Price range:  1-2 containers: $19.95 each.    3-5: $18.95    6+: $18.50

 

Healthy Skin, Hair & Nails is a formulated blend of nutrients specifically responsible for promoting the health of connective tissues, including cartilage, tendons, and bones.  The formula contains vitamin C, vitamin A, calcium, manganese, iron, magnesium, zinc, bioflavonoids, PABA, horsetail, and lecithin. 

Healthy skin, hair, and nails require healthy cells.  Antioxidants such as vitamins A and C and elemental minerals such as calcium, iron, zinc, manganese, and magnesium are all important nutrients at the cellular level.  Healthy Skin, Hair & Nails provides optimal doses of vitamins and minerals for overall good health as well as healthy cells. 

 

CLICK FOR INGREDIENTS LIST

For research reports and further information on the ingredients in this formula, scroll down below or simply click the name of each ingredient:

 Vitamin C is included for its importance in synthesizing collagen, the major constituent of connective tissue.  A deficiency of vitamin C can lead to spots on the skin, open wounds, and painful joints, all resulting from weakened connective tissue in the skin and blood vessels.  One of vitamin C’s most important biological benefits is its powerful antioxidant properties.  Vitamin C protects cells from free radicals, harmful particles present naturally in the body which damage cell walls.  As one of the most important nutrients in the body, vitamin C is essential to overall good health, and healthy levels of vitamin C are especially important to the skin, hair, and nails.

Bioflavonoids are complexes similar to vitamin C.  Acu-Cell.com states that bioflavonoids are important for “maintaining healthy capillaries, to help form collagen in connective tissue, to help heal wounds, and to support a healthy immune system.”  Deficiency can result in bruising, vascular degeneration, varicose veins, and nose bleeds.  Bioflavonoids mostly appear as yellow pigments in citrus fruits.  Because they are often found in the same foods as vitamin C, and because the body processes bioflavonoids in a similar way to vitamin C, sometimes vitamin C is credited with the benefits of bioflavonoids.

Vitamin A (provided here as retinol) is another important antioxidant, traditionally associated with the eyes, but also important for growth, cell division, and the immune system.  According to Lynn Grieger, RD, CDE, vitamin A can help prevent wrinkles and resist infection in the skin (see her article from iVillage).

Calcium is the main mineral component of bones.  Thus healthy amounts of calcium from the diet are necessary for maintaining strong bones. 

Magnesium is involved in energy metabolism at the cellular level, especially in relation to the heart, skeletal muscles, and nervous system.

Manganese also exhibits antioxidant properties, but in addition it is important for bone growth and cartilage synthesis. 

Zinc, like many other minerals, is important for growth.  Zinc also plays a role in healing wounds, synthesizing proteins, and in boosting the immune system.

Iron is essential to the blood because it carries oxygen to the tissues from the lungs.  It also helps the muscles store and use oxygen.  Healthy skin, hair, and nails require overall good health, especially good circulatory health.

PABA, or para aminobenzoic acid, is a non-essential nutrient which is vital to some intestinal bacteria.  Some reports find that PABA can return color to gray hair and stop hair loss, especially in older adults.  It is also used as a sunscreen.  PABA has been researched for its ability to reverse the effects of some connective tissue disorders. 

The National Institutes of Health cite horsetail as a possible natural treatment for osteoporosis.  Horsetail grass is a traditional herbal treatment for wounds, and scientific research supports this traditional use.  The high silicon content of horsetail grass is responsible for its benefits to the skin, bones, and other connective tissues.  Silicon, along with protein, is an integral part of the building blocks of connective tissue like collagen, elastin, and glycosaminoglycans.  Supplementation with horsetail grass can provide extra support for the basic structures of skin, bones, muscles, joints, cartilage, tendons, and other connective tissues.

Lecithin, a source of phosphatidylcholine, provides for healthy cell membranes.  With age, phosphatidylcholine levels in brain cell membranes decline, possibly contributing to memory loss, according to Dr. Ray Sahelian, M.D.  One study tested lecithin as a possible treatment for Parkinson’s Disease.

 

 

 

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VITAMIN C:

From the University of Maryland Medical Center:

Vitamin C (Ascorbic acid)
Also listed as: Ascorbic acid

Overview
Vitamin C is a water-soluble vitamin needed for the growth and repair of tissues in all parts of the body. It is necessary to form collagen, an important protein used to make skin, scar tissue, tendons, ligaments, and blood vessels. Vitamin C is essential for the healing of wounds, and for the repair and maintenance of cartilage, bones, and teeth.

Vitamin C is one of many antioxidants. Vitamin E and beta-carotene are two other well known antioxidants. Antioxidants are nutrients that block some of the damage caused by free radicals, which are by-products that result when our bodies transform food into energy. The build up of these by-products over time is largely responsible for the aging process and can contribute to the development of various health conditions such as cancer, heart disease, and a host of inflammatory conditions like arthritis. Antioxidants also help reduce the damage to the body caused by toxic chemicals and pollutants such as cigarette smoke.

Vitamin C deficiency can lead to dry and splitting hair; gingivitis (inflammation of the gums) and bleeding gums; rough, dry, scaly skin; decreased wound-healing rate, easy bruising; nosebleeds; weakened enamel of the teeth; swollen and painful joints; anemia; decreased ability to ward off infection; and, possibly, weight gain because of slowed metabolic rate and energy expenditure. A severe form of vitamin C deficiency is known as scurvy, which mainly affects older, malnourished adults.

The body does not manufacture vitamin C on its own, nor does it store it. It is therefore important to include plenty of vitamin C-containing foods in one's daily diet. Large amounts of vitamin C are used by the body during any kind of healing process, whether it's from an infection, disease, injury, or surgery. In these cases extra vitamin C may be needed.

Uses
Low levels of vitamin C have been associated with a variety of conditions including hypertension, gallbladder disease, stroke, some cancers, and atherosclerosis (the build up of plaque in blood vessels that can lead to heart attack and stroke; conditions that are caused by atherosclerotic build up are often collectively referred to as cardiovascular diseases). Eating adequate amounts of vitamin C in the diet (primarily through lots of fresh fruits and vegetables) may help reduce the risk of developing some of these conditions. There is little evidence, however, that vitamin C supplements can cure any of these diseases.

As an anti-oxidant, vitamin C plays an important role in protecting against the following:

HEART DISEASE
Results of scientific studies regarding the benefit of vitamin C for heart disease or stroke is somewhat confusing. While not all of the studies agree, some information suggests that vitamin C may help protect blood vessels from the damaging effects that lead to or result from the presence of atherosclerosis.

For example, those with low levels of vitamin C may be more likely to have a heart attack, stroke, or peripheral artery disease, all potential outcomes of atherosclerosis. Peripheral artery disease is the term used to describe atherosclerosis of the blood vessels to the legs. This can lead to pain with walking, known as intermittent claudication.

In terms of damage that can cause atherosclerosis, some studies have shown that vitamin C helps prevent oxidation of LDL (bad) cholesterol – a process that contributes to plaque buildup in the arteries.

Under most circumstances, dietary vitamin C is adequate for protecting against the development of or consequences from cardiovascular disease. If you have low levels of this nutrient, however, and find it difficult to obtain through dietary sources, a knowledgeable healthcare provider may recommend vitamin C supplements.

HIGH CHOLESTEROL
Information from several studies, involving only small numbers of people, suggest that vitamin C (3 glasses of orange juice per day or up to 2000 mg per day as a supplement) may help decrease total and LDL cholesterol and triglycerides, as well as increase HDL levels (the good kind of cholesterol). Studies evaluating larger groups of people would be helpful in determining how accurate these preliminary research results are and to whom this potential benefit applies.

HIGH BLOOD PRESSURE
Free radicals, the damaging by-products of metabolism mentioned earlier, are associated with higher blood pressure in studies of animals and people. Population based studies (which involve observing large groups of people over time) suggest that people who eat foods rich in antioxidants, including vitamin C, are less prone to high blood pressure than people without these nutritious foods in their diet. For this reason, many clinicians recommend foods rich in vitamin C, particularly if you are at risk for high blood pressure. In fact, the diet most frequently recommended for treatment and prevention of hypertension, known as the DASH (Dietary Approaches to Stop Hypertension) diet advocates lots of fruits and vegetables, which are loaded with antioxidants.

COMMON COLD
Despite the popular belief that vitamin C can cure the common cold, the scientific evidence supporting this conviction is limited. There have been a few studies suggesting that taking large doses of vitamin C supplements at the onset of cold or flu symptoms, or just after exposure to one of these viruses, can shorten the duration of the cold or ward it off altogether. However, the majority of studies, when looked at collectively, lead researchers to conclude that vitamin C does not prevent or treat the common cold. Some experts suggest that vitamin C may only be useful in case of a cold if you have low levels of this nutrient to begin with. Another possibility is that the likelihood of success may be very individual – some improve, while others do not. If you are amongst the 67% of people who believe that vitamin C is helpful for your colds, there may be power in your conviction. In other words, your experience is probably more important than what the research is stating. Talk to your doctor about any pros and cons with regards to using vitamin C during cold and flu season.

