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Published by Ballantine Books:

THE PDR® FAMILY GUIDE TO OVER-THE-COUNTERDRUGS™

THE PDR® FAMILY GUIDE ENCYCLOPEDIA OFMEDICAL CARE™

THE PDR® FAMILY GUIDE TO COMMONAILMENTS™

THE PDR® FAMILY GUIDE TO NATURAL MEDICINESAND HEALING THERAPIES™

THE PDR® FAMILY GUIDE TO NUTRITIONALSUPPLEMENTS™

pdr_0345433769_3p_fm_r1.qxd 9/28/01 8:24 Page iv

THE PDR®

FAMILY GUIDE

TO NUTRITIONALSUPPLEMENTS™

BALLANTINE BOOKS • NEW YORK

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Sale of this book without a front cover may be unauthorized. If this book iscoverless, it may have been reported to the publisher as “unsold or destroyed”and neither the author nor the publisher may have received payment for it.

A Ballantine BookPublished by The Ballantine Publishing GroupCopyright © 2001 by Medical Economics Company, Inc.

All rights reserved under International and Pan-American Copyright Conven-tions. Published in the United States by The Ballantine Publishing Group, a di-vision of Random House, Inc., New York, and simultaneously in Canada byRandom House of Canada Limited, Toronto.

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Family Guide to Prescription Drugs®, The PDR® Family Guide to Women’sHealth and Prescription Drugs®, and The PDR® Family Guide to Nutrition andHealth® are registered trademarks used herein under license. PDR for Oph-thalmic Medicines™, PDR for Nonprescription Drugs and Dietary Supple-ments™, PDR Companion Guide™, PDR Pharmacopoeia™ Pocket DosingGuide, PDR® for Herbal Medicines™, PDR® for Nutritional Supplements™,PDR® Medical Dictionary™, PDR® Nurse’s Drug Handbook™, PDR® Nurse’sDictionary™, The PDR® Family Guide Encyclopedia of Medical Care™, ThePDR® Family Guide to Natural Medicines and Healing Therapies™, The PDR® Family Guide to Common Ailments™, The PDR® Family Guide toOver-the-Counter Drugs™, The PDR® Family Guide to Nutritional Supple-ments™, and PDR® Electronic Library™ are trademarks used herein under license.

Officers of Thomson Healthcare: Chief Executive Officer: Michael Tansey;Chief Operating Officer: Richard Noble; Chief Financial Officer and ExecutiveVice President, Finance: Paul Hilger; Executive Vice President, Directory Ser-vices: Paul Walsh; Senior Vice President, Planning and Business Development:William Gole; Vice President, Human Resources: Pamela M. Bilash

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Contents

Contributors and Consultants ixPublisher’s Note xiForeword: The Promises and Pitfalls

of Dietary Supplements xiii

Nutritional Supplements

vii

Alginates 1Androstenedione 4Arabinogalactan 8Arginine 10Arginine Pyroglutamate 14Aspartic Acid 17Bee Pollen 20Bee Propolis 23Beta-Glucan 26Bifidobacterium Bifidum 29Bioflavonoids 32Bone Meal 37Branched-Chain Amino

Acids 41Brewer’s Yeast 44Caprylic Acid 46Carnitine 49Carnosine 53Cartilage (Shark and Other) 56CDP-Choline (Cytidine

Diphosphate Choline) 60Chitosan 63Choline 66

Chondroitin 70Chromium Picolinate 73Coenzyme Q10 76Colloidal Silver 79Colostrum 83Conjugated Linoleic

Acid 87Creatine 89Cysteine 92Desiccated Liver 95DHEA

(Dehydroepiandrosterone) 98

Digestive Enzymes 101DMAE

(Dimethylaminoethanol) 105

DMG (Dimethylglycine) 109Dolomite 112Fish Oil 116Flaxseed Oil 119Fructo-Oligosaccharides

(FOS) 122

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GABA (Gamma-Aminobutyric Acid) 124

Gelatin 128Germanium 131GLA (Gamma-

Linolenic Acid) 135Glandular Extracts 139Glucosamine 143Glutamine 146Glutathione 149Glycine 152Glycosaminoglycans

(GAGs) 155Grape Seed Extract 159Histidine 161HMB (Hydroxy-

methylbutyrate) 164Inosine 167Inositol 169Ipriflavone 172Lactobacillus 176Lecithin 180Lipoic Acid 183Lutein 186Lycopene 189Lysine 193Malate 196Melatonin 198Methionine 201MSM (Methyl Sulfonyl

Methane) 204NADH (Nicotinamide

Adenine Dinucleotide) 207Omega-3 Fatty Acids 210Ornithine 213Oscillococcinum 216PABA (Para-Aminobenzoic

Acid) 220

Pantethine 223Pectin 227Perilla Oil 230Phenylalanine 233Phosphatidylcholine 237Phytoestrogens 240Phytosterols 244Potassium

Glycerophosphate 247Pregnenolone 251Proline 255PS (Phosphatidylserine) 258Pycnogenol 261Pyroglutamate 264Pyruvate 267Red Yeast Rice 270Ribose 273RNA (Ribonucleic Acid) 275Royal Jelly 278SAMe

(S-Adenosylmethionine) 281Soy Isoflavones 285Soy Protein 289Spirulina 293Streptococcus

Thermophilus 296Sulforaphane 300Taurine 304TMG (Trimethylglycine) 307Tryptophan 310Tyrosine 314Vinpocetine 318Wheat Germ 321Whey 324

Usage Index 329

CONTENTS viii

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The PDR® Family Guideto Nutritional Supplements™

Contributors and Consultants

Editor-in-Chief: David W. Sifton

Medical Advisors: Richard Galbraith, M.D., Ph.D.,Professor of Medicine, the University of Vermont Col-lege of Medicine; Naomi K. Fukagawa, M.D., Ph.D., As-sociate Professor of Medicine, the University of VermontCollege of Medicine

Senior Associate Editors: Janette V. Carlucci; LoriMurray

Assistant Editor: Gwynned L. Kelly

Writers: Nancy K. Bannon; Brenda L. Becker; Paul L.Cerrato; Kris Hallam; Ami Havens; Judith K. Lud-wig, Ph.D.; Lisa A. Maher; Cynthia H. Starr, M.S., R.Ph.;Marissa J. Ventura

Medical Economics Company

Executive Vice President, Directory Services: PaulWalsh

Vice President, Clinical Communications and NewBusiness Development: Mukesh Mehta, R.Ph.

Vice President, Sales and Marketing: Dikran N.Barsamian

Director of Trade Sales: Bill Gaffney

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Publisher’s Note

The PDR® Family Guide to Nutritional Supplements™ isthe product of an extensive review of the relevant litera-ture. Nevertheless, it’s important to remember that itmerely summarizes and synthesizes key data from the underlying reports, and of necessity includes neither everypublished report nor every recorded fact. Observationsregarding the effectiveness of the nutritional supplementsdiscussed in this book are based on the preponderance ofcurrent evidence and are neither conclusive nor final. Thepublisher does not warrant that a nutritional supplementwill provide any of the effects claimed for it. Likewise, thepublisher does not guarantee that every possible hazard,adverse effect, contraindication, precaution, or conse-quence of overdose is included in the summaries pre-sented here. All dosage recommendations cited in the textare those of the supplement’s suppliers and other advo-cates, and not those of the publisher. The publisher hasperformed no independent verification of the data re-ported herein, and expressly disclaims responsibility forany error. All information is presented without guaran-tees by the authors, consultants, and publisher, who dis-claim all liability in connection with its use.

xi

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It should be understood that by making this materialavailable, the publisher is not advocating the use of anysubstance described herein. Inclusion of a substance doesnot signify an endorsement by the publisher; absence of asubstance does not imply rejection. Please rememberthat in the United States, nutritional supplements andherbal products must be in compliance with the DietarySupplement Health and Education Act of 1994, whichstipulates that they may not be marketed for the diag-nosis, treatment, cure, or prevention of any disease. Theprofiles in this book do not discuss claims made for anyspecific proprietary dietary supplement. They merely re-port general findings on generic nutrients and botanicals.

This book is intended only as a reference for use in anongoing partnership between doctor and patient in thecomprehensive management of the patient’s health. It isnot a substitute for a doctor’s professional judgment,and it serves only as a guide to the many options and is-sues that may bear discussion. All readers are urged toconsult with a physician before undertaking any form ofself-diagnosis or self-treatment with nutritional, herbal,and other over-the-counter remedies.

PUBLISHER’S NOTE xii

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Foreword:The Promises and Pitfallsof Dietary Supplements

There’s no question about it: Better food is good medi-cine. As scientists learn more and more about the potentnutrients that lace our everyday diet, they’re discoveringunsuspected benefits that sometimes rival the impact ofprescription drugs.

Welcome to the exciting new world of “designerfoods” and “nutraceuticals.” Here you’ll find a host ofnatural substances that promise to boost immunity, fendoff cancer, sharpen memory, and lift depression. Thereare “phytosterols” to bring down your cholesterol,“probiotics” to improve your digestion, and “phyto-estrogens” to relieve the symptoms of menopause. A va-riety of oils, acids, and enzymes offer protection for yourheart. And to build muscle and renew energy, a stag-gering array of “ergogenic aids” await you with a bevyof alluring claims.

But note this carefully: Too often in the world of nu-tritional supplements, the operative word is “claim.”While the evidence in favor of certain substances con-tinues to mount, the effectiveness of others remains

xiii

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totally unverified. Every product has an appealing theo-retical rationale, but for many, that’s where the story ends.Either tests have failed to detect any benefit or—moreoften than not—no reliable tests have been conducted.

Products that haven’t undergone adequate testing posean especially difficult dilemma. On one hand, claimsmade for such products could be totally genuine. On theother, they might be completely bogus. Without the kindof exhaustive clinical trials that medical authorities andsmart consumers demand today, it’s impossible to tell—and no one can say for certain whether such products areworth trying or not.

Because many nutritional supplements hold truly greatpromise, this book endeavors to steer a middle course,describing each product’s potential benefits whether con-clusively proven or not, but clearly distinguishing be-tween claims that scientists consider valid and those thatare still regarded as theoretical. When a substance flat-out doesn’t work, we’ll tell you. Most of the time, how-ever, you’ll find that the scientific evidence remains inlimbo—neither conclusively pro nor absolutely con.

In the end, it’s up to you and your doctor to decidewhat’s worth a try. But choose thoughtfully, and re-member that in the realm of nutritional supplements it’sespecially important for the buyer to beware. In thisbook, we’ve summarized special cautions to take witheach specific supplement. No matter what the product,however, always keep the following general do’s anddon’ts in mind.

FOREWORD xiv

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Do choose a supplier you trustNutritional supplements are not subject to regulation bythe U.S. Food and Drug Administration, so they’re notroutinely checked for purity and potency. When privateconsumer watchdog groups do a spot check, they some-times find that the products contain little or none of theactive ingredients they claim.

Worse yet, when buying from an unreliable source,you also run the risk of contamination. In the late 1980s,contaminated batches of the usually harmless aminoacid tryptophan killed more than 30 people. Even aseemingly innocuous product such as bone meal maycontain unhealthy levels of lead, and supplements re-fined from animal sources, such as desiccated liver, couldbe laced with growth hormones and antibiotics. Whenchoosing any supplement, stick with established manu-facturers that have a reputable name.

Don’t rely on supplements to replace existing therapyAlthough there’s little doubt that certain nutritional sup-plements can boost immune function, protect the heart,and relieve a wide variety of specific ailments, in mostcases they work best as an adjunct to traditional treat-ments. For instance, although coenzyme Q10 may helpboost cardiac function, patients with congestive heartfailure would be in for an unpleasant surprise if they at-tempted to use it in place of their regular prescriptionmedication. Likewise, someone with HIV may benefitfrom certain supplements, but it would be suicide to usethem instead of regular AIDS drugs.

xv FOREWORD

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Do avoid virtually all supplements during pregnancyAside from a handful of vitamins—such as folic acid—that are known to be important during pregnancy, virtu-ally no dietary supplements have been tested for safetywhen used during this critical period. Taken in reasonableamounts, many are probably harmless—but we don’tknow this for sure. Since anyone can live without thesesupplements for a matter of months, there’s no reason toexpose the baby to even the slight possibility of risk that asupplement may harbor.

Don’t assume that if a little is good, a lot is betterEven supplements as common as vitamins A and D canbe poisonous in large doses. Phosphorus is essential for healthy bones, but too much can actually promotebone loss. Likewise, amino acids, the building blocks ofprotein, are needed to maintain all the body’s tissues, butexcessive amounts won’t build extra muscle and couldoverburden the kidneys and liver, doing more harm thangood. And while many researchers think that smallamounts of phytoestrogen might protect against cancer,they’re beginning to suspect that large doses could havethe opposite effect.

The key is balance. When using supplements, re-member that the goal is to fine-tune your body chemistry,not reorganize it. Nutrients interact in unexpected ways,so that an increase in one may demand a compensatoryincrease in another. Similarly, hormones affect eachother in complex ways that can lead to unforeseen conse-quences. Use moderation, and be careful to follow yourdoctor’s recommendations.

FOREWORD xvi

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Do remember that “natural” isn’t necessarily safeSome of history’s most celebrated poisons—hemlock,nightshade, and wormwood—are entirely natural. Na-tural substances such as bee pollen and bee propolis canharbor unpleasant natural contaminants. And, as we’veseen, natural everyday nutrients may have unwantedside effects when taken in unnatural amounts.

In any event, many “natural” products are distinctlyartificial. Some are synthetic versions of the real thing.Others are so highly refined that they act more like drugsthan like food—possibly with greater benefits, but alsowith greater risks. Never assume a product is benign justbecause it’s labeled “natural.”

Don’t go to the health food store instead of a doctorYes, the right supplements may relieve specific ailments,but first you need to be certain of the problem. Thehuman body is so complex that even doctors havetrouble diagnosing many ailments. And lacking the nec-essary knowledge and tests, it’s a sure thing that youwon’t be able to diagnose yourself. If you try, it’s all toolikely that you’ll wind up taking the wrong supplementfor the wrong reason, while your underlying conditiongets worse.

On the other hand, once you know what’s wrong, don’thesitate to take full advantage of what nutritional sci-ence has revealed. The right nutrients, in the rightamounts, really can improve your health and fend offdisease. Some of the supplements described in this bookmay be a disappointment—and some may be virtually

xvii FOREWORD

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useless—but many others can be expected to deliver ontheir promise. There’s no reason to delay. Get to workwith your doctor to get the most out of them and the restof your diet.

FOREWORD xviii

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Alginates

Why People Take ThemDerived from brown seaweeds, these substances are asurprisingly common part of the American diet. Thefood industry uses them as a thickening, stabilizing, orgelling agent in foods such as ice cream, pudding, andsalad dressings. As food additives, they are rated “gener-ally recognized as safe” by the U.S. Food and Drug Administration.

In the health care industry, dentists use Alginates tocreate dental impressions. Alginates are also reportedlyuseful for removing toxins such as lead from the body.And, for some time, these compounds have been used aswound dressings because of their ability to absorb excessfluid from the wound while keeping the wound itselfmoist. (But whether this type of dressing actually pro-motes healing is a subject of continued debate.)

As medicines, Alginates are used primarily for relief ofindigestion and heartburn, taken alone or in combina-tion with antacids. There is some evidence to supporttheir value as a heartburn remedy. At least one clinicalstudy has found that an Alginate liquid reduced thenumber of attacks of acid backflow (reflux) that leads to

1

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heartburn. (But the study also found that, when refluxdid occur, the Alginate did not shorten its duration.)

Another study found greater improvement in symp-toms of gastroesophageal reflux disease (GERD) amongpeople treated with Alginate than among those treatedwith the prescription drug Propulsid (a heartburnremedy that was recently taken off the market due to po-tentially dangerous interactions with other drugs). How-ever, a third study found that treatment with yet anotherprescription drug—namely, omeprazole (Prilosec)—wasmore effective in relieving symptoms of GERD than anantacid/Alginate combination.

A variety of other claims have been made for Algi-nates. They are being investigated as a possible cancerpreventive. They are being studied for their role in treat-ing diabetes, stimulating the growth of human skin cells,and immobilizing cells for transplantation purposes. Thepossibility that they can boost the immune system is alsobeing examined. To date, however, none of these poten-tial benefits has been conclusively verified.

What They Are; How They WorkAlginates are a form of indigestible polysaccharide (fiber).There are various types, all derived from the salts of al-ginic acid; they include ammonium alginate, calcium alginate, potassium alginate, and sodium alginate.

Their “healing power” comes from their ability to ab-sorb fluids and to form a gel. In the treatment of gastro-esophageal reflux, for example, Alginates are believed toform a foamlike layer that floats on the surface of gastriccontents in the stomach and prevents the backflow ofthese contents into the esophagus.

ALGINATES 2

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Avoid if . . .Don’t take Alginates if you have an allergy to seaweed orare sensitive to iodine.

Special CautionsIn one study, Alginates were found to cause constipation,digestive difficulties, and weight gain. However, suchproblems are rare.

Possible Drug InteractionsAlginates may decrease intestinal absorption. For example, they could affect the absorption of other treat-ments for gastroesophageal reflux disorder such as rani-tidine (Tritec, Zantac) or cimetidine (Tagamet). If you’retaking these or any other drugs, it’s best to check withyour doctor before taking Alginates.

Special Information if You Are Pregnant or Breast-feedingAlthough there’s no reason to suspect a problem, the effectof Alginates on a developing baby has not been studied.It’s wise to check with your doctor before taking this orany other supplement while pregnant or breast-feeding.

Available Preparations and DosageAlginates are available in tablet, capsule, powder, andliquid form. Over-the-counter tablets containing Algi-nates are usually found in combinations with antacids.

Clinical studies involving liquid Alginate typically useddoses ranging from 10 to 20 milliliters. The recommendeddose for an antacid/Alginate tablet is two tablets con-taining 200 milligrams of alginic acid.

3 ALGINATES

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OverdosageNo information on overdosage is available.

Androstenedione

Why People Take ItWith a surge of publicity over the use of Androstene-dione (Andro) by popular athletes such as home run kingMark McGwire, sales of this trendy over-the-countersupplement have soared. Promoters of Andro claim thatit boosts testosterone levels—an appealing effect for ath-letes and bodybuilders who want increased muscle massand athletic endurance. There are also reports that it en-hances the sex drive and sexual performance.

However, the popularity of Andro, especially amongteenage athletes, has set off alarms in the medical com-munity. Concern over the safety of this hormonal pre-cursor has prompted increased scientific investigationand revealed some decidedly unwanted effects. While notillegal, the substance is now banned by the InternationalOlympic Committee, the National Football League, theNational Basketball Association, and the National Colle-giate Athletic Association for use by their athletes. Physi-cians argue that it is a powerful steroid and warn that its

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effects, especially in the long term, are not known andcould have a negative impact on health. Consequently,there are groups working to have it banned completely bythe U.S. Food and Drug Administration.

Bottom line: This product delivers results, but possiblymore than you bargained for. Until more is known aboutthe health risks associated with Androstenedione, use itonly with your doctor’s advice.

What It Is; How It WorksAndrostenedione is a naturally occurring hormone pre-cursor produced primarily in the testes of men. The bodyconverts Androstenedione into the male sex hormonetestosterone, which is responsible for male sexual char-acteristics such as facial hair, lower voice, and largermuscles. It is also produced in smaller amounts by theadrenal glands of both men and women. Testosterone isresponsible for muscle building and is part of a healthyhormonal balance in both sexes.

Promoters of synthetic over-the-counter Andro insistthat it is safe and that oral doses are converted directly toboost testosterone levels in the bloodstream, resulting in increased muscle strength and mass, and endurance.However, the evidence is mixed. One study did showthat 300 milligrams of Andro increased testosteronelevels in men, though it found the effect short-lived—nomore than three hours—because testosterone breaksdown quickly in the body, making high frequent dos-ing necessary for sustained results. But another studythat measured blood levels of testosterone and musclestrength and mass concluded that 300 milligrams of

5 ANDROSTENEDIONE

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Andro did not boost testosterone levels in males or pro-duce the muscle-building results that promoters promise.

Both research teams agreed, however, on one little-advertised effect: Regardless of its impact on testosterone,Androstenedione taken by men is converted into estra-diol, a powerful female hormone. Both studies showed anincrease in blood estrogen levels in the men who tookAndro. This may account for several unwelcome side ef-fects, including breast enlargement and lowered “goodcholesterol” in some Andro users, in addition to an in-creased risk of liver problems and pancreatic cancer.

Other questions loom over the safety and efficacy ofAndrostenedione. Doctors don’t know whether taking ex-cessive amounts of the supplement orally interferes withthe production or effects of naturally occurring testos-terone. In addition, there’s concern about the quality, pu-rity, and stability of over-the-counter Androstenedione,since dietary supplements are largely unregulated.

Avoid if . . .Women and children under the age of 18 should not takeAndrostenedione. Substances that work like steroids areknown to stunt growth in children, and women may de-velop decreased breast size, deepened voice, facial hairgrowth, and menstrual irregularities. Men should avoidAndro if they have prostate cancer or an elevated PSA(prostate-specific androgen) level. Increased testosteronelevels are associated with a greater risk of this cancer. Do not take Andro if you have a family history of anyhormone-related cancer.

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Special CautionsTreatment with some forms of testosterone can causeliver damage, and may lead to water retention and swell-ing in people with kidney, liver, or heart disease. If youhave one of these conditions, check with your doctor be-fore using Andro. Also consult your doctor if you havediabetes or any serious psychological condition. UseAndro with caution if you have acne; it can make thiscondition worse.

Possible Drug InteractionsDo not use Androstenedione in combination with steroidsor any other kind of hormone therapy. Such combinationsincrease the likelihood of side effects.

Special Information if You Are Pregnant or Breast-FeedingAll women should avoid Androstenedione, and that’sdoubly true for those who are pregnant or breast-feeding.Its potential hormonal effects could harm a develop-ing baby.

Available Preparations and DosageAndrostenedione is available in capsules, sublingual tab-lets, and sprays in strengths ranging from 50 milligramsto 250 milligrams. Most manufacturers recommend tak-ing from 50 milligrams to 300 milligrams prior to exer-cise. Andro use should be cycled: if you take Andro forfour to six weeks, follow it with a two-week break.

7 ANDROSTENEDIONE

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OverdosageThere’s no information on Andro overdose, but an ex-treme overdose of testosterone has been implicated in acase of stroke.

Arabinogalactan

Why People Take ItAdvocates of Arabinogalactan (also known as galacto-arabinan and larch gum) claim that it rivals the popularherb echinacea in its positive effects on the immunesystem. Arabinogalactan is said to help fight off infectiontwo ways. First, it is thought to promote the growth ofbeneficial bacteria in the gut. Second, it is said to stimu-late the activity of the body’s natural killer (NK) cells,agents of the immune system that attack and destroy cer-tain types of cancer cells and cells infected by viruses. Itsability to actually fend off disease has not, however, beentested in any sort of major clinical trial.

What It Is; How It WorksArabinogalactan is a naturally occurring carbohydratefound in many common foods, including carrots, lettuce,tomatoes, spinach, radishes, corn, wheat, red wine, sor-ghum, and coconut. (Not surprisingly, it’s also one of the

ANDROSTENEDIONE 8

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active ingredients in echinacea.) Commercially producedArabinogalactan is obtained from the sap of larch trees.Approved for use as a food additive by the FDA in the1960s, Arabinogalactan is often used as a stabilizer,thickener, and texturizer in such products as nonnutri-tive sweeteners, flavor bases, and pudding mixes.

Evidence suggests that consuming Arabinogalactansupports the growth of the beneficial bacteria—such asLactobacillus acidophilus and Bifidobacterium bifidum—that live in the human body and help promote good gastrointestinal health while increasing resistance to infec-tions. (See separate entries.) There’s some evidence thatfriendly bacteria may also normalize hormone levels, re-duce cholesterol levels, and protect against some forms ofcancer.

Experimental studies also indicate that Arabinoga-lactan may help inhibit bacteria from attaching to cells,slow the spread of tumor cells to the liver, and dramati-cally increase the activity of immune cells that destroyforeign invaders and cancer cells.

Avoid if . . .There are no known reasons to avoid this supplement.

Special CautionsNo side effects have been reported.

Possible Drug InteractionsNo interactions are known.

9 ARABINOGALACTAN

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Special Information if You Are Pregnant or Breast-FeedingThis common food additive has been deemed safe forpregnant and breast-feeding women.

Available Preparations and DosageNo standard dosage has been established. However,human studies conducted at several major U.S. universi-ties found increased immune cell growth with a dailydose of 1.5 grams of Arabinogalactan.

OverdosageNo information on overdose is available.

Arginine

Why People Take ItScientists discovered this amino acid—one of the rawmaterials of human protein—more than a century ago,but only recently has it become a popular dietary supple-ment. It is now being promoted as the “natural alterna-tive to Viagra,” a cure for erectile dysfunction. It has alsobeen advertised as a natural remedy for other effects ofaging if taken in doses larger than the body can produce.These sometimes extravagant claims remain largely un-

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proven. In particular, Arginine’s effect on erectile dys-function is questionable. It has been shown to be of somebenefit in tests on rats, but there have been no conclusivetrials in humans.

Claims have also been made for Arginine as a tumorretardant and immune system stimulant, beneficial tothose suffering from AIDS and other diseases that sup-press the immune system. And several recent scientificstudies suggest that Arginine may play a role in heart at-tack prevention by blocking the formation of plaque inarteries, widening blood vessels, and helping to preventplatelets from forming clots that block arteries.

Because Arginine promotes the production of growthhormone, some bodybuilders take it in the belief that itwill aid in the development of muscle bulk. Many experts,however, warn against adult use of growth hormone—orsubstances such as Arginine that stimulate its release.

What It Is; How It WorksArginine is classified as a “nonessential” amino acid be-cause, if it’s lacking in the diet, the body can usuallymanufacture the amount it needs. During periods ofgrowth, healing, or stress, however, the body may not beable to keep up with demand, and dietary sources be-come essential. Arginine is available in meat and dairyproducts, as well as cereals, whole wheat, brown rice,nuts, beans, and raisins.

In addition to its role in protein synthesis and produc-tion of growth hormone, Arginine contributes to immunecell maintenance, and makes up a significant percentageof collagen, one of the major building blocks of cartilage

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and bone. It also appears naturally in seminal fluid, sug-gesting to some proponents that it may be a factor insexual maturity, aiding sperm production and motility.This theoretical impact on male fertility adds to its appealas a potential remedy for sexual dysfunction.

The body requires Arginine for the production of ni-tric oxide, a compound whose importance to health hasonly recently been recognized. Nitric oxide is one of thefactors that control dilation of the blood vessels, and itmay play a role in discouraging the circulatory disordersthat often come with advancing age. Nitric oxide wasnamed Molecule of the Year in 1993 by the journal Sci-ence, and the scientists who discovered its cardiovas-cular benefits received the Nobel Prize for Physiology in 1998.

The effect of nitric oxide on blood vessels may helpsome people with high blood pressure. It’s also the basisfor claims that Arginine can relieve erectile dysfunction.And a shortage of nitric oxide is known to accompany at least one other medical problem: interstitial cystitis, a painful inflammation of the bladder. Studies indicatethat supplemental Arginine raises nitric oxide levels andcan relax bladder muscle spasms to help control the painfor some sufferers.

The body converts some of its Arginine into ornithine,another important amino acid (see separate entry). Or-nithine is necessary for proper immune system and liverfunction, helps rid the body of ammonia, and aids inliver regeneration.

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Avoid if . . .Children should not be given Arginine supplements dueto this amino acid’s impact on growth hormone levels.For the same reason, it should be avoided during preg-nancy and breast-feeding. Arginine supplements may reactivate latent herpes virus infections (both genitalherpes and cold sores); so if you have herpes it’s wise toavoid them.

Special CautionsGrowth hormone and substances that promote its release,such as Arginine, can aggravate diabetes; diabetics shoulduse them only under their doctor’s supervision. Argininemay worsen some types of psychosis. Some critics chargethat, while Arginine may retard the growth of some typesof tumors, it seems to promote the growth of others.

Possible Drug InteractionsDo not take Arginine supplements with drugs that dilatethe blood vessels, such as nitroglycerine or Viagra.

Special Information if You Are Pregnant or Breast-feedingBecause this amino acid activates growth hormone re-lease, it’s best to avoid Arginine supplements while preg-nant or nursing.

Available Preparations and DosageArginine is available as L-arginine (levo-rotatory form),which is produced by a fermentation process that sepa-rates it from other amino acids. It is also sold as ADNO(arginine-derived nitric oxide), and can be purchased incapsules combined with ornithine.

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Manufacturers typically suggest daily dosages of 2grams to improve male fertility and sexual performance,and 3 to 4 grams for the growth hormone effect. It is alsoavailable in some diet bars.

OverdosageLarge doses of Arginine may cause diarrhea, nausea,and, rarely, dizziness.

Arginine Pyroglutamate

Why People Take ItA modified form of the amino acid arginine (see separateentry), this nutritional supplement is used primarily bybodybuilders and people attempting to preserve theiryouth. Its popularity is based on the fact that, like argi-nine, it stimulates the release of human growth hormone.Enthusiasts believe this hormone can build muscle mass, improve endurance, and stave off old age. Unfor-tunately, there’s scant evidence to support this view.

Arginine Pyroglutamate suffuses brain tissue morereadily than regular arginine, so researchers have alsobeen testing it as a treatment for cognitive dysfunctionrelated to senility and alcoholism. To date, the resultshave been disappointing.

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What It Is; How It WorksArginine is one of the “nonessential” amino acids thatthe body can usually manufacture for itself when dietarysupplies are insufficient. Most people don’t need argininesupplements to prevent a deficiency. Extra supplies be-come necessary only under conditions of extreme physi-cal stress, such as major injury, surgery, or infection,when the body can’t keep up with demand.

Arginine plays a variety of important roles. It buildsprotein, supports immune cells, and provides raw mate-rial for the production of nitric oxide, a natural tonic forthe heart and blood vessels. It promotes the productionof several hormones, including insulin, prolactin, andhuman growth hormone, and it’s a key ingredient of col-lagen, one of the major building blocks of cartilage andbone. Because some arginine is converted into the aminoacid ornithine (see separate entry), which helps to rid thebody of ammonia and aids in liver regeneration, it alsosupports healthy liver function. Arginine Pyroglutamateis, in fact, often marketed in combination with ornithine,despite the fact that there is little to be gained from sucha combination.

Avoid if . . .Because Arginine Pyroglutamate may increase levels ofhuman growth hormone, it is not recommended for chil-dren and adolescents, who are still growing and, presum-ably, producing all the growth hormone they need. Itsimpact on growth hormone also makes it a bad choiceduring pregnancy and breast-feeding, and because someexperts fear that growth hormone may promote the

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growth of certain types of tumors, Arginine Pyrogluta-mate should also be avoided by anyone with a history ofor high risk for cancer.

Special CautionsDue to the effect of arginine on insulin secretion, Argi-nine Pyroglutamate may not be appropriate for peoplewith diabetes. Arginine supplements have also beenknown to trigger herpes outbreaks in infected indi-viduals, and should be completely avoided by anyonewith brain or ocular herpes. Arginine may also worsenschizophrenia.

Possible Drug InteractionsArginine Pyroglutamate can dramatically reduce the ef-fectiveness of barbiturates and some other sedatives usedin anesthesia. If you’re taking Arginine Pyroglutamate,check with your doctor before taking any drugs that af-fect the central nervous system.

Because arginine promotes dilated blood vessels, it’swise to avoid combining arginine products and prescrip-tion drugs with a similar effect, including nitroglycerin,Viagra, and some blood pressure medications. Avoid sup-plements of the amino acid lysine as well, since it cancelssome of arginine’s effects.

Special Information if You Are Pregnant or Breast-feedingDue to its stimulating effect on growth hormone, Argi-nine Pyroglutamate is not recommended during preg-nancy or breast-feeding.

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Available Preparations and DosageArginine Pyroglutamate is available in tablet and capsuleform, typically in strengths of 400 milligrams. Althoughthere are no established dosages for this supplement,suppliers recommend between 2 and 8 tablets daily.

OverdosageEven large doses of amino acids are generally nontoxic.However, excessive doses of arginine have been reportedto cause diarrhea, nausea, and dizziness.

Aspartic Acid

Why People Take ItA beneficiary of the fitness craze, Aspartic Acid is one ofthe many amino acid compounds that bodybuilders taketo improve performance, increase stamina, and minimizepostexercise fatigue.

Some proponents also claim that Aspartic Acid helpspromote mental alertness and suggest that it can combatchronic fatigue, depression, heart failure, irregular heart-beat, infertility, and toxemia. However, more clinicalstudies are needed to determine precisely what role, ifany, Aspartic Acid should play as a dietary supplementfor regular use.

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What It Is; How It WorksAlso known as aminosuccinic acid, asparagic acid, as-paraginic acid, and aspartate, Aspartic Acid is one of the“nonessential” amino acids that the body can manufac-ture if they’re lacking in the diet. Few Americans arelikely to suffer a dietary deficiency of this amino acid,since it’s found in a wide variety of animals and plants, in-cluding sugarcane, sugar beets, molasses, brewer’s yeast,whole grains, dairy products, eggs, meat, fish, nuts, seeds,and beans.

Aspartic Acid plays an important role in carbohydratemetabolism and protein metabolism. It helps reduceblood ammonia levels after exercise—thus lessening fatigue—and serves as a carrier molecule for the trans-port of magnesium and potassium in your cells. By com-bining with other amino acids to form molecules thatabsorb toxins and remove them from the bloodstream,Aspartic Acid may help protect the liver and aid cellfunction. It’s also involved in the production of DNAand RNA, the compounds that carry and transmit thegenetic code.

Advocates of Aspartic Acid have proposed it as a treat-ment for depression because it is one of the major ex-citatory (stimulating) chemical messengers in the brain.Aspartic Acid levels are frequently decreased in peoplewith unipolar depression and brain atrophy, and may beincreased in those with seizures and strokes.

Aspartic Acid is the key raw material from which as-partame, the low-calorie artificial sweetener, is manufac-tured. Perhaps not coincidentally, some researchers haveobserved seizures and abnormally high levels of neuro-

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transmitters after feeding laboratory animals massivedoses of aspartame. (Used in normal amounts, however,the sweetener is harmless.) Aspartic Acid is also an ingre-dient in detergents, fungicides, and germicides.

Avoid if . . .Because of its many potential effects, Aspartic Acid shouldbe used only by healthy adults, for short periods—a fewweeks at a time. If you have an existing medical condition,use only under your doctor’s supervision. Children shouldnot be given Aspartic Acid without a doctor’s supervision.

Special CautionsCheck with your doctor before taking Aspartic Acid ifyou have any medical problems.

Possible Drug InteractionsNo interactions have been reported.

Special Information if You Are Pregnant or Breast-feedingAspartic Acid is not recommended for use by pregnantor breast-feeding women without a doctor’s supervision.

Available Preparations and DosageCurrently, Aspartic Acid is used in high doses. Propo-nents suggest 2 to 4 grams a day for short periods, undera doctor’s supervision.

OverdosageToxic levels have not been established, and there is no in-formation on the effects of an overdose.

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Bee Pollen

Why People Take ItPollen extracts have been used for many years to detect allergies, but it is only during the past few yearsthat Bee Pollen has gained popularity as a nutritionalsupplement.

Promoted as an energy booster and general tonic forbetter health, vitality, and happiness, it does in fact con-tain vitamins, minerals, sugar, protein, and fat—but notin exceptional quantities. For instance, claims that it isan outstanding source of protein are, to say the least, ex-aggerated. Despite its extravagant cost per pound, it’s nobetter than a variety of common sources.

Some athletes take Bee Pollen in the belief that it in-creases their strength, endurance, energy, and speed. It’ssaid to help the body recover from exercise by returningbreathing and heart rate to normal and improving en-durance for repeat exertion. It is also promoted as ametabolic booster, to increase the speed at which caloriesare burned and eliminate excess weight. Unfortunately,scientific tests have failed to detect any improvement inperformance due to Bee Pollen.

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Reports that Bee Pollen slows the aging process andincreases longevity also appear unduly optimistic. Thebelief is based on the long lives of an isolated clan ofmountain people who, when studied closely, didn’t ap-pear to consume any Bee Pollen whatsoever.

A variety of other claims seem equally baseless. BeePollen has been promoted as a remedy for weakness,anemia, neurasthenia, brain damage, cerebral hemor-rhage, indigestion, enteritis, colitis, and constipation, butstudies confirming its effectiveness for such problems areconspicuously absent. Likewise, its use as a remedy for al-lergies seems debatable. Although it’s said to reduce pro-duction of the histamine involved in allergic reactions, ithas in fact caused allergic reactions in some individuals.

What, then, is Bee Pollen good for? Studies conductedin Sweden and Japan seem to indicate that it might be ofvalue in treating chronic prostate problems. And an Aus-trian report claims that it’s useful in alleviating the symp-toms of radiation sickness in patients treated for cervicalcancer. However, all such isolated studies require furtherconfirmation.

What It Is; How It WorksPollen consists of microspores, the male reproductive ele-ments of seed-bearing plants. Although the “Bee Pollen”label on many commercial supplements implies that itwas collected from various plants by honeybees, that maynot necessarily be the case. While a trap does exist thatbrushes off and collects the pollen carried on the backlegs of bees as they reenter the hive, there’s no way to de-termine whether a particular pollen grain was collected inthis way or not.

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Although the constituents of pollen vary greatly, de-pending on the originating plant species, season of theyear, and harvest methods, Bee Pollen typically containsa broad spectrum of nutrients. Promoters say that thevegetable protein in the product includes at least 18amino acids (and all 8 essential amino acids). The pollenis also said to contain more than a dozen vitamins in-cluding B complex, A, C, D, and E; 28 minerals; 11enzymes and coenzymes; and 11 carbohydrates.

Although this sounds impressive, an ordinary bal-anced diet provides all these nutrients and more—whilesparing you from the insect eggs and droppings, fungi,and bacteria that often contaminate pollen. Remember,too, that while any of the nutrients in these products mayindeed have therapeutic value when taken individually inpurified form, when mixed together in pollen they haveyet to exhibit any clinically proven benefits.

Avoid if . . .Avoid all bee products if you’re allergic to bee stings.

Special CautionsIf you have seasonal allergies, keep in mind that pollencan trigger an allergic reaction whether inhaled or eaten.The possibility of any therapeutic benefit you might re-ceive from pollen could be more than outweighed by thedanger of a serious reaction. Especially for people with aheart condition or a serious infection, experiments withpollen are not worth the risk.

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Possible Drug InteractionsNo information on interactions is available.

Special Information if You Are Pregnant or Breast-feedingNo specific information is available. However, it’s wiseto check with your doctor before taking any supplementwhile pregnant or breast-feeding.

Available Preparations and DosageBee Pollen is available in granule form, and in capsulesand tablets ranging from 500 to 1,000 milligrams. Manu-facturer’s dosage recommendations vary. One typicaldosage of granules is 32 grams.


Bee Propolis

Why People Take ItTherapeutic properties have been ascribed to Bee Propolissince the dawn of medicine, when Hippocrates recordedits effectiveness in healing wounds. The ancient Romansand Egyptians revered the bee, and commonly consumed

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Propolis both as a remedy and for its health benefits. To-day advocates recommend taking it internally as a healthenhancer or applying it externally for skin disorders.

Those who favor the use of Propolis as a dietary supplement call it nature’s antibiotic. And, indeed, thesubstance does exhibit some anti-inflammatory, antibac-terial, antiviral, and antifungal effects in lab tests andtrials in small animals. Its effectiveness in humans, how-ever, has yet to be verified.

What It Is; How It WorksBee Propolis starts out as tree resin, the waxy coat thatprotects new tree growth. Bees harvest the resin andcombine it with their own secretions to produce a darkgluelike substance that is used in the building and repairof the hive. Bees coat each cell of the hive with a layer ofPropolis to protect the contents against invading micro-organisms and other environmental threats to the healthof the hive.

Laboratory analysis shows that Propolis is half madeup of resins gathered from various trees and other plants,with the rest a mixture of beeswax, oils, and pollen. Itcontains amino acids, enzymes, vitamins, and minerals.Advocates suggest that it may provide protective effectsfor humans in much the same way it guards the health ofthe hive. They report that it shows the ability to preventthe growth of certain microbes in laboratory cultures, in-cluding influenza and herpes viruses and some bacteriaresponsible for upper respiratory infections.

Propolis is also rich in flavonoids (pigments that givecolor to plants), which are known for their antioxidant

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effects. Flavonoids were discovered in the middle of thetwentieth century, and by later decades researchers hadfound that they not only play a role in the prevention ofcell damage from oxidation, but also tend to promotenutrient absorption, support the immune system, and re-duce inflammation.

This array of purported beneficial properties promptssome advocates to suggest that Propolis could proveuseful in the treatment of heart disease, high blood pres-sure, arthritis, and asthma. Some also recommend it forstomach ulcers, burns, acne, herpes, and certain diseasesof the eyes, mouth, and throat. At this point, however, itsmedicinal value must still be considered theoretical.

Avoid if . . .Do not use Bee Propolis if you have a history of allergicreaction to bee stings or bee products.

Special CautionsSome people are highly allergic to bee products. Makeyour first dose of Bee Propolis very small, and be alert forwarning signs of an allergy. If a rash or swelling develops,stop using the product. If you feel faint or have difficultybreathing, seek emergency attention immediately.

Possible Drug InteractionsNo interactions have been reported. Because Bee Propolisis often used in combination with other herbs and minerals, be sure you know all the ingredients in thepreparation.

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Special Information if You Are Pregnant or Breast-feedingNo harmful effects are known. However, it’s best tocheck with your doctor before taking any supplementduring this critical period.

Available Preparations and DosageThere are no guidelines for taking Bee Propolis. Manu-facturers generally recommend 750 milligrams daily, di-vided into smaller doses. The supplement can be taken in tablet, capsule, tincture, or lozenge form. Propolis isalso available in tinctures, sprays, and ointments for ex-ternal use.


Beta-Glucan

Why People Take ItBeta-Glucan has prompted medical research on severalfronts. In Japan and China, doctors have found thatBeta-Glucan derived from certain mushrooms can ex-tend the survival of patients with some cancers, whileminimizing symptoms caused by the cancer itself or thetoxic therapies used to treat the disease. (Indeed, in

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Japan two forms of this substance—namely, lentinanand schizophyllan—have been approved for clinical usein the treatment of cancer patients.) However, there is noevidence that Beta-Glucan supplements can prevent thedevelopment of tumors.

Meanwhile, in 1997, the U.S. Food and Drug Admin-istration singled out Beta-Glucan in the soluble fiber ofwhole oats as the compound responsible for loweringlevels of “bad” LDL cholesterol. (However, even thoughthe FDA acknowledged that Beta-Glucan from othersources—such as Beta-Glucan supplements—might havea similar effect, it said that more evidence was needed be-fore such products could be considered effective.)

In addition, laboratory and animal studies have de-termined that Beta-Glucan can protect against certainviruses and bacteria. This finding has led Beta-Glucan’smore enthusiastic advocates to suggest that the supple-ment can benefit all people whose immune systems havebeen compromised—people with HIV/AIDS and thoseunder physical or emotional stress, for example. Manyproponents recommend taking daily doses of Beta-Glucanto ward off infection and repair and rejuvenate the skin.However, the supplement’s anti-infective properties havenot been proven in humans, and little research exists tosupport immune-boosting claims.

What It Is; How It WorksBeta-Glucan is a polysaccharide (a complex carbo-hydrate) found in the cell walls of plants, fungi, and certainbacteria. Over-the-counter Beta-Glucan supplements aretypically derived from yeast or mushrooms.

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Beta-Glucan’s effect on the immune system remains tobe clarified. However, one prominent theory suggeststhat it boosts immunity by binding to the body’s macro-phages, the white blood cells that seek and destroy for-eign invaders such as bacteria and viruses. Once thisbinding occurs, it is thought that the immune system’sother weapons—including natural killer cells, neutro-phils, and cytokines—will spring into action.

Avoid if . . .Researchers have yet to uncover any toxic effects. How-ever, if you are allergic to yeast, you might want to approach some Beta-Glucan supplements with caution.Products derived from Saccharomyces cerevisiae, alsoknown as baker’s yeast, may not be purified enough toprevent a reaction.

Special CautionsBeta-Glucan derived from Coriolus versicolor, a mush-room, has been known to produce the occasional dark-ening of the fingernails in cancer patients—the onlysignificant side effect to date.

Possible Drug InteractionsNo drug interactions are known.

Special Information if You Are Pregnant or Breast-feedingNo information is available on the effect of Beta-Glucanduring pregnancy or breast-feeding. Check with yourdoctor before using it during this critical period.

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Available Preparations and DosageBeta-Glucan is available in capsule, tablet, powder, andliquid form. (The supplement is also an ingredient in somecreams and cosmetics.) Preparations range in strengthfrom 1 to 500 milligrams.

Most clinical trials of Beta-Glucan for cancer therapyinvolved doses of 3 grams daily.


Bifidobacterium Bifidum

Why People Take ItJust mention the word “bacteria” to most people, andthey think “disease.” But not all bacteria are bad for you.A variety of “good” bacteria are permanent tenants inthe human body and help maintain its health. Collec-tively, these friendly bacteria are known as probiotics(which means “for health”).

Bifidobacterium bifidum (B. bifidum), together withother probiotics—including B. longum, Lactobacillusacidophilus, L. bulgaricus, L. sporogenese, and Strepto-coccus thermophilus—work together with the body’s

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own defenses to promote good digestive health and in-crease resistance to infections. There’s also at least someevidence to suggest that these beneficial bacteria maynormalize hormone levels, reduce cholesterol, and pro-tect against some forms of cancer.

What It Is; How It WorksIn the healthy human being, colonies of B. bifidum typi-cally inhabit the vagina and the lower part of the smallintestine, where they synthesize B vitamins (thiamin, ri-boflavin, pyridoxine) and vitamin K, decrease the pH—thereby increasing the acidity—of the intestines to levelsthat discourage harmful bacteria, and produce sub-stances that suppress their growth.

Unfortunately, good bacteria can easily be killed byantibiotics or overrun by harmful bacteria from foodand the environment. There is strong evidence that thenumbers and efficiency of these bacteria decline as weage. And people eating a poor diet or suffering from diar-rhea can loose millions of probiotics. The absence ofthese bacteria enables harmful germs to grow out of con-trol, causing all sorts of health problems, from yeast infection to constipation.

