Jennifer Depew, R.D.'s Fullscript

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Jennifer Depew, R.D.'s Fullscript's general recommendations, available to anyone who visits this store.

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Pectin & Galectin-3
Modified Citrus pectin may help remove heavy metals from the body and improve cardiovascular health, kidney and liver disease. It has also been used in cancer treatment. Use for autoimmune conditions is being researched or trialed. Citrus bioflavonoids or modified citrus pectin have been used for weight control and Metabolic Syndrome conditions. Modified citrus pectin is shortened lengths of the pectin which seems to improve efficacy to block galectin- which is inflammatory. Levels of galectin-3 that are elevated may be useful as a biomarker of severity of a patient's condition. It is also an issue for Covid-19 patients from chimeric spike effects. Pectin or milk sugar, lactose, are inhibitors of galectin-3. Product example - PectaSol-C R Professional Lime - Clinical Synergy Professional "PectaSol-C® Professional is a natural inhibitor of galectin-3 (Gal-3), a protein involved in cardiovascular health.* Research shows that modifying Gal-3 levels in the circulation supports healthy aging, cellular function, cardiovascular health and normal immune response.* PectaSol-C® Professional is a low molecular weight pectin from the pith of citrus fruit peels, increasing absorption to provide beneﬁts systemically.* PectaSol-C® Professional Modified Citrus Pectin is supported by over 20 published peer-reviewed studies and over 20 years of research." Pomegranate peel, inner pith, is also a source of pectin and rhubarb. Apples and other fruits have pectin. Milk and dairy products are a source of milk sugar; goat milk or cheese or cow's milk products.
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Indigestion - Heartburn
General tips for indigestion and digestive health : Overly large meals or greasy rich meals can be more upsetting. Large servings of raw vegetables or fruits like apples and pears or beans may lead to gassiness from microbiome overgrowth. Taking a Beano type digestive enzyme tablet prior to eating can help. Smaller servings are also key - half of the large apple or pear is a good serving size for fruit. Steamed vegetables may be less gas promoting and cooking methods can help reduce gas from beans. If heartburn is a frequent problem than an autoimmune condition might be present and avoiding typical food allergens might help resolve the condition (autoimmune esophagitis). Acid reflux is another term for a slight regurgitation of stomach bile after meals or upon laying down after a meal. It can occur with pregnancy too as there is increased pressure from the baby. Stay upright for 45 minutes after meals and try not to overeat or have large beverages with meals. Sip a little water with meals and have large beverages in between meals so as to not dilute the stomach acid which we need to digest food. Lack of stomach acid as we age becomes the more common problem than over-acidity. Using Rolaids type anti-acid tablets just make that problem worse. Use of Betaine hydrochloride as a supplement might help to take with meals or adding a spoonful of apple cider vinegar, lemon or lime juice to your entrees can help with digesting the meal. It also helps to include a little fresh produce with meals as the fresh fruit and veggies have their own active enzymes which can aid digestion. If early morning nausea even with water is a problem, then a little salt might be needed to rebalance the stomach electrolytes. I sprinkle a little sea salt in my hand to lick and then have a drink of water. Apple cider vinegar and honey in a glass of water may be a soothing beverage for a sore throat or a sore belly. It is a traditional remedy called Oxymel and also may be made as a flavored herbal extract by steeping herbs or ground seeds in the apple cider vinegar or honey in advance. Mucilaginous foods or herbs like okra and slippery elm powder or marshmallow root powder, psyllium fiber, or flax seed meal, all can be soothing to the gut as they can help form our own mucilaginous lining which protects our cells from pathogens. Detox aids like activated charcoal, Bentonite clay, diatomaceous earth, or zeolite may also be helpful as they can help clear toxins from the gut. Zeolite also can benefit the body. The others stay in the gut. Generally important - adequate water, fiber, and exercise or gentle full range motion all helps the bowels stay regular and happy. Product examples and ingredient information: 1) DGL licorice is used in a chewable tablet designed for ‘acid indigestion’ that is fairly low in calcium - so safer than standard Rolaids type anti-acids. It includes 250 mg of DGL licorice and 50 mg of Slippery Elm which is mucilaginous and soothing to the gut lining. Licorice has benefits against indigestion. Alginic acid and Sodium alginate : “ Alginic acid, also called algin, is the polysaccharide form of bio-based materials found in the cell walls of brown algae. Due to its hydrophilic nature, it is usually found in a hydrated form as a viscous gum or in the form of neutralized sodium or calcium salt, which is called alginate.” and “At present, it is approved for use only in combination with antacids . Alginic acid can absorb 200-300 times its weight in water and solutes at low pH yielding a high viscosity, high pH gel. This forms a physical barrier floating in the gastric acid contents, reducing acid reflux into the esophagus. It is useful for treating gastroesophageal reflux disease and indigestion . ” (viewable at ScienceDirect) These ingredients are available in: Acid Block Chewable Tablets - Rx Vitamins For Temporary Relief of Occasional Indigestion* As a dietary supplement, chew one to two tablets after meals or before retiring. For best results, drink a glass of water after chewing tablets. Serving Size: 1 Chewable Tablet Amount Per Serving Calories ... 10 Total Carbohydrate ... 2g Sugars ... 2g Calcium Carbonate ... 30mg Alginic Acid ... 450mg Licorice (DGL) (Glycyrrhiza glabra root) ... 250mg (standardized <2% [<10mg] glycrrhizin) Sodium Alginate ... 50mg Slippery Elm (bark) ... 50mg (standardized 20% phytosterols) Other ingredients: Fruit sugar, proprietary chicory root and mung bean extract, stearic acid. Contains no: yeast, dairy, eggs, gluten, corn, wheat, starch, artificial colors or preservatives. 2) Ginger and B6 are used in a combined product suggested for prenatal nausea. Ginger-B6 - Karuna Ginger-B6 "Combination formula for digestive system comfort. Maintaining digestive system comfort is a challenge during pregnancy, while traveling in cars and boats, or after receiving surgical anesthesia or other medical treatments. Ginger root is a pungent and traditionally popular remedy for preventing disturbances of this type and has been the subject of several successful clinical trials as well. Ginger possesses other useful properties related to blocking production of certain prostaglandins and other eicosanoids. Pyridoxine (vitamin B6) has long been used during pregnancy for maintaining digestive system comfort." Adults: 1-2 capsules twice daily, or as directed. Serving Size: 1 Capsule Amount Per Serving Vitamin B6 ... 25mg (pyridoxine HCl) Ginger Root ... 250mg (Zingiber officinale) Other Ingredients: Vegetarian capsule, cellulose, magnesium stearate. *** Caution: Ginger in large quantities might be a risk prenatally - it can increase bleeding risks and possibly affect a pregnancy. Vegetable amounts - or crystallized ginger candy if eaten frequently in quantity. 