Public protocols
20 of Alegro Health Fullscript Account's general recommendations, available to anyone who visits this store.
Neurological Health - Mood Support
The ingredients presented in the protocol below reflect research findings demonstrating the efficacy of herbs and supplements that might be used to support mood and associated symptoms. Fluctuations in mood are common and normal; however, prolonged disruptive patterns in mood can present themselves at various times in life. One of the most common mood conditions is that of depression or depressive symptoms, with an overall pooled prevalence cited at 27%. (28) Specific populations may be more susceptible to these symptoms. Factors such as gender and age play a role in risk factors associated with depressed moods. (23) Depressed moods may be present in conjunction with other cognitive dysfunction such as anxiety, memory problems, and sleep disorders. Depending on the individual patient’s needs, there are a variety of options to address their symptoms. Pharmaceutical interventions such as antidepressants are typically used to address prolonged periods of low mood or diagnosed depression. Supplements such as the herb St. John’s Wort (Hypericum perforatum) and 5-HTP have shown potential promising effects on mood symptoms. (11)(19) Omega-3 fatty acids are another option that might also have benefits on memory and sleep symptoms. (10) Moderating stress with an adaptogen such as Rhodiola can also play a role in assisting with mood function. (1) St. John’s Wort ( Hypericum perforatum) 600 mg, total per day of 0.3 % hypericin and 1-4 % hyperforin standardized formula, minimum 6 weeks (2)(4)(5)(6)(7) Hypericum perforatum demonstrated similar efficacy to SSRIs for remission rate and HAM-D symptom scores after 4-12 weeks in patients with mild to moderate depression (3)(19) Improvement in relapse rates, Hamilton-Anxiety Scale, Beck Depression Inventory time courses, and greater overall improvement (Clinical Global Impressions (CGI) scale) was observed; additional potential for a prophylactic effect on symptoms in patients with chronic depression or depression alone (13)(15)(25) May have a similar magnitude of effect as antidepressant medications, including an increased memory for positive words, and a decreased ability to recognize disgusted faces or fearful faces (29) Omega-3 fatty acids 930-1400 mg EPA and 200-750 mg DHA, total per day, minimum of 12 weeks (4)(6)(11)(12) Dietary omega-3 polyunsaturated fatty acids may be related to a lower the risk of depressive symptoms (9)(17)(26) Increased plasma levels of EPA and DHA, as well as a higher EPA/DHA:AA ratio, may be correlated with improved remission rate (6) Omega-3 polyunsaturated fatty acids containing more than or equal to 60% EPA and a total of at least 1 gram per day improved mood symptoms and inflammatory markers (14) When provided as adjuvant therapy to sertraline, patients experienced improved mood symptoms, improved sleep, and reduced sensitivity to anxiety symptoms (10) Rhodiola rosea Rhodiola ( Rhodiola rosea) 340 mg, total per day, minimum of 6 weeks (7)(16) May improve mood symptoms through improved cell response to stress and neuroendocrine-immune and neurotransmitter effects (1) Improved symptoms of insomnia, somatization, and emotional instability (7) A decrease in HAM-D score was observed with fewer adverse effects than sertraline (16) Improved self-rated symptoms for mood and anxiety, as well as decreased serum superoxide dismutase and malondialdehyde levels, suggesting improvements in oxidative stress (30) Magnesium 250-500 mg equivalent of elemental magnesium, per day, for a minimum of 6 weeks (5)(21)(27) Magnesium chloride for two weeks reduced PHQ-9 scores by six points in adults with mild to moderate symptoms of depression (27) When given to elderly patients with type 2 diabetes and hypomagnesemia, magnesium chloride had similar outcomes to imipramine (5) After eight weeks, patients who received magnesium oxide at 500 mg total per day reported improved Beck Depression Inventory-II scores and normalized magnesium levels by 88.5% (21) A systematic review found dietary magnesium levels to be associated with lower depressive symptoms, and indicated possible use as adjuvant therapy (8) 5-Hydroxytryptophan (5-HTP) 100-400 mg per day, up to 8 weeks, either alone or with an antidepressant (1)(2)(22) A systematic review of 13 studies supported the use of 5-HTP for improving remission rate (0.65), as determined by questionnaire results (12) Patients receiving L-5-hydroxytryptophan (73%) experienced similar improvements in HAM-D mood scores compared to those receiving fluoxetine medication (80%) for two to eight weeks following their first depressive episode (11) Patients receiving chlorimipramine with concomitant L-5-HTP (vs. placebo) experienced greater improvements in HAM-D mood scores after 28 days (18) Evidence rating The following protocols were developed using only a,b,c -quality evidence Learn more about our rating scale References Amsterdam, J. D., & Panossian, A. G. (2016). Rhodiola rosea L. as a putative botanical antidepressant. Phytomedicine: International Journal of Phytotherapy and Phytopharmacology , 23 (7), 770–783. https://pubmed.ncbi.nlm.nih.gov/27013349/ (A) Angst, J., Woggon, B., & Schoepf, J. (1977). The treatment of depression with L-5-hydroxytryptophan versus imipramine. Results of two open and one double-blind study. Archiv Fur Psychiatrie Und Nervenkrankheiten , 224 (2), 175–186. https://pubmed.ncbi.nlm.nih.gov/336002/ (C) Apaydin, E. A., Maher, A. R., Shanman, R., Booth, M. S., Miles, J. N. V., Sorbero, M. E., & Hempel, S. (2016). A systematic review of St. John’s wort for major depressive disorder. Systematic Reviews , 5 (1), 148. https://pubmed.ncbi.nlm.nih.gov/27589952/ (A) Arnold, L. E., Young, A. S., Belury, M. A., Cole, R. M., Gracious, B., Seidenfeld, A. M., Wolfson, H., & Fristad, M. A. (2017). Omega-3 Fatty Acid Plasma Levels Before and After Supplementation: Correlations with Mood and Clinical Outcomes in the Omega-3 and Therapy Studies. Journal of Child and Adolescent Psychopharmacology , 27 (3), 223–233. https://pubmed.ncbi.nlm.nih.gov/28157380/ (C) Barragán-Rodríguez, L., Rodríguez-Morán, M., & Guerrero-Romero, F. (2008). Efficacy and safety of oral magnesium supplementation in the treatment of depression in the elderly with type 2 diabetes: a randomized, equivalent trial. Magnesium Research: Official Organ of the International Society for the Development of Research on Magnesium , 21 (4), 218–223. https://pubmed.ncbi.nlm.nih.gov/19271419/ (C) Carney, R. M., Steinmeyer, B. C., Freedland, K. E., Rubin, E. H., Rich, M. W., & Harris, W. S. (2016). Baseline blood levels of omega-3 and depression remission: a secondary analysis of data from a placebo-controlled trial of omega-3 supplements. The Journal of Clinical Psychiatry , 77 (2), e138–e143. https://pubmed.ncbi.nlm.nih.gov/26930527/ (C) Darbinyan, V., Aslanyan, G., Amroyan, E., Gabrielyan, E., Malmström, C., & Panossian, A. (2007). Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression. Nordic Journal of Psychiatry , 61 (5), 343–348. https://pubmed.ncbi.nlm.nih.gov/17990195/ (B) Derom, M.