Nutritional Supplements: Has the Fringe Become the Cutting Edge?

Just a few years ago, doctors were telling their patients that multivitamins were a waste of time and money and that you could get all the nutrients you need from your diet. In the June 2002 issue of The Journal of the American Medical Association, the AMA reversed its long-standing anti-vitamin policy and began advising all adults to take at least one multivitamin pill each day. What was once considered fringe medicine or quackery has now become cutting edge medicine.

It is estimated that over 80% of Americans do not eat at least five helpings of fruits and vegetables a day, the recommended minimum amount believed to provide sufficient essential nutrients. Humans don’t make their own vitamins and minerals, except for some Vitamin D, and we must get them from outside sources to prevent degenerative disease.

There is also growing concern that the recommended daily allowances of vitamins and minerals, or the RDA, are set too low. RDAs were originally established to prevent the symptoms of vitamin deficiency disorders, not to prevent disease itself. The National Academy of Sciences is now looking at its recommendations based on the new evidence that has been released.

We now know that vitamins, minerals and herbs can prevent and treat degenerative diseases such as macular degeneration, cancer, osteoporosis, heart disease, and birth defects just to name a few. In this chapter we will discuss specific vitamins, minerals and other supplements that are proving to be effective in the battle against AMD.

The Age-Related Eye Disease Study (AREDS)

For years, cutting edge eye doctors have been recommending antioxidants for AMD patients, many times enduring criticism from their fellow doctors who are entrenched in orthodox medicine. That all changed in October 2001 when the National Institutes of Health and the National Eye Institute released the results of The Age-Related Eye Disease Study which conclusively stated that patients with extensive AMD could benefit from certain high doses of antioxidants and minerals. While the study was not complete in terms of evaluating all of the possible nutrients that can help AMD, it did come out with findings that 25-27 percent of patients with advanced AMD could preserve their vision and prevent further vision loss by taking specific antioxidants plus zinc. The study did not evaluate the effect of nutritional supplements on those with early or moderate stages of AMD, which in the author’s opinion is the group that stands to benefit the most from nutritional therapy.

The study used the following formula:

Beta Carotene - 15 mg
Vitamin C - 500 mg
Vitamin E - 400 IU
Zinc - 80 mg

Zinc can, at high doses, cause anemia in some patients as well as exacerbate the symptoms associated with Alzheimer‘s. As will be demonstrated later in this chapter, it may be prudent to cut back on the amount of Zinc from the amount used in the controlled study.

Nevertheless, the point is that mainstream medicine is now waking up to the fact that nutritional therapy should be included as part of every patient’s treatment when they have AMD. According to Paul A. Sieving, M.D., Ph.D., Director of the NEI, “This is an exciting discovery because, for people at high risk for developing advanced AMD, these nutrients are the first effective treatment to slow the progression of the disease.” Frederick Ferris, M.D., Director of Clinical Research at NEI and Chairman of the AREDS said, “The AREDS formula is the first demonstrated treatment for people at high risk for developing advanced AMD.”

The Antioxidant-Zinc Recommendation For AMD

Vitamins should generally be taken in a combination or multivitamin formula whenever possible. The reason for this is that vitamins and minerals work synergistically with one another for better absorption and assimilation. So instead of taking a Vitamin A capsule and a separate Vitamin C pill, a multivitamin with adequate doses of each is preferable. Furthermore, capsules are preferred over tablets because evidence indicates that they are easier to absorb and assimilate than tablets.

BETA-CAROTENE / VITAMIN A

Beta-carotene is a substance made from plants that the body can convert into Vitamin A. It also acts as an antioxidant, an immune system booster, helps cells reproduce normally, protects the photoreceptors against free radicals, and enhances night vision. Other members of the carotene family are beta-carotene’s cousins, zeaxanthin, lutein, and lycopene. However, unlike beta-carotene, most of these nutrients do not convert to significant amounts of Vitamin A.

Beta-carotene does not cause any side effects; however, excessive intake may sometimes give the skin a yellow-orange hue. Several years ago there was a study published showing that beta-carotene could increase the risk of lung cancer by 35% in those individuals who smoked. This is not true of the pure form of Vitamin A however. While otherwise harmless, it may be prudent for smoker’s to stay away from beta-carotene and stick with Vitamin A. Better yet, stop smoking!