CANCER
While the precise role of vitamin C in preventing cancer remains controversial, results of many population based studies (evaluating groups of people over time) imply that foods rich in vitamin C may be associated with lower rates of cancer, including skin cancer, cervical dysplasia (changes to the cervix which may be cancerous or precancerous, picked up by pap smear), and, possibly, breast cancer. At best, however, particularly for breast cancer, the specific connection of vitamin C and cancer prevention is weak. This is mainly because protection comes from eating foods, such as fruits and vegetables, which contain many beneficial nutrients and antioxidants, not only vitamin C.

Also, there is no evidence that taking large doses of vitamin C once diagnosed with cancer will help your treatment. In fact, there is concern that large doses of antioxidants from supplements could interfere with chemotherapy medications. Much more research in the area of antioxidants and cancer treatment is needed.

OSTEOARTHRITIS
Vitamin C is essential for normal cartilage. Plus, free radicals can be produced in the joints and have been implicated in many degenerative changes in the aging body, including destruction of cartilage and connective tissue that lead to arthritis. Antioxidants appear to offset the damage caused by free radicals. Although further evidence is needed to substantiate these claims, studies of groups of people observed over time suggest that vitamin C, as well as vitamin E, may help to reduce the symptoms of OA.

OBESITY AND WEIGHT LOSS
Studies suggest that obese individuals may have lower vitamin C levels than nonobese individuals. Researchers speculate that insufficient amounts of vitamin C may contribute to weight gain by decreasing metabolic rates and energy expenditures. Many sensible weight loss programs will be sure to include foods rich in vitamin C, such as plenty of fruits and vegetables.

CATARACTS
Studies have shown that vitamin C may slow or even stop the progression of cataracts in the elderly. A recent study, for example, of women from the Nurses' Health Study (a very large, important study that has followed women over many years) showed that women under 60 years of age who had high dietary intake of vitamin C or who had used vitamin C supplements for 10 years or more had significantly reduced chances of developing cataracts.

AGE-RELATED MACULAR DEGENERATION
Vitamin C works together with other antioxidants like selenium, beta-carotene, and vitamin E to protect the eyes against developing macular degeneration. This is a painless, degenerative eye disease that affects more than 10 million Americans. It is the leading cause of legal blindness in persons over the age of 55 in the United States. While complete blindness does not occur in most people with the disorder, macular degeneration often interferes with reading, driving, or performing other daily activities.

While not all research agrees, antioxidants, including vitamin C, primarily from dietary sources may help prevent macular degeneration. Many qualified clinicians will recommend a combination of these nutrients for treating or preventing this serious and frustrating eye disorder.

DIABETES
Vitamin C may be helpful for people with diabetes in a number of ways. First, some studies suggest that people with diabetes have high levels of free radicals (the damaging metabolic by-products, mentioned earlier, associated with many chronic illnesses) and low levels of antioxidants, including vitamin C. This imbalance may contribute to the fact that those with diabetes are at greater risk for developing conditions such as high cholesterol and atherosclerosis.

Secondly, insulin (which is low in type 1 diabetics and does not function properly in type 2 diabetics) helps cells in the body take up the vitamin C that they need to function properly. At the same time, lots of circulating blood sugar (glucose), as is often the present in diabetics, prevents the cells from getting the vitamin C that they need, even if eating lots of fruits of vegetables. For this reason, taking extra vitamin C in the form of supplements may be helpful in those with diabetes.

ALZHEIMER'S DISEASE AND OTHER TYPES OF DEMENTIA
While the evidence is somewhat stronger for another important antioxidant, namely vitamin E, vitamin C may help prevent the development of Alzheimer's disease. It may also improve cognitive function in dementia from causes other than Alzheimer's (such as multiple strokes). The use of these antioxidants for improving cognitive ability in those who already have dementia of the Alzheimer's type has not been well tested to date.

OTHER

Although the information is somewhat limited, studies suggest that vitamin C may also be helpful for:

Boosting immune system function
Maintaining healthy gums
Relieving eye pressure in those with glaucoma
Improving visual clarity for those with uveitis (an inflammation of the middle part of the eye)
Slowing progression of Parkinson's disease
Treating allergy-related conditions, such as asthma, eczema, and hay fever (called allergic rhinitis)
Relieving pain from pancreatitis; vitamin C levels are often low with this condition
Reducing effects of sun exposure, such as sunburn or redness (called erythema) and even, possibly, skin cancer
Alleviating dry mouth, particularly from antidepresant medications (a common side effect from these drugs)
Healing burns and wounds

Precautions
Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable healthcare provider.

It is important to drink plenty of fluids when taking supplemental vitamin C because it has a diuretic effect.

Most commercially available vitamin C is derived from corn. People sensitive to corn should look for alternative sources, such as sago palm.

Vitamin C increases the amount of iron absorbed from foods. This may be helpful for people who have low blood iron levels. However, people with hemochromatosis should not take vitamin C supplements because of enhanced accumulation of non-heme iron in the presence of this vitamin.

During periods of stress (either emotional or physical), urinary excretion of vitamin C is increased. Extra vitamin C through vitamin C rich foods as well as supplements is often recommended to keep the immune system working properly during these times.
While vitamin C is generally non-toxic, in high doses (more than 2,000 mg daily) it can cause diarrhea, gas, or stomach upset. Those who have kidney problems should check with a healthcare provider before taking vitamin C supplements. Infants born to mothers taking 6,000 mg or more of vitamin C may develop rebound scurvy due to a sudden drop in daily intake. As described earlier, scurvy is a condition caused by extreme vitamin C deficiency. See earlier explanation for the possible symptoms of vitamin C deficiency.

Possible Interactions
If you are currently being treated with any of the following medications, you should not use vitamin C supplements without first talking to your healthcare provider.

ASPIRIN AND NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS)
Very limited research suggests that vitamin C may protect the stomach and intestines against injury from NSAIDs such as ibuoprofen. On the other hand, high doses of vitamin C (equal to or greater than 500 mg per day) may raise the blood levels of aspirin and other acidic medications.

ACETOMINOPHEN
Vitamin C may decrease excretion of acetaminophen (a medication sold over the counter for pain and headache) in the urine, which may increase blood levels of this medication.

DIURETICS, LOOP
Animal studies suggest that vitamin C may amplify the effects of furosemide, which belongs to a class of medications known as loop diuretics.

BETA-BLOCKERS FOR HIGH BLOOD PRESSURE
Vitamin C may decrease the absorption of propranolol, a medication that belongs to a class known as beta-blockers used for high blood pressure and other heart-related conditions. If taking vitamin C and a beta-blocker, therefore, it is best to take them at different times of the day.

CYCLOSPORINE
Cyclosporine, a medication used for the treatment of cancer, may reduce blood levels of
vitamin C.

NITRATE MEDICATIONS FOR HEART DISEASE
The combination of vitamin C with nitroglycerin, isosorbide dinitrate, or isosorbide mononitrate reduces the occurrence of nitrate tolerance. Nitrate tolerance is when the body builds up a tolerance to the medicine so that it no longer has its desired effect. People taking nitrate-containing medications generally follow a 12 hours on, 12 hours off schedule to avoid this tolerance. Studies suggest that taking vitamin C along with nitrate medications may reduce the development of this tolerance.

TETRACYCLINE
There is some evidence that taking vitamin C with the antibiotic tetracycline may increase the levels of this medication.

WARFARIN
There have been rare case reports of vitamin C interfering with the effectiveness of this blood thinning medication. In recent follow up studies, no such association has been found with doses of vitamin C up to 1,000 mg per day. Because of these much earlier reports, however, some conservative clinicians suggest not exceeding RDA values of vitamin C (see earlier section entitled How To Take It). Whether taking recommended dietary amounts or larger quantities of vitamin C, anyone on warfarin must have their bleeding time measured regularly and followed closely using a value called an INR, measured at your doctor's office. If you take this blood thinner, any time you make a change to your diet, medications, or supplements, you must notify your physician.

Supporting Research on Vitamin C

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Christen WG, Ajani UA, Glynn RJ, Manson JE, Schaumberg DA, Chew EC, Buring JE, Hennekens CH. Prospective cohort study of antioxidant vitamin supplement use and the risk of age-related maculopathy. Am J Epidemiol . 1999;149(5):476-484.

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Dreher F, Gabard B, Schwindt DA, Maibach HI. Topical melatonin in combination with vitamins E and C protects skin from ultraviolet-induced erythema: a human study in vivo. Br J Dermatol. 1998;139(2):332-339.

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Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Of Sciences. 2002. Accessed March 4, 2002 at www.iom.edu .

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VanEenwyk J, Davis FG, Colman N. Folate, vitamin C, and cervical intraepithelial neoplasia. Cancer Epidemiol Biomarkers Prev . 1992;1(2):119-124.

van Rooij J, Schwartzenberg SG, Mulder PG, Baarsma SG. Oral vitamins C and E as additional treatment in patients with acute anterior uveitis: a randomised double masked study in 145 patients. Br J Ophthalmol . 1999;83(11):1277-1282.

