Handout for Miami PPS Conference

PLEASE CONSULT YOUR DOCTOR BEFORE TAKING ANY SUPPLEMENT!

My favorite reliable source of safe, reasonably priced supplements:
www.vitacost.com. Phone ordering: 1-800-793-2601
Everything I recommend can be ordered there.

Another excellent company is www.vrp.com, phone ordering: 1-800-877-2447. They are also reliable, but more expensive. Their products are not exactly the same as Vitacost's, but both companies have a doctor specializing in nutrition formulating their products (only the NSI line at Vitacost).


Unless otherwise stated, you can safely mix and match any of these supplements. They often work synergistically.

It’s a really good idea to start supplements one at a time. Although side effects or reactions are generally mild and rare with the nutraceuticals I recommend, anyone can have a reaction to anything he puts in his mouth. More common reactions would be stomach upset, constipation or loose stools, headache, itching, wooziness, nervousness or insomnia.

Try each product for 3 days. If you don’t notice any reaction by then, it should be safe to introduce another product at that time.

Different products show results at different rates: some right away, some take as much as a year. With most, you will see improvements in 2 or 3 months.

Trouble swallowing pills? Get capsules and open them, then sprinkle in applesauce or yogurt. Some softgels are soft enough to pierce and squeeze out contents. Or coat capsules with olive oil and sip some warm water before swallowing.

Nutrition supplementation do not “treat” conditions and should NOT replace medical treatment. They are to be taken in conjunction with a doctor’s care.

THE BASICS – SUPPLEMENTS RECOMMENDED FOR EVERYONE
THIS MEANS YOU!!

These cover most of the vitamins, minerals, and the one fatty acid that most Americans are most commonly deficient in. Offer the whole smorgasbord to your body, and it will pick and choose what it needs and excrete what it doesn’t.
If you don’t have enough of the “basics,” your body simply WILL have more problems than it should – period.

1. A high-quality multivitamin/mineral formula, 3 to 6 capsules a day.
My recommendations at vitacost.com:

a. NSI Nutrislim Low Carb Dieter’s Basic Multi-Vitamin Version 2 is quite adequate for those of you who, like me, will be taking many additional supplements.

b. NSI Synergy Multi-vitamin Version 10 is more expensive, but more complete, for those of you who do NOT want to add on a lot of other supplements. Its ORAC value is over 8000, which means it’s exceptionally high in antioxidant/anti-inflammatory potential.
Caution I: It contains the herb ginkgo. This is a wonderful antioxidant and supposedly the most commonly taken nutraceutical worldwide, but if you are taking blood-thinning meds or aspirin, you MUST be monitored by a doctor before and while taking it.
Caution II: If you haven’t tried ginkgo before, and especially if you tend to be high-strung or easily stimulated, you may want to buy a little and try it before investing in this vitamin formula. Buy in a 30-mg. dosage. Start with 1 a day, and add 1 more every few days until you are taking 120 mg., the amount in the Synergy multivitamin, to see how it might affect you.

c. NSI Synergy RX is equivalent in potency and price to the Synergy Version 10, but has NO ginkgo.

2. If you don't eat fatty fish (sardines, salmon, herring, sablefish) at least twice a week, or other fish more often than that, you probably need EFA or fish oil supplementation.
(Fried fish does NOT count! Frying counteracts the benefits of the good oil.)

My recommendation at vitacost.com is NSI Mega EFA – 2 capsules a day (equal to 1200 mg. of the active ingredients EPA and DHA, stated on the back label).

EFAs are very chemically reactive with light, heat, and air. So, just in case, I like to store them in the refrigerator. And I take them along with some antioxidants, such as a multi-vitamin capsule, or vitamin E and vitamin C.

If not ordering from my recommended source, choose an opaque bottle with "molecularly distilled" on the label, to make sure it’s free of contaminants.

For treatment of high blood pressure, depression or any inflammatory condition (bursitis, tendonitis, arthritis), you will get more benefits by building up to 2400, 3600 mg. or even more, under your doctor’s supervision. Stick to 1200 mg. if you take aspirin, ginko, or blood-thinning medication.

Handout for Miami conference, part 2

HIGHLY RECOMMENDED

FOR ANY NEUROMUSCULAR, DEGENERATIVE CONDITION

These have been clinically studied and well substantiated for conditions similar to PPS. Results have shown that they may can slow down progression of degeneration. They also may improve physical and mental energy, muscle strength and endurance, and muscle pain.

1. Coenzyme Q10 – at least 100 mg. a day. The more the better, up to 1200 mg. a day. Take with a meal containing some fat. Consult your doctor if you’re taking blood-thinning medication. EXTRA IMPORTANT to take at least 100 or 200 mg. a day if you are taking a statin, a tricyclic antidepressant, oral diabetes medicine, or a beta-blocker, or if you have congestive heart failure, periodontal disease or high blood pressure.

For those of you who intend to take fish oil, coenzyme Q10 and the Synergy Version 10 multivitamin, there is a product at vitacost.com that combines the 3 products. It is NSI Synergy Multi-Vitamin Version 10 plus ToCoQ10 & Mega EFA. It costs $15 less than the 3 products taken separately.

2. Creatine (monohydrate) - 5 grams, two to four times daily for five days as a loading dose, with 2 to 5 grams daily thereafter. It is best to take creatine between meals with a small amount of honey or non-acidic juice to enhance its function. Always take with 16 oz. of water or watered-down juice, and try to drink another 48 oz. of water during the rest of the day. Contraindicated if you have kidney damage or disease.

OTHER SUPPLEMENTS THAT MIGHT SLOW DOWN PPS PROGRESSION
(Neuroproctective, mitochondrial energizers, antioxidants, or anti-inflammatory)

1. Acetyl-l-carnitine- Take 1500 to 3000 mg., in divided doses, without food.

2. Ginkgo biloba – The usual dosage is 120 or 240 mg., although lesser dosages MAY have some beneficial effect. See Cautions I and II on page 2.

3. Lipoic acid –
R-lipoic acid is the preferred form. Take 100 to 300 mg. a day with food.

Alpha lipoic acid is usually cheaper, but take 300 to 600 mg. a day.

With either form, I believe the lower dosage to be adequate UNLESS you have diabetes or pre-diabetes.

If you are hypoglycemic, as many polio survivors are, take the lower dosage. If that dosage exacerbates your hypoglycemia, try taking 3000 mcg. (3 mg.) of biotin with the lipoic acid.

4. Resveratrol - (17 to 100 mg. standardized), grapeseed (50 – 300 mg.), green tea extract (50 mg. or more), quercetin (50 mg. or more), and red wine extract (any amount) all work together. You can take them singly, but I recommend formulas containing at least 2 of them.

5. Progesterone cream:Also good for your bone-building cells.

for WOMEN - 20 to 40 mg.

for MEN - 5 mg.

Pregnenolone for women and men (15 to 30 mg.)
You may use either product, or both together.

THESE ARE HORMONES. They are considered by some experts to carry more risk than other supplements. CHECK WITH YOUR DOCTOR before taking.
The authoritative source on progesterone is What Your Doctor May Not Tell You About Menopause, by Dr. John R. Lee.

6. Vitamin E – 800 IU. Always take together with lipoic acid or 500 mg. vitamin C!

The best form: mixed tocopherols and tocotrienols
2^nd best: mixed tocopherols
Also acceptable (and cheaper): alpha tocopherol or d-alpha tocopherol
Not recommended: dl-alpha tocopherol (synthetic vitamin E)
Cautions: Don’t take more than 400 IU (including the amount in your multivitamin) if you are taking blood-thinning medication. Consult doctor.

If you have rheumatic heart disease, high blood pressure (not controlled by medication) or take digitalis drugs, limit vitamin E to 150 IU.

TO LESSEN MUSCLE FATIGUE, WEAKNESS AND PAIN

1. Creatine (see above)

2. Coenzyme Q10 (see above)

3. D-ribose: This "pentose" sugar is a component of ATP, the energy-transporting molecule produced by the mitochondria. A shortage of d-ribose can produce fatigue and muscle pain. Some PPS patients have reported significant improvement when taking on the order of 20 grams/day of d-ribose. Start with 5 grams and try for 2 weeks. Increase every 2 weeks until you notice a difference, up to 20 grams.

4. Whey protein – 20 to 40 grams a day. The more whey protein isolate in the product, the better it will be assimilated. Usually can be tolerated by those sensitive to lactose.

5. Magnesium: Also VERY important for cardiovascular and bone health! May help relieve depression, anxiety, and restless legs.

CHECK WITH YOUR DOCTOR before taking any amount if you have kidney disease, or are taking medications, or are over 65

Dosages vary greatly with individuals. The RDA is around 300 mg. for women and 400 mg. for men. However, polio survivors may get increased benefits with higher dosages, up to 800 mg. a day.

CHECK WITH YOUR DOCTOR before taking more than the RDA.

Other dosage guidelines:

1. If you supplement with calcium, always take at least half as much magnesium as calcium (i.e, 500 mg. magnesium with 1000 mg. calcium). Equal amounts may be even better.