The good news is that there are a number of ways—from diet to supplements—to ensure that you maintainan optimal level of beneficial bacteria, including B. bi-fidum. In addition to eating a healthful diet (low in re-fined sugars and high in fresh fruits and vegetables), youmay want to increase the amount of yogurt in your diet.Choose nonfat or lowfat yogurt with live, active cultures.

If you’re interested in using a supplement, consider one

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that combines several types of probiotics (for example,Lactobacillus plus Bifidobacterium) and read the label toensure that the manufacturer guarantees potency and stability. Most formulas need to be refrigerated. Yoursupplement should also contain fructo-oligosaccharides(FOS), a nonnutritive sugar that serves as a source of en-ergy for B. bifidum.

Avoid if . . .B. bifidum appears to be safe for all ages and genders.

Special CautionsMost experts advise against taking probiotics continu-ously. Instead, they recommend reserving them for shortcourses to repopulate the colon with friendly flora afterantibiotic therapy, to treat intestinal yeast overgrowth,or to stave off infectious diarrhea when you are travelingin underdeveloped countries.

B. bifidum has no serious side effects. When you firststart taking any probiotics, you may notice an increase ingassiness or bloating (a sign that the good bacteria arefermenting). Don’t worry. Within a week or two, yourbody will adjust to the change.


Special Information if You Are Pregnant or Breast-feedingB. bifidum is generally considered safe during pregnancyand breast-feeding. (In breast-fed infants, in fact, Bifi-dobacterium may account for 90 to 100 percent of thetotal population of friendly bacteria.)

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Available Preparations and DosageB. bifidum supplements typically come in capsule, liquid,or powder form. “Probiotic” formulations contain from2 to 12 billion cells per daily dosage. “Multinutrient”formulas usually have a lower cell content: from 250million to 2 billion cells.

While counts of 300 to 500 million cells have beenshown to be clinically effective, some authorities haveclaimed as many as 1 billion bacteria are necessary for aneffective daily dose. A typical regimen might involve 3 capsules daily, half an hour before meals, or 1 table-spoon of liquid half an hour before meals. Because for-mulations vary, follow the supplier’s directions.

OverdosageEven in large doses, probiotics don’t appear to have anyharmful effects.

Bioflavonoids

Why People Take ThemBioflavonoids, a diverse group of plant-based chemicalcompounds, have been used historically to treat a varietyof conditions, including rheumatic fever, polio, mis-

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carriage, excessive bleeding in childbirth or menstrua-tion, rheumatoid arthritis, gum disease, diabetic retinitis,macular degeneration, and cataracts. They were isolatedin the 1930s by Dr. Albert Szent-Györgi, the Hungarianscientist who won the Nobel Prize in Medicine for dis-covering vitamin C. He found that Bioflavonoids in-crease that vitamin’s effectiveness.

Although Bioflavonoids were frequently prescribed bydoctors for the next three decades, all Bioflavonoid drugproducts were pulled off the market by the Food andDrug Administration in 1968, following a finding thatthey were ineffective for treating any medical conditionsin humans. The FDA did nothing to prevent Bioflavo-noids from being sold as food supplements, however,and they have continued to be available, usually in com-bination with vitamin C.

Recently, Bioflavonoids have regained some of theirmid-twentieth-century popularity. Clinical research stud-ies in humans have shown that substances contained inBioflavonoids may be helpful in treating varicose veinsand easy bruising, and certain eye conditions as well. ABioflavonoid substance found in extracts of both grapeseed (see separate entry) and pine bark may also play arole in preventing heart disease and stroke.

The association of Bioflavonoids with vitamin C hasled to claims that they can help to ward off colds andtreat flu. It is also claimed that they play a role, either di-rectly or indirectly through vitamin C, in maintaining thehealth of the collagen that helps to bind human cells, tissues, and cartilage. Some claim that it may there-fore have some effect on the pain, bumps, and bruises

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commonly caused by athletic injuries. However, there’slittle scientific evidence to support these claims.

Certain individual Bioflavonoids have commanded aflurry of interest recently. Proponents of green tea as ahealth remedy claim that the Bioflavonoid polyphenols it contains have anticancer, antioxidant, antibacterial,and antiviral properties. However, these compounds arefound not just in green tea, but in all plants, and theirbeneficial effects in humans remain unproven.

Another Bioflavonoid, catechin, is under study as anallergy remedy. Advocates claim—without convincingevidence—that it also helps to protect the liver from theeffects of alcohol and helps cure people with hepatitis B.Similar claims are made for the Bioflavonoid quercetin.This compound is also said to be helpful in combatingthe effects of bursitis, arthritis, asthma, prostate prob-lems, and tissue trauma. Some think that it may decreasethe infectiousness of certain RNA and DNA viruses,such as herpes, polio, and Epstein-Barr. Unfortunately,all these possibilities are far from proven.

What They Are; How They WorkBioflavonoids can be found in a variety of fruits and vege-tables, where they provide much of the pigment that lendsthe plants their color. They usually accompany vitamin C,and have a positive effect on its absorption and process-ing. Among the more important Bioflavonoid compounds are hesperidin, nobeletin, rutin, sinensetin, tangeretin,quercetin, catechin, genistein, and citrus Bioflavonoids.

Advocates of Bioflavonoids claim that most of theirbenefits stem from their ability to increase the strength of

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the capillaries and to regulate their permeability, an ef-fect first noted by their discoverer, Dr. Szent-Györgi. Theeffect on capillary permeability is also the source ofclaims for the usefulness of Bioflavonoids in preventingstroke and eye diseases.

Some researchers believe that Bioflavonoids also haveantioxidant properties, mopping up the by-products ofmetabolism (free radicals) that often receive blame fortissue damage and the aging process. In particular, thepurported anticancer effects of green tea and especiallygrape seed extract are commonly ascribed to their anti-oxidant action.

Advocates also claim that some Bioflavonoids restrainthe activity of certain compounds that cause inflammationin the body, such as the histamines associated with allergyand a compound that causes cataracts. For example, it isthis property that is supposedly responsible for quercetin’seffectiveness against prostate inflammation.

Bioflavonoids are found in soybeans, citrus fruits, rootvegetables such as potatoes and onions, rose hips, blackcurrants, grapes, apricots, strawberries, cherries, plumsand prunes, buckwheat, green peppers, tomatoes, andnuts. Conservative nutritionists insist that Americans getenough Bioflavonoids in their everyday diet to meet theirneeds, and that supplements are unnecessary.

Avoid if . . .There are no known reasons to avoid ordinary amountsof Bioflavonoids.

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Special CautionsTest-tube research indicates that heavy doses of someBioflavonoids may cause genetic damage in the veryyoung and may be linked with leukemia in infants andchildren. Most adult leukemia involves a different sort ofgenetic damage and therefore Bioflavonoids are not as-sociated with its onset. Otherwise, Bioflavonoids haveno known toxicity.

Possible Drug InteractionsBioflavonoids are not known to have any adverse druginteractions.

Special Information if You Are Pregnant or Breast-feedingDue to their association with genetic damage, mega-doses of Bioflavonoids should be strictly avoided duringpregnancy.

Available Preparations and DosageThere is no official recommended dietary allowance forBioflavonoids. They are often included in vitamin C supplements, which provide many people with theirmain source of the compounds, and can be found inmany multivitamin supplements as well.

When they are taken as supplements apart from vi-tamin C, a typical dosage is 500 milligrams—including50 milligrams of rutin and 50 milligrams of hesperidin—taken 1 to 3 times daily. Supplements containing 125 or250 milligrams of Bioflavonoids are also available, andmay be taken on the same schedule.

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OverdosageBioflavonoids have no known overdose effects.

Bone Meal

Why People Take ItAs you might have guessed, Bone Meal is used primarilyas a calcium supplement. (Some makers also advertise it as a source of magnesium, vitamin D, phosphorus, andother minerals, and some preparations have other vita-mins added.)

Everyone knows that calcium is needed for strongbones and teeth. But it also aids in the transmission ofnerve impulses, and enables muscles—such as the heart—to relax and contract. It helps to maintain the body’s acidbalance, assists in the clotting process, strengthens cellmembranes, and aids in the passage of nutrients andother substances in and out of cells.

Depending on their age and gender, people need from1,000 to 1,300 milligrams of calcium daily—and manydon’t get enough. A shortage of calcium can cause musclecramps, brittle nails, eczema, aching joints, arthritis,heart palpitations, and numbness in the arms and legs.Over the long term, it can lead to internal bleeding, toothdecay, and the brittle-bone disease osteoporosis.

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Given the host of benefits that calcium confers, you’dthink that Bone Meal would be highly recommended. Actually, quite the opposite is true. The U.S. Food andDrug Administration and many other authorities stronglywarn against the use of Bone Meal. Why? Because in addition to a host of beneficial minerals, it often con-tains lead.

Lead is especially dangerous for children and pregnantwomen. Yet an analysis of 70 brands of calcium supple-ments found that about a quarter of them exceeded theFDA’s total allowable lead intake level for children aged6 and under. Bone Meal supplements were among thehighest in lead content.

What It Is; How It WorksBone Meal is simply animal bones, primarily beef bones,ground to a powder. A number of early health food ad-vocates assumed that Bone Meal would be a superiormineral supplement because animal bones have muchthe same composition as human bones. However, mostresearch shows that the calcium in Bone Meal is not wellabsorbed, and that a number of other over-the-countercalcium supplements are at least as good or better.

Actually, the best way to increase your calcium intakeis to add calcium-rich foods to your diet. Scientists saythat the body absorbs minerals obtained from food moreeffectively than it does minerals in supplement form. Thebest dietary sources of calcium are dairy foods, becausethey also contain vitamin D and lactose, which help thebody to absorb calcium. Salmon, sardines, and leafygreen vegetables are other good sources.

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If your diet still leaves you short of calcium and youwant to try Bone Meal as a natural supplement, read thelabel carefully. Some brands advertise that they are safebecause they are derived from the bones of speciallytreated calves raised in a chemical-free environment.Check, too, to see whether the product is imported. Con-cerns about bovine spongiform encephaly, the “mad cowdisease” that contaminated British beef in the 1990s maybe relevant here. Also make sure that the Bone Meal is labeled for human consumption, and not for pets orplants.

To check any calcium supplement for proper absorba-bility, drop a tablet into a container with 2 to 4 ounces ofvinegar and stir twice. After 30 minutes, the pill shouldhave completely dissolved or disintegrated into fine par-ticles. If not, change brands.

Avoid if . . .Anyone with cancer, hyperparathyroidism, sarcoidosis,or a tendency to develop kidney stones should take cal-cium supplements only under a doctor’s supervision.

Special CautionsThe body can generally tolerate up to 2,000 milligramsof calcium daily, although that’s more than it needs. Be-yond that, calcium can build up in the body in painfuldeposits. Early warning signs of calcium overload in-clude loss of appetite, constipation, dry mouth or ametallic taste in the mouth, headache, drowsiness, and afeeling of weakness or fatigue.

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Possible Drug InteractionsThere are no known specific drug interactions with BoneMeal. However, you may need extra magnesium and vi-tamin D to make optimal use of the calcium in BoneMeal. Remember, too, that calcium supplements shouldnot be taken at the same time as iron supplements. Cal-cium can interfere with the absorption of iron.

Special Information if You Are Pregnant or Breast-feedingDue to the possibility of contamination, it’s especiallyimportant to avoid Bone Meal while you’re pregnant orbreast-feeding.

Available Preparations and DosageFor proper absorption, the National Institutes of Healthrecommend that calcium intake be limited to 500 mil-ligrams per dose, and that doses be taken between meals.A number of manufacturers offer Bone Meal in tablet orpowder form, with recommendations of about 5 gramsper dose. Check the calcium content; 1,000 milligrams ofBone Meal provides significantly less than 1,000 mil-ligrams of calcium.

OverdosageA single massive dose of calcium is unlikely to cause se-rious problems, However, an overdose of the magnesiumin Bone Meal may cause diarrhea, and in extreme casescould lead to kidney failure.

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Branched-Chain Amino Acids

Why People Take ThemLike all amino acids, the three in the so-called branched-chain group are building blocks of protein. Fitness enthusiasts take them to build muscle. They say they reduce fatigue, permitting longer workouts. They also believe that these compounds minimize the amount of“muscle repair” needed after a strenuous workout. But,while there’s some evidence that Branch-Chain AminoAcids may in fact help restore muscle mass after surgeryor an injury, their value in bodybuilding has yet to be veri-fied in clinical trials.

What They Are; How They WorkThe three Branched-Chain Amino Acids—leucine, iso-leucine, and valine—are classified as “essential,” becausethe body is unable to manufacture them and they mustbe obtained from the diet. Each of these amino acidsplays a different role in the body:

Isoleucine serves as raw material for certain chemicalsused in the production of energy. It also contributes to

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the formation of oxygen-carrying hemoglobin and helpsregulate the body’s blood sugar levels. The estimated safeand adequate daily intake is about 6 milligrams perpound of body weight. Infants require more than threetimes that amount per pound of body weight; childrenrequire twice the adult amount.

Leucine is essential for growth. It boosts the productionof growth hormone and lowers elevated blood sugarlevels by stimulating insulin secretion. The estimatedsafe and adequate daily intake is about 9 milligrams perpound of body weight. Infants require almost five timesthat amount per pound of body weight; children requireapproximately twice the adult amount.

Valine, along with the other two in the group, is a con-stituent of most of the body’s proteins. The estimatedsafe and adequate daily intake is about 6 milligrams perpound of body weight. Infants require more than fourtimes that amount per pound of body weight; childrenrequire approximately twice the adult amount.

Branched-Chain Amino Acids are plentiful in most meatand dairy products, and most healthy adults get all theyneed from their diet. A deficiency of protein and aminoacids would be signaled by a loss of stamina, lowered re-sistance to infection, slow healing of wounds, weakness,and depression.

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Avoid if . . .High doses of amino acids lay an extra burden on theliver and kidneys. If you have a problem in either area,don’t take this product without your doctor’s approval.

Special CautionsFor adults, even large amounts of amino acids are un-likely to cause any side effects. However, some infantsare unable to process the Branched-Chain Amino Acidsproperly and develop a problem called “maple syrupurine disease.” The first sign of trouble is an odor ofmaple syrup from the child’s urine. Left untreated, thecondition can quickly lead to convulsions, coma, anddeath. Stringent dietary restrictions are needed to over-come the problem.

Possible Drug InteractionsNo drug interactions have been reported.

Special Information if You Are Pregnant or Breast-feedingScientists have not studied the effects of Branched-ChainAmino Acid supplements during pregnancy. Since youdon’t need these supplements to maintain good health,the safest course is to avoid them while pregnant orbreast-feeding.

Available Preparations and DosageCombinations of the three amino acids are available intablet form. For muscle building, suppliers typically rec-ommend 3 to 6 tablets, taken before meals and after aworkout.

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OverdosageNo information on overdosage with Branched-ChainAmino Acids is available. However, excessive leucine cancause low blood sugar and boost the body’s ammonialevels.

Brewer’s Yeast

Why People Take ItRich in B vitamins, amino acids, and chromium, Brewer’sYeast has long been recommended for maintaining thebody’s fitness and resistance. It’s used as a remedy forminor infections such as coughs and colds, sore throat,bronchitis, acne, and boils. It’s also taken for chronic in-digestion and poor appetite.

Because of its high chromium content, some research-ers feel it could prove helpful for diabetes, loweringblood sugar levels and reducing the need for insulin andoral diabetes drugs. Some studies indicate that the chro-mium in Brewer’s Yeast can also lower cholesterol levels.And, due to its impact on the immune system and thebacteria that inhabit the intestines, Brewer’s Yeast oftenproves helpful in cases of infectious diarrhea.

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What It Is; How It WorksBrewer’s Yeast is a powdered preparation of Saccha-romyces cerevisiae, a type of fungus employed in brewingbeer. It has been used since antiquity, in all probability,both for the preparation of alcoholic beverages and as amedication.

Brewer’s Yeast grows worldwide and is found exten-sively in the wild. It is, in fact, an independently livingplant, but was not recognized as such until the nine-teenth century. Its effectiveness as a health remedy wasfirst confirmed in 1886. Researchers have found that ithas antibacterial properties and that it promotes produc-tion of certain white blood cells.

Avoid if . . .People with severely weakened immune systems shouldavoid unsterilized Brewer’s Yeast. Contaminants in theproduct could cause infection.

Special CautionsIf you are prone to migraine headaches, use Brewer’sYeast with caution; it can trigger migraines in susceptiblepeople.

Large quantities of Brewer’s Yeast can cause gas. Insome people it prompts allergiclike reactions such asitching, skin eruptions, rashes, and swelling.

Possible Drug Interactions

Brewer’s Yeast can trigger an increase in blood pressure ifyou take it with a drug classified as a monoamine oxidase

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(MAO) inhibitor, such as the antidepressants Nardil andParnate and the Parkinson’s disease medication Eldepryl.

Special Information if You Are Pregnant or Breast-feedingNo harmful effects are known. However, it’s best tocheck with your doctor before taking any supplementduring this critical period.

Available Preparations and DosageBrewer’s Yeast is often taken in powder form, but is alsoavailable in tablets. Dosage recommendations range froma teaspoonful to 1 to 2 tablespoonfuls daily. Since potencymay vary, check the manufacturer’s recommendations.


Caprylic Acid

Why People Take ItCaprylic Acid supplements are often taken to increase orrebalance the “good” bacteria that live in the intestinaltract, and to fight yeast infections such as Candida albi-cans. However, the effectiveness of Caprylic Acid forthese purposes has yet to be established scientifically.

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A type of saturated fatty acid, Caprylic Acid is moreeasily digested and absorbed than some other varieties offat. As a result, an oil form of Caprylic Acid is sometimesused as a dietary supplement for individuals with dis-orders that interfere with the absorption of nutrients.

Recent studies suggest that Caprylic Acid may alsohave beneficial effects on high blood pressure, althoughscientists are not certain why.

What It Is; How It WorksCaprylic Acid occurs naturally in a number of foods, in-cluding butter and coconut oil. It’s also one of the fattyacids found in the oil of the saw palmetto berry, which isused as a natural remedy for prostate enlargement.

Caprylic Acid gets its name from goat’s milk, whichcontains it; the word “caprylic” comes from capparis,the Latin word for goat. Also known as octanoic acid,it’s known to increase the acidity in the bowel—an ac-tion that may have suggested its advocates’ claims of in-testinal benefits.

Caprylic Acid is often added to processed foods suchas baked goods, frozen dairy desserts, snack foods, andcandy. It’s also an ingredient in many soaps, lotions, andother cosmetic products. It softens the skin and has amild exfoliating effect that promotes the sloughing-off ofdead skin cells. It is considered gentle to sensitive skin.

Avoid if . . .Some experts recommend avoiding Caprylic Acid if youhave diabetes or an illness affecting the liver.

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Special CautionsLarge doses of Caprylic Acid can cause diarrhea. Supple-ment suppliers also caution that a few individuals takingCaprylic Acid may experience mild to severe fatigue,headaches, nausea, flulike aches, a generally ill feeling,itching, and hives.

Possible Drug InteractionsIf you are taking a drug for high blood pressure, checkwith your doctor before taking this supplement.

Special Information if You Are Pregnant or Breast-feedingResearchers have not studied the effects of this supple-ment during pregnancy. No harmful consequences areknown, but during this crucial period it’s wise to avoidany supplement that isn’t specifically recommended.

Available Preparations and DosageCaprylic Acid comes in capsule and tablet form, usuallyin strengths of 300 to 400 milligrams. Some capsules arecoated to prevent release of the ingredients until they’vereached the intestinal tract. A number of preparations in-clude a variety of herbs.

The suppliers’ dosage recommendations vary. Higherdoses are usually recommended if the problem is yeastinfection. The supplement is typically taken with meals 2 or 3 times per day.

OverdosageExcessive doses can cause stomach upset, nausea, and diar-rhea. Check with your doctor if you suspect an overdose.

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Carnitine

Why People Take ItCarnitine is one of the chemical workhorses of human me-tabolism. It helps the body transport fatty acids into tinystructures within cells called mitochondria, where thefatty acids are broken down for energy. Carnitine is foundin meat and dairy foods, but even vegetarians usually haveenough of it, because the human body can manufacture itsown supply. That hasn’t stopped proponents from toutingCarnitine supplements, usually in a form called levocar-nitine (or L-carnitine). Another form, called L-acetyl-carnitine, has been investigated for possible use in slowingthe progression of Alzheimer’s disease.

Carnitine is popular among bodybuilders, who say itboosts stamina and energy while helping weight loss.Advocates claim that it also promotes heart health (par-ticularly for people with congestive heart failure), boostsimmunity, and increases sperm quality to combat maleinfertility. Some of these claims are based on intriguingpreliminary research in animals and humans, but Carni-tine isn’t cheap, and there’s still not enough evidence tojustify recommendations for supplementation unless you

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have a medically diagnosed deficiency. However, Carni-tine does not appear to be harmful even at relatively highdoses.

What It Is; How it WorksSince Carnitine is plentiful in most people’s diets and canbe built by the body from the amino acids lysine and me-thionine, deficiencies are rare. When they do occur (usu-ally as a result of liver disease, kidney dialysis, or a geneticdisorder), they are treated with a high-grade prescriptionform of L-carnitine called Carnitor. L-carnitine is alsoavailable without prescription in health-food stores andvitamin shops.

None of the benefits claimed for Carnitine have beenevaluated by the Food and Drug Administration (FDA) or endorsed by any respected medical authority or organi-zation. The weakest claims are those related to muscle-building and endurance athletics. Carnitine was one of theso-called ergogenic aids whose usefulness was dismissedby the American Dietetic Association in a recent positionpaper, “Nutrition for Athletic Adults.” Although somebodybuilders and other athletes insist these supplementshelp them, the ADA states that such anecdotal reports are not supported by sufficient scientific evidence fromclinical trials, and may arise from nothing more than be-lief in the product (the “placebo effect”).

On the other hand, L-carnitine may have a genuinerole to play in the treatment of infertility—at least incases where either the cause is unknown after a thoroughworkup, or the cause is known to relate to a man’s lowsperm count or poor sperm motility (the sperm’s abilityto move). Seminal fluid has extremely high levels of

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carnitine, and clinical studies have shown that about 3 grams a day of L-carnitine combined with L-acetyl-carnitine, taken for up to six months, significantly in-creased sperm count and motility, with some impact onpregnancies achieved.

In people whose hearts have been weakened by an outright Carnitine deficiency, L-carnitine supplementsoften clear up the problem. Some research suggests thatL-carnitine may also help people with congestive heartfailure, though Carnitine is not a recognized treatmentfor this disorder in the United States.

In the form of L-acetyl-carnitine, Carnitine has alsoshown at least some promise as a treatment for Alz-heimer’s disease. In a few clinical trials, it seems to havedelayed the progression of the disease and temporarilyimproved mental performance. Doses used were at least500 milligrams 3 times per day.

Avoid if . . .While Carnitine may have minimal value for conditionsother than deficiency diseases and infertility, there is noknown reason, other than pregnancy, for avoiding it.

Special CautionsIf you have reason to suspect a Carnitine deficiency (suchas muscle weakness, fatigue, liver disease, or kidneyfailure), see your doctor for a laboratory test of yourCarnitine levels. He or she can prescribe a supplement ifnecessary. Don’t attempt to treat yourself with over-the-counter supplements. Your symptoms could be totallyunrelated to Carnitine deficiency.

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The L-carnitine supplements prescribed for a defi-ciency have been known to cause digestive upset (nausea,vomiting, abdominal cramps); large doses may cause di-arrhea. The use of L-carnitine has also occasionally beenassociated with body odor.

Possible Drug InteractionsThere are no reported significant drug interactions withL-carnitine.

Special Information if You Are Pregnant or Breast-feedingCarnitine is considered relatively safe in pregnancy. How-ever, since there’s no pressing need for it unless you have adeficiency, it’s best to avoid it—and all other unnecessarysupplements—when pregnant or breast-feeding.

Available Preparations and DosageNonprescription L-carnitine supplements in tablet or capsule form are available in strengths ranging from 250 to 1,000 milligrams. Supplements of L-acetyl-carnitine are available in 250- to 500-milligram strengths.Pharmaceutical-grade carnitine, a prescription drug, isavailable in tablet, liquid, or injectable form, for useunder a doctor’s supervision.

OverdosageAlthough large doses may cause unpleasant side effects,no life-threatening overdoses have been reported.

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Carnosine

Why People Take ItThis amino acid compound is often confused with thesound-alike substance carnitine. And in fact the two dohave more in common than their names. Both are fa-vored by bodybuilders, who take them in an effort toboost muscle energy, endurance, and strength, and bothare manufactured inside the body from a pair of aminoacids. There, however, the similarity ends.

Carnitine is a product of two “essential” amino acidsavailable only in the diet, while Carnosine is built fromtwo “nonessential” amino acids that the body itself canproduce. Carnitine seems to act primarily by expeditingthe conversion of fat into energy. Carnosine, on the otherhand, is an antioxidant that appears to have protectiveeffects on muscle tissue and the brain.

Bodybuilders value Carnosine for its ability to retardthe formation of lactic acid, the chemical that makesyour muscles sore after a hard workout. However, whileresearchers have verified this effect, they’ve produced noevidence that Carnosine supplements can improve per-formance, or can even increase the body’s own naturalstores.

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Carnosine’s antioxidant action remains largely unex-plored. Preliminary research hints at a variety of excitingpossibilities, though none have been confirmed in rigorousclinical trials. Lab experiments show that Carnosine helpsprotect the brain and may be useful for treating seizures,stroke, and Alzheimer’s disease. Proponents claim it couldalso play a role in controlling blood pressure, regulatingthe immune system, reducing inflammation, alleviating the complications of diabetes, and combating harden-ing of the arteries, among other things. In addition, animalstudies suggest that Carnosine might be helpful in thetreatment of cataracts and skin wounds. All such claims,however, remain unproven and await significant addi-tional research.

What It Is; How It WorksBuilt from the two nonessential amino acids histidineand alanine, Carnosine is both produced by the bodyand absorbed from the diet. The best source is meat—just a single serving of beef, pork, or chicken provides 50to 250 milligrams—but even strict vegetarians have anadequate supply, thanks to the body’s own contribution.

Carnosine carries out a variety of duties within thebody. In addition to counteracting the effects of lactic acidin the muscles, it appears to contribute to the activation ofthe muscle fibers. In the brain, it seems to prevent—andeven repair—some of the damage done by oxidation, pos-sibly reducing the buildup of waste proteins associatedwith conditions such as Alzheimer’s disease. However,whether supplemental Carnosine has any therapeutic ef-fect remains an open question.

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Avoid if . . .No long-term safety studies have been conducted in hu-mans; therefore, it’s not known if certain people shouldavoid Carnosine. So far, lab tests indicate that it is rela-tively safe.

Special CautionsLarge doses of some nonessential amino acids can causenausea, diarrhea, headache, and blood pressure changes.In general, however, even large amounts of amino acidsare unlikely to cause any severe reactions, and it’s notknown whether Carnosine supplements cause any prob-lems at all.

Before taking this supplement, it’s wise to check thesource. Researchers caution that synthetic Carnosine is sometimes made with toxic materials, including thepoisonous compound hydrazine. Buy only pure forms ofCarnosine, and check the label to make sure the manu-facturer uses formulas based on U.S. patents.

Possible Drug InteractionsIt is not known whether Carnosine interacts with medi-cations. If you take any medicine on a regular basis,check with your doctor before taking this supplement.

Special Information if You Are Pregnant or Breast-feedingThe effects of taking extra Carnosine during pregnancyand breast-feeding are unknown. Since it’s not needed tomaintain short-term health, it’s best to avoid using itduring this period.

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Available Preparations and DosageCarnosine is usually found in bodybuilding products orsupplements labeled as “performance enhancers.” Indi-vidual supplements are less common, with dosages vary-ing according to the manufacturer. Some recommendtaking Carnosine in several small doses throughout theday to maximize absorption. Follow the directions on thelabel and check with your doctor if you have any doubts.


Cartilage (Shark andOther)

Why People Take ItFor centuries, the Chinese have ascribed healthful prop-erties to shark cartilage, taking it in the form of shark finsoup. Today, preparations of cartilage from sharks andcows are sold by numerous companies as unregulatedover-the-counter dietary supplements.

Cartilage is promoted for the treatment of joint dis-eases such as osteoarthritis and other inflammatory conditions such as psoriasis. In addition, cartilage hasbecome a subject of research and controversy for its al-leged anticancer properties. Promoters of cartilage prod-

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ucts, claiming that “sharks don’t get cancer,” have takensome intriguing test-tube and animal studies of the sub-stance’s effect on cancer cells as a sign that it may helpprevent and treat cancer in humans.

Such claims are premature, to say the least. Sharks doget cancer (although less commonly than humans do),and shark or other cartilage has been evaluated as acancer treatment in very few well-conducted trials inhuman subjects.

The few clinical trials that have been published in re-spected medical journals have failed to show proof ofany significant benefit. However, shark cartilage has pro-voked enough legitimate scientific interest to warrantongoing cancer research. The National Cancer Instituteis currently sponsoring a study of liquid shark cartilageextract along with standard chemotherapy and radiationfor lung cancer patients. Unlike most previous trials ofcartilage products, this one is placebo-controlled (that is,divided into two groups of patients, some of whom takea dummy pill).

What It Is; How it WorksCartilage is a tough, translucent material found pri-marily in the joints. In sharks, cartilage forms most of theskeleton. The material is made up of almost half protein,along with carbohydrate (sugar) compounds and cal-cium. One possible active ingredient in cartilage is chon-droitin sulfate, a substance that has been shown inEuropean clinical research to help ease the pain and in-flammation of arthritis. (Chondroitin is also sold as a di-etary supplement, often in combination with another

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compound called glucosamine.) Despite promising re-sults with chondroitin, there is little evidence from clini-cal trials in humans that cartilage itself, in any form, iseffective against arthritis, psoriasis, or other inflamma-tory conditions.

Anticancer hopes for cartilage arose in the 1970s, whenseveral researchers reported that cartilage and other ma-terial from sharks might combat cancer in mice. Furtherstudies raised more questions than answers, particularlyabout the way shark cartilage might do its work. Hopecenters on its potential for “antiangiogenesis,” the abilityto curb the formation of blood vessels that nourish tu-mors and help them grow. Cartilage, which has no bloodsupply, was shown in 1983 to contain substances that in-hibit the growth of blood vessels in animal tumors.

Some scientists question whether the antiangiogenesiscompounds in cartilage can even be absorbed through thedigestive system into the human bloodstream at levelshigh enough to make a difference. Others have suggestedthat cartilage may deter cancer by inhibiting cell divisionor boosting the immune system. These claims, too, arebased largely on preliminary biochemical research, nottrials of actual cartilage products in people with cancer.

Avoid if . . .Shark cartilage products are generally costly, and there isscant evidence of their health benefits. The AmericanCancer Society recommends against using them as atreatment for cancer unless you are participating in anindependently monitored clinical trial using clinical-quality cartilage. (There are no standards for the purity,potency, or effectiveness of commercially available carti-

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lage supplements.) It would certainly be inadvisable touse cartilage products in place of standard medical treat-ment for cancer, arthritis, or any other condition.

Special CautionsCartilage rarely causes side effects. If any do occur, theyare likely to take the form of a bad aftertaste, nausea, in-digestion, excessive levels of calcium in the body, fever,and dizziness.

Since the effect of cartilage supplements on younggrowing bodies hasn’t been studied, they are not recom-mended for children.

Possible Drug InteractionsThere are no reports of dangerous interactions betweencartilage and any type of drug. Given the high levels ofcalcium in cartilage, it may be prudent to avoid com-bining cartilage products and high doses of calciumsupplements. As with any new medication, it’s wise toalert your doctor when you begin taking cartilage.

Special Information if You Are Pregnant or Breast-feedingNo information is available on the effect of shark carti-lage during pregnancy. Since its benefits are questionable,any risk to the developing baby can hardly be justified,and it should be avoided during both pregnancy andbreast-feeding.

Available Preparations and DosageShark cartilage is available in dozens of formulations, in-cluding capsules, tablets, powders, liquid extracts, en-emas, and injectable preparations. Suggested doses are

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relatively high; one major manufacturer recommends fiveto eight 750-milligram caplets a day.

OverdosageThe results of an overdose—if one is possible—are un-known. Given the high doses recommended to achieveeven the possibility of a therapeutic effect, overdosageseems an unlikely risk.

CDP-Choline (CytidineDiphosphate Choline)

Why People Take ItTouted as a stronger type of choline (see separate entry),CDP-Choline is said to offer many of the same benefits.Like choline, it may sharpen the memory and boostlearning—two effects that might help stall aging in thebrain. Also like choline, it promises to alleviate somemovement disorders. It has been tested in people whohave trouble carrying out voluntary movements such aswalking—people with Parkinson’s disease, for example.And it has also been studied as a treatment for involuntarymovements such as the continual chewing or writhingmotions (called tardive dyskinesia) occasionally triggeredby long-term use of antipsychotic drugs.

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Unfortunately, results to date have been less than spec-tacular. A number of studies have detected small improve-ments when people with Alzheimer’s disease, head injury,or tardive dyskinesia were treated with large doses of thesubstance. Minor benefits have also been observed instudies of people with multi-infarct dementia or stroke—examples of the cerebrovascular diseases that disruptblood circulation in the brain, robbing it of oxygen. Like-wise, some people with Parkinson’s disease have en-joyed small improvements in their symptoms when CDP-Choline was added to their regular drug regimen.On balance, though, experts agree that bigger and betterstudies are needed before CDP-Choline can win a passinggrade.

What It Is; How It WorksRoutinely present throughout the body, CDP-Choline is a necessary ingredient in the production of com-pounds known as phospholipids, especially the phos-pholipid known as phosphatidylcholine. (See separateentry for more on the use of this compound as a dietarysupplement.) In turn, phosphatidylcholine and otherphospholipids are used to manufacture cell membranes,the barriers protecting the intricate machinery that al-lows cells to function properly.

Some research suggests that CDP-Choline, like otherforms of choline, boosts production of acetylcholine, achemical messenger (neurotransmitter) that’s deficient inthe brains of people with Alzheimer’s disease. Similarly,CDP-Choline seems to enhance the action of dopa-mine, the neurotransmitter that’s lacking in people with

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Parkinson’s disease or tardive dyskinesia. Other studies indicate that the drug may somehow protect cell mem-branes or slow down damage when the brain is deprivedof oxygen, as it is in stroke. To some degree, CDP-Choline may also increase the circulation in the brain. Atthis point, however, all of these possible effects needmore research.

Avoid if . . .Because of its potential impact on neurotransmitters,check with your doctor before using CDP-Choline if yousuffer from bipolar disorder or Parkinson’s disease. Avoidthis product if you’re allergic to choline.

Special CautionsPeople in research studies have taken as much as 1,000milligrams of CDP-Choline per day without serious con-sequences. The most common complaints have been gastrointestinal reactions (nausea, vomiting, diarrhea,stomach pain), dizziness, headache, and fatigue. A smallnumber of people have suffered low blood pressure andchanges in heart rate after taking CDP-Choline.

Possible Drug InteractionsCDP-Choline could interfere with the action of drugsthat work by blocking the effect of acetylcholine (for ex-ample, the antinausea medication scopolamine). Checkwith your doctor if you’re not sure whether you’re tak-ing such a drug.

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Special Information if You Are Pregnant or Breast-feedingIt is best to avoid any unnecessary medication duringpregnancy and breast-feeding. Take only what has beenprescribed or recommended by your physician.

Available Preparations and DosageTypically, CDP-Choline is sold in capsule form instrengths of 200 to 250 milligrams. Follow directions onthe label and check with your doctor if you have anydoubts.


Chitosan

Why People Take ItChitosan (pronounced kite-o-san) is used primarily as adietary supplement to aid in weight-loss programs. Oncein the stomach, it is said to attract and bind the fat fromfood, thereby preventing the body from digesting, ab-sorbing, and storing it.

This product may also help to improve cholesterolprofiles by binding with the cholesterol-rich bile pro-duced by the liver, an action that prompts the liver to

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draw extra cholesterol out of the blood. By reducinglevels of “bad” LDL cholesterol and triglycerides, it mayhelp fend off heart disease.

Because it’s a type of fiber, it seems to speed elimina-tion of waste, toxins, and undigested fats from the body,thereby relieving constipation and perhaps helping totreat or prevent irritable bowel syndrome. The calcium it contains has also been advocated as a treatment forbowel disease, and even as a cancer preventive.

Chitosan is also purported to reduce blood levels ofuric acid, which causes gout. Some say it also promoteshealing of ulcers and lesions, has antibacterial proper-ties, fights yeast infections, acts as an antacid, relievesarthritis, and lowers blood pressure, though its practicalvalue for these purposes remains unproven.

What It Is; How It WorksChitosan is derived from chitin, a substance found inplankton and the shells of crustaceans such as shrimp,crab, and lobster. Like more traditional forms of fiber, itpasses through the body without being absorbed. Be-cause it absorbs water, it promotes a full feeling that maylead you to eat less. It also acts as a bulking agent andspeeds the transit time of the food we eat; this preventsundigested food and metabolic waste from creating toxicby-products.

Clinical trials have verified Chitosan’s weight-loss prop-erties, but only in conjunction with a low-calorie diet thatmight account for most of the improvement. Its ability toslightly reduce cholesterol levels has also been clinicallyconfirmed.

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Avoid if . . .Do not use Chitosan if you have an allergy or sensitivityto shellfish. Avoid all fiber supplements if you have anytype of intestinal obstruction.

Special CautionsBecause Chitosan absorbs water, it’s important to drink6 to 8 glasses per day. Chitosan also tends to bind fat-soluble vitamins, potentially depleting the body’s supply;so take a good-quality multivitamin supplement daily.

You might also want to consider supplementing the“friendly” intestinal bacteria Bifidobacterium bifidumand Lactobacillus, since Chitosan may reduce the naturalpopulation. Animal studies suggest that Chitosan maydecrease calcium absorption, so a calcium supplementmay be needed as well.

Possible Drug InteractionsAvoid taking medications or nutritional supplements atthe same time of day as Chitosan, since the Chitosan caninterfere with their absorption and utilization.

Special Information if You Are Pregnant or Breast-feedingAlthough no problems have surfaced, it’s best for womenwho are pregnant or breast-feeding to check with theirdoctor before using any fiber supplement.

Available Preparations and DosageThis supplement is generally taken in the form of capsulescontaining 250 to 500 milligrams of Chitosan. Manufac-turers typically recommend that you take 2 capsules 10 to

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30 minutes before each meal or before eating snacks highin fat.


Choline

Why People Take ItCholine is a vitaminlike compound that has recentlygained acceptance as an essential nutrient. Although thebody can produce a certain amount of Choline on itsown, a dietary deficiency can lead to liver and kidney dis-orders, high blood pressure, and heart disease.

Choline is one of the building blocks of acetylcholine, akey chemical messenger in the nervous system. This facthas led researchers to study it for a wide variety of neuro-logic disorders, including Huntington’s disease, Parkin-son’s disease, Alzheimer’s disease, and tardive dyskinesia.

Choline shows promise as a way to control moodswings and reduce memory loss. Increases in acetyl-choline in the brain seem to improve mood, alertness,and mental energy, while low levels are linked to depres-sion and lack of concentration. Many people who useCholine notice an improvement in overall disposition.

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Athletes who take Choline-based supplements reportgreater energy and less fatigue. And researchers havealso found that Choline boosts the mood of at least someAlzheimer’s patients. (Choline will not, however, cureAlzheimer’s, though it might play a role in staving it off.)

Choline is also reported to help prevent or treat liverdisorders such as cirrhosis, fatty liver, hepatitis, anddamage due to drugs or toxic substances. In addition, itmay confer some benefit to those with eczema, kidneyand gallbladder disorders, and bipolar disorder. It alsoappears to have some positive impact on cholesterollevels, although not to the extent of two related com-pounds, phosphatidylcholine and lecithin.

What It Is; How It WorksClosely related to the B-complex family of vitamins, cho-line is found in all living cells, where it supports the integrity of cell membranes. In addition to its role in theproduction of acetylcholine, it aids in the transport offats into the body’s cells. An adequate supply of Cholineis essential for proper liver function.

Choline helps the body to form acetylcholine, a chemi-cal used in the transmission of brain impulses betweennerves, muscles, and organs, and plays an important rolein the workings of the nervous system. It also aids in themetabolism of fats and their movement in and out ofcells, and is necessary for proper liver function.

Avoid if . . .Don’t take Choline supplements if you have an ulcer,since they can increase stomach acid. Consult with your

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doctor before using Choline if you suffer from bipolardisorder or Parkinson’s disease.

Special CautionsCholine is generally safe and nontoxic even at high levels,although megadoses are usually reserved for treatingbipolar disorder and other serious psychiatric disorders.High doses (more than 3.5 grams a day) can be counter-productive, actually causing depression in some people,and can lead to a fishy body odor and such side effects asdizziness, nausea, diarrhea, and abdominal cramps. Ex-cess consumption can also overstimulate muscles, leadingto tightening in the shoulders and neck and, ultimately,tension headaches.

Possible Drug InteractionsAvoid Choline if you’re taking a prescription drug suchas scopolamine (an antinausea medication) that worksby blocking the effects of acetylcholine.

Special Information if You Are Pregnant or Breast-feedingFor healthy women, Choline supplements are not recom-mended during pregnancy and breast-feeding.

Available Preparations and DosageThe new recommended dietary intake (RDI) for Cholineranges from 425 to 550 milligrams per day for adults. Fewpeople suffer an outright deficiency, since Americans’ av-erage dietary intake ranges from 500 to 1,000 milligramsdaily. However, since many of the foods richest in Cho-line, such as egg yolks and liver, are also high in choles-

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terol, intake may be falling among people who watch theircholesterol levels.

Choline is available as tablets, capsules, gel caps, andliquids. The different forms of Choline (bitartrate, chlo-ride, and dihydrogencitrate) vary in potency from 36 to 75 percent Choline. The optimal daily supplementaldose of Choline is often pegged at 250 to 350 milligrams.Aside from eggs and liver, good dietary sources of Cholineare wheat germ, lentils, soybeans, cabbage, and cauli-flower. Supplements such as lecithin and phosphatidyl-choline supply significant amounts of basic Choline. It’salso found in brewer’s yeast, and is often included in B-complex and multinutrient vitamins or sold in combi-nation with vitamin B6 or inositol. It should be taken withmeals.

OverdosageA dose of 200 grams or more (one hundred times thetypical dose) could prove dangerous. Sustained mega-doses of 3,500 milligrams daily or more tend to causemuscle stiffness and digestive upsets.

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Chondroitin

Why People Take ItAlthough many doctors demand further evidence, someosteoarthritis sufferers are convinced that Chondroitinhas given them relief. It is said to ease joint pain, reduceinflammation, and even repair the damaged cartilagethat cushions the joints.

Because of its beneficial effect on connective tissue,Chondroitin has also been used to treat torn ligamentsand tendons. Some advocates even suggest that it can re-lieve the pain of gout, cure headaches, relieve respiratoryailments and allergies, hasten wound healing, preventcancer, improve cardiovascular health, and stave off theeffects of aging. However, there is no scientific evidencefor these additional claims.

What It Is; How It WorksChondroitin is a complex carbohydrate found in theconnective tissue of all mammals. In the resilient carti-lage that pads the joints, Chondroitin acts like a magnet,drawing fluid into the tissues. This fluid plays two im-portant roles: it attracts essential nutrients to the area,and it makes the cartilage spongier and better able to ab-

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sorb shocks. Chondroitin also protects healthy cartilagefrom premature decline by preventing the production ofcertain enzymes that weaken connective tissue and de-feating other enzymes that stop nutrients from reachingthe cartilage.

Many researchers are convinced that Chondroitinstrengthens the protein strands that make up connectivetissue. There is also some evidence that, because it con-tains complex sugar molecules called glycosaminogly-cans, it not only can reduce inflammation but can actuallyrebuild cartilage, especially if the tissue has not been to-tally destroyed. Chondroitin seems to play an active rolein reducing the pain that often accompanies osteoarthritis;and, in some cases, it may even eliminate the need forsurgery.

Although Chondroitin often works well on its own, it is frequently combined with glucosamine sulfate, anatural sugar involved in the maintenance and produc-tion of cartilage. For some people, this combination—orChondroitin alone—seems to reduce the need for pow-erful painkillers such as nonsteroidal anti-inflammatories(NSAIDs). However, it doesn’t work for everyone, andwon’t necessarily restore complete mobility.

Avoid if . . .Suppliers recommend consulting your doctor before giv-ing Chondroitin to children.

Special CautionsAlthough Chondroitin contains sugar molecules, it is con-sidered safe for diabetics. Large doses (more than 10 gramsa day) may cause nausea.

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Possible Drug InteractionsChondroitin may reduce the tendency of blood to clot.Consult your physician before taking Chondroitin if youare taking an anticoagulant drug such as Coumadin, or ifyou have a blood-clotting disorder.

Chondroitin may interfere with the action of pre-scription and nonprescription drugs, herbal prepara-tions, and nutritional supplements. If you are using anyof these preparations, talk to your doctor before takingChondroitin.

Special Information if You Are Pregnant or Breast-feedingAs with any supplement not needed for the relief of anacute medical problem, your safest course is to avoidtaking Chondroitin while pregnant or breast-feeding.

Available Preparations and DosageChondroitin sulfate capsules and Chondroitin sulfate/glucosamine sulfate combination capsules and tabletsare found in many health-food stores or can be orderedby mail.

There are no standard dosage guidelines. For osteo-arthritis, some advocates recommend 400 milligrams 3 times a day with meals. Others suggest doses rangingfrom 250 to 1,600 milligrams a day, depending on bodyweight. Dosage can be adjusted according to your re-sponse. If you are overweight or are taking a water pill(diuretic), you may need a larger dose.


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Chromium Picolinate

Why People Take ItChromium has a single major role to play in maintaininghealth: it improves the effectiveness of insulin, enhanc-ing its ability to move blood sugar into the cells, whereit’s converted to energy. Some researchers believe thatbecause of poor eating habits, overprocessing of foods,and certain farming practices, some Americans have de-veloped a chromium deficiency, and that this has con-tributed to an increase in adult-onset diabetes. Since thebody is slow to absorb ordinary chromium, a more easilyused form, Chromium Picolinate, was developed in thelab as a dietary supplement.