Watanabe H, Kakihana M, Ohtsuka S, Sugishita Y. Randomized, double-blind, placebo-controlled study of ascorbate on the preventive effect of nitrate tolerance in patients with congestive heart failure. Circulation . 1998;97(9):886-891.

Watanabe H, Kakihana M, Ohtsuka S, Sugishita Y. Randomized, double-blind, placebo-controlled study of the preventive effect of supplemental oral vitamin C on attenuation of development of nitrate tolerance . J Am Coll Cardiol . 1998;31(6):1323-1329.

Yokoyama T, Date C, Kokubo Y, Yoshiike N, Matsumura Y, Tanaka H. Serum vitamin C concentration was inversely associated with subsequent 20-year incidence of stroke in a Japanese rural community. The Shibata study. Stroke . 2000;31(10):2287-2294.

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VITAMIN A:

Healthy Skin with Vitamin A, by Lynn Grieger, RD, CDE

What do broccoli, carrots and milk have in common?
They are all an important part of nature's arsenal to protect your skin from the effects of aging and the environment. The common element in these foods is that they are all good sources of vitamin A.

Many people equate only eyes and vision with vitamin A. But the health of our epithelial tissue -- skin and the lining of passageways that open to the outside of the body, such as the throat and sinuses -- is directly dependent on the amount of vitamin A in our diet. Vitamin A acts as an antioxidant to neutralize harmful elements in our skin, helping to prevent wrinkles, resist infection and keep our skin youthful.

Think green and deep orange
Two-thirds of the vitamin A in the typical American diet comes from carotene, which is part of the yellow pigment in fruits and vegetables. Carotene is manufactured into vitamin A by our body, and therefore is crucial to healthy skin. Deep orange? Think sweet potatoes, carrots and apricots. Dark green? Try spinach, collards and broccoli. (Food Sources & Amounts for Carotene). Consuming more foods high in carotene is a simple way to increase your body's vitamin A to healthy levels without reaching toxicity.

The negative side of too much vitamin A
Vitamin A is a potent fat-soluble vitamin, easily stored in our body tissue. It is known to be toxic at levels above the RDA (800 RE for women and 1,000 RE for men). Symptoms of toxicity are similar to those of brain tumors: headache, blurred vision, pain in the bones and joints, dry skin and poor appetite. It is wise NOT to supplement your diet with Vitamin A pills. Instead, focus on the delicious tastes of those fruits and vegetables high in carotene for a safe way to healthy skin.

What happens if my skin turns yellow?
Too much carotene can actually turn your skin noticeably yellowish, particularly on the palms of your hands and soles of your feet. Don't worry: The effects aren't permanent and pose no medical danger. It just means you're eating too much of a good thing, and need to include a broader variety of foods in your diet. This often happens in toddlers who are on a food jag consisting of squash, sweet potatoes or carrots. Too much carotene in their small bodies leads to a yellow baby. Serve green beans and peas more often, and their normal skin color will reappear.

Eat your way to healthier skin
In addition to the wrinkle creams and sunscreen, add foods rich in carotene or vitamin A to your healthy skin arsenal. Never has beauty tasted so good!

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CALCIUM:

I.   “Effects of oral calcium carbonate on blood pressure in subjects with mildly elevated arterial pressure.” By Bloomfield RL, Young LD, Zurek G, Felts JH, Straw MK.
Recent investigations suggest that calcium supplementation may cause a lower arterial pressure in hypertensive individuals. We studied 32 patients with mildly elevated arterial pressure (diastolic pressure 88-95 mmHg) and inadequate dietary calcium intake (less than 750 mm/day), who were randomly assigned to placebo or 1500 mg/day elemental calcium for 4 weeks. Baseline and post-treatment urinary calcium concentrations and 3 biweekly supine blood pressures were recorded. Supine systolic blood pressure in the calcium group rose during the first 2 weeks of treatment (delta systolic blood pressure +5.9 mmHg; P less than 0.025) compared with no change in supine blood pressure for the placebo group. Within the calcium group, seven out of 15 patients had decreased or unchanged supine blood pressure during treatment. A lower urinary calcium concentration and a lower dietary sodium intake were found in this subgroup compared with those whose supine blood pressure increased with calcium administration.

II.   “The influence of dietary and non-dietary calcium supplementation on blood pressure, an updated meta-analysis of randomized controlled trials.”  By Griffith LE, Guyatt GH, Cook RJ, Bucher HC, Cook DJ.  Published by the American Journal of Health, 1999; 12: 84-92.
Date review completed: May 1997
Number of trials included: 42
Number of patients: (2068 active; 2059 control; 433 patients in cross-over studies)
Control groups: no calcium, placebo.

Main outcomes: change in systolic and diastolic blood pressure (mm Hg).
Inclusion criteria were randomized controlled trial (RCT) which assessed the effect of calcium supplementation on blood pressure in non-pregnant normotensive or hypertensive individuals. Duration of treatment had to be more than two weeks and dose of calcium more than 1000 mg daily.

The Cochrane Collaboration search strategy, MESH terms and relevant key words were used to identify randomized trials and meta-analyses from MEDLINE (January 1993 to May 1997). No language restrictions were made, bibliographies of retrieved reports were checked and unpublished information was sought from experts. If necessary, additional information was sought from authors. Quality assessments were made. Pooled data was assessed using a random effects model to calculate effect size with 95% confidence intervals and heterogeneity was tested.

FINDINGS:
Blood pressure was assessed in either the sitting, standing, supine or lateral position. Study duration mainly varied between 4-14 weeks; eight had an intervention period of more than six months. Mean baseline values for systolic pressure ranged between 102-166 mm Hg and for diastolic pressure ranged between 58-98 mm Hg. Nine trials assessed dietary supplements (lactovegetarian or lacto-ovo-vegetarian versus omnivorous diet; low versus dairy product rich diet; diet with dairy-products versus diet mineral-poor in dairy products). There was no significant difference in reduction in blood pressure with the different dietary supplements. Thirty-three RCTs assessed non-dietary calcium supplementation (e.g. calcium carbonate).
The majority of studies showed a reduction in blood pressure with calcium supplementation for both dietary and non-dietary supplementation. When information was pooled for all studies the mean reduction in systolic blood pressure was 1.44 (2.2 to 0.68) and for diastolic blood pressure it was 0.84 (1.44 to 0.24). Dietary supplementation produced slightly, but not significantly better reductions in both diastolic and systolic blood pressure than non-dietary supplementation.


III.   From the National Institutes of Health:
CALCIUM: WHAT IS IT?
Calcium, the most abundant mineral in the human body, has several important functions. More than 99% of total body calcium is stored in the bones and teeth where it functions to support their structure [1]. The remaining 1% is found throughout the body in blood, muscle, and the fluid between cells. Calcium is needed for muscle contraction, blood vessel contraction and expansion, the secretion of hormones and enzymes, and sending messages through the nervous system [2]. A constant level of calcium is maintained in body fluid and tissues so that these vital body processes function efficiently.

Bone undergoes continuous remodeling, with constant resorption (breakdown of bone) and deposition of calcium into newly deposited bone (bone formation) [2]. The balance between bone resorption and deposition changes as people age. During childhood there is a higher amount of bone formation and less breakdown. In early and middle adulthood, these processes are relatively equal. In aging adults, particularly among postmenopausal women, bone breakdown exceeds its formation, resulting in bone loss, which increases the risk for osteoporosis (a disorder characterized by porous, weak bones) [2].

There is a widespread concern that Americans are not meeting the recommended intake for calcium. According to the Continuing Survey of Food Intakes of Individuals (CSFII 1994-96), the following percentage of Americans are not meeting their recommended intake for calcium [3]:  44% boys and 58% girls ages 6-11; 64% boys and 87% girls ages 12-19; and 55% men and 78% of women ages 20+.

Although dairy products are the main source of calcium in the U.S. diet, other foods also contribute to overall calcium intake. Individuals with lactose intolerance (those who experience symptoms such as bloating and diarrhea because they cannot completely digest the milk sugar lactose) and those who are vegan (people who consume no animal products) tend to avoid or completely eliminate dairy products from their diets [2]. Thus, it is important for these individuals to meet their calcium needs with alternative calcium sources if they choose to avoid or eliminate dairy products from their diet. Foods such as Chinese cabbage, kale and broccoli are other alternative calcium sources [2]. Although most grains are not high in calcium (unless fortified), they do contribute calcium to the diet because they are consumed frequently [2]. Additionally, there are several calcium-fortified food sources presently available, including fruit juices, fruit drinks, tofu and cereals. Figure 1 compares portion sizes of various foods that provide the amount of calcium in one cup of milk. This figure takes into account that calcium absorption varies among foods. Certain plant-based foods such as some vegetables contain substances which can reduce calcium absorption. Thus, you may have to eat several servings of certain foods such as spinach to obtain the same amount of calcium in one cup of milk, which is not only calcium-rich but also contains calcium in an easily absorbable form.