Magnesium competes with calcium for the same absorption site in the intestine, so too much of one of these minerals causes a deficiency in the other one.

2. Check how much magnesium is in your multivitamin, so you can compute your daily total intake.

3. To begin magnesium supplementation, start with 100 or 200 mg. Increase once a week until you reach a 1 to 1 ratio with your calcium supplement, or until your stools become too loose. In that case, decrease to the maximum you can take that does NOT affect your stools.

Recommended forms:
Magnesium aspartate seems to give people the most energy, but ANY form is better absorbed than magnesium oxide.

6. Vitamin D – Because of recent studies, the trend among nutritionists is to raise their recommendation from the RDA of 400 IU to 1000 IU or more, up to 2000 IU. I recommend 400 IU in addition to the 700 IU in the Nutrislim and Synergy RX multis. This isn’t necessary with the Synergy Version 10, which has 1000 IU.

There is evidence that many older people have unnecessary muscle weakness attributable to vitamin D shortfalls that makes them tire easily. The weakness occurs predominantly in the legs, often manifesting itself as a feeling of heaviness in the limbs and difficulty climbing stairs or getting up from a chair. Compromised handgrip strength has been seen, too.

Handout for Miami conference, part 3

GENERALIZED (SYSTEMIC) FATIGUE

1. Potassium - You can get more by increasing consumption of fruits, vegetables, fish, yogurt, nuts, seeds, and soybeans. Many people also find increased energy when they take 100 to 400 mg. of potassium supplements.

The most effective form is potassium ASPARTATE taken in conjunction with magnesium aspartate.

CHECK WITH YOUR DOCTOR before taking potassium supplements OR increasing the potassium in your diet if you have a medical condition, are taking medications, or are over 65.

2. Iron – Even a borderline (subclinical) iron deficiency can exacerbate fatigue, insomnia, lack of concentration, and restless legs. These symptoms will NOT improve if you are NOT deficient in iron or in the very low “normal” range. As you can have too much iron in the body, CHECK WITH YOUR DOCTOR. There is NO iron in the multivitamins I have recommended.

If you do need to supplement with iron, try Ferrochel, or any slow-release form. Start with 10 mg. a day (or 18 mg. every other day) for a month. Continue taking only IF your symptoms have improved.

DO NOT TAKE at the same time you take your calcium supplement or a large dose of vitamin C.

3. B vitamins – These ARE included in the multivitamins, but occasionally people will need additional amounts.

It is cheaper to buy the NSI Vitamin B formula, break open the capsules, and take ¼ to ½ capsule a day, in addition to your multivitamin.

If you don’t want to mess with doing that, buy the Country Life Coenzyme B-Complex and take 1 or 2 capsules a day.

4. Fish oil (See above)

5. Carnitine (any form, including acetyl-l-carnitine; see above)

6. Eleuthero - Eleuthero has been shown to enhance mental acuity and physical endurance without the letdown that comes with caffeinated products. May also normalize blood sugar.

Daily dosage is usually given as 2 - 3 grams of dry, powdered root or 300 - 400 mg of standardized extract, but I find one 648 mg. capsule of the NSI product makes a difference for me.

Historically, eleuthero is taken continuously for six to eight weeks, followed by a one- to two-week break before resuming.

7. DHEA – As well as boosting energy, a deficiency of DHEA has been found to correlate with chronic inflammation, immune dysfunction, depression, cognitive decline, osteoporosis, and heart disease.

Ideally, a doctor should test you to find out what your DHEA level is.

If you try it on your own, women should start with 10 mg., and raise to 25 mg. if no results are felt after a week. Men typically do better with 25 to 50 mg.

If you get acne, hot flashes, become irritable or hyper, you’re taking more than your body needs.

CONSULT WITH YOUR DOCTOR if you have or have had a hormone-related cancer!

PAIN

1. MSM is a sulfur-containing anti-inflammatory compound best known for alleviating arthritis. It may also help muscle pain, nasal allergies, and fatigue after exercise. Dosage: start at 500 mg. 3 times a day with food; increase by 500 mg. until you get results, up to 6000 mg. MSM works better if 2000 mg. vitamin C is taken daily.

2. Fish oil (see above). In a recent study on back pain, more people were able to stop taking or lower their pain medication when taking 2400 mg. of EFA/DHA than the lower dosage of 1200 mg.