Recommended Dosage:

Beta-Carotene: 15 - 25 mg per day (or)
Vitamin A: 5,000 - 10,000 IU per day

VITAMIN C

Vitamin C is a water-soluble vitamin that functions as a powerful antioxidant. It is critical to make collagen, the glue that strengthens many parts of the body, such as blood vessels. Vitamin C also plays an important role in wound healing. This vitamin also aids in the formation of liver bile and helps to fight viruses and detoxify alcohol and other toxic substances.

Natural sources for Vitamin C are broccoli, red peppers, Brussels sprouts, parsley, citrus fruit and strawberries.

Recommended Dosage:

Vitamin C: 500 - 1,000 mg per day

VITAMIN E

Vitamin E is a powerful antioxidant that protects cell membranes and other fat-soluble parts of the body. In addition to Vitamin E’s benefit for the eyes, two studies published in the New England Journal of Medicine show that both men and women who supplement with at least 100 IU of vitamin E per day for at least two years have a 37–41% drop in the risk of heart disease.

Natural sources of Vitamin E are wheat germ oil, nuts, seeds, vegetable oils, whole grains, egg yolks, and leafy green vegetables. However, the high levels found in supplements, over 100 IU per day, are not obtainable from eating food.

Recommended Dosage:

Vitamin E: 200 IU per day

ZINC

Zinc is a component of more than 300 enzymes that are needed to repair wounds, maintain fertility, synthesize protein, help cells reproduce, preserve vision, boost immunity and protect against free radicals, among other functions. The average diet frequently provides less than the recommended daily allowance for zinc. Zinc deficiencies are more common in alcoholics and individuals with sickle cell anemia, and chronic kidney disease.

Good sources of zinc include oysters, meat, eggs, seafood, black-eyed peas, tofu, and wheat germ.

Also, zinc can inhibit copper absorption, however this is typically not a concern since most supplements include copper in the formulation.

Recommended Dosage:

Zinc: 20 - 70 mg per day

Other Supplements For Macular Degeneration

LUTEIN

Lutein (loo-teen) is a carotenoid found in vegetables and fruits. Lutein acts as an antioxidant, protecting cells against the damaging effects of free radicals. Chances are you're not getting the lutein you need because most Americans simply don't eat enough vegetables rich in lutein. A recent survey of eye doctors indicated that 91% believe that lutein promotes eye health and can be beneficial in treating AMD. A recent study sponsored by the National Institutes of Health found that people who ate the highest amounts of leafy green vegetables like kale, collard greens, and spinach had a 57% lower risk of developing AMD than those who ate these foods the least. In an AMD study published in the Journal of the American Optometric Association, it was shown that a diet rich in spinach may help stop AMD and even reverse some of the effects of the disease.

Nutritional supplements are a beneficial alternative for those people who cannot get nutrients directly from fruits and vegetables. The recommended daily dosage is a minimum of 6 mg for prevention and maintenance and 20 mg per day for therapeutic use. Nutritional studies show the average person consumes less than 1 mg of lutein per day. Subsequently, supplements are a sensible answer.

One thing that you must be careful of is being mislead into thinking that you are getting an adequate amount of lutein from the heavily advertised popular multivitamins that tout they include lutein. Most of them only have 250 mcg of lutein, which less than 5% of the recommended daily dosage. There are 1000 mcg in 1 mg, so 250 mcg is only one quarter of 1 mg. Remember, 6 mg is the “minimum” recommended dosage.

Recommended Dosage:

Lutein : 6 - 20 mg per day

TAURINE

Taurine is an amino acid found naturally in egg whites, meat, fish, and milk. High concentrations are found in the heart muscle, white blood cells, skeletal muscle, and central nervous system. In the retina there are two binding proteins specific to taurine. Intracellular concentrations are higher in the retina than in any other region derived from the central nervous system.

Taurine plays a role in the process of rhodopsin regeneration necessary for night vision. It is essential to the retinal pigment epithelium and the photoreceptors where it is found at levels ten times higher than other amino acids. Taurine helps to protect the cell membranes from oxidative attack. It helps transport nutrients across cell membranes, acts as a catalyst to retinal cells that remove cellular debris and assists in the elimination of potentially toxic substances. Taurine in combination with retinol protects lipids twice as much as retinol by itself. Taurine also protects the rod outer segment lipids during exposure to cyclic light.

Several studies have shown definite correlations between taurine deficiency and retinal degenerations. Taurine deficiency is often associated with an imbalance of intestinal flora, commonly called “leaky gut” and inhibits taurine absorption. Taurine levels can also be lowered by overgrowth of candida, physical or emotional stress, and excessive consumption of alcohol. The drugs chlorpromazine (a tranquilizer) and chloroquine (an anti-inflammatory agent and anti-malarial) also inhibit the uptake of taurine and have been known to cause retinal damage with prolonged or excessive dosage.