3) I have included an example of a homeopathic remedy for varied digestive complaints. It contains a mixture of remedies that may help varied types of GI issues. Homeopathic remedies should be shaken before use and leave them in your mouth to dissolve slowly. Ideally do not mix with food or beverages other than water. PRO Gas~Indigestion - Newton Laboratories, Inc . 4) I also added a powder mix with extracts of fruits, herbs and spices that may help digestive health. An extract is a concentration of the plant parts. Pomegranate extract and many other other beneficial plants are included in the blend. The serving recommended is a 4 gram scoop which would be about a teaspoon. The container should provide 43 servings at that dose. Buying a pomegranate and some cilantro would be less expensive and also good for digestive health. See: Nourish Greens TM - Apex Energetics, Inc . As always - these are examples of products with ingredients that might help. Pick any, a few, or go buy the ginger, cilantro, and pomegranate - look at the ingredient lists for more ideas. Eat more of these foods and your digestive health will likely thank you: 4) Nourish Greens TM - Apex Energetics, Inc . (Serving size one scoop ~ 4 grams) Proprietary Blend ... 3.91 g Pea Protein Medium Chain Triglycerides Oil Raspberry Extract (Rubus idaeus) (fruit) - organic Broccoli (Brassica oleracea var. italica) (flower) - organic Acai Juice Powder (Euterpe oleracea) (fruit) - organic Luo Han Guo Extract (fruit) - wildcrafted Kale (Brassica oleracea var. acephala) (leaf) - organic Collard Greens Extract (Brassica oleracea var. acephala) (leaf) - organic Black Currant Extract (Ribes nigrum) (fruit) - organic Turmeric Extract (Curcuma longa) (root) - wildcrafted Maqui (Aristotelia chilensis) (fruit) - organic Goji Extract (Lycium barbarum) (fruit) - wildcrafted Apple Extract (Malus domestica) (fruit) - organic Acerola Cherry (Malpighia glabra) (fruit) - wildcrafted Mangosteen (Garcinia mangostana) (fruit) - organic Carrot Extract (Daucus carota) (root) - organic Cilantro (Coriandrum sativum) (leaf) - wildcrafted Glucoamylase Amylase Pomegranate Extract (Punica granatum) (fruit) - organic Flax (Linum usitatissimum) (seed) - organic Sumac Extract (Sorghum bicolor) (berry) Parsley Extract (Petroselinum crispum) (leaf) - organic Hesperidin Rutin (from Japanese Pagoda Tree Extract [Sophora Japonica]) (bud) Oregano Extract (Origanum vulgare) (leaf) - organic Basil Extract (Ocimum basilicum) (leaf) - organic Clove (Syzygium aromaticum) (stem, bud) - organic Quercetin (as quercetin dihydrate) Sea Salt Ginger Extract (Zingiber officinale) (root) - organic Lycopene Luteolin (from chrysanthemum leaf extract [Dendranthema morifolium]) Astaxanthin Cellulase Cinnamon Extract (Cinnamomum cassia) (bark) - wildcrafted Some of those herbs, foods or spices are TRP channel activators. If Inflammatory Bowel disease or colitis is a problem, then TRP over activity might be a problem and avoiding things like horseradish and cinnamon might be needed for bowel comfort (or to prevent migraines for me – cinnamon was a problem that I can now tolerate again). Disclaimer: This information is being shared for educational purposes within the guidelines of Fair Use and is not intended to provide individual health care guidance.
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Cardiometabolic Protocol - Metagenics
11 more items in Cardiometabolic Protocol - Metagenics
This Cardiometabolic Protocol includes support for the gut microbiome and our cardiovascular system. It is based on the Foundational Metabolic Health Protocol by Ovation Labs ( guide, pdf ) which includes the Metagenics brand products seen below (*all of the products are Metagenics brand unless otherwise specified - the last few are by Microbiome Labs, Pendulum, and Life Extension). Everything listed added up to $894 full price but there are duplicates. That also makes the nutrient totals too high, so I have deselected duplicates. That got the full price total down to $736.87. Not much better. I did leave quite a few of the microbiome products in the basket as they provide different beneficial species. Taking one for a couple months and then another and then another over six months, might be a way to try to recolonize the gut with healthy species while also trying to eat more zinc, resistant starches and fiber in your diet to support their ongoing growth. Unless we take antibiotics, ideally we should just be able to eat fermented foods for bacterial live culture boosts to our gut microbiome. There are five probiotic products in the basket (totaling $267) and one postbiotic Akkermansia product ($69.99) in the basket. Taking the postbiotic when initially the bowel is flared up and 'leaky' may help restore membrane integrity while diet and other probiotics are working on reestablishing a healthy balance of species in the gut. Fiber and resistant starch rich veggies help the beneficial species but a high carbohydrate diet or very high fat diet might not. Processed foods are also a way to promote negative species. What we eat is the restaurant buffet for our gut microbes. The helpful species in the expensive products cannot survive on processed food diets while negative species can. Taking a look at the grand total in daily nutrient intake led me to add an Only Trace Minerals product by Life Extension (and the basket total went up to $75.86). Older adults over age 65 may need more zinc, 50 mg of zinc per day, for thymus gland function. Depending on what products were selected there is overlap adding up to quite a bit of chromium. Gut microbiome health impacts the rest of our health. Akkermansia are a species of gut bacteria which have been found to be more prevalent in people who are centenarians - over 100 years old. The species helps our health by removing old mucin from our internal 'jelly-like' lining and builds new mucin. A postbiotic chemical created by the species also helps improve the tight junction between our intestinal cells, protecting the body's interior from undigested proteins or pathogens from entering. The product, SPM Active ®, provides that postbiotic support, but it added to the total basket cost - $122.99. If your gut issues are not severe, then focusing on diet improvement and probiotics like the Akkermansia product by Pendulum ; could help your microbiome build your own supply of postbiotics. If your gut issues are at the level of colitis or Inflammatory Bowel Disease than starting with the postbiotic Akkermansia product and adding the amino acid powdered drink mix, UltraInflamXPlus 360°®, Metgenics; , back into the basket might help the gut heal a little faster. Weight and glucose control, and multi-vitamin support. The Akkermansia Company™ Healthy Weight with Glucose Control ; take 1/day. The product contains Pasteurized Akkermansia muciniphila to support healthy weight and glucose metabolism. This is a postbiotic product which would help the tight junctions between cells in the intestine. PhytoMulti ® Multivitamin; take 2-3/day. The product contains a proprietary blend of 13 concentrated extracts and phytonutrients with scientifically tested biological activity to support cellular health and overall wellness. Pomegranate extract is included. The product also provides a basic one-a-day of vitamins and minerals with methyl forms of folate and B12. It has a plant-based capsule. Cautions: The folate amount is quite generous which might be a negative for some people - gene differences can make some people produce too much instead of too little and excess can also add to a risk for gout - uric acid derived from the abundance of purines. Citrus bioflavonoids are the primary ingredient in the phyto-blend, so someone with histamine excess may not be able to tolerate this product. [Not in the basket] MetaGlycemX ™; Take 2x/day. This product provides some of the basics of a one-a-day multivitamin