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November 1999

Letter from Dr. Janson

The health potential of MSM
Essential fatty acids (EFA) for depression and mental health
Why Standardized Herbs?
Ginseng -- American, Korean or Siberian?
Sleep Helps Prevent Accelerated Aging
In the Health News
By the Way
References

Letter from Dr. Janson
I recently returned from the meeting of the American College for Advancement in Medicine in Reno, Nevada. Many speakers reported their research on various treatments in alternative medicine, including nutrition and dietary supplements. The speakers presented information on supportive cancer therapies, immune support, toxic metals, athletic performance, and more.

The health potential of MSM
One of the reports was about the dietary sulfur supplement called MSM, or methyl sulfonyl methane. This was presented by Dr. Ronald Lawrence of the UCLA School of Medicine. Sulfur is an essential mineral, it is a component of antioxidant defense systems, and it has many therapeutic uses. It is present in the B-vitamin thiamine, and in several amino acids. MSM is an organic form of sulfur present in all living things. Sulfur is part of the liver detoxification systems, as it is often added to toxic molecules as a way of eliminating them. You may have heard about the benefits of DMSO, but one of the drawbacks of DMSO is its strong garlic-like odor residue, and local skin irritation where it is applied topically.

MSM is a derivative of DMSO, having the benefits without the odor or skin irritation. It is usually taken as a pill or powder, and it is both tasteless and odorless. MSM has been effective in treating the pain and swelling of arthritis—both osteoarthritis and rheumatoid arthritis. Other rheumatic disorders, such as lupus (SLE) with joint pain and inflammation may respond to supplements of MSM. Research is ongoing on the use of MSM for allergies, asthma and diabetes.

MSM inhibits the cross linking of collagen and therefore is useful to reduce hardening of connective tissue with age. One suggestion is to take it to prevent the signs of aging in the skin. The typical doses of MSM range from 500-1000 mg daily as a maintenance or preventive level, and up to 5000 mg daily as a treatment for allergies, arthritic disorders and fibromyalgia syndrome with a reduction of the dose after a period of a few days to a few weeks. Some people appear to benefit if they stay on MSM at a range of 2000 to 4000 mg daily. Taking it for only a day or two is probably ineffective–at least several days to several weeks of supplementation are necessary to see benefits.

Essential fatty acids (EFA) for depression and mental health
Another presentation at the ACAM meeting, by Dr. David Horrobin, was about the value of the omega-3 oils called EPA and DHA (found in supplements of fish oil) for the treatment of depression and other psychiatric disorders. I have been recommending supplements of essential fatty acids (EFA) for many years, even before I first heard Dr. Horrobin speak in 1981. I was using supplements of gamma-linolenic acid from either evening primrose oil or borage oil to treat many different diseases. Now this new report shows even further value of the right balance of the EFA in treatment. I often recommend flaxseed oil for its omega-3 content, but EPA and DHA from fish oil may be better for some patients. This information is confirmed in a recent psychiatry journal. Typical doses of EPA/fish oil supplements are from 4 to 12 capsules daily, each one containing about 300 mg of the omega-3 oils. They are valuable not only for psychiatric disorders but also for heart disease, skin disorders (eczema and psoriasis), the immune system, and high blood pressure.

Why standardized herbs?
Although herbs have a long history of use for medicinal purposes, it is only recently that they have been analyzed to reveal their most active components. These active chemicals are commonly present in very variable amounts in herbs, depending on where and how they are grown, soil quality, when they are harvested, the amount of rain and sun, and other factors. Standardized herbs have guaranteed specific amounts of the known, active herbal components, as well as the other factors that might be of help but are not as well studied.

Recently, the German government formed a Commission (Commission E) to conduct a review of the clinical value of many herbs in common therapeutic use for natural prevention and treatment of disease. The main focus of their review was on standardized herbs, in order to control as many variables as possible. This Commission E has published the results of their review in a monograph, and they concluded that many herbs do have the effects that are claimed.