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MAGNESIUM:

I.   “Magnesium supplement lowers blood pressure.”  Witteman, Jacqueline C.M., et al. Reduction of blood pressure with oral magnesium supplementation in women with mild to moderate hypertension. American Journal of Clinical Nutrition, Vol. 60, July 1994, pp. 129-35.
ROTTERDAM, THE NETHERLANDS. A double-blind controlled trial was recently carried out by Dutch and Belgian researchers in order to determine if oral supplementation with magnesium is an effective way of lowering blood pressure in women suffering from mild to moderate hypertension. Their experiment involved 91 women between 35 and 77 years of age who did not take anti-hypertensive medication. All the women had a systolic blood pressure between 140 and 185 mm Hg and a diastolic pressure between 90 and 105 mm Hg. After a two-week period where all subjects received a placebo, the participants were randomly assigned to two groups. One group continued to receive the placebo while the other group received 485 mg per day of magnesium aspartate-HCl. Both the placebo and the magnesium supplement were supplied in the form of four packets of water-soluble powder per day to be taken with meals. At the end of the six-month trial period the systolic blood pressure in the magnesium supplementation group had decreased by 2.7 mm Hg and the diastolic pressure by 3.4 mm Hg when compared to the placebo group. The researchers conclude that oral supplementation with magnesium aspartate- HCl may be effective in lowering blood pressure in people suffering from mild to moderate hypertension who are not taking anti-hypertensive drugs.


II.   “Magnesium – Natural Facts.”  By Dr. Michael Murray.  © 2005 http://www.doctormurray.com/
Magnesium supplementation has been shown to be an extremely effective therapy or adjunctive measure in many common conditions especially cardiovascular disease. Magnesium is absolutely essential in the proper functioning of the heart. Magnesium's role in preventing heart disease and strokes is generally well-accepted. In addition, there is a substantial body of knowledge demonstrating that magnesium supplementation is effective in treating a wide range of cardiovascular diseases.

For example, magnesium was first shown to be of value in the treatment of cardiac arrhythmias in 1935. More than seventy years later, there are now numerous double-blind studies showing magnesium to be of benefit for many types of arrhythmias including atrial fibrillation, ventricular premature contractions, ventricular tachycardia, and severe ventricular arrhythmias.
Magnesium supplementation has also been shown to be helpful in angina due to either a spasm of the coronary artery or atherosclerosis. The beneficial effects of magnesium in angina relate to its ability improve energy production within the heart; dilate the coronary arteries resulting in improved delivery of oxygen to the heart; reduce peripheral vascular resistance resulting in reduced demand on the heart; inhibit platelets from aggregating and forming blood clots; and improve heart rate.

Magnesium supplementation is also critical in congestive heart failure (CHF). Studies have shown that CHF patients with normal levels of magnesium significantly live longer than those with lower magnesium levels. Many of the conventional drugs for CHF and high blood pressure (diuretics, beta-blockers, calcium channel-blockers, etc.) deplete body magnesium stores. Magnesium supplementation generally produces a modest impact in lowering high blood pressure (i.e., less than 10 mm Hg for both the systolic and diastolic).

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MANGANESE:

“Deficiency Diseases and Good Nutrition” (WaltonFeed.com)
Manganese activates many enzymes and vitamins in your body. It also helps to neutralize poisons in your blood. It helps in the production of such vital hormones as insulin. Manganese also works as an antioxidant to keep your cellular membranes healthy.

Vitamin C cannot work correctly without manganese. Enzymes are needed to direct vitamin C to detoxify the body, fight infection, build collagen, or perform one of its many other functions. Manganese encourages the production of these enzymes, without which vitamin C could not function. In fact, a study done on animals given no manganese showed that when given hydralazine (poison), they died. When manganese was supplemented in the diet and the animals were administered hydralazine, they lived. It is believed to be due to the detoxifying effect of vitamin C, that can only be put to use when there is adequate manganese to activate it.
Manganese activates arginase, which also has a detoxifying function in the body. Ammonia is a substance naturally produced by your body. The only problem is 1/1000 of a milligram of the stuff in a quart of your blood will kill you! Arginase helps to bind ammonia and carbon dioxide to make urea, which is harmless. The urea is filtered out of your blood by the kidneys and excreted as urine.

The specialized beta cells in your pancreas need manganese to manufacture insulin. No manganese, no insulin. Insulin is what moves sugar from your bloodstream to your cells. If you don't get enough manganese, you could get a blood sugar disorder, like diabetes. An observation done on 122 diabetics and an identical control group showed diabetics to be twice as low in manganese than those without the disease.

Manganese activates choline, a phospholipid produced in the liver. Activated choline and ATP form acetyl choline. This compound functions as a neurotransmitter and works in the energy producing Krebs cycle. It also stimulates adrenaline and noradrenaline to be released from the adrenal glands. These hormones help you deal with stress.

Dopamine is a neurotransmitter and needs manganese to be produced. Sufferers of Parkinson's disease have a decreased ability to produce dopamine. Additional manganese may help decrease the effects of the disease.

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ZINC:

Zinc Helps Kids Grow
By Jennifer Warner, WebMD Medical News
May 24, 2002 -- Some infants and children may benefit from adding zinc to their diets. New data suggest that increasing the amount of this mineral may help children reach a healthy height and weight.

"Because of the important functional consequences of zinc deficiency for children's growth and other health outcomes, interventions to improve zinc ... [in the diet] should be considered in those populations at particularly high risk of zinc deficiency," write the authors of a report published in the June issue of the American Journal of Clinical Nutrition.

Zinc is a mineral found in a variety of foods such as red meat, whole-grain breads and cereals, dried beans, and seafood. It is also found in small amounts in breast milk.

Zinc is vital for the normal growth and development of the reproductive organs and brain and plays a role in the normal functioning of the immune system and many other processes in the body. Recently, zinc deficiency has been linked to decreased growth, increased colds and infections, impaired memory, learning disabilities, and poor attention span. The deficiency is a major problem in developing countries; for instance, 70% of school age children in Thailand are deficient in zinc.

In the U.S., zinc deficiency in children is not well recognized, although it affects an estimated 6% of girls and 10% of boys overall. Disadvantaged children are especially at risk -- more than 50% of poor children and 30% of non-poor children aged 1-5 get less than 70% of the Recommended Dietary Allowance of zinc (10 milligrams per day for children). In fact, recent data suggest that of 16 key nutrients, more children were deficient in zinc than in any other nutrient.

This new report looked at 33 studies on the effects of zinc supplementation on children up to 10 years old that were published between 1976 and 2001.

Overall, zinc supplementation produced very significant positive effects on both height and weight measures of the children. And the effect was even greater among children who already suffered from stunted growth or were underweight.

Researchers say it is hard to quantify the impact because the effects vary according to the age of the child, duration of supplementation, and other factors. But they cite the example of a Guatemalan study that found three years of zinc supplementation (from 3 to 36 months of age) was responsible for nearly an inch in additional growth.

Currently, scientists do not believe there is enough data to recommend widespread zinc supplementation in U.S. children as other studies of zinc's benefits have been inconclusive. In addition, scientists are unsure as to how much is enough; too much zinc can be as dangerous as a deficiency.

Adequate zinc can be obtained thorough a well-balanced diet of a variety of foods. Those foods include red meat, nuts, shellfish, potatoes with skins, beans, and mushrooms.
© 2002 WebMD Inc. All rights reserved.

Have a Cold? Think About Zinc
By Roxanne Nelson, WebMD Medical News, Reviewed By Merle Diamond, MD

Aug. 14, 2000 -- Sneezes, sniffles, that all over blah, achy feeling ... the average American gets between two and six colds a year, and so far, treatments have been ineffective at snuffing them out. But now researchers have found that zinc lozenges may actually cut the time spent suffering from a cold and lessen the symptoms.

In a study that appears in the current issue of the Annals of Internal Medicine, researchers from Wayne State University in Michigan found that patients who took zinc lozenges recovered almost twice as quickly as those who took a placebo. These findings fly in the face of at least five previous trials that didn't show a beneficial effect of zinc.

Led by Ananda Prasad, MD, PhD, a professor of medicine at Wayne State University, the researchers gave either zinc lozenges or a placebo to 48 individuals who had come down with cold symptoms within the previous 24 hours. Each person had to have at least two standard cold symptoms, such as sneezing, sore throat, fever, cough, and muscle aches.

The colds of patients taking the zinc lozenges lasted an average of four and a half days, while the colds of those taking the placebo had symptoms for eight days. Coughing stopped in the zinc group in half the time of the placebo group, and runny noses cleared up about two days sooner.

Prasad acknowledges in the study that previous research has not had such encouraging results. He points out to WebMD, however, that certain problems in previous studies may account for the differences in results. Some of the studies, he says, may have used a type of lozenge that doesn't release the zinc properly when a person takes it in his mouth.