without using citrus bioflavonoids and it contains methyl forms of folate and B12 in more moderate amounts than product 2 above. Choose one or the other, not both. An additional Trace Minerals complex might be helpful if this product was selected. MetaGlycemX includes methylcobalamin, biotin, chromium, and vitamins C, D and E among others. It contains a unique combination of green tea extract, cinnamon, and alpha-lipoic acid, nutrients that support healthy insulin metabolism when used as part of a healthy diet for maintaining healthy blood sugar levels already in the normal range. Green tea contains epigallocatechin gallate (EGCG), which may support healthy glucose metabolism. Alpha-lipoic acid is a potent antioxidant that acts as a free radical scavenger. Insinase ® 3/day Nutritional supplement with scientifically tested ingredients designed to support healthy insulin function. [Not in the basket] Berberine GT , Metagenics; Take 1-3/day; Supports healthy weight and glucose metabolism. Stress coping and general immune support SPM Active ®; take 2/day. This product is designed to help support the body’s natural capacity to respond to physical challenges and resolve the immune response. This may improve stress coping and symptoms of an over-active immune response seen during inflammation. Specialized pro-resolving mediators (SPMs) are molecules our bodies produce naturally in response to damaged tissue created during physical challenges and are a critical component of the body’s natural healing process. Unfortunately, the body may not produce enough SPMs on its own. Diet, lifestyle, excess body fat, and other health challenges can affect SPM production. That’s where the clinically studied product SPM Active can help. *It is not inexpensive. The SPMS are a specialized form of DHA that is may be absent when there is plenty of DHA in the blood. Taking it has helped with pain from osteoarthritis. https://www.nature.com/articles/s41598-017-09516-3 D3 5000 + K 1/day High-potency, bioactive vitamin D with vitamin K2. Magnesium Glycinate 3/day Magnesium is an essential mineral that acts as a cofactor in many metabolic processes. OmegaGenics® EPA DHA 1000 1-3/day Helps support cardiovascular, musculoskeletal, and Immune system health. Gut Microbiome support Depending on your health needs and your money supply, the first three of the following microbiome support products could be taken at the same time as they provide different species, or pick one at a time. The fourth product is a protein powder with probiotics for gut repair when colitis or Inflammatory Bowel Syndrome are problems. To support our butyrate producing Bifidobacterium species, we also need plenty of zinc and resistant starches in our diet - a 1/2 cup of pudding made with tapioca starch rather than a couple Gummies' worth. Cooked and chilled yucca root, parsnips, or potato and pasta salads have resistant starches and raw fruits and vegetables do also. Leeks and onions are a good source. This protocol has zinc in three different products, - the two multi-vitamin supplements in the first group, and the protein powder, #4 below, but I wouldn't recommend taking all three - it is too much methyl folate. Excess methyl folate can inhibit our methylation cycles and if we want Cardiometabolic health, then we want our methylation cycles to be functioning with aerobic efficiency. I have added a vitamin K2 product which also has 15 mg of zinc to help feed our butyrate producing species. GT UltraFlora® Control ; Take 1/day; Targeted to help control body weight. UltraFlora® Control is designed to help support body weight regulation by delivering targeted probiotic support as Bifidobacterium lactis B-420™ ††† which has been shown to help control body fat and body weight.* UltraFlora® 3-in-1 Gummy ; Take 2/day; Targeted probiotics + prebiotic fiber that naturally help promote overall health. UltraFlora 3 in 1, a proprietary synbiotic formula created by healthcare professionals, contains two clinically studied probiotic strains- Bacillus coagulans SNZ 1969 ® and Bacillus subtilis DE111® - known to promote gut and immune health, and to support healthy cholesterol levels in both adults and children. This daily supplement also features a prebiotic sourced from chicory root, which has been found to support levels of health-promoting bacteria Bifidobacterium in the gut. UltraFlora 3 in 1 synbiotic gummy formulation is free of added sugars, artificial-sweeteners, or gelatin, making it an ideal choice for those seeking a convenient and palatable alternative to traditional tablets or capsules. UltraFlora® BiomePro ; Take 1/day; This product contains a complex of eight clinically-studied probiotic strains to support gastrointestinal health and immune health. It does not need refrigeration. Proprietary Blend ... 105 billion CFU†† Lactobacillus acidophilus NCFM †††, Lactobacillus rhamnosus GG, Lactobacillus plantarum Lp-115, Bifidobacterium lactis Bl-04, Bifidobacterium lactis Bi-07†††, Lactobacillus paracasei Lpc-37, Lactobacillus rhamnosus HN001, Bifidobacterium lactis HN019. UltraInflamXPlus 360°®; 2 scoops 2x/day; This product is a medical food formulated to provide strategic macro- and micronutrient support for patients with compromised gut function resulting from inflammatory bowel disease, including ulcerative colitis and Crohn’s disease. Provided in a proprietary, vegan pea/rice protein base, this formula addresses increased nutrient needs and potential deficiencies in these patients. This formula features CurQfen®, a clinically studied, patented curcumin blend designed for greater bioavailability and more reliable clinical outcomes. It has been demonstrated to result in up to 45.5 times more free curcuminoids in human plasma compared to standard curcumin extract. UltraInflamX Plus 360° also features XNT ProMatrix®– a proprietary protein matrix technology designed to enhance the delivery of a high quality xanthohumol compound for increased bioavailability and stability. *This product is like a supplement protein shake to have between meals - extra protein of specific types of amino acids. Caution if sensitive to glutamine/glutamate or other amino acids. It provides some multi-vitamin support with methyl forms of folate and B12. It is expensive, providing a one week supply at the suggested dosing. It would be for a special need situation rather than for preventative health and might be the support needed to improve bowel health and avoid a more expensive medical situation. [Not in the basket] MegaQuinone K2-7, Microbiome Labs ; Take one per day. Provides vitamin K2, magnesium glycinate and 15 mg zinc. Akkermansia, Pendulum ; Take one per day. Refrigerate. MegaSporeBiotic, Microbiome Labs ; Take one per day, for two months. This product does not need to be refrigerated. The probiotics are spore forms of Bacillus species which help modulate the gut environment towards health. Only Trace Minerals, Life Extension , take one per day. *I have used this product for years. It does not provide iodine though. This link has an overview of many beneficial microbiome species and focuses on the Lactobacillus and Bacillus species. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586196/ Foundational Metabolic Health Protocol by Ovation Labs - colorful guide with three pages of references supporting the recommendations for the Metagenics products included here. This is a copy of the protocol summary provided by Ovation Labs. Lab tests that might be of value are included along with a brief listing of the products with dosing guidance: ( Cardiometabolic Protocol with Metagenics ) Disclaimer This information is being provided for educational purposes within the guidelines of Fair Use and is not intended to provide individual health guidance.
