Letter from Dr. Janson
Additional Supplements for Enhanced
Hormones for AgingMelatonin and
U.S. Diet Still a Problem
Indicators of Heart Disease
In the Health News
In the Mailbag
I promised you more on aging and how to slow it down. I have
already covered diet, stress management, and exercise, and
some of the supplements that might be of help. In a sense,
almost any dietary supplement that you take might help, except
iron if you already have enough (iron is a "transition
metal" and excess may be a source of increased free-radical
damage, a leading cause of accelerated aging and degenerative
To slow the aging process, you need to focus on protecting
your brain, heart, lungs, digestive tract, and the organs
most commonly involved in cancer. You also want to maintain
your energy, your vision, strength, and ability to enjoy your
Supplements that can help provide vibrant and vital later
years also help to provide energy and better function at almost
any age. It is not necessary to take all of the valuable supplements
(even though I take most of them, myself). Choose the basic
ones plus those that seem right for your specific needs.
Prevention of brain aging is clearly desirable. Not all substances
that you take will pass into the brain, but those that do
can protect the brain from aging, vertigo, loss of memory,
ringing in the ears (tinnitus), loss of balance, and degenerative
diseases such as Parkinson's disease, strokes, and Alzheimer's
disease. In addition to the important role of vitamin C in
the brain (it uses more than any other organ), others that
may help include ginkgo biloba, proanthocyanidins and alpha-lipoic
Several of the flavonoid compounds in ginkgo biloba help
to enhance memory as people get older. In test tubes, these
substances protect nerve cells because they reduce damage
from a free-radical compound called "A-beta amyloid."
In another study in mice, ginkgo preserved the activity of
an important energy production enzyme called ATPase, and itreduced
the damage that results from low blood flow.
Both studies used a standardized extract, and one found that
the non-standardized extracts did not work because they did
not contain enough of the active compounds. I recommend 60
to 120 mg of standardized extract twice a day. Ginkgo also
helps relieve migraines, vertigo, and tinnitus. Animal studies
also show that ginkgo helps to protect the retina, especially
Proanthocyanidins (PAC) are another group of compounds related
to flavonoids (many of the active substances in herbs and
botanical remedies are flavonoids, a beneficial collection
of plant pigments). Supplements come mainly from pine bark,
grape seeds and grape skins (related substances called anthocyanosides
are found in blueberries and cranberries). Each of these PAC's
has a slightly different chemical makeup, so it is good to
take a mixture of more than one source for the full benefits.
PAC's help to maintain elasticity of the skin by preventing
the destruction of the "elastin" component of the
connective tissue. As a result they not only help maintain
youthful skin, but also improve the strength of blood vessels,
including veins and arteries. They are commonly included in
supplements that help with varicose veins.
Other benefits of PAC's include reduced inflammation and enhanced
immune function. I usually recommend a mix of grape seed and
pine bark sources, at about 100 to 200 mg per day.
(By the way, you might also see these under the name OPC
or PCO, other terms for the same substances. When flavonoids
were first discovered, they were called "vitamin P"
because they reduced the permeability of blood vessels.)
Also called thioctic acid because of its sulfur content,
this supplement is a potent antioxidant that protects both
water- and fat-soluble tissue components both inside and outside
of cells. It helps regenerate vitamins C and E, and it increases
the level of coQ10 and glutathione, another valuable antioxidant
for the brain.
Unlike some antioxidants, lipoic acid is able to get into
brain tissue to have its beneficial effects. It is one treatment
for diabetic neuropathy (the nerve damage in the extremities
that leads to pain and/or numbness and tingling), and it also
helps control blood sugar and prevent cataracts.
Many degenerative brain diseases are the result of oxidative
damage, and lipoic acid is one of the supplements that can
help with Parkinson's disease, Alzheimer's, and possibly multiple
The usual dose of lipoic acid is about 1000 mg a day for diabetics,
and anywhere from 300 to 600 mg for antioxidant benefit or
as preventive medicine.
By now you may have read about DHEA, melatonin, estrogen,
testosterone, and growth hormone. I believe it is wise ot
be more careful with hormones than with other dietary supplements.
Having said that, supplements of all of these hormones may
be very beneficial as people age.
Melatonin is one of the safest supplements for age-related
problems. It is a hormone produced in the tiny pineal gland
(about th esize of a pea) in the base of the brain, and it
is one of the most potent antioxidants (it scavenges the dangerous
hydroxyl free radical).
In addition to its antioxidant function, melatonin is the
controller of the biological clock that determines the daily
body rhythms. It promotes sleep, reduces depression, enhances
immune function, and protects blood vessels. It also helps
adjustment to jet lag and shift work. Your own production
of melatonin declines with age, so supplements are a good
idea as you get older. The usual dose of melatonin is 3 mg
at bedtime, with a range from 1/2 mg up to 6 mg.
Dehydroepiandrostrone is considered one of the "mother"
hormones in the adrenal gland because other hormones such
as testosterone and estrogen are made from it. DHEA levels
decline with age. High levels are associated with a decreased
risk of heart disease. Supplements in animals inhibit the
development of a variety of tumors and enhance immune function.
Because of its role as a hormone precursor, I recommend that
people take DHEA if they have low blood levels, as is so common
in the elderly. The typical dose for women is 5 to 10 mg,
and for men it is from 25 to 50 mg.