"The dosage also has to be adequate," Prasad says. "I think one study used half the dose that we did, and the zinc must be taken within 24 hours of symptom onset."

Ronald Turner, MD, doesn't think this study will have much impact on usage by the public at large. "The data on zinc treatment have been extremely inconsistent from study to study," he says. "And zinc has been available to the public for some time. The product is available as a dietary supplement, and usage is probably unrelated to physician recommendation." Turner, who was not involved in the study, is a professor of pediatrics at the Medical University of South Carolina, and he has done unrelated research on zinc.

In an editorial that accompanied the study, Norman Desbiens, MD, with the University College of Medicine in Chattanooga, questions whether the study was properly "blinded," meaning, were the participants completely unaware of whether they were taking the placebo or the zinc. For the conclusions to be accurate, this is a very important issue in any study that uses a placebo to measure the effectiveness of a medication.

Turner agrees. "Inadequate blinding has been a consistent criticism of the zinc studies, and these authors do not appear to have adequately addressed the issue."

For example, the patients were asked to guess whether they were taking the placebo or the zinc. About half of those taking the zinc, and around a quarter taking the placebo, identified the lozenges correctly. But the researchers felt that these numbers were not high enough to negatively influence the results.

However, Desbiens feels the fact that more than three and a half times as many participants who received zinc correctly guessed that they were given zinc, may have affected the results of the study. "I suspect that the zinc and placebo had detectable differences, and therefore, a blind was not completely established," he writes.

Prasad writes that a test was done with healthy people who were given both types of lozenges, and it "showed that the zinc and placebo lozenges were indistinguishable in taste." He points out that none of the people involved in the study had ever previously used zinc lozenges, and in fact, they could not participate if they had used zinc in the past.

"This is the question I don't understand," Prasad tells WebMD, "how they would know if they've never had zinc or if they only taste one lozenge."

Everyone was only given one kind of lozenge -- either zinc or the placebo, he says, and they had no opportunity to taste the other kind. "It would be one thing if they had both kinds, but they didn't. So how would they be able to detect a difference in taste?"

The most common side effects from taking the zinc were a dry mouth and constipation. But since the amount of zinc that the study patients took is five times the current RDA of 15 mg, the researchers caution that zinc lozenges should not be taken for more than three days at a time. They recommend that if a person does not improve after three days of zinc treatment, then he should be evaluated for other type of respiratory illnesses or allergies.

Desbiens isn't convinced that taking zinc will help a cold, but the researchers disagree, saying their results show zinc can reduce the average duration and severity of the common cold.
"I think our results are very clear-cut," Prasad says. "The editorialist is saying that if they knew it was the zinc, it might have had an effect on their perception of whether or not they were getting better.

"But we measured symptoms," he adds. "It's hard to say you don't have symptoms if you're coughing or sneezing. Some of the people I recruited were physicians, and they're highly critical people and not easily convinced. So when they were cured in three days, they came to tell me and let me know."

The study was supported in part by an unrestricted grant from the George and Patsy Eby Research Foundation. George Eby holds patent rights to zinc lozenges and supplied both the zinc and placebo lozenges for this study. But Prasad writes the research funds were "unrestricted," and "the authors have neither industry connections nor personal financial conflicts of interest related to this study."  
© 2000 WebMD Inc. All rights reserved.

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IRON – DIETARY SUPPLEMENT FACT SHEET:

From the National Institutes of Health

Iron: What is it?
Iron, one of the most abundant metals on Earth, is essential to most life forms and to normal human physiology. Iron is an integral part of many proteins and enzymes that maintain good health. In humans, iron is an essential component of proteins involved in oxygen transport [1,2]. It is also essential for the regulation of cell growth and differentiation [3,4]. A deficiency of iron limits oxygen delivery to cells, resulting in fatigue, poor work performance, and decreased immunity [1,5-6]. On the other hand, excess amounts of iron can result in toxicity and even death [7].

Almost two-thirds of iron in the body is found in hemoglobin, the protein in red blood cells that carries oxygen to tissues. Smaller amounts of iron are found in myoglobin, a protein that helps supply oxygen to muscle, and in enzymes that assist biochemical reactions. Iron is also found in proteins that store iron for future needs and that transport iron in blood. Iron stores are regulated by intestinal iron absorption [1,8].

What affects iron absorption?
Iron absorption refers to the amount of dietary iron that the body obtains and uses from food. Healthy adults absorb about 10% to 15% of dietary iron, but individual absorption is influenced by several factors [1,3,8,11-15].

Storage levels of iron have the greatest influence on iron absorption. Iron absorption increases when body stores are low. When iron stores are high, absorption decreases to help protect against toxic effects of iron overload [1,3]. Iron absorption is also influenced by the type of dietary iron consumed. Absorption of heme iron from meat proteins is efficient. Absorption of heme iron ranges from 15% to 35%, and is not significantly affected by diet [15]. In contrast, 2% to 20% of nonheme iron in plant foods such as rice, maize, black beans, soybeans and wheat is absorbed [16]. Nonheme iron absorption is significantly influenced by various food components [1,3,11-15].

Meat proteins and vitamin C will improve the absorption of nonheme iron [1,17-18]. Tannins (found in tea), calcium, polyphenols, and phytates (found in legumes and whole grains) can decrease absorption of nonheme iron [1,19-24]. Some proteins found in soybeans also inhibit nonheme iron absorption [1,25]. It is most important to include foods that enhance nonheme iron absorption when daily iron intake is less than recommended, when iron losses are high (which may occur with heavy menstrual losses), when iron requirements are high (as in pregnancy), and when only vegetarian nonheme sources of iron are consumed.

What is the recommended intake for iron?
Recommendations for iron are provided in the Dietary Reference Intakes (DRIs) developed by the Institute of Medicine of the National Academy of Sciences [1]. Dietary Reference Intakes is the general term for a set of reference values used for planning and assessing nutrient intake for healthy people. Three important types of reference values included in the DRIs are Recommended Dietary Allowances (RDA), Adequate Intakes (AI), and Tolerable Upper Intake Levels (UL). The RDA recommends the average daily intake that is sufficient to meet the nutrient requirements of nearly all (97-98%) healthy individuals in each age and gender group [1]. An AI is set when there is insufficient scientific data available to establish a RDA. AIs meet or exceed the amount needed to maintain a nutritional state of adequacy in nearly all members of a specific age and gender group. The UL, on the other hand, is the maximum daily intake unlikely to result in adverse health effects [1].

Healthy full term infants are born with a supply of iron that lasts for 4 to 6 months. There is not enough evidence available to establish a RDA for iron for infants from birth through 6 months of age. Recommended iron intake for this age group is based on an Adequate Intake (AI) that reflects the average iron intake of healthy infants fed breast milk [1].

Iron in human breast milk is well absorbed by infants. It is estimated that infants can use greater than 50% of the iron in breast milk as compared to less than 12% of the iron in infant formula [1]. The amount of iron in cow's milk is low, and infants poorly absorb it. Feeding cow's milk to infants also may result in gastrointestinal bleeding. For these reasons, cow's milk should not be fed to infants until they are at least 1 year old [1]. The American Academy of Pediatrics (AAP) recommends that infants be exclusively breast fed for the first six months of life. Gradual introduction of iron-enriched solid foods should complement breast milk from 7 to 12 months of age [26]. Infants weaned from breast milk before 12 months of age should receive iron-fortified infant formula [26]. Infant formulas that contain from 4 to 12 milligrams of iron per liter are considered iron-fortified [27].

Data from the National Health and Nutrition Examination Survey (NHANES) describe dietary intake of Americans 2 months of age and older. NHANES (1988-94) data suggest that males of all racial and ethnic groups consume recommended amounts of iron. However, iron intakes are generally low in females of childbearing age and young children [28-29].

Researchers also examine specific groups within the NHANES population. For example, researchers have compared dietary intakes of adults who consider themselves to be food insufficient (and therefore have limited access to nutritionally adequate foods) to those who are food sufficient (and have easy access to food). Older adults from food insufficient families had significantly lower intakes of iron than older adults who are food sufficient. In one survey, twenty percent of adults age 20 to 59 and 13.6% of adults age 60 and older from food insufficient families consumed less than 50% of the RDA for iron, as compared to 13% of adults age 20 to 50 and 2.5% of adults age 60 and older from food sufficient families [30].

Iron intake is negatively influenced by low nutrient density foods, which are high in calories but low in vitamins and minerals. Sugar sweetened sodas and most desserts are examples of low nutrient density foods, as are snack foods such as potato chips. Among almost 5,000 children and adolescents between the ages of 8 and 18 who were surveyed, low nutrient density foods contributed almost 30% of daily caloric intake, with sweeteners and desserts jointly accounting for almost 25% of caloric intake. Those children and adolescents who consumed fewer "low nutrient density" foods were more likely to consume recommended amounts of iron [31].
Data from The Continuing Survey of Food Intakes by Individuals (CSFII1994-6 and 1998) was used to examine the effect of major food and beverage sources of added sugars on micronutrient intake of U.S. children aged 6 to 17 years. Researchers found that consumption of presweetened cereals, which are fortified with iron, increased the likelihood of meeting recommendations for iron intake. On the other hand, as intake of sugar-sweetened beverages, sugars, sweets, and sweetened grains increased, children were less likely to consume recommended amounts of iron [32].