Although there’s little question that Chromium Picoli-nate improves the activity of insulin in people with lowchromium levels, its role in the treatment of diabetes remains controversial. Several studies have found thatChromium Picolinate can reduce a diabetic’s need formedication, but other research has failed to confirm this.As a result, the official position of the American DiabetesAssociation is that currently there is insufficient evidenceto indicate that Chromium Picolinate supplementationstabilizes blood sugar levels in diabetics.

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Chromium Picolinate also tends to reduce cholesterollevels, and scientists think it may be a factor in loweringblood pressure in some people. Preliminary studies showthat it might also be helpful in preventing bone loss inpostmenopausal women.

Because chromium improves the body’s ability to burnblood sugar, Chromium Picolinate has also been toutedas an energy-booster, and some manufacturers claim thatit can burn body fat for weight loss, build muscle mass,and reverse some effects of aging. All such claims, how-ever, have yet to be confirmed by clinical research.

What It Is; How It WorksChromium is classified as an “essential” nutrient, since itcan be obtained only through dietary intake. Good sourcesinclude brewer’s yeast, wheat germ, beer, American cheese,whole grains, potatoes, apples, meats, and eggs. Thanks toits alliance with insulin, it is sometimes referred to as “glu-cose tolerance factor.” Without it, glucose tolerance be-comes unbalanced and blood sugar levels tend to rise, justas they do in diabetes.

The picolinate added to chromium supplements is anamino acid derivative called a “chelator.” Chelation of asubstance encourages its absorption by the cells. In thiscase, the chemical binding of chromium and picolinateacts to help insulin enter cells more easily and improvesglucose delivery. It is this effect that prompted claims forChromium Picolinate as a remedy for diabetes. How-ever, most diabetics appear to have an adequate supplyof chromium, so it seems unlikely that the supplementwill prove to be a universal cure.

Chromium Picolinate may ultimately be found to pose

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some long-term risks, as well. Recent studies show thatlarge doses of Chromium Picolinate cause DNA damagein lab animals, possibly increasing the risk of cancer.Workers exposed to chromium have developed skin,liver, and kidney problems, and in some cases, lungcancer. And, while chromium by itself has a low absorp-tion rate, its ready availability in the form of ChromiumPicolinate may allow it to accumulate in body tissue andorgans, especially the liver. Because so many of its long-term effects have yet to be studied, you might want tocheck with your doctor before taking the supplement, es-pecially if you are diabetic.

Avoid if . . .Large doses of Chromium Picolinate have occasionallycaused kidney or liver problems. Avoid this supplementif you have kidney or liver disease.

Special CautionsAlthough Chromium Picolinate may help keep somecases of diabetes under control, it’s no substitute forregular medical treatment. If you have diabetes, continueto follow the plan your doctor recommends, while care-fully monitoring your blood sugar.

Possible Drug InteractionsIn some diabetics who are chromium deficient, takingChromium Picolinate can cause a change in insulin re-quirements. If you feel light-headed after taking Chro-mium Picolinate, check your blood sugar and adjustyour insulin according to your doctor’s instructions.

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Special Information if You Are Pregnant or Breast-feedingWomen who are pregnant or breast-feeding should nottake Chromium Picolinate.

Available Preparations and DosageChromium Picolinate is available in capsule form instrengths ranging from 200 to 1,000 micrograms. Whilethere is no recommended dietary allowance (RDA) forChromium Picolinate, the estimated safe and adequatedaily intake of chromium is 50 micrograms to 200 micro-grams for adults and children 7 and older. Clinical trialsof Chromium Picolinate have used doses of 200 to 1,000micrograms daily.

OverdosageSustained doses of more than 1,000 micrograms dailyhave, in rare cases, produced kidney and liver problems.

Coenzyme Q10

Why People Take ItFor some people suffering from congestive heart failure,irregular heartbeat, or angina, Coenzyme Q10 holds thepromise of reduced symptoms and better cardiac func-tion. Some doctors also recommend it after heart surgery

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to speed recovery with a minimum of permanent damage.As is true of all other heart medications, however, Co-enzyme Q10 is not a cure.

Some advocates contend that Coenzyme Q10 can staveoff hardening of the arteries by discouraging the buildupof plaque on artery walls. Others suggest that it can boostthe immune system, helping to prevent the spread ofcancer. It has also been recommended for a host of addi-tional disorders ranging from high blood pressure, dia-betes, allergies, and fatigue to Alzheimer’s disease, Bell’spalsy, Huntington’s disease, Ménière’s disease, musculardystrophy, and deterioration of the retina. However, itseffectiveness for all such conditions has yet to be scientifi-cally verified.

What It Is; How It WorksFound in every cell in the body, Coenzyme Q10 plays avital role in the production of energy, triggering the con-version of nutrients into a “fuel” for the cells to burn.This substance, called adenosine triphosphate (ATP),can’t be stored in quantities sufficient to sustain op-timum bodily functions for more than a few minutes.Stores must be continually renewed, making an amplesupply of Coenzyme Q10 mandatory.

Adequate levels of the enzyme are particularly crucialfor the heart because it is constantly in motion, burningtwice as much energy as the other organs. If supplies ofthe enzyme decline, the action of the heart muscle willtend to weaken, reducing the amount of fresh blood theheart can pump out to the body. It is for this reason thatsome researchers regard a deficiency of the enzyme as an

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aggravating factor in conditions such as congestive heartfailure.

Good dietary sources of Coenzyme Q10 include beef,pork, and lamb; certain types of fish and shellfish; vege-tables such as broccoli and spinach; and vegetable oils. Ifyou have a heart condition, however, you may want toconsider a commercial supplement.

Avoid if . . .No known medical condition precludes the use of Co-enzyme Q10.

Special CautionsBy itself, Coenzyme Q10 is not a sufficient treatment forany type of heart disease. It is generally employed as asupplement, rather than a replacement, for standard medi-cal therapy. Do not attempt to substitute it for any of yourregular prescriptions.


Special Information if You Are Pregnant or Breast-feedingDo not use Coenzyme Q10 while pregnant or breast-feeding.

Available Preparations and DosageCoenzyme Q10 is available in capsule, tablet, gel cap,and chewable form. To improve its absorption, take itwith some type of oil (olive oil is recommended) or fat(peanut butter, for example). It is also best to take yourdose with meals.

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Advocates of Coenzyme Q10 recommend doses rang-ing from 30 to 400 milligrams daily, generally reservingthe higher dose for more severe problems. Large dailydoses are typically divided into 2 or 3 smaller doses (forexample, one 60 milligram tablet taken 2 times a day in-stead of a single 120 milligram tablet taken once).

If you are taking the enzyme for a heart condition, itmay be 2 to 8 weeks before you notice any benefit, andyou will need to continue taking the product to maintainany improvement.

Store in a dry and cool place, away from light. Do notallow to freeze.

OverdosageSince Coenzyme Q10 is not toxic, experts say you maytake large amounts without danger.

Colloidal Silver

Why People Take ItThis old-fashioned antiseptic, also known as silver pro-tein, is currently enjoying renewed popularity as an over-the-counter antimicrobial agent and immunity booster.Advocates tout it for a remarkable variety of illnesses.

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These include serious ailments such as arthritis, can-cer, cholera, diabetes, HIV infection, leprosy, malaria,septicemia (commonly known as blood poisoning), tu-berculosis, and ulcers. Other, if less dramatic, conditionssupposedly improved by Colloidal Silver include acne,athlete’s foot, eczema, herpes infections, prostate prob-lems, rectal itching, runny nose, and yeast infections.

If you think a drug with this many uses seems too goodto be true, you’re not alone. In September 1999, the U.S.Food and Drug Administration (FDA) banned the use ofColloidal Silver and other silver-based compounds inany nonprescription drug, whether for internal or ex-ternal use. The reason: Nobody has gathered sufficientscientific evidence to show that any of the claims are trueor that people can use colloidal silver on a regular basiswithout harming themselves.

Nevertheless, a regulatory loophole still allows Col-loidal Silver to be sold as a dietary supplement, providedthat it meets certain requirements and is labeled properly.For example, to qualify as a dietary supplement, theseproducts must be taken by mouth; something spread onthe skin would not be eligible. The label must also carrythe following wording: “This statement has not beenevaluated by the Food and Drug Administration. Thisproduct is not intended to diagnose, treat, cure, or pre-vent any disease.”

Despite these roadblocks, the Internet hosts a numberof companies that are attempting to turn silver into goldby promoting Colloidal Silver and its alleged benefits, orby selling special equipment for people who want tomake their own Colloidal Silver. Remember, though,

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that there is currently no proof that this substance willhelp you in any way—or that it will not hurt you.

What It Is; How It WorksSilver does have the ability to kill germs. Scientists be-lieve that this happens, at least in part, when silver mole-cules bearing an electric charge attach to a portion of theoffending bug and destroy its protective cell membrane.

In Colloidal Silver, tiny particles of silver are evenlydispersed throughout a liquid or solid medium known as the vehicle. (Think of the vehicle as an inactive sub-stance that carries the active ingredient to the site of theproblem.) Today’s Colloidal Silver products are very di-lute, containing minute specks of silver suspended in avehicle from which they will not readily settle out.

Far more concentrated Colloidal Silver products wereused as antiseptics in the first half of the twentieth centurybefore antibiotics were widely available. These wouldcustomarily be applied to wounds or to the mucus mem-branes of the eyes, nose, throat, genitourinary tract, andrectum when patients had an infection, inflammation, orirritation. For example, Colloidal Silver preparationswere used to treat inflammation of the urethra caused bygonorrhea. Some people who frequently used these prod-ucts developed a side effect known as argyria: the skin ormucus membranes took on a permanent blue-gray discol-oration, the result of silver deposits in the affected areas.

Today, the use of silver-based drugs is fairly limited.Silver nitrate solution is used in the treatment of stub-born wounds and foot conditions such as plantar warts.In these cases, silver is valued not only for its germicidalproperties but for its ability to destroy unnecessary tissue

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when used in concentrations of 10 percent and higher. A1 percent solution of silver nitrate is used for newbornsto prevent gonorrheal infections of the eyes. Silver sulfa-diazine is applied to serious burns in an effort to preventdeadly infections from spreading into the body.

Avoid if . . .You have ever had an allergic reaction to a silver-based drug.

Special CautionsOverall, silver does not appear to be toxic when lowdoses are swallowed or applied to the skin. (Never injectcolloidal silver.) The primary concern is argyria, whichcan occur after prolonged use. While it is not known ex-actly how much silver can discolor the skin, it has beenestimated that argyria can be triggered by taking 25 to30 grams or more over a 6-month period or by taking asingle dose of 3.8 grams. Irritation of the skin or mucusmembranes is also possible. Because these agents arebeing used in ways that have not been studied to anygreat extent, they might cause adverse effects that havenot yet been reported.

Possible Drug InteractionsColloidal Silver’s interaction potential has not beenstudied.

Special Information if You Are Pregnant or Breast-feedingIt’s best to avoid any unnecessary medication duringpregnancy and breast-feeding. Take only what has beenprescribed or recommended by your physician.

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Available Preparations and DosageColloidal Silver is commonly sold as a liquid to be takenby mouth. Strengths and dosages vary. For example, youmay find Colloidal Silver in strengths of 10, 20, 30, or 50 parts per million. You may also find products madespecifically for use on the skin or note directions sug-gesting application of an oral product to the skin. Don’tconfuse such products with approved prescription medi-cations such as Silvadene Cream, a preparation of silversulfadiazine used to treat burns.

OverdosageSwallowing 10 grams of silver or more in a single dosecan prove fatal. If you suspect an overdose, seek emer-gency aid immediately.

Colostrum

Why People Take ItThe very first food an infant receives from its mother,Colostrum is rich in a host of life-sustaining compoundssuch as proteins, vitamins, minerals, amino acids, anti-bodies, and growth factors. Nature provides this potentmixture to nourish and protect the health of all new-borns, human and animal alike. Commercial Colostrum

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preparations are promoted primarily as immune en-hancers. But Colostrum’s array of healthy propertieshave inspired marketers to make a variety of other claimsfor it—most without scientific basis. Assertions that itcan cure diseases such as cancer, heart disease, multiplesclerosis, colds, flu, allergies, and arthritis have yet to beverified by any sort of clinical study.

Human Colostrum is not available for sale, but bovine(cow) Colostrum is produced and packaged as an over-the-counter food supplement. Bovine colostrum is an effective treatment for diarrhea in children who havebeen infected with E. coli bacteria or rotavirus, with no apparent side effects. It may also prevent and repairdamage to the stomach lining caused by nonsteroidalanti-inflammatory drugs (NSAIDs) such as ibuprofen(Motrin, Advil) and naproxen (Naprosyn). This protec-tive property leads researchers to believe that it couldalso be used to treat other gastrointestinal disorders suchas ulcerative colitis and inflammatory bowel disease. Inaddition, a recent laboratory study showed that bovineColostrum can block H. pylori, the bacteria associatedwith peptic ulcers.

Some preliminary studies suggest that a component ofColostrum could also improve cognitive functioning inpeople with Alzheimer’s disease. But more studies areneeded to confirm this possibility.

What It Is; How It WorksColostrum is a fluid produced as the primary food sourcefrom a mother’s breasts during the first few days after ababy’s birth. The first food introduced to a newborn’ssensitive digestive system, it is sometimes referred to as

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foremilk because it precedes the production of breastmilk and contains more proteins and antibodies than theregular breast milk that follows. Its rich assortment ofnutrients, immune agents, and growth factors offer anti-viral and antibiotic properties designed to ensure the sur-vival and health of newborns.

The bovine Colostrum harvested from dairy cows isintended for their own newborn calves. Manufacturersdry and process it into a powdered form. Producers ofbovine Colostrum suggest that, just as cow’s milk hasbenefited humans for centuries, it’s reasonable to expectthat the benefits of bovine Colostrum are transferable aswell, and that the product can be well tolerated as a foodsupplement.

Advocates of Colostrum supplementation base their rec-ommendations on its hoped-for immune-boosting proper-ties. They reason that as we age our bodies graduallyproduce a diminishing amount of immune and growth fac-tors, and that this results in the decline in the body’s abilityto repair damaged tissues, fight off disease, and counter thedestructive effects of environmental toxins. Since bovineColostrum is so rich in immunoglobulins, antibodies, andother immune and growth factors, they believe it canconfer on adults the same protective effects it bestows onnewborns. In addition, they suggest since Colostrum is abalanced, whole food, and not an isolated nutrient thatmay have unwanted consequences, it may provide healthbenefits with a minimum of side effects.

While this rationale may sound convincing, actualhealth benefits (other than those affecting the digestivetract) still need confirmation with human trials. To date,much of the research has been restricted to animals.

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Avoid if . . .There have been no reports of allergic reactions to bo-vine Colostrum. Still, if you have a dairy allergy or lac-tose intolerance, use this product with care.

Special CautionsColostrum is generally free of side effects.

Possible Drug InteractionsNo interactions have been reported. However, Colostrumproducts are often combined with other ingredients. Readthe label to make sure you know what you’re taking.

Special Information if You Are Pregnant or Breast-feedingBecause commercial Colostrum is not from humansources, it’s best to check with your doctor before takingone of these products while pregnant or breast-feeding.

Available Preparations and DosageColostrum is available in capsule, tablet, and powderform in strengths of 500 to 1,000 milligrams. Suppliersgenerally recommend dosages of between 500 and 2,000milligrams per day, the larger amount taken in divideddoses. Colostrum can be taken with or without food.

OverdosageColostrum has no known overdose effects.

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Conjugated Linoleic Acid

Why People Take ItConjugated Linoleic Acid (CLA) has been studied for al-most two decades. The results have been encouraging inanimals, but researchers have only begun to examinewhat CLA does in humans. Animal research suggeststhat this fatty acid boosts the immune system and acts asan antioxidant, helping to rid the system of unstablemolecules that cause cellular damage. Researchers alsonote that CLA decreases LDL cholesterol, increases theamount of vitamin A stored in the liver, and seems to pre-vent diabetes.

Those who swear by CLA, however, are most likely tolaud its apparent ability to change the way the bodyprocesses food—specifically fat. They believe that CLAacts as a “fat-burner,” encouraging the breakdown offatty acids and leaving less to accumulate as unwantedpounds.

Although several medical uses of CLA are currentlyunder investigation, it is important to note that the U.S.Food and Drug Administration has not yet endorsed theuse of CLA for any disease, condition, or purpose.

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What It Is; How It WorksLinoleic Acid is a polyunsaturated fatty acid. Polyunsatu-rated fats have several open chemical links that allow themeasily to react with other chemicals and produce energy.(Saturated fats have all their links occupied by hydro-gen atoms and aren’t as easy to burn.) CLA’s purportedtendency to provide extra energy while encouraging theburning of fat is the reason it appeals to bodybuilders.

However, extra linoleic acid is hard to come by natu-rally. It’s one of three “essential fatty acids” that the bodycan’t manufacture and that therefore must be obtainedfrom the diet. The foods that contain it—particularly beefand dairy products—are also high in undesirable satu-rated fats. Hence, the only way to get plenty of LinoleicAcid “uncontaminated” by other fats is to take CLA.

Avoid if . . .Check with your physician before using ConjugatedLinoleic Acid. Advocates warn that CLA increases theactivity of a substance called tyrosine kinase C, whichhelps cancer cells make energy. They recommend thatpeople with cancer use CLA only if they also take a highdose of a substance called soy genistein extract, which issaid to counteract this effect.

Special CautionsExtensive animal research has uncovered no side effectsat doses equivalent to 2 to 3 grams of CLA a day.


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Special Information if You Are Pregnant or Breast-feedingUse of CLA during pregnancy has not been studied, so its safety remains unverified. Like most supplements, it’s best avoided during pregnancy unless absolutelynecessary.

Available Preparations and DosageCLA is available in 1,000-milligram gel caps. A typicalregimen is 2 capsules 3 times a day either before or withmeals. (Four capsules yield about the same amount oflinoleic acid that you would get if you ate 6 pounds ofbeef or 50 slices of American cheese or a gallon of icecream.)


Creatine

Why People Take ItThis popular amino acid compound is used by many ath-letes and bodybuilders to expand muscle mass, increaseshort-term muscle strength, and produce quick bursts ofenergy.

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What It Is; How It WorksCreatine (methyl guanidine–acetic acid) is made up ofthree amino acids: arginine, glycine, and methionine. It ismanufactured in the liver, and it can also be found inmilk, red meat, and some fish. At any given time, an av-erage 160-pound person has about 120 grams of thiscompound stored in his or her muscles.

Creatine supplements are thought to provide additionalenergy for the muscles by bonding with phosphorousstores in muscle tissue to produce creatine phosphate.This substance reacts, in turn, with adenosine diphos-phate to create adenosine triphosphate, the chemical thatfuels our muscular activity.

In addition, research indicates that Creatine pullswater from the body into the muscles, making them ap-pear larger. Because of this, it’s still unclear whether Cre-atine truly increases muscle fiber or simply inflates themuscles with water. If it’s the latter, your muscles arelikely to shrink back to normal shortly after you stoptaking Creatine.

Some studies suggest that Creatine also acts as a bufferagainst the lactic acid that builds up in muscles during ex-ercise and eventually causes an intense burning feeling.Others report that it throws the body into an anabolicstate that promotes protein synthesis, thereby fosteringmuscle gain. One study found that Creatine may be bene-ficial for elderly persons suffering from loss of musclestrength and for those with muscle-wasting diseases suchas muscular dystrophy.

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Avoid if . . .Do not use Creatine if you have kidney problems, since itcan stress the kidneys. It’s best to avoid Creatine, too, ifyou are trying to lose weight. Because it encourageswater retention, people taking it usually put on extrapounds, which is why the supplement is favored more bybodybuilders and football players than, for example,marathon runners.

Special CautionsFollow the manufacturer’s directions closely. Takingmore than the recommended amount of Creatine cancause stomach upset and diarrhea. Also, be sure to drink8 to 12 glasses of water per day while taking Creatine. Because Creatine sequesters water in the muscles, ex-tra fluid intake is needed to prevent dehydration andcramping.

Possible Drug InteractionsThere are no reports of interactions with drugs. How-ever, advocates say that Creatine can enhance the effectsof other bodybuilding supplements such as whey andglutamine. (See individual entries.)

Special Information if You Are Pregnant or Breast-feedingThere is no information on the effect of Creatine supple-mentation during pregnancy and breast-feeding. Yoursafest course is to check with your doctor before takingany supplement during this period.

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Available Preparations and DosageCreatine is available in powder and liquid formulations.Most manufacturers recommend loading up on the sub-stance with doses totaling 25 grams a day during the firstweek, then maintaining muscle mass with doses of up to5 grams a day thereafter. The long-term effects of suchdoses are unknown; the typical dietary intake is about 2 grams daily.


Cysteine

Why People Take ItThis nonessential amino acid (“nonessential” becausethe body can manufacture its own supply if there’s nonein the diet) helps to maintain and preserve the body’scells. It is a key ingredient of glutathione, an antioxidantthat protects cells from damage caused by alcohol, ciga-rette smoke, pollution, copper, and heavy toxic metals.(See separate entry.) Proponents claim that it staves offhangovers and may even have a protective effect againstX rays and nuclear radiation. Recently, some advocateshave recommended it for the treatment of arthritis.

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Some studies have shown that it strengthens the liningof the stomach and intestines, which might diminishdamage caused by aspirin and similar drugs, and whichcould make it useful in the treatment of gastritis. It alsoappears to moderate the effects of excess insulin, mak-ing it a potential aid in the management of low bloodsugar (hypoglycemia). Because hair contains a significantamount of Cysteine, the supplement has also been pro-moted as a remedy for baldness.

Cysteine also seems to play a role in the proper func-tion of the immune system. Several studies have shownthat blood levels of Cysteine and glutathione are low inpeople infected with HIV.

What It Is; How It WorksCysteine itself is rarely used as a dietary supplement. Instead, it is usually taken in an altered form called N-acetylcysteine (NAC). NAC helps to break down mu-cus and has been found useful for people with bronchitis,emphysema, tuberculosis, and chronic obstructive pul-monary disease.

Like Cysteine, NAC helps the body synthesize theantioxidant glutathione, which helps to clear damagingcompounds from the liver. In animal studies, it has beenfound effective against a variety of toxins in the liver. Infact, in emergency rooms NAC is used as an antidote forliver-damaging overdoses of acetaminophen.

Our bodies can build Cysteine from the related anti-oxidant amino acid methionine. In turn, Cysteine is usedto produce taurine, an amino acid that plays an impor-tant role in the regulation of the nervous system. Good

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dietary sources of Cysteine include high-protein food,particularly eggs.

Avoid if . . .There are no known reasons to avoid normal doses ofCysteine.

Special CautionsCysteine is not entirely without risk. Studies involvingrats found that extremely large amounts may be toxic tonerve cells. One small study of NAC found that dailyamounts of 1.2 grams or more could lead to oxidativedamage. Side effects of NAC reported during one clinicaltrial included nausea, vomiting, headache, dry mouth,dizziness, and abdominal pain.

Possible Drug InteractionsCheck with your doctor before taking Cysteine or NACif you are taking any prescription or over-the-countermedication.


Available Preparations and DosageOutright deficiencies of Cysteine are rare, and no recom-mended dietary allowance exists. For Cysteine itself,proponents often suggest a dosage of 200 milligrams 2 to 4 times daily. For NAC, dosage suggestions range from250 to 1,500 milligrams daily.

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Supplementary Cysteine and NAC are available incapsule, powder, and tablet form. Follow the manufac-turer’s directions; avoid high doses.

OverdosageNo specific information on overdosage in humans isavailable.

Desiccated Liver

Why People Take ItDesiccated (dehydrated) liver is a rich source of supple-mental protein, B vitamins, and iron. It’s also high invitamins A, C, and D, as well as choline and inositol (seeseparate entries).

All of these ingredients make essential contributionsto our health. Iron is vital for the formation of oxygen-carrying red blood cells, helps the muscles store oxygen,and promotes production of the cellular “fuel” ATP(adenosine triphosphate). B vitamins play a central rolein the processing of nutrients and the production of en-ergy. Vitamins A, C, and D respectively maintain thehealth of the eyes, connective tissues, and bones; cholineand inositol aid in the efficient processing of fats.

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Small wonder, then, that for half a century body-builders turned to desiccated liver in an effort to addweight and improve muscle tone and endurance. Only inrecent years has it been supplanted by other, more so-phisticated substances. (Several manufacturers have nowdiscontinued their desiccated liver products.) Still, advi-sors on nutrition for bodybuilders continue to rate desic-cated liver as a good source of protein and vitamins.

Since desiccated liver is a natural product, it hasn’tbeen subjected to the elaborate clinical trials conductedfor drugs, and most claims for it are based on the effectsof the nutrients it contains. For instance, statements thatit aids in recovery from liver disease are based on thebeneficial effects that protein, vitamins, and minerals areknown to have on the human liver. Likewise, desiccatedliver’s reputation as a superior source of iron is based on the generally accepted notion that organic iron fromanimal sources is more readily absorbed than either ironfrom plants or inorganic mineral iron.

What It Is; How It WorksDesiccated liver is simply beef liver with the water, muchof the fat, and the tough connective tissue removed.(Note, however, that it remains high in calories and cho-lesterol.) Marketers claim that the desiccation process,which requires a relatively low temperature, leaves thenutrients mostly intact, as compared to cooked liver.

Virtually all the desiccated liver on the U.S. market isbeef liver, although “swine liver” is sold in Europe. Ifyou’ve been avoiding beef due to the risk of “mad cow dis-ease” (the viral illness bovine spongiform encephalopathy,detected several years ago in British cattle), you’ll probably

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want to avoid desiccated liver as well. Many of these prod-ucts are said to be made from high-quality Argentine beef,and are therefore supposedly free of both viral contamina-tion and the growth hormones and antibiotics used on U.S.cattle. Remember, however, that dietary supplements arelargely unregulated, so purity cannot be assured. Buy onlyfrom a trusted source, look for a disclaimer that healthclaims have not been evaluated by the Food and Drug Ad-ministration, and avoid products with “secret ingredients”such as “antistress factors.”

Avoid if . . .If you have high cholesterol or have been advised toavoid organ meats, check with your doctor before start-ing a diet regimen that includes desiccated liver.


Possible Drug InteractionsThere are no known drug interactions.

Special Information if You Are Pregnant or Breast-feedingNo harmful effects are known, and a pure liver supple-ment could, in fact, be beneficial. Still, it’s best to checkwith your doctor before taking any supplements whilepregnant or breast-feeding.

Available Preparations and DosageDesiccated liver is usually advertised as being four timesas concentrated as regular liver. It’s available in tablet,capsule, and powder form. The powder is sold at retail in

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containers as large as 10 pounds. The usual capsule sizeis about 680 milligrams. Some sources advise takingmore than a dozen desiccated liver tablets daily.

You’ll also find desiccated liver in a variety of combi-nation products. For example, it’s frequently combinedwith other natural substances such as brewer’s yeast, andenriched with other vitamins and minerals.

OverdosageThere are no known effects of overdosage. If you ex-perience any adverse effects, check the label for other ingredients.

DHEA(Dehydroepiandrosterone)

Why People Take ItWhether or not DHEA should be taken at all as an un-regulated over-the-counter supplement is a controversialissue. There is evidence that DHEA can improve feelingsof well-being and increase sexual satisfaction—but onlyin people whose adrenal glands are functioning poorly.There are also preliminary results indicating that it mayhave a beneficial effect on some people with major depression.

Much of the controversy arises because DHEA is being

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promoted as a cure for many other ailments and hastaken on the reputation of an antiaging remedy—a kindof modern-day fountain of youth. Advocates claim that itcan help you lose weight; boost your sex drive and im-mune system; enhance your mood, memory, and energy;and reverse the aging process. Some proponents even sug-gest using it as an adjunct to conventional cancer therapy.And a number of antiaging clinics recommend taking it asearly as your forties or fifties to fight off old age and re-main biologically young. Athletes take it in large doses toenhance their performance. However, much of the re-search behind these claims was done on laboratory ani-mals, and experts caution that the results of such studiesare often inconclusive and cannot necessarily be appliedto humans. The long-term effects of supplementation arenot known, and since DHEA is a powerful hormone, itshould be used with great caution and only with yourdoctor’s advice.

What It Is; How It WorksDHEA is a steroid hormone produced primarily by theadrenal glands. It is the most abundant hormone in the body, with the highest concentrations found in thebrain. The only known function of DHEA is as a pre-cursor hormone—which means that it is a source mate-rial that the body converts into other hormones, such asestrogen and testosterone. It peaks in production by theage of 25 and gradually declines until, by age 70, levelsmay be more than 80 percent below their earlier highs.

Low DHEA levels have been associated with certain dis-eases, such as Alzheimer’s, cancer, diabetes, multiple scle-rosis, lupus, and other immune-function disorders. For this

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reason, researchers have been tempted to speculate thatsupplementation with a synthetic form of DHEA could reverse these diseases, much as hormone replacementtherapy reduces some of the symptoms of menopause byreturning the hormone balance to a premenopausal state.However, it has not yet been proven that either the diseasesor the aging process itself are a result of lowered levels ofDHEA, and it is not yet clear whether using DHEA ishelpful or, in the long run, harmful.

Despite all this, there are physicians who recommenduse of this hormone to treat a variety of ailments orcombat the effects of aging. If you decide to try DHEA,find a qualified physician to plan and monitor yourcourse of treatment.

Avoid if . . .You have breast, cervical, uterine, or ovarian cancers, orprostate cancer, or if you have a family history of one ofthese cancers, since they are hormone related.

Special CautionsDHEA has been known to cause acne, facial hair growth,and deepening of the voice in some women, and there arereports of breast enlargement in men taking high doses,probably because it triggers hormone production.

Possible Drug InteractionsCheck with your doctor about medications you aretaking that may be affected by DHEA.

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Special Information if You Are Pregnant or Breast-feedingBecause of its hormonal effects, DHEA should not beused during pregnancy or while breast-feeding.

Available Preparations and DosageDHEA is available in capsule, tablet, cream, and sprayform in strengths ranging from 5 to 200 milligrams.

The dosage should be set by your physician followinga blood test or saliva test to determine if your currentDHEA level is low, and whether that level is likely to rep-resent a deficiency in you. Based on the results, you maybe given 5 to 30 milligrams per day. Your doctor willmonitor the level of DHEA in your blood and may adjustthe dose as needed.


Digestive Enzymes

Why People Take ThemEnzyme supplements have been promoted for an aston-ishing array of maladies. From acne to AIDS and sci-atica to shingles, advocates say Digestive Enzymes arejust what’s needed to relieve the problem. According to

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enthusiasts, even multiple sclerosis, cancer, and agingcan be helped by regular enzyme supplementation.

Is there any truth to these claims? The good news isthat the supplements can indeed be helpful—if you haveone of the rare conditions that cause enzyme deficiency.(Cystic fibrosis, Gaucher’s disease, and celiac disease are the leading culprits.) Certain enzymes can also helppeople with specific digestive problems such as lactoseintolerance, bloating, and gas. For the rest of us, how-ever, the supplements appear to be completely unneces-sary and have no scientifically verified effect.

What They Are; How They WorkEnzymes are catalysts for virtually every biological andchemical reaction in the body, and digestive enzymes arecrucial for the breakdown of food into nutrients thebody can absorb. Without sufficient digestive enzymes,the fat, starch, and sugar that we eat can’t be fully di-gested, and this, in turn, can disrupt absorption of min-erals and fat-soluble vitamins.

Various digestive enzymes are produced at differentpoints along the digestive tract, from the salivary glandsto the small intestine. Other digestive enzymes, includingseveral of the most important, are produced in the pan-creas. If the pancreas is chronically infected or damagedby a disease such as cystic fibrosis, the result is severe mal-absorption, diarrhea, and malnutrition. In such cases, en-zyme supplements can be a lifesaver.

Likewise, if the small intestine fails to produce enoughof the digestive enzyme lactase, the milk sugar called lac-tose will move down the intestinal tract unabsorbed,causing gas, bloating, and diarrhea. A shortage of the en-

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zyme alpha-galactosidase can also have unpleasant con-sequences, leading to incomplete digestion of certaincarbohydrates in foods such as beans and cabbage, andthus causing gas.

Proponents of “enzyme therapy” are not, however,concerned with these specific deficiencies. Instead, theyseek to maintain peak digestion by bolstering the body’snatural enzymes with ample supplements from othersources. This is thought to reduce the body’s workload,allowing the immune system to flourish and ridding thesystem of toxic, only partially digested nutrients.

How is it that we supposedly lack sufficient enzymes?Many proponents of enzyme therapy blame it on ourpreference for cooked food. The destruction of enzymes,minerals, and vitamins at the high temperatures used infood preparation is a well-accepted fact. Faced with ashortage of these dietary enzymes, the theory goes, thebody’s digestive system is forced to compensate by in-creasing its own enzyme production. Advocates of en-zyme therapy hope to ease the extra burden.

Avoid if . . .According to virtually all medical experts, unless you’vebeen diagnosed with a clear-cut deficiency, enzyme supple-ments are a waste of money. Clinical research suggeststhat, for most problems, your odds of success with en-zyme therapy are low, while another, more tightly targetedform of treatment might quickly remedy the problem. Beespecially wary of experimental cancer treatments withpancreatic enzymes and vitamins A and C. There’s no sci-entific evidence that they do any good.

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For people who do suffer an outright deficiency, sup-pliers warn that pancreatic enzymes cannot be used bythose with an allergy to pork protein.

Special CautionsDigestive Enzyme supplements rarely cause side effects.When problems do occur, they are usually limited to thedigestive system. Among the most common are diarrhea,abdominal pain, intestinal obstruction, nausea, vomit-ing, gas, constipation, and blood in the stool.

Possible Drug InteractionsPancreatic enzyme supplements available by prescrip-tion are not known to interact with other drugs. Enzymeproducts sold as dietary supplements are said to boostthe action of blood-thinning drugs, leading to the needfor a dosage adjustment.

Special Information if You Are Pregnant or Breast-feedingThere’s no evidence that Digestive Enzyme supplementswill cause any harm during pregnancy. Nevertheless, un-less you suffer from a serious deficiency, your safest courseis to avoid them while pregnant or breast-feeding.

Available Preparations and DosageFor genuine cases of enzyme deficiency, verified by bloodtests and assessment of digestive status, doctors prescribesupplements such as Donnazyme, Cotazyme, Creon, Pan-crease, Ultrase, and Zymase. For people with lactose in-tolerance, there’s the over-the-counter remedy Lactaid.And for those troubled by chronic gas, there’s a productcalled Beano.

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Enzyme products touted for other disorders are typi-cally sold as dietary supplements. Numerous prepara-tions and combinations are available. Suppliers typicallyrecommend taking from 1 to 4 tablets or capsules before,during, after, or between meals. These products can’tlegally be sold as a cure for any specific disease. If you’reconcerned about a particular medical problem, your bestbet is to check with your doctor for a more appropriatetreatment.

OverdosageThere have been no reports of serious harm.

DMAE(Dimethylaminoethanol)

Why People Take ItDMAE is sold in health food stores as a “brain booster.”Its proponents say it enhances memory and learning, in-creases intelligence, and lifts the mood. Preliminarystudies have shown that it lengthens the life span of labo-ratory animals, although no definitive tests have beenconducted on humans.

DMAE’s advocates have long claimed that it re-lieves attention deficit disorder. In addition to improv-ing memory, it is said to decrease aggression in ADD

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sufferers. From the 1950s until the early 1980s, a pre-scription drug, Deanol or “deaner,” based on DMAE,was prescribed for children suffering from learning dis-abilities, ADD, and hyperactivity. However, the U.S.Food and Drug Administration forced its withdrawalfrom the market when a number of studies raised ques-tions about its efficacy.

Promoters claim that DMAE simultaneously aids sleepand improves waking alertness, without the restlessnesscaused by caffeine. DMAE is also said to decrease anxietywhile increasing assertiveness, and it’s thought to in-crease the lucidity of dreams. DMAE also is sold as ahangover remedy, athletic performance booster, and anaid to smoking cessation.

Early studies focused on the possible use of DMAE to relieve trembling caused by long-term use of anti-psychotic drugs, but several trials failed to confirm anyeffectiveness. Attempts to use it as a treatment for Alz-heimer’s disease also ended in failure. In fact, it was foundto actually increase drowsiness and confusion in Alz-heimer’s patients.

What It Is; How It WorksDMAE is a natural substance found in small amounts inthe human brain. It is abundant in fish such as sardinesand anchovies—a fact that may have helped to establishthe reputation of fish as “brain food.”

DMAE’s purported memory- and intelligence-enhancingeffects are said to stem from its ability to promote theproduction of acetylcholine, one of the major chemicalmessengers in the brain. However, not all studies confirmthat DMAE is a precursor of acetylcholine, and some

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medical authorities insist that its mechanism of action isunknown.

Several other actions have been claimed for DMAE.Marketers suggest that it’s an efficient antioxidant andfree-radical deactivator, and that it strengthens the mem-branes surrounding the lysosomes. These tiny sacs withinthe cells collect and digest various toxins and protein-damaging enzymes, and damage to their membranescould result in toxic leakage. DMAE is also said to re-verse the formation of lipofuscin, a brown residue oflysosomal digestion that causes so-called aging or liverspots. (This reported effect may account for some of theclaims that DMAE fights aging.) DMAE is also said toimprove the oxygen capacity of the blood, and to im-prove the storage life of blood for transfusions.

Proponents of DMAE say that it takes several weeks—or months—for the supplement to make an impact, andthat it works better when combined with vitamin B5 andcalcium pantothenate. It is also taken in combinationwith choline, ginkgo biloba, and other brain stimulants,and is sometimes included in products containing several“brain-boosting” supplements.

Avoid if . . .People who suffer from a seizure disorder, Alzheimer’sdisease, or bipolar disorder should not take DMAE.

Special CautionsDMAE may be overstimulating for some people, and oc-casionally causes anxiety, nervousness, insomnia, andhigh blood pressure. A few people may also developheadaches, muscle tension, and leg cramps. Excessive

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use increases the likelihood of side effects. Athletes incompetition should check the list of banned substancesbefore taking DMAE.

In addition to its use as a dietary supplement, forms of DMAE are marketed as industrial chemicals, used in making dyes, textiles, and emulsifiers in paints andcoatings. As an industrial chemical, DMAE is highly cor-rosive, and appears on government lists of hazardousmaterials. It may cause adverse effects when inhaled andmay be absorbed through the skin. It can irritate thelungs, causing coughing or shortness of breath. Exten-sive exposure can cause fluid buildup in the lungs, endingin a medical emergency.

Possible Drug InteractionsThere are no known drug interactions with DMAE.

Special Information if You Are Pregnant or Breast-feedingDo not use DMAE while pregnant or breast-feeding.

Available Preparations and DosageDMAE is available from a number of suppliers, mostcommonly in 100-milligram capsules. Manufacturerstypically suggest dosages of 1 to 5 capsules per day. Mostproponents recommend the lower end of the dosingrange, starting with 1 capsule daily. People in their for-ties and fifties may need 2 capsules a day; older adultsmay require 3.

OverdosageSome researchers have used up to 1,600 milligrams ofDMAE per day with few reported side effects. However,

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the effects of a massive overdose are unknown. If yoususpect an overdose, seek medical attention immediately.

DMG (Dimethylglycine)

Why People Take ItThis common amino acid derivative has been touted forits immune-boosting and “ergogenic” (energy-enhancing)properties. It has, in fact, been shown to improve the im-mune response in people exposed to bacterial vaccines. It’salso true that it helps promote the use of oxygen in thecells. However, its practical value as an immune-systemstimulant and physical energizer has yet to be verified inclinical trials.

Some doctors who specialize in treating children withautism recommend DMG because they have found it tobe helpful in some cases. Its effectiveness remains contro-versial because the only published study in this area sug-gests that the treatment wasn’t effective. However, eventhe researchers who conducted the trial felt that thedosage and the size of the study were probably too smallto be meaningful.

DMG enthusiasts also claim that it can be used to treatepilepsy, headaches, insomnia, memory disorders, heart

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disease, and the effects of aging. None of these claims hasbeen borne out by any research.

What It Is; How It WorksDMG is a naturally occurring substance found in smallamounts in certain foods including brown rice, liver,brewer’s yeast, pumpkin seeds, and sesame seeds. It’s aderivative of glycine, the most abundant amino acid inthe body (see separate entry). It contributes to a num-ber of important biochemical processes in the body, in-cluding the respiratory cycle of cells and the regulationof certain hormones.

DMG enhances the immune system by stimulatingantibody response and supporting cellular immunity. Pro-moters of DMG as a food supplement suggest that it maytherefore help reverse the gradual decline in immunitybrought on by aging, stress, nutritional deficiency, anddisease. However, more research is needed to determineexactly how much impact it may have.

Advocates also speculate that, by increasing oxygena-tion of the tissues, DMG may help boost the body’s en-ergy levels. Oxygenation of the muscles, they add, mayhelp to reduce the formation of lactic acid, thus delayingmuscle fatigue and improving physical endurance. Theyalso suggest that DMG can supply extra energy duringexercise thanks to the role it plays in the production ofATP (adenosine triphosphate), the body’s primary cel-lular fuel. But, like other claims for DMG, all these pur-ported benefits await clinical verification.

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Avoid if . . .As far as researchers know at this point, there are nomedical conditions that preclude the use of DMG.

Special CautionsThere has been little research into DMG’s safety. Cur-rently, it’s thought to be relatively nontoxic and side-effect free.

Possible Drug InteractionsNo interactions have been reported. However, DMG isoften combined with other ingredients. Read the label tomake sure you know what you’re taking.

Special Information if You Are Pregnant or Breast-feedingDMG’s safety during this critical period has never beenstudied. As with any supplement not needed to relieve aserious disorder, your wisest course is to avoid using itduring pregnancy and breast-feeding.

Available Preparations and DosageThere is no official recommended daily intake for DMG.Manufacturers suggest taking 125 to 600 milligrams perday, the larger amount in divided doses.

OverdosageNo reliable information on overdosage is available.

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Dolomite

Why People Take ItPeople take Dolomite for the calcium and magnesium itcontains. Along with vitamin D, both these minerals areessential for maintaining strong bones and teeth. Manywomen now take calcium supplements to stave off thebrittle-bone disease osteoporosis.

Although getting extra calcium is an accepted way tolower your risk of osteoporosis, proponents of Dolomitemake several other claims that have little scientific sup-port. Dolomite has been promoted as a cleansing agentfor teeth, a treatment for inflammation of the bladder, asleep aid, and a heartbeat regulator. Some researchershave also advanced the theory that the calcium carbonatein Dolomite may discourage the growth of precancerouscolon and rectal polyps.

What It Is; How It WorksDolomite is a natural mineral compound found in especiallylarge deposits in the Dolomite Mountains of northern Italy.It is a calcium magnesium carbonate and, when mined, usu-ally contains at least some traces of other minerals, including

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potassium and lead. Its lead content has raised serious ques-tions about its safety as a food supplement.

In addition to building bones, the calcium in Dolomiteplays a number of other vital roles. It helps muscles to contract, nerves to transmit electrical impulses, andblood to clot. It also strengthens cell membranes andhelps regulate the passage of nutrients and other sub-stances in and out of cells. A deficiency leads to musclecramps, numbness in the arms and legs, weak bones,tooth decay, brittle nails, joint pain, insomnia, and aslow or pounding heartbeat.

The magnesium in Dolomite is equally important forhealthy bones: About three-quarters of the body’s supplyis found in the bones and teeth. It helps the body absorbcalcium and other important minerals such as phos-phorus, sodium, and potassium. It helps regulate activityof the nerves and muscles, and it activates the enzymesneeded for the production of energy. Early warning signsof a deficiency include muscle twitches and tremors, ir-regular heartbeat, depression, and irritability. Left un-corrected, a deficiency can eventually lead to kidneystones, seizures, and, in extreme cases, diabetic coma.

However, both calcium and magnesium are sufficientlyplentiful in most diets to prevent outright deficiencies.And if you do need more, most experts recommendboosting the amount in your diet rather than taking sup-plements. They say that the body absorbs minerals ob-tained from food more effectively. Good sources of bothminerals include dairy products, the soft bones in cannedsalmon and sardines, green leafy vegetables, and soyproducts.

If you do opt for supplementation, Dolomite still may

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not be the preferred choice. There are numerous over-the-counter calcium supplements that will meet your cal-cium needs just as effectively, and some medical expertsadvise that if magnesium supplements are needed, theyshould be taken separately from calcium. The close asso-ciation of the two minerals in the bones may result in onebeing absorbed at the expense of the other. In addition,extra magnesium is usually needed only under certainspecial circumstances, such as diabetes, chronic diar-rhea, Crohn’s disease, and chronic abuse of alcohol.

Avoid if . . .People with cancer, an overactive parathyroid gland, sar-coidosis, or a tendency to develop kidney stones shouldcheck with their doctor before taking any form of supple-mental calcium.

Special CautionsThe U.S. Food and Drug Administration and other medi-cal authorities strongly warn against use of Dolomite tomeet mineral needs because of its possible lead content.Others note the possibility of lead contamination, but in-sist that brand-name products are safe.

Possible Drug InteractionsThe calcium carbonate in Dolomite may interact withiron preparations such as Feosol and quinolone anti-biotics such as Cipro.

Special Information if You Are Pregnant or Breast-feedingDolomite could be harmful when taken by women whoare pregnant or breast-feeding. An analysis of 70 brands

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of calcium supplements found that about a quarter ofthem exceeded the FDA’s total allowable lead intakelevel for children aged 6 and under. Dolomite was amongthe highest in lead content.

Available Preparations and DosageThe recommended dietary intake of calcium ranges from400 milligrams for infants to 1,500 milligrams for post-menopausal women (who are at greatest risk of osteo-porosis). The recommended dietary intake of magnesiumis 300 milligrams for adult women and 350 milligramsfor adult males.

There is no comparable figure for Dolomite. It is avail-able in tablet form in doses of 250 to 800 milligrams ofcombined calcium and magnesium. However, because of the FDA warning, few manufacturers still produce orpromote it.

OverdosageThe body can generally tolerate up to 2,000 milligramsof calcium daily, although that is more than is needed.Beyond that, calcium can build up in deposits that leadto kidney stones and hardening of the arteries.

A magnesium overdose may result in nausea, vom-iting, diarrhea, weakness, low blood pressure, irregularheartbeat, and, in extreme cases, kidney failure.

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Fish Oil

Why People Take ItFish Oil is one of those nutritional megastars that holdpromise for a wide variety of chronic conditions. Rich intwo omega-3 fatty acids (see separate entry), it may helpprotect against heart disease, high blood pressure, andsome types of cancer. Proponents say the acids could alsobe useful in the treatment of arthritis, endometriosis,obesity, osteoporosis, and several emotional disorders.