In order to benefit the most from herbal treatments, I recommend that you buy standardized herbs for your specific needs. You can then be assured of getting the most therapeutic value from your purchase. High quality standardized herbal supplements usually contain all of the other possible active components of the herb, but they have at least the measured amount of the known active principles. This is not to say that non-standardized herbs are not valuable, but their levels of active principles are not as well known.

Examples of standardized herbs (standardization percentage in parentheses) include ginkgo biloba (24 percent ginkgo flavonglycosides), milk thistle extract (80 percent silymarin), kava kava (30 percent kavalactones), St. John's wort (0.3-0.5% hypericin), and bilberry (25 percent anthocyanosides).

The Commission E Monographs are available from the American Botanical Council (512-331-8868; www.herbs.org), but they are rather technical for the general reader.

Ginseng -- American, Korean or Siberian?
Many people ask me which ginseng they should take as a general tonic, and what are the differences between the different sources of ginseng. Ginseng is considered a "restorative" or aid in adaptation to stress. The American ginseng (Panax quinquefolium) is more sedative and relaxing, while helping stress, fatigue, and nervousness.

Components of American ginseng help to reduce levels of substances that participate in both inflammatory and allergic responses, and help control fever and pain. It is now being studied for benefits in sugar regulation and controlling blood fats.

Korean ginseng (Panax ginseng, also called Asian or Chinese ginseng) has many of the same properties, but it is more stimulating, and is probably better to take in the morning, rather than at night. It is used for fatigue, stress, fever and inflammation. Population studies in Korea show reduced rates of cancer among people who regularly consume Korean ginseng. It has antioxidant effects, and in lab studies it protects cells against radiation.

Siberian ginseng (Eleutherococcus senticosus) is reported to reduce the effects of stress and to enhance athletic performance as well as mental acuity. It also helps cells survive after exposure to radiation, and it has potent antioxidant effects.

Typical doses of all of the standardized ginseng extracts range from 200-400 mg twice a day.

Sleep helps prevent accelerated aging
Researchers at the University of Chicago recently showed that lack of sleep can produce the signs of rapid aging in healthy young men. They let the students sleep only four hours a night for a week, and noted increased signs of aging—poor glucose tolerance, meaning they appeared to be prediabetic, and changes in their levels of the stress hormone cortisol to patterns seen in older people. After catching up with several nights of 12 hours of sleep, they returned to normal, but older people might not recover so easily. Since 1910 average sleep duration has decreased from about 9 hours per night to 7.5 hours. If you have trouble sleeping you might benefit from regular exercise and elimination of caffeine and alcohol from your diet (even coffee in the morning can influence sleep the same night). Eating sugar at any time may also disrupt sleep as it can lead to hypoglycemia. Begin some relaxation program, especially in the evening before bedtime. Listen to relaxing classical music, avoid violent or loud television programs, and avoid late-night computer work. A hot bath before bed raises body temperature which promotes sleep.

If you still have problems, several dietary supplements may help promote sleep. Common herbs such as valerian, skullcap, hops, and passion flower are often helpful. Melatonin helps to adjust the body clock, typically in doses from 3 to 6 mg at bedtime. Timed release melatonin might be best, as your melatonin normally peaks around 2 am, but plain melatonin dissolved in the mouth usually works fine. If you find you are a bit drowsy the next morning–this occasionally happens–try taking the melatonin earlier in the evening.

Kava kava is a relaxing herb from the South Pacific islands. The common dose is 250 to 500 mg of standardized extract at bedtime. You can also take this herb for anxiety anytime during the day without side effects. Another sleep enhancing supplement is magnesium, 200 to 400 mg, which acts as a relaxant, especially if you are deficient in the mineral.

For sleep deprivation related to depression, you might find that 5-hydroxy tryptophan (or 5-HTP) helps. It is a pre-cursor to the neurotransmitter serotonin, which reduces anxiety and depression. The usual dose is 50 to 150 mg daily, most at bedtime.

Similarly, St. John's wort can relieve depression and anxiety and promote sleep. It is safer than SSRI drugs such as Prozac®, or Zoloft®, and not addictive. The typical daily dose is 900 mg of standardized extract.

Some combination of these health practices and supplements should help you sleep.

