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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Overcoming Seasonal Allergies: A Natural Approach to Dealing with Hay Fever

3/4/2014

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Allergy season is upon us. For those who suffer from Hay fever or seasonal allergies (medically termed allergic rhinitis) this time of year can be extremely frustrating and debilitatiting. Itcthy or burning eyes, stuffed up or runny noses, with constant sneezing that returns on a yearly basis are the classic signs of hay fever. Allergies are becoming a modern era pandemic. Research shows that the incidence of allergies is on the rise in most developed countries. The number of sufferers from seasonal allergy has tripled in the last 20 years. Allergies are a long-term health problem; typically beginning between 8 and 12 years of age and lasting for decades if not for a lifetime.

What causes seasonal allergies?

Hay Fever/Seasonal allergies are caused when the body makes allergic antibodies (IgE) to a substance such that occurs at specific times of year such as tree pollen, grasses and weeds (these are known as allergens). Symptoms of allergy that continue all year long are called perennial allergic rhinitis and commonly relate to indoor allergens, such as house dust mites, pets and indoor moulds.

In people sensitive to these allergens, exposure causes the release of chemicals (such as histamine) from special cells (called Mast cells) in the nasal passages, eyes or airways. Chemicals such as histamine released from these mast cells then trigger inflammation and irritation to the lining of the eyes, nose and throat.

Hay fever or seasonal allergies is actually an immune disorder characterized by an inappropriate allergic response to pollen and these other allergenic substances mentioned above. Inflammation is normally a beneficial and essential event in the body. It is the immune system's response to tissue injury and infection, and ensures that the body recovers from damage and continues to function properly. However, this response is meant to be short lived but for people with seasonal allergies it can go on for months on end.

The Best Defense - Avoid the Triggers

The best way to combat an allergen assault is to avoid coming in contact with the allergens.  Symptoms can be often be prevented if you can directly control your environment and avoid the allergen “triggers.” Here are a few helpful tips on how to do this:

1) Close your windows and doors; use your air conditioning.

2) Pollen levels are highest in the morning, so schedule your outdoor activities for afternoons or evenings.

3) Change your clothes after you come in from outside.

4) Bathe before bed to keep pollen off pillows and sheets.

5) Wash your hands if you pet an animal that’s been outside.

What if I do not know what I am allergic to?

Allergy testing is not usually required in simple hay fever because the trigger substances can be easily identified from the history of when and where symptoms occur. However, in certain cases a doctor or allergist might use a skin prick test or blood test to find out exactly what you allergic to. This is especially important in certain desensitization treatments that allergists use. If you want to find out what you might be allergic to ask your doctor for a test or a referral to an allergist.

What can be done about Hayfever naturally?

Naturopathic medicine has many tools to help you with your Seasonal Allergies. The following are some of the natural treatments options available:

Supplementation Therapy: Various nutritional supplements have shown to greatly reduce seasonal allergies.  At my clinic in Jerusalem we use supplement protocols that have shown to be effective in reducing allergic symptoms. Our supplement therapy often includes a few supplements. I will speak hear of two notable superstars to be aware of:

Quercetin:

Quercetin an antioxidant derived from apples and onions and it has been shown to prevent the release of histamine, which is responsible for many allergic symptoms. It also decreases the number of cells in the blood that contribute to allergic responses. In animal models, Quercetin has been shown to inhibit elevated levels of IgE, the antibody responsible for allergic reactions, and to inhibit bronchial obstruction in a model of allergic asthma.

Vitamin D:

Another important supplement to be aware of for people with hayfever is vitamin D. If you suffer from Hay fever it is crucial to investigate your Vitamin D status. Researchers out of Korea found that adults with low levels of vitamin D are at greater risk of hay fever.  Ask you doctor for a vitamin D blood test and if low make sure to take Vitamin D.