What It Is; How It WorksThe two omega-3 fatty acids contained in Fish Oils areeicosapentaenoic acid (EPA) and docosahexaenoic acid(DHA). These acids are especially prevalent in oily cold-water fish such as cod, tuna, mackerel, herring, andsalmon. Because the omega-3s come from algae that arethen eaten by krill that in turn are eaten by larger fish,farm-raised fish that have been fed grain alone may con-tain little or none of these beneficial acids.

Omega-3s are thought to protect against heart diseaseby lowering total cholesterol and triglyceride levels, rais-ing “good” HDL cholesterol, and thinning the blood.They lower the level of fibrinogen, the blood-clotting

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factor, and keep blood platelets from becoming toosticky, all of which helps to prevent the buildup of artery-clogging plaque. They also tend to dilate the blood ves-sels, which can help to lower blood pressure in those withhypertension. Recent studies suggest that these beneficialeffects of Fish Oil may help reduce the risk of sudden car-diac death, but conclusive proof of this remains lacking.

Some researchers have found that the omega-3s haveanti-inflammatory properties that could make them use-ful in the treatment of arthritis, lupus, and endometrio-sis. In addition, laboratory experiments suggest thatthese fatty acids may have an anticancer effect. Otherstudies indicate that they may help regulate mood inbipolar disorder, depression, schizophrenia, and otherpsychiatric disorders. And there’s even research hintingat a beneficial effect on bone formation, which wouldmake them useful in the treatment and prevention of os-teoporosis. They are also being studied for a variety ofother disorders, including eczema, psoriasis, and Ray-naud’s phenomenon.

To obtain the greatest heart benefits from the fattyacids found in fish and fish oils, you need to follow alow-fat diet.

Avoid if . . .Because of their blood-thinning effects, you should nottake Fish Oil supplements if you have a bleeding disordersuch as hemophilia or a tendency to hemorrhage.

Special CautionsCod liver oil and other fish liver oils are very high in vita-mins A and D. Check with your doctor before taking

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high doses of these oils, especially if you’re taking othervitamin supplements. Dangerously toxic levels could result.

Keep in mind, too, that high doses of these oils some-times cause an increase in “bad” LDL cholesterol levels.If you have diabetes, you should also be aware that FishOil has occasionally been linked to an increase in bloodsugar levels.

Potential side effects of Fish Oil capsules include afishy odor or taste, digestive upset, increased bleeding,and easy bruising. In some people, Fish Oil supplementsmay negatively affect the immune system.

Possible Drug InteractionsIf you are taking a blood-thinning drug such as aspirin orCoumadin, check with your doctor before taking FishOil supplements, which could further thin the blood.

Special Information if You Are Pregnant or Breast-feedingHigh doses of vitamin A (25,000 IU or more) can causebirth defects, so taking vitamin A–rich cod liver oilduring pregnancy is not recommended.

Available Preparations and DosageFish Oil is available in liquid, gel cap, or capsule form.Most Fish Oil supplements range in potency from 200 to400 milligrams of omega-3 acids. Choose preparationsthat contain vitamin E to prevent oxidation of the easilydamaged oil, and take a little extra vitamin E to preventoxidation within the body. Supplements that contain 18 percent EPA and 12 percent DHA are generally con-

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sidered standard. Pay attention to expiration dates andrefrigerate after opening. Be aware that some prepara-tions may contain pesticides.

There is no recommended dietary allowance (RDA) foromega-3 fatty acids. Most nutritionists recommend eatingfish 2 or 3 times a week to boost your intake, rather thantaking large amounts of supplements. A 7-ounce servingof salmon or bluefish provides 2.4 grams of omega-3acids. The same amount of herring contains 3.2 grams.

OverdosageHigh doses taken for a long time can bring on vitamin Atoxicity, with symptoms such as hair loss, headache,menstrual problems, stiffness, joint pain, weakness, anddry skin. Vitamin D toxicity, which can lead to irre-versible kidney and cardiovascular damage, is also adanger.

Flaxseed Oil

Why People Take ItFlaxseed Oil has gained attention recently as a potentialalternative to fish oil for prevention of heart disease. It appears to lower cholesterol, thus discouraging the

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buildup of fatty plaque in the arteries. However, unlikefish oil, it does not reduce the high triglyceride levels thatmay also contribute to heart problems.

Researchers suspect that Flaxseed Oil has anti-inflammatory properties as well, and in at least one clini-cal study, it has proven to be an effective remedy forsymptoms of an enlarged prostate (benign prostatichyperplasia). Some studies also suggest a beneficial effecton high blood pressure.

What It Is; How It WorksFlaxseed Oil is one of the few vegetable oils that containalpha linolenic acid. To a limited extent, this compoundis converted by the body into EPA (eicosapentaenoicacid), one of the heart-friendly omega-3 oils supplied byfish. EPA, in turn, serves as raw material for a set ofchemicals (prostaglandins) that combat inflammation.

Although Flaxseed Oil may keep cholesterol levels incheck, it doesn’t pack the same punch as fish oil. Some experts suggest that you need to take ten times as much to achieve the same effects. It’s also important to avoidconfusing the oil with other Flaxseed preparations(cracked, crushed, or milled seeds), which are used to re-lieve constipation and soothe inflammation of the diges-tive tract.

Avoid if . . .There are no medical conditions that preclude the use ofFlaxseed Oil.

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Special CautionsTaken in recommended amounts, Flaxseed Oil is un-likely to cause side effects.

Possible Drug InteractionsFlaxseed may delay absorption of drugs taken at thesame time.

Special Information if You Are Pregnant or Breast-feedingAt normal dosage levels, no harmful effects are known.Nevertheless, it’s best to check with your doctor beforetaking this or any other supplement during this criticalperiod.

Available Preparations and DosageFlaxseed Oil is available in liquid and capsule form. Dailydoses of 1 tablespoonful or 5 capsules are typical. Be-cause the size of the capsules varies, follow the manufac-turer’s instructions unless otherwise advised by yourdoctor.

OverdosageNo information is available.

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Fructo-Oligosaccharides(FOS)

Why People Take ThemThough your taste buds recognize them as sugar, Fructo-Oligosaccharides (FOS) have one extra molecule thatmakes them too large for humans to digest. Instead, theyfuel the growth of the beneficial bacteria that reside in everyone’s intestines. These microorganisms protectagainst infections and—perhaps—reduce the risk of gas-trointestinal cancers. Proponents also credit FOS withincreasing the absorption of calcium, lowering bloodsugar and cholesterol levels, and relieving constipation,diarrhea, vaginitis, mouth ulcers (canker sores), indiges-tion, and heartburn.

What They Are; How They WorkFructo-Oligosaccharides are sometimes referred to asprebiotics, since they promote the growth of probiotics—the good bacteria like L. acidophilus and B. bifidum thatmaintain intestinal health. (Interestingly, bad bacteria,such as E. coli, are unable to make use of FOS.)

Also known as inulin or neosugar, Fructo-Oligosaccharides are naturally occurring sugars found inmany foods, including bananas, barley, garlic, honey,

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onions, wheat, and tomatoes. Fresh Jerusalem artichokesare a particularly good source of FOS, but nutritionalsupplements provide them in an even more concentratedform. Because they are not digested, when you consumeFOS your blood sugar levels remain stable.

For optimal health, the body must maintain the rightbalance between good and bad bacteria. As we age, thenumber of good bacteria declines. FOS supplements re-verse this trend. Studies have shown that when they’retaken by older people, their Bifidobacterium count rises.There’s also a decrease in the pH (which translates to anincrease in the acidity) of the lower intestine, making itinhospitable to bad bacteria. And Japanese studies haveshown that adding 3 to 6 grams of FOS to the daily dietcan reduce the level of toxic cancer-causing compoundsin human waste by over 40 percent within three weeks

Avoid if . . .FOS appears to be safe for everyone.

Special CautionsFructo-Oligosaccharides are not toxic and are free ofside effects.


Special Information if You Are Pregnant or Breast-feedingThere’s no reason to believe that FOS would cause anyharm. As with any supplement, however, it’s best tocheck with your doctor before taking them.

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Available Preparations and DosageSome companies sell FOS as a nutritional supplement,while others add it to their probiotics. It’s available incapsules and powder which can be mixed into liquids.Probiotic enthusiasts generally recommend 4 to 8 gramsper day. Start with 1 gram daily. If you have a chronicyeast infection, gas, bloating, or other digestive prob-lems, you may want to increase your dose to 4 gramsdaily.

OverdosageWhile the maximum recommended daily dosage of FOSis 18 grams, no amount appears to cause toxicity.

GABA (Gamma-Aminobutyric Acid)

Why People Take ItNerve cells pass along messages by firing brief bursts ofchemicals (neurotransmitters) into receptor sites on adja-cent cells. GABA is one of these neurotransmitters. Butunlike some of the other chemical messengers in the brain,this one tends to inhibit further transmissions instead oftriggering them. It has a stabilizing effect on brain cells,preventing them from firing too fast or too frequently.Studies show that an inadequate or disrupted GABA

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supply is associated with disorders such as anxiety, in-somnia, epilepsy, premenstrual syndrome (PMS), pain,and possibly depression.

Ever since GABA’s role in maintaining a healthy bio-chemical balance in the brain was established, pharma-ceutical manufacturers have sought to develop drugs thatmimic its action. Several prescription medications thatseem to affect GABA activity or GABA receptor sites inthe brain are now on the market and are used to reduceanxiety, relieve pain, induce sleep, or control seizures.New GABA-related compounds are being studied andnew uses are being found for them all the time. Re-cent studies show that these agents may also be use-ful in treating PMS and gastroesophageal reflux disease(GERD).

The synthetic GABA supplements found in healthfood stores are, however, a different matter. Their manu-facturers claim that these products augment the brain’snatural GABA supply and stabilize its effects. But theconsequences of taking GABA supplements, if any, arestill unknown. And some experts have even questionedthe body’s ability to absorb and make use of GABA inthe form found in such supplements.

Still, GABA’s promoters continue to tout it as the“Valium” of nutritional supplements. In addition to claim-ing a relaxant effect, some manufacturers promote GABAto increase sex drive, treat enlarged prostate, and relieve attention deficit disorder. Marketers of bodybuilding sup-plements claim that GABA can also be used to decreasebody fat and enhance athletic performance by stimulatinggrowth hormone production. Though these claims are en-ticing, none has been scientifically verified.

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What It Is; How It WorksGABA is an amino acid compound produced in the bodyfrom glutamic acid. It is one of the most abundant neuro-transmitters in the brain. Although GABA activity is af-fected by other substances in the brain such as enzymesand hormones, scientists don’t fully understand howGABA levels get out of balance. They do know, however,that sufficient levels of GABA must be maintained to en-sure equilibrium in the system—and that there is a deli-cate balance between too much stimulation and toolittle.

Producers of manufactured GABA, on the other hand,seem to operate on the assumption that if a little is good,more will be better. They argue that taking a supplementwhen natural supplies are low is bound to produce bene-ficial effects. At this point, however, this theory hasn’tbeen tested and we don’t know if it’s true.

Avoid if . . .There are no known conditions precluding the use ofGABA supplements.

Special CautionsIf you are taking a prescription medication for epilepsy,anxiety, or insomnia, don’t abruptly discontinue it whenyou start taking GABA; serious problems could develop.For safety’s sake, check with your doctor before usingGABA for these and other medical conditions.

Possible Drug InteractionsThere are no reported drug interactions with GABA, butsome researchers suspect combining GABA supplements

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with tranquilizers such as Valium or Xanax could lead toheightened effects. Taking GABA with alcohol is also notrecommended.

Special Information if You Are Pregnant or Breast-feedingThe safety of GABA supplementation during pregnancyhas not been verified. Your safest course is to avoid itwhile pregnant or breast-feeding.

Available Preparations and DosageGABA is available in capsule form in strengths varyingfrom 100 to 750 milligrams. Some manufacturers sug-gest taking 500 to 1000 milligrams a day, the higheramount divided into smaller doses. (Beware, however:One source advises against taking more than 500 mil-ligrams a day.) When using GABA for insomnia, take itat bedtime.

OverdosageWhile no information on overdose is available, highdoses of GABA are reported to cause agitation and in-crease anxiety, as well as cause numbness around themouth and tingling in the arms and legs.

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Gelatin

Why People Take ItAs any reader of health and beauty magazines knows,gelatin is a popular remedy for poor hair and nails. What-ever its actual benefits, it has enjoyed this reputation forgenerations. Lately, however, Gelatin has sparked interestfor an entirely different reason. Among arthritis sufferersit is now discussed along with chondroitin and glu-cosamine as a “natural” approach to treating joint painand joint disease.

What It Is; How It WorksGelatin, while often called a natural product, cannot befound in nature. It is manufactured by boiling skin, tendons, ligaments, and bones taken from cows and pigs. The end product is a mixture of animal proteins, in-cluding several amino acids (glycine, proline, and hy-droxyproline). When dry, Gelatin is a tasteless powder.When mixed with liquid, it forms a gel used throughoutthe food and pharmaceutical industries. It serves as a sta-bilizer and thickener in confectionery and ice cream, andprovides the raw material for the capsules used for manymedicines. It is classified by the U.S. Food and Drug Ad-

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ministration as a “generally recognized as safe” food additive.

Gelatin is an inexpensive source of animal protein. Butthat protein is incomplete, lacking the essential aminoacid tryptophan and offering only small amounts ofsome others. Its value in maintaining joint health is sub-ject to debate. Proponents say it provides large amountsof two amino acids (proline and glycine) that the bodyuses to make collagen, an important part of joint carti-lage. But since these two amino acids are manufacturedby the body as needed, and no shortage has been docu-mented in cases of joint disease, the basis for any benefitsfrom supplementation remains unclear.

Proponents of Gelatin cite a handful of studies as evi-dence of its effectiveness. One trial, funded by a manufac-turer, found that gelatin reduced joint pain and improvedflexibility among the twenty athletes in the eight-weekstudy. The researchers argued that the amino acids inGelatin promote cartilage development, and that in-creased consumption gives the joints more raw materialsto use for repair. A more demanding trial was conductedin 1985 on 51 people with arthritis in their hips andknees. The half of the group using Gelatin therapeuticallyfor two months experienced less pain but were no moremobile than the half using a placebo (dummy treatment).

Most experts consider these and other studies toosmall and too limited to provide any conclusive answersabout Gelatin’s benefits. Gelatin seems to do no harmand may be helpful to some people, but there’s no evi-dence that it can cure arthritis by itself. Even if you takeit, you should consult your doctor for other—possiblymore effective—treatments.

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Avoid if . . .Side effects are rare, but allergic reactions to Gelatin havebeen reported. If you suffer from food allergies, proceedwith caution. Since Gelatin is an animal product, vege-tarians will want to avoid it.

Special CautionsBecause Gelatin is produced from cattle, there is a dangerthat it could carry bovine spongiform encephalopathy(BSE), also known as mad cow disease. The FDA hasbanned the import for food and pharmaceutical use ofany Gelatin from countries where BSE is present in thecattle population. However, the FDA does not regulatedietary supplements, so Gelatin sold as a supplement isnot subject to the ban. If you are concerned about pos-sible transmission of BSE, you should check with thesupplement’s manufacturer to determine the source of theGelatin, or forgo taking it.


Special Information if You Are Pregnant or Breast-feedingNo problems during pregnancy have been reported.Nevertheless, it’s wise to double check with your doctorbefore taking any supplement.

Available Preparations and DosagePlain Gelatin is readily available in grocery stores, healthfood stores, and pharmacies in capsule, tablet, and pow-dered form. The pills typically contain 650 milligrams ofGelatin. Recommended dosages have not been estab-

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lished. Follow the manufacturer’s instructions or checkwith your doctor.


Germanium

Why People Take ItGermanium first entered the health-and-fitness spotlightin the 1970s, after a Japanese scientist announced that itcould relieve rheumatoid arthritis, cure certain forms of cancer, and protect against a host of degenerative dis-orders. It is still promoted for these problems today, andis now sold as a treatment for high blood pressure andhigh cholesterol as well. It is said to have both anti-oxidant properties and an antiviral effect. Lately it hasreceived attention as a potential remedy for osteoporosisand Alzheimer’s disease.

There’s good reason to think twice, however, beforeexperimenting with this substance. Although it is avail-able over the counter and can be found in a number offoods and herbs, it’s the subject of a U.S. Food and DrugAdministration (FDA) hazard assessment declaring that“Germanium products present a potential human health

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hazard.” When cases of kidney failure, and even death,occurred following its use, the FDA imposed a ban onimports and forced certain Germanium products off themarket.

Manufacturers insist that some forms of organic Ger-manium (Ge-132, germanium-lactate-citrate, and others)are safe even at high dosages. Promoters of organic Ger-manium as a supplement argue that it has been exten-sively studied and found to be “virtually nontoxic,” andthey object to being associated with the hazardous form,inorganic Germanium (germanium dioxide). However,there is at least one reported incident of irreversiblekidney damage after use of one of the so-called safe sub-stances; and the FDA hazard warning on Germanium ap-plies to both the inorganic and organic forms, especiallywhen used for prolonged periods of time.

What It Is; How It WorksGermanium is a trace element found in both plants andanimals. Some medical authorities argue that it’s an es-sential part of the diet, while others disagree. A normaldiet supplies an estimated daily intake of between 0.5and 3.5 milligrams. No one has ever shown evidence of a deficiency. Foods rich in Germanium include garlic,onions, shiitake mushrooms, ginseng, and comfrey.

Germanium owes its popularity to the Japanese scien-tist Kazuhiko Asai. Dr. Asai noticed that many Asianherbal remedies contained higher-than-usual amounts ofGermanium, as did the healing waters at Lourdes. Hetheorized that most disease processes originate from anacid excess caused by oxygen deprivation in the blood.He believed that Germanium could help correct this im-

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balance by removing excess hydrogen and improvingoxygen delivery. After years of experimentation withvarious forms, he developed the organic Germanium for-mula known as Ge-132 and pronounced it a miracle cureand preventive for illness.

There is no shortage of research on the organic formsof Germanium, though very little work has been done inhumans. In tests on laboratory animals, organic Germa-nium has been found to stimulate an immune responseby inducing interferon production and activating naturalkiller cells. These agents of the immune system are partof the body’s line of defense against diseases such ascancer, as indicated by another study in which a Germa-nium compound blocked the progression of lung cancerin mice. In yet another animal study, researchers showedthat treating mice with organic Germanium appeared toprevent the accumulation of the cellular debris that is as-sociated with Alzheimer’s disease. And scientists exam-ining the effects of organic Germanium on mice withinduced osteoporosis have found that Ge-132 preventsthe decrease in bone density and bone strength caused byosteoporosis.

While Germanium’s exact mechanism of action is stillunknown, supporters speculate that many of the re-search results obtained with lab animals stem from thecompound’s ability to improve oxygenation of the tis-sues. (Some promoters package Germanium as “vita-min O,” for oxygen.) Germanium is also said to have asignificant impact on the immune system, boosting syn-thesis of the antiviral substance interferon, activating thelarge killer cells called macrophages, and stimulatingproduction of T-suppressor cells.

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Avoid if . . .Do not take Germanium if you have any kind of kidneyor liver disorder.

Special CautionsSince there is very little regulation of dietary supple-ments, you can’t be certain about the quality and purityof over-the-counter Germanium. Buy only from a sourceyou trust, and see your doctor regularly to be monitoredfor toxic effects. (Industrial-grade germanium used as anelectrical semiconductor is considered toxic and shouldnever be ingested.)

Prolonged use of Germanium products can lead tokidney failure and even death. Signs of Germanium tox-icity include yellow skin and eyes, digestive upsets, fatigue, gastrointestinal bleeding, anemia, muscle weak-ness, and nerve pain.

Possible Drug InteractionsThere are no known drug interactions associated withGermanium.

Special Information if You Are Pregnant or Breast-feedingGiven its possible toxicity, Germanium should be strictlyavoided during pregnancy and breast-feeding.

Available Preparations and DosageOrganic Germanium is available in powder and capsuleform. Strengths range from 25 to 150 milligrams. Thereis no recommended dietary intake for Germanium. Be-cause of the serious health risks associated with its use,check with your doctor before taking it.

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OverdosageWhile there are no reports of acute toxicity from a singlemassive overdose of Germanium, remember that long-term use of Germanium supplements may lead to kidneyand liver damage.

GLA (Gamma-LinolenicAcid)

Why People Take ItGamma-Linolenic Acid (GLA) is a fatty acid that thebody uses to produce hormonelike substances calledprostaglandins—particularly “prostaglandin E1.” Thistype of prostaglandin fights inflammation, and GLA is often used to treat the inflammation and pain ofarthritis. Some studies have found that it provides relief,particularly for rheumatoid arthritis, but not all test re-sults have been positive. Preparations containing GLAare also used to treat a variety of symptoms associatedwith premenstrual syndrome (PMS) and may be helpfulfor some people with eczema.

GLA is one of the more thoroughly studied naturalsubstances. It is generally regarded as essential to healthyskin, hair, and nails. It has been shown to enhance theimmune system in older adults. It also increases “good”prostaglandins and decreases the “bad” ones that can

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lead to hardening of the arteries, prompting some re-searchers to speculate that it could be helpful in pre-venting or treating heart disease. There is also someevidence that GLA can lower total cholesterol and im-prove “good” cholesterol levels.

In addition to rheumatoid arthritis, GLA may relieveother inflammatory autoimmune conditions such as Sjö-gren’s syndrome (chronically dry eyes and mouth). Studieson a painful degenerative nerve condition suffered by diabetics, who can’t process GLA properly, found thatsupplements provided relief. Oils containing GLA haveproven helpful for people hospitalized with acute respira-tory distress syndrome.

GLA’s promoters have also claimed it can be used totreat cancer, schizophrenia, childhood hyperactivity, irri-table bowel syndrome, endometriosis, multiple sclerosis,lupus, Raynaud’s disease, and the repetitive involuntarymovements dubbed tardive dyskinesia. There is little sci-entific evidence to support these claims and, for someconditions, such as tardive dyskinesia, research has foundthat GLA seems to have no effect.

What It Is; How It WorksThe body manufactures its own supply of Gamma-Linolenic Acid from linolenic acid, one of the essentialfatty acids we obtain from our diets. However, due todisease, dietary imbalance, or the effects of aging, somepeople either cannot manufacture GLA from linolenicacid or can’t convert GLA into prostaglandins. Suchpeople are candidates for GLA supplementation. Richsources are oils from evening primrose, borage, andblack currant seeds.

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Some nutritional experts have recently suggested thatAmericans may be suffering from a widespread deficiencyof essential fatty acids such as linolenic acid. At one timein our history, daily intake of potentially harmful satu-rated fats was about equal to that of the beneficialpolyunsaturated fats. Under those conditions, enough of the raw material to manufacture GLA, and thus prosta-glandins, was taken in through a normal diet.

However, during the last century daily fat intake hasnot only increased sharply, but has also included a grow-ing amount of unhealthy hydrogenated oils and transfatty acids. Today, the ratio of saturated to polyunsatu-rated dietary fats stands at about six to one, and manyexperts believe that the relative lack of essential fattyacids has combined with the hyperabundance of satu-rated fats and hydrogenated oils to promote clogged ar-teries and heart disease while reducing production ofpotentially protective GLA.

Avoid if . . .There is no known reason to avoid GLA supplements.

Special CautionsBe sure to get adequate amounts of magnesium, zinc, vi-tamin C, and the B vitamins when taking GLA. Some nu-tritional experts believe these nutrients are needed tosupport conversion of GLA to prostaglandin E1.


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Special Information if You Are Pregnant or Breast-feedingGLA is not known to be harmful. However, as with anysupplement, it’s wise to check with your doctor beforetaking it during this critical period.

Available Preparations and DosageResearchers studying GLA have typically used dailydoses of 150 to 300 milligrams, although some studieshave been done with 250 to 500 milligrams. The totaldaily intake is divided into smaller doses. It may take 6 to8 weeks for results to appear.

The three major sources of GLA—evening primrose,borage, and black currant seed oil—are available in cap-sules or softgels (gel caps), which vary in the amountthey supply. A 500-milligram capsule of evening prim-rose oil contains between 35 and 45 milligrams of GLA.The same-sized capsule of borage oil contains about 120milligrams of GLA. Black currant seed oil has about 80 milligrams of GLA per 500-milligram capsule.


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Glandular Extracts

Why People Take ThemTaking a cue from homeopathic medicine—which restson the Greek adage of “Like cures like”—advocates ofthese supplements believe that preparations made fromanimal glands can be used to jump-start poorly func-tioning human glands. Bodybuilders and athletes in par-ticular think they can gain an edge by taking glandularextracts. Likewise, some people use them in an attemptto strengthen their immune system. For example, thosewith AIDS and those with rheumatoid arthritis use glan-dular extracts in the hopes of curing their disease, whileothers use them to battle chronic infections like hepatitis.But despite minor changes observed in some lab results,the majority of evidence provides little reason to expectany therapeutic benefit from these products.

Glandular extracts have also been promoted as aweapon against aging. Some proponents say that becauseour bodies produce fewer hormones as we age, animal-based glandular products can help slow down, andmaybe even reverse, the aging process. However, thoughthe theory is alluring, there’s no real-world evidence tosupport it.

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It’s important to distinguish over-the-counter glan-dular extracts from the hormonal medications that playsuch a vital role in modern medicine. The insulin used fordiabetes, the thyroid hormone prescribed for a sluggishmetabolism, and the steroids used to reduce pain and in-flammation are all products of various glands. But unlikestore-bought glandular extracts, these medications, inthe right doses, have a well-established track record forunquestionable efficacy.

What It Is; How It WorksExtracts can be found for just about any gland, includingthe thyroid, liver, thymus, pancreas, and adrenals. Thesepreparations are made from the glands of animals, usu-ally pigs or cows, and supposedly stimulate activity insimilar tissues. For example, thymus extract is intendedto prompt the thymus gland into producing more anti-bodies, thereby strengthening the immune system. (Re-sults of experiments with thymus extract have beenmixed, with some studies showing moderate improve-ment in some patients, and other studies finding nothing.)

Proponents also speculate that glandular supplementspromote “conservation”—that is, taking a particular ex-tract will spare the corresponding gland from extra work.However, the mechanism that allows this to happen hasnever been established. (If it did happen, stopping a sup-plement could prove dangerous, since glandular activitymight be slow to return to normal.)

Some scientists question whether the body can actuallyabsorb oral supplements made from animal glands, al-though recent studies conclude that, in theory at least, asmall amount could reach the bloodstream. On the other

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hand, the efficacy of certain glandular supplements in thedigestive tract is undisputed. Enzymes taken to supple-ment the output of an underperforming pancreas actwithin the intestines, and yield an immediate improve-ment in digestion. Speculation that these enzymes canalso relieve immune disorders remains to be verified,however; and there’s no proof that they have any value incancer therapy.

Avoid if . . .A variety of medical problems can be corrected with au-thentic hormone therapy, but establishing the correctdosage is a complex matter that requires appropriatemedical tests and supervision by your doctor. Truly effec-tive products are generally available only by prescrip-tion. Self-medicating with over-the-counter extracts—ifit has any effect at all—could throw your delicately bal-anced hormone system out of kilter. If you suspect anysort of glandular problem, don’t waste valuable time ex-perimenting with these products. Instead, make an ap-pointment with your doctor.

Special CautionsShort-term side effects from taking one of these extractscan range from stomach upset to loss of feeling and tin-gling in the limbs. Long-term side effects are unknown.

Before taking any glandular product, it’s wise to checkthe source. The U.S. Food and Drug Administration hasconcerns that imported extracts could be contaminatedwith the same proteins that cause the rare form of braindegeneration known as “mad cow disease.”

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Possible Drug InteractionsIt is not known whether glandular extracts interact withmedications. If you’ve been prescribed any medicationon a regular basis, check with your doctor before takingan extract.

Special Information if You Are Pregnant or Breast-feedingGlandular extracts should never be taken during preg-nancy or while breast-feeding.

Available Preparations and DosageSome proponents of glandular extracts believe thatpredigested, water-soluble forms are the most effective.Practitioners of naturopathic medicine caution that suchextracts should be used only for a short time, since thegland should continue to function on its own after re-ceiving this jump start.

Dosage varies according to both the type of extractand its form of preparation. Follow the manufacturer’sdirections and check with a doctor if you have anydoubts. The supplements should be stored in a cool, dryplace, but should not be frozen. Store them safely awayfrom children.


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Glucosamine

Why People Take ItAlthough this natural remedy still inspires controversy, it has gained increasing acceptance as a treatment for the joint pain and inflammation of osteoarthritis. Manyadvocates say that it may also slow progression of thedisease.

Because of its ability to reduce and—in some cases—completely eliminate the pain of osteoarthritis, somephysicians and researchers feel Glucosamine might offersimilar benefits for people suffering from rheumatoidarthritis, ankylosing spondylitis, spinal disc degenera-tion, tendinitis, bursitis, and physical injuries to thejoints. There is even speculation that it could play a pre-emptive role, eliminating the development of osteoarthri-tis in people over 40.

What It Is; How It WorksGlucosamine is a natural sugar produced by the bodyand found in certain foods. It plays an important role inthe production, maintenance, and repair of cartilage, thewhite, smooth, rubberlike padding that covers the endsof bones and prevents them from rubbing against each

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other painfully as we move. It also helps form ligaments,tendons, and nails.

Glucosamine stimulates the production of glycosa-minoglycans and proteoglycans, two essential buildingblocks of cartilage. In most cases, the joints produce sufficient Glucosamine to keep the cartilage in good re-pair, but if they fail to do so, it dries out, degenerates,cracks, and may even completely wear away. Left un-protected, the joints then become swollen, stiff, in-flamed, tender, and painful—the condition known asosteoarthritis.

While Glucosamine has been used to treat osteo-arthritis in Europe since the 1980s, its use in the UnitedStates has been confined mainly to arthritic animals.However, several scientific studies have recently sup-ported its effectiveness, and its popularity in this countryis spreading quickly. There’s also a widely held—but unproven—theory that combining Glucosamine withchondroitin sulfate increases its effectiveness.

Avoid if . . .No known medical conditions preclude the use of Glucosamine.

Special CautionsAlthough Glucosamine may relieve your osteoarthritis,other treatments, such as a regular exercise program, re-main just as important. If you have this condition, it’s wiseto keep in touch with your doctor for regular checkups.

Unlike the potent nonsteroidal anti-inflammatory drugs(NSAIDs) usually prescribed for arthritis, Glucosaminedoes not produce serious side effects. You might, however,

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experience mild symptoms such as diarrhea, heartburn, in-digestion, and nausea. Try taking the medication with foodif it upsets your stomach (or if you have an ulcer). If thisfails to eliminate the symptoms, check with your doctor.

Possible Drug InteractionsGlucosamine sulfate taken alone or in combination withchondroitin does not interfere with NSAIDs, aspirin, orany other anti-inflammatory or analgesic medication. In-deed, there is some evidence that taking this supplementmay help people reduce their use of these strong drugs.

Special Information if You Are Pregnant or Breast-feedingCheck with your doctor before taking Glucosamine whilepregnant or breast-feeding.

Available Preparations and DosageGlucosamine is available in three forms:

Glucosamine sulfate. This is considered thepreparation of choice for osteoarthritis.Glucosamine hydrochloride. This is the leastexpensive variety. It is used primarily for arthriticanimals.N-acetyl glucosamine. This form delivers less of theactive ingredient to the joints.

Glucosamine sulfate capsules and Glucosamine sulfate–chondroitin combination capsules and tablets can befound in many health food stores and may also be or-dered by mail.

There is no consensus on the ideal dosage of

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Glucosamine sulfate. Some doctors recommend 1,000 to2,000 milligrams per day. Others suggest up to 3,000milligrams per day, since they insist it is safe and pro-duces no serious side effects. Dosage can be adjusted ac-cording to your response. If you are overweight or aretaking a water pill (diuretic), you may need a higherdosage.

Some people experience pain relief immediately. Never-theless, it may take anywhere from 8 weeks to 6 months torepair damaged cartilage.


Glutamine

Why People Take ItThis common amino acid serves as an energy storehouse.It also supports healthy muscle tissue and provides the in-testinal lining with needed fuel. In addition, it’s used bythe white blood cells that protect the body from infection.

Glutamine supplements are used primarily by fourgroups:

1. Dedicated athletes, to improve performance and pre-vent the breakdown of muscle tissue

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2. People with weakened immunity, such as AIDS pa-tients, to help prevent wasting and muscle atrophy

3. Those with intestinal conditions such as gastritis, ul-cers, and colitis, to help protect the intestinal lining

4. Individuals withdrawing from alcohol

What It Is; How It WorksAs the building blocks of human protein, amino acidsare a vital part of everyone’s diet. Glutamine is the mostabundant amino acid in the body, and, as such, is in-volved in more metabolic processes than any other. It isstored primarily in muscle tissue, then converted to glu-cose and transported to whatever part of the body re-quires energy. It is particularly important as a source offuel for cells lining the intestines. Without it, these cellswaste away.

Converted to the related compound glutamate andcombined with N-acetylcysteine (see entry on cysteine), it promotes the synthesis of glutathione (see separateentry). The body’s major antioxidant, glutathione playsan important role in neutralizing harmful waste productsand toxins. Glutathione levels often drop significantly inpeople with HIV infection, leading to a dangerous con-dition called HIV wasting syndrome, in which, for someunknown reason, people lose weight and muscle tone.Glutamine or L-glutamine is commonly given to counter-act the wasting, and to strengthen immunity in hospitalpatients who have been weakened by infection or otherimmune-stressing illnesses.

While the body is capable of manufacturing its ownsupply of Glutamine, deficiencies can develop during ex-tended fasting, cirrhosis, and weight loss due to AIDS or

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cancer. High-protein foods, such as most meat and dairyproducts, provide generous amounts of Glutamine. Avariety of Glutamine supplements are also available.

Avoid if . . .Because excess amino acids can put a strain on the liverand kidneys, it’s best to avoid Glutamine if you havekidney or liver problems or are undergoing chemotherapy.

Special CautionsThe most common side effect of Glutamine supplementa-tion is occasional constipation. To prevent it, drink at least10 glasses of water per day. If you suffer from chronic con-stipation, you should also supplement your diet with sometype of soluble fiber while taking Glutamine.

Possible Drug InteractionsIf you are taking antibiotics to cure stomach ulcers,check with your doctor before taking Glutamine. It caninterfere with some of these drugs.


Available Preparations and DosageGlutamine is available in capsules and as a powder.Doses of up to 20 to 25 grams daily are said to be safe,but experts recommend that you take no more than 1.5 grams daily unless your doctor orders a higher dose.

Since Glutamine is tasteless, it can be mixed with

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water in its powder form, but do not add it to hot foodsor acidic ones, such as orange juice, since they canchange the chemical composition of the supplement.


Glutathione

Why People Take ItGlutathione is the body’s key line of defense against theharmful oxygen by-products called free radicals. It’s alsoa key player in many of the reactions that neutralize for-eign toxins within the body. Proponents claim that Glu-tathione supplements can help treat lead poisoning anddamage from other heavy metals, lower the toxicity ofchemotherapy and radiation in cancer patients, reversecataracts, and prevent oxygen toxicity during hyperbaricoxygen therapy. Others believe that the nutrient mayhelp protect the liver from alcohol-induced damage. Un-fortunately, the jury is still out on most of these claims.

There is, however, some scientific evidence to suggestthat Glutathione may help people with HIV infection,the cause of AIDS. Clinical trials have shown that Glu-tathione levels in the body drop during HIV infection,

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and low levels of Glutathione seem to be linked to poorsurvival among patients.

Similarly, test-tube experiments have shown that ashortage of Glutathione depresses the function of T lym-phocytes, a key group in the immune system’s arsenal of infection-fighting agents. That could be important toHIV-positive patients because it is these white blood cellsthat come under attack in AIDS.

Human studies also hint at the possibility that giv-ing HIV-positive patients a drug like N-acetylcysteine—which the body converts into Glutathione—may helpfight the disease. Unfortunately no large-scale scientificstudies have yet been done to confirm these preliminaryresults.

Some researchers also believe that persons who are onkidney dialysis may benefit from Glutathione. In one ex-periment, 1,200 milligrams of intravenous Glutathionehelped control the damage to red blood cells that oftenaccompanies dialysis. The patients’ hemoglobin levelsimproved and their red blood cells became healthier.

What It Is; How It WorksGlutathione is made up of three amino acids: cysteine,glutamic acid, and glycine. (See separate entries.) It’sproduced naturally by the body and plays an importantrole in maintaining the health of virtually every cell.

Glutathione’s protective role depends partially on itsability to act as an antioxidant. Like vitamins C and E,Glutathione protects cell membranes from the damagingeffects of free radicals. Acting as a natural antitoxin, italso helps rid the body of poisonous chemicals. But mostof the research that suggests Glutathione supplements

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can protect us from toxic substances like pesticides orheavy metals was done in animals. And since animal andhuman physiology are often quite different, there’s noway to be sure at this point whether the supplementshave the same beneficial effects in humans.

Avoid if . . .There’s no known reason to avoid this nutrient.

Special CautionsNo toxic side effects have been reported.

Possible Drug InteractionsSome doctors have suggested that supplements contain-ing Glutathione should be avoided by cancer patients onradiation or chemotherapy. Some of these treatments par-tially depend on damaging free radicals to kill cancerouscells, and antioxidants such as Glutathione inhibit theformation of free radicals. Such concerns, however, havebeen proven unwarranted by further research. In fact,during a British study of 150 women with ovarian can-cer who were receiving the anticancer drug cisplatin, thosewho were also given a fifteen-minute IV infusion of Glu-tathione not only remained responsive to the cisplatin,but also developed fewer complications from the anti-cancer drug than did patients given a dummy infusion.

Special Information if You Are Pregnant or Breast-feedingTo date, there are no reports indicating that Glutathioneis harmful during pregnancy or breast-feeding. But be-cause the supplement has never been tested for safetyduring these periods, your safest course is to avoid its use.

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Available Preparations and DosagesThere is no recommended dietary allowance for Glu-tathione, and under normal conditions the body is ableto manufacture all it needs from amino acids in the diet.Supplements, however, can be purchased in tablet, cap-sule, and powder form. Because formulations vary, al-ways follow the manufacturer’s dosage instructions.

OverdosageGlutathione is not known to be toxic at any dosage level,although few tests have been done.

Glycine

Why People Take ItGlycine is one of the many nutritional supplementsadopted by bodybuilders to boost physical performance.Its popularity stems from its role in the formation of crea-tine, a key ingredient in the chemical reaction that powersthe muscles. (See separate entry.) Unfortunately, whilecreatine may indeed enhance performance, Glycine alonedoes not seem to have the same effect. In fact, theAmerican Dietetic Association notes that Glycine andother supposedly ergogenic (energy-producing) substances

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may owe their standing more to psychological than toany physical effects.

Over-the-counter Glycine supplements have beentouted for a variety of purposes. The substance promoteselimination of the uric acid responsible for gout, and isused as a remedy. It’s also said to have a calming effectand, when paired with glutamine, is believed to stave offcravings for alcohol. It’s thought to be helpful in de-creasing spastic conditions such as epilepsy and multiplesclerosis, and has been used to treat hypoglycemia. Itsadvocates also say that in high doses (4 to 8 grams), itstimulates the release of growth hormone.

Glycine’s proponents assert that it stimulates N-methyl-D-aspartic acid (NMDA) receptors in the brain, therebyenhancing mental function. Based on this assumption,Glycine has been proposed as a treatment for mental disorders such as bipolar disorder and schizophrenia.However, in small clinical trials among people with schizo-phrenia, it has produced only mixed results.

At least one review of the scientific literature has un-covered substantial experimental evidence that Glycinemay have a role in protecting tissues against damagingdisruptions of the blood and oxygen supplies. But ani-mal studies have not produced consistent results, andclinical trials have yet to confirm a protective effect.

Glycine appears naturally in prostate fluid, and is usedas a bladder irrigation solution during transurethral re-section of the prostate (TURP) and other surgeries in-volving the urinary canal.

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What It Is; How It WorksGlycine is one of the “nonessential” amino acids that thebody can produce for itself whenever they fall short inthe diet. It’s also available from high-protein foods suchas meat, fish, beans, and dairy products.

Glycine combines with two other amino acids—arginine and methionine—to build energy-producingcreatine. It also promotes the storage of blood sugar(glucose) in the form of glycogen. Together with theamino acids cysteine and glutamic acid, it produces theprotective antioxidant glutathione (see separate entry). It plays an important role in the production of oxygen-carrying hemoglobin, and in the synthesis of nucleicacid. On top of all these duties, it also serves as one of thenervous system’s chemical messengers, inhibiting neuro-logical responses in the spinal cord.

Avoid if . . .High doses of Glycine and other amino acids lay an extraburden on the liver and kidneys. If you have a problem in either area, don’t take Glycine without your doctor’sapproval.

Special CautionsWhen used as an irrigation solution in transurethral sur-geries, Glycine has caused side effects such as excessiveurination, urinary retention, high or low blood pressure,backache, nausea, vomiting, swelling, thirst, and dehy-dration. However, studies conducted with oral Glycinesupplements have encountered no such problems.

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Possible Drug InteractionsThere are no reported interactions.

Special Information if You Are Pregnant or Breast-feedingIt’s not known whether high levels of Glycine are safeduring pregnancy. As with any supplement not absolutelynecessary for your health, it’s best to avoid Glycine whilepregnant or breast-feeding.

Available Preparations and DosageGlycine is available in tablet, capsule, and powder formin doses ranging from 100 to 600 milligrams. There is norecommended dietary allowance for glycine. Follow themanufacturer’s directions closely.

OverdosageReportedly, high doses can cause fatigue. If you suspectan overdose, check with your doctor.

Glycosaminoglycans(GAGs)

Why People Take ThemHardening and clogging of the arteries (atherosclerosis)is widely known as a major cause of heart disease andstroke. It takes hold when high blood pressure, cigarette

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smoking, or other factors damage the inner lining ofblood vessels, creating rough patches that snag choles-terol and debris.

Glycosaminoglycans (GAGs) form part of the struc-ture the body uses to reinforce blood-vessel walls, andpreliminary evidence suggests that they may be helpful inslowing the progress of a variety of vascular disorders,including atherosclerosis, varicose veins, phlebitis, andhemorrhoids. And when blood pressure is under control,GAGs may also prevent kidney problems in people withtype 2 diabetes (the kind that usually doesn’t require in-sulin shots).

What They Are; How They WorkGAGs, which are needed to make cartilage and buildstrong connective tissue, are found throughout the body,including the joints and the lining of blood vessels. Whilethey are very important, GAGs are not considered “es-sential” nutrients because the body usually manufacturesthem from scratch. Chondroitin (see separate entry), amajor component of cartilage and a popular arthritisremedy, is a type of GAG. Unlike chondroitin, however,GAG supplements are used primarily to treat diseases ofblood vessels.

GAGs are long chains of sugars—including glucosa-mine, chondroitin, and heparin—attached to a core protein. The whole entity, which is shaped like a bottlebrush, is referred to as a proteoglycan. Located primarilyon the surface of cells, GAGs are characterized by highviscosity and low compressibility. That makes them idealas a lubricating fluid in the joints. Moreover, their rigidityprovides structural integrity to tissues.

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In a recent study, one group of men with early hard-ening of the coronary arteries was given 200 milligramsof GAGs daily, while another group received no treat-ment. After 18 months, deposits on the lining of the ves-sels were 7.5 times thicker in the untreated group than inthe GAG group—a significant difference. We don’tknow precisely how GAGs achieve this, but in additionto strengthening blood-vessel walls, they may reducecholesterol levels and “thin” the blood, preventing its co-agulation.

Other clinical studies have demonstrated that supple-menting the diet with GAGs has a substantial effect onthe structure, function, and integrity of arteries, easingthe flow of blood. Improving cerebral (brain) and pe-ripheral (in hands and feet) blood flow helps lessen thesymptoms of cerebral vascular insufficiency—which caninclude short-term memory loss, vertigo, headache, ring-ing of the ears, and depression—and peripheral vasculardisease—coldness of the hands and feet, pain, musclecramps, and impotence.

Because of the effect GAGs have on blood-vesselwalls, they are also essential in maintaining the structureand integrity of the veins. Without proper structural sup-port, veins will lose their shape and become bulging andunsightly, causing such symptoms as a sense of heavinessin the legs, tingling sensations, fluid retention, itchiness,and painful cramps. Several researchers have, in fact,suggested that GAGs should be used as the “drug of firstchoice” in the nonsurgical treatment of varicose veinsand hemorrhoids.

Despite these promising reviews, however, it’s worthremembering that the therapeutic effects of GAGs still

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need to be confirmed by the type of large, double-blindtrial in which neither the researchers nor the patientsknow who’s getting the real drug.

Avoid if . . .If you have a blood clotting disorder or liver or kidneydisease, use GAGs only under a doctor’s supervision.

Special CautionsEven if GAGs seem to relieve your circulatory problem,it’s essential to see a doctor about any type of cardiovas-cular disorder. Even phlebitis, for instance, is a potentiallydeadly disease.

Possible Drug InteractionsIf you are taking drugs that reduce blood clotting—including Coumadin (warfarin sodium), heparin, Trental(pentoxifylline), and even aspirin—do not use GAGs ex-cept under a physician’s supervision. Because GAGs tendto thin the blood, there is a chance that the combinationcould cause bleeding problems.

Special Information if You Are Pregnant or Breast-feedingThe safety of GAG supplements during pregnancy andbreast-feeding has not been evaluated. Because they’retaken only for their long-term benefits, the safest courseis to forgo their use during this critical period.

Available Preparations and DosageThe GAGs used in supplements are commercially pro-duced from chondroitin sulfate, cartilage, bone, or theaortas (the largest artery) of cows. A typical dosage of

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aortic GAGs is 100 milligrams daily. Follow the sup-plier’s directions. Take with meals to avoid any potentialgastrointestinal upsets.


Grape Seed Extract

Why People Take ItGrape Seed Extract is used in the treatment of (periph-eral venous insufficiency) poor circulation in the legs. Ina study of more than 4,700 women with this condition,four out of five experienced improvement after taking150 milligrams of this preparation twice a day for threemonths. Their legs felt lighter; did not burn, prickle, ortingle as much; and were less swollen and blue. Thewomen also had fewer leg cramps at night.