3. Boron – 3 mg. is the standard dosage for bone health. 6 mg. or 9 mg. a day can often alleviate arthritic pain.

4. Turmeric – 900 to 1200 mg. a day, standardized for 95 percent curcuminoids.

You can also use as a culinary spice in powdered form - brightly colored and aromatic is best. Has also shown results in preventing colon cancer and Alzheimer's. It may take 2 months to show results. Turmeric has anti-clotting properties; CON SULT YOUR DOCTOR if taking anticoagulants or taking daily aspirin. In rare instances, daily use over an extended period of time can cause stomach upset and/or heartburn. Do not use curcumin if you have gallstones or a bile duct dysfunction.

5. Ginger – Try 1 or 2 grams a day in capsule form, or any amount in the form of culinary powdered ginger (in recipes), candied ginger or ginger tea (steeped covered for 10 minutes; you can use the teabag twice if it still tastes “gingery”). Also takes up to 2 months to work, and has anti-clotting properties; CON SULT YOUR DOCTOR if taking anticoagulants or taking daily aspirin.

6. Proteolytic enzymes – Follow label directions, being sure you take them at least 1 and ½ hours after a meal:

a. At www.vitacost.com: NSI Flavenzym

b. At stores: Wobenzym, or Priority One’s Proto-Zyme or Priority-Zyme

MEMORY; COGNITIVE FUNCTIONING

1. Creatine, fish oil, and B vitamins (see above)

2. Acetyl-l-carnitine (see above)

3. Phosphatidylserine – buy a 500 mg. complex that has 100 mg. (or 20%) phosphatidylserine. Start with 1 a day for a week. If you don’t notice any effect on mood or cognitive functioning, you can build up to 2 or 3 a day. If you take 3 a day for a full month, you may continue getting good results with only 1 a day after that. Do not take near bedtime; can be stimulating.

4. Huperzine A - an alkaloid found in club moss, helps to increase acetylcholine levels by inhibiting the acetylcholinesterase enzyme. Start with one 50 mcg. capsule. Increase to 2 a day, if you don’t notice any improvement in a month.

5. Choline – For a source of acetylcholine in the brain, I recommend:

Alpha GPC (glyceryl phosphoryl choline) – 600 mg. a day; 1200 mg. in extreme cases of cognitive dysfunction

The other forms provide some choline to the brain, but mainly provide benefits to the liver. They are:

Phosphatidylcholine – 3000 mg. a day

Lecithin – 15 grams a day

Choline Bitartrate -- 500 mg

Cautions: Do not exceed dosage recommendations. Excess may cause diarrhea, nausea, or depression. Start with even lower doses if prone to depression.

MOOD; DEPRESSION

1. Fish oil (see above), B vitamins (see above), DHEA (see above), ginkgo biloba (see above), acetyl-l-carnitine (see above), phosphatidylserine (see above)

2. St. John’s Wort – 900 to 1200 mg. a day. CHECK WITH YOUR DOCTOR if taking any medication, as it reduces the effectiveness of some. Usage with SSRIs can cause mild serotonin syndrome.

3. Tyrosine – start with 500 mg. a day, and build up once a week until effective, up to 1500 mg. May also increase energy and concentration.

Only works with people deficient in this amino acid, which may include hypoglycemics and people under a lot of stress.

Take in the morning on an empty stomach.

Cautions: Do not use if you have a Glioblastoma Multiforme tumor, Melanoma, Hyperthyroidism, or Schizophrenia, or if you are taking a Monoamine Oxidase Inhibitor.

4. SAM-e - also very good for the liver and, if taken for several months, may help arthritis pain. Start with 400 mg. taken between meals. Add in increments of 400 mg. until effective, up to 1600 mg. a day. DO NOT USE IF YOU HAVE BIPOLAR DISORDER. Expensive.

5. Positrol (taken in the evening; follow label instructions) along with SynCholamine (taken in the morning; follow instructions). Also helps you sleep, but they're very expensive, too. You have to order them from Vitamin Research Products: www.vrp.com or 1-800-877-2447.

manganese (addendum to hand-out)

Manganese is important in the formation and maintenance of bone and connective tissue (tendons, ligaments), so it’s commonly taken for osteoporosis, sprains, and strains. It also is needed for carbohydrate metabolism; diabetics and pre-diabetics tend to have low levels and need supplemental manganese. It’s involved in energy production, and it’s a necessary cofactor in making superoxide dismutase, an antioxidant enzyme your body makes. It is necessary for your body to make thyroid hormone. Taking supplemental iron, calcium, and/or zinc without adding manganese can cause manganese deficiency.

I feel PPS may increase your need for manganese, because these are symptoms of deficiency:

1. Prone to strained knees and elbows

2. Loss of ligament tone or strength

3. Muscular weakness

4. Creaking or clicking of joints

5. Knee, hip or ankle pain

Including what is in your multivitamin, you may need 5 to 15 mg. a day. Don’t exceed 15 mg.