When can iron deficiency occur?
The World Health Organization considers iron deficiency the number one nutritional disorder in the world [33]. As many as 80% of the world's population may be iron deficient, while 30% may have iron deficiency anemia [34].

Iron deficiency develops gradually and usually begins with a negative iron balance, when iron intake does not meet the daily need for dietary iron. This negative balance initially depletes the storage form of iron while the blood hemoglobin level, a marker of iron status, remains normal. Iron deficiency anemia is an advanced stage of iron depletion. It occurs when storage sites of iron are deficient and blood levels of iron cannot meet daily needs. Blood hemoglobin levels are below normal with iron deficiency anemia [1].

Iron deficiency anemia can be associated with low dietary intake of iron, inadequate absorption of iron, or excessive blood loss [1,16,35]. Women of childbearing age, pregnant women, preterm and low birth weight infants, older infants and toddlers, and teenage girls are at greatest risk of developing iron deficiency anemia because they have the greatest need for iron [33]. Women with heavy menstrual losses can lose a significant amount of iron and are at considerable risk for iron deficiency [1,3]. Adult men and post-menopausal women lose very little iron, and have a low risk of iron deficiency.

Individuals with kidney failure, especially those being treated with dialysis, are at high risk for developing iron deficiency anemia. This is because their kidneys cannot create enough erythropoietin, a hormone needed to make red blood cells. Both iron and erythropoietin can be lost during kidney dialysis. Individuals who receive routine dialysis treatments usually need extra iron and synthetic erythropoietin to prevent iron deficiency [36-38].

Vitamin A helps mobilize iron from its storage sites, so a deficiency of vitamin A limits the body's ability to use stored iron. This results in an "apparent" iron deficiency because hemoglobin levels are low even though the body can maintain normal amounts of stored iron [39-40]. While uncommon in the U.S., this problem is seen in developing countries where vitamin A deficiency often occurs.

Chronic malabsorption can contribute to iron depletion and deficiency by limiting dietary iron absorption or by contributing to intestinal blood loss. Most iron is absorbed in the small intestines. Gastrointestinal disorders that result in inflammation of the small intestine may result in diarrhea, poor absorption of dietary iron, and iron depletion [41].

Signs of iron deficiency anemia include [1,5-6,42]:
  feeling tired and weak
  decreased work and school performance
  slow cognitive and social development during childhood
  difficulty maintaining body temperature
  decreased immune function, which increases susceptibility to infection
  glossitis (an inflamed tongue)

Eating nonnutritive substances such as dirt and clay, often referred to as pica or geophagia, is sometimes seen in persons with iron deficiency. There is disagreement about the cause of this association. Some researchers believe that these eating abnormalities may result in an iron deficiency. Other researchers believe that iron deficiency may somehow increase the likelihood of these eating problems [43-44].

People with chronic infectious, inflammatory, or malignant disorders such as arthritis and cancer may become anemic. However, the anemia that occurs with inflammatory disorders differs from iron deficiency anemia and may not respond to iron supplements [45-47]. Research suggests that inflammation may over-activate a protein involved in iron metabolism. This protein may inhibit iron absorption and reduce the amount of iron circulating in blood, resulting in anemia [48].

Who may need extra iron to prevent a deficiency?

Three groups of people are most likely to benefit from iron supplements: people with a greater need for iron, individuals who tend to lose more iron, and people who do not absorb iron normally.

These individuals include [1,36-38,41,49-57]:
  pregnant women
  preterm and low birth weight infants
  older infants and toddlers
  teenage girls
  women of childbearing age, especially those with heavy menstrual losses
  people with renal failure, especially those undergoing routine dialysis
  people with gastrointestinal disorders who do not absorb iron normally

Celiac Disease and Crohn's Syndrome are associated with gastrointestinal malabsorption and may impair iron absorption. Iron supplementation may be needed if these conditions result in iron deficiency anemia [41].

Women taking oral contraceptives may experience less bleeding during their periods and have a lower risk of developing an iron deficiency. Women who use an intrauterine device (IUD) to prevent pregnancy may experience more bleeding and have a greater risk of developing an iron deficiency. If laboratory tests indicate iron deficiency anemia, iron supplements may be recommended.

Total dietary iron intake in vegetarian diets may meet recommended levels; however that iron is less available for absorption than in diets that include meat [58]. Vegetarians who exclude all animal products from their diet may need almost twice as much dietary iron each day as non-vegetarians because of the lower intestinal absorption of nonheme iron in plant foods [1]. Vegetarians should consider consuming nonheme iron sources together with a good source of vitamin C, such as citrus fruits, to improve the absorption of nonheme iron [1].
There are many causes of anemia, including iron deficiency. There are also several potential causes of iron deficiency. After a thorough evaluation, physicians can diagnose the cause of anemia and prescribe the appropriate treatment.

Does pregnancy increase the need for iron?
Nutrient requirements increase during pregnancy to support fetal growth and maternal health. Iron requirements of pregnant women are approximately double that of non-pregnant women because of increased blood volume during pregnancy, increased needs of the fetus, and blood losses that occur during delivery [16]. If iron intake does not meet increased requirements, iron deficiency anemia can occur. Iron deficiency anemia of pregnancy is responsible for significant morbidity, such as premature deliveries and giving birth to infants with low birth weight [1,51,59-62].

Low levels of hemoglobin and hematocrit may indicate iron deficiency. Hemoglobin is the protein in red blood cells that carries oxygen to tissues. Hematocrit is the proportion of whole blood that is made up of red blood cells. Nutritionists estimate that over half of pregnant women in the world may have hemoglobin levels consistent with iron deficiency. In the U.S., the Centers for Disease Control (CDC) estimated that 12% of all women age 12 to 49 years were iron deficient in 1999-2000. When broken down by groups, 10% of non-Hispanic white women, 22% of Mexican-American women, and 19% of non-Hispanic black women were iron deficient. Prevalence of iron deficiency anemia among lower income pregnant women has remained the same, at about 30%, since the 1980s [63].

The RDA for iron for pregnant women increases to 27 mg per day. Unfortunately, data from the 1988-94 NHANES survey suggested that the median iron intake among pregnant women was approximately 15 mg per day [1]. When median iron intake is less than the RDA, more than half of the group consumes less iron than is recommended each day.

Several major health organizations recommend iron supplementation during pregnancy to help pregnant women meet their iron requirements. The CDC recommends routine low-dose iron supplementation (30 mg/day) for all pregnant women, beginning at the first prenatal visit [33]. When a low hemoglobin or hematocrit is confirmed by repeat testing, the CDC recommends larger doses of supplemental iron. The Institute of Medicine of the National Academy of Sciences also supports iron supplementation during pregnancy [1]. Obstetricians often monitor the need for iron supplementation during pregnancy and provide individualized recommendations to pregnant women.

Some facts about iron supplements

Iron supplementation is indicated when diet alone cannot restore deficient iron levels to normal within an acceptable timeframe. Supplements are especially important when an individual is experiencing clinical symptoms of iron deficiency anemia. The goals of providing oral iron supplements are to supply sufficient iron to restore normal storage levels of iron and to replenish hemoglobin deficits. When hemoglobin levels are below normal, physicians often measure serum ferritin, the storage form of iron. A serum ferritin level less than or equal to 15 micrograms per liter confirms iron deficiency anemia in women, and suggests a possible need for iron supplementation [33].

Supplemental iron is available in two forms: ferrous and ferric. Ferrous iron salts (ferrous fumarate, ferrous sulfate, and ferrous gluconate) are the best absorbed forms of iron supplements [64]. Elemental iron is the amount of iron in a supplement that is available for absorption. Figure 1 lists the percent elemental iron in these supplements.

The amount of iron absorbed decreases with increasing doses. For this reason, it is recommended that most people take their prescribed daily iron supplement in two or three equally spaced doses. For adults who are not pregnant, the CDC recommends taking 50 mg to 60 mg of oral elemental iron (the approximate amount of elemental iron in one 300 mg tablet of ferrous sulfate) twice daily for three months for the therapeutic treatment of iron deficiency anemia [33]. However, physicians evaluate each person individually, and prescribe according to individual needs.

Therapeutic doses of iron supplements, which are prescribed for iron deficiency anemia, may cause gastrointestinal side effects such as nausea, vomiting, constipation, diarrhea, dark colored stools, and/or abdominal distress [33]. Starting with half the recommended dose and gradually increasing to the full dose will help minimize these side effects. Taking the supplement in divided doses and with food also may help limit these symptoms. Iron from enteric coated or delayed-release preparations may have fewer side effects, but is not as well absorbed and not usually recommended [64].

