Dr. Anders Nerman, N.D. Naturopathic Doctor in Israel
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Dr. Anders Nerman’s Vitamin and Supplements Guide Part 1

5/1/2014

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People often ask me what I think about taking supplements. In truth, I honestly believe that supplements are not the best way to get our vitamins and minerals. I prefer to help my patients understand how to get the critical nutrients they need from the foods they eat. The problem is however, that people are not eating well. It is a reality of our culture. Our modernized society and time pressured lives have created a lifestyle where we eat a lot of easy to obtain refined, whitened, processed foods that are much more deficient in vitamins, nutrients and minerals than the whole food diets of the past. The recognition of this deficiency led many world governments to mandate that vitamins like riboflavin and folic acid be added to the foods we eat. We don’t seem to have the time or the money to prepare nourishing foods. It’s a major problem. So with that in mind and based on evidence based scientific research I offer you this quick reference guide to taking vitamin and supplements.

One Caveat:

I do not talk much in this blog about dosages because I feel that vitamin dosages are patient specific. That being said, one can easily obtain a list of the recommended daily intake (RDI) values.  These values differ if you are male or female, a child or pregnant. I would suggest however, that everyone talk to their naturopathic doctor, nutritionist or medical doctor specifically about what they would like to try and why before starting to take supplements. This is because vitamins can be dangerous when taking with certain medical conditions and some vitamins interact with other medications you might be taking. This is why it is always important to discuss your supplements with your doctor. So please be cautious when taking supplements and get guidance from a licensed professional.

I wrote this article to help educate about some common deficiencies, and possible medical benefits that can be found by using vitamin and mineral supplementation.


The Multivitamin


Although this is the most popular supplement, it is considered by many alternative medical practitioners as one of the most overrated. Multivitamins are a good idea in theory but multivitamins have some major drawbacks. A multivitamin usually does not contain enough of each vitamin for that vitamin to have any effect. As well, taking a multivitamin might provide you with more than enough of certain vitamins like Vitamin C which is already very plentiful in most peoples diets and not enough of the vitamins many people are deficient in like Vitamin D. I don’t recommend multivitamins unless a patient has a very restricted diet and really cannot afford to purchase more than one supplement.


Common Vitamin Deficiencies

The following are a list vitamins people are commonly deficient in:

Vitamin D

Vitamin D is currently a very popular supplement and this is for good reason: most people are deficient in Vitamin D and it is very important for our health.  Vitamin D is different from other essential vitamins because our own bodies manufacture it through our exposure to sunlight.  Since sunshine is somewhat limited during certain months in the UK and since most peoples bodies are not uncovered most of the time, Vitamin D can be somewhat difficult to acquire.

The main function of vitamin D is to regulate the absorption of calcium and phosphorus in our bones (bone health). It also plays a critical role in healthy immune function. If you or someone you know has constant colds and flus it may be due to low Vitamin D status. It has also been shown to help maintain healthy body weight, reduce the risk of heart attacks and some cancers. Interestingly, it has been shown to prevent the natural cognitive decline in aging. Ask your doctor to test your Vitamin D levels and if deficient take it as a supplement.


Calcium

Calcium deficiency tends to be common in older people and those that don’t consume much dairy. Calcium is crucial for bone health. I prefer if patients focus on getting their calcium from non-dairy sources if possible. Foods like Bok Choy, Spinach, Collard greens, Almonds, Salmon and canned sardines are high in Calcium. If however, you do not think you can eat these very often then perhaps take a calcium supplement.



Magnesium

Magnesium has a role in the body in helping with the proper function of many of  our enzymes, it also works as a muscle relaxant. In fact, magnesium deficiency is often associated with muscle pain and spasm; especially back pain.

Magnesium is hard to obtain in our diets, because it is mainly removed with processing - so only whole unprocessed food contain it. Good magnesium sources are nuts, tofu, soybeans, figs, and unrefined whole wheat or rye bread. If your diet is lacking in magnesium, definitely consider supplementation. It also works wonders in helping people suffering from constipation get relief. As well magnesium is depleted by stress and coffee. Magnesium deficiency has been found in people suffering from Fibromyalgia and they will benefit from it in its magnesium malate form or a mixture of citrate and malate. I prefer Magnesium citrate as the supplement form of choice for most people.



It is important to note that people can often get Magnesium, Calcium and Vitamin D in one supplement. In my opinion this may be a better supplement to take than a multivitamin since it is these vitamins in which we are most likely deficient.

Iron

One of the most common mineral deficiencies in the world is iron. A direct consequence of iron deficiency is iron deficiency anemia. Iron works is a part of the molecule hemoglobin and therefore is crucial to proper red blood cell function.