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Pregnancy Support
7 more items in Pregnancy Support
Pregnancy Support Protocol by Fullscript follows my notes- my modification/recommendation would be add more iodine or seaweed, at least 100 mcg worth of iodine. I added an Iodine from Kelp example product. See the post 'Iodine and Pregnancy' for the references, 250 mcg day is recommended. ( deNutrients.Substack ) I also added another prenatal multi vitamin, Vital brand which also would benefit from additional iodine and also more niacin. Both of the multi's in this protocol have methyl forms of folate and B12 which I do look for. The Vital brand prenatal multi vitamin has less iron and "is gentler on the stomach" - with 15 mg instead of the whopping 45 mg in the multi by Thorne. Pick one or the other, don't take them both. Other product examples are an omega-3 DHA supplement - liquid fruit flavored fish oils can be a less expensive and fresher choice. There is a calcium and a chelated magnesium supplement which can help protect bone health during pregnancy or lactation and provide for the baby's needs. Ginger extract may help with nausea, eating ginger could too, or sipping Gingerale. Lemonade and salty potato chips is a classic hyperemesis combination to give the body some electrolytes while nothing is staying down well. - Jennifer Depew, RD. Disclaimer: This information is provided for educational purposes within the guidelines of Fair Use and is not intended to provide individual health guidance. ~~ Overview Pregnancy may be a difficult time for some individuals, with various challenges. From nausea and vomiting to meeting various heightened nutritional requirements, supplemental nutrients can be a very useful tool for expecting mothers. ( Khorasani 2020 ) For example, multivitamin and mineral supplements can help mothers to hit these nutritional targets, and thereby reduce the risk of certain birth defects and preterm delivery. ( Wolf 2017 ) Some nutrients may require supplementation beyond a prenatal multivitamin in order to hit therapeutic targets for reducing the risk of pre-eclampsia or hospitalization. ( Makrides 2014 )( Regitz-Zagrosek 2018 ) Certain nutrients such as EPA and DHA are even associated with improved measures of infant cognitive development. ( Nevins 2021 ) Finally, certain therapeutics may reduce nausea and vomiting experienced during pregnancy. ( Khorasani 2020 ) Based on current research findings, the ingredients in the protocol below have been associated with improved health outcomes in women who are pregnant. Prenatal Multivitamin Variable based on ingredient and formulation, for 5-6 weeks within the preconceptional period A 2021 Australian systematic review of guidelines for complementary medicines and therapies found many of the guidelines to be recommending the following common ingredients in prenatal multivitamins: folic acid, vitamin D, iodine, iron, vitamin B6, and vitamin B12. ( Ee 2021 ) A 2017 systematic review (SR) and meta-analysis (MA) of multivitamin supplementation in high-income countries examined 98,926 females in 35 studies, finding reduced relative risk of small gestational age by 23%, neural tube defects by 33%, cardiovascular defects by 17%, urinary tract defects by 40%, and limb deficiencies by 32%. Due to the difficulty of having an ethical placebo group in studies on pregnancy, of the 35 studies, only four were randomized controlled trials. ( Wolf 2017 ) Folic acid A 2021 SR and MA of 39 studies examining folic acid supplementation concluded that folic acid was associated with a positive impact on an offspring’s neurodevelopmental outcomes, including improved intellectual development and reduced risk of autism traits, ADHD, behavioral, and language problems. ( Chen 2021 ) A Cochrane review found risk of neural tube defects was lowered at a dose of > 400 µg per day. ( De-Regil 2015 ) Iodine A Cochrane review found RCTs showing iodine supplementation reduced the risk of postpartum hyperthyroidism by 68%. ( Harding 2017 ) Iodine content in multivitamin products studied was typically found to be sufficient (> 150 μg). ( Leung 2009 ) Iron Many women, even in developed countries, may be at risk of low iron status. A cohort study found that 68-82% of pregnant Australian females were not meeting the recommended daily intake of iron. ( Livock 2017 ). A 2015 Cochrane review found preventative iron supplementation reduced the risk of maternal anemia at term by 70%, iron-deficiency anemia at term by 67%, and iron deficiency at term by 57%. This Cochrane review found moderate-quality evidence of a borderline significant reduction in preterm babies of 7%. ( Peña-Rosas 2015 ) The same Cochrane review found no significant differences in effectiveness or likelihood of side effects for daily vs. weekly dosing of iron. ( Peña-Rosas 2015 ) Vitamin B12 A 2021 SR of complementary medicines and therapies in clinical guidelines in pregnancy found no consistent recommendations for B12, except four organizations recommending routine supplementation for vegetarians and vegans and two recommending the intervention after screening for deficiencies. ( Ee 2021 ) The lowest quartiles in three different Irish cohorts had 2-3x the risk of neural tube defects versus the highest quartiles. To reduce neural tube defects, the authors recommended vitamin B12 levels of at least >221 pmol/L (>300 ng/L) prior to conception. ( Molloy 2009 ) Vitamin B6 A 2021 SR of complementary medicines and therapies in clinical guidelines in pregnancy found five guidelines recommended routine supplementation with vitamin B6, for its moderate-quality evidence for nausea and vomiting and safety. ( Ee 2021 ) 20-80 mg of vitamin B6 daily was found to be effective for nausea and vomiting in pregnancy in this 2020 