What It Is; How It WorksProanthocyanidins, a class of compounds found in grapeseeds, strengthen the tiny blood vessels called capillaries,preventing leakage and reducing swelling in nearby tis-sues. They also help prevent unstable oxygen moleculescalled free radicals from getting out of control and doing

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harm to the body. This antioxidant effect serves to re-duce the oxidation of so-called bad cholesterol, therebydiscouraging the buildup of the artery-clogging plaquethat leads to stroke and heart attacks. The extract’s anti-oxidant properties have also been found to limit thegrowth of tumors in laboratory animals.

There’s at least some reason to believe that proantho-cyanidins can also protect the liver from damage by thepopular painkiller acetaminophen, improve vision inolder adults, boost heart function, reduce swelling aftersurgery, and even promote hair growth. However, all ofthese possibilities await final verification.

Native to southern Europe and western Asia, grape-vines are now grown in all temperate regions of theworld. The leaves, fruit, and juice have all been usedmedicinally, but Grape Seed Extract produces the mostpronounced therapeutic effects.

Avoid if . . .No known medical condition precludes the use of GrapeSeed Extract.

Special CautionsGrape Seed Extract has no reported side effects.


Special Information if You Are Pregnant or Breast-feedingNo harmful effects are known. As with all nutritionalsupplements, however, it’s best to check with your doc-tor before taking it during this critical period.

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Available Preparations and DosageGrape Seed Extract is available commercially in capsuleand tablet form. Typical dosage recommendations fortreatment of poor circulation range from 150 to 600 mil-ligrams, taken in two or more smaller doses. For preven-tive therapy, daily doses of 50 milligrams are sometimesrecommended.

OverdosageProanthocyanidins are water-soluble, so any excess in-take is quickly eliminated in the urine.

Histidine

Why People Take ItScientists know that this amino acid is important—lackof an adequate supply can stunt a youngster’s growth—but they have yet to understand its full impact on thebody. The only clinically tested therapeutic use of Histi-dine is in the treatment of rheumatoid arthritis, a diseasethat’s sometimes accompanied by low levels of Histidine.However, the few trials conducted for this purpose wereinconclusive, and little work has been done in the past 20 years.

Even Histidine’s proponents make few other claims

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for it. Some say it can remedy digestive problems bystimulating gastric secretions. Others claim it can en-hance sexual pleasure by increasing circulation in the sexorgans. However, no research has been done to confirmeither of these effects.

What It Is; How It WorksAmino acids are the building blocks of human protein—a vital component in all of the body’s cells. Histidine isone of several amino acids that the body can manufac-ture when dietary supplies fall short. For that reason it isconsidered “nonessential” in adults, who require onlymodest amounts. Growing children, on the other hand,need more than the body can produce, making it an es-sential part of a youngster’s diet.

Histidine seems to play an important role in the pro-duction of histamine, a chemical that, among otherthings, stimulates digestion and dilates the arteries. His-tidine also seems to be necessary for production of redand white blood cells, and may help support the activityof the immune system. It can bind and transport severalmetals, including copper and iron, and is said to be es-sential for zinc absorption. It plays a role in protectingthe body from the effects of the sun, and may be helpfulin maintaining the myelin sheaths that protect nervecells. In children, a deficiency retards growth; in adults, ashortage is said to cause deafness.

Like all amino acids, Histidine is plentiful in high-protein foods such as eggs, meat, poultry, and fish.

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Avoid if . . .Some researchers have linked elevated levels of Histidinewith anxiety and schizophrenia. If you have a history ofmental illness, it’s best to take Histidine only under adoctor’s supervision.

Excess protein is either converted to energy or storedas fat, and because waste products from this conversionare eliminated in the urine, too much protein (or aminoacid) intake can put a strain on the kidneys and liver. Ifyou have kidney or liver disease, don’t take any supple-mental amino acids without your doctor’s approval.

Special CautionsHistidine supplements have no reported side effects.

Possible Drug InteractionsHistidine has not been well studied; no drug interactionsare known.

Special Information if You Are Pregnant or Breast-feedingThere is no information on the effect of Histidine supple-ments during pregnancy. Since their safety during thiscritical period remains unverified, it’s best to avoid them.

Available Preparations and DosageThere is no official recommended dietary allowance fornonessential amino acids such as Histidine. Doses of be-tween 1 and 8 grams a day have been used in clinicaltrials.

Histidine is available in tablet, capsule, and powderform, commonly in doses of 500 or 600 milligrams. It isalso sold in combination with other amino acids.

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OverdosageNo specific information on Histidine overdosage is avail-able. However, even large doses of nonessential aminoacids are unlikely to cause severe problems.

HMB(Hydroxymethylbutyrate)

Why People Take ItThis exotic bodybuilding aid is derived from the aminoacid leucine, which itself is taken to enhance muscle bulk(see the entry on branched-chain amino acids). Althoughthe evidence is still sketchy, HMB is said to improvestrength and muscle mass, decrease fat, and reduce muscledamage and soreness for some individuals involved inweight-training programs.

What It Is; How It WorksAlso known as beta-hydroxy beta-methylbutyrate(BHMB), HMB supplements were first developed forcattle feed by researchers at Iowa State University. Butdespite this less-than-glamorous past, HMB is rapidlygaining popularity as a dietary supplement for competi-tive athletes.

The rationale goes like this: Amino acids are thebuilding blocks of human protein, and leucine in par-

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ticular plays an essential role in growth. Along with theother branched-chain amino acids (isoleucine and va-line), leucine is said to reduce protein breakdown in themuscles during periods of intense physical stress. Propo-nents of HMB hope that it, as a by-product of leucinemetabolism, will provide similar benefits.

Although the research on HMB supplementation inhumans is still considered preliminary, several recentlypublished articles and abstracts support the theory thatHMB can enhance the effects of vigorous exercise bybuilding muscle and reducing body fat. In one study con-ducted at Iowa State University, 40 men received eitherHMB (3 grams per day) or a dummy supplement. All un-derwent four weeks of weight training, three times aweek. At the end of the four weeks, the group taking theHMB showed more increase in muscle, less fat, andgreater strength than those not taking HMB.

Because of studies like this, HMB is now being pro-moted as a safe alternative to anabolic steroids (which,while they build muscle, are both unsafe and illegal).However, other studies have detected no significant effects of HMB supplementation in well-trained athletes,so HMB’s true value remains uncertain.

Avoid if . . .If you have a medical problem, particularly with the liveror kidneys, check with your doctor before taking HMB.

Special CautionsFor use by healthy adults only. There are no reportedside effects in short-term clinical studies, but researchersare still examining the supplement’s long-term safety.

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Remember that HMB is not a miracle pill. If it is capableof producing any benefits at all, you certainly won’t seethem unless you work out regularly.

Possible Drug InteractionsSome bodybuilders advocate “stacking”—that is, takingHMB with creatine. Thus far, there is no evidence thatthis is harmful (or helpful, for that matter).

Special Information if You Are Pregnant or Breast-feedingThe safety of HMB during pregnancy has not been evalu-ated. Since it’s not needed to treat a disease, it should beavoided during pregnancy and breast-feeding.

Available Preparations and DosageAvailable in capsule or powder form, HMB is some-times included in supplements with other performance-enhancing nutrients, such as creatine and protein. Proponents say that a dosage ranging from 1.5 to 4 grams per day can improve muscle size and strength.

You may want to start with 2 grams daily, taken withfood. Many experts recommend limiting use of HMB toshort intervals, up to three months—with three to fourweeks off between cycles—until long-term studies con-firm its safety.


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Inosine

Why People Take ItInosine is one of the supplements that athletes take in thedrive to boost performance. Closely related to the basiccellular “fuel” known as adenosine triphosphate (ATP),Inosine is said to increase energy, endurance, strength,and the body’s ability to handle strenuous exercise andtraining. It is promoted to maintain and replenish levelsof ATP, improve protein synthesis, speed recovery afterexercise, and enhance the red blood cells’ ability to carryoxygen to the muscles by increasing available levels of2,3, diphosphoglycerate (2,3 DPG), a compound essen-tial for the transport of oxygen.

Scientific research does not provide much support forthese claims. Studies designed to confirm Inosine’s abilityto improve aerobic performance have produced mixedresults. One study devoted specifically to 2,3, diphos-phoglycerate levels has debunked the theory that Inosinesupplements increase them. Studies of anaerobic perfor-mance (e.g., weight lifting) have not been conducted, andclaims that Inosine is beneficial to muscle growth arebased on speculation. On the other hand, some limited

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animal and human studies suggest that Inosine supple-ments may boost muscle function in the heart.

What It Is; How It WorksIn theory, Inosine promotes the release of energy fromATP within the cells, thereby boosting the strength ofmuscular contractions, including those of the heart. Inpractice, it’s unclear whether Inosine supplements makemuch of a difference.

Natural sources of Inosine include brewer’s yeast andorgan meats such as liver.

Avoid if . . .Do not take an Inosine supplement if you have a diseaseaffecting the kidneys.

Special CautionsThe body converts unused Inosine into uric acid. Thiscould aggravate your condition if you have gout, a dis-ease in which crystals of uric acid cause pain in the joints.No other side effects have been reported.


Special Information if You Are Pregnant or Breast-feedingAlthough there’s no reason to expect harmful effectsfrom Inosine, it has not been tested for safety duringpregnancy and should therefore be avoided.

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Available Preparations and DosageInosine supplements come in tablet and powder forms,often as part of a multi-ingredient sports supplement.Powdered supplements are mixed with 8 to 12 ounces ofwater and taken prior to major workouts or competition.

There is no dietary requirement for Inosine and no offi-cial dosage recommendation. Some athletes take as muchas 5 to 8 grams per day.


Inositol

Why People Take ItBecause Inositol seems to reduce high cholesterol levels, itcan be used along with other treatments to help preventclogged arteries and heart disease in people with un-healthy cholesterol levels. It may also prove helpful in re-versing the peripheral neuropathy (tingling or numbnessof hands and feet) that often accompanies diabetes. It has been used as a remedy for hair loss and eczema. Andmost recently it has been studied as a possible treatmentfor anxiety and mood disorders, including obsessive-compulsive disorder, depression, and panic disorder.

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What It Is; How It WorksInositol is naturally present in the cells of most plantsand animals. In humans, it promotes the production oflecithin, a compound that aids in the transport of fat tothe cells of the body and promotes its conversion to en-ergy. It is by encouraging the proper use of fat that Inosi-tol is thought to lower cholesterol.

Inositol is found in especially large concentrations inthe brain and spine, where it may help support nervetransmission. Recent studies suggest that it may helpregulate levels of the chemical messenger serotonin, ac-counting for its mood-altering effect. It also seems vitalfor healthy eyes, hair, bone marrow, and intestines.

A deficiency of Inositol is highly unlikely. It’s manufac-tured by the body, and is part of the vitamin B complex inthe foods that we eat. It is abundant in foods such asbeans and lentils, liver, cantaloupe, citrus fruits otherthan lemons, nuts, oats, rice, wheat germ, and wholegrains. Nutritionists estimate that the average daily con-sumption of Inositol ranges from 300 to 1,000 milligramsa day.

Avoid if . . .Although Inositol is not known to have any toxic side effects, it’s not recommended for healthy people, who ordinarily have an ample supply.

Special CautionsIf you are diabetic, have high cholesterol, or are consid-ering using Inositol for a problem such as peripheral neu-ropathy or depression, be sure to check with your doctor

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before you begin. While Inositol may improve symptomsin some cases, it is not a cure for these conditions, andother types of treatment may be needed as well.


Special Information if You Are Pregnant or Breast-feedingThere is no reason to believe that Inositol is harmfulduring pregnancy. Nevertheless, it’s best to consult yourdoctor before taking any type of supplement at thiscritical time.

Available Preparations and DosageInositol, either synthetic or natural, is available as cap-sules and powder, and is also often part of lecithin sup-plements. There is no official recommended dietaryallowance (RDA) for Inositol, but doctors typically sug-gest 500 to 1,000 milligrams daily. Some multivitamintablets contain Inositol, but in amounts too small to beof any significance.

OverdosageHigh doses of Inositol seem free of problems, but no spe-cific information on overdosage is available.

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Ipriflavone

Why People Take ItA synthetic form of plant-based estrogen, Ipriflavone hasdrawn interest primarily because of its beneficial actionagainst postmenopausal bone loss. Researchers hopethat it may help prevent osteoporosis without incurringthe risks associated with regular estrogen, the treatmentagainst which all other bone-saving drugs are compared.

After many decades of use, estrogen is known to pre-vent bone loss and help build thicker bones—effects thatreduce the chance of fractures. It also relieves symptomsof menopause and provides some protection againstheart disease. However, estrogen can increase the risk ofcancers of the breast and uterus. Progesterone, anotherhormone, is prescribed with estrogen to reduce the threatof uterine tumors, but its use does not protect breasttissue. Not surprisingly, researchers continue to look fora safer alternative that is equally effective in preventingand treating osteoporosis, if not in other areas as well.

Research suggests that Ipriflavone may indeed be ableto play such a role. Studies have confirmed that it doesslow bone loss, although whether or not it increases bonedensity to any significant degree remains to be seen. Some

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data also suggest that Ipriflavone may fortify the effectsof low doses of estrogen, helping to produce a greater ef-fect on bones. On the downside, though, Ipriflavone alsoseems to increase estrogen’s effect on the uterus, so thatcombining the two may be too risky for some women.Other studies have shown that Ipriflavone might beuseful in the treatment of Paget’s disease of bone, apainful bone-deforming ailment. In clinical trials, it re-duced the aching discomfort that plagues people with thisillness.

Some advocates say that Ipriflavone is a useful tool forbodybuilders, suggesting that it can help produce leanmuscle. Scientists generally dismiss this claim, concen-trating on its potential for slowing bone loss. Ipriflavoneis sold as an osteoporosis remedy in Italy, Japan, and theUnited Kingdom, but remains an experimental drug inthe United States, where more rigorous tests are required.For example, researchers will want to see how Ipriflavonestacks up against other osteoporosis treatments andwhether its beneficial effect on bone actually results in alower risk of fractures.

What It Is; How It WorksIpriflavone is modeled after a compound called daidzein,found naturally in soybeans. Daidzein is a member of agroup of beneficial nutrients called soy isoflavones (seeseparate entry) that may possess cancer-fighting proper-ties. Due to its estrogenlike effect on bone, it is also classi-fied as a phytoestrogen (phyto for “plant”). (See separateentry.)

Nobody knows why Ipriflavone seems to stall bone

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loss. Bones undergo constant renewal through the coop-erative efforts of two types of cells: osteoblasts, whichmake new bone, and osteoclasts, which clear away oldbone. After age 30, the osteoclasts begin to get rid of oldbone faster than the osteoblasts can produce new mate-rial, a situation that worsens after menopause. Some re-searchers suggest that Ipriflavone may stunt the activityor development of the destructive osteoclasts. Otherstheorize that it may promote the activity or developmentof the nurturing osteoblasts. A third hypothesis holdsthat Ipriflavone spurs the body to release calcitonin, ahormone that prevents bone loss by diminishing the num-ber of osteoclasts and their ability to function. (In nasalspray or injection form, calcitonin is frequently used inthe treatment of osteoporosis.)

Avoid if . . .Never use Ipriflavone while taking estrogen, since itcould increase the hormone’s negative effects. Also avoidIpriflavone if you’ve ever had an allergic reaction to it.

Special CautionsIf you have kidney disease, take Ipriflavone only under adoctor’s supervision; you could build up excessive levelsof the drug. In fact, anyone with kidney disease shouldcheck with her doctor about taking smaller amounts ofIpriflavone than generally advised on the label.

Ipriflavone appears to have few side effects. The mostcommon complaints are stomach pain or burning and diarrhea.

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Possible Drug InteractionsIpriflavone impairs the body’s ability to eliminate theasthma drug theophylline, and can produce elevatedblood levels of the drug, almost as if higher doses weresuddenly being taken. As a result, people who combineIpriflavone and theophylline could develop symptoms oftheophylline toxicity, such as nausea, vomiting, a racingheartbeat, or seizures. Researchers think Ipriflavone mayinteract with other important drugs as well, includingphenytoin, an anticonvulsant; warfarin, a blood thinner;and tolbutamide, which is used to treat people with dia-betes. Given Ipriflavone’s interaction potential, it’s wiseto check with your doctor before combining it with anyother medication.

Special Information if You Are Pregnant or Breast-feedingRegular estrogen must never be taken during pregnancy,since it can cause the developing baby significant harm.It’s not known whether plant-based estrogens pose asimilar danger. However, since Ipriflavone is considereduseful only for postmenopausal bone loss, there’s novalid reason for taking it during pregnancy in any event.

Available Preparations and DosageIpriflavone is taken by mouth and may be sold alone orin combination with calcium and other vitamins or min-erals. The usual dosage is 600 milligrams of Ipriflavoneper day. How many times per day you take the drug de-pends on the contents of the pills that you’ve purchased.For example, a pill containing 300 milligrams of Ipri-flavone would be taken twice a day, while one containing200 milligrams would be taken three times a day.

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Lactobacillus

Why People Take ItThe human digestive tract is inhabited by a variety ofbeneficial bacteria referred to as probiotics. Among themost important of these friendly fellow travelers are the Lactobacillus species, especially Lactobacillus aci-dophilus (probably best known for its role in reestab-lishing friendly bacteria in the colon after a course ofantibiotics), Lactobacillus bifidis (more common in ba-bies), and Lactobacillus GG, a newly identified type ofLactobacillus particularly useful for postantibiotic boutsof diarrhea.

What It Is; How It WorksThe Lactobacillus group helps to maintain a healthy en-vironment in the intestines by producing lactic acid,acetic acid, hydrogen peroxide, and other organic com-pounds that increase acidity inside the intestine and dis-courage the reproduction of many harmful bacteria.Lactobacillus species also produce bacteriocins, naturalantibiotics that kill a variety of detrimental organisms.

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The anti-infective properties of these probiotic bac-teria make them potentially helpful in the prevention ofrecurrent vaginal yeast infections. Lactobacillus supple-ments can also reduce your chances of getting traveler’sdiarrhea and may prevent renewed attacks. Reports alsosuggest a beneficial impact on stomach and digestiveupset, indigestion and heartburn, intestinal gas, irritablebowel syndrome, and gastrointestinal inflammation.

Lactobacillus acidophilus is the most common probi-otic supplement. It’s taken to restore intestinal balanceafter bouts of diarrhea, and to maintain general intestinalhealth. As a source of lactase (the enzyme needed for thedigestion of milk), it may also help relieve lactose intoler-ance, although conclusive proof of this is lacking. Otherlargely unverified claims for acidophilus assert that it im-proves immunity, helps allergies, improves skin, relievescanker sores, reduces cholesterol levels, alleviates consti-pation, improves acne, and lessens the risk of coloncancer.

Lactobacillus bifidis performs essentially the samefunctions as acidophilus, but is more prevalent in the di-gestive tracts of infants and may be more protectiveagainst such food-borne infections as salmonellosis.

Lactobacillus GG, one of the newest of the probiotics,has recently sparked considerable excitement as a remedyfor antibiotic-induced diarrhea, digestive problems, andvaginal yeast infections. Antibiotics prescribed to killharmful bacteria frequently kill the beneficial ones aswell. Lactobacillus GG seems to be particularly good atreestablishing friendly intestinal organisms, possibly be-cause it survives stomach acids better than acidophilus. Inany event, clinical research has shown it to significantly

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cut the rate of antibiotic-induced diarrhea, as well asmany other types of the disorder.

Lactobacillus supplements are totally unnecessary aslong as your native population of probiotic bacteria main-tain their health. However, antibiotics, chronic diarrhea,and poor eating habits often serve to give harmful bac-teria the upper hand, while emotional stress seems tolower the count of friendly ones. If you face any one ofthese problems, extra probiotics might prove beneficial.

Avoid if . . .There’s no known reason to avoid probiotics.

Special CautionsThe safety of Lactobacillus is well documented. It hasbeen used since the early 1900s in the fermentation ofproducts such as yogurt, buttermilk, cheese, and sour-dough. In fact, acidophilus milk and many yogurt prod-ucts contain live bacteria and are sometimes used tomaintain intestinal health, though the bacteria count inthese products is not very high.

Because Lactobacillus supplements contain living or-ganisms, freshness is important. Purchase products con-taining lactobacilli well before their expiration date.Refrigerate the supplements once you have opened them,and throw them out when they are more than six monthsold. At that point, the organisms are dead.

Possible Drug InteractionsAlthough Lactobacillus supplements can often remedyantibiotic-induced diarrhea, they do not interfere withthe therapeutic action of the antibiotic itself.

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Available Preparations and DosageLactobacillus supplements are available as powders,capsules, tablets, and liquids. The count of live bacteriain these products is in the millions and billions per dailydose. Generally, 1 to 2 billion colony forming units(CFUs) of acidophilus per day is considered sufficient to keep intestinal probiotic bacteria in tip-top shape.Larger doses may be warranted if the population is depleted.

Most experts advise against taking Lactobacillussupplements continuously. Instead, they recommendreserving them for short courses to repopulate the colonwith friendly flora after antibiotic therapy, to treat in-testinal yeast overgrowth, or to stave off infectious diar-rhea when traveling in underdeveloped countries.

OverdosageEven large doses of Lactobacillus have no reported sideeffects.

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Lecithin

Why People Take ItCommercial Lecithin supplements are composed pri-marily of choline and inositol, two fatty compounds thathelp support the integrity of the body’s cell membraneswhile aiding the transport of fats into the cells and regu-lating cholesterol levels. (See separate entries.) Lecithinsupplements can produce a significant reduction in cho-lesterol levels, which in turn may stave off the buildup ofartery-clogging plaque and help prevent heart disease.

Because choline and inositol have been associatedwith the regulation of various chemical messengers in thenervous system, they’ve also been proposed as treat-ments for Alzheimer’s disease and several neurologicaldisorders. Studies to date, however, have revealed little ifany benefit in such cases. The primary value of Lecithinsupplements remains in their effect on cholesterol.

What It Is; How It WorksDiscussions of Lecithin can be confusing, since scientistsuse the term as a synonym for phosphatidylcholine, one of the ingredients of commercial Lecithin supplements.Phosphatidylcholine by itself can be taken to fight high

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cholesterol (see separate entry). The phosphatidylcholinecontent of commercial Lecithin products ranges from 5 to30 percent.

In addition to lowering cholesterol, the phosphatidyl-choline in Lecithin products may fight heart disease byacting as a blood thinner, discouraging the clumping ofblood platelets that can sometimes produce dangerousclotting in the bloodstream. The choline found in phos-phatidylcholine also supports the health of the liver andmay be helpful in preventing or treating liver disorderssuch as cirrhosis, fatty liver, hepatitis, and damage fromtoxic substances.

The richest dietary sources of Lecithin are egg yolks andorgan meats such as liver. Since these foods are also high incholesterol and saturated fats, some nutritionists fear thatthe current drive for low-cholesterol diets could be leadingto deficiencies of Lecithin and choline in some people. Ifyou’re concerned about this, soybean products and vege-tables such as cabbage and cauliflower will provide youwith good alternative sources of choline. Lecithin is alsofound in a number of processed foods, where it is used asan emulsifier to keep oil and water from separating and toretard spoilage.

Avoid if . . .Pure choline supplements are not recommended forpeople with ulcers, bipolar disorder, or Parkinson’s dis-ease. Although commercial Lecithin supplements are lesspotent, you still may want to avoid them under these circumstances.

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Special CautionsPotential side effects include nausea, upset stomach, ab-dominal discomfort, diarrhea, and stiff muscles. The like-lihood of side effects increases with the size of the dose.

If you’re on a low-fat diet, be aware that regular dosesof Lecithin will significantly boost your fat intake.

Possible Drug InteractionsBecause the choline in Lecithin supplements can boostlevels of the chemical messenger acetylcholine, you shouldavoid combining these supplements with a prescriptiondrug such as scopolamine (an antinausea medication) thatworks by blocking the effects of acetylcholine.

Special Information if You Are Pregnant or Breast-feedingThere is no reason to believe that ordinary amounts ofLecithin are harmful during pregnancy. Nevertheless, it’sbest to consult your doctor before taking any type ofsupplement at this critical time.

Available Preparations and DosageLecithin is available in liquid, powder, granule, and capsuleform. Dosage recommendations vary with the amount ofcholine in the supplement. For a medium-potency product,doses can range from 5 to 10 grams daily. Follow themanufacturer’s directions, and to benefit from Lecithin’sability to help break down fats, take it just prior to, orwith, meals.


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Lipoic Acid

Why People Take ItA vitaminlike substance with antioxidant properties,Lipoic Acid also acts as a cofactor in the conversion ofblood sugar (glucose) into energy. In Germany it’s an approved treatment for a painful degenerative nerve con-dition called diabetic neuropathy, as well as other compli-cations of diabetes. (Diabetic neuropathy is thought to becaused in part by oxidative stress.) Lipoic Acid is alsoused in Europe as a treatment for mushroom poisoning.

Laboratory research on Lipoic Acid suggests other po-tential benefits. Several studies on animals have foundthat it improves their memory and cognitive function,prevents cataract formation, and lowers their bloodpressure. Possibly because of its antioxidant effect, it hasalso shown promise for certain kidney and liver condi-tions. At this point, however, we don’t know whether ithas the same effects in humans.

Manufacturers of Lipoic Acid recommend it as a treat-ment for AIDS, on the basis of a study in which it pre-vented the reproduction of the HIV virus in test tubes.Promoters also claim that it can improve muscle perfor-mance, slow the aging process, remedy glaucoma and

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many other conditions, and protect against liver disease,heart disease, and cancer. Unfortunately, most of theseclaims are based either on animal studies or the knownantioxidant action of Lipoic Acid, and there is currentlyno proof that it has the same effects on humans.

What It Is; How It WorksLipoic Acid is manufactured by the body, so deficienciesare unknown and it’s not classified as a dietary essential. Itcan, however, be obtained from red meats, liver, and yeast.It is sometimes called the perfect antioxidant because it isboth fat- and water-soluble.

In its role as an antioxidant, Lipoic Acid acts as a free-radical scavenger. Free radicals are highly reactive un-paired molecules that cruise the bloodstream looking forother unpaired molecules to combine with. If they linkup with the wrong molecules in healthy cells, oxidationand damage result. While free radicals are products ofthe normal metabolic process, environmental pollution,smoking, the effects of the sun, and a poor diet can fosterexcessive amounts. Lipoic Acid not only neutralizes freeradicals itself, but also seems to help recycle other anti-oxidant agents with similar abilities, such as vitamins Cand E, as well as glutathione.

Avoid if . . .No known medical conditions preclude the use of Li-poic Acid.

Special CautionsIf you take Lipoic Acid for diabetes, remember that it’snot a substitute for other forms of treatment. Continue

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to follow the plan your doctor recommends and care-fully monitor your blood sugar. Similarly, you can’t relyon Lipoic Acid as a replacement for prescription HIVdrugs.

Possible Drug InteractionsDiabetics may have to readjust their insulin intake whentaking high doses of Lipoic Acid. If you feel light-headedafter taking this supplement, check your blood sugar andadjust your insulin according to your doctor’s instructions.

Special Information if You Are Pregnant or Breast-feedingAlthough Lipoic Acid is a natural bodily substance, theeffects of high doses during pregnancy are unknown. Aswith all nutritional supplements, it’s best to check withyour doctor before taking it during these critical periods.

Available Preparations and DosageIt is available as a nutritional supplement in 50- to 200-milligram capsules. Manufacturers recommend taking50 milligrams per day as an antioxidant, 300 to 600milligrams per day for diabetes-related conditions, and150 milligrams three times daily for AIDS.

OverdosageThere are no reports of overdosage with Lipoic Acid.

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Lutein

Why People Take ItLutein offers powerful protection against two seriouseye problems. It significantly reduces the odds of devel-oping macular degeneration, a wasting of the retina thatleads to irreversible blindness in many older adults. It’salso one of the nutrients thought to protect againstcataracts, cloudy areas on the lens of the eye that eventu-ally afflict more than half of all senior Americans.

Lutein may also be one of the key elements that lendcertain vegetables their ability to fend off colon cancer.And ongoing research is investigating Lutein’s role inprotecting the skin from sun damage, as well as its poten-tially heart-healthy effects on cholesterol.

What It Is; How It WorksLutein is one of the carotenoids, a large group of anti-oxidants that protect the body’s cells from the harmfulmolecules called free radicals. A light-absorbing pigmentrelated to vitamin A, Lutein is not produced by the bodyand so must be obtained from food or vitamin supple-ments. It is one of two pigments that seem to filter dam-aging forms of light from reaching the macula, or central

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region of the retina. The macula is responsible forstraight-ahead vision and visual sharpness. It can eventu-ally succumb to damage from free radicals, poor circu-lation, and overexposure to UV sun rays. Currently, 90 percent of the people with macular degeneration failto respond to treatment, so prevention remains crucial.Those most at risk for macular degeneration are smokersand people with light-colored eyes.

A study conducted in 1994 showed that people withthe highest intakes of six carotenoids, including Lutein,and three vitamins (A, C, and E) enjoyed 43 percent lessrisk of macular degeneration than those with the lowestintakes. And those who ate a diet rich specifically inLutein and zeaxanthin, another carotenoid, had a 57 per-cent reduction in risk. Likewise, diets high in Lutein seemto be associated with a lower risk of cataracts, possibly byprotecting the lens from light-induced free radicals.

Lutein’s reputation as a potential cancer-fighter rests on a recent study that concluded that, of all the manycarotenoids that occur in vegetables, Lutein demonstratesthe strongest protective effects against colon cancer. (It wasalso found to improve chances of recovery in certaincases.) Lutein may also discourage the development of skincancer by protecting the skin from damaging UVA rays.

Avoid if . . .There are no known reasons to avoid Lutein supplements.


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Special Information if You Are Pregnant or Breast-feedingThere’s no reason to expect any harm from Lutein. How-ever, it’s wise to check with your doctor before takingany supplement while pregnant or breast-feeding.

Available Preparations and DosageThe best dietary sources of Lutein include spinach, col-lard greens, kale, mustard greens, turnip greens, romainelettuce, peas, and leeks. It is also included in a number ofmultivitamin formulas and eye care supplements, andcan be purchased as an individual supplement in capsule,softgel (gel cap), or tablet form.

In studies of macular degeneration, intake of about 6 milligrams of Lutein per day has shown a protective ef-fect. A large bowl of spinach salad will provide the neces-sary amount. If you choose to take a Lutein supplement,combine it with the related carotenoid zeaxanthin, andtake it with food to improve absorption.


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Lycopene

Why People Take ItLycopene, a compound found in fruits and vegetables(especially tomatoes), has been associated with a re-duced risk of heart attack. It is also thought to provide a certain amount of protection against some types ofcancer, particularly cancers of the prostate or breast.

Most evidence of Lycopene’s benefit comes from studiescomparing disease rates in groups of people with dietshigh or low in Lycopene-rich foods. Such foods containother substances, such as beta-carotene and fiber, thatmay have contributed to the effects the researchers ob-served. Still, that hasn’t stopped vitamin manufacturersfrom rolling out tomato-oil capsules and other supple-ments containing Lycopene alone.

Although these products may well confer benefitssimilar to those of a Lycopene-rich diet, that has yet to beconfirmed by large-scale testing. As long as the jury re-mains out, most experts recommend enjoying more redsauce and ketchup instead of popping Lycopene pills.

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What It Is; How it WorksLycopene is one of the carotenoids, a group of naturallyoccurring plant chemicals found in yellow, orange, red,and leafy green vegetables and fruits. Researchers haveestablished that Lycopene, the most common carotenoidin the American diet and the human body, is a powerfulantioxidant. Oxidation is a chemical process (akin toburning) that produces toxic compounds called free radi-cals. These compounds react easily with surrounding tis-sues, triggering a host of damaging effects, from aging tocancer development. Lycopene scavenges free radicals inthe body, guarding various types of cells (including im-mune cells) against their attack.

True to its antioxidant nature, Lycopene has beenshown to suppress the growth of cancer cells in labora-tory and animal studies. And recent studies in humanshave bolstered these findings, showing significant bene-fits from elevated Lycopene levels both in the diet and inthe body.

• In a study of more than 47,000 men, those who atetomato products at least 10 times a week had less thanhalf the risk of developing advanced prostate cancercompared to men who ate such products less often.

• A review of 72 studies of the cancer prevention–tomato connection found that tomato intake waslinked to reduced risk in 57 studies, with the connec-tion considered statistically reliable in 35. (The studies,however, were analyses of disease rates in variousgroups, rather than actual clinical trials.)

• Prostate cancer patients have been shown to havelower Lycopene levels in their prostate tissue and blood

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than those found in healthy men; this relationship ismore pronounced for Lycopene than for any othercarotenoid.

• In a small study of 33 men facing prostate surgery,those who took Lycopene supplements for 30 days be-fore the operation were less likely to have their cancerspread than those who took no supplements.

• In a multicenter European study, higher levels of ca-rotenoids in fatty tissue were associated with a lowerrisk for heart attack.

The richest and best-absorbed sources of Lycopene arecooked tomato products such as tomato sauce and pasteor tomato ketchup. Lycopene is also present in water-melon, tomato juice, raw tomatoes, and pink grapefruit.

Why not just swallow a Lycopene pill? The benefits oftaking this compound in isolation from its chemical fellowtravelers are still uncertain. Lycopene supplements lackmany of the complex substances found in fresh or cookedfruits and vegetables, including dietary fiber, vitamins,minerals, and other phytochemicals (plant chemicals)—substances that may turn out to be responsible for at leastsome of the beneficial impact of Lycopene-rich foods.Carotenoids may also interact with one another, and it’sunknown whether supplementing one carotenoid mightimpair the absorption of others.

Avoid if . . .The effects of habitual, long-term Lycopene supplementa-tion, and its potential for toxicity, are still unknown. Atthis point, however, there appear to be no well-establishedmedical reasons to avoid Lycopene.

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Special CautionsConcerns have been raised as to whether Lycopene mayskew the results of testing for prostate-specific antigen(PSA), a substance in the blood that signals the possi-bility of prostate cancer. If you’re taking Lycopene, besure to tell the doctor before undergoing a PSA test.

Possible Drug InteractionsThere are no well-known drug interactions for Lycopene.However, tell your doctor if you are taking this or othersupplements before starting any new medication.

Special Information if You Are Pregnant or Breast-feedingThe effect of large doses of Lycopene on a developingbaby remain unknown. Since the supplement isn’t nec-essary for your short-term health, it’s best to avoid itduring pregnancy and nursing. Stick to dietary sourcesof the compound, which are high in other vital nutrientsas well.

Available Preparations and DosageThere is no officially recommended dietary allowancefor Lycopene, and researchers have yet to establish anoptimal dosage for cancer prevention and other healthbenefits. In one study, the men with the lowest rate ofcancer had at least 6.5 milligrams of Lycopene in theirdiets a day—approximately the amount in one cup ofcubed watermelon, two medium tomatoes, or half a cupof tomato sauce.

If you choose to take a pill, supplements containingfrom 3 to 15 milligrams of Lycopene are available.

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OverdosageDoctors don’t yet know whether a high dose of Lycopenecould prove harmful, or what the size of such a dosewould be. However, it’s wise not to exceed the dosagerecommended by a supplement’s manufacturer.

Lysine

Why People Take ItAlthough Lysine has been part of everyone’s diet sincethe dawn of mankind, medical researchers have only re-cently identified two properties that suggest it could be auseful medication. Some studies have found that it canblock proliferation of the herpes simplex virus, raisingthe possibility of using it as a remedy for cold sores andgenital herpes. Other research has revealed that it playsan important role in the absorption and conservation ofcalcium, making it a potential weapon in the battleagainst osteoporosis. Although neither benefit has beenconfirmed conclusively, experts say the results of thestudies to date are promising, and more research shouldbe done.

Some proponents insist that Lysine also maintainshealthy blood vessels and helps build muscle, but theseclaims have yet to be verified.

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What It Is; How It WorksLysine is one of the eight amino acids deemed essential in the diet, since the body is unable to manufacture itsown supply. It’s a vital component of numerous proteinsneeded to build and repair tissue and synthesize adequatesupplies of hormones, enzymes, and antibodies. In addi-tion to its role in conserving calcium, it helps form thecollagen that makes up cartilage and connective tissues.

Poultry, eggs, fish, dairy products, meat, beans, yeast,and nuts all provide abundant amounts of Lysine, so de-ficiencies of this nutrient are virtually unknown in theUnited States. Even strict vegetarians have enough intheir diet. Experts say the only possible exceptions mightbe burn victims and strict vegetarians who are pregnantor breast-feeding.

Avoid if . . .High doses of amino acids lay an extra burden on theliver and kidneys. If you have a problem in either area,don’t take Lysine without your doctor’s approval. Alsoavoid it if you have diabetes or an allergy to proteinssuch as those found in eggs, milk, or wheat.

Special CautionsIn animal studies, Lysine has retarded growth in theyoung. Lysine supplements are therefore not recom-mended for children. (Normal dietary levels of Lysine arenot a concern.)


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Special Information if You Are Pregnant or Breast-feedingIt’s not known whether high doses of Lysine are safeduring pregnancy. As with any supplement not absolutelynecessary for your health, it’s best to avoid using Lysinewhile pregnant or breast-feeding.

Available Preparations and DosageBoth natural and synthetic forms of Lysine are available, intablet and capsule form, most commonly in 500-milligramstrengths. Lysine is also included in many multivitamin formulations.

Adults need a daily intake of approximately 5.5 milli-grams of Lysine per pound of body weight. When Lysineis taken for a herpes simplex infection, a typical dosage is1,000 to 3,000 milligrams daily.

OverdosageUnless you have an underlying disease, even high dosesof amino acids rarely cause problems. Sustained use ofexcessive amounts of Lysine could, however, increaseyour risk of gallstones, high cholesterol, or diarrhea.

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Malate

Why People Take ItSupplement suppliers claim that Malate can improve thebody’s ability to absorb minerals. In the form of malicacid, it is often included in magnesium supplements thatclaim to relieve the nagging muscle aches of fibromyal-gia. It’s also taken by some athletes in hopes that it willboost their energy levels.

To date, there’s no evidence that Malate can helpachieve either of these goals. One animal study, pub-lished in 1986, hints that Malate supplements may in-crease the processing of certain chemicals in the body,but no human trials have verified an actual increase inenergy. There are also no scientific studies confirmingMalate’s ability to relieve fibromyalgia.

What It Is; How It WorksMalate is produced by the body as it breaks apart thechemical bonds in carbohydrates, proteins, and fats inorder to release their energy (a process called the Krebscycle). When you are involved in endurance training, theamount of malate in your system increases as the Krebscycle works to supply extra energy. It’s this fact that leads

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some athletes to take Malate—and other by-products ofthe Krebs cycle—in an attempt to maximize the release ofenergy.

In the form of malic acid, Malate is found in a varietyof foods, including apples and grapes. In fact, it’s some-times labeled “apple acid.” It is used commercially in the aging of wine and as a food additive for flavoring ofnonalcoholic beverages, chewing gum, hard candy, fruitjuices, jams, and jellies.

Malate is also an ingredient in a number of prescrip-tion drugs, including medications for high blood pres-sure. It is often found in calcium supplements as well.For instance, calcium citrate–malate, which combinescalcium with citric acid and malic acid, is considered bysome to be the most easily absorbed calcium supplement.

Avoid if . . .No known medical conditions preclude the use of malate.

Special CautionsThe Food and Drug Administration generally recognizesmalic acid as safe when used as a food additive. However,its safety when used as a dietary supplement remains unknown. A number of Malate-containing supplementshave in fact caused adverse effects. But since these supple-ments include ten or more substances, it’s unclear whichingredient or combination of ingredients caused the ad-verse reaction.

Possible Drug InteractionsCheck with your doctor before taking a Malate supple-ment if you are taking a medication that contains Malateor malic acid.

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Special Information if You Are Pregnant or Breast-feedingNo harmful effects are known, but during this period it’sbest to avoid taking any supplement that isn’t manda-tory for your health.

Available Preparations and DosageMalate supplements are available in tablet, capsule, and powder forms. There is no official recommended di-etary allowance, and manufacturers’ dosage recommen-dations vary.


Melatonin

Why People Take ItWith its ability to regulate body rhythms and promotenormal sleep, this natural hormone has become a popularalternative to artificial sleep aids. For many people, itseems to relieve not only insomnia but jet lag and sea-sonal affective disorder (SAD) as well.

Other roles proposed for Melatonin are more contro-versial. Some advocates claim it can hold back the spreadof cancer. Others say it can delay the onset of aging,

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combat the symptoms of Alzheimer’s disease, lower cho-lesterol levels, and reduce high blood pressure. However,most doctors feel that its effectiveness for these purposesremains unproven.

What It Is; How It WorksMelatonin is a product of the pineal gland, where it is syn-thesized from the amino acid tryptophan. Under normalconditions, Melatonin levels foreshadow the sleep cycle,usually increasing rapidly from the late evening until mid-night, then decreasing as morning approaches. In this way,Melatonin helps regulate circadian rhythm, the body’s 24-hour “dark-light clock” that governs the timing of hor-mone production, sleep, body temperature, and more.

Not surprisingly, people with high levels of Melatoninusually sleep longer and more soundly than those with adeficiency. For example, the elderly, who produce lessMelatonin than the young and middle-aged, are typicallymore susceptible to insomnia. Similarly, events that throwMelatonin levels out of synch, such as a jet trip betweentime zones, seem to interfere with production of the hor-mone and thus disrupt sleep. Consumption of alcohol, tobacco, and narcotics has a similar effect.

Some researchers speculate that chronically low Mela-tonin levels may also be linked with cancer, especially inthe breast, skin, or prostate gland. They note that manycancer patients have poorly functioning pineal glandsand show low levels of Melatonin. Boosting these levels,they theorize, might strengthen the immune system andstimulate it to kill malignant cells, or at least prevent thecells from dividing rapidly. Until further proof is avail-able, however, Melatonin can be considered at best an

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adjunct to conventional treatment—and certainly not asubstitute for it.

Avoid if . . .Unless your doctor approves, do not take Melatonin ifyou have an autoimmune disease such as rheumatoidarthritis, any condition that affects your lymphatic sys-tem, AIDS, osteoarthritis, depression or any other emo-tional disorder, diabetes, epilepsy, heart disease, leukemia,multiple sclerosis, or serious allergies.

Couples who are trying to conceive a baby shouldavoid this hormone. It is also not for use by children orteenagers.

Special CautionsTake Melatonin only at bedtime. Do not drive or operatemachinery after taking a dose.

If you develop a headache, rash, or upset stomach, orfind that your normal sleeping patterns are disrupted,stop taking Melatonin and check with your doctor.

Possible Drug InteractionsCheck with your doctor before combining Melatoninwith the following:

Beta-blockers such as Inderal, Lopressor, and Tenormin

Large amounts of ibuprofen (Motrin, Advil)Mood-altering drugs such as diazepam (Valium)Steroid medications such as prednisone

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Special Information if You Are Pregnant or Breast-feedingDo not take Melatonin supplements during pregnancyor while breast-feeding.

Available Preparations and DosageMelatonin is available without prescription in tablet andcapsule form. Most experts recommend taking from 1 to3 milligrams approximately 20 minutes before bedtime.Controlled-release formulations should be taken 2 hoursbefore going to bed.

To determine the exact dosage that is best for you, askyour doctor to monitor your blood level and adjust thedosage accordingly. Do not attempt to medicate yourself.

OverdosageSeveral physicians and researchers say that dosages ashigh as 200 milligrams of Melatonin per day appear todo no harm.

Methionine

Why People Take ItThis sulfur-containing amino acid is one of several“lipotropic” substances that promote the processing offats within the body. (Others are choline, inositol, and

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lecithin. See separate entries.) In particular, Methioninehelps clear fat out of the liver, and is used to treat certaintypes of liver damage.

Methionine also helps rid the body of toxins such aslead, mercury, and cadmium. This property has promptedsome experts to speculate that Methionine could provehelpful in the treatment of such problems as depression,schizophrenia, Alzheimer’s disease, other forms of de-mentia, hyperactivity in children, and kidney damage.There’s currently little evidence to support these theo-ries, although a Methionine-containing compound calledSAMe has shown promise in the treatment of depression,osteoarthritis, and the muscle pain of fibromyalgia. (Seeseparate entry.)

What It Is; How It WorksMethionine is one of the “essential” amino acids thatcan’t be manufactured by the body and must be obtainedfrom the diet. Like all amino acids, it’s one of the rawmaterials the body uses to manufacture human proteins.Its sulfur content makes it especially important for themaintenance of healthy skin, hair, and nails, all of whichare high in sulfur-containing keratin.

Methionine is required for the production of glu-tathionine, one of the body’s chief natural detoxifiers(see separate entry). When higher levels of toxic com-pounds are present, more Methionine is needed. Abun-dant supplies are available in meat, fish, eggs, and dairyproducts, so supplementary Methionine is rarely neededby anyone other than a strict vegetarian.

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Avoid if . . .High doses of amino acids lay an extra burden on theliver and kidneys. If you have a problem in either area,don’t take Methionine without your doctor’s approval.Also avoid it if you have diabetes (which puts furtherstress on the kidneys) or an allergy to proteins such asthose found in eggs, milk, or wheat.

Special CautionsWhen taking a Methionine supplement, you might wantto take a multivitamin as well. Excessive Methionine in-take accompanied by a shortage of folic acid, vitamin B6,and vitamin B12 can boost levels of homocysteine, a sub-stance linked to heart disease and stroke.


Special Information if You Are Pregnant or Breast-feedingIt’s not known whether high doses of Methionine aresafe during pregnancy. As with any supplement not ab-solutely necessary for your health, it’s best to avoid usingMethionine while pregnant or breast-feeding.

Available Preparations and DosageThe average adult requires about 800 to 1,000 milli-grams of Methionine per day, an amount exceeded bymost Western diets. If you take Methionine for a liver ail-ment or a problem such as depression, proponents rec-ommend taking anywhere from 200 to 400 milligramstwo to three times a day. Methionine supplements aremost often found in capsule form.

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OverdosageUnless you have an underlying disease, even high dosesof amino acids rarely cause problems.

MSM (Methyl SulfonylMethane)

Why People Take ItAccording to its proponents, MSM relieves osteoarthri-tis pain. And because MSM is inexpensive and low intoxicity, people who haven’t had good results with othertreatments are often tempted to give it a try. Before youbegin taking it, though, you should know that there’slittle carefully controlled research to back up its efficacy,and that individual experiments often prove nothing. As the Arthritis Foundation points out, symptoms ofarthritis often come and go on their own, so any im-provement could be a coincidence, particularly sinceMSM is said to take several weeks to produce its results.

What It Is; How It WorksMSM is an organic sulfur compound found naturally inthe body. It is readily available in the diet through freshfruits and vegetables, grains, fish, and milk. (Packagedfoods may lack MSM, which breaks down during foodprocessing.) The sulfur in MSM plays a variety of roles in

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the body. It’s important for the maintenance of healthyskin, hair, and nails. More important, it appears to benecessary for the production of collagen, one of the majorbuilding blocks of the cartilage that cushions the joints.

MSM is chemically related to DMSO, a drug that en-joyed popularity in the 1960s as a purported antioxi-dant, anti-inflammatory, and antiarthritis agent. Despitethese claims, DMSO has been judged effective by theFDA for only one ailment, a bladder inflammation calledinterstitial nephritis.

Advocates believe that MSM and DMSO share a similarmechanism of action. They think that both may slowtransmission of pain impulses by the nerves, and perhapshelp make the body’s own inflammation fighter, corti-sol, work more effectively. They claim that, in addition to osteoarthritis, MSM can relieve rheumatoid arthri-tis, fibromyalgia, gout, and chronic headache, as well as back pain.

There are a few unpublished studies on the claims forMSM, conducted by proponents, which seem to showthat the product has helped people with osteoarthritispain. These studies are impossible for experts to evaluate.They say MSM is worthy of further research, but at thispoint the work remains to be done.

Avoid if . . .If you are healthy, you don’t need supplemental MSM.

Special CautionsIf you have osteoarthritis, it’s best to check with your doc-tor before starting MSM. There may be a more promising

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alternative to try first. Remember, too, that the long-termeffects of MSM are still unknown.

Possible Drug InteractionsDon’t combine MSM with drugs that thin the blood,such as Coumadin or aspirin, since MSM may have ablood-thinning effect.

Special Information if You Are Pregnant or Breast-feedingThe effects of MSM in pregnancy are unknown. Avoidusing it while pregnant or breast-feeding.

Available Preparations and DosageMSM is a white, odorless, slightly bitter powder which iseasily dissolved. Proponents often recommend a startingdose of 1,000 milligrams daily, with up to 8,000 milli-grams daily considered safe. The product is available incapsule and powder form. For topical use in pain relief, itis available as a cream, lotion, or gel.

OverdosageMSM is considered to have very low toxicity. However,doses exceeding 8,000 milligrams per day may cause diarrhea.

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NADH (NicotinamideAdenine Dinucleotide)

Why People Take ItA chemical cousin of vitamin B3 (niacin), NADH is natu-rally present in each of the body’s cells, where it’s needed totrigger conversion of nutrients into the cellular “fuel”adenosine triphosphate (ATP). Proponents of NADH havetested it for several serious diseases, including Parkinson’s,Alzheimer’s, depression, and chronic fatigue syndrome.However, controlled studies (trials comparing patients re-ceiving a drug with others who aren’t) have so far beenconducted only for chronic fatigue syndrome. The results,while promising, are considered preliminary by experts.

What It Is; How It WorksBecause of its role in the synthesis of ATP, NADH is akey factor in the body’s production of energy. There isalso some evidence that high levels of NADH in the brainmay increase production of such chemical messengers as dopamine, norepinephrine, and serotonin. The bodyproduces NADH continuously, using vitamin B3 as rawmaterial. NADH is also readily available from such di-etary sources as fish, poultry, beef, and products made

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with yeast. Deficiencies of NADH in the United Statesare almost unknown, except in rare cases of alcoholism.

Research on the use of NADH for treatment of chronicfatigue syndrome has produced encouraging, though notspectacular, results. The study included 26 patients withchronic fatigue, and found that 31 percent of those taking10 milligrams of NADH daily had fewer symptoms. Theresearchers theorize that a shortage of ATP may con-tribute to the symptoms of chronic fatigue, and that theextra NADH works by helping to replenish depleted cel-lular stores of the compound.

Because Parkinson’s disease is caused by a shortage ofdopamine at certain locations in the brain, researchershave speculated that NADH’s dopamine-boosting effectmight relieve the tremors and rigidity the disease pro-duces. Preliminary studies seem to indicate that for manyParkinson’s patients this may be true. In one trial ofNADH in 885 people with Parkinson’s disease, nearly 80 percent showed improvement. (There were, however,no “controls”—patients given no NADH—to provide abasis of comparison for judging the results.)

Since NADH supports production of other chemicalmessengers in the brain, scientists are also eyeing it for use against Alzheimer’s disease and depression. In onesmall trial, 17 patients suffering from Alzheimer’s showed improvement after taking NADH for 8 to 12 weeks. Like-wise, a 10-month trial of NADH in 205 depressed pa-tients ended in improvement for 93 percent. But sincethese studies were small, uncontrolled, and conducted byadvocates of NADH, experts say more rigorous testing isneeded before any firm conclusions can be drawn.

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Avoid if . . .Given the lack of conclusive research, it would be unwiseto use NADH as a replacement for more promising treat-ments. Although there are no known reasons to avoidthe supplement, it’s best used as part of an overall treat-ment plan designed by your doctor.

Special CautionsLittle is known about the effects of long-term, high-doseuse of NADH, but excessive use of the related compoundnicotinic acid can lead to liver damage, so caution is inorder.


Special Information if You Are Pregnant or Breast-feedingNo information is available on the effects of NADH inpregnancy or while breast-feeding. Like any supplementwith uncertain effects, it should be avoided during thiscritical period.

Available Preparations and DosageNADH is available in 2.5- and 5-milligram tablets. Atypical dosage recommendation is 10 milligrams per day,with water, on an empty stomach. An injectable form isused by physicians to treat complications of alcoholism.

OverdosageNo information is available on overdosage.

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Omega-3 Fatty Acids

Why People Take ThemThese special fatty acids, found in most cold-water fish,may lower the risk of heart disease. Greenland Inuitshave a diet high in fat, but one that is also high inOmega-3s, and they have a far lower incidence of heartdisease and far less cholesterol in their blood than the av-erage beef-eating American. In addition, they have lowerrates of some cancers and almost no high blood pressure,obesity, arthritis, or diabetes. While there’s no proof thatOmega-3s are responsible for this situation, proponentsconsider it more than a coincidence.

Ongoing research suggests that Omega-3 Fatty Acidsmay also reduce symptoms of bipolar disorder, schizo-phrenia, and other psychiatric disorders by helping toregulate mood. Some scientists feel there’s also a pos-sibility that the Omega-3s can ease the symptoms ofarthritis, lupus, and endometriosis, and that they maypromote bone growth and fight the brittle-bone diseaseosteoporosis.

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What They Are; How They WorkOmega-3 Fatty Acids are among the highly polyunsatu-rated fats that tend to keep cholesterol levels in check.Dubbed eicosapentaenoic acid (EPA) and docosahexae-noic acid (DHA), they are found primarily in cold-water fish such as cod, mackerel, sardines, herring, tuna, andsalmon. A vegetable product called perilla oil is also richlyendowed with these acids, and they can be manufacturedby the body, using another fatty acid—alpha linolenic acid(LNA)—as a raw material. Good sources of LNA includeflaxseed and canola oils, walnuts, soybeans, spinach, andmustard greens. (For more information on the majorsources of Omega-3s, see the separate entries on Fish Oils,Flaxseed Oil, and Perilla Oil.)

EPA and DHA have been shown to lower total choles-terol and triglyceride levels, while raising “good” HDLcholesterol. They also exert a blood-thinning effect byincreasing the slipperiness of the blood platelets involvedin clot formation. This is thought to discourage thebuildup of artery-clogging plaque and reduce the risk ofheart attack due to a clot in the coronary arteries. By ex-panding the blood vessels, EPA may also lower bloodpressure in those with hypertension.

Researchers speculate that the Omega-3 Fatty Acidsmay confer their cardiovascular benefits by displacinganother, less beneficial, type of fatty acid called omega-6.Omega-3s also appear to suppress the production ofprostaglandins, hormonelike substances that often pro-mote inflammation. It is this property that could makethem beneficial to people suffering from inflammatorydiseases such as arthritis.

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Avoid if . . .Because of their blood-thinning effects, you should nottake Omega-3 supplements if you have a bleeding dis-order such as hemophilia or a tendency to hemorrhage.

Special CautionsIf you decide to boost Omega-3 levels by taking fish oilsupplements, you should know that cod liver or otherfish liver oils are so rich in vitamins A and D that highdoses of the oils could cause vitamin toxicity. High dosesof fish oil have also been known to increase “bad” LDLcholesterol levels and cause an increase in blood sugar.See the entry on fish oil for more information.

Possible Drug InteractionsIf you are taking a blood-thinning drug such as aspirin or Coumadin, check with your doctor before takingOmega-3 supplements, which could further thin theblood.

Special Information if You Are Pregnant or Breast-feedingDuring pregnancy, do not take extra Omega-3s in theform of fish oil. High doses (25,000 IU or more) of the vi-tamin A in fish oil can cause birth defects.

Available Preparations and DosageThere is no recommended dietary allowance (RDA) forOmega-3 Fatty Acids. To boost your intake, most nu-tritionists recommend eating fish two or three times a week, rather than taking large amounts of supple-ments. A 7-ounce serving of salmon or bluefish provides

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2.4 grams of Omega-3 acids. The same serving of herringcontains 3.2 grams.

To supplement your intake of linolenic acid—and thusthe body’s supply of Omega-3s—you can also take flax-seed. Typical doses are 35 to 50 grams of crushed seedsor 1 to 2 tablespoonfuls of flaxseed oil daily. To addextra linolenic acid to your diet, make a habit of usingcanola oil in cooking.

If you use fish oil, flaxseed oil, or perilla oil, rememberthat these products can quickly become rancid. Storethem in air-tight containers kept in the refrigerator.

OverdosageExcessive intake of Omega-3s can lead to bleeding prob-lems in case of accident or trauma, and may causeanemia in menstruating women. Large doses of fish oilcan also lead to problems. See the fish oil entry for addi-tional information.

Ornithine

Why People Take ItBy boosting the body’s production of human growthhormone, Ornithine is said to yield two major health

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benefits: a reinvigorated immune system and a leaner,more muscular body.

An amino acid, Ornithine is produced in the body fromarginine, a related amino acid with similar properties (seeseparate entry). Both compounds stimulate synthesis ofgrowth hormone, which in turn is said to promotegrowth of the white blood cells that patrol the body on search-and-destroy missions against bacteria, viruses,and cancer-causing chemicals. They also aid in healingand repair of damaged tissues. And, in large doses, theyare said to promote weight loss by building muscle whileburning off extra fat.

Ornithine is one of the raw materials of spermine andspermidine, two compounds that support production ofsperm. Some researchers have linked low levels of sper-mine with poor memory, and suggest that Ornithinesupplements could serve as memory boosters. This theoryhas not yet, however, been verified in clinical trials.

Ornithine also plays a role in the processing of thebody’s waste products for elimination in the urine, help-ing to rid the body of toxic ammonia. It supports liverfunction and helps the liver filter waste products fromthe blood. Because of its beneficial effect on the liver—itmay even help the liver regenerate—Ornithine has beenused as a treatment when people with liver disease lapseinto coma.

What It Is; How It WorksOrnithine is available in milk products, as well as chickenand other meats. Because the body can produce a certainamount of Ornithine when it’s lacking in the diet, it isconsidered a “nonessential” amino acid. Nevertheless,

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diets severely deficient in protein may leave the body witha shortage of this important nutrient.

Scientists have yet to conduct the major human trialsneeded to verify Ornithine’s protective effects againstgerms and toxins. However, tests on laboratory animalshave been encouraging. In one animal study, a combina-tion of Ornithine and arginine effectively blocked tumorsfrom forming in mice injected with a cancer-causingvirus.

Avoid if . . .Children should not be given Ornithine supplements dueto its impact on growth hormone levels. For the samereason, it should be avoided during pregnancy and breast-feeding. Ornithine and arginine sometimes reactivate la-tent herpes virus infections; so people who have had brainor ocular herpes must strictly avoid both substances. Or-nithine may also aggravate schizophrenia and shouldn’tbe taken by anyone with this disorder.

Special CautionsGrowth hormone and substances that promote its re-lease, such as Ornithine, can aggravate diabetes; dia-betics must use them with care. Although side effects arerare, Ornithine occasionally causes insomnia.


Special Information if You Are Pregnant or Breast-feedingBecause it affects growth hormone, Ornithine should beavoided during pregnancy and breast-feeding.

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Available Preparations and DosageOrnithine and arginine are typically taken together. Or-nithine is available by itself in 500-milligram hard gelatincapsules. Combination supplements containing 500 milli-grams of arginine and 250 milligrams of Ornithine arealso available, reflecting the belief that Ornithine is twiceas potent as arginine. Typical Ornithine doses range from1,000 to 2,500 milligrams daily; arginine doses are doublethose amounts.

OverdosageExcess growth hormone can make the skin tough andthick. This problem will disappear when the amount ofgrowth hormone in the body returns to normal. How-ever, long-term stimulation of growth hormone can leadto other changes that don’t go away, including enlarge-ment of the larynx, deepening of the voice, and over-grown joints. Excessive growth hormone has also beenlinked to certain cases of diabetes (high blood sugar).

Oscillococcinum

Why People Take ItThis patented homeopathic remedy is a popular item inhealth food stores during flu season. Marketed for the re-

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lief of influenza symptoms such as fever, chills, aches, andpains, Oscillococcinum (pronounced o-sill-oh-cox-in-um) is the leading nonprescription remedy for flu symp-toms in France, according to Boiron, Inc., the Frenchcompany that manufactures it. It is also a prime examplein the ongoing controversy over homeopathic medicine:its supporters claim it’s one of the most scientifically vali-dated of all homeopathic remedies, while debunkers holdit up as a classic example of the reason homeopathy ismere quackery.

What It Is; How It WorksOscillococcinum is prepared from the heart and liver ofwild duck, but like most homeopathic medicines, thisone is diluted so many times that a given dose may notcontain a single molecule of duck. Following this “law ofinfinitesimals” is a hallmark of homeopathy, but onethat defies the principles of mainstream medical science.Some drugs do work better at lower doses than at higherones, but none work better when the active ingredient isessentially missing. Why duck liver? Because of anotherseemingly paradoxical law of homeopathy: “Like cureslike” (substances that cause symptoms can cure the samesymptoms when taken in small enough doses), and duckorgans are claimed to be reservoirs for influenza viruses.

These unscientific-sounding principles have long givenskeptics cause to label all homeopathic medicine a fraud,or at best a placebo (a “dummy pill” that works becausea patient believes it will). And indeed, past clinical trialsof Oscillococcinum, although purporting to prove it ef-fective, have failed to meet rigorous standards of scien-tific research.

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In recent years, however, a few homeopathic products,including Oscillococcinum, have actually performed bet-ter than a placebo in a handful of well-conducted clinicaltrials, the kind in which patients are randomly assignedto the medicine or a placebo without knowing which. Ina review of seven such trials of Oscillococcinum, re-searchers from Memorial Sloan-Kettering Cancer Centerfound that the product might indeed shorten the dura-tion of flu symptoms (although not by much). The re-searchers called the evidence promising, but didn’t find itstrong enough to recommend Oscillococcinum as a first-choice therapy for the flu.

Homeopaths continue to theorize about how theirultra-diluted remedies actually work, suggesting that thewater in which the active ingredients are diluted retainssome kind of “memory” or energy pattern. Even skepticsagree that if they ever prove their case, the conventionalwisdom about how drugs cure disease will be turned onits head.

Avoid if . . .The makers of Oscillococcinum state that it is safe forpeople with other medical conditions and free from anyside effects—not surprising, its critics would add, for aproduct that contains virtually no active ingredients.

Special CautionsLike most homeopathic remedies, Oscillococcinum pre-sents only two risks: wasting money and—if you rely onthe product exclusively—losing an opportunity for moreeffective medical treatment. Since Oscillococcinum issafe and moderately priced by the standards of trendy al-

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ternative remedies, there’s little to lose by trying it at thefirst sign of flu and deciding for yourself—provided youdon’t forgo standard medical care. Be extra cautious ifyou have other medical conditions that make flu espe-cially dangerous for you. Standard care for the flu startswith immunization shots recommended for high-risk in-dividuals such as the elderly and those with respiratoryconditions like asthma. Several prescription medicationsare also available to tame the symptoms of flu in additionto these old standbys, bed rest and chicken soup.

Possible Drug InteractionsDrug interactions, the manufacturer assures us, are not aproblem. Detractors would agree, citing the lack of any-thing with which a drug could interact.

Special Information if You Are Pregnant or Breast-feedingThe remedy’s manufacturer claims that Oscillococcinummay be used by children and pregnant women under a physician’s supervision. Given the diluted-to-nothingnature of homeopathic remedies, this is a reasonable assumption.

Available Preparations and DosageLike many homeopathic preparations, Oscillococcinumis formulated in tiny pellets for oral dosing. Each dose ispackaged in a separate tube; the recommended dosage isone dose every 6 hours for a total of three doses daily, tobe taken at the first signs of influenza.

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OverdosageBecause this remedy contains no detectable active ingre-dient, overdosage is not a concern.

PABA (Para-Aminobenzoic Acid)

Why People Take ItBest known as the active ingredient in a variety of sun-block products, PABA has been tried as a remedy for several unusual disorders, but without notable success. Ithas been studied for the treatment of diseases marked byan abnormal buildup of fibrous tissues, such as sclero-derma, but has rarely produced an effect. Some research-ers have also reported that it relieves certain skin diseasessuch as vitiligo, in which the skin loses pigment in patches.Other studies, however, suggest that PABA may actuallyworsen this disease.

A single study done nearly 60 years ago found PABAuseful as a treatment for female infertility, but the resultshave never been duplicated. It has also been used, butagain without much scientific verification, as a treatmentfor male infertility. Some alternative health authoritiesclaim PABA can darken gray hair in some older adults,though in most trials it has failed to do so. Also unveri-fied are claims that PABA helps to slow aging, support

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the immune system, treat arthritis and headaches, andrelieve constipation.

What It Is; How It WorksPABA is a member of the vitamin B complex. It is re-quired in the formation of folic acid in the body and aidsin the breakdown and use of proteins. Through its asso-ciation with folic acid, it promotes red blood cell forma-tion. It is also said to enhance the effects of cortisone andestrogen by delaying their breakdown in the liver.

A water-soluble vitaminlike substance, PABA is notconsidered to be an essential human nutrient. However,to the extent that all members of the B complex areneeded for maximum effect, PABA may lend support tothe other vitamins in the B family.

Under ordinary circumstances, there’s no need for extraPABA in the diet. If a shortage does develop, it will be sig-naled by headaches, fatigue, depression, nervousness, anddigestive disturbances. Good sources of PABA includebrewer’s yeast, bran, wheat germ, eggs, liver, spinach, mo-lasses, and rice.

Avoid if . . .If you’re allergic to sunscreens containing PABA, youshould probably avoid PABA supplements.

Special CautionsHigh doses of PABA can be fatal, especially in children,and sustained megadosing can cause low blood sugar,rash, fever, and liver damage. Consult with a physicianbefore giving PABA to a child, before taking doses of

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more than 400 milligrams per day, and before takingPABA preparations for an extended period of time.

Possible Drug InteractionsDo not combine PABA with sulfa drugs, methotrexate,or the antibacterial drug Dapsone; it may interfere withtheir effects. Because PABA is often one of the ingredi-ents in multivitamin products, be sure to read all yoursupplement labels.

Special Information if You Are Pregnant or Breast-feedingPABA spurs production of folic acid, and adequateamounts of folic acid are essential during pregnancy.Nevertheless, the full effects of PABA supplementationduring pregnancy are unknown, so it’s best to avoid itwhile pregnant or breast-feeding.

Available Preparations and DosagePABA is widely available in strengths ranging from 50 to1,000 milligrams. It can be purchased by itself, in combi-nation with other B vitamins, and in multivitamin supple-ments. It’s an ingredient in many children’s vitaminproducts.

Typical daily dosages never exceed 400 milligrams,though megadoses of up to 12 grams a day are sometimesprescribed for disorders of the connective tissue and skin.Daily doses above the 400-milligram level should betaken only under a doctor’s supervision.

OverdosageChildren have reportedly died from PABA overdoses.Massive doses can damage the liver, heart, and kidneys.

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Symptoms include loss of appetite, nausea, vomiting, andshortness of breath.

Pantethine

Why People Take ItPantethine is a form of pantothenic acid (vitamin B5) thatoffers some benefits not available from other forms of thevitamin. In particular, Pantethine has been shown to lowerblood cholesterol and triglyceride levels. Some studieshave found that it’s especially helpful for diabetics, re-ducing cholesterol without disturbing blood sugar. It ap-pears to be particularly useful for diabetics on dialysis.

Other benefits are less well documented. The substancehas been used as a treatment for cataracts and hepatitis A,as a detoxifier of alcohol in the body, and as an immunestimulant, but results have been inconclusive. Most cur-rent research focuses on Pantethine’s potential value inlowering cholesterol and protecting against cardiovas-cular disease.

What It Is; How It WorksPantothenic acid is so common in plants and animals thatits name is taken from a Greek word meaning “every-where.” It is necessary for the formation of cell membranes

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and plays an important role in a variety of the body’s metabolic processes. It also aids the healing process andsupports the normal functioning of the nervous system.Common in many foods, it is also produced by the bacteriain our intestines. Good dietary sources include blue cheese,brewer’s yeast and baker’s yeast, eggs, lobster, salmon, allkinds of meats (especially liver), lentils, peanuts, peas, soy-beans, sunflower seeds, wheat germ, corn, and whole grainproducts. Because it’s so widely available in commonfoods, cases of deficiency are rare.

Pantothenic acid (and Pantethine) acts as a coenzyme tofacilitate the release of energy from carbohydrates, pro-tein, and fat. It plays an essential role in the body’s produc-tion of cholesterol and fatty acids. It is also needed in theproduction of acetylcholine, one of the nervous system’skey chemical messengers. It stimulates the adrenal glandsto expand the body’s supply of cortisone and other steroidhormones, and it promotes red blood cell production. It has an acknowledged role in the healing process, andproponents have suggested that it could be helpful intreating arthritis, premenstrual syndrome, vitiligo (mottledskin), and stress-related conditions. It has also been pro-posed as a remedy for conditions ranging from gray hair,constipation, aging, and fatigue to allergies, cirrhosis ofthe liver, and stomach ulcers. However, its therapeuticvalue for such problems remains to be verified.

Pantethine is metabolized slightly differently than pan-tothenic acid, and this seems to account for its differenteffects. Pantethine has been tested for a wide range ofconditions, including rheumatoid arthritis, acne, lupus,and sinusitis, but the most promising results have beenobtained against high cholesterol and triglycerides. Pan-

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tethine supplements have been found to lower “bad”LDL cholesterol and triglyceride levels, and raise “good”HDL cholesterol, perhaps by slowing cholesterol syn-thesis and speeding up the use of fats for energy. A 1990study showed an improvement in cholesterol levels inperimenopausal women taking 900 milligrams daily.Another study—of 1,045 diabetics taking an average of900 milligrams daily—found similar improvements. Im-portantly, Pantethine is well tolerated by most people,with no significant side effects.

Avoid if . . .At customary dosage levels, Pantethine is safe for virtu-ally everyone. However, rare allergic reactions have beenreported.

Special CautionsWhile Pantethine promises substantial benefits withoutrisk of side effects, it would be unwise to view it as a sub-stitute for conventional treatment. If you have a condi-tion such as high cholesterol, Pantethine alone may notsolve the problem. Regular medical supervision is essen-tial, whether you use Pantethine or not.

Possible Drug InteractionsDo not take supplemental Pantethine if you are takinglevodopa for Parkinson’s disease. (It’s okay, however, totake Pantethine if you are using a combination of car-bidopa and levodopa such as the brand Sinemet.)

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Special Information if You Are Pregnant or Breast-feedingPantethine requirements tend to rise during pregnancyand breast-feeding. However, it’s best to check with yourdoctor before starting Pantethine or any other supple-ment during this critical period.

Available Preparations and DosageThere is no official recommended dietary allowance forpantothenic acid. It’s estimated that most adults get 4 to10 milligrams daily in their diet—an amount sufficient tomeet the average daily requirement of 4 to 7 milligrams.Stress, injury, and illness may increase the need for pan-tothenic acid, and some evidence suggests that use ofcigarettes, sulfa drugs, some sleeping pills, estrogen, andalcohol tend to raise the body’s requirements.

Proponents of the therapeutic use of Pantethine typi-cally recommend taking 300 milligrams 3 times a day.(Therapeutic doses of pantothenic acid range from 50 to200 milligrams per day.) Pantethine is available in tabletand capsule form, in a wide variety of strengths. It is alsoavailable in combination with pantothenic acid.

OverdosagePantethine and pantothenic acid are considered similarin toxicity. Daily doses of 1,000 milligrams or more ofpantothenic acid have been taken for months without illeffects. However, megadoses of several grams a day cancause diarrhea and water retention. If you develop suchproblems, discontinue the supplement.

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Pectin

Why People Take ItAs a form of dietary fiber, Pectin promises a variety ofbenefits. Health authorities universally agree that fibercontributes to digestive health. High-fiber, low-caloriefoods such as fruits and vegetables, all of which containat least some Pectin, are recommended for weight loss.Diabetics may benefit from adding it to their diets. In ad-dition, preliminary studies have shown that Pectin, par-ticularly grapefruit pectin, can help to lower cholesteroland reduce the risk of heart disease.

Preparations containing Pectin have proven effective inthe treatment of gastroesophageal reflux disease (GERD)and heartburn. It has also been studied as a remedy for ul-cers, but was found ineffective. Research has shown thatPectin, as an active ingredient in combination with othermedications, is useful in treating diarrhea.

Studies with laboratory animals indicate that modifiedcitrus pectin may help to slow the spread of cancer, par-ticularly prostate and colon cancer. While its effect hasnot yet been confirmed in humans, Pectin is now beingwidely recommended to cancer patients, since it’s un-likely to cause harm and could prove helpful.

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What It Is; How It WorksPectin is the type of water-soluble fiber that is noted forits ability to reduce cholesterol levels. It helps providestructure to plant cells, and is almost impossible to avoidin any kind of normal diet. Primary sources are citrusfruits, apples, potatoes, peas, beans, and oats. Pectin iswidely used by food manufacturers as a gelling agent injams, jellies, and salad dressings.

Studies have found that Pectin works as a diet aid byhelping to slow the emptying of the stomach and in-hibiting the absorption of food in the intestines, where itprovides bulk but is not itself absorbed. Some health au-thorities think it may be helpful to diabetics because itslows the rise of blood sugar.

In cancer studies in rats, Pectin appeared to reduce theability of cancer cells that break off from the main tumorand cling elsewhere in the body—the cancer-spreadingprocess called metastasis. Further studies are under way.

Avoid if . . .Avoid all fiber supplements if you have an intestinal ob-struction or fecal impaction, or have difficulty swallow-ing. Check with your doctor before taking Pectin if youhave a fever or there is blood or mucus in your stools.

Special CautionsAs with any dietary fiber, adding large amounts of Pectinto the diet may cause gas or abdominal distress. Increaseyour intake of Pectin gradually, and always be sure to getplenty of fluids.

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Possible Drug InteractionsLarge amounts of Pectin may interfere with the absorp-tion of some drugs. Like other fiber supplements, it shouldbe taken at least 2 hours before or after medications.

Special Information if You Are Pregnant or Breast-feedingFiber supplements are not known to be harmful. Still, it’sbest to check with your doctor before using Pectin whilepregnant or breast-feeding.

Available Preparations and DosagePectin, mostly made from citrus fruits or apples, is avail-able in tablet and powder form. Mix the powdered formwith water or juice according to the manufacturer’s di-rections and drink it quickly before it gels. To avoid therisk of choking, always take fiber supplements such asPectin with sufficient liquid, at least an 8-ounce serving.

Pectin is also found as an ingredient in commercial dietpreparations, multivitamins, and other food supplements.

OverdosageAn overdose of Pectin won’t prove toxic. However, largequantities of fiber taken without sufficient fluids couldlead to fecal impaction.

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Perilla Oil

Why People Take ItThis exotic variety of vegetable oil, native to the Orient,has seized attention in recent years as a rich source of theomega-3 fatty acids said to protect against heart disease.It is now promoted as a stomach-friendly alternative tothe sometimes upsetting fish oil supplements that peoplehave traditionally taken to get extra omega-3s.

The omega-3 fatty acids in fish oil have been studiedfor decades. Many proponents believe that these com-pounds not only can stave off heart disease but may alsodiscourage some forms of cancer and relieve arthritis.Research on Perilla Oil, on the other hand, is still in itsearliest stages, with very few formal trials yet conductedin humans.

Nevertheless, animal experiments have uncovered sometantalizing hints of the oil’s potential benefits. There is atleast a possibility that it can help relieve allergies andasthma, control excess weight and high blood pressure, re-duce blood sugar levels, and fight various inflammatorydiseases. None of these effects, however, have been con-firmed in large-scale trials.

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What It Is; How It WorksPerilla Oil is extracted from the seeds and leaves of thebeefsteak plant, an Asian herb that resembles the orna-mental coleus found in many Western gardens. The oil,which has a delicate fragrance, has been used for years inJapanese cooking.

The omega-3 fatty acids in Perilla Oil are labeled “es-sential” because they cannot be made by the body butmust come from the diet. Advocates say that they lowerthe levels of artery-clogging triglycerides (fats) and “bad”LDL cholesterol in the blood, while raising the amount of“good” HDL cholesterol. Omega-3s also appear to dis-courage heart attacks by preventing unwanted clotting,which can lead to a blockage in the arteries serving theheart.

Some researchers believe that Americans suffer from arelative imbalance between omega-3 fatty acids and theirmore common counterparts, the omega-6 fatty acidsfound in products such as corn and safflower oils. Highintakes of omega-6 compounds seem to promote cloggedarteries and blood clots—the opposite of the effects encountered with omega-3s. While both oils are essen-tial parts of the diet, some researchers suggest reducingomega-6 intake and boosting omega-3 levels until thetwo are roughly in balance.

Avoid if . . .Due to one of its ingredients, it’s best to avoid Perilla Oil during pregnancy and obtain omega-3s from othersources. (See “Special Information if You Are Pregnantor Breast-Feeding.”)

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Special CautionsBecause omega-3 fatty acids discourage clotting, exces-sive levels can lead to bleeding problems in case of an ac-cident or trauma. Overly high intake could also increasethe risk of anemia for women who menstruate.

In theory, an excessive increase in omega-3 fatty acidscould induce bleeding in the brain, leading to stroke.However, diets high in omega-3 fats have not producedsuch problems in animal tests.

Certain agents—called ketones—in Perilla Oil havebeen shown in animal studies to cause allergic reactions,including life-threatening breathing difficulties. In hu-mans, the only reported allergic reactions so far havebeen in Japan, where 20 to 50 percent of long-termworkers in the Perilla industry developed skin irritationon their hands.

Possible Drug InteractionsYou should check with your doctor before using PerillaOil if you are already taking cholesterol-lowering orblood-thinning drugs, including aspirin.

Special Information if You Are Pregnant or Breast-feedingLab tests suggest that perillaldehyde, one of the com-pounds in Perilla Oil, might have damaging effects on a de-veloping baby. Do not use this product during pregnancy.Since we do not know whether it appears in breast milk, itwould be wise to avoid it while breast-feeding as well.

Available Preparations and DosageThere is no recommended dietary allowance for theomega-3 fatty acids. Proponents suggest that a daily intake

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of 3 to 4 grams of Perilla Oil is sufficient to provide a pro-tective effect against heart disease. Specifically, they recom-mend 6,000 milligrams of stabilized Perilla Oil capsules aday, which provide 3.3 grams of omega-3 fatty acids.

Because dietary fiber can absorb any fatty acid, somesupplement manufacturers recommend taking PerillaOil at a different time than fiber. To enhance absorption,at least one supplier recommends taking Perilla Oil witha sulfur-containing food such as low-fat cottage cheese.And remember that the body cannot process fatty acidswithout nutrients such as magnesium, zinc, vitamin B6,vitamin B3, and vitamin C.

Protect Perilla Oil from heat and light. To maintainshelf life, refrigerate after opening.


Phenylalanine

Why People Take ItPhenylalanine serves as one of the raw materials forthree of the nervous system’s most important chemicalmessengers: dopamine, epinephrine, and norepineph-rine. The body can also convert it to phenylethylamine,

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a mood-boosting substance that’s said to have pain-relieving effects as well.

In light of these properties, Phenylalanine has been pro-posed as a treatment for depression, Parkinson’s disease,and chronic-pain conditions such as arthritis. Trials forarthritis have yielded conflicting results, but preliminarytrials for depression have proved encouraging. Phenylala-nine has also been promoted as an appetite suppressantand sexual stimulant, but its effectiveness for these pur-poses remains unproven.

What It Is; How It WorksAn “essential” amino acid that the body can’t manufactureon its own, Phenylalanine is one of the building blocks of protein. There are two types: L-phenylalanine and D-phenylalanine. The L variety occurs naturally in the dietand supports production of dopamine, epinephrine, nor-epinephrine, and the mood elevator phenylethylamine.The D form of the substance doesn’t occur naturally andserves only as a raw material for phenylethylamine. Bothforms are created during the commercial manufacturingprocess and are typically sold in the combined supplementknown as DLPA. Products containing the L form only arealso available.

Outright deficiencies of L-phenylalanine are rare, buthave been known to strike people who don’t eat enoughprotein. (Signs of protein deficiency include a loss of en-ergy and stamina, lowered resistance to infection, slowhealing of wounds, weakness, and depression.) Foodsrich in L-phenylalanine include almonds and peanuts,bananas and avocados, cheese and cottage cheese, limabeans, nonfat dry milk, pumpkin and sesame seeds, and

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pickled herring. Phenylalanine is also an ingredient ofthe popular artificial sweetener aspartame.

Avoid if . . .Children born without the ability to process Phenyl-alanine can build up dangerous levels of this amino acid, leading to mental retardation, seizures, extremehyperactivity, and psychosis. Children with this condi-tion, called phenylketonuria, must follow a special dietdesigned to supply no more Phenylalanine than neces-sary, and must be monitored regularly for excess Phenyl-alanine in the blood.

Special CautionsIf you have high blood pressure, use Phenylalanine cau-tiously; it may aggravate this condition. High doses canalso cause anxiety; if you’re subject to anxiety attacks,it’s wise to keep your doses low.

The combination supplement DLPA occasionally causesmild nausea, heartburn, or headache. Because it can havesignificant effects on mood, it’s best to use this type ofPhenylalanine only under a doctor’s supervision.

Possible Drug InteractionsDo not combine Phenylalanine supplements with drugsknown as MAO inhibitors, including the antidepres-sants Nardil and Parnate.

Special Information if You Are Pregnant or Breast-feedingPhenylalanine supplements are not recommended duringpregnancy and breast-feeding.

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Available Preparations and DosageThe combination supplement DLPA is available in tabletand capsule form. It has been used in doses ranging from75 to 1,500 milligrams per day. Discuss dosage withyour doctor.

The estimated adult daily requirement for L-phenyla-lanine and the related amino acid tyrosine combined is approximately 7 milligrams per pound of body weight. Infants require almost 9 times that amount; chil-dren need 10 milligrams per pound. Most people fulfill these requirements through diet alone, but commercial L-phenylalanine supplements are available in capsule andtablet form. Follow the manufacturer’s dosage instruc-tions, and do not take the supplement with other aminoacids or protein foods. L-phenylalanine is most effectiveif taken on an empty stomach prior to meals. Vitamin B6

is said to enhance its absorption.

OverdosageDoses of 1,500 milligrams or less are generally consid-ered safe. However, very high doses can affect your bloodpressure and even cause migraines. Check with yourdoctor if you suspect an overdose.

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Phosphatidylcholine

Why People Take ItTwo potential benefits have attracted interest in Phos-phatidylcholine: its impact on cholesterol levels and its ef-fect on memory loss. Of the two, only its ability to reduceserum cholesterol has received a tentative thumbs-upfrom researchers.

Several studies have found, for instance, that lecithin, afood supplement rich in Phosphatidylcholine, may lowerserum cholesterol by 18 percent. Similarly, Russian inves-tigators have found that a supplement containing Phos-phatidylcholine and several related compounds producedsignificant reductions in total serum cholesterol, triglyc-erides, and LDL cholesterol—the “bad” variety mostclosely linked to clogged arteries and heart disease. Theimprovements were equivalent to those seen in patientstaking high doses of nicotinic acid, a form of the B vi-tamin niacin that’s been proven effective in combatingheart disease. And unlike high doses of niacin, Phos-phatidylcholine had no negative effect on the liver.

More important than Phosphatidylcholine’s ability to lower cholesterol is the fact that it may provide directrelief of angina (chest pain due to clogged coronary

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arteries), reducing both the number and the intensity ofattacks. Scientists studying lecithin have found that itmay also reduce clumping of platelets in the blood, an-other phenomenon that probably contributes to heartdisease and circulatory diseases of the arms and legs.Platelets normally clump together to stop the bleedingfrom a cut, but if they form clots within the bloodstream,they can promote a dangerous blockage. In one experi-ment, investigators gave 12 grams of lecithin a day forthree months to patients at risk of heart attacks andfound that, in addition to lowering cholesterol, the sup-plement decreased platelet stickiness.

Hopes that Phosphatidylcholine might combat memoryloss have been based on its ability to increase levels ofacetylcholine in the brain. This important chemical mes-senger appears to play a role in maintaining memory, andhas been found to be in short supply in Alzheimer’s patients. Unfortunately, an analysis of 11 carefully con-trolled clinical experiments with lecithin supplements wasunable to detect any significant benefit. The supplementmay have very modest effects on patients with impairedthinking or dementia, but it doesn’t seem to yield anymajor improvement.

Similarly, some experts once believed that Phosphatidyl-choline might relieve the symptoms of tardive dyskine-sia, a severe neurological disorder that’s brought on by long-term use of certain antipsychotic drugs. But whenschizophrenic patients suffering from the signs and symp-toms of the disorder—involuntary movements of the muscles of the face, mouth, and cheeks—were put onlecithin or related compounds, they experienced only slight improvement.

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What It Is; How It WorksPhosphatidylcholine is a combination of choline, fattyacids, glycerol, and phosphorus. It is one of severalphosphorus-based compounds contained in lecithin, anaturally occurring substance derived from beef liver, eggs,soybeans, and peanuts. Lecithin products are generallycomposed of from 5 to 30 percent Phosphatidylcholine.

Choline, the most important ingredient in Phosphatidyl-choline, constitutes about 13 percent of the total. It has recently been classified as an essential nutrient by the Na-tional Academy of Sciences. (See entry on choline.)

Avoid if . . .Phosphatidylcholine is generally considered safe.

Special CautionsHigh doses of choline can cause overstimulation, muscletension, and digestive upsets. You’d need to take ex-tremely large doses of Phosphatidylcholine to achieve asimilar effect, but cases have been reported.

Possible Drug InteractionsIt’s best to avoid choline-containing supplements if you’retaking a prescription drug such as scopolamine (an anti-nausea medication) that works by blocking the effects ofacetylcholine.

Special Information if You Are Pregnant or Breast-feedingFor healthy women, choline supplements are not recom-mended during pregnancy and breast-feeding.

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Available Preparations and DosagePhosphatidylcholine supplements typically come in cap-sule and powder form. Potency ranges from 20 to 100percent.

Dosage recommendations for formulations containing55 percent Phosphatidylcholine range from 1,000 to2,000 milligrams daily, supplying from 72 to 144 mil-ligrams of choline. The National Academy of Sciencesestimates that adults need 425 to 550 milligrams ofcholine a day to stay healthy. A typical diet usually sup-plies the full basic requirement.

OverdosageThe upper tolerable limit of choline is 3.5 grams a day. (Ittakes approximately 27 grams of Phosphatidylcholine to supply this amount.) Dosages above this level maybring on dizziness, nausea, diarrhea, cramps, and a fishybody odor.

Phytoestrogens

Why People Take ThemPhytoestrogens, the hormonelike compounds found in avariety of beans, fruits, and herbs, appear to offer manyof the same benefits as human estrogen, the hormone that

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governs the menstrual cycle. Researchers have found, forinstance, that women who eat Phytoestrogen-rich soy-bean products have longer cycles, strongly suggestingthat the foods mimic the action of the human hormone.

Similarly, a recent study of women at menopause,when estrogen levels decline, found that adding dailyservings of isolated soy protein to their diets reduced thenumber of hot flashes they experienced. And since nei-ther the volunteers participating in this trial nor the re-searchers themselves knew who was getting the soy andwho was getting an inactive substitute—an experimentreferred to as a double-blind study—it’s unlikely that theresults were influenced by prior belief in the benefits of soy.

Phytoestrogens from other sources offer similar bene-fits. Studies conducted with the phytoestrogen-ladenherb black cohosh found that taking either two tablets or40 drops of a black cohosh extract twice daily relievedthe symptoms of menopause.

Nor are the benefits limited to postmenopausal relief.Other researchers have discovered that women who eatlarge amounts of Phytoestrogen-rich foods are less likelyto develop breast cancer. And scientists have noted thatmen—who also respond to estrogen—suffer less prostatecancer if they follow a vegetarian diet or live in prein-dustrial African or Asian communities, where peoplerely more heavily on Phytoestrogen-rich fruits and vege-tables. (Researchers have not, however, ruled out thepossibility that some other difference in diet or lifestylemay account for the lower rate.)

After menopause, estrogen replacement therapy staves

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off osteoporosis and heart disease, and some studies sug-gest a similar role for Phytoestrogens. In keeping withthis line of reasoning, the U.S. Food and Drug Adminis-tration, on the basis of convincing evidence, has recentlygiven food manufacturers permission to state on their la-bels that soy foods can reduce the threat of heart disease.

What They Are; How They WorkPhytoestrogens are actually a family of compounds, in-cluding isoflavones and lignins. Isoflavones are foundprimarily in legumes like soybeans, peas, and beans,while lignins are found in nuts, cereals, berries, andvarious other fruits and vegetables. Investigators havefound more than twenty types of Phytoestrogens in vege-tation. In some plants, scientists have isolated hormonesidentical to those found in the animal kingdom. Theseplants include pomegranates, green beans, dates, hops,licorice, and apples.

The effect of Phytoestrogens depends in part on howmuch estrogen the body is already producing and howsaturated its estrogen receptor sites have become. If es-trogen levels are low, as in menopause, empty estrogen re-ceptor sites can be filled with Phytoestrogens, which thenexert a weak estrogenlike effect. If estrogen levels are high,as in premenstrual syndrome (PMS) and endometriosis,then Phytoestrogens that bind with the receptors will displace regular estrogen, moderating its effects. Phyto-estrogens may also trick the hypothalamus and pituitaryglands, which regulate female hormones, into thinking thebody has enough estrogen, thus reducing internal estrogenproduction and the health risks—such as uterine cancer

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and possibly breast cancer—posed by high levels of themore potent human hormone.

Avoid if . . .Phytoestrogens are generally considered safe for everyone.

Special CautionsAlthough Phytoestrogen-rich foods present no prob-lems, certain extracts demand caution. For instance,Germany’s Commission E, a government group that stud-ies and regulates herbal medicines, recommends that useof black cohosh be limited to six months.

Possible Drug InteractionsDong quai, a Chinese herb that contains Phytoestrogens,also contains coumarin, which acts as a blood thinner.Persons on anticoagulant drugs may therefore want toavoid combining the herb with their medication for fearthat it will have an additive effect, increasing the risk ofbleeding.

Black cohosh should be used cautiously by patientstaking medications to lower their blood pressure becausethe herb itself has been reported to lower blood pressure,and the combined effect could cause one’s pressure todrop too low. The resulting hypotension can cause dizzi-ness and fainting.

Special Information if You Are Pregnant or Breast-feedingWhile there are no specific precautions for Phytoestro-gens as a group, experts warn that black cohosh, a richsource of these compounds, should be avoided in preg-nancy. That’s the case because the herb has the potential

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to act like oxytocin, a hormone made by the pituitarygland that increases uterine contractions.

Available Preparations and DosageHerbal extracts such as black cohosh and dong quai areavailable in tablet, capsule, and liquid form. Follow themanufacturer’s directions for proper dosage.

With soy isoflavones, some studies suggest that 40 to80 milligrams daily may relieve hot flashes, or even im-prove cholesterol levels. Soy products such as tofu (soy-bean curd), tempeh (soybean cake), and roasted soy nutscontain about 40 milligrams per half cup. A full cup ofsoy milk provides the same amount. Two servings a daymay be needed to relieve menopausal symptoms.


Phytosterols

Why People Take ThemThese plant-based analogs of cholesterol have assumed asignificant role in the ongoing battle against heart dis-ease. Two of the most thoroughly studied Phytosterols,sitosterol and sitostanol, have been shown to lower

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artery-clogging serum cholesterol levels and are now in-cluded in a variety of “designer foods.” Several “heart-healthy” margarines and salad dressings rely on thesePhytosterols to achieve their effect.

Clinical studies have found that 2 to 4 grams a day ofsitosterol or sitostanol can lower blood levels of “bad”LDL cholesterol by as much as 14 percent. In one study,for example, a third of a group of women who had previ-ously suffered heart attacks were able to drive their LDLlevels down to less than 100 milligrams per deciliter,which is considered safe. Similarly, in another investiga-tion one of the “heart-healthy” margarines lowered totalserum cholesterol by about 24 points. To put these num-bers into perspective, experts estimate that every 1 per-cent drop in serum cholesterol yields a 2 percent declinein your risk of coronary heart disease.

Even if you’re already eating a low-fat, low-cholesteroldiet, chances are that adding Phytosterol-containingproducts to your menu will still be beneficial. Researchershave found that volunteers who eat a low-fat diet plusPhytosterols have lower serum LDL levels than thosewho combine the same products with a higher-fat diet.

Researchers have also shown that Phytosterols offeradded benefits when combined with cholesterol-loweringprescription drugs. When patients were given Pravacholalone, for example, their LDL levels dropped by 38 per-cent, while adding Phytosterols to their regimen causedtheir lipid levels to plummet 44 percent.

Still, it’s worth keeping one caveat in mind: While there’s little doubt that Phytosterols reduce cholesterollevels, researchers have yet to formally prove that products

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containing these substances lower the odds of a heart at-tack or reduce the death rate from heart disease.