People suffering from iron deficiency mostly tend to be women. It is usually low in vegans and some vegetarians as well.   Symptoms of iron deficiency are tiredness, moodiness, restless leg syndrome, muscle weakness, hair loss and impaired concentration. Some good food sources are meat, poultry, fish, leafy green vegetables, beans, whole grains, and blackstrap molasses. Iron supplementation is usually handled medical doctors, as overdosing can be toxic. Ask you doctor to test your iron and if low make sure to take a supplement.

Zinc

Zinc is involved with over 200 enzymatic reactions in the body and is critical for proper genetic expression and cellular division. Zinc deficiency is not rare because Zinc is hard for many people to absorb. It is critical for fertility in men, and for immune function in general. Signs and symptoms of Zinc deficiency is often loss of taste and smell. Excellent sources of Zinc are Meats, Eggs (mostly in the yolk), wheat bran, buckwheat, millet rice bran, whole wheat flour, oatmeal, brown rice and corn meal. It can also be found in black-eyed peas, green peas, garbonzos, lentils, limas, pumpkin and peanuts seeds, Spinach, Sweet corn, and Onions. The best form of zinc is the highly absorbable zinc picolinate. Zinc and copper compete in the stomach for absorption so any supplement you take of zinc longterm should also include a small amount of copper.


In my blog next article (Part 2) of Dr. Anders Nerman’s Vitamin and Supplements Guide, I will be discussing some other important supplements to consider taking for general health and will be identifying some supplements that are a fad and do not work. I will also be giving information on targeted supplementation for specific disorders.

To Health,

Dr. Anders Nerman, ND

Dr. Anders Nerman, N.D. is a Naturopathic Doctor with an Integrative Family Medical practice in Wolfson Medical Center in Jerusalem, Israel. For more visit www.drnerman.com or call 972-54-427-8667.

Information is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or adopting any treatment for a health problem.


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Coffee Revisited: A Critical Look at the Health Effects of Caffeine

11/10/2013

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I am sitting in my office in Jerusalem with a really bad headache. The “I am trying to get off of coffee” kind. Most of my life I was not a coffee drinker but at some point during Yeshiva I just needed a pick-me-up to keep me going---and so began the long term relationship with coffee. Seven years and approximately 4000 cups of coffee later I am beginning to wonder why I need more and more coffee and why I am feeling so tired all the time.

As a naturopathic doctor we are supposed to live what we preach but sadly, in regards to coffee consumption, I am not a very good role model. The naturopathic profession always spoke about how detrimental coffee was for a person’s health.  I have written this article not only for the health conscious reader, but also as a reminder for myself as to why it is important to try to kick this habit. Having prefaced this article with this coffee self-confession, I can now begin to talk to you about the health realities of coffee.


What is it about coffee that makes it so desirable?

Coffee contains caffeine.  In 1994 scientists established that caffeine was an addictive substance. Why do most people not look at coffee this way? When 80% of people are drinking coffee every day it becomes extremely hard to see caffeine for what it really is-- a drug.

Caffeine is in coffee, green tea, black tea, chocolate, coke and other soft drinks. The average cup of drop coffee contains 136 milligrams of caffeine per cup. Three cups per day (my latest average) means one is consuming more than 500 milligrams of caffeine – twice the amount considered a large drug dose of caffeine.  A five minute steeped black tea has between 40-100mg. Coca has 45mg.

How does caffeine work?

Soon after you drink or eat something containing caffeine, it’s absorbed through the small intestine and dissolved into the bloodstream.  Its chemical nature makes it able to penetrate the blood-brain barrier and enter the brain, which is where most of the action of this drug takes place.

Once in the brain caffeine is blocks Adenosine receptors. Adenosine normally activated its receptors which cause a chain reaction that makes us feel tired. Caffeine works by getting to those receptors first and blocking the receptors from being able to accept the Adenosine. Without the adenosine activation the receptor will not be able to trigger the feeling of tiredness.  As well, some of the brain’s own natural stimulants (dopamine) work more effectively when the adenosine receptors are blocked, and all the surplus adenosine floating around in the brain cues the adrenal glands to secrete adrenaline, another stimulant.

Regardless of the scientific chemical ways that caffeine works, one thing is forsure, caffeine makes us less tired and more alert. With the ever-increasing work and family demands we are in need of more and more energy and it appears that as a society we reach out to the drug caffeine to help us cope. But the question is clear - what are the long-term side effects of taking an addictive drug?


Why is caffeine/coffee so bad for our health?