SR. ( Khorasani 2020 ) Vitamin D A 2019 Cochrane review found a reduced relative risk of pre-eclampsia by 52%, gestational diabetes by 49%, low birthweight by 45%, and may reduce risk of severe postpartum hemorrhage by 32%. ( Palacios 2019 ) A 2021 SR of complementary medicines and therapies in clinical guidelines in pregnancy found three regulatory bodies recommending vitamin D at 400 IU to all pregnant women, and four organizations recommended over 1000 IU if a deficiency of less than 50 nmol/L of 25-hydroxyvitamin D was found. ( Ee 2021 ) Omega-3 Fatty Acids > 1g of combined EPA and DHA per day from early pregnancy (<20 weeks) to 34 weeks ( Sun 2020 ) Omega-3 fatty acids are an ingredient typically not found in a prenatal multivitamin or not in high enough quantity. A 2018 Cochrane meta-analysis (MA) of the addition of omega-3 fatty acids during pregnancy concluded that high-quality evidence showed a risk reduction of 11% for preterm birth (less than 37 weeks), a 42% risk reduction of early preterm birth (less than 34 weeks), and a 10% risk reduction of low birth weight. Studies tended towards favoring higher DHA formulations, though there was no tendency towards higher or lower doses of omega-3s being favorable. ( Middleton 2018 ) Subgroup analysis of a 2020 SR and MA found that prenatal supplementation with ≥ 1g of combined EPA and DHA significantly reduced preterm birth. ( Sun 2020 ) Five of eight RCTs examined in a 2021 SR on omega-3 fatty acid supplementation during pregnancy found significantly improved measures of infant cognitive development by 6-11%. ( Nevins 2021 ) A 2021 SR and MA of 11 RCTs showed no significant effect or adverse effects of omega-3 fatty acids for perinatal depression prevention or treatment across different dosages and ratios of EPA and DHA. ( Suradom 2021 ) Omega 3’s Ingredient Review Ginger Ginger 35-500mg of ginger daily for 2 months ( Khorasani 2020 ) Ginger is an ingredient typically not found in prenatal multivitamins, though it may be very useful for typical morbidities found in pregnancy. A 2021 SR of complementary medicines and therapies in clinical guidelines in pregnancy found six regulatory bodies recommending ginger for the treatment of nausea and/or vomiting in pregnancy. ( Ee 2021 ) Five of these bodies also recommended the use of vitamin B6 for the same indication. A 2020 SR on alternative medicine treatments for nausea and vomiting in pregnancy found ginger and vitamin B6 to be equally effective for up to 60 days at doses of 35-500 mg for ginger and 20-80 mg for vitamin B6. Beyond 60 days, vitamin B6 was found to be superior to ginger. ( Khorasani 2020 ) Ginger Ingredient Review Calcium Calcium 1-2g per day, especially if dietary intake less than 600 mg, from 28-32 weeks until delivery ( Hofmeyr 2018 )( Regitz-Zagrosek 2018 ) Calcium is an ingredient typically not found in high enough quantities in prenatal multivitamins, though it is commonly recommended; a 2021 SR of complementary medicines and therapies in clinical guidelines in pregnancy found five organizations recommending calcium supplementation for low dietary intake for prevention of pre-eclampsia. For instance, one organization recommended 1.5-2 g per day for dietary intake of less than 600 mg per day. ( Regitz-Zagrosek 2018 ) The risk of preterm birth was found to be 24% lower in high dose (over one gram) calcium supplementation in a 2018 Cochrane review. Additionally, pre-eclampsia risk was lowered by 55% overall and 64% in women with low calcium diets. Publication bias was noted. Lastly, maternal death and/or serious morbidity were reduced by 20% ( Hofmeyr 2018 ) Calcium Ingredient Review Magnesium Magnesium 365 mg of magnesium citrate or aspartate per day from 13-24 weeks until birth ( Makrides 2014 ) Magnesium is an ingredient typically not found in high enough quantities in prenatal multivitamins, though it may have certain benefits; a 2014 Cochrane SR found magnesium supplementation to be associated with higher Apgar scores in newborns, along with less likelihood of hospitalization by 35%. Null effects were noted on perinatal mortality, low birth weight, or pre-eclampsia. ( Makrides 2014 ) Additionally, a 2021 MA of RCTs found no significant effect of magnesium supplementation in pregnancy on leg cramps. No side effects were noted. ( Liu 2021 ) There was considerable heterogeneity in dosing in magnesium trials. However, more common formulations were magnesium citrate or aspartate, at doses of 365 mg per day. ( Makrides 2014 ) Magnesium Ingredient Review Evidence rating The following protocols were developed using only a,b,c -quality evidence Learn more about our rating scale References Abboud, M., Rizk, R., AlAnouti, F., Papandreou, D., Haidar, S., & Mahboub, N. (2020). The Health Effects of Vitamin D and Probiotic Co-Supplementation: A Systematic Review of Randomized Controlled Trials. Nutrients , 13 (1). https://doi.org/10.3390/nu13010111 – A Bashir, M., Prietl, B., Tauschmann, M., Mautner, S. I., Kump, P. K., Treiber, G., Wurm, P., Gorkiewicz, G., Högenauer, C., & Pieber, T. R. (2016). Effects of high doses of vitamin D3 on mucosa-associated gut microbiome vary between regions of the human gastrointestinal tract. European Journal of Nutrition , 55 (4), 1479–1489. https://doi.org/10.1007/s00394-015-0966-2 – D Chedid, V., Dhalla, S., Clarke, J. O., Roland, B. C., Dunbar, K. B., Koh, J., Justino, E., Tomakin, E., & Mullin, G. E. (2014). Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Global Advances in Health and Medicine , 3 (3), 16–24. https://doi.org/10.7453/gahmj.2014.019 – D Chen, M.-R., Zhao, J., Fu, S.-F., Yu, J.-Q., Zhang, X., Zhang, Q.-Y., & Zhou, Z.-H. (2019). Clinical practice of Chinese medicine navel therapy for chronic diarrhea: A literature review. Journal of Gastroenterology and Hepatology , 34 (4), 643–649. https://doi.org/10.1111/jgh.14549 – F Ee, C., Levett, K., Smith, C., Armour, M., Dahlen, H. G., Chopra, P., Maroun, P., Rao, V. S., Avard, N., Grant, S., Keedle, H., Armour, S., Arentz, S., Cave, A. E., Sutcliffe, K., & Templeman, K. (2021). Complementary medicines and therapies in clinical guidelines on pregnancy care: A systematic review. Women and Birth: Journal of the Australian College of Midwives . https://doi.org/10.1016/j.wombi.2021.08.003 – A García-Collinot, G., Madrigal-Santillán, E. O., Martínez-Bencomo, M. A., Carranza-Muleiro, R. A., Jara, L. J., Vera-Lastra, O., Montes-Cortes, D. H., Medina, G., & Cruz-Domínguez, M. P. (2020). Effectiveness of Saccharomyces boulardii and Metronidazole for Small Intestinal Bacterial Overgrowth in Systemic Sclerosis. Digestive Diseases and Sciences , 65 (4), 1134–1143. https://doi.org/10.1007/s10620-019-05830-0 – D Gurusamy, S. R., Shah, A., Talley, N. J., Koloski, N., Jones, M. P., Walker, M. M., Morrison, M., & Holtmann, G. (2021). Small Intestinal Bacterial Overgrowth in Functional Dyspepsia: A Systematic Review and Meta-Analysis. The American Journal of Gastroenterology , 116 (5), 935–942. https://doi.org/10.14309/ajg.0000000000001197 – A Kubota, Y., Nagano, H., Ishii, K., Kono, T., Kono, S., Akita, S., Mitsukawa, N., & Tanaka, T. (2020). Small intestinal bacterial overgrowth as a cause of protracted wound healing and vitamin D deficiency in a spinal cord injured patient with a sacral pressure sore: a case report. BMC Gastroenterology , 20 (1), 283. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444194/ – D Lauritano, E. C., Gabrielli, M., Scarpellini, E., Lupascu, A., Novi, M., Sottili, S., Vitale, G., Cesario, V., Serricchio, M., Cammarota, G., Gasbarrini, G., & Gasbarrini, A. (2008). Small intestinal bacterial overgrowth recurrence after antibiotic therapy. The American Journal of Gastroenterology , 103 (8), 2031–2035. https://doi.org/10.1111/j.1572-0241.2008.02030.x – D Lissiman, E., Bhasale, A. L., & Cohen, M. (2014). Garlic for the common cold. Cochrane Database of Systematic Reviews , 11 , CD006206. https://doi.org/10.1002/14651858.CD006206.pub4 – A Liu, J., Song, G., Zhao, G., & Meng, T. (2021). Effect of oral magnesium supplementation for relieving leg cramps during pregnancy: A meta-analysis of randomized controlled trials. Taiwanese Journal of Obstetrics & Gynecology , 60 (4), 609–614. https://doi.org/10.1016/j.tjog.2021.05.006 – A Logan, A. C., & Beaulne, T. M. (2002). The treatment of small intestinal bacterial overgrowth with enteric-coated peppermint oil: a case report. Alternative Medicine Review: A Journal of Clinical Therapeutic , 7 (5), 410–417. https://www.ncbi.nlm.nih.gov/pubmed/12410625 – D Middleton, P., Gomersall, J. C., Gould, J. F., Shepherd, E., Olsen, S. F., & Makrides, M. (2018). Omega-3 fatty acid addition during pregnancy. Cochrane Database of Systematic Reviews , 11 , CD003402. https://doi.org/10.1002/14651858.CD003402.pub3 – A Palacios, C., Kostiuk, L. K., & Peña-Rosas, J. P. (2019). Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews , 7 , CD008873. https://doi.org/10.1002/14651858.CD008873.pub4 – A Shang, M., & Sun, J. (2017). Vitamin D/VDR, Probiotics, and Gastrointestinal Diseases. Current Medicinal Chemistry , 24 (9), 876–887. https://doi.org/10.2174/0929867323666161202150008 – F Si, X.-B., Zhang, X.-M., Wang, S., Lan, Y., Zhang, S., & Huo, L.-Y. (2019). Allicin as add-on therapy for Helicobacter pylori infection: A systematic review and meta-analysis. World Journal of Gastroenterology: WJG , 25 (39), 6025–6040. https://doi.org/10.3748/wjg.v25.i39.6025 – A Wang, J., Gu, S., & Qin, B. (2021). Efficacy of Helicobacter pylori eradication therapy for treatment of functional dyspepsia: A protocol for systematic review and meta-analysis. Medicine , 100 (20), e26045. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136982/ – A Yu, M., Jin, X., Liang, C., Bu, F., Pan, D., He, Q., Ming, Y., Little, P., Du, H., Liang, S., Hu, R., Li, C., Hu, Y. J., Cao, H., Liu, J., & Fei, Y. (2020). Berberine for diarrhea in children and adults: a systematic review and meta-analysis. Therapeutic Advances in Gastroenterology , 13 , 1756284820961299. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7586028/ – A Disclaimer: Protocols are intended solely as an informational reference tool for practicing health care professionals. The content provided is not intended to be for medical diagnosis or treatment, is not a substitute for your professional judgment, and is not meant to provide you medical or professional advice. You should evaluate and independently confirm the appropriateness of the content provided, including verifying uses, dosages, warnings and contraindications on product labels, and rely on your experience and judgment and other available resources when applying the provided content to an actual client care situation. While content has been obtained from sources believed to be reliable, we cannot and do not guarantee the accuracy, validity, timeliness or completeness of the content. 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Lymphedema / Venous Insufficiency
7 more items in Lymphedema / Venous Insufficiency