-L., Sayón-Orea, C., Martínez-Ortega, J. M., & Martínez-González, M. A. (2013). Magnesium and depression: a systematic review. Nutritional Neuroscience , 16 (5), 191–206. https://pubmed.ncbi.nlm.nih.gov/23321048/ (A) Grosso, G., Micek, A., Marventano, S., Castellano, S., Mistretta, A., Pajak, A., & Galvano, F. (2016). Dietary n-3 PUFA, fish consumption and depression: A systematic review and meta-analysis of observational studies. Journal of Affective Disorders , 205 , 269–281. https://pubmed.ncbi.nlm.nih.gov/27544316/ (A) Jahangard, L., Sadeghi, A., Ahmadpanah, M., Holsboer-Trachsler, E., Sadeghi Bahmani, D., Haghighi, M., & Brand, S. (2018). Influence of adjuvant omega-3-polyunsaturated fatty acids on depression, sleep, and emotion regulation among outpatients with major depressive disorders – Results from a double-blind, randomized and placebo-controlled clinical trial. Journal of Psychiatric Research , 107 , 48–56. https://pubmed.ncbi.nlm.nih.gov/30317101/ (B) Jangid, P., Malik, P., Singh, P., Sharma, M., & Gulia, A. K. D. (2013). Comparative study of efficacy of l-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode. Asian Journal of Psychiatry , 6 (1), 29–34. https://pubmed.ncbi.nlm.nih.gov/23380314/ (C) Javelle, F., Lampit, A., Bloch, W., Häussermann, P., Johnson, S. L., & Zimmer, P. (2020). Effects of 5-hydroxytryptophan on distinct types of depression: a systematic review and meta-analysis. Nutrition Reviews , 78 (1), 77–88. https://pubmed.ncbi.nlm.nih.gov/31504850/ (A) Kasper, S., Volz, H. P., Möller, H. J., Dienel, A., & Kieser, M. (2008). Continuation and long-term maintenance treatment with Hypericum extract WS 5570 after recovery from an acute episode of moderate depression–a double-blind, randomized, placebo controlled long-term trial. European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology , 18 (11), 803–813. https://pubmed.ncbi.nlm.nih.gov/18694635/ (B) Liao, Y., Xie, B., Zhang, H., He, Q., Guo, L., Subramaniapillai, M., Fan, B., Lu, C., & Mclntyer, R. S. (2019). Efficacy of omega-3 PUFAs in depression: A meta-analysis. Translational Psychiatry , 9 (1), 190. https://pubmed.ncbi.nlm.nih.gov/31383846/ (A) Mannel, M., Kuhn, U., Schmidt, U., Ploch, M., & Murck, H. (2010). St. John’s wort extract LI160 for the treatment of depression with atypical features – a double-blind, randomized, and placebo-controlled trial. Journal of Psychiatric Research , 44 ( 12), 760–767. https://pubmed.ncbi.nlm.nih.gov/20181361/ (B) Mao, J. J., Xie, S. X., Zee, J., Soeller, I., Li, Q. S., Rockwell, K., & Amsterdam, J. D. (2015). Rhodiola rosea versus sertraline for major depressive disorder: A randomized placebo-controlled trial. Phytomedicine: International Journal of Phytotherapy and Phytopharmacology , 22 (3), 394–399. https://pubmed.ncbi.nlm.nih.gov/25837277/ (C) Mocking, R. J. T., Harmsen, I., Assies, J., Koeter, M. W. J., Ruhé, H. G., & Schene, A. H. (2016). Meta-analysis and meta-regression of omega-3 polyunsaturated fatty acid supplementation for major depressive disorder. Translational Psychiatry , 6 , e756. https://pubmed.ncbi.nlm.nih.gov/26978738/ (A) Nardini, M., De Stefano, R., Iannuccelli, M., Borghesi, R., & Battistini, N. (1983). Treatment of depression with L-5-hydroxytryptophan combined with chlorimipramine, a double-blind study. International Journal of Clinical Pharmacology Research , 3 (4), 239–250. https://pubmed.ncbi.nlm.nih.gov/6381336/ (C) Ng, Q. X., Venkatanarayanan, N., & Ho, C. Y. X. (2017). Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. Journal of Affective Disorders , 210 , 211–221. https://pubmed.ncbi.nlm.nih.gov/28064110/ (A) Rahimi, R., Nikfar, S., & Abdollahi, M. (2009). Efficacy and tolerability of Hypericum perforatum in major depressive disorder in comparison with selective serotonin reuptake inhibitors: a meta-analysis. Progress in Neuro-Psychopharmacology & Biological Psychiatry , 33 (1), 118–127. https://pubmed.ncbi.nlm.nih.gov/19028540/ (A) Rajizadeh, A., Mozaffari-Khosravi, H., Yassini-Ardakani, M., & Dehghani, A. (2017). Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial. Nutrition , 35 , 56–60. https://pubmed.ncbi.nlm.nih.gov/28241991/ (B) Rousseau, J. J. (1987). Effects of a levo-5-hydroxytryptophan-dihydroergocristine combination on depression and neuropsychic performance: a double-blind placebo-controlled clinical trial in elderly patients. Clinical Therapeutics , 9 (3), 267–272. https://pubmed.ncbi.nlm.nih.gov/3111702/ (B) Salk, R. H., Hyde, J. S., & Abramson, L. Y. (2017). Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms. Psychological Bulletin , 143 (8), 783–822. https://pubmed.ncbi.nlm.nih.gov/28447828/ (A) Sarris, J., Fava, M., Schweitzer, I., & Mischoulon, D. (2012). St John’s wort (Hypericum perforatum) versus sertraline and placebo in major depressive disorder: continuation data from a 26-week RCT. Pharmacopsychiatry , 45 (7), 275–278. https://pubmed.ncbi.nlm.nih.gov/22592504/ (B) Singer, A., Schmidt, M., Hauke, W., & Stade, K. (2011). Duration of response after treatment of mild to moderate depression with Hypericum extract STW 3-VI, citalopram and placebo: a reanalysis of data from a controlled clinical trial. Phytomedicine: International Journal of Phytotherapy and Phytopharmacology , 18 (8-9), 739–742. https://pubmed.ncbi.nlm.nih.gov/21514125 (C) Sublette, M. E., Ellis, S. P., Geant, A. L., & Mann, J. J. (2011). Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. The Journal of Clinical Psychiatry , 72 (12), 1577–1584. https://pubmed.ncbi.nlm.nih.gov/21939614/ (C) Tarleton, E. K., Littenberg, B., MacLean, C. D., Kennedy, A. G., & Daley, C. (2017). Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PloS One , 12 (6), e0180067. https://pubmed.ncbi.nlm.nih.gov/28654669/ (C) Wang, J., Wu, X., Lai, W., Long, E., Zhang, X., Li, W., Zhu, Y., Chen, C., Zhong, X., Liu, Z., Wang, D., & Lin, H. (2017). Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis. BMJ Open , 7 (8), e017173. https://pubmed.ncbi.nlm.nih.gov/28838903/ (A) Warren, M. B., Cowen, P. J., & Harmer, C. J. (2019). Subchronic treatment with St John’s wort produces a positive shift in emotional processing in healthy volunteers. Journal of Psychopharmacology , 33 (2), 194–201. https://pubmed.ncbi.nlm.nih.gov/30484733/ (C) Yu H. L., Zhang P. P., Zhang C., Zhang X., Li Z. Z., Li W. Q., & Fu A. S. (2019). [Effects of rhodiola rosea on oxidative stress and negative emotional states in patients with obstructive sleep apnea]. Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery , 33 (10), 954–957. https://pubmed.ncbi.nlm.nih.gov/31623042/ (C) Disclaimer: The content provided is not intended to be for medical diagnosis or treatment, and is not meant to provide you medical or professional advice. Consult with your healthcare provider to determine if this plan is right for you. 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. We make no representation or warranty, express or implied, including, without limitation, any warranty of merchantability or of fitness for a particular purpose, and you assume full responsibility for the use of the content and products, and agree that Fullscript and its content providers are not responsible or liable for any claim, loss, injury or damage arising from your use of the information. Statements regarding dietary and other health care supplements have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease.
View protocolThyroid Support
Based on current research findings, the ingredients in the protocol below have demonstrated efficacy in improving a variety of factors associated with an underactive or suppressed thyroid. Suboptimal or underactive thyroid function can lead to a condition known as hypothyroidism, which affects approximately 4.6% of people in the US (age 12 and older). ( 4 ) Hashimoto’s thyroiditis is the most common cause of an underactive thyroid in developed countries, while iodine deficiency is the most common cause worldwide. ( 10 ) Other causes might include goiter, genetic disorders, or radiation treatment/exposure. Conventional treatment tends to focus on replacing the low levels of thyroid hormones with pharmaceutical sources such as levothyroxine. Supporting thyroid function can be achieved through other methods as well. Selenium 200 μg, total per day of selenomethionine, minimum 3 months ( 1 )( 8 )( 16 ) A decrease between 20% and 63.6% in anti-TPO marker was observed ( 1 )( 8 )( 16 )( 20 ) Meta-analysis of 16 randomized controlled trials found supplementation of selenium to decreased TPOAb (serum thyroid peroxidase) in people receiving LT4 therapy and newly diagnosed untreated patients ( 20 ) Meta-analysis of 4 studies found selenium decreased TPOab and increased chance of reporting improved well-being or mood compared to control while having no impact on LT4 therapy in patients with Hashimoto’s ( 18 ) 17.2% of patients with autoimmune thyroiditis and mild subclinical hypothyroidism demonstrated restored euthyroidism, and 31.3% of patients responded to treatment (83 mcg selenomethionine/day for four months) compared to 3.1% in control ( 16 ) Decreased anti-TPO (anti-thyroid peroxidase) in women with Hashimoto’s who were given 200 mcg of l-selenomethionine per day for 6 months ( 8 ) Zinc, in addition to selenium supplementation, increased fT3 mean serum, fT4 mean serum, and decreased TSH; when compared to selenium alone, additional zinc improved thyroid function in overweight or obese female hypothyroid patients ( 7 ) Vitamin D 2000 IU, total per day, minimum 6 months ( 5 )( 6 )( 9 ) It has been demonstrated that low levels of serum 25-hydroxyvitamin D is related to thyroid auto-immune diseases like Hashimotos ( 19 ) Vitamin D has been linked to a decrease in thyroid autoimmunity in Hashimoto’s thyroiditis treated with levothyroxine. The impact is more significant for thyroid peroxidase than thyroglobulin antibodies ( 5 )( 6 )( 9 ) The combination of Simvastatin and vitamin D supplementation had a stronger effect in reducing concentrations of thyroid peroxidase and thyroglobulin antibodies than vitamin D supplementation alone ( 6 ) Improved disease control in female patients with Hashimoto’s demonstrated by a decrease in Th17/Tr1 ratio compared to placebo when given 50,000 IU once per week for 6 months as cholecalciferol ( 11 ) Women treated with levothyroxine demonstrated reduced thyroid autoimmunity when given 2000 IU per day of vitamin D compared to control as demonstrated by a decrease in titers for thyroid antibodies and improved thyroid peroxidase to thyroglobulin ( 5 ) Patients with Hashimoto’s who have a euthyroid state were tested for vitamin D deficiency and found that 85.3% of patients were deficient at the beginning of the study; supplementation improved condition as shown by a decrease in serum anti-tpo by 20.3% when supplemented 1200-4000 IU of vitamin D for 4 months ( 9 ) Myo-inositol 600 mg, total per day, minimum 6 months ( 12 )( 13 )( 14 )( 15 ) Thyroid nodules decreased in size, number, and elasticity and TSH decreased in patients with subclinical hypothyroidism when given myo-inositol with selenium for 6 months ( 14 ) Myo-inositol supplementation in addition to selenium decreased TSH, TPOAb, and TgAb, as well as decreased size and stiffness of thyroid nodules compared to selenium alone ( 13 ) Supplementation was effective in achieving euthyroidism for patients with Hashimoto’s as shown by improved thyroid panel (TSH, TPOAb, TgAb, fT3, fT4) and improved QOL ( 12 ) When given in addition to selenomethionine, myo-inositol supplementation decreased TSH more effectively compared to selenomethionine alone in patients with subclinical hypothyroidism ( 15 ) Ashwagandha 600 mg once per day for a minimum of 8 weeks ( 17 ) 600 mg per day of ashwagandha was effective for achieving euthyroidism as shown by improved TSH, T3, and T4 compared to placebo in patients with subclinical hypothyroid ( 17 ) Patients with bipolar disorder experienced secondary thyroid benefits as shown by improved TSH and T4 compared to baseline when given ashwagandha extract for 8 weeks ( 2 ) Cordyceps sinensis 6 g, total per day, minimum 24 weeks ( 3 ) Preliminary research shows that Cordyceps sinensis may balance the proportion between helper T cells and cytotoxic T cells ( 3 ) In addition, Cordyceps sinensis may contribute to a significant decrease in anti-TPO antibodies in Hashimoto’s thyroiditis patients ( 3 ) Evidence rating The following protocols were developed using only a,b,c -quality evidence Learn more about our rating scale References de Farias, C. R., Cardoso, B. R., de Oliveira, G. M. B., de Mello Guazzelli, I. C., Catarino, R. M., Chammas, M. C., Cozzolino, S. M. F., & Knobel, M. (2015). A randomized-controlled, double-blind study of the impact of selenium supplementation on thyroid autoimmunity and inflammation with focus on the GPx1 genotypes. Journal of Endocrinological Investigation , 38 (10), 1065–1074. https://pubmed.ncbi.nlm.nih.gov/25894865/ (B) Gannon, J. M., Forrest, P. E., & Roy Chengappa, K. N. (2014). Subtle changes in thyroid indices during a placebo-controlled study of an extract of Withania somnifera in persons with bipolar disorder. Journal of Ayurveda and Integrative Medicine , 5 (4), 241–245. https://pubmed.ncbi.nlm.nih.gov/25624699/ (C) He, T., Zhao, R., Lu, Y., Li, W., Hou, X., Sun, Y., Dong, M., & Chen, L. (2016). Dual-Directional Immunomodulatory Effects of Corbrin Capsule on Autoimmune Thyroid Diseases. Evidence-Based Complementary and Alternative Medicine: eCAM , 2016 , 1360386. https://pubmed.ncbi.nlm.nih.gov/27721890/ (C) Hypothyroidism (Underactive Thyroid) . (n.d.). Retrieved March 31, 2021, from https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism (F) Krysiak, R., Szkróbka, W., & Okopień, B. (2017). The Effect of Vitamin D on Thyroid Autoimmunity in Levothyroxine-Treated Women with Hashimoto’s Thyroiditis and Normal Vitamin D Status. Experimental and Clinical Endocrinology & Diabetes: Official Journal, German Society of Endocrinology [and] German Diabetes Association , 125 (4), 229–233. https://pubmed.ncbi.nlm.nih.gov/28073128/ (C) Krysiak, R., Szkróbka, W., & Okopień, B. (2018). Moderate-dose simvastatin therapy potentiates the effect of vitamin D on thyroid autoimmunity in levothyroxine-treated women with Hashimoto’s thyroiditis and vitamin D insufficiency. Pharmacological Reports: PR , 70 (1), 93–97. https://pubmed.ncbi.nlm.nih.gov/29331793/ (C) Mahmoodianfard, S., Vafa, M., Golgiri, F., Khoshniat, M., Gohari, M., Solati, Z., & Djalali, M. (2015). Effects of Zinc and Selenium Supplementation on Thyroid Function in Overweight and Obese Hypothyroid Female Patients: A Randomized Double-Blind Controlled Trial. Journal of the American College of Nutrition , 34 (5), 391–399. https://pubmed.ncbi.nlm.nih.gov/25758370/ (B) Mazokopakis, E. E., Papadakis, J. A., Papadomanolaki, M. G., Batistakis, A. G., Giannakopoulos, T. G., Protopapadakis, E. E., & Ganotakis, E. S. (2007). Effects of 12 months treatment with L-selenomethionine on serum anti-TPO Levels in Patients with Hashimoto’s thyroiditis. Thyroid: Official Journal of the American Thyroid Association , 17 (7), 609–612. https://pubmed.ncbi.nlm.nih.gov/17696828/ (C) Mazokopakis, E. E., Papadomanolaki, M. G., Tsekouras, K. C., Evangelopoulos, A. D., Kotsiris, D. A., & Tzortzinis, A. A. (2015). Is vitamin D related to pathogenesis and treatment of Hashimoto’s thyroiditis? Hellenic Journal of Nuclear Medicine , 18 (3), 222–227. https://pubmed.ncbi.nlm.nih.gov/26637501/ (C) Mincer, D. L., & Jialal, I. (2020). Hashimoto Thyroiditis. In StatPearls . StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459262/ (F) Nodehi, M., Ajami, A., Izad, M., Asgarian Omran, H., Chahardoli, R., Amouzegar, A., Yekaninejad, S., Hemmatabadi, M., Azizi, F., Esfahanian, F., Mansouri, F., Mazaheri Nezhad Fard, R., & Saboor-Yaraghi, A. A. (2019). Effects of vitamin D supplements on frequency of CD4+ T-cell subsets in women with Hashimoto’s thyroiditis: a double-blind placebo-controlled study. European Journal of Clinical Nutrition , 73 (9), 1236–1243. https://pubmed.ncbi.nlm.nih.gov/30696977/ (C) Nordio, M., & Basciani, S. (2017). Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis. International Journal of Endocrinology , 2017 , 2549491. https://pubmed.ncbi.nlm.nih.gov/28293260/ (C) Nordio, M., & Basciani, S. (2017). Myo-inositol plus selenium supplementation restores euthyroid state in Hashimoto’s patients with subclinical hypothyroidism. European Review for Medical and Pharmacological Sciences , 21 (2 Suppl), 51–59. https://pubmed.ncbi.nlm.nih.gov/28724185/ (C) Nordio, M., & Basciani, S. (2018). Evaluation of thyroid nodule characteristics in subclinical hypothyroid patients under a myo-inositol plus selenium treatment. European Review for Medical and Pharmacological Sciences , 22 (7), 2153–2159. https://pubmed.ncbi.nlm.nih.gov/29687875/ (C) Nordio, M., & Pajalich, R. (2013). Combined treatment with Myo-inositol and selenium ensures euthyroidism in subclinical hypothyroidism patients with autoimmune thyroiditis. Journal of Thyroid Research , 2013 , 424163. https://pubmed.ncbi.nlm.nih.gov/24224112/ (C) Pirola, I., Gandossi, E., Agosti, B., Delbarba, A., & Cappelli, C. (2016). Selenium supplementation could restore euthyroidism in subclinical hypothyroid patients with autoimmune thyroiditis. Endokrynologia Polska , 67 (6), 567–571. https://pubmed.ncbi.nlm.nih.gov/28042649/ (B) Sharma, A. K., Basu, I., & Singh, S. (2018). Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. Journal of Alternative and Complementary Medicine , 24 (3), 243–248. https://pubmed.ncbi.nlm.nih.gov/28829155/ (B) Toulis, K. A., Anastasilakis, A. D., Tzellos, T. G., Goulis, D. G., & Kouvelas, D. (2010). Selenium supplementation in the treatment of Hashimoto’s thyroiditis: a systematic review and a meta-analysis. Thyroid: Official Journal of the American Thyroid Association , 20 (10), 1163–1173. https://pubmed.ncbi.nlm.nih.gov/20883174/ (A) Wang, J., Lv, S., Chen, G., Gao, C., He, J., Zhong, H., & Xu, Y. (2015). Meta-analysis of the association between vitamin D and autoimmune thyroid disease. Nutrients , 7 (4), 2485–2498. https://pubmed.ncbi.nlm.nih.gov/25854833/ (A) Wichman, J., Winther, K. H., Bonnema, S. J., & Hegedüs, L. (2016). Selenium Supplementation Significantly Reduces Thyroid Autoantibody Levels in Patients with Chronic Autoimmune Thyroiditis: A Systematic Review and Meta-Analysis. Thyroid: Official Journal of the American Thyroid Association , 26 (12), 1681–1692. https://pubmed.ncbi.nlm.nih.gov/27702392/ (A) Disclaimer: The content provided is not intended to be for medical diagnosis or treatment, and is not meant to provide you medical or professional advice. Consult with your healthcare provider to determine if this plan is right for you. 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. We make no representation or warranty, express or implied, including, without limitation, any warranty of merchantability or of fitness for a particular purpose, and you assume full responsibility for the use of the content and products, and agree that Fullscript and its content providers are not responsible or liable for any claim, loss, injury or damage arising from your use of the information. Statements regarding dietary and other health care supplements have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease.
View protocolImmune Health - Cold and Flu Support
The ingredients present in the protocol below reflect research findings that demonstrate efficacy when used prophylactically and therapeutically to support physiological immune function in regards to cold and flu. Seasonal occurrences of cold and flu are to be expected. Targeting the immune system during this time has the potential to help decrease the frequency, severity, or duration of cold and flu symptoms. Decreasing the risk of developing a cold or flu is possible through prophylactic supplementation, especially among high-risk populations, such as in children, the elderly, or those with compromised immune systems. In the event a cold or flu does occur, the desired focus of supplementation may shift to decreasing the duration and severity of symptoms. Zinc may be considered in this case; when given during the initial 24 hours of symptom onset, it has been shown to reduce the number of patients with symptoms after one week. ( Singh 2015 ) Vitamin C is another popular remedy to decrease the length of a cold and has the potential to decrease duration by approximately half a day. ( Ran 2018 ) Vitamin C Adults: 1 g daily as an ongoing maintenance dose, ( Hemila 2013 )( Johnstone 2014 )( Ran 2018 ) or 3 to 4 g daily at the onset of symptoms and for the duration of illness ( Hemila 2013 )( Ran 2018 ) Children: 1 to 2 g daily as an ongoing maintenance dose ( Hemila 2013 ) Reduces the duration of the common cold by approximately a half-day, ( Ran 2018 ) or by 8% in adults and by 14-18% in children ( Hemila 2013 ) Reduces time of confinement by approximately six hours and fever duration by approximately a half-day, relieves chest pain and chills by approximately eight hours when given an extra therapeutic dose at the time of onset of cold ( Ran 2018 ) Improves antimicrobial and natural killer (NK) cell activities, lymphocyte levels, chemotaxis, delayed T cell responses, sympathetic nervous response, and induces anti-reactive oxygen species activity ( Ran 2018 ) Decreased duration of cold by 59% and increased weekly activity levels by 39.5% when compared to placebo in otherwise healthy adult males ( Johnstone 2014 ) American ginseng ( Panax quinquefolius ) 400 mg, once per day, minimum 8-16 weeks in healthy adults as a preventative measure ( McElhaney 2006 )( Predy 2005 )( Seida 2011 ) Reduces the duration of colds or acute respiratory infections by approximately 5-6 days ( McElhaney 2006 )( Seida 2011 ) Reduces the incidence of colds by 25%, the incidence of influenza and respiratory syncytial virus, and the relative risk of respiratory symptoms by 48% ( McElhaney 2006 )( McElhaney 2004 )( Predy 2005 ) Reduces total symptom severity score for sore throat, runny nose, sneezing, nasal congestion, malaise, fever, headache, hoarseness, earaches, and cough ( Predy 2005 ) Echinacea purpurea Prevention: 0.9 mL, three times per day (equivalent to 2400 mg of extract), minimum 4 months ( Jawad 2012 ) Acute: Up to 4.5 mL liquid extract (equivalent to 4000 mg), once per day at the first stage of cold development ( Jawad 2012 ) Reduces the relative risk of cold development by 10-58% ( Karsch-Völk 2014 )( Schoop 2006 )( Shah 2007 ) Reduces days with symptoms by 26% (1.4 days)( Jawad 2012 )( Shah 2007 ) and symptom scores by 23% ( Goel 2004 ) 52% fewer patients requiring concomitant use of aspirin, paracetamol, or ibuprofen ( Jawad 2012 ) Reduces the incidence of cumulative viral infections by 26% and recurring infections by 59%, including influenza virus and parainfluenza virus ( Jawad 2012 ) Increases associated counts for white blood cells, monocytes, neutrophils, and natural killer cells, and suppresses superoxide production in the later phase of the cold by neutrophils ( Goel 2005 ) Zinc 75-100 mg of elemental zinc as zinc acetate or zinc gluconate lozenges, once per day, within 24 hours of the onset of common cold symptoms, minimum 1 to 2 weeks cold ( Hemila 2017 )( Hemila et al. 2017 )( Hemila 2016 )( Hemila 2015 )( Singh 2015 ) Reduces cold duration by 33%, ( Hemila 2017 ) or by approximately 1.65 to 3 days in healthy adults cold ( Hemila et al. 2017 )( Hemila 2016 )( Prasad 2008 )( Singh 2015 )( Science 2012 ) Zinc acetate equivalently reduces the duration by 40% and zinc gluconate reduces the duration by 28%, ( Hemila 2017 ) while other sources indicate greater efficacy with zinc acetate in healthy adults ( Science 2012 ) Reduces the incidence of cold symptoms after 5-7 days in healthy adults and children ( Hemila et al. 2017 )( Singh 2015 ) Reduces the duration of muscle soreness by 54%, cough by 46%, voice hoarseness by 43%, nasal congestion by 37%, nasal discharge by 34%, scratchy throat by 33%, sneezing by 22%, and sore throat by 18% in healthy adults ( Hemila 2015 )( Prasad 2008 ) Reduces the incidence of common cold development, absence from school, and antibiotic use in children ( Singh 2015 ) Improves anti-inflammatory and antioxidant profile via reductions in plasma interleukin-1 receptor antagonist (IL-1ra), intercellular adhesion molecule-1 (ICAM-1), TNF-ɑ, MDA, HAE, and 8-oHdG, and increases in IL-2 mRNA in mononuclear cells in healthy adults ( Prasad 2008 )( Prasad 2007 ) Reduces duration of symptoms particularly when given within the first 24 hours of symptom onset ( Singh 2015 ) Probiotics (Pediatric) Probiotics may reduce the incidence of colds with minor effects on prevention, as well as improve influenza vaccination efficacy for A/H1N1, A/H3N2, and B strains, but is dependent on strain and population. ( Kang 2013 )( Lei 2017 )( Yeh 2018 ) Common Cold 5 billion CFU of Lactobacillus acidophilus NCFM (ATCC 700396), twice per day, minimum 6 months ( Leyer 2009 ) Reduces the incidence of fever by 53%, cough by 41%, and antibiotic use by 68% Reduces the duration of fever, coughing, and rhinorrhea by 32% Reduces days absent from childcare by 32% Influenza 10 billion CFU of Bifidobacterium animalis subs. lactis Bi-07 (ATCC PTA-4802) & Lactobacillus acidophilus NCFM (ATCC 700396), twice per day for 6 months ( Leyer 2009 ) Reduces the incidence of fever by 73%, rhinorrhea by 73%, cough by 62%, and antibiotic use by 84% Reduces the duration of fever, coughing, and rhinorrhea by 48% Reduces days absent from childcare by 28% Probiotics (Adult) Probiotics may reduce the incidence of colds with minor effects on prevention, as well as improve influenza vaccination efficacy for A/H1N1, A/H3N2, and B strains, but is dependent on strain and population. ( Kang 2013 )( Lei 2017 )( Yeh 2018 ) Common Cold 1 billion CFU of Lactobacillus paracasei 8700:2 (DSM 13434) & Lactobacillus plantarum HEAL 9 (DSM 15312), once per day for 3 months ( Berggren 2011 ) Reduces the incidence of developing more than one common cold episode and number of days with a cold Reduces total symptom scores & pharyngeal symptoms of cold Reduces B lymphocyte proliferation Influenza 10 billion CFU of Lactobacillus fermentum CECT5716, once per day for 2 weeks before influenza vaccination and two weeks after ( Olivares 2007 ) Reduces the incidence of influenza 5-months after vaccination compared to vaccine alone Increases natural killer cells, T-helper response, and IgA levels 10 billion CFU of Lactobacillus rhamnosus GG, twice per day for 4 weeks after influenza vaccination ( Davidson 2011 ) Increases seroprotection for the H3N2 strain during the supplementation period 500 mg of Saccharomyces cerevisiae (EpiCor®), once per day for 12 weeks ( Moyad 2010 )( Moyad 2008 ) Reduces the incidence of cold/flu symptoms with or without prior vaccination Reduces the duration of symptoms with prior vaccination Evidence rating The following protocols were developed using only a,b,c -quality evidence Learn more about our rating scale References Berggren, A., Lazou Ahrén, I., Larsson, N., & Önning, G. (2011). Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections. European Journal of Nutrition , 50 (3), 203–210. https://doi.org/10.1007/s00394-010-0127-6 (B) Davidson, L. E., Fiorino, A.-M., Snydman, D. R., & Hibberd, P. L. (2011). Lactobacillus GG as an immune adjuvant for live-attenuated influenza vaccine in healthy adults: A randomized double-blind placebo-controlled trial. European Journal of Clinical Nutrition , 65 (4), 501–507. https://doi.org/10.1038/ejcn.2010.289 (C) Goel, V., Lovlin, R., Barton, R., Lyon, M. R., Bauer, R., Lee, T. D. G., & Basu, T. K. (2004). Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: A randomized, double-blind, placebo-controlled trial. Journal of Clinical Pharmacy and Therapeutics , 29 (1), 75–83. https://doi.org/10.1111/j.1365-2710.2003.00542.x (B) Goel, V., Lovlin, R., Chang, C., Slama, J. V., Barton, R., Gahler, R., Bauer, R., Goonewardene, L., & Basu, T. K. (2005). A proprietary extract from the echinacea plant (Echinacea purpurea) enhances systemic immune response during a common cold. Phytotherapy Research , 19 (8), 689–694. https://doi.org/10.1002/ptr.1733 (B) Hemilä, H. (2017). Zinc lozenges and the common cold: A meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage. JRSM Open , 8 (5), 2054270417694291. https://doi.org/10.1177/2054270417694291 (A) Hemilä, H., & Chalker, E. (2013). Vitamin C for preventing and treating the common cold. Cochrane Database of Systematic Reviews , 1 , CD000980. https://doi.org/10.1002/14651858.CD000980.pub4 ( A) Hemilä, H., & Chalker, E. (2015). The effectiveness of high dose zinc acetate lozenges on various common cold symptoms: A meta-analysis. BMC Family Practice , 16 , 24. https://doi.org/10.1186/s12875-015-0237-6 (A) Hemilä, H., Fitzgerald, J. T., Petrus, E. J., & Prasad, A. (2017). Zinc acetate lozenges may improve the recovery rate of common cold patients: An individual patient data meta-analysis. Open Forum Infectious Diseases , 4 (2), ofx059. https://doi.org/10.1093/ofid/ofx059 (A) Hemilä, H., Petrus, E. J., Fitzgerald, J. T., & Prasad, A. (2016). Zinc acetate lozenges for treating the common cold: An individual patient data meta-analysis. British Journal of Clinical Pharmacology , 82 (5), 1393–1398. https://doi.org/10.1111/bcp.13057 (A) Jawad, M., Schoop, R., Suter, A., Klein, P., & Eccles, R. (2012). Safety and efficacy profile of echinacea purpurea to prevent common cold episodes: A randomized, double-blind, placebo-controlled trial. Evidence-Based Complementary and Alternative Medicine , 2012 , 841315. https://doi.org/10.1155/2012/841315 (B) Johnston, C. S., Barkyoumb, G. M., & Schumacher, S. S. (2014). Vitamin C supplementation slightly improves physical activity levels and reduces cold incidence in men with marginal vitamin C status: A randomized controlled trial. Nutrients , 6 (7), 2572–2583. https://doi.org/10.3390/nu6072572 (C) Kang, E.-J., Kim, S. Y., Hwang, I.-H., & Ji, Y.-J. (2013). The effect of probiotics on prevention of common cold: A meta-analysis of randomized controlled trial studies. Korean Journal of Family Medicine , 34 (1), 2–10. https://doi.org/10.4082/kjfm.2013.34.1.2 (A) Karsch-Völk, M., Barrett, B., Kiefer, D., Bauer, R., Ardjomand-Woelkart, K., & Linde, K. (2014). Echinacea for preventing and treating the common cold. Cochrane Database of Systematic Reviews , 2 , CD000530. https://doi.org/10.1002/14651858.CD000530.pub3 (A) Lei, W.-T., Shih, P.-C., Liu, S.-J., Lin, C.-Y., & Yeh, T.-L. (2017). Effect of probiotics and prebiotics on immune response to influenza vaccination in adults: A systematic review and meta-analysis of randomized controlled trials. Nutrients , 9 (11). https://doi.org/10.3390/nu9111175 (A) Leyer, G. J., Li, S., Mubasher, M. E., Reifer, C., & Ouwehand, A. C. (2009). Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics , 124 (2), e172–e179. https://doi.org/10.1542/peds.2008-2666 (B) McElhaney, J. E., Goel, V., Toane, B., Hooten, J., & Shan, J. J. (2006). Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: A randomized, double-blinded, placebo controlled trial. Journal of Alternative and Complementary Medicine , 12 (2), 153–157. https://doi.org/10.1089/acm.2006.12.153 (C) McElhaney, J. E., Gravenstein, S., Cole, S. K., Davidson, E., O’neill, D., Petitjean, S., Rumble, B., & Shan, J. J. (2004). A placebo-controlled trial of a proprietary extract of North American ginseng (CVT-E002) to prevent acute respiratory illness in institutionalized older adults. Journal of the American Geriatrics Society , 52 (1), 13–19. https://doi.org/10.1111/j.1532-5415.2004.52004.x (B) Moyad, M. A., Robinson, L. E., Zawada, E. T., Jr, Kittelsrud, J. M., Chen, D.-G., Reeves, S. G., & Weaver, S. E. (2008). Effects of a modified yeast supplement on cold/flu symptoms. Urologic Nursing , 28 (1), 50–55. https://www.ncbi.nlm.nih.gov/pubmed/18335698 (B) Moyad, M. A., Robinson, L. E., Zawada, E. T., Kittelsrud, J., Chen, D.-G., Reeves, S. G., & Weaver, S. (2010). Immunogenic yeast-based fermentate for cold/flu-like symptoms in nonvaccinated individuals. Journal of Alternative and Complementary Medicine , 16 (2), 213–218. https://doi.org/10.1089/acm.2009.0310 (B) Olivares, M., Díaz-Ropero, M. P., Sierra, S., Lara-Villoslada, F., Fonollá, J., Navas, M., Rodríguez, J. M., & Xaus, J. (2007). Oral intake of Lactobacillus fermentum CECT5716 enhances the effects of influenza vaccination. Nutrition , 23 (3), 254–260. https://doi.org/10.1016/j.nut.2007.01.004 (B) Prasad, A. S., Beck, F. W. J., Bao, B., Fitzgerald, J. T., Snell, D. C., Steinberg, J. D., & Cardozo, L. J. (2007). Zinc supplementation decreases incidence of infections in the elderly: Effect of zinc on generation of cytokines and oxidative stress. The American Journal of Clinical Nutrition , 85 (3), 837–844. https://doi.org/10.1093/ajcn/85.3.837 (B) Prasad, A. S., Beck, F. W. J., Bao, B., Snell, D., & Fitzgerald, J. T. (2008). Duration and severity of symptoms and levels of plasma interleukin-1 receptor antagonist, soluble tumor necrosis factor receptor, and adhesion molecules in patients with common cold treated with zinc acetate. The Journal of Infectious Diseases , 197 (6), 795–802. https://doi.org/10.1086/528803 (B) Predy, G. N., Goel, V., Lovlin, R., Donner, A., Stitt, L., & Basu, T. K. (2005). 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The influence of prebiotic or probiotic supplementation on antibody titers after influenza vaccination: A systematic review and meta-analysis of randomized controlled trials. Drug Design, Development and Therapy , 12 , 217–230. https://doi.org/10.2147/DDDT.S155110 (A) Disclaimer: The content provided is not intended to be for medical diagnosis or treatment, and is not meant to provide you medical or professional advice. Consult with your healthcare provider to determine if this plan is right for you. 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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View protocolMusculoskeletal and Joint Pain Improvement
In the protocol below we present ingredients associated with improved pain management, prevention of degradation, and improvement of joint function. Joint pain and degradation has been steadily increasing throughout the past two decades. Incidence of osteoarthritis (OA) in the hip and knee increased from an estimated 6-8% in early industrial and prehistoric years to 16% in postindustrial people, which is 2.1 fold higher. ( 25 ) Additionally, the years of life lived with this disability rose from 10.5 million in 1990 to 17.1 million in 2010. ( 8 ) A variety of features make up osteoarthritis. Of these features, pooled prevalence for cartilage defects is 24% and meniscal tear is 10%. ( 9 ) Osteoarthritis prevalence and contributing features increases with age. Risk for OA is associated with obesity, prior trauma, female sex, and old age. ( 4 ) Comorbidities contribute to increased pain and/or decreased physical function. Common comorbidities with osteoarthritis are cardiac disease, hypertension, back pain, and diabetes, or a combination of them. ( 5 ) Mainstream prevention and treatment for osteoarthritis relies on pain management through nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoid injections, exercise therapy, bracing, and kinesio-taping. Additionally, integrative treatments such as acupuncture, heat therapy, topical herbs, and supplements, are widely accepted as well. ( 18 ) Managing pain and inflammation as well as preventing further degradation of the affected joints is key to helping patients with OA and related joint concerns. Glucosamine chondroitin 1500 mg of glucosamine sulfate combined with 800-1200 mg of chondroitin sulfate total per day, for a minimum of 6-24 months ( 14 )( 11 ) Chondroitin sulfate combined with glucosamine sulfate is comparable to celecoxib treatment as demonstrated by decreased Western Ontario and McMaster osteoarthritis index (WOMAC) by 50.1%, with 79.7% of patients fulfilling Outcome Measures in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) ( 14 ) When given CS and GH, similarly patients treated with the 200 mg of celecoxib had a decrease of WOMAC by 50.2% with 79.3% fulfilling OMERACT-OARSI; additionally both groups reduced joint swelling and effusion by more than 50% ( 14 ) Combined supplementation of glucosamine sulfate with chondroitin sulfate decreased joint space narrowing by a mean difference of 0.10 mm when compared to placebo over 2 years in patients with chronic knee pain and medial tibio-femoral compartment narrowing ( 11 ) In a meta-analysis of common knee and hip osteoarthritis therapies, it was found that celecoxib had the largest effect size, followed by combined supplementation of glucosamine and chondroitin, both demonstrating effect in improving physical function when compared to placebo as well as being ideal for stiffness ( 27 ) S-adenosyl methionine (SAMe) 1200 mg, one to two times per day, minimum 30 days ( 23 ) Demonstrated effectiveness at reducing symptoms of osteoarthritis ( 22 ) Multiple RDBPC studies demonstrated comparable pain reduction to OTC pharmaceuticals like naproxen and nabutone ( 6 )( 16 ) When compared with celecoxib, SAMe had no difference in efficacy for isometric joint function; additionally both demonstrated similar reductions in pain ( 22 ) Decreases in pain intensity on visual analog scale by 13.0 and 15.7 were observed in SAMe and nabumetone therapy, respectively ( 16 ) When compared with naproxen, SAMe demonstrated similar analgesic activity and fewer side effects ( 6 ) Turmeric ( Curcuma longa ) 500 mg Meriva® or 400 mg of curcumin, two to four times per day, minimum 30 days ( 1 )( 10 ) Curcuma longa extract ameliorates pain as demonstrated by improvements in visual analog scale (VAS) and WOMAC; additionally decreases in oxidative stress and inflammation occurred as shown by improved viz., IL-1β, ROS, and MDA ( 24 ) When used for acute pain management, 2g per day of meriva (corresponding to 400 mg of curcumin) was comparable to 1g dose of acetaminophen while having improved gastric tolerability in comparison ( 10 ) When compared to 800 mg per day of ibuprofen, 2g per day of curcuma extract was equally effective in ameliorating pain as shown by similar WOMAC scores; subsequently, less gastrointestinal adverse effects were observed with curcuma extract than ibuprofen ( 19 ) Bio-optimized curcuma longa extract supplementation decreased visual analog pain scores by 29.5% in low dose group and 36.5% in high dose group, compared to 8 mm in placebo group in patients with OA; although adverse events were not significant a general trend of more adverse events was noted in the high dose group; the comparison suggests that patients finding difficulty with high doses will still benefit when given a lower dose ( 13 ) Boswellia 338 mg of standardized extract, minimum 4 weeks ( 20 )( 26 ) or 150 mg of boswellic acid in addition to curcumin supplement ( 12 ) Patients with knee OA experienced a decrease in pain and frequency of swelling as well as an increase in knee flexion and walking distance when compared to placebo ( 17 ) Physical function improved after 120 days, as demonstrated by a decrease in stiffness and increase in knee joint; inflammation also improved as shown by a decrease in CRP, osteophytes, and pain ( 20 ) When given in addition to curcumin, boswellic acid improved the efficacy of curcuminoids to decrease pain shown by WOMAC score and improve physical performance ( 12 ) A meta-analysis of seven trials (including 545 patients) showed reduced weighted mean difference for visual analog scale pain scores (-8.33), WOMAC pain scores (-14.22), WOMAC stiffness scores (-10.04), and improved WOMAC joint function (-10.75), for Boswellia extract compared to control, when taken for a minimum of four weeks ( 26 ) Pycnogenol 100-200 mg per day, minimum of 3 weeks ( 15 )( 2 ) Inflammation improved as demonstrated by a decrease in CRP from 3.9 mg/l to 1.1 mg/l (compared to control decreasing to 3.6 mg/l), decrease in free radicals to 70.1% of baseline, and a decrease of fibrinogen to 61.8% of baseline ( 3 ) Pain decreased as shown by an improvement in WOMAC and VAS, as well as decreased use of analgesic pharmaceuticals (NSAIDs) while no improvements were observed in placebo ( 7 ) Decreased WOMAC by 56% (9.6% in placebo), drug use by 58% (less than 1% in placebo), gastrointestinal complications by 63% (3% in placebo), foot edema by 79% (1% in placebo), and treatment cost (no notable change in placebo); additionally walking distance increased from 68 m at baseline to 198 m compared to 65 m at baseline to 88 m in placebo ( 2 ) When given in the 3 weeks prior to knee arthroplasty, gene expression of cartilage degradation markers were downregulated in chondrocytes; MMP3, MMP13, cytokine IL1B, and ADAMTS-5 protein concentration decreased, suggesting improvements in catabolic and inflammatory processes ( 15 ) Evidence rating The following protocols were developed using only a,b,c -quality evidence Learn more about our rating scale References Belcaro, G., Cesarone, M. R., Dugall, M., Pellegrini, L., Ledda, A., Grossi, M. G., Togni, S., & Appendino, G. (2010). Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients. Alternative Medicine Review: A Journal of Clinical Therapeutic , 15 (4), 337–344. https://pubmed.ncbi.nlm.nih.gov/21194249/ (C) Belcaro, G., Cesarone, M. R., Errichi, S., Zulli, C., Errichi, B. M., Vinciguerra, G., Ledda, A., Di Renzo, A., Stuard, S., Dugall, M., Pellegrini, L., Errichi, S., Gizzi, G., Ippolito, E., Ricci, A., Cacchio, M., Cipollone, G., Ruffini, I., Fano, F., … Rohdewald, P. (2008). Treatment of osteoarthritis with Pycnogenol. The SVOS (San Valentino Osteo-arthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspects. Phytotherapy Research: PTR , 22 (4), 518–523. https://pubmed.ncbi.nlm.nih.gov/18386255/ (B) Belcaro, G., Cesarone, M. R., Errichi, S., Zulli, C., Errichi, B. 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The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Annals of the Rheumatic Diseases , 73 (7), 1323–1330. https://pubmed.ncbi.nlm.nih.gov/24553908/ (A) Culvenor, A. G., Øiestad, B. E., Hart, H. F., Stefanik, J. J., Guermazi, A., & Crossley, K. M. (2019). Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. British Journal of Sports Medicine , 53 (20), 1268–1278. https://pubmed.ncbi.nlm.nih.gov/29886437/ (A) Di Pierro, F., Rapacioli, G., Di Maio, E. A., Appendino, G., Franceschi, F., & Togni, S. (2013). Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Meriva(®)), nimesulide, and acetaminophen. Journal of Pain Research , 6 , 201–205. https://pubmed.ncbi.nlm.nih.gov/23526055/ (C) Fransen, M., Agaliotis, M., Nairn, L., Votrubec, M., Bridgett, L., Su, S., Jan, S., March, L., Edmonds, J., Norton, R., Woodward, M., Day, R., & LEGS study collaborative group. (2015). Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens. Annals of the Rheumatic Diseases , 74 (5), 851–858. https://pubmed.ncbi.nlm.nih.gov/24395557/ (B) Haroyan, A., Mukuchyan, V., Mkrtchyan, N., Minasyan, N., Gasparyan, S., Sargsyan, A., Narimanyan, M., & Hovhannisyan, A. (2018). Efficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: a comparative, randomized, double-blind, placebo-controlled study. BMC Complementary and Alternative Medicine , 18 (1), 7. https://pubmed.ncbi.nlm.nih.gov/29316908/ (B) Henrotin, Y., Malaise, M., Wittoek, R., de Vlam, K., Brasseur, J.-P., Luyten, F. P., Jiangang, Q., Van den Berghe, M., Uhoda, R., Bentin, J., De Vroey, T., Erpicum, L., Donneau, A. F., & Dierckxsens, Y. (2019). Bio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: a double-blind multicenter randomized placebo-controlled three-arm study. Arthritis Research & Therapy , 21 (1), 179. https://pubmed.ncbi.nlm.nih.gov/31351488/ (B) Hochberg, M. C., Martel-Pelletier, J., Monfort, J., Möller, I., Castillo, J. R., Arden, N., Berenbaum, F., Blanco, F. J., Conaghan, P. G., Doménech, G., Henrotin, Y., Pap, T., Richette, P., Sawitzke, A., du Souich, P., Pelletier, J.-P., & MOVES Investigation Group. (2016). Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Annals of the Rheumatic Diseases , 75 (1), 37–44. https://pubmed.ncbi.nlm.nih.gov/25589511/ (C) Jessberger, S., Högger, P., Genest, F., Salter, D. M., & Seefried, L. (2017). Cellular pharmacodynamic effects of Pycnogenol® in patients with severe osteoarthritis: a randomized controlled pilot study. BMC Complementary and Alternative Medicine , 17 (1), 537. https://pubmed.ncbi.nlm.nih.gov/29246219/ (C) Kim, J., Lee, E. Y., Koh, E.-M., Cha, H.-S., Yoo, B., Lee, C. K., Lee, Y. J., Ryu, H., Lee, K. H., & Song, Y. W. (2009). Comparative clinical trial of S-adenosylmethionine versus nabumetone for the treatment of knee osteoarthritis: an 8-week, multicenter, randomized, double-blind, double-dummy, Phase IV study in Korean patients. Clinical Therapeutics , 31 (12), 2860–2872. https://pubmed.ncbi.nlm.nih.gov/20110025/ (C) Kimmatkar, N., Thawani, V., Hingorani, L., & Khiyani, R. (2003). Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee–a randomized double blind placebo controlled trial. Phytomedicine: International Journal of Phytotherapy and Phytopharmacology , 10 (1), 3–7. https://pubmed.ncbi.nlm.nih.gov/12622457/ (C) Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W. F., Hawker, G., Herzig, E., Kwoh, C. K., Nelson, A. E., Samuels, J., Scanzello, C., White, D., … Reston, J. (2020). 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research , 72 (2), 149–162. https://pubmed.ncbi.nlm.nih.gov/31908149/ (F) Kuptniratsaikul, V., Dajpratham, P., Taechaarpornkul, W., Buntragulpoontawee, M., Lukkanapichonchut, P., Chootip, C., Saengsuwan, J., Tantayakom, K., & Laongpech, S. (2014). Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study. Clinical Interventions in Aging , 9 , 451–458. https://pubmed.ncbi.nlm.nih.gov/24672232/ (C) Majeed, M., Majeed, S., Narayanan, N. K., & Nagabhushanam, K. (2019). A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee. Phytotherapy Research: PTR , 33 (5), 1457–1468. https://pubmed.ncbi.nlm.nih.gov/30838706/ ( C) McAlindon, T. E., LaValley, M. P., Gulin, J. P., & Felson, D. T. (2000). Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA: The Journal of the American Medical Association , 283 (11), 1469–1475. https://pubmed.ncbi.nlm.nih.gov/10732937/ (A) Najm, W. I., Reinsch, S., Hoehler, F., Tobis, J. S., & Harvey, P. W. (2004). S-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: a double-blind cross-over trial. [ISRCTN36233495]. BMC Musculoskeletal Disorders , 5 , 6. https://pubmed.ncbi.nlm.nih.gov/15102339/ (C) Pavelká, K., Gatterová, J., Olejarová, M., Machacek, S., Giacovelli, G., & Rovati, L. C. (2002). Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Archives of Internal Medicine , 162 (18), 2113–2123. https://pubmed.ncbi.nlm.nih.gov/12374520/ (B) Srivastava, S., Saksena, A. K., Khattri, S., Kumar, S., & Dagur, R. S. (2016). Curcuma longa extract reduces inflammatory and oxidative stress biomarkers in osteoarthritis of knee: a four-month, double-blind, randomized, placebo-controlled trial. Inflammopharmacology , 24 (6), 377–388. https://pubmed.ncbi.nlm.nih.gov/27761693/ (B) Wallace, I. J., Worthington, S., Felson, D. T., Jurmain, R. D., Wren, K. T., Maijanen, H., Woods, R. J., & Lieberman, D. E. (2017). Knee osteoarthritis has doubled in prevalence since the mid-20th century. Proceedings of the National Academy of Sciences of the United States of America , 114 (35), 9332–9336. https://pubmed.ncbi.nlm.nih.gov/28808025/ (D) Yu, G., Xiang, W., Zhang, T., Zeng, L., Yang, K., & Li, J. (2020). Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis. BMC Complementary Medicine and Therapies , 20 (1), 225. https://pubmed.ncbi.nlm.nih.gov/32680575/ (A) Zhu, X., Wu, D., Sang, L., Wang, Y., Shen, Y., Zhuang, X., Chu, M., & Jiang, L. (2018). Comparative effectiveness of glucosamine, chondroitin, acetaminophen or celecoxib for the treatment of knee and/or hip osteoarthritis: a network meta-analysis. Clinical and Experimental Rheumatology , 36 (4), 595–602. https://pubmed.ncbi.nlm.nih.gov/29465368/ (A) Disclaimer: The content provided is not intended to be for medical diagnosis or treatment, and is not meant to provide you medical or professional advice. Consult with your healthcare provider to determine if this plan is right for you. 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. We make no representation or warranty, express or implied, including, without limitation, any warranty of merchantability or of fitness for a particular purpose, and you assume full responsibility for the use of the content and products, and agree that Fullscript and its content providers are not responsible or liable for any claim, loss, injury or damage arising from your use of the information. Statements regarding dietary and other health care supplements have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease.
View protocolFall Health
The transition between any season can pose challenges to our health; however, optimizing patient wellness during the fall months can help individuals perform at their best and head into the winter months feeling rested and calm. Concerns around topics such as immune health, stress, sleep support, and burnout prevention are common themes that may become particularly relevant this time of year. Immune health Vitamin C Generally speaking, taking vitamin C may help reduce the duration of colds by about a half-day, ( Ran 2018 ) or by about 8% in adults and 14-18% in children. ( Hemila 2013 ) It appears to be particularly helpful for individuals who are exercising regularly. ( Douglas 2007 ) A typical dose is 1,000-2,000 mg daily. ( Hemila 2013 ) For more information about vitamin C, check out our ingredient review . N-Acetyl Cysteine (NAC) NAC is a precursor to cysteine, one of the amino acids the body needs to synthesize glutathione. Studies indicate that supplementing with NAC can help preserve and replenish glutathione. ( Mikhtari 2017 )( Shackebaei 2005 ) Supporting glutathione levels is critical for maintaining healthy immune function. ( Ghezzi 2011 )( Droge 2000 ) A typical dose is 600 mg one to three times daily. ( Hashemi 2019 ) Probiotics Probiotics may modestly reduce the incidence, severity, and duration of colds, and may possibly improve influenza vaccination efficacy. ( Zhang 2018 )( Kang 2013 )( Lei 2017 )( Yeh 2018 ) A typical minimum dose is 1 billion CFU; however, dosages of 5-10 billion CFU are common as well. ( Berggren 2011) For more information on probiotics, check out our probiotics immune support guide . Sleep & stress support Sleep & stress support Magnesium Magnesium is involved with over 300 enzymatic reactions in the body, so it has implications for multiple systems including cardiovascular, musculoskeletal, digestive, metabolic, and neurological function. ( de Baaij 2015 ) Magnesium supplementation has been associated with improvements in both sleep latency ( Mah 2021 ) and symptoms of anxiety. ( Boyle 2017 ) A typical dose is 325-1000 mg daily, depending on the form. ( Mah 2021 ) GABA Gamma-aminobutyric acid (GABA) is an inhibitory neurotransmitter, a chemical substance found in the nervous system. GABA plays an important role in regulating nervous system activity by balancing nerve excitation and inhibition. ( Gajcy 2010 )( Ngo 2019 ) In clinical trials, GABA has been associated with improvements in sleep quality and latency, ( Byun 2018 ), as well as reduced stress markers according to a recent systematic review. ( Hepsomali 2020 ) L-theanine L-theanine, an amino acid found in green tea , has been shown to have calming effects. A meta-analysis of nine peer-reviewed articles concluded that L-theanine supplementation reduces stress and anxiety in individuals experiencing stressful situations. ( Williams 2020 ) One study showed that perceived stress was significantly reduced one hour after supplementation and cortisol levels decreased after three hours. ( White 2016 ) A typical dose for L-theanine is 200-400 mg daily. ( Williams 2020 ) For more information on L-theanine, check out our ingredient review . Lavender Lavender has long been used as a sleep remedy in various forms including essential oil (aromatherapy) and tea. ( Hirokawa 2012 )( Chen 2015 ) A systematic review of 11 randomized controlled trials found that inhaled lavender essential oil had a positive effect on sleep for people with mild sleep disturbances ( Lillehei 2014 ) Energy & adrenal support Energy & adrenal support B vitamins B vitamins such as vitamin B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), and B12 (cobalamin) are involved in hundreds of chemical reactions in the body, and thus impact a variety of functions and body systems. Factors such as chronic stress, poor sleep, and inadequate diet can lead to B vitamin deficiencies, ( Porter 2016 ), so supplementing with these can be helpful to ensure proper mitochondrial function and energy support. ( O’Leary 2010 ) Ashwagandha ( Withania somnifera ) Daily use of ashwagandha root extract may be effective in reducing physical symptoms of stress, including elevated blood pressure , heart rate, and feelings of anxiety . Additionally, ashwagandha may lower serum levels of cortisol , the body’s primary stress hormone . ( Chandrasekhar 2012 ) A typical dose is 125–600 mg daily, depending on the form. ( Auddy 2008 )( Chandrasekhar 2012 ) For more information, check out our Ashwagandha ingredient review . Other adaptogens Adaptogens are commonly used to support adrenal function and increase the body’s resilience to stress. ( Panossian 2009 ) Additional adaptogens to consider might be Siberian ginseng ( Eleutherococcus senticosus ) ( Hartz 2004 ) and rhodiola ( Rhodiola rosea ). ( Darbinyan 2000 )( Olsson 2009 ) For more information, check out our Rhodiola ingredient review . Evidence rating The following protocols were developed using only a,b,c -quality evidence Learn more about our rating scale References Auddy, B., Hazra, J., Mitra, A., & Abedon, B. (2008). A standardized Withania Somnifera extract significantly reduces Stress-Related parameters in chronically stressed humans: A Double-Blind, randomized, Placebo-Controlled study. JANA . https://www.researchgate.net/profile/Achintya_Mitra/publication/242151370_A_Standardized_Withania_Somnifera_Extract_Significantly_Reduces_Stress-Related_Parameters_in_Chronically_Stressed_Humans_A_Double-Blind_Randomized_Placebo-Controlled_Study/links/54d6463a0cf2970e4e6a4f3f.pdf – B Berggren, A., Lazou Ahrén, I., Larsson, N., & Önning, G. (2011). Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections. European journal of nutrition , 50 (3), 203–210. https://doi.org/10.1007/s00394-010-0127-6 – B Boyle, N. B., Lawton, C., & Dye, L. (2017). The Effects of Magnesium Supplementation on Subjective Anxiety and Stress—A Systematic Review. Nutrients , 9 (5). https://doi.org/10.3390/nu9050429 – A Chandrasekhar, K., Kapoor, J., & Anishetty, S. (2012). A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults. Indian Journal of Psychological Medicine , 34 (3), 255-262. https://doi.org/10.4103/0253-7176.106022 – B Chen, S. L., & Chen, C. H. (2015). Effects of Lavender Tea on Fatigue, Depression, and Maternal-Infant Attachment in Sleep-Disturbed Postnatal Women. Worldviews on evidence-based nursing , 12 (6), 370–379. https://doi.org/10.1111/wvn.12122 – B Darbinyan, V., Kteyan, A., Panossian, A., Gabrielian, E., Wikman, G., & Wagner, H. (2000). Rhodiola rosea in stress induced fatigue–a double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty. Phytomedicine : international journal of phytotherapy and phytopharmacology , 7 (5), 365–371. https://doi.org/10.1016/S0944-7113(00)80055-0 – B de Baaij, J. H., Hoenderop, J. G., & Bindels, R. J. (2015). Magnesium in man: implications for health and disease. Physiological reviews , 95 (1), 1–46. https://doi.org/10.1152/physrev.00012.2014 – A Douglas, R. M., Hemilä, H., Chalker, E., & Treacy, B. (2007). Vitamin C for preventing and treating the common cold. The Cochrane database of systematic reviews , (3), CD000980. https://doi.org/10.1002/14651858.CD000980.pub3 – A Dröge, W., & Breitkreutz, R. (2000). Glutathione and immune function. The Proceedings of the Nutrition Society , 59 (4), 595–600. https://doi.org/10.1017/s0029665100000847 Ghezzi, P. (2010). Role of glutathione in immunity and inflammation in the lung. International Journal of General Medicine , 4 , 105-113. https://doi.org/10.2147/IJGM.S15618 – A Hartz, A. J., Bentler, S., Noyes, R., Hoehns, J., Logemann, C., Sinift, S., Butani, Y., Wang, W., Brake, K., Ernst, M., & Kautzman, H. (2004). Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychological medicine , 34 (1), 51–61. https://doi.org/10.1017/s0033291703008791 – B Hashemi, G., Mirjalili, M., Basiri, Z., Tahamoli-Roudsari, A., Kheiripour, N., Shahdoust, M., Ranjbar, A., Mehrpooya, M., & Ataei, S. (2019). A Pilot Study to Evaluate the Effects of Oral N-Acetyl Cysteine on Inflammatory and Oxidative Stress Biomarkers in Rheumatoid Arthritis. Current rheumatology reviews , 15 (3), 246–253. https://doi.org/10.2174/1573403X14666180926100811 – C Hemilä, H., & Chalker, E. (2013). Vitamin C for preventing and treating the common cold. The Cochrane Database of Systematic Reviews , 2013 (1). https://doi.org/10.1002/14651858.CD000980.pub4 – A Hepsomali, P., Groeger, J. A., Nishihira, J., & Scholey, A. (2019). Effects of Oral Gamma-Aminobutyric Acid (GABA) Administration on Stress and Sleep in Humans: A Systematic Review. Frontiers in Neuroscience , 14 . https://doi.org/10.3389/fnins.2020.00923 – A Hirokawa, K., Nishimoto, T., & Taniguchi, T. (2012). