most preventable cause of brain damage in the world,” and as more Americans eat sea salt, Himalayan salt, and other so-called “gourmet salts” (as opposed to table salt), they are becoming increasingly iodine-deficient.
When it comes to healthy-aging supplements, the medical evidence comes out strongly in favor of alpha-lipoic acid and acetyl-L-carnitine. “Dr. Bruce Ames, an emeritus professor of biochemistry and molecular biology at the University of California, Berkeley, has done extensive research on mitochondria and aging,” Dr. Low Dog relates in Fortify Your Life. “Dr. Ames discovered that if you want to maintain a healthy heart, brain, and nervous system, there is probably no better combination than the antioxidant alpha-lipoic acid and acetyl-L-carnitine, a potent [amino acid].” These enhance the energy production of the mitochondria, the powerhouse of our cells. Dr. Low Dog believes that many people 50 and over “would benefit from taking a supplement that provides 500 to 1,500 mg of acetyl-L-carnitine in addition to alpha-lipoic acid.”
As Dr. Low Dog writes in Fortify Your Life, “Since alpha-lipoic acid easily crosses the blood-brain barrier, its antioxidant effects may be particularly important in protecting the central nervous system from illness, disease, and DNA damage. Thus, it may play a role in helping protect us against Alzheimer’s disease, dementia, and Parkinson’s disease. One small, double-blinded, placebo-controlled 12-month study published in 2014 in the Journal of Alzheimer’s Disease found that the combination of fish oil (975 mg of EPA and 675 mg of DHA) and 600 mg of alpha lipoic acid slowed both cognitive and functional decline in people with dementia.”
Although Dr. Low Dog emphasizes that we are only in the “very early stages of research, and neurodegenerative diseases are complex, based upon what we know so far, alpha-lipoic acid may play an important role in the healthy aging of our brain.” Anyone aged 65 or older, diabetics, and those with a family history of dementia or other neurodegenerative diseases may want to consider supplementing with alpha-lipoic acid. Dr. Low Dog recommends 200 to 400 mg a day for most users and 600 mg two times per day in case of neuropathy or cognitive decline.
These and other highly nuanced insights into maximizing our nutrient intake for well-being and optimum aging makes Fortify Your Life such a worthwhile book to read and refer to as you manage your health.
Dr. Tieraona Low Dog is an internationally recognized expert in the fields of dietary supplements, herbal medicine, women’s health, and natural medicine. In 2000, she was appointed by President Bill Clinton to serve on the White House Commission of Complementary and Alternative Medicine and she recently completed a three-year term as a member of the Advisory Council for the National Institutes of Health National Center for Complementary and Alternative Medicine (NCCAM). She has published 45 peer-reviewed articles, written 22 chapters for medical textbooks, and authored three National Geographic books, including Healthy at Home and Life Is Your Best Medicine. She has also co-authored the Guide to Medicinal Herbs. For more information, or to contact Dr. Low Dog, visit www.drlowdog.com.
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