What happens is that people who consume coffee, tea, soda or energy drinks with caffeine on a daily basis eventually begin to have altered brains with adjusted brain chemistry. The most notable change is that brain cells grow more adenosine receptors. As I mentioned above, Adenosine receptors control the feeling of being tired. With more receptors we are going to need increased amounts of caffeine to block them or we will end up feeling even more tired. As well, studies indicate that caffeine causes the brain to decrease the number of receptors for norepinephrine, our natural stimulant that gives us energy.  In other words – Drinking Coffee makes us more tired in the long run.  

What else is coffee/caffeine doing to my body?

Although research has not always been consistent, caffeine has been implicated as a definite or contributing factor in reactive hypoglycemia, anxiety, panic attacks, depression, moodiness, insomnia, hypertension, fibrocystic breast changes, impaired fertility, headaches, cardiac arrhythmias, and acid reflux.

As can be ascertained from the above list, coffee is not a good choice for people who have with these concerns or anyone trying to avoid the their development. 

Aside from the abovementioned disease states caffeine causes a host of other problems.

Depletes Magnesium: Caffeine has been noted to block Magnesium from being absorbed in the body, which is a critical mineral, involved in relaxing muscles – so you may end up with body aches and pains as a heavy coffee drinker. Note that the Fibromyalgia patients have 20% less magnesium to begin with, so coffee is a really bad idea for people suffering from Fibromyalgia.

Depletes B vitamins: Most common is B1 – responsible for energy metabolism, protein synthesis and nervous system function. Deficiency leads to fatigue, and headaches.

Pesticides: Yes it is unfortunate but true. Growers of coffee use more pesticides on coffee plants than on any other crop.

Nitrosamines: These naturally occurring substances in coffee are the same carcinogens found in bacon and other cured meats.

Dehydration: Caffeine is a diuretic. For each cup of coffee you drink you lose a cup of water. When drinking it you are actually not getting any water intake.


Adrenal exhaustion: Feeling extremely tired? Remember I mentioned that adrenal glands secrete the stimulant adrenaline. The problem is that eventually the adrenal glands start to burn out from being stimulated for adrenaline too much by the caffeine.

Suppressing Optimal Digestive Functioning: The response of the body to coffee is to not "rest and digest" but to shunt blood away from the stomach. Eating food while drinking coffee is therefore not a good idea. Food left in the stomach will ferment, putrify and turn rancid. Nutrients and mineral will not be absorbed.

Acidic: The acidic nature of coffee will over time kill a lot of the healthy bacteria in your stomach. Health problems associated with decreased good bacteria are: acne, constipation, diarrhea, recurring colds and flu’s, colitis, IBS, and fibromyalgia.

Blood Sugar Chaos: Caffeine makes blood sugar levels rise slightly. Adding sugar and milk to your coffee further worsens this increase in blood sugar. What happens is that the sugars are then removed rapidly from the blood into the cells via insulin but the effect is that you are left more sugar deficient in the blood (reactive hypoglycemia) than you started before drinking the coffee. Then you end up craving more sugar and feel tired shortly after your coffee – it’s a vicious cycle.

Is there any good news about Coffee?

It is an antioxidant, which is generally a pretty good thing. It also is associated with reduced incidence of certain chronic diseases, namely gallbladder disease, Parkinson’s disease and type 2 diabetes. But green tea has the same effect (at least on reducing the incidence of acquiring diabetes) with much less caffeine and a much wider variety of bioflavonoids, antioxidants and anti cancer properties.

What are some Coffee Alternatives?

Start kicking your caffeine addiction by replacing coffee with green tea or herbal teas. Drink a lot of water.

What are some healthy alternatives I can use for improving my energy?

There are a lot of healthier ways to support energy production in the body. Diet, nutrition, exercise, certain vitamins and herbs can help you safely support the body as it tries to cope with the rigors and stresses of work and life demands.

 
The final word on coffee:

It’s clear from the abovementioned information that caffeinated Coffee is not a good long-term solution for dealing with our need for more energy. It has been shown to have many negative side effects and seriously affects our bodies while at the same time altering our brain chemistry. What’s worse – it contains a known addictive substance that makes us more tired in the long run. Although coffee has some real benefits, in my opinion, they do not outweigh the negative effects it causes to our overall health. Hopefully this article has inspired you to think a bit more critically about the nature of coffee and possibly given a few of you the “boost” you needed to quit drinking coffee for good.


Dr. Anders Nerman, N.D. is a Naturopathic Doctor with an Integrative Family Medical practice in Wolfson Medical Center in Jerusalem, Israel. For more visit www.drnerman.com or call 972-54-427-8667.

Information is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or adopting any treatment for a health problem.


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    Dr. Anders Nerman, N.D. is a Canadian-trained Naturopathic Physician living and practicing in Jerusalem, Israel.

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