Physicians monitor the effectiveness of iron supplements by measuring laboratory indices, including reticulocyte count (levels of newly formed red blood cells), hemoglobin levels, and ferritin levels. In the presence of anemia, reticulocyte counts will begin to rise after a few days of supplementation. Hemoglobin usually increases within 2 to 3 weeks of starting iron supplementation.

In rare situations parenteral iron (provided by injection or I.V.) is required. Doctors will carefully manage the administration of parenteral iron [66].

Who should be cautious about taking iron supplements?
Iron deficiency is uncommon among adult men and postmenopausal women. These individuals should only take iron supplements when prescribed by a physician because of their greater risk of iron overload. Iron overload is a condition in which excess iron is found in the blood and stored in organs such as the liver and heart. Iron overload is associated with several genetic diseases including hemochromatosis, which affects approximately 1 in 250 individuals of northern European descent [67]. Individuals with hemochromatosis absorb iron very efficiently, which can result in a build up of excess iron and can cause organ damage such as cirrhosis of the liver and heart failure [1,3,67-69]. Hemochromatosis is often not diagnosed until excess iron stores have damaged an organ. Iron supplementation may accelerate the effects of hemochromatosis, an important reason why adult men and postmenopausal women who are not iron deficient should avoid iron supplements. Individuals with blood disorders that require frequent blood transfusions are also at risk of iron overload and are usually advised to avoid iron supplements

What are some current issues and controversies about iron?

IRON AND HEART DISEASE:
Because known risk factors cannot explain all cases of heart disease, researchers continue to look for new causes. Some evidence suggests that iron can stimulate the activity of free radicals. Free radicals are natural by-products of oxygen metabolism that are associated with chronic diseases, including cardiovascular disease. Free radicals may inflame and damage coronary arteries, the blood vessels that supply the heart muscle. This inflammation may contribute to the development of atherosclerosis, a condition characterized by partial or complete blockage of one or more coronary arteries. Other researchers suggest that iron may contribute to the oxidation of LDL ("bad") cholesterol, changing it to a form that is more damaging to coronary arteries.

As far back as the 1980s, some researchers suggested that the regular menstrual loss of iron, rather than a protective effect from estrogen, could better explain the lower incidence of heart disease seen in pre-menopausal women [70]. After menopause, a woman's risk of developing coronary heart disease increases along with her iron stores. Researchers have also observed lower rates of heart disease in populations with lower iron stores, such as those in developing countries [71-74]. In those geographic areas, lower iron stores are attributed to low meat (and iron) intake, high fiber diets that inhibit iron absorption, and gastrointestinal (GI) blood (and iron) loss due to parasitic infections.

In the 1980s, researchers linked high iron stores with increased risk of heart attacks in Finnish men [75]. However, more recent studies have not supported such an association [76-77].
One way of testing an association between iron stores and coronary heart disease is to compare levels of ferritin, the storage form of iron, to the degree of atherosclerosis in coronary arteries. In one study, researchers examined the relationship between ferritin levels and atherosclerosis in 100 men and women referred for cardiac examination. In this population, higher ferritin levels were not associated with an increased degree of atherosclerosis, as measured by angiography. Coronary angiography is a technique used to estimate the degree of blockage in coronary arteries [78]. In a different study, researchers found that ferritin levels were higher in male patients diagnosed with coronary artery disease. They did not find any association between ferritin levels and risk of coronary disease in women [79].

A second way to test this association is to examine rates of coronary disease in people who frequently donate blood. If excess iron stores contribute to heart disease, frequent blood donation could potentially lower heart disease rates because of the iron loss associated with blood donation. Over 2,000 men over age 39 and women over age 50 who donated blood between 1988 and 1990 were surveyed 10 years later to compare rates of cardiac events to frequency of blood donation. Cardiac events were defined as (1) occurrence of an acute myocardial infarction (heart attack), (2) undergoing angioplasty, a medical procedure that opens a blocked coronary artery; or (3) undergoing bypass grafting, a surgical procedure that replaces blocked coronary arteries with healthy blood vessels. Researchers found that frequent donors, who donated more than 1 unit of whole blood each year between 1988 and 1990, were less likely to experience cardiac events than casual donors (those who only donated a single unit in that 3-year period). Researchers concluded that frequent and long-term blood donation may decrease the risk of cardiac events [80].

Conflicting results, and different methods to measure iron stores, make it difficult to reach a final conclusion on this issue. However, researchers know that it is feasible to decrease iron stores in healthy individual through phlebotomy (blood letting or donation). Using phlebotomy, researchers hope to learn more about iron levels and cardiovascular disease.

IRON AND INTENSE EXERCISE:
Many men and women who engage in regular, intense exercise such as jogging, competitive swimming, and cycling have marginal or inadequate iron status [1,81-85]. Possible explanations include increased gastrointestinal blood loss after running and a greater turnover of red blood cells. Also, red blood cells within the foot can rupture while running. For these reasons, the need for iron may be 30% greater in those who engage in regular intense exercise [1].

Three groups of athletes may be at greatest risk of iron depletion and deficiency: female athletes, distance runners, and vegetarian athletes. It is particularly important for members of these groups to consume recommended amounts of iron and to pay attention to dietary factors that enhance iron absorption. If appropriate nutrition intervention does not promote normal iron status, iron supplementation may be indicated. In one study of female swimmers, researchers found that supplementation with 125 milligrams (mg) of ferrous sulfate per day prevented iron depletion. These swimmers maintained adequate iron stores, and did not experience the gastrointestinal side effects often seen with higher doses of iron supplementation [86].

IRON AND MINERAL INTERACTIONS:
Some researchers have raised concerns about interactions between iron, zinc, and calcium. When iron and zinc supplements are given together in a water solution and without food, greater doses of iron may decrease zinc absorption. However, the effect of supplemental iron on zinc absorption does not appear to be significant when supplements are consumed with food [1,87-88]. There is evidence that calcium from supplements and dairy foods may inhibit iron absorption, but it has been very difficult to distinguish between the effects of calcium on iron absorption versus other inhibitory factors such as phytate [1].

What is the risk of iron toxicity?
There is considerable potential for iron toxicity because very little iron is excreted from the body. Thus, iron can accumulate in body tissues and organs when normal storage sites are full. For example, people with hemachromatosis are at risk of developing iron toxicity because of their high iron stores.

In children, death has occurred from ingesting 200 mg of iron [7]. It is important to keep iron supplements tightly capped and away from children's reach. Any time excessive iron intake is suspected, immediately call your physician or Poison Control Center, or visit your local emergency room. Doses of iron prescribed for iron deficiency anemia in adults are associated with constipation, nausea, vomiting, and diarrhea, especially when the supplements are taken on an empty stomach [1].

In 2001, the Institute of Medicine of the National Academy of Sciences set a tolerable upper intake level (UL) for iron for healthy people [1]. There may be times when a physician prescribes an intake higher than the upper limit, such as when individuals with iron deficiency anemia need higher doses to replenish their iron stores. Table 5 lists the ULs for healthy adults, children, and infants 7 to 12 months of age [1].

Selecting a healthful diet:
As the 2000 Dietary Guidelines for Americans states, "Different foods contain different nutrients and other healthful substances. No single food can supply all the nutrients in the amounts you need" [89]. Beef and turkey are good sources of heme iron while beans and lentils are high in nonheme iron. In addition, many foods, such as ready-to-eat cereals, are fortified with iron. It is important for anyone who is considering taking an iron supplement to first consider whether their needs are being met by natural dietary sources of heme and nonheme iron and foods fortified with iron, and to discuss their potential need for iron supplements with their physician. If you want more information about building a healthful diet, refer to the Dietary Guidelines for Americans http://www.usda.gov/cnpp/DietGd.pdf [89], and the U.S. Department of Agriculture's Food Guide Pyramid http://www.usda.gov/cnpp/DietGd.pdf [90].


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BIOFLAVONOIDS:

According to Acu-Cell Nutrition:

Bioflavonoids: Rutin and Hesperidin share left / right-sided cell receptors and may be considered essential to human health. (Bio)flavonoids comprise the most abundant group of plant Polyphenols, next to Phenolic acids (found in a variety of foods), Stilbenes (resveratrol, pinosylvin, isorhapontin), and Lignans (nuts, seeds, whole grain cereals). Several thousand flavonoids have been identified, which provide much of the flavor and color in fruits and vegetables, and also berries and flowers.

As a group with other polyphenols, flavonoids have been linked to reduced cardiovascular disease, cancer and osteoporosis, and many other health benefits as a result of their antioxidant, antibacterial, antiviral, anti-inflammatory, anti-allergenic properties.

Flavonoids / Bioflavonoids (bioflavinoids) are accessory nutrients to form an ascorbic acid or Vitamin C complex. Rutin and hesperidin are part of this Vitamin P group and function synergistically with Vitamin C in regard to maintaining healthy capillaries, to help form collagen in connective tissue, to help heal wounds, and to support a healthy immune system.
Rutin and/or hesperidin, when low, frequently result in predictable, and even side-specific medical problems that include a greater risk for vascular degeneration, bruising / capillary fragility, nose bleeds, periodontal bleeding, varicose veins, hemorrhoids and aneurysm, with few individuals exhibiting optimal levels, even after mega-supplementation. One reason is the chemical interaction of bioflavonoids with other nutrients, which can have a synergistic or inhibiting effect on them. Various drugs are also able to interact with (bio)flavonoids and affect their efficacy.