Lymphedema Protocol, *may also be Alzheimer's preventative . Swelling in the lower leg area when sitting or standing still for too long, and from salt intake, can be due to lymphatic vessel insufficiency. Lack of essential nutrients can be a causal factor. Genetics can be involved too. Compression socks helps and moving more regularly - set a timer to get up for a few minutes every half hour or so. A lymphedema exercise routine also helps promote lymph flow. See: 10 Exercises for Leg Lymphedema (Swelling or Edema of the Lower Extremities) , ( Youtube ) Physical trauma can be a factor - sitting too long is cutting off circulation and can lead to pressure sore type bruising which damages lymphatic and blood vessels. See the attached handout for references and more information about how lymphedema and Alzheimer's risk may be related. Lymphedema Protocol - the link is after the text section and before the supplement images. >> Iodine, selenium, magnesium, vitamin B6, biotin, other B vitamins and vitamin A and C adequacy are all helpful. Omega 3 fatty acids and glycine also help membrane health. >> A good multivitamin can cover the basic needs. Basic Nutrients 2/Day , Thorne , 60 capsules (vegetarian) *This is a methyl folate and B12 mix with generous amounts of other B vitamins also and 250 mg of vitamin C. It contains 75 mcg of iodine in a 2 capsule serving which is less than needed probably. It has minimal amounts of calcium and magnesium and a few trace minerals but not all of them. It does not have any CoQ10. >> Hesperidin methyl chalcone (HMC) in combination with ruscus extract and vitamin C may be helpful. Product examples 1, 2, 3, 4. >> Silica/Horsechestnut extract may be helpful. Product example 4. >> EGCG/catechins and other polyphenols or delphinidin can help stabilize proteins in proper folds and stabilize intra and extracellular fluid. Green tea and pomegranate peel are good sources of EGCG and pomegranate has other catechins, delphinidin and other beneficial phytonutrients. >> Pomegranate extract also helps as a diuretic. Dandelion leaf or root would also and is considered safe in for use in childbearing years or during pregnancy and lactation. Rooibos tea is also safe for pregnancy, lactation and children and may help reduce edema. Pomegranate Extract , Life Extension , 30 capsules (vegetarian) - contains 400 mg of Pomella, standardized to 30% punicalagins - tested in clinical trials, and 100 mg of pomegranate fruit (5-1) extract. I added three examples of dandelion products, a tea, an extract which you would add a dropperful of to a beverage or water, or a capsule product - pick one. Using both dandelion and pomegranate can be okay as long as the diuretic effect is a good amount for your body. First thing in the morning a little salt and a drink of water might be needed to replace lost electrolytes from urination to settle the stomach. Avoiding salt for the rest of the day helps reduce leg swelling in lymphedema. A product designed for menopause includes HMC along with lepidium meyeneii root extract, (Maca Root extract): 1. Warmi , Lane Medical , one capsule per day, (90 capsule bottle), Vegetarian capsule. Proprietary blend ... 510mg Organic lepidium meyeneii root extract (* Maca Root extract is okay for men and women's use.) Hesperidin methyl chalcone (a methylated form of hesperidin which is found in citrus peel) NeuroO2, a venous support product for brain health (#2) contains ruscus extract (Butcher's Broom), gingko biloba, vinpocetine, and cayenne pepper all of which have been shown to be helpful for cardiovascular health. Riboflavin is vitamin B and it helps with methylation cycle support. The magnesium is helpful but not a 100% of a day's needs. Feverfew is used for migraines. I have used all of these individually for an ongoing basis except the ruscus extract and cayenne pepper. This product does contain a typically used amount of vinpocetine, Gingko and Feverfew. It seems like it could be a good deal - fewer capsules to swallow, fewer bottles to buy. The other examples also have good blends with therapeutic amounts of the ingredients instead of tiny smidge. 1 through 4 contain similar things and picking one would be the recommendation. Add vitamin C if the blended product doesn't contain it, 100-400 mg/day would be enough to help without risking excess acidity or oxalate crystal formation. 2. NeurO2™ , Apex Energetics, Inc , 90 capsules (vegetarian), 2 per day recommendation Per one capsule: Riboflavin ... 20mg Magnesium ... 40mg (as magnesium citrate) Feverfew Extract ... 300mg (Tanacetum parthenium) (flower) (standardized to 0.7% parthenolide) Butcher's Broom Extract ... 200mg (Ruscus aculeatus) (root, fruit & flower) (standardized to 20% saponins) Ginkgo Extract ... 100mg (Ginkgo biloba) (leaf) (standardized to 24% flavone glycosides and 6% terpene lactones) Cayenne Pepper ... 40mg (Capsicum annuum) (fruit) Vinpocetine ... 10mg 3. Healthy Veins , DaVinci Labs , 60 capsules (vegetarian) - combines vitamin C with ruscus and hesperidin, 2 capsules per day provides: Vitamin C ... 75mg (as Ascorbic Acid) Diosmin .. .600mg (from citrus peel, has been found helpful for " hemorrhoids, varicose veins, poor circulation in the legs (venous stasis), and bleeding (hemorrhage) in the eye or gums " ( RxList.com ) (bioflavonoid) Proprietary blend ... 290mg Containing: Butchers Broom Root Extract, Mixed Citrus Bioflavonoids Hesperidin ... 60mg 4. Veinoblend , Vitanica , 90 capsules (vegetarian) Serving Size: 1 Capsule Vitamin C ...250mg (as calcium ascorbate, buffered) Bioflavonoids (from citrus) ...250mg Bromelain ...100mg (can help reduce congestion or fibrosis within vessels) Butcher's Broom extract ...100mg (10% ruscogienim) (Ruscus aculeatus) Horse chestnut extract ...100mg (source of silica which helps vessel/membrane health) (aescin 20%) (Aesculus hippocastanum) Gotu kola extract ...40mg (shown to help reduce swelling, high blood pressure, and improve cognitive health/memory. It may promote collagen production.) (10% centella triterpenes) (Centella asiatica) Grape seed extract ...20mg (source of resveratrol, shown helpful for circulatory health) (95% proanthocyanidins) (Vitis vinifera) Disclaimer: This information is being shared for educational purposes within the guidelines of Fair Use and is not intended to provide individual health guidance.