In the Health News
Not only can alpha-lipoic acid help treat diabetic neuropathy, but recent evidence shows that it can also help control blood glucose and increase insulin sensitivity in type II diabetics. Alpha-lipoic acid is an antioxidant nutrient that helps to regenerate vitamin C and works with vitamins C and E to protect both fatty and non-fatty tissues as well as nerves. For diabetic neuropathy it works well when combined with gamma-linolenic acid (GLA). It also increases the cellular levels of glutathione as well as Coenzyme Q10, both important antioxidants.

Other potential benefits of lipoic acid are in the prevention of cataracts, glaucoma, oxidative heart injury, and mushroom poisoning. Typical doses of alpha-lipoic acid are from 300 to 1000 mg daily.

Diet and Disease
Eating more cruciferous vegetables can reduce the risk of bladder cancer. This finding was independent of the consumption of fruits and vegetables in general, so it is important to eat a wide variety of healthy foods, including that cabbage family such as broccoli, brussels sprouts, cauliflower, and of course, cabbage itself. This is only one of many findings that show the importance of fruits, vegetables, whole grains and legumes in prevention of diseases including cancer, heart disease, strokes, and hypertension.

As average Americans typically eat few vegetables and fruits, it is important to encourage this at every opportunity. Beware of diets that make light of a wide variety of vegetarian foods.

By the way:
As I mentioned in my last newsletter, I spoke in October at the Philadelphia College for Osteopathic Medicine for an enthusiastic group of doctors for whom this was mostly new information. The talk was very well received, and I am sure there were some converts in the audience.

At the Natural Products Expo in Baltimore, I spoke on nutrition and immunity, and the health food industry participants went home with more information to share with their customers about the importance of diet, supplements, exercise and relaxation for normal immune function. One thing I introduced was the value of "transfer factor" derived from either colostrum or white blood cells to enhance immunity and treat chronic fatigue, fibro-myalgia, cancer, allergies and autoimmune diseases such as lupus.

I am now off to present some of the same information in Japan.

Click here to receive the Healthy Living newsletter free.

References

EFA and depression
Stoll AL, et al., Arch Gen Psychiatry 1999 May; 56:407-412, 413-414, 415-416.

Ginseng:
Ro JY, Ahn YS, Kim KH, Inhibitory effect of ginsenoside on the mediator release in the guinea pig lung mast cells activated by specific antigen-antibody reactions. Int J Immunopharmacol 1998 Nov;20(11):625-41

Yun TK, Choi SY, Non-organ specific cancer prevention of ginseng: a prospective study in KoreaInt J Epidemiol 1998;27:359-364.

Ben-Hur E, Fulder S, Effect of Panax ginseng saponins and Eleutherococcus senticosus on survival of cultured mammalian cells after ionizing radiation. Am J Chin Med 1981 Spring;9(1):48-56.

Sleep
Spiegel K, Impact of sleep debt on metabolic and endocrine function. Lancet 1999;354:1435-1439

Alpha-lipoic acid:
Jacob S, et al., Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial. Free Radic Biol Med 1999 Aug;27(3-4):309-14.

Altern Med Rev 1998 Aug;3(4):308-11 Monograph:Alpha-Lipoic

Acid.
Cameron NE, et al., Effects of alpha-lipoic acid on neurovascular function in diabetic rats: interaction with essential fatty acids. Diabetologia 1998 Apr;41(4):390-9

Diet and Disease
Michaud DS, J Natl Cancer Inst 1999;91:605-613.

 


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CONSULTATIONS:

From September to June, I see patients in New Smyrna Beach, Florida.
Call 386-409-7747, or send an email to to make arrangements.

In summer, I have a variable schedule, and I see patients in offices at the
Rothfeld Center for Integrative Medicine in Waltham, Massachusetts. For appointments, send an email to make arrangements, or call: 386-409-7747.

I primarily do phone consultations, as well as email and instant messaging consults.


Information herein is not medical advice or direction. All material in this newsletter is provided for information only. Its contents should not be used to provide medical advice on individual problems. Consult a health care professional for medical or health advice.

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