In addition to the important lifestyle changes I mentioned
in May, almost all dietary supplements can help slow the aging
process and provide protection from degenerative diseases.
Consumption of healthy levels of fruits and vegetables
is appallingly low in the United States. Even after the big
campaign to encourage people to eat up to 9 servings a day,
starting in 1990, the numbers of people who ate a mere five
servings a day increased from a paltry 19.0% to a measly 22.7%
in the six succeeding years (with no recent increase). Both
numbers are extremely low.
An even worse finding is that obese people actually reduced
their already low consumption of these healthy foods. Consumption
by sedentary people stayed the same. These are just the people
who need to eat more healthy foods and fewer fatty, rich,
sweet desserts and animal products if they are going to improve
their health and weight.
Evidence continues to mount that there is a serious association
between mental state and physical disease. It has been known
that depression is linked to deaths and recurrent heart attacks
in people who already have heart disease. In a recent study,
depression was associated with the development of heart disease.
In both men and women, the risk of new heart disease was
over 70 percent greater in depressed patients than in non-depressed
patients. This demonstrates the importance of both treating
depression and preventing heart disease.
Regular exercise and a healthy diet often help to relieve
depression (and, not coincidentally, also help with heart
disease), and a number of dietary supplements are also beneficial.
Vitamin B3 (niacin), vitamin C, St. John's wort, and 5-HTP
may help in mild to moderate depression.
The typical dose of St. John's wort is 300 mg of standardized
extract three times a day.For 5-HTP it is 50 to 100 mg twice
a day. Both of these influence serotonin levels in the brain
and are extremely safe, although St. John's wort might cause
sun sensitivity in some people and it might interact with
some medicationsdon't take it with other antidepressants
without medical advice. (Melatonin, mentioned in the article
on aging can also help with depression.)
Recommendations for heart disease include a high-fiber, mostly-vegetarian
diet and aerobic exercise. Supplement with vitamins C and
E, B-complex, coenzyme Q10, and omega-3 oils, as well as magnesium,
L-carnitine, and a variety of flavonoids.
I just returned from a medical conference and was exposed
to an increasingly common phenomenonacademic researchers
who present scientific studies on "alternative medicine."
Dr. Paul Ridker's presentation showed that cholesterol in
the blood is not the best predictor of heart disease. He confirmed
that blockage of the arteries is an inflammatory process,
not just fatty deposits. However, free-radical damage and
inflammation of the arteries may be caused in part by oxidized
fats. You can reduce these risks through lifestyle change
and dietary supplements.
He showed that one of the best tests to predict heart disease
is a "high-sensitivity CRP" test, now available
at testing labs. The CRP, or C-reactive protein, is an old
test for inflammation, but the new high-sensitivity test,
when combined with the cholesterol/HDL ratio, is probably
the best choice for evaluation of heart disease risk.
As heart disease involves the inflammatory process, it is
beneficial to take anti-inflammatory supplements. These include
vitamin C (4000 mg daily) and several botanicals, including
curcumin from turmeric, bromelain from pineapple, and ginger
extract, plus many others.
You also want to improve your blood lipid ratios with exercise,
diet, garlic, and vitamin E. In addition, a new study shows
that niacin raises the level of good cholesterol (HDL) better
than a common drug called gemfibrozil. It's also better than
the drug for the other lipid levels. The doses ranged from
1500 to 2000 mg daily.
A new study shows that ginseng can help diabetics and
normal subjects metabolize sugar. When given a sugar drink,
those people who had been given a dose of ginseng 40 minutes
earlier handled the sugar better and cleared it from their
systems more quickly than those given a placebo. (When the
ginseng was given at the same time as the sugar drink, only
the diabetics benefited. I usually recommend 200 to 400 mg
of standardized extract twice a day. (Arch Intern Med 2000
A new review article concludes that Ginkgo biloba
is valuable for traumatic brain injury (reducing the edema,
inflammation, and free-radical toxicity, and improving memory
and cognitive function), Alzheimer's disease, stroke, hardening
of the arteries to the brain, macular degeneration, and normal
aging (see the lead article in this issue). (Arch Phys Med
Rehabil 2000 May;81(5):668-78.)
Diet and Disease
Yet another study shows that meat consumption increases
your risk of disease. An Italian team reviewed the relationship
of red meat to cancer. Three groups were analyzed: high, moderate,
and low meat consumption. Those in the highest meat consumption
group had significantly increased odds of getting cancer of
the stomach, colon, rectum, pancreas, bladder, breast, uterus,
and ovaries. (Int J Cancer 2000 May 1;86(3):425-8.) Add this
information to the considerable evidence of a protective role
for fruits, vegetables, whole grains, and legumes, and it
becomes clear what the best diet is for overall health.
I advise against adding refined sugar to the diet,
but one reader asked me about the use of artificial sweeteners.
I recommend avoiding them, whether it is aspartame (Nutra-Sweet,
Equal), saccharin (Sweet 'n Low), or acesulfame. Aspartame
causes neurological problems in many people.Saccharin is suspected
of causing cancer in humans (we know it does in rats). The
National Toxicology Program just took it off the list of carcinogens,
but they are ignoring important evidence. In addition, none
of these artificial ingredients have ever been shown to help
with weight loss or diabetes, for which many people take them.
You will be healthier with very small amounts of natural sweeteners.
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