In unrelated research, scientists have also found thatPhytosterols often relieve the symptoms of prostate en-largement (benign prostatic hyperplasia). In four separateclinical studies involving over 500 men with enlargedprostate, sitosterol, given at a dose of 60 to 195 milli-grams per day, significantly reduced urinary symptoms.The men were less likely to have to get up in the middle of the night to urinate and were able to more fully emptytheir bladders.

What They Are; How They WorkBecause these plant-derived compounds have a chemicalstructure similar to cholesterol, they partially block theabsorption of cholesterol in the gastrointestinal tract.They also interfere with the reabsorption of cholesterolthat has been secreted into the digestive tract in bile. Thedrop in cholesterol uptake indirectly brings about a re-duction in blood levels of LDL cholesterol.

Avoid if . . .There’s no known reason to avoid Phytosterols.

Special CautionsAside from some mild constipation, there have been noreported side effects from Phytosterol-enriched foods.Some experts suspect, however, that they may interferewith the absorption of fat-soluble nutrients like beta-carotene. As a result, some products are fortified withbeta-carotene to avert any possible deficiency.

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Special Information if You Are Pregnant or Breast-feedingAdequate cholesterol is essential for the developing baby.While Phytosterols are not known to cause any directharm, attempts to achieve very low cholesterol levels areunwise during pregnancy.

Available Preparations and DosageTo lower cholesterol levels, the usual recommendation is1 to 2 tablespoons daily of a Phytosterol-enriched mar-garine such as Benecol or Take Control.

OverdosageOral doses as high as 3 grams have not caused seriousside effects.

PotassiumGlycerophosphate

Why People Take ItPromoted as the most readily absorbed and easily metabo-lized form of potassium available, Potassium Glycerophos-phate has been adopted by fitness enthusiasts as an aid to

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better, harder training. Overexertion and excessive sweat-ing can deplete the body’s potassium stores, which in turnresults in weakness, fatigue, and muscle cramps. Propo-nents say that potassium supplements help to prevent theseunpleasant aftereffects of intensive training.

There are also claims that the glycerophosphate in thisproduct helps the body produce adenosine triphosphate(ATP), the chemical that fuels the muscles. Glycerophos-phate is also believed to aid exercisers by eliminatinglactic acid, a by-product of muscular activity that cancause tired, achy muscles and muscle spasms. However,there have been no clinical trials to verify these theories.

There is, of course, no question that Potassium Glycero-phosphate can remedy potassium deficiency. Potassiumis needed for the proper functioning of the heart, muscles,kidneys, and nerves, and excessively low levels can causewidespread muscular malfunctions, impair the kidneys,and trigger irregular heartbeats. In addition, a shortageof potassium, combined with an oversupply of sodium,can lead to high blood pressure. Studies have shown thatpotassium intake can reduce the need for blood pressuremedicine in people with low potassium levels. Moreover,some animal and human studies have shown that potas-sium supplements can reduce the risk of stroke.

What It Is; How It WorksPotassium Glycerophosphate is an organically boundcompound of potassium and glycerophosphate. Both in-gredients are part of any ordinary diet. Potassium, a min-eral and an electrolyte, is found in fruits, vegetables, nuts,whole grains, and dairy products. Glycerophosphate can

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be obtained from poultry, meat, fish, cereal, and dairyproducts.

Potassium Glycerophosphate is classified therapeuti-cally as a tonic. It easily passes through cell walls, and thusis able to aid in the conduction of nerve impulses that reg-ulate the heartbeat and cause muscle contractions.

Avoid if . . .There is no reason to avoid Potassium Glycerophos-phate. The dietary supplement is “generally recognizedas safe” by the U.S. Food and Drug Administration.

Special CautionsStrictly limit the size of your doses. Excessive levels ofpotassium (hyperkalemia) can disrupt the heartbeat,cause paralysis in the arms and legs, and produce a se-rious drop in blood pressure. The risk of hyperkalemia is small, since excess potassium is usually eliminatedquickly in the urine. However, a buildup is possible in someone suffering kidney problems, gastrointestinalbleeding, rapid protein breakdown, or a major infection.

Possible Drug InteractionsDo not combine Potassium Glycerophosphate with drugsthat control spasms, such as Bentyl, Donnatal, and Lo-motil. Be cautious if you are taking a high blood pressuremedicine categorized as an ACE inhibitor (for example,Capoten or Vasotec) or a potassium-sparing diuretic (Al-dactone or Midamor). These drugs can drive up yourpotassium level. If you’re unsure about any of the drugsyou’re taking, check with your doctor before taking anyextra potassium.

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Special Information if You Are Pregnant or Breast-feedingAt ordinary intake levels, Potassium is generally consid-ered safe during pregnancy and nursing.

Available Preparations and DosageThere is no official recommended dietary allowance forpotassium. Your needs vary according to the amount ofsalt you use. However, for general purposes, many ex-perts peg the minimum daily requirement at roughly2,000 to 2,500 milligrams. Since a normal diet can supplyas much as 6,000 milligrams a day, supplements are usu-ally unnecessary. They are typically recommended onlywhen certain medical conditions or prescription drugsdeplete the body’s supply.

Potassium Glycerophosphate is most often found asan ingredient within a combination supplement product.Supplements that contain Potassium Glycerophosphateare available in capsule, tablet, powder, and liquid form.

OverdosageA severe overdose can lead to convulsions, coma, andeven cardiac arrest. Seek emergency treatment immedi-ately if you notice such early warning signs of overdoseas muscle weakness or paralysis, fast or irregular heart-beat, or blood in your stool.

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Pregnenolone

Why People Take ItPromoted as the “mother of all hormones” because itserves as a raw material for many other steroid hormones,Pregnenolone isn’t known to have any specific functions ofits own. Nevertheless, advocates of Pregnenolone and itsoffspring, DHEA, refer to them as “superhormones,” sug-gesting that they can be used as over-the-counter solutionsto conditions such as depression, rheumatoid arthritis,Alzheimer’s disease, multiple sclerosis, immune disorders,premenstrual syndrome (PMS), and the symptoms ofmenopause.

To date, none of these claims has been verified in reli-able clinical trials. However, Pregnenolone is classified asa neurosteroid—a chemical known to modify mood andbehavior—and some researchers believe that it does havea beneficial modifying effect on the activity of chemi-cal messengers (neurotransmitters) and receptors in thebrain, helping to balance and stabilize brain function.

In one small study of young men, it seems to have improved sleep and decreased the frequency of nightwaking. A World War II–era study of fatigued army pilotssuggested that it may also play a role in helping the body

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deal with the effects of stress. Other research, conductednearly 50 years ago, indicated that injectable Pregne-nolone might be helpful in the treatment of arthritic and rheumatologic conditions such as lupus, psoriasis,and scleroderma.

More recently, studies of Pregnenolone done on labo-ratory animals have demonstrated its ability to enhancememory. One study that tested Pregnenolone along withan anti-inflammatory and an immune system enhancerfound that the combination helped improve motor func-tion in rats with spinal cord injury. However, neither ofthese properties has yet been verified in humans.

Indeed, scientists still aren’t certain whether takingsupplementary Pregnenolone has any significant benefi-cial effect. What we do know is that Pregnenolone is apowerful substance that could affect the entire hormonebalance of the body. Further research is being conducted,but until more is known, the safest course is to take Preg-nenolone only with great caution and under a doctor’ssupervision.

What It Is; How It WorksPregnenolone is a natural substance manufactured in thebody from cholesterol and found in high concentrations inthe brain and other nerve tissues. Pregnenolone sits at thebeginning of the steroid assembly line, with a number ofother hormones proceeding from it, including dehydro-epiandrosterone (DHEA), progesterone, estrogen, and tes-tosterone. While it seems to serve primarily as a sourcematerial for these hormones, some health authorities be-lieve that it also has a balancing effect, regulating levels asneeded.

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Various studies measuring Pregnenolone levels founddecreased amounts in people with low thyroid functionand increased amounts in those with an overactive thy-roid. People with depression also have unusually lowlevels. Reduced levels have also been linked to condi-tioned fear response and social isolation in animal studies.

Pregnenolone levels also decline with age, and pro-moters suggest that certain disease processes—and evenaging itself—are “caused” by a shortage of this hor-mone. However, a variety of body chemicals diminish aswe grow older and so far scientists have been unable tosingle out any specific culprits. On the other hand, theydo know that trying to restore hormonal levels to thoseof our youth may have unintended consequences. Es-trogen replacement therapy, for example, was prescribedas a menopausal treatment for decades before scientistsdiscovered that it could dramatically increase a woman’srisk of certain cancers.

Some researchers also warn that taking Pregnenoloneas a dietary supplement could have an inhibitory effecton the body’s ability to manufacture its own supply. It’snot known whether this is true, but there’s no questionthat the body is in a constant balancing act to keep hor-mones at an optimal level. Adding Pregnenolone mayupset this balance in ways we don’t yet understand.

Avoid if . . .Because of its potential impact on the nervous system, donot take Pregnenolone if you have a history of seizures.Also avoid it if you are at high risk of hormone-dependentcancers such as cancer of the breast, uterus, ovaries, orprostate.

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Special CautionsIf you have any kind of glandular disorder, be sure tocheck with your doctor before taking Pregnenolone. Andremember that the long-term effects of this hormonalsupplement remain unknown.

Possible Drug InteractionsDo not combine Pregnenolone with the antiseizure drugNeurontin or other drugs chemically similar to the neuro-transmitter GABA. Remember that Pregnenolone mayalso affect the action of hormonal medications such asprogesterone, testosterone, estrogen, and oral contra-ceptives, and may require a reduction in the dose of anyDHEA supplement you may be taking.

Special Instructions if You Are Pregnant or Breast-feedingBecause of its hormonal effects, do not take Pregnenolonewhile pregnant or breast-feeding.

Available Preparations and DosagePregnenolone is available from natural supplement sup-pliers in capsules of 10 to 150 milligrams. There is littleagreement over the proper dosage. While some manufac-turers promote taking as much as 500 milligrams per day, others advise taking no more than 5 milligrams—and many experts recommend avoiding it entirely. At thevery least, if you want to experiment with this product,seek the advice of a physician who is familiar with naturalsupplements.

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Proline

Why People Take ItThis amino acid supplement is sold primarily as a tonicfor muscles, tendons, and joints, and as a remedy forsoft-tissue injuries. It’s an ingredient in a variety of com-bination supplements that claim to help build muscletissue, preserve lean body mass (muscle) during body-building and weight-loss programs, reinforce connectivetissue, improve skin health, give an energy boost, pro-mote a healthy heart, decrease blood pressure, and im-prove memory and mental sharpness.

To the extent that all amino acids are needed for theproduction of human protein, Proline does in fact buildmuscle—but probably no more so than would a well-balanced meal. Clinical trials of amino acids in the samecategory as Proline have failed to uncover any effect onmuscle after exercise. There are also no scientific studiesconfirming the other benefits claimed for this product.

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What It Is; How It WorksProline is one of the “nonessential” amino acids that thebody can manufacture on its own if it’s lacking in thediet. Proline is also available in dairy products, eggs,meat, poultry, seafood, and nuts.

Athletes and bodybuilders are interested in aminoacids such as Proline because these nutrients are neededto build and maintain virtually all the body’s tissues, in-cluding the muscles. A deficiency of amino acids (or theprotein in which they’re contained) can stunt growth inchildren and sap vigor, stamina, and resistance in adults.Hair, nails, skin, and muscles are all adversely affected.

However, extra amino acids won’t necessarily givemuscles a boost. (Sufficient calorie intake combined withregular exercise is what ultimately builds muscle.) Excessprotein is either converted to energy or stored as fat—and because waste products from this conversion areeliminated in the urine, too much protein intake can puta strain on the kidneys and liver. Excess protein con-sumption also slows the absorption of needed calcium.

Proline has also sparked interest as a potential remedyfor joint problems. It’s a major component of collagen,the fibrous protein that makes up bone, joint-cushioningcartilage, tendons, and other connective tissue. Althoughadvocates of Proline supplementation are convinced thatit can encourage collagen maintenance and repair, there’sno solid evidence supporting this view. At this point, sci-entists don’t fully understand what governs collagen syn-thesis or its breakdown in the human body.

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Avoid if . . .It’s best to avoid Proline supplements if you have kidney or liver problems, or a rare condition called prolinemia,type II. This disorder defeats the body’s ability to pro-cess Proline, and can lead to convulsions and mental retardation.

Special CautionsThe U.S. Food and Drug Administration recognizes Pro-line as a generally safe dietary supplement when used inaccordance with good manufacturing and dietary prac-tices. However, there have been reports of serious reac-tions to commercial amino acid supplements. Since theseproducts contain as many as fifteen amino acids, it’s notknown which ingredient, or combination of ingredients,might be at fault.

Remember, too, that amino acid supplements and ex-cessively high intakes of protein can increase calcium lossand put an added burden on the kidneys. Also, the effectsof amino acid supplements on the endocrine system—thepituitary, thyroid, and adrenal glands—have not beenfully investigated and can’t be conclusively judged safe.

Possible Drug InteractionsTetracycline may reduce absorption of amino acids.

Special Information if You Are Pregnant or Breast-feedingThere is no information on the effect of Proline supple-ments during pregnancy. Especially at this critical junc-ture, it’s best to avoid any medication that isn’t absolutelynecessary for your health.

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Available Preparations and DosageProline supplements are available in capsule, tablet, andpowder form. There are no official recommended dietaryallowances for nonessential amino acids such as Proline.Follow the manufacturer’s recommendations and avoidsustained megadosing.

OverdosageAlthough no specific information is available, even highdoses are unlikely to cause any severe problems.

PS (Phosphatidylserine)

Why People Take ItPhosphatidylserine is used to combat memory loss andimprove cognitive performance in people with age-related decreases in mental function. It is taken primarilyby elderly people with depression, senile dementia, andAlzheimer’s disease.

In addition to improved mental performance in peopleon PS, research has documented positive changes in be-havior, such as better social interactions and cooperationwith caregivers. Studies have also found beneficial changesin anxiety levels and depression among elderly womentaking PS. And there is some evidence that PS can help the

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body deal with some of the damaging biochemical effectsof stress.

Most of what is known about PS comes from studiesusing a form made from cow brain. Since the scare over“mad cow disease” (bovine spongiform encephalopathy),manufacturers have stopped using cow brain and are nowexperimenting with supplements made from soy. Medicalauthorities believe that soy-based PS confers the samebenefits as the version derived from cows, but this has yetto be conclusively confirmed.

What It Is; How It WorksPS is a naturally occurring phospholipid produced in thebody and found in every cell. Composed primarily of es-sential fatty acids, phospholipids play a major role inbuilding cell membranes and maintaining their flexibility.PS is particularly abundant in nerve cell membranes, in-cluding the junctures where one cell passes a messagealong to the next (the synapses). The performance of thesynapses is believed to decline with age, and researchersbelieve that PS works by improving their fluidity and in-tegrity. Some animal studies suggest that PS not onlymaintains healthy brain function but may also help re-store damaged brain networks. The beneficial effects ofPS on stress are thought to result from its ability to reducelevels of the hormone cortisol, which is produced duringperiods of extreme stress.

Some people, especially those with age-related men-tal decline, may have difficulty synthesizing adequateamounts of PS. A deficiency in the building blocks thatmake up PS could also lead to a shortage. The raw mate-rials needed to assure an ample supply include essential

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fatty acids, folic acid, and vitamin B12. PS itself is avail-able from only one dietary source—lecithin—and eventhere is found in only small amounts.

One drawback of PS supplementation is its cost. Thedaily doses recommended for treatment of age-associatedmental decline can cost as much as $100 per month. Ifthis is more than you want to spend, nutritional authori-ties suggest that maintaining an adequate supply of theraw materials needed to synthesize PS provides a cheaperalternative.

Avoid if . . .There is no known reason to avoid this natural phospholipid.

Special CautionsPS per se is generally regarded as safe. However, due toconcerns over “mad cow disease,” be sure to check thelabel and make certain that the product is soy-derived.

Possible Drug InteractionsThere are no known interactions with PS.

Special Information if You Are Pregnant or Breast-feedingPS supplements have not been tested for safety duringpregnancy. Since the supplements are used primarily forage-related dementia, there’s no good reason to risk tak-ing them while pregnant or breast-feeding.

Available Preparations and DosageIf nutritional deficiencies result in a shortage of PS, yourdoctor may recommend PS supplementation. The product

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is available in 100-milligram capsules. Manufacturerstypically recommend a dosage of 300 milligrams per day,taken with meals.


Pycnogenol

Why People Take ItPycnogenol, an extract of pine bark and/or grape seed, isrich in proanthocyanidins, a group of potent antioxi-dants that reduce the buildup of toxic wastes in the body.The proanthocyanidins, also found in grape seed extract(see separate entry), are used to treat vein and capillarydisorders, including varicose veins, retinal degeneration,swelling, and a tendency to bruise easily.

Thanks to its antioxidant properties, Pycnogenol mayalso reduce the risk of heart disease, and some propo-nents suggest it may even protect against cancer. It hasalso been said to relieve conditions such as tendinitis andarthritis by strengthening collagen and elastin, two build-ing blocks of the body’s connective tissue.

Although there is a small body of valid scientific re-search to support some of these claims—particularly the

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product’s effect on heart disease—you should know thatPycnogenol has also been a magnet for quack “cure-all”claims and multilevel distributorship schemes. Most re-cently, the Federal Trade Commission ordered one Pyc-nogenol distributor to cease its unsupported claims thatthe product can cure attention deficit hyperactivity dis-order in children.

What It Is; How it WorksAlthough derived from humble stuff like grape seeds andpine bark, proanthocyanidins carry an impressive bio-chemical résumé. These pigments, also found in cranber-ries and tea, belong to a family of plant-based compounds,or phytochemicals, called flavonoids. The antioxidant ac-tivity of proanthocyanidins is especially powerful whenthese compounds are bound together in a form calledoligomeric proanthocyanidin complexes, or OPCs. TheFrench biochemist who developed a patented process forextracting OPCs from pine bark and grape seeds coinedthe name Pycnogenol for the resulting substance. Thename’s trademark status is still under dispute, but is usedgenerically by many leading supplement manufacturers.Grape seed extract supplements, which supply OPCs thatseem to work as well as those in pine bark extract, tend tocarry a lower price tag.

Antioxidants are chemicals that bind with and elimi-nate products of oxidation called free radicals. Unstablefree-radical molecules can combine with a variety ofcompounds within the body, causing damage that canlead to anything from cancer to coronary heart disease.

Reputable research on Pycnogenol has verified a varietyof effects that may stem from its antioxidant or other, less

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well-understood properties. It acts as a vasodilator,opening blood vessels wider, and it reduces the oxidationof “bad” LDL cholesterol—a key step in the buildup thatclogs arteries and leads to heart disease. It also may protect against excessive blood clotting. In a study ofsmokers, a single high dose of Pycnogenol (200 milli-grams) worked better than aspirin in reversing the ten-dency of platelets to clump together (a clot-forming risk),without the bleeding risk associated with aspirin use.

Some studies suggest that Pycnogenol may also increasethe action of vitamin C and E in the body by protectingthem from oxidative breakdown. In laboratory studies ofmice, Pycnogenol has enhanced immune system activity.

Avoid if . . .Pycnogenol has been used since the 1950s and appears tobe relatively safe for everyone.

Special CautionsAt ordinary dosage levels, Pycnogenol seems to cause noproblems.

Possible Drug InteractionsNo interactions have been reported. However, if you aretaking any other medication for heart disease or vascularconditions, it’s a good idea to alert your doctor beforetaking Pycnogenol or other OPC supplements.

Special Information if You Are Pregnant or Breast-feedingThere is little reliable information on the effect of Pyc-nogenol and OPCs on a developing baby. Since a tempo-rary interruption of therapy won’t permanently damage

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your health, your wisest course is to avoid these productsduring pregnancy and breast-feeding.

Available Preparations and DosageIt is available in capsules ranging from 30 to 100 mil-ligrams. Doses used in trials showing benefits to the venoussystem have ranged from as little as two 50-milligramtablets a day to as much as 300 milligrams a day. Optimaldosage levels remain unknown.

OverdosageOPCs are water-soluble nutrients, so excessive amountsare eliminated in urine. There are no well-recognizedsymptoms or dangers associated with Pycnogenol overdosage.

Pyroglutamate

Why People Take ItLike dietary supplements such as choline and DMAE (di-methylaminoethanol), Pyroglutamate is prized as a po-tential memory-booster. Also known as pyroglutamicacid and pyrrolidone carboxylic acid (PCA), it is said toincrease alertness, concentration, and recall.

There is at least some justification for these claims.

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Animal studies have demonstrated Pyroglutamate’s abilityto raise levels of acetylcholine, one of the key chemicalmessengers in the brain. And in human trials, it has report-edly reduced memory deficits caused by alcohol, the nor-mal aging process, and multi-infarct dementia.

On the other hand, because of Pyroglutamate’s effecton memory, some advocates have also promoted it as anantiaging remedy, with the ability to boost intelligenceand postpone or even reverse the normal aging of thebrain. This sort of proposition is pure speculation at present, still in need of scientific testing and verification.

What It Is; How It WorksPyroglutamate is an amino acid found in large concentra-tions in the brain and cerebrospinal fluid, where it con-tributes to the chain of chemical reactions that ends in theproduction of acetylcholine. It is supplied naturally in the diet by vegetables, fruits, dairy products, and meat.

The exact mechanism by which Pyroglutamate may enhance cognitive function is not known. However, itsability to boost output of acetylcholine is thought to be atleast part of the answer. The picture is unclear becauseacetylcholine plays a variety of roles throughout the body,and because older adults often suffer from a shortage ofseveral neurotransmitters in the brain.

Avoid if . . .Because of the potentially stimulative effects of supple-ments that boost acetylcholine levels, it might be wise toavoid Pyroglutamate if you suffer from convulsions orbipolar disorder.

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Special CautionsIn 1998, the U.S. Food and Drug Administration issued awarning about over-the-counter products that list as oneof their ingredients pyroglutamic acid or arginine pyro-glutamate (a compound combining Pyroglutamate andthe nonessential amino acid arginine). The agency had re-ceived reports of nausea, vomiting, headache, rectal rash,and bloody stools in association with such products.However, it’s not known whether the Pyroglutamate inthe products was the component at fault.

Possible Drug InteractionsThere are no reports of interactions with other supple-ments or drugs.

Special Information if You Are Pregnant or Breast-feedingAlthough Pyroglutamate is a normal part of our diet andpresumably poses no threat during pregnancy, it’s alwaysa good idea to consult with your doctor before using anysupplement.

Available Preparations and DosagePyroglutamate is available in tablet, capsule, and powderform. A typical dosage recommendation is 500 milligramsonce or twice a day. The dosage for arginine pyrogluta-mate preparations is similar.

Advocates often recommend combining Pyroglutamatewith choline and other supplements meant to enhanceproduction of acetylcholine.


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Pyruvate

Why People Take ItPyruvate is promoted as a weight loss aid. In somestudies, people taking very high doses of the substancealong with a low-fat diet and exercise have experienced aslight reduction in weight and body fat. However, dietand exercise alone are capable of trimming away excesspounds, and Pyruvate suppliers generally recommendmuch lower doses, so proof of the product’s effectivenessis somewhat less than conclusive.

One study also found that, when people stop dieting,they tend to regain a little less weight if they continuetaking this supplement. Advocates make a variety ofother claims as well. They say that Pyruvate decreasesappetite, increases the metabolism, improves heart func-tion, reduces cholesterol, and combats free radicals.Some recommend it as an endurance booster during ex-ercise. However, none of these claims has been verified.

What It Is; How It WorksPyruvate is a substance created by the body as one of thesteps in the production of energy. Pyruvate is also found

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in some foods, including red apples, dark beer, red wine,and some types of cheese.

The cells in the body release energy by breaking apartthe chemical bonds in carbohydrates, proteins, and fats.During this process, a series of chemicals are formed andtransformed. Pyruvate, also called pyruvic acid, is cre-ated early in the process. Later, it’s broken down furtherin the process of producing ATP (adenosine triphos-phate), the energy molecule that fuels all of the body’s activities.

It is unclear how (or even if) Pyruvate promotes weightloss. Because the substance has a critical role in the con-version of food to energy, proponents believe that Pyru-vate supplements can improve fat utilization, increase theefficiency of energy production, and speed up the metabo-lism. Those who advocate its use as an endurance boosterfeel that it increases the supply of energy to the muscles.

An inability to process Pyruvate properly is at the rootof several hereditary disorders. Defects in Pyruvate me-tabolism can lead to mental retardation, muscle andorgan damage, or seizures. In times of physical stress, ab-normalities in energy metabolism can lead to a dangerousbuildup of lactic acid in the system (lactic acidosis).

Avoid if . . .Do not take Pyruvate if you’ve been diagnosed with adisorder that affects its metabolism.

Special CautionsLarge doses of Pyruvate may cause gastrointestinal up-set, including bloating, diarrhea, gas, gurgling sounds inthe digestive tract, and upset stomach.

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Commercial preparations of Pyruvate may containextra ingredients such as sodium, potassium, magne-sium, and calcium. If you have high blood pressure,suffer from a heart condition, or are taking any medica-tions, check with your doctor before using a Pyruvatesupplement.


Special Information if You Are Pregnant or Breast-feedingPyruvate is not recommended for women who are preg-nant or breast-feeding.

Available Preparations and DosagePyruvate is available in capsule and powder form. Cap-sule strengths range from 500 to 1,000 milligrams ofPyruvate. Suppliers generally recommend dosages of 2 to6 grams (2,000 to 6,000 milligrams) per day, taken inseveral small doses. If taken for weight loss, the supple-ment should not replace a comprehensive diet and exer-cise program.


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Red Yeast Rice

Why People Take ItKnown in China as Hong-Qu, Red Yeast Rice is a stan-dard part of the national cuisine—used, for example, inthe preparation of Peking duck. For centuries, it has alsobeen employed in traditional Chinese medicine to helpmaintain a healthy heart and circulatory system. Recentstudies suggest there may be good reason. Research has shown that when taken along with a healthy low-cholesterol diet and regular exercise, Red Yeast Rice may reduce cholesterol levels in people with mild to moderately high cholesterol (although how much of the benefit stems from diet and exercise alone remains undetermined).

What It Is; How It WorksRed Yeast Rice (Monascus purpureus) is made, quitesimply, by fermenting red yeast on rice. A special process isused to isolate a higher concentration of the natural ingre-dient mevinolin. This substance is similar to the “statin”drugs, such as Zocor, Pravachol, and Lipitor, that doctorsprescribe for high cholesterol. Products containing mevi-

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nolin, however, can be purchased without a prescription asover-the-counter dietary supplements under names such asCholestin.

Everyone’s body needs a certain amount of cholesterolto function properly. The substance is found in cell mem-branes and helps the body make certain hormones. But iftoo much cholesterol gets into the system, it can accumu-late as fatty deposits in the arteries, increasing the risk ofheart disease. The liver produces about 80 percent of thecholesterol we need, with the other 20 percent comingfrom food sources. Red Yeast Rice (and “statin” drugs)block the action of an enzyme in the liver that triggerscholesterol production. Some researchers also speculatethat the unsaturated fatty acids in Red Yeast Rice couldcontribute to its beneficial effects.

Avoid if . . .In very high doses, the mevinolin in Red Yeast Rice hasbeen known to damage the liver. Do not take it if youhave liver disease, are in danger of developing it, or con-sume more than two alcoholic beverages a day.

Special CautionsIt’s best to stop using Red Yeast Rice during a serious in-fection. Avoid it, too, after major surgery. If you developany muscle pain or weakness, discontinue the productimmediately and check with your doctor.

Possible Drug InteractionsDo not combine Red Yeast Rice with prescription cholesterol-lowering drugs, antifungal medications, drugs

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that suppress the immune system, or erythromycin. These drugs may increase the chance of muscle pain andweakness.

Special Information if You Are Pregnant or Breast-feedingBecause generous supplies of cholesterol are needed by adeveloping baby, you should strictly avoid Red YeastRice during pregnancy. You should also avoid it whilebreast-feeding.

Available Preparations and DosageRed Yeast Rice is available commercially in capsuleform. The typical dosage recommendation is 1,200 milli-grams per day, divided into two doses. Do not exceed2,400 milligrams daily. Take with food to reduce the riskof digestive disturbance.

OverdosageIn animal tests, massive overdoses of mevinolin producedno ill effects. Nevertheless, if you suspect a problem, besure to check with your doctor.

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Ribose

Why People Take ItA type of simple sugar, Ribose is taken by athletes in aneffort to increase energy, endurance, alertness, and leanmuscle mass, and to reduce fatigue and recovery timefollowing exercise.

What It Is; How It WorksRibose is one of the key constituents of the human body. Produced during digestion, it’s one of the buildingblocks of DNA and RNA, the compounds that carry thegenetic code and interpret its instructions for buildingproteins.

Ribose also is one of the main components of ATP(adenosine triphosphate), the compound that serves asthe primary source of energy for all the cells in the body.In muscle cells, excess ATP molecules are joined with the chemical creatine to create a reserve form of fuel.

During exercise, the cells break down ATP to releaseits energy. ATP used up in this fashion is replaced by thebody during the following hours and days, using Riboseand other chemicals as raw materials. The extra Ribose

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gained from supplements is supposed to speed up pro-duction of new ATP, hastening the return to normallevels.

Avoid if . . .Do not take Ribose supplements if you have gout or diabetes.

Special CautionsUse Ribose judiciously. Large doses may cause diarrhea,stomach upset, and low blood sugar.


Special Information if You Are Pregnant or Breast-feedingHarmful effects seem unlikely, and none are known.Nevertheless, as with any supplement that’s not requiredfor good health, the safest course is to avoid Riboseduring pregnancy.

Available Preparations and DosageRibose supplements are available in capsule, lozenge,tablet, powder, and syrup form. Some products are avail-able in different flavors. Ribose is also an ingredient insome combination supplements that include creatine.

A single dose usually consists of 2 to 3 grams of Ribose.Suppliers often recommend that athletes take a divideddose, one part before a workout and one part after. Somesuppliers also recommend a larger “loading dose” in cer-tain situations.

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RNA (Ribonucleic Acid)

Why People Take ItA key component of every living cell, RNA (ribonucleicacid) is the compound that transmits the instructionscoded into our DNA. As such, it has been the subject of avariety of exaggerated claims. For example, some propo-nents insist that supplemental RNA can slow aging andimprove memory. They say it can enhance vision andhearing, create tighter, more radiant skin, and restore vi-tality and sexual vigor. Unfortunately, there’s no evi-dence that it actually does any of these things.

What it may do is bolster the body’s ability to ward offinfection. A number of studies conducted on animalshave demonstrated that a diet supplemented with RNAenhances immune response and helps restore lost im-mune function and maintain it. Moreover, clinical studieshave found that critically ill and malnourished patientswhose diets are supplemented with RNA often exhibit animproved immune response. Likewise, studies in cancerpatients have shown that RNA supplementation seems toreduce the chance of infection and postoperative surgical

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complications. Some clinical trials also suggest that RNAsupplementation can help maintain normal growth anddevelopment in infants.

Nevertheless, there’s still a chance that these benefitsstem from some other nutrient in a person’s diet, so mostexperts regard the evidence as inconclusive. And whetheror not the effects are genuine, the supplements seem to dono more than bring a weakened immune system up topar. They won’t provide any extra boost to someonewho’s already fit.

What It Is; How It WorksProduced in the nucleus of each cell, RNA governs theconstruction of proteins from various combinations ofamino acids. Both RNA and DNA are integral parts ofall human cells—and of everything we eat.

Laboratory and animal studies suggest that RNA sup-plements improve the body’s resistance by stimulatingthe proliferation of T lymphocytes and macrophages—two key players in the immune system’s ongoing defenseagainst invading germs and toxins.

Avoid if . . .There are no reported reasons to avoid RNA supplements.

Special CautionsCheck with your doctor for a reliable source of RNA.Contaminated products could harbor infectious agents.


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Special Information if You Are Pregnant or Breast-feedingThe effect of RNA supplementation during pregnancyremains unknown. As with all supplements, your safestcourse is to avoid it while pregnant.

During breast-feeding, however, RNA might actuallyprove beneficial. Compounds containing RNA and DNA(nucleotides) are released naturally by the breakdown ofcells in breast milk. In at least one study, infants who werefed breast milk or nucleotide-enriched formula showedgreater macrophage activity than babies who were fed un-supplemented formula. Still, despite this apparent benefit,it’s a good idea to consult your doctor before taking anRNA supplement.

Available Preparations and DosageRNA is typically used as an ingredient in combinationdietary supplements. It can also be found in powder andtablet form, in strengths ranging from 25 to 250 milli-grams. No recommended dietary allowance has been established.


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Royal Jelly

Why People Take ItThanks to a striking disparity in the life spans of bees,Royal Jelly has enjoyed a long and undeserved reputa-tion as an antiaging agent and purported aphrodisiac.Produced from the salivary glands of bees, it serves asfood for both the bees’ immature larvae and their queen.The ordinary larvae feed on it for only the first few daysof life, then change into worker bees and, within sixweeks, die. The queen, however, continues to consumeRoyal Jelly for the remainder of her fertile life—and, forthe queen, life can last up to five years! Noting thistremendous discrepancy, seers in both medieval Europeand China adopted Royal Jelly as a cure for old age.

Modern science has failed to find any evidence thatRoyal Jelly actually extends life. However, it does havesome other potentially beneficial effects. It seems to re-duce cholesterol levels in humans and laboratory ani-mals, and one German study found that it may also behelpful in reducing some of the symptoms of menopause.Several studies involving experimental animals suggestthat it may strengthen the immune system and fight can-

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cerous tumors. Laboratory tests show that it also hassome antibacterial properties.

Enthusiasts offer an extensive list of conditions thatRoyal Jelly supposedly relieves; the roster includesrheumatoid arthritis, bone and joint disorders, multiplesclerosis, lupus, chronic fatigue syndrome, kidney andliver disease, pancreatitis, insomnia, headaches, stomachulcers, and skin disorders. They also claim that RoyalJelly can increase energy and help support weight loss.There has been no research to date, however, that sup-ports any of these assertions.

One claim made for Royal Jelly is not only baseless butpotentially dangerous: Some proponents recommend itfor asthma. There are many documented reports of res-piratory distress, asthmatic attack, anaphylaxis (extremeallergic reaction), and even death among people who areallergic to bee products. For someone with allergies,asthma, or any other respiratory condition to even con-sider using Royal Jelly would therefore be foolhardy.

Royal Jelly’s antiaging mystique has also brought itpopularity as an additive in many skin-care products, in-cluding creams, lotions, soaps, and cosmetics. Manufac-turers claim that some of the ingredients in Royal Jellysupport collagen production and slow the effects of agingon skin, though there’s no conclusive evidence of this.

What It Is; How It WorksAnalysis of Royal Jelly shows it contains a rich blend ofproteins, unsaturated fats, enzymes, sugar, all of the es-sential amino acids, and ample quantities of mineralsand vitamins, especially the B vitamins and, in particular,pantothenic acid. Many of the current claims for Royal

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Jelly seem to be based on the known health benefits ofthis complex mixture of ingredients. (There are, how-ever, many other ways to get the same proteins, minerals,and vitamins without exposing yourself to the risks ofRoyal Jelly.)

The cancer-fighting compound in Royal Jelly has beententatively identified as 10-HDA (10-hydroxy-2-decanoicacid), and 10-HDA levels are used as an index of theamount of Royal Jelly a product actually contains. Testsfor 10-HDA reveal that the buyer definitely had better be-ware. They show that many products claiming to be pureRoyal Jelly contain little of it—or none at all. (As dietarysupplements, Royal Jelly products are subject to minimalinspection and regulation.)

Avoid if . . .Do not take Royal Jelly if you are allergic to bee pollen orother bee products, have asthma, or suffer from any otherrespiratory condition. There are reports of respiratory dis-tress, anaphylaxis, and death among susceptible peoplefollowing ingestion of Royal Jelly products. People whotend to have allergies can be at risk even if they don’tsuffer from asthma.

Special CautionsRoyal Jelly products such as creams and lotions appliedto the skin can cause skin inflammation in people whoare sensitive to bee products.

Possible Drug InteractionsThere are no known drug interactions with Royal Jelly.

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Special Information if You Are Pregnant or Breast-feedingAuthentic Royal Jelly is a potpourri of chemicals, and its effects during pregnancy have not been carefullystudied. Your best course is to avoid it while pregnant orbreast-feeding.

Available Preparations and DosageRoyal Jelly products come in tablets, capsules, gel caps,and ampules containing 50 to 500 milligrams. Manufac-turers’ dosage recommendations vary widely. Royal Jellyis also available in creams, lotions, and soaps for topicaluse according to package recommendations.


SAMe (S-Adenosylmethionine)

Why People Take ItIn a series of small but promising clinical trials, this over-the-counter remedy for depression has proved itself theequal of traditional prescription drugs. Though some au-thorities dismiss it as a mild mood-lifter, others regard itas an important new medication, since it has not onlyperformed as well as potent “tricyclic” antidepressants,

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but it also starts working faster (within one or twoweeks, versus three to four weeks or longer for standarddrugs). Outside the United States, it has been sold foryears as a prescription antidepressant, mainly under thename AdoMet.

SAMe has been studied as an aid to the effectiveness ofother antidepressants, with promising results. It also hasbeen found to provide at least some relief from post-partum depression and depression associated with Park-inson’s disease and epilepsy. In addition, it has been testedfor usefulness against a number of other neurological dis-orders, including schizophrenia, Alzheimer’s disease, anddementia. Although these tests are far from conclusive,they’ve produced encouraging results.

SAMe is also used to treat osteoarthritis, the type ofarthritis caused by wear and tear on the protective carti-lage in the joints. Preliminary studies appear to confirmits ability to relieve stiffness, pain, and swelling. How-ever, there’s no evidence to support manufacturers’claims that it can renew damaged cartilage. SAMe alsoshows promise as a treatment for the painful muscle con-dition called fibromyalgia. And studies show that sup-plementation with SAMe can improve liver function,making it a candidate for treatment of cirrhosis, im-paired bile flow, and liver damage from drugs or alcohol.

Claims that SAMe is useful in the treatment of heartdisease and cancer are currently unsubstantiated, thoughpreliminary clinical studies are under way. Assertionsthat SAMe fights the effects of aging also remain unproven.

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What It Is; How It WorksSAMe is a natural substance found in the body’s cells.The body manufactures it from the essential amino acidmethionine. In turn, it plays an important role in the pro-duction of a wide variety of hormones, amino acids, antioxidants, and chemical messengers in the brain. Re-searchers have noted low levels of SAMe in people withdepression, and have found that SAMe rises as depres-sion improves. SAMe also helps maintain the strengthand flexibility of cell walls, and it participates in the pro-duction of DNA and RNA.

SAMe supplements are especially helpful in cases ofliver disease, which depletes the body’s natural supply.Extra vitamins B6, B12, and folic acid are usually recom-mended with SAMe supplementation. In fact, some prod-ucts already have them added.

When purchasing a SAMe product, be sure to ask for areliable brand. Independent analyses of SAMe productshave found that the content varies widely, with at leastone brand containing almost no usable SAMe. Abouthalf the brands tested delivered all that they claimed.

Avoid if . . .It’s best to avoid SAMe if you have bipolar disorder(manic-depressive illness); it can cause episodes of mania.People taking antidepressants should not discontinuetheir medication or start taking SAMe without theirphysician’s advice.

Special CautionsIf you’re already taking a prescription antidepressant,check with your doctor before attempting to replace it

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with SAMe or add SAMe to your regimen. You may needto reduce your dose gradually.

If you suffer from high homocysteine levels (a conditionassociated with increased risk of heart disease), you mightwant to consider adding the homocysteine-loweringsupplement TMG to your regimen (see separate entry).Homocysteine is a by-product of SAMe.

Unlike some prescription antidepressants, SAMe is saidto have no serious side effects. However, some peoplesuffer mild attacks of indigestion, anxiety, insomnia, ma-nia, and hyperactive muscles.

Possible Drug InteractionsSAMe may reduce the effectiveness of some medications,including the Parkinson’s disease medication L-dopa.

Special Information if You Are Pregnant or Breast-feedingThe safety of SAMe supplements during pregnancy hasnot been determined. Check with your doctor beforeusing SAMe while pregnant or breast-feeding.

Available Preparations and DosageSynthetic SAMe is available in tablets, usually in strengthsof 200 or 400 milligrams. For depression, some authori-ties recommend dosages of 400 to 1,600 milligrams perday. For arthritis, recommendations vary from 200 to1,200 milligrams per day. For liver disease, daily dosagesof 1,600 milligrams are common. The daily total is di-vided into smaller doses. They should be taken 1 hourbefore or 2 hours after meals.

Some forms of SAMe tend to degrade quickly at any

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temperature above freezing. Look for a temperature-stable form in a coated tablet. Store away from moisture.


Soy Isoflavones

Why People Take ThemSoy has enjoyed a sudden surge of popularity in thiscountry, largely thanks to the estrogenlike compoundsknown as Soy Isoflavones. For postmenopausal women,these compounds have offered the hope of estrogen’sbenefits without its accompanying risks—in particularthe risk of breast cancer. Unfortunately, while soy-basedfoods offer well-documented health benefits, the jury isstill out on refined Soy Isoflavone supplements.

Numerous studies show that Asian women, whosediets tend to be high in soy, have lower rates of breast,ovarian, and uterine cancers than do women who eat atypical American diet. And certain lab tests show thatisoflavones can inhibit the growth of cancerous cells.However, other research in animals and humans suggestthat Soy Isoflavones may increase cancer risk by stimu-lating breast cell growth.

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Timing could be the secret behind this Jekyll-and-Hyde quality: Some scientists speculate that eating soyearly in life, as many Asian women do, may protectagainst breast cancer, while not eating it until later in lifemay promote cancer in susceptible individuals. Dosagecould also be involved: the modest amounts of iso-flavones found in food may be protective, while the highdoses provided by isoflavone supplements may have theopposite effect. At this point, the only thing that can besaid with certainty is that we simply don’t know whetherthe isoflavones in soy can help or hinder cancer.

And so it goes with the isoflavones’ other potentialbenefits. Many advocates have recommended them formenopausal hot flashes, but a recent study designed totest their effectiveness for this purpose found that iso-flavone supplements worked no better than an inactivepill. Evidence hints that a soy-rich diet may reduce therisk of prostate cancer and help protect against osteo-porosis, but researchers don’t know whether isoflavonesare the ingredients responsible. Likewise, soy protein’s in-disputable effect on high cholesterol levels may or maynot be due to the isoflavones it contains.

The reason we know so little about isoflavones is thatmost of the research on soy has centered on food prod-ucts, not supplements. Scientists note that a whole foodbehaves differently in the body than a single compound.There could be numerous protective components in soybesides isoflavones. And because the isoflavone content inpills tends to be much higher than that in natural foods,the potential risks could be greater as well—particularlyfor women who have estrogen-dependent breast cancer.

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That’s why, at least for now, most researchers recommendavoiding isoflavone supplements.

What They Are; How They WorkIsoflavones belong to a group of plant chemicals known asphytoestrogens (see separate entry). The most-researchedSoy Isoflavones are genistein, daidzein, and glycitein. Sci-entists are still unraveling how they work, but they seem tocompete with human estrogen by attaching to hormone receptors in the body. In theory, this can produce a moder-ating effect. If there’s too little estrogen in the body, iso-flavones may attach to estrogen receptors and make up forthe shortage. But if there’s too much, isoflavones may“crowd out” some of the more potent human estrogen andkeep it from activating hormonal receptors. Advocates be-lieve this double-barreled action is what makes soy benefi-cial for both treating hot flashes (by increasing estrogenlevels) and preventing cancer (by decreasing estrogen ac-tivity). Whether this is true remains to be verified.

Other research shows that isoflavones may have benefitsunrelated to their estrogenlike effects. Some researchersbelieve that isoflavones could protect against cancer bypromoting or inhibiting certain enzymes that affect tumorgrowth. Others say that they seem to work like antioxi-dants, neutralizing the highly reactive molecules, calledfree radicals, that can damage tissue when they get out ofcontrol.

Avoid if . . .Women with hormone-dependent cancers, includingbreast, ovarian, and uterine cancers, should not take

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isoflavone supplements. It is also best to avoid thesupplements if you have a family history of these diseases.

Special CautionsAlthough soy foods pose no known health risks—andmay even protect against cancer—women with hormone-dependent cancers should still check with their doctor be-fore adding soy to their diet.

Possible Drug InteractionsIt is not known whether Soy Isoflavones interact withmedications. If you take any medicine on a regular basis,check with your doctor before taking this supplement.

Special Information if You Are Pregnant or Breast-feedingBecause of the isoflavones’ estrogenlike activity, womenwho are pregnant or breast-feeding should avoid iso-flavone supplements.

Available Preparations and DosageSupplements are available in tablet, capsule, liquid, andpowder form. Products should contain a mixture ofisoflavones, including genistein and daidzein. Manufac-turers recommend taking isoflavone supplements with alarge glass of warm water at mealtime. Also be aware thata high-fiber meal may interfere with their absorption.

Manufacturers’ dosage recommendations for hotflashes range from 200 to 600 milligrams a day. Forprostate problems, a typical dosage recommendation is1,000 milligrams of a standardized supplement con-taining 5 percent isoflavones.

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If you choose to boost your intake of soy products in-stead of taking supplements, remember that the isoflavonecontent of soy foods varies widely, depending on the plantspecies, growing conditions, and how the soybeans areprocessed, among other things. For example, one-half cupof roasted soybeans can contain as much as 170 milli-grams of isoflavones, while one cup of soy milk generallyhas only 20 to 50 milligrams. The typical soy-rich diet inJapan provides 25 to 50 milligrams of isoflavones a day.


Soy Protein

Why People Take ItThe U.S. Food and Drug Administration allows only ahandful of foods to carry specific health claims on theirlabels, and Soy Protein is one of them. In October 1999,government researchers agreed that eating 25 grams ofSoy Protein a day can lower your cholesterol levels andthereby reduce the risk of heart disease. To get thesebenefits, however, remember that you must also follow adiet low in saturated fat and cholesterol.

The FDA approved this health claim after research

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showed that a daily intake of at least 25 grams of Soy Pro-tein could lower LDL, or “bad,” cholesterol by up to 10percent, a reduction that’s known to cut the risk of heartdisease in people with a severe cholesterol problem.Other research has found that Soy Protein can also lowerblood pressure and total cholesterol levels. And some ex-perts suggest that because Soy Protein is easier for thekidneys to process than animal protein, it may play auseful role in the treatment of kidney problems resultingfrom diabetes and other diseases.