Homeopathic Treatment:

Homeopathic medicine can be taken as a preventive medicine before allergy season to avoid the onset of allergies.  As well, they can be used when a person is already suffering from allergies.  Going to a trained homeopath for allergy treatment can often help reduce hay fever greatly.

Special Anti-Allergy Diet:

As a general rule adding Omega 3 oils to the diet can be very helpful in lessening seasonal allergy symptoms. Excellent omega-3 fatty acid sources include flaxseeds, cabbage, cauliflower, walnuts. brussels sprouts, French beans, broccoli, turnip, collard greens, and of course fish and their oils.

Refined sugars should be avoided as they are mucus forming.  As well, Dairy products are also mucus forming and they contain omega-6 fatty acids, which are believed to worsen allergy symptoms. Cutting out dairy altogether would probably significantly benefit your hay fever, but it is not recommended unless you are familiar with ways to get calcium outside of dairy and willing to do so. Calcium rich foods include nuts, vegetables and fish (such as collard greens, bok choy, spinach, almonds and Salmon to name a few) as the calcium in dairy foods is essential for building and maintaining strong bones and teeth. Children, pregnant and breastfeeding women, and people with the bone-thinning disease osteoporosis need substantial amounts of calcium and in our communities often dairy is the best option. If you do choose to avoid dairy you can also use almond milk and rice milk, which if fortified with calcium, can be used as a replacement. Unless you belong to one of the groups mentioned above, try to limit your consumption of animal milk products or cut them out altogether.

Desensitization therapies – Some allergists can identify your allergen and help you desensitize to it through various modern techniques. There are a few different kinds of desensitization therapies. Ask your allergist what test might be right for you.

Conclusion:

Hay fever is growing problem for people in westernized countries and the number of sufferers is getting worse each and every year. There are however many ways to deal with hay fever naturally. It is my sincerest hope that by heeding some of the advice given here in this article that this year and years to come will be ones free of the frustration of seasonal allergies for you or someone you know. Refuah Shelaima!

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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A Vitamin a day will keep the Doctor Away this Winter

10/31/2013

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Generally I do not feel people need to use Vitamins unless they have a known vitamin deficiency. However, in the winter there are some real concerns about becoming Vitamin D deficient. Vitamin D is made in your body with the help of sunlight. And with sunlight being very minimal in the winter, we are at risk of becoming deficient and if we become deficient we may likely be at risk of getting sick more often.

Vitamin D has been found to be a central part in enabling the immune system to be primed to help to fight infection. So with low Vitamin D, one would be more likely to get sick. Since so many people are deficient, it may be worth getting tested by your doctor and if your are low, to take supplemental vitamin D.

Another reason to supplement Vitamin D, is that it is quite difficult it from food. Vitamin D is only in a few foods and often in very small amounts. Foods that provide vitamin D include Fatty fish (tuna, mackerel, and salmon), beef liver, cheese and egg yolks It is also found in foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals.

Other vitamins that boost immune function and that have antiviral activity are Vitamins A, C and Zinc. Taking a supplement that has these vitamins might be necessary in someone who is prone to getting sick. If you think your immune system is weak try to find a natural supplement with these in it.  However it should be noted that Vitamin A in high doses should not be taken during pregnancy.

For those of you opposed to taking vitamins I have the following list of Food sources of these immune boosting vitamins!


Foods highest in vitamin C include:
Papaya, Kale, Strawberries, Oranges, Hot Peppers, Red/Yellow Peppers, Dark Green Vegetables, (ie Brussel Sprouts), Pomegranate and Kiwi.

Vitamin A is found in:
Sweet Potatoes, Liver, Paprika, Cayenne, Cantaloupe, Butternut Squash, Dark Leafy Greens and Dried Apricots.

Zinc can be found in:
Pumpkin seeds, Cashews, Spinach, Beans, Mushrooms, Chicken and Beef.

Try eating more of these foods to improve immune function. Wishing you a happy healthy winter!


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

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