Copper is the most common and potent inhibitor of hesperidin and Vitamin C, being the reason why high levels of copper create a greater risk for vascular degeneration, which in turn requires greater intake of Vitamin C, sulfur, chromium, or molybdenum to lower copper - to make it more bioavailable, otherwise hesperidin levels will not go up, no matter how much is supplemented. (see also Acu-Cell"Vitamin C Supplementation"). Abnormal liver functions, triggered by drugs, hormones – particularly elevated estrogen - alcohol, etc., or the structural changes experienced during pregnancy, as well as lack of exercise and excessive amounts of time spent in a sitting position can be equally responsible to promote vascular degeneration.

Hesperidin has a right-sided cell receptor (as has copper), so medical problems associated with its deficiency, and/or with copper excesses, are invariably right-sided as well. It is not unusual to see hemorrhoids or varicose veins being noticeably worse on one side only. Rutin is inhibited mostly by chromium, and since chromium levels are on average not as high as copper levels, rutin levels are invariably higher than hesperidin levels as long as dietary intake of rutin and hesperidin are similar.

Vanadium and selenium support rutin uptake, and molybdenum and sulfur support hesperidin uptake. Rutin + hesperidin are associated the same way as calcium + magnesium, in that taking only the one can over time deplete the other. For instance, the need to supplement rutin alone (without hesperidin)can only be justified when there is either a notable deficiency ratio-wise to hesperidin, or when there is a significant vascular problem, which is confined to the left side only.

Measuring the actual levels of bioflavonoids will help establish whether they, or other aspects such as impaired liver functions or drugs are causative factors with vascular degeneration. Low to moderate intake of alcohol or blood thinning medications favorably enhance the activity of flavonoids, however excessive intake compromises not only Vitamin K, but causes a sharp drop with rutin and hesperidin levels. (see also Acu-Cell "Osteoporosis" on details on Vitamin K and its DRI / RDA).

Citrus Bioflavonoids are the most commonly supplemented forms of flavonoids. Unless there is an allergy or intolerance to citrus (some individuals find that flavonoids, particularly from citrus worsen their eczema), there are no other adverse or overdose reactions known, even when very high amounts are supplemented every day. Since citrus bioflavonoid tablets are usually quite large, brands should be chosen that either supply oval-shaped tablets, caplets, or capsules for easier swallowing.

Anthocyanins and their precursors Proanthocyanins (also called condensed tannins) are chemically related to quercetin, and they are another class of flavonoids that are excellent antioxidants with similar benefits to other bioflavonoids. Pycnogenol, which comes from the bark of the French Maritime Pine (pinus maritima), is a particularly promoted and well-known source of proanthocyanidins. While their cost is several times that of citrus bioflavonoids, tablet sizes are only a fraction of those containing other types of flavonoids, so they are easier to take for individuals with swallowing difficulties, or children. 

Anthocyanidins are found in tea, beets, cherries, plums, red grapes, hawthorn, and some berries, (cyanidin, delphinidin, pelargonidin, peonidin, petunidin, malvidin).

Proanthocyanidins are found in tea, bilberry, apple, pear, grape seed, pine bark, beer, red wine, cranberry, red beans, (procyanidin, prodelphinidin, propelargonidin).

Isoflavones from soy products (genistein, daidzein, glycitein), are another class of flavonoids that function as antioxidants and in addition possess phytoestrogenic properties that can be effective for menopausal symptoms and to promote bone density in post-menopausal women. They may also be beneficial in the treatment and prevention of cardiovascular disease (inhibition of lipoprotein oxidation, thrombin formation and platelet activation), and cancer (inhibition of angiogenesis, and tyrosine kinase activity - an enzyme that promotes cancer growth), although there are conflicting opinions on the tumor-protective benefits in light of new evidence of also a possible pro-tumor effect following high soy intake.

Isoflavones are mostly found in soybeans, garbanzo beans, chick peas, red clover and legumes.

Cocoa is an excellent source of catechins, which are polyphenols of the flavanol group, and which are believed to protect against heart disease, cancer, and various other medical conditions. While health benefits apply to some isolated compounds in cocoa - as a whole - they do not apply to processed cocoa products such as Chocolate any longer because of other less desirable ingredients offsetting these health benefits (i.e. added sugar, corn syrup, milk fats / dairy cream, hydrogenated oils, etc...), and also since the actual cocoa content may be less than 20% in most chocolate bars sold. (see also Acu-Cell "Chocolate" for more details on some of the positive / negative health effects of chocolate).

Theobromine, found in chocolate, can be toxic or even lethal to domestic animals such as dogs, cats, horses and many other animals as a result of affecting their kidneys, heart, and central nervous system.

In addition, cocoa products contain a high level of copper, which - with few exceptions - is already too high in many individuals, and so consuming a lot of chocolate aggravates many high copper-related medical conditions, or creates additional ones (see also Acu-Cell Nutrition "Chromium & Copper").

Horse Chestnuts contain flavonoids, sterols, and tannins. Studies have identified a saponin known as Aescin as the active constituent in horse chestnut extracts, which has been found effective in the treatment of chronic venous insufficiency, varicose veins and edema, and can be taken topically or internally. Extracts of the seeds, leaves and bark of the horse chestnut tree (aesculus hippocastanum) have been traditionally used in Europe for vascular degeneration, hemorrhoids, water retention, cough, rheumatism, phlebitis, skin problems and other ailments.
People with kidney or liver conditions should avoid horse chestnuts or any horse chestnut extracts, as the aescin may worsen their functions. Reactions such as nausea, stomach upsets, and itching are another possibility in people sensitive to horse chestnuts.
Quercetin (quercitin, quercetrin) is chemically related to a class of flavonoids called (pro)anthocyanins.

Early research on quercetin suggested that ingesting higher amounts may induce cancer, after it failed a standard - but somewhat controversial laboratory test called the Ames Test. This test supposedly identifies chemicals that might be carcinogenic. Subsequent studies however disputed those earlier findings and attributed cancer-protective or cancer-fighting properties to quercetin instead.

In addition, quercetin has been found to be an effective hyperthermia sensitizer, making it a potential adjunct therapeutic agent in the treatment of various cancers that are sensitive to heat stress (prostate, ovarian, uterine, or cervical cancer, leukemia, melanoma, colon adenocarcinoma, and others).

However, I have seen a few patients who developed cancerous tumors after supplementing quercetin -which proves that positive outcomes in experimental studies are not necessarily reflected in positive outcomes when applied in a "real world" environment. At the same time, patient feedback on the touted anti-allergenic and anti-inflammatory aspects of quercetin has not been all that favorable either, so while this is not intended to discourage anyone from using it for a specific condition (particularly when found beneficial), quercetin nevertheless fits the "Caveat Emptor" category.

Quercetin isn't the first to be listed among naturally occurring carcinogens and mutagens found in foods and beverages. Many phytochemicals contained in common fruits, vegetables, spices, grains, seeds, nuts, mushrooms, coffee, tea, and herbs are rodent carcinogens, while for instance Psoralens (found in parsnips, parsley and celery), are considered to be human carcinogens, as is acrylamide, contained in crisp breads and rolls, which is also a neurotoxin. Ingesting large amounts of Grape Seed Extract has shown liver toxicity in some animal studies as well.

Nevertheless, test tube and animal studies - where many times astronomical amounts of food fractions are used - have generally little relevance to normal human consumption of these same types of foods, but they make great headlines, or they may assure next year's research grant for an otherwise starving research team.

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PABA (PARA AMINOBENZOIC ACID):

Wikipedia:

4-Aminobenzoic acid (also known as para-aminobenzoic acid or PABA) is an organic compound with the molecular formula C7H7NO2. PABA is a white crystalline substance that is only slightly soluble in water. It consists of a benzene ring substituted with an amino group and a carboxylic acid.

PABA is an essential nutrient for some bacteria and is sometimes called Vitamin Bx[citation needed]. However, PABA is not essential to human health, and is therefore not officially classified as a vitamin. Although humans lack the ability to synthesize folate from PABA, it is sometimes marketed as an essential nutrient under the premise that it can stimulate intestinal bacteria.

PABA is an intermediate in bacterial synthesis of folate. Sulfonamides are chemically similar to PABA, and their antibacterial activity is due to their ability to interfere with conversion of PABA to folate, and subsequent utilization, by bacteria.

In the past, PABA has been widely used as a UV filter in sunscreen formulations. However, it has been determined that it increases the formation of a particular DNA defect in human cells, thus increasing the risk of skin cancer in people who lack the mechanisms to repair these cellular defects.[1] Currently, safer and more effective derivatives of PABA, such as octy