Recommended Dosage:

Taurine (or L-Taurine): 400 - 500 mg per day

DHA (DocosaHexanoic Acid) Essential Omega-3 Fatty Acids

Is it really possible that eating more fat is the key to better health? Several years ago the following headline was in one of the medical journals “Canned Tuna Reduces Risk of AMD.” The headline was obviously a bit sensational, but it caught my attention and I investigated further. In a study from Australia it was determined that a higher frequency of fatty fish consumption was associated with decreased incidence of advanced cases of AMD. Yes, fish consumption actually seemed to prevent or slow down the disease. What subsequent studies have found is that there is a direct correlation between the consumption of certain species of fish high in DHA and a reduced incidence of AMD.

We have known for some time that Omega-3 Fatty Acids are critical in the development of the retina and in brain tissue. DHA is typically found in cold water or fatty fish, such as tuna, salmon, and mackerel. To get adequate amounts of DHA, an individual should consume 3 - 4 servings of these fish each week. Since this can be difficult for many people, especially those who don‘t like fish, supplementation is advised.

It is interesting to note that DHA has recently been approved by the FDA as a supplement for baby formula. Studies show advanced neurological development and more mature retinal function in those children who were either breast fed (breast milk contains DHA naturally) or those who were fed formula with the DHA supplement. It has also been reported that DHA can prevent or reverse heart disease, diabetes, neurological disorders, and cancer. Bottom line, DHA is a critical nutritional supplement to add to your supplement war chest.

Recommended Dosage:

DHA: 500 - 1000 mg per day

GINKGO BILOBA EXTRACT

Ginkgo Biloba is a tree that lives as long as 1,000 years and grows to a height of 120 feet. It is the world’s oldest living tree species as it can be traced back more than 200 million years. The medicinal use of Ginkgo Biloba can be traced back to China in 2800 B.C. Ginkgo Biloba Extract are is among the leading prescription medicines used in Europe and it is backed by more than 400 scientific studies.

Clinical studies have shown Ginkgo Biloba Extract (GBE) to be effective for macular degeneration as well as diabetic retinopathy. In addition, GBE is being explored as a therapy for Alzheimer’s Disease. It is believed that GBE may help reverse or delay mental deterioration during the early stages of Alzheimer’s and may help the patient maintain a normal life and avoid life in a nursing home.

As we will learn in the next chapter, every cell in the body has an electrical charge that is maintained by a pump that transports potassium in and sodium out of the cell. GBE has been shown to enhance the activity of this pump, leading to a better electrical charge. This effect is particularly important in excitable tissues, such as the photoreceptors of the eye.

Recommended Dosage:

Ginkgo Biloba Extract (GBE): 120 mg per day

As medical science continues to embrace nutritional therapy, research will undoubtedly find additional nutritional supplements and herbal remedies that are beneficial in treating AMD.

Eye On Nutrition™ Dietary Risk Assessment

Since it can be challenging to know if and how much of these nutrients your diet is providing, the American Optometric Association provides an online dietary risk assessment at no charge. The assessment is based on the latest published scientific research on nutrition and age-related eye disease and is adapted from the National Cancer Institute's Diet History Questionnaire, which uses nutrient intake data from both the U.S. Department of Agriculture and the University of Minnesota's Nutrition Data System for Research. Eye on Nutrition™ was created as a user-friendly tool to help patients and optometrists talk about nutrition and other risk factors for AMD.

You can access the Eye On Nutrition™ Dietary Risk Assessment through the American Optometric Association’s website at: www.aoa.org.

This simple quiz, which will take about 20 minutes, will help you find out if your diet is 20/20 and what you can do to help protect your eyes from AMD.

As we close out this article, let’s review our nutritional supplement and herbal remedy recommendations:

Beta-Carotene: 15 - 20 mg per day (or) Vitamin A: 5,000 - 10,000 IU per day

Vitamin C: 500 - 1,000 mg per day

Vitamin E: 200 IU per day

Zinc: 20 - 70 mg per day

Lutein: 6 - 20 mg per day

Taurine: 400 - 500 mg per day

DHA: 500 - 1000 mg per day

Ginkgo Biloba Extract: 120 mg per day

Dr. Edward Paul
http://www.DrEdwardPaul.com