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Colitis and microbiome support
3 more items in Colitis and microbiome support
Standard probiotics only address the microbes that live in the oxygen rich areas of the intestines. Zinc and resistant starch foods are needed to support beneficial species in the intestines and colon. In the colon it is oxygen free and standard yogurt type of fermented foods will not replenish that area of the microbiome. Either area of our gut will be helped by avoiding highly processed foods and strong emulsifiers that are now common in dairy type products. Whether called "natural" or not - the emulsifiers may be so creamily effective that they 'emulsify' our gut lining too. Ultra-processed foods as a larger proportion of a daily diet has been linked to more overweight/obesity, greater waist circumference ('apple' shape belly instead of a hippy 'pear'), Metabolic Syndrome, and an increased mortality rate. ZINC : Our healthy species of microbiome bacteria need about 30% of the zinc that we eat - so for us and them to have enough we need plenty. The current nutrient guidelines are likely about half of what an older adult needs. Teens and younger adults may benefit from ~ 25 mg of zinc and 2 mg of copper per day and adults over 65 may do better with 50 mg of zinc and 3 mg of copper per day. *Zinc can reduce copper absorption. Some diners may be low in copper intake but on average the standard diet tends towards enough copper and not enough zinc. Meat and shellfish eaters (oysters have 75 mg in a serving could reach excessive intake if a daily habit) would likely be eating more zinc than vegetarians or vegans. In older adults the thymus gland loses function and the increased intake of zinc may help maintain or restore its function. The thymus gland is where antibody forming immune cells are formed - so having thymus function intake is really MORE important than being given a vaccine. Higher dose zinc supplements can be hard on the stomach so do take them with a meal and ideally take zinc at one meal and other trace mineral supplements (like the copper) at another meal. This high dose zinc is in an amino acid chelate form and includes a small amount of pumpkin seed as a natural source of zinc. Chelated minerals may be better absorbed and less likely to cause stomach upset. ( Brand product page ) Zinc 50 , Solaray , 100 capsules $9.99 ($7.99 with 20% discount) Zinc Plus, Klaire Labs, 60 capsules $14.99 ($11.99) - this product provides a smaller amount of zinc (15 mg) along with 1 mg of copper and some vitamin B6 (4 mg) and vitamin C (60 mg). That is convenient - one could be taken in the morning and evening to be closer to a generous 25-30 mg daily intake. Caution - when taking mixed supplements and a one-a-day - do the math. Add up the total amount of 'elemental' mineral or vitamin to double check if it is nearing excess amounts. For people who don't like pills, trace minerals and/or zinc can be purchased in liquid forms to add by dropper amounts to a small amount of beverage or food. Lack of zinc can cause loss of appetite to an anorexic level. I have started adding zinc/trace mineral drops to a 2 ounce juice serving for my mother with Alzheimer's as she no longer swallows pills well and has had diminished appetite. The addition of the drops did seem to help. Different drops: Zinc , Global Healing Center , 2 ounces $24.95 ($19.96) - vegan, organic guava leaves is the source and is suposed to be gentle on the stomach as it is still in a chelate from the plant extract. This product provides 7.5 mg of elemental zinc in 1 milliliter dropper - take twice a day is the product recommendation. More could be used for a higher dose. Polyphenols : Catechin type polyphenols from pomegranate/peel and green tea and other polyphenols have been found to help promote the butyrate forming species that live in anaerobic colon. Dark chocolate products have more of the polyphenols left than refined milk chocolate or very refined chocolate syrup. Unsweetened cocoa powder to use in your own chocolate drinks or foods would provide more of the beneficial but bitter tasting polyphenols. Bitter tasting phytonutrients are medicinal but are removed from processed foods to increase "consumer acceptance" - the average consumer likes bland and sweet or maybe the excessively spicy excitotoxin effect of Nacho-flavored snack chips. Products may be available for purchase, but one dinky capsule of polyphenols is not going to do as much as eating more strongly flavored plant foods every day - more oregano, rosemary, leeks - more dark cocoa, pomegranate products, and maybe some green tea or red wine if you like it. I will add some products but I am a fan of "food first" - if our microbes eat 30% of our zinc, then a supplement might help - but if they are eating 30% of our dietary resistant starch - then a capsule of starch is not going to help you or the microbes much. The catechins in pomegranate peel or green tea are so strong that some can fit in a capsule. Probiotics : The other reason to focus on food first is price - we need food and little capsules of stuff is not really giving us protein or other macronutrients like resistant starches. The company Pendulum has developed a method for growing the anaerobes that can help our colon, and packaging them in a capsule - and it is out of stock and pricy ~ $50/30 capsules. Akkermansia muciniphila are particularly helpful because they can breakdown the mucilaginous structure of the biofilm that protects our cells and intestinal lining. The species was found to be more prevalent in people living over 100 years and can be low in colitis and other chronic conditions. We need a mucus layer lining our intestines and forming a barrier against pathogens and toxins in between our cells but too much is like congestion - adding too much stickiness. Pendulum Akkermansia , Pendulum, 30 capsules, Out of stock until approx.  May 22  (in 26 days). Another colon/butyrate producing species is also available from the company and is in stock. Akkermansia is a newer release. Butyricum, Pendulum , 30 capsules, $49.99 ($39.99 with a 20% discount) And they have a Polyphenol support product to help feed the Butryricum or Akkermansia species. Polyphenol Booster, Pendulum , 60 capsules $35.99 ($28.79) Polyphenols are bulky - the company is recommending two capsules a day which would provide: Serving Size:  2 capsules, Amount per Serving Pomegranate Extract  ... 375mg (Punica granatum, peel) (90% Ellagic acid) Grape Seed Extract  ... 275mg (Vitis vinifera) (95% Proanthocyanidins) Green Tea Extract  ... 225mg Camellia sinensis, Leaf) (95% EGCG) Other Ingredients:  Hypromellose (Vegetarian capsule). NOTE: If it seems like I focused on zinc - very perceptive of you to have noticed - I did. If a healthy microbiome needs 30% of the zinc in our daily diet - then being low in zinc is going to be a surefire way to have an unhealthy microbiome and/or and unhealthy body. Zinc is very important for gene transcription. We can't make taste buds without zinc being available for a gene transcription protein - like an ON switch for genes. Attached is a document with more information about the company Pendulum and the Akkermansia species. ( Colitis/Microbiome pdf in my Dropbox )
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