Some evidence suggests that soy, in addition to fos-tering a healthy heart, may be helpful for treating such ill-nesses as menopausal hot flashes, osteoporosis, and evencertain cancers. Many advocates, however, feel that thesepotential benefits are due to soy isoflavones (see separateentry), not Soy Protein per se. Isoflavones extracted fromsoy exhibit significantly different properties than those ofordinary Soy Protein—and some researchers fear theymay even pose cancer risks. According to the FDA, how-ever, these issues do not apply to whole foods such as tofuor soy milk, or to intact Soy Protein added to other foods.

What It Is; How It WorksThe protein in soy is “complete”—that is, it contains all20 of the amino acids needed for human health. And soy-beans are the only vegetable source of protein that iscomparable to the protein in animal foods.

How Soy Protein lowers cholesterol and other bloodfats is unclear. Researchers speculate that by eating moresoy, you’ll eat fewer animal foods, which are relativelyhigh in saturated fat and cholesterol. Others suggest thatsoy may alter hormonal levels, which in turn signals the

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liver to make less cholesterol. In addition, many soyproducts are rich in fiber, which has been shown to re-duce cholesterol and other blood fats.

Avoid if . . .There are no known risks in eating the Soy Protein that occurs naturally in whole foods. But women with hormone-dependent cancers (such as breast, ovarian, anduterine cancers) should discuss with their doctor whetherto avoid soy-based extracts and supplements, due to thepossible presence of isoflavones. It may also be best toavoid such products if you have a family history of thesediseases.

Special CautionsSoy Protein allergies, although rare, are possible. Studiesestimate that 0.5 percent of children, and even feweradults, are allergic to soy. Raw, unprocessed soy foodsare generally more likely to cause allergic reactions thanroasted soybeans or those foods that undergo chemicalor heat processing (tofu, for example).


Special Information if You Are Pregnant or Breast-feedingBecause of the isoflavone content in certain soy-basedsupplements, women who are pregnant or breast-feedingshould not take them. Whole soy foods, however, areconsidered safe.

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Available Preparations and DosageAccording to the FDA, a product must provide at least25 grams of Soy Protein a day (typically in four 6.25-gram portions) to improve cholesterol levels. Remembertoo that the emphasis is on daily Soy Protein intake; youcan’t just have it once in a while.

Supplements containing Soy Protein usually use soy-beans that have been processed by heat or chemical treat-ments. These include soy protein concentrate, soy proteinisolates, textured soy protein, and meat substitutes madewith Soy Protein. A variety of supplements are availablein powder forms, drink mixes, and “energy” bars. SoyProtein is also found in many of the products used bybodybuilders and athletes. When using the supplements,follow the manufacturer’s recommendations.

Be aware that some Soy Protein products could con-tain flavorings such as monosodium glutamate (MSG),an additive often found in Chinese food that causes ad-verse reactions in some people. Another caveat: Soy pro-tein isolates that are processed using alcohol extraction(rather than water extraction) have significantly lowerlevels of potentially beneficial isoflavones. In contrast,soy protein isolates in general have the highest proteincontent of all Soy Protein products.


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Spirulina

Why People Take ItIt’s amazing but true: The maestros of health and fitnesshave succeeded in taking a foul-tasting pond scum, pro-moting it as a cure-all “superfood,” and selling tons of it.Spirulina, a form of blue-green algae, actually does havean unusual concentration—and combination—of nutri-ents. There’s also a possibility that it may eventually proveto have certain antiviral and anticancer properties. How-ever, all of the nutrients it offers are easily obtained—at farlower cost—in conventional foods. Its therapeutic effectshave yet to be scientifically demonstrated. And its pur-ported abilities to “detoxify,” “boost energy,” or helpweight loss are all without foundation.

What It Is; How it WorksSpirulina, a substance composed of microscopic fresh-water plants, is harvested commercially in huge man-made ponds, dried, and sold as pills or powder. Promoterspoint out that it is packed with protein, beta-carotene, vi-tamin B12, and gamma-linolenic acid (GLA). Legitimatenutrition experts confirm this, but point out that there’sscant reason to obtain any of these nutrients from an

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expensive, exotic source like Spirulina when they arereadily available elsewhere.

In general, the health claims made for Spirulina arewildly exaggerated. It’s true, for instance, that cultiva-tion of blue-green algae has been eyed as an alternativeprotein source in impoverished countries, and that theWorld Health Organization (WHO) used Spirulina tohelp feed protein-deficient children in India. But mostAmericans eat too much protein, not too little, and canget high-quality protein from lean meat and eggs for afraction of the cost of Spirulina.

Similarly, the WHO found that 1 gram of Spirulinadaily reduced the incidence of Bitot’s spots (a type ofblindness caused by vitamin A deficiency) by supplyingvictims with adequate amounts of the vitamin A pre-cursor beta-carotene. But beta-carotene can be obtainedin abundance from a variety of inexpensive fruits andvegetables.

It’s also a fact that Spirulina is packed with vitamin B12

(found mainly in animal products), but it is a form of B12

that the human body can’t use. And one species of Spiru-lina does indeed contain high levels of gamma-linolenicacid, an essential fatty acid with anti-inflammatory ef-fects. However, supplement labels are not required to listwhich species is contained in the product, and there areover a thousand species.

As promised, blue-green algae products also contain anarray of nutrients and phytochemicals that are beingtested for protective effects against cancer, viruses, andother conditions, either alone, in combination, or in theform of extracts. But the jury is still out on the value of

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these substances, and Spirulina itself has not been scientifi-cally proven to offer immune support or cure any disease.

Finally, Spirulina has been touted as a safe, naturalweight-loss aid because it contains the amino acid pheny-lalanine, which supposedly acts as an appetite suppres-sant (see separate entry). However, the U.S. Food andDrug Administration has debunked these claims, con-cluding that there is no evidence that phenylalanine—orSpirulina—reduces the appetite.

Avoid if . . .There have been a few reports of allergy to blue-greenalgae. If you have a history of food allergies, use theproduct with caution. Large amounts of Spirulina, whichare high in protein, would also be inappropriate foranyone who is on a protein-restricted diet for medicalreasons (such as kidney failure).

Special CautionsNo side effects are associated with Spirulina or otherblue-green algae, but concerns have been raised over thepurity of these supplements. Liver toxins were found inanother type of blue-green algae (not Spirulina, but con-cern persists over the actual type and content of algae inSpirulina supplements).

Possible Drug InteractionsThere are no reported drug interactions with Spirulina.

Special Information if You Are Pregnant or Breast-feedingThere’s no evidence that Spirulina is harmful duringpregnancy. But since it hasn’t been formally tested for

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safety, and since you can easily find alternative sourcesfor the nutrients it supplies, your safest course is to avoidit while pregnant or breast-feeding.

Available Preparations and DosageSpirulina is available in 30- to 100-milligram capsulesand tablets from a number of leading supplement manu-facturers, and can also be taken in bulk or powderedform. Manufacturers typically recommend a total dailyintake of 2 to 3 grams (2,000 to 3,000 milligrams), takenin several small doses.

OverdosageThere is no well-established threshold for an overdosageof Spirulina. Its chief “active ingredients” are not associ-ated with significant risk of overdose in the quantitiesyou’re likely to obtain from it.

StreptococcusThermophilus

Why People Take ItDespite its forbidding name, Streptococcus thermophilusis actually a beneficial type of microorganism that pro-tects the body from the germs that cause diarrhea.Known as probiotics, these friendly bacteria reside in the

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lower intestine, rendering it uninhabitable for a variety oftheir less beneficial cousins, as well as the fungus respon-sible for yeast infections. Some evidence suggests thatthese beneficial bacteria may also improve cholesterolprofiles and protect against certain cancers.

What It Is; How It WorksStreptococcus thermophilus is one of the two types ofbacteria most often used to produce cultured dairy foodssuch as cheese, sour cream, and yogurt. (The other is lac-tobacillus; see separate entry.) When you eat yogurt con-taining live cultures, you ingest millions of these friendlybacteria. Although up to 90 percent die on their way tothe lower intestine, enough survive to make the environ-ment uncomfortable for disease-causing bacteria. Theydo this by breaking down lactose (milk sugar) into lacticacid, which increases the overall acidity of the intestineenough to kill off large numbers of harmful germs, including those that cause botulism, salmonellosis, diar-rhea, and yeast infections.

Some researchers believe that Streptococcus thermo-philus may also play a role in controlling cholesterollevels. There are at least two ways in which these bac-teria could accomplish this. As the bacteria in the lowerintestine ferment, they produce compounds called short-chain fatty acids (SCFAs). One SCFA—propionic acid—has been shown to decrease cholesterol production in theliver, thus reducing the amount of cholesterol circulatingin the blood. Some bacteria also have the ability to breakdown the cholesterol-rich bile acids that the liver poursinto the intestines. These acids are largely reabsorbed, sothat most of their cholesterol is recycled back into the

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body. But if the bile acids are broken down, their choles-terol is flushed out as waste instead of returning to thebloodstream.

There are also theories that probiotic bacteria may helpfend off certain types of cancer. Many of these bacteriaproduce volatile fatty acids that have been shown to in-hibit the growth of certain cancer cells. Some researcherssuggest that the bacteria may also contain or produce en-zymes that detoxify potential cancer-causing agents asthey pass through the intestine.

Streptococcus thermophilus supplements are totallyunnecessary as long as your native population of probi-otic bacteria is sufficient to maintain their health. How-ever, antibiotics, chronic diarrhea, and poor eating habitsoften serve to give harmful bacteria the upper hand.High-fat, high-sugar diets encourage proliferation of undesirable organisms, while emotional stress seems tolower the count of friendly ones. If you face any one ofthese problems, extra probiotics might prove beneficial.

Avoid if . . .There is no known reason to avoid Streptococcus thermophilus.

Special CautionsBecause probiotic supplements contain living organisms,freshness is important. Purchase the supplements wellbefore their expiration date. Once the supplements areopened, refrigerate them, and throw them out when theyare more than six months old. At that point, the organ-isms are dead.

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Available Preparations and DosageStreptococcus thermophilus can be obtained from certainyogurts. Check the label to make sure you’re purchas-ing a brand that contains live cultures. Streptococcusthermophilus is also found in certain probiotic supple-mental preparations, usually available in the form of cap-sules, powders, or liquids.

Follow the manufacturer’s directions for supplementdosage. Most experts advise against taking probioticscontinuously. Instead, they recommend reserving themfor short courses to repopulate the colon with friendlyflora after antibiotic therapy, to treat intestinal yeastovergrowth, or to stave off infectious diarrhea whentraveling in underdeveloped countries.


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Sulforaphane

Why People Take ItSulforaphane is a member of the intriguing new class ofnutritional compounds known as phytochemicals. Foundin plant-based foods, including fruits, vegetables, andgrains, a number of these organic chemicals have shownsigns of exciting health-enhancing properties. Scientists al-ready know that Mother Nature uses phytochemicals toprotect plants against bugs and too much sun. Now they’refinding that some of them, including Sulforaphane, mayalso serve as potent inhibitors of cancer and other diseases.

Sulforaphane is abundant in cruciferous vegetables likebroccoli and cauliflower. A few years ago, researchers discovered they could easily extract Sulforaphane frombroccoli sprouts. When they gave it to laboratory ani-mals, the compound lowered the rate of breast cancer,and also reduced the size of tumors that did develop. Onfurther study, they realized that certain strains of thesprouts contained up to 100 times more Sulforaphanethan mature broccoli florets. A trial designed to study theeffects of these supercharged broccoli sprouts in humansis now under way.

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the risk of bladder and colon cancer. But though the earlyfindings are promising, more investigation is needed be-fore we can be sure. For instance, the study on coloncancer was conducted, not in humans, but on culturedcells in the lab. And although the one on bladder cancerverified that a diet high in cruciferous vegetables (espe-cially broccoli and cabbage) is associated with a lowerrisk of the disease, purified Sulforaphane alone wasn’tgiven a test.

Nevertheless, many supplement manufacturers arenow including Sulforaphane in their products. Their ra-tionale? Because a lot of us fail to eat the recommendedservings of vegetables—and some of us wouldn’t touchbroccoli if our lives depended on it—taking Sulforaphanein pill form is supposed to act as a kind of insurancepolicy for our health.

What It Is; How It WorksSulforaphane spurs the production of natural detoxifyingenzymes in the body. In the case of breast cancer, the com-pound seems to make certain enzymes in breast cellsjump into action, locating potentially cancer-causing sub-stances and locking those substances to molecules that re-move them from the cells. However, scientists still don’tknow exactly how much Sulforaphane is needed totrigger this search-and-destroy mission, or whether it per-forms better in concert with other nutrients.

Many nutritionists caution that, although it sounds at-tractive to distill the benefits of certain vegetables andput them in a pill, it’s probably an array of phytochemi-cals from a wide variety of plants that provides themaximum benefit. No single phytochemical, they say, is

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likely to be the silver bullet against cancer. Until all theresults are in, they still recommend eating a variety ofvegetables—including the cruciferous ones—to provideyour body with a full set of tools for fighting off cancerand other diseases.

There is one way to radically boost your Sulforaphaneintake without relying on supplements: eat plenty of broc-coli sprouts. Researchers at Johns Hopkins Universityhave developed a strain that contains from 30 to 50 timesmore Sulforaphane than the average head of mature broc-coli. Eating a half cup of these designer sprouts—sold instores as BroccoSprouts—is equal to eating three and one-half cups of the cooked mature vegetable. Unlike other“enhanced” foods, these mildly spicy sprouts are in noway genetically altered—they’re merely younger versionsof the full-grown plant.

Avoid if . . .Because no long-term safety studies have been conductedwith human subjects, it is not known whether certainpeople should avoid taking Sulforaphane in supplementform. So far, animal and lab tests have yet to uncover anysignificant side effects.

Special CautionsWhile the reasons to increase your intake of Sulforaphanesound compelling, scientists point out that many chemi-cals found to protect against cancer in animal studies or laboratory tests have failed to have the same effect inhumans.

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Possible Drug InteractionsIt is not known whether Sulforaphane supplements inter-act with any medications.

Special Information if You Are Pregnant or Breast-feedingThe effects of taking extra Sulforaphane during pregnancyand breast-feeding are unknown. As with any supplementor medication, it’s best to avoid using it during this periodunless absolutely necessary. You can get plenty of Sul-foraphane from vegetables.

Available Preparations and DosageSulforaphane is available in capsule and powder form.Dosage recommendations vary according to the manufac-turer. Some manufacturers claim that one capsule of Sul-foraphane equals one serving of cruciferous vegetables,usually broccoli. Others say that one capsule is equivalentto 1 pound, or close to 2 servings. Sulforaphane can alsobe found in comprehensive supplements containing a variety of phytochemicals. It is often listed as “broccoli extract.”

If you choose to augment your diet with speciallygrown, Sulforaphane-rich broccoli sprouts, the sug-gested intake is two or three half-cup servings a week.You can find the sprouts in the produce section of manysupermarkets.


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Taurine

Why People Take ItThis common amino acid was largely ignored by medicalresearchers until the early 1970s, when serious investiga-tions first began. To date, it has shown its greatest promiseas a supplemental treatment for congestive heart failure(CHF) and epilepsy.

Taurine is an accepted treatment for CHF in Japan,and several U.S. studies have confirmed its benefits. In one double-blind trial (in which neither the patientsnor their doctors knew who was receiving actual Tau-rine), 58 people with CHF showed improvement in sev-eral measures while taking 2 grams of Taurine 3 timesdaily for 4 weeks. A second double-blind study was alsoencouraging.

Studies of Taurine’s use in treating epilepsy have beenless conclusive, with researchers calling for more, better-controlled trials in this area. Some studies have foundthat Taurine may also be beneficial for cystic fibrosis pa-tients who have difficulty absorbing nutrients. Otherstudies have suggested that it may be helpful in loweringcholesterol, as well as in treating some eye diseases, liverdiseases, and diabetes. Although experts say these results

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are promising, they assert that more research is neededbefore the product can be widely recommended for anyof these conditions.

Some proponents of Taurine suspect that it might beuseful in the treatment of Alzheimer’s disease. However,there have been no significant trials to date.

What It Is; How It WorksTaurine is best known as a component of the liver’s bileacids, used by the body to help absorb fats and fat-soluble vitamins. But it also plays many other importantroles in metabolism, especially in the nervous system andmuscles. High levels of Taurine are found in the heart,the brain, and the retina of the eye, as well as in whiteblood cells. Taurine helps regulate the heartbeat, affectsthe release of the nervous system’s chemical messengers,and maintains cell membranes.

Taurine is considered a “nonessential” amino acid,since the body can produce its own supply when there’s ashortage in the diet. The body manufactures it from vi-tamin B6 and the amino acids methionine and cysteine.Taurine also is readily available from foods such as eggs,fish, meat, and milk. Only infants do not make enough ofit to meet their needs, although the amounts supplied bybreast milk or infant formula are sufficient to make upthe difference. Adults—even strict vegetarians—do notneed supplemental Taurine to maintain good health.

Avoid if . . .Don’t take Taurine if you are allergic to proteins such asthose in eggs, milk, or wheat.

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Special CautionsIf you have a serious medical condition such as conges-tive heart failure or epilepsy, don’t try to treat yourselfwith Taurine without seeing a doctor. You’ll need othermedications, and your condition should be monitored bya professional.

Possible Drug InteractionsTaurine tends to boost the effect of anticonvulsant medi-cations, reducing the frequency of seizures. But beforeadding it to your treatment regimen, check with yourdoctor; dosages should be carefully monitored.

Special Information if You Are Pregnant or Breast-feedingNo specific information is available, but it’s wise toavoid any supplement during these periods unless it isabsolutely necessary.

Available Preparations and DosageBoth tablets and capsules are available, in 500- and1000-milligram strengths. Taurine is also included in anumber of combination preparations.

No official recommended dietary allowance has been es-tablished for Taurine, and there are no standard dosages. A typical recommendation for epilepsy is 500 milligrams 3 times a day. For congestive heart failure, researchers haveused 2,000 milligrams 3 times daily.

OverdosageTaurine is considered unlikely to cause serious symp-toms, but high dosages may produce diarrhea and pepticulcers.

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TMG (Trimethylglycine)

Why People Take ItTMG’s sudden popularity stems from its ability to re-duce blood levels of homocysteine, an amino acid com-pound that has been linked to heart disease. At normallevels, your body uses homocysteine to manufactureother amino acids. But research shows that people withhigh blood levels of this substance have an increased riskfor heart problems and blood-vessel damage.

Two small trials in people with abnormally high homo-cysteine levels confirmed that TMG can eliminate excessquantities of this compound. One study was conductedamong people whose levels remained high despite treat-ment with vitamin B6 and folate—a common therapy forhigh homocysteine. Adding TMG to the regimen broughttheir levels close to normal. The other study verifiedTMG’s ability to maintain reduced homocysteine levelsfor up to 13 years. The authors pointed out that thebenefit soon disappeared after the supplements werestopped.

A few studies hint that homocysteine may also be a riskfactor for other diseases—depression, diabetes, stroke,liver disease, and Alzheimer’s disease, among others.

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Whether TMG supplementation would be helpful forthese conditions remains largely unexplored. However,an animal-based study did show that TMG protectedagainst the early stages of liver injury due to alcohol-ism, although the findings have yet to be duplicated in humans.

Because of homocysteine’s link with hardening of thearteries and heart disease, finding ways to lower it hasbeen a goal of much ongoing research. Scientists alreadyknow that certain B vitamins, particularly B6 and folate,can help keep homocysteine from accumulating in theblood. They’ve also confirmed, in a Harvard Universitystudy of over 80,000 nurses, that taking supplements ofthese vitamins is in fact associated with a reduced risk of heart attack. To date there’s been no comparable trialof TMG, but it is not unreasonable to expect a similarbenefit.

What It Is; How It WorksTMG (also called betaine) rids the blood of excess homocysteine by converting it to the amino acid methio-nine in a natural chemical reaction known as methyla-tion. Methionine, in turn, serves as raw material for avariety of additional amino acids and other beneficialcompounds, including S-adenosylmethionine, or SAMe,a natural substance that has been shown to fight depres-sion (see separate entry). TMG’s promoters credit thisdouble-barreled action—decrease in homocysteine andincrease in SAMe—for its therapeutic effects.

TMG occurs naturally in various foods; the bestsources are beets and broccoli. In fact, most of the supple-ments are derived from beet sugars.

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Avoid if . . .Although very few long-term safety studies have beenconducted, lab tests and limited human studies per-formed to date suggest that TMG is relatively safe.

Special CautionsIf your homocysteine levels are normal, you won’t benefitfrom TMG. Only those with abnormally high homocys-teine levels face the increased risk of heart disease thatTMG may reduce. If you’re concerned about your risk forheart disease, check with your doctor. A simple blood testcan document whether your homocysteine levels are toohigh. Although there are no formal recommendations forhomocysteine testing, people who might benefit includethose with a family history of atherosclerosis (clogged ar-teries) and those who have heart problems but no knownrisk factors such as high blood pressure or cholesterol.

There are no studies documenting the side effects ofTMG. Proponents say that taking large amounts of thesupplement without food can cause tension headaches.

Possible Drug InteractionsIt is not known whether TMG interacts with medica-tions. If you take any medicine on a regular basis, checkwith your doctor before taking this supplement.

Special Information if You Are Pregnant or Breast-feedingTMG’s safety during pregnancy has not been evaluated,and a temporary interruption in treatment is unlikely toaffect your long-term health. Therefore your wisest courseis to avoid TMG while pregnant or breast-feeding.

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Available Preparations and DosageTMG is also known chemically as glycine betaine. Ifyou’re buying a supplement, be sure to get this kind ofbetaine. Another version called betaine hydrochloride(betaine HCl) does not lower homocysteine and may in-crease stomach acid.

TMG is available in tablet and powder form. Thepowder must be mixed with liquid, such as water orjuice. For maximum effectiveness, manufacturers recom-mend taking TMG with food, along with vitamins B6,B12, and folate.

To lower homocysteine levels, suggested dosagesrange from 500 to 4,000 milligrams a day. For depres-sion or liver problems, one manufacturer recommendstaking 3,000 to 6,000 milligrams a day under the super-vision of your doctor.


Tryptophan

Why People Take ItIn the 1980s, Tryptophan enjoyed widespread popularityas an inexpensive over-the-counter alternative to prescrip-

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tion antidepressants and sleep aids. Although research on the substance always produced mixed results, it wasfrequently recommended for depression, insomnia, andpain. It was used in the treatment of alcohol and cocaineaddictions, and as a diet aid. Proponents claimed it couldalso be used for migraine headaches, premenstrual syn-drome (PMS), obsessive-compulsive disorder, Alzheimer’sdisease, attention deficit disorder (ADD), autism, Parkin-son’s disease, and multiple sclerosis, among others.

Then in 1989 disaster struck. More than 1,500 peopletaking Tryptophan came down with a serious blood dis-ease called eosinophilia-myalgia syndrome (EMS), andat least 30 people died of it. The U.S. Food and Drug Ad-ministration recalled all Tryptophan supplements fromthe market, and in 1990 it banned any further sales.

Most nutritional experts agree that the EMS outbreakwas the result of contamination introduced by a singleJapanese manufacturer of the substance. Nevertheless,over-the-counter Tryptophan supplements remain bannedin the United States, though the substance is still added toinfant formulas and intravenous feeding solutions, andcan be obtained by prescription from a few special “com-pounding” pharmacies.

In its place, a related substance called 5-HTP (5-hydroxy-L-tryptophan) is now marketed in the UnitedStates for the same purposes as Tryptophan, although it’snot clear that it works in exactly the same way. Caution is in order, however. In 1998, the FDA reported that the same contaminant that forced Tryptophan off themarket in 1989 had been found in 5-HTP. Although thenewer supplement hasn’t been banned, the FDA has askedhealth professionals to report any illnesses associated with

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its use. Because of the risks involved, it’s advisable to haveyour doctor monitor you if you decide to take 5-HTP.

What It Is; How It WorksTryptophan is far from exotic. In fact, it is one of theeight essential amino acids that must be included in everydiet because they can’t be manufactured by the body.Like other amino acids, it’s a building block of protein(although the body uses less of it than of the others). It’salso necessary for the production of vitamin B3 (niacin).

Any reasonable diet provides enough Tryptophan tomeet the body’s needs. Good sources include meat, fish,turkey, milk, cheese, eggs, fruits, nuts, and dates. Vi-tamin B6 is required for its proper utilization. A lack ofTryptophan in the diet, like a shortage of protein in gen-eral, is thought to slow growth in children, cause apathyand weakness, and lead to a loss of hair color, weightloss, liver damage, and skin problems.

Tryptophan’s reported therapeutic effects arise fromits status as the raw material for serotonin. One of thenervous system’s major chemical messengers, serotoninexerts a mood-lifting and calming effect on the brain. Italso appears to play a role in pain control, and may re-duce inflammation and stimulate movement in the diges-tive tract.

Research has confirmed that Tryptophan supplementsproduce an increase in serotonin levels. 5-HTP, which isformed from Tryptophan as an intermediate step in theproduction of serotonin, has a similar effect. Small trialsof 5-HTP for anxiety and migraine have yielded definite,though moderate, improvement.

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Avoid if . . .Because Tryptophan supplements are banned in theUnited States, it’s unwise to take any product labeledTryptophan, L-tryptophan, Pacitron, Trofan, Tryptacin,or any other brand name for natural or synthetic Trypto-phan. These products have not been checked for purityor safety, and therefore could lead to the potentially fatalblood disorder EMS.

Also avoid Tryptophan supplements—even by prescription—if you have asthma or lupus. Steer clear of5-HTP if you have a digestive ailment such as an ulcer orCrohn’s disease, or suffer from a rare condition calledcarcinoid syndrome that is associated with excessivelyhigh levels of serotonin in the blood.

Special CautionsTryptophan per se has only occasional mild side effects,such as nausea, headaches, and constipation. However,if you’re unlucky enough to contract EMS from a con-taminated supplement, you can expect symptoms suchas high fever, muscle and joint pain, weakness, skin rash,and swelling of the arms and legs.

The most common side effects associated with 5-HTPare nausea and diarrhea. Occasionally, some people suffergrogginess.

Possible Drug InteractionsTryptophan (and 5-HTP) may interact with prescriptionantidepressants, including monoamine oxidase inhibitors(MAO inhibitors). Check with your doctor before com-bining either supplement with such medications.

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Special Information if You Are Pregnant or Breast-feedingDo not take Tryptophan or related substances if you arepregnant or breast-feeding.

Available Preparations and DosageAdvocates of 5-HTP, the only substance related to tryp-tophan available on the U.S. market, often recommenddoses of 100 to 300 milligrams three times daily. Inclinical studies, it has been used in dosages ranging from50 milligrams to 1,200 milligrams per day. It may take 2or 3 weeks for antidepressant effects to appear.

OverdosageHigh doses of 5-HTP can cause nausea and vomiting.

Tyrosine

Why People Take ItTyrosine is the raw material for three of the nervoussystem’s leading chemical messengers: dopamine, norepi-nephrine, and epinephrine. Called neurotransmitters,these substances pass messages from one nerve cell to thenext, helping to regulate brain function, muscle function,body movement, and more.

Deficiencies of these neurotransmitters can lead to

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physical and mental fatigue and depression. Since allthree are manufactured from Tyrosine, many people be-lieve that boosting the supply of this substance can fightdepression. Tyrosine has also been tried, without muchsuccess, in the treatment of attention deficit disorder(ADD) in children.

Studies have shown that Tyrosine may improve memoryand alertness, and a limited military study indicates it mayimprove the ability to perform under stress. Other claimsfor Tyrosine remain unsubstantiated. They include asser-tions that it can improve sexual interest, relieve pain, andpromote weight loss. Also, since dopamine is used to treatParkinson’s disease, Tyrosine has been proposed as anatural remedy for this movement disorder. It has beentried as a treatment for symptoms of alcohol withdrawal as well.

Athletes and bodybuilders take Tyrosine, most oftenin combination with other amino acids, but there is noevidence that Tyrosine itself helps to build muscles or im-prove endurance.

What It Is; How It WorksTyrosine is one of the “nonessential” amino acids that thebody can produce for itself. It’s built from the amino acidphenylalanine with the help of vitamin B6 and folic acid.Tyrosine is also abundant in meat, bananas, and papaya,and can be found in dairy products, oats, nuts, and fish. Although outright deficiencies of Tyrosine are rare, they are known to occur in people with kidney dis-ease and in individuals who are unable to process phenylalanine.

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In addition to supplying the raw material for dopa-mine, norepinephrine, and epinephrine, Tyrosine is usedby the thyroid gland to produce thyroxine, a hormonethat is involved in most body processes, helping to regu-late growth rate and metabolism. A deficiency of Tyro-sine can lead to hypothyroidism (low thyroid function),and Tyrosine supplements have been used to correct theproblem. Tyrosine is also associated with the productionof melanin, the pigmenting substance that protects theskin from harmful ultraviolet rays.

Infants with a rare genetic disorder known as tyro-sinemia have difficulty processing Tyrosine. Unless intakeof Tyrosine and phenylalanine is carefully restricted, thiscondition can lead to mental retardation.

Avoid if . . .Due to its potential effects on the brain, it’s best to avoidTyrosine if you have a psychotic disorder. Do not give itto children.

Special CautionsBecause of its stimulative effect on the nervous system,Tyrosine can sometimes boost blood pressure or triggeranxiety and insomnia. Use it with caution if you havehigh blood pressure.

Possible Drug InteractionsDo not use Tyrosine if you are taking a drug classified asa monoamine oxidase (MAO) inhibitor, such as the anti-depressant medications Nardil and Parnate. The combi-nation can cause a life-threatening rise in blood pressure.

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Special Information if You Are Pregnant or Breast-feedingDo not take Tyrosine during pregnancy or breast-feeding.

Available Preparations and DosageTyrosine is available in capsules and tablets in strengthsof 100 to 500 milligrams. It is also available in powderform, and can be found in a variety of natural supplementpreparations containing other amino acids, vitamins, andminerals. Always be careful to choose a quality brand, assome may contain impurities that could have adverse effects.

Manufacturers typically recommend dosages of 500 to1,000 milligrams daily, taken between meals for maxi-mum effect, or in the morning if the supplement tends togive you insomnia. Doses as high as 2,000 to 4,000 milli-grams three times daily have been used to treat depres-sion, but experts warn that you need regular monitoringby your doctor when you take doses that high.

OverdosageEven a massive single dose is unlikely to cause harm,though it could lead to nausea and diarrhea. Sustainedmegadosing could theoretically strain the liver and kidneys.

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Vinpocetine

Why People Take ItA so-called smart drug, Vinpocetine is said to improvememory and mental function in healthy people, as wellas in those with some degree of brain impairment. Users,noting that use of the agent causes the brain to burnmore oxygen and blood sugar, suggest that Vinpocetinerevs up the mind. Further evidence of Vinpocetine’s ef-fect, according to advocates, is an increase in the level ofadenosine triphosphate found in the brain. Adenosinetriphosphate, commonly known as ATP, serves as thebody’s principal storehouse of ready energy.

Additional benefits attributed to Vinpocetine includean ability to relax blood vessels in the brain, thus im-proving circulation, and the capacity to alter blood cellsso that they will be less likely to form dangerous clots.Vinpocetine has also been described as a possible anti-oxidant, protecting cells from the damaging free radicalsthat can oxidize tissues throughout the body, includingthe brain.

Vinpocetine is sold as a drug in Germany, Japan,Mexico, and Portugal for the treatment of cerebrovas-cular disorders—ailments that interrupt blood circula-

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tion in the brain, starving it of oxygen. In Portugal, it’salso used to treat general circulatory problems, as well ascertain disorders of the eyes and ears. The drug is ap-proved in Australia for the treatment of mental functiondisorders in the elderly and for other disorders of thebrain. However, in the United States it remains an unap-proved, experimental agent.

What It Is; How It WorksLike other members of the vinca alkaloid family ofdrugs, such as the cancer drugs vincristine, vinblastine,and vinorelbine, Vinpocetine comes from the periwinkleplant. Limited research data show that Vinpocetine doesin fact relax the blood vessels of the brain, improve cere-bral blood flow, and inhibit blood clotting to some ex-tent. One study implies that the drug improves memoryin healthy people. Studies in animals also indicate a pro-tective effect when the brain is deprived of oxygen.

On the other hand, a number of trials have producedless encouraging results. To date, studies in people withAlzheimer’s disease or stroke have been very disappoint-ing. Trials in people with brain dysfunction due to othercauses have produced mixed results, providing no clearanswers for researchers. It’s evident that additional, wide-scale studies are needed before any firm conclusions canbe drawn about Vinpocetine’s real value and most appro-priate uses.

Avoid if . . .Do not take Vinpocetine if you have ever had an allergicreaction to one of the vinca-based anticancer drugs, or toVinpocetine itself.

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Special CautionsIf you have liver disease, a seizure disorder, or a psy-chotic illness, do not take Vinpocetine except under aphysician’s supervision. In fact, it’s a good idea to get pe-riodic checkups while taking Vinpocetine whatever thestatus of your health. Your doctor will probably want tocheck your blood pressure on a regular basis. He or shemay also want to order a routine blood test from time totime to ensure that your liver is breaking down the drugproperly. Don’t forget that outside the United States Vin-pocetine is used like a potent prescription drug. A bit ofextra caution is merited.

Side effects are relatively mild. People enrolled in re-search studies have taken up to 60 milligrams of Vinpoce-tine per day without suffering serious adverse reactions.Some people found that their blood pressure droppedslightly—an effect that can cause dizziness. Facial flushinghas also occurred among people taking Vinpocetine.Other complaints reported include temporary sleep dis-turbances and restlessness (usually after ten weeks oftherapy), pressure headache, and stomach disturbances.Minor decreases in blood sugar have been noted, too, butit has not been determined whether this effect was actuallycaused by Vinpocetine.

Possible Drug InteractionsSmall changes in clotting time have been reported inpeople who combine the blood thinner Coumadin withVinpocetine. If you are taking any type of blood thinner,be sure to let your doctor know when you begin takingVinpocetine. While the combination does not seem to

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pose a great danger, more frequent monitoring of yourclotting time is a good idea.

Special Information if You Are Pregnant or Breast-feedingDuring pregnancy and breast-feeding it’s best to avoidany medication that’s not absolutely necessary for yourshort-term health. Forgo Vinpocetine throughout thisperiod.

Available Preparations and DosageVinpocetine is typically sold as 5-milligram tablets. De-pending on the product you purchase, the label may di-rect you to take anywhere from 5 to 30 milligrams daily.Do not exceed the recommended amount.


Wheat Germ

Why People Take ItRich in vitamins, minerals, and a unique ingredientcalled octacosanol, Wheat Germ is often taken to im-prove energy and endurance. Proponents make otherclaims for it as well. They say that the octacosanol in

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Wheat Germ acts as a blood thinner, discouraging theformation of clots on artery walls and thus reducing the risk of a heart attack. Some experts speculate that octaconasol may also prove useful in the treatment ofmuscular dystrophy and other degenerative diseases of thenervous system.

Thanks to its high vitamin content, Wheat Germ alsosupports a healthy immune system and may help to con-trol high cholesterol levels. And applied to the skin, wheatgerm oil is used to soothe burns and sores and alleviatesuch skin conditions as psoriasis, seborrheic dermatitis,and abnormally dry skin.

What It Is; How It WorksWheat Germ is the embryo of the wheat plant. In addi-tion to octacosanol, it contains a multitude of vitaminsand minerals, including calcium, copper, manganese,magnesium, most B vitamins, and phosphorus; and it’sone of the richest natural sources of vitamin E. It is tothese vitamins and minerals that Wheat Germ owesmuch of its effect.

Vitamin E, for example, is a leading antioxidant, pro-tecting cells from destructive oxidation and possiblymoderating some of the damage that occurs with age. Itis also necessary for efficient immune function and theproduction of normal red blood cells, and it aids in con-trolling glucose and fat in the blood. The B vitamins playa vital role in the body’s production of energy, while alsosupporting healthy neuromuscular function, proper di-gestion, normal immune function, acceptable cholesterollevels, and healthy skin, hair, and eyes. Wheat Germ isalso a good source of folic acid, the vitamin that’s recom-

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mended during pregnancy to prevent neural tube defectsfrom developing in the baby.

It’s reasonable to suppose that the cornucopia of nutri-ents in Wheat Germ would have beneficial effects on en-ergy and stamina, and several small clinical trials seem toconfirm this. In particular, high-potency wheat germ oiland pure octaconasol outscored dummy medicines by asmuch as 100 percent in a test of their ability to boost en-ergy and endurance.

Avoid if . . .Wheat Germ is generally considered safe and nontoxic.

Special CautionsWheat Germ contains a plant-based analog of the femalesex hormone estrogen; long-term use of massive doses ofthe high-potency oil has been known to cause testiculardegeneration and loss of sex drive in some men.


Special Information if You Are Pregnant or Breast-feedingSome studies suggest that wheat germ oil may actuallyreduce the risk of miscarriage and prematurity whentaken during pregnancy. Nevertheless, be sure to checkwith your doctor before using it, and avoid excessivedoses.

Available Preparations and DosageWheat Germ is available in food and as flakes to mix withfood. It should be kept cool and dry, but not frozen. Wheat

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germ oil can be purchased in capsule or liquid form; itshould be stored tightly covered in the refrigerator.

No official dosage has been established. One to oneand a half teaspoonfuls of the oil daily is often consideredsufficient. Follow the manufacturer’s directions wheneveravailable.


Whey

Why People Take ItForget about Miss Muffet. Today, you’re more likely tofind bodybuilders eating their Whey. This milk-basedsupplement has recently gained popularity among ath-letes and fitness enthusiasts because of its rich supply ofbranched-chain amino acids (see separate entry). Thesebuilding blocks of protein support normal growth andare said to enhance muscle mass. Whey is, in fact, a goodsource of a variety of proteins, and contains a minimumof unwanted fat. There’s little evidence, however, that itbuilds muscle better than any other food rich in protein.

Most of the health claims made for Whey are based onits protein content. Proponents say that it helps to slow

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aging and prevent cataracts and age-related macular de-generation. Whey and its proteins are also recommendedby natural health advocates to improve appetite in cancerpatients, to protect women against breast cancer, and tofight immune system diseases such as AIDS. Whey pro-teins have been credited with slowing the wasting effectsof amyotrophic lateral sclerosis (Lou Gehrig’s disease),though this disorder originates in the nervous systemrather than muscle tissue. Whey is also advertised as anaid to mental alertness, memory, and sleep.

Since Whey is sold as a natural food supplement, it hasundergone little medical testing, and there is scant clinicalevidence to support any claimed effects beyond those thatcould be expected from proteins in general. Its high-protein, low-fat nutritional profile is thought to aid inweight control. An Australian study suggested that itmight speed up wound healing. It has also been studied as a treatment for muscular dystrophy, but was found ineffective.

What It Is; How It WorksWhey is typically a by-product of cheese production—the substance left when the curds used to make thecheese are removed. Like most cheeses, Whey usuallycomes from cow’s milk. In liquid form, it has long been adietary staple wherever milk and cheese are consumed.Today, it’s an ingredient in many frozen and canned pre-pared foods.

Whey’s popularity as a powdered food supplement isrelatively new. It is known to contain most of the pro-teins the body needs, and some preparations include ad-ditional proteins, vitamins, and minerals. Many Whey

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supplements are now advertised as “ion-exchanged” or“hydrolized.” Ion-exchange is a process used to removefat and lactose, and hydrolization breaks up some pro-teins for better digestion.

Although the proteins in Whey are available in mostordinary diets, some researchers think that they’re ab-sorbed more quickly from Whey than from other sources.(Hence the claim that Whey is more beneficial to athletesafter a workout.) The substances contained in Whey in-clude natural growth factors, which may account for anymuscle-building or wound-healing properties it exhibits.Whey also contains antioxidant compounds, providingthe basis for claims that it may combat the chemicalbreakdowns that contribute to aging and age-related con-ditions such as cataracts and macular degeneration.

Avoid if . . .People with lactose intolerance or an allergy to cows’milk should avoid Whey products.

Special CautionsLike any type of protein, Whey can put damaging stresson the kidneys and liver when taken in massive amountsfor an extended period of time.

Possible Drug InteractionsThere are no known drug interactions.

Special Information if You Are Pregnant or Breast-feedingWhey has no known harmful effects. However, be sureto check product labels for other—possibly harmful—

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ingredients, and check with your doctor if you have anydoubts.

Available Preparations and DosageWhey supplements are available in powder form, eitherflavored or plain, and sometimes sweetened. Many manu-facturers recommend about a tablespoonful mixed withwater, juice, or milk. However, ingredients and processingmethods vary widely, and some brands may be purer andmore effective than others.

OverdosageAs a natural substance, Whey is considered generally safe.

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Usage Index

For each disease, condition, or objective listed below,this index presents the nutritional supplements that aregenerally considered most likely to have a positive effect.A substance is listed only if clinical research has pro-duced encouraging results or the product’s widespreadacceptance suggests some satisfaction with its perfor-mance. If a claim remains speculative or theoretical, it isnot included here.

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Adrenal InsufficiencyDHEA

AgingArginineArginine

PyroglutamateDHEA

Alcohol WithdrawalGlutamineGlycine

Alzheimer’s DiseaseCarnitineCDP-Choline

CholineNADHPSSAMe

AnginaPhosphatidylcholine

AnxietyGABAInositolPSTryptophan

Attention Deficit DisorderDMAE

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Bladder CancerPrevention

Sulforaphane

BodybuildingAndrostenedioneArginineArginine PyroglutamateAspartic AcidBranched-Chain Amino

AcidsConjugated Linoleic AcidCreatineDesiccated LiverDMGGlutamineHMBOrnithinePotassium GlycerophosphateRiboseWheat GermWhey

Breast Cancer PreventionPhytoestrogensSulforaphane

Bruising, EasyBioflavonoidsPycnogenol

Cancer, AdjunctiveTherapy

Beta-Glucan

Cataracts, Prevention ofLutein

Celiac DiseaseDigestive Enzymes

Cholesterol, HighBeta-GlucanBrewer’s YeastChitosanCholineChromium PicolinateFish OilFlaxseed OilGLAInositolLecithinOmega-3 Fatty AcidsPantethinePectinPerilla OilPhosphatidylcholinePhytosterolsRed Yeast RiceRoyal JellySoy Protein

Chronic FatigueSyndrome

NADH

Circulation Problems inthe Legs

BioflavonoidsGlycosaminoglycansGrape Seed ExtractPycnogenol

Colon Cancer PreventionLuteinPectinSulforaphane

Congestive Heart Failuresee Heart Failure

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ConstipationChitosan

Cystic FibrosisDigestive Enzymes

DepressionCholineInositolNADHPhenylalaninePSSAMeTryptophanTyrosine

DermatititsWheat Germ

DiabetesBrewer’s YeastChromium PicolinatePectin

Diabetic NeuropathyGLAInositolLipoic Acid

DiarrheaBifidobacterium

BifidumBrewer’s YeastColostrumLactobacillusPectin

EczemaGLAInositol

Erectile DysfunctionArginine

EpilepsyGlycineTaurine

Flu SymptomsOscillococcinum

Gallbladder DisordersCholine

GastritisGlutamineLactobacillus

Gaucher’s DiseaseDigestive Enzymes

GoutGlycine

Hair LossInositol

Hardening of the ArteriesGlycosaminoglycans

Heart Disease PreventionArginineBioflavonoidsChitosanFish OilFlaxseed OilInositolGLAGlycosaminoglycansLecithinLycopeneOmega-3 Fatty Acids

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PantethinePectinPerilla OilPhosphatidylcholinePhytoestrogensPhytosterolsPycnogenolSoy proteinTMGWheat Germ

Heart FailureCarnitineCoenzyme Q10InosineTaurine

HeartburnAlginatesLactobacillusPectin

HemorrhoidsGlycosaminoglycans

Herpes Simplex InfectionsLysine

High Blood PressureChromium PicolinateFish OilOmega-3 Fatty AcidsPotassium GlycerophosphateSoy Protein

HIV/AIDSGlutamineGlutathione

Homocysteine, HighTMG

HypothyroidismTyrosine

Immune SystemStimulation

ArabinogalactanArginineBifidobacterium BifidumBrewer’s YeastColostrumCysteineDMGFructo-OligosaccharidesGLAGlutamineGlutathioneLactobacillusOrnithineRNARoyal JellyWheat Germ

Infections, MinorBrewer’s Yeast

InfertilityCarnitine

InsomniaMelatoninTryptophan

Intestinal DisordersBifidobacterium BifidumChitosanGlutamineLactobacillusStreptococcus

Thermophilus

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Jet LagMelatonin

Kidney DisordersCholine

Liver DisordersCholineDesiccated LiverLecithinMethionineSAMe

Macular Degeneration,Prevention of

Lutein

Memory LossCarnitineDMAEGlycosaminoglycansPSPyroglutamateTyrosineVinpocetine

Menopause, Symptoms of

PhytoestrogensSoy IsoflavonesSoy Protein

Migraine HeadachesTryptophan

Multiple SclerosisGlycine

Obsessive-CompulsiveDisorder

Inositol

OsteoarthritisChondroitinGelatinGLAGlucosamineMSMSAMe

OsteoporosisBone MealChromium PicolinateDolomiteIpriflavoneLysinePhytoestrogensSoy IsoflavonesSoy Protein

Paget’s Disease of Bone

Ipriflavone

Panic DisorderInositol

Parkinson’s Disease CDP-CholineNADH

Peripheral NeuropathyInositol

Premenstrual Syndrome

GLA

Prostate Cancer Prevention

LycopenePectinPhytoestrogens

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Prostate ProblemsBee PollenFlaxseed OilPhytosterols

PsoriasisWheat Germ

Radiation SicknessBee Pollen

Respiratory DisordersCysteine

Rheumatoid ArthritisGLAHistidine

Seasonal AffectiveDisorder

Melatonin

Sex Drive, LowDHEA

StrokeCDP-CholineVinpocetine

Stroke PreventionPotassium Glycerophosphate

Vaginal Yeast InfectionsLactobacillus

Varicose VeinsGlycosaminoglycansPycnogenol

Weight LossChitosanPyruvatePectinWhey

Wound CareBee PropolisWheat GermWhey

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Documents

the PDR Family Guide to Nutritional Supplements an Authoritative a to Z Resource on the 100 Most Popular Nutritional Therapies and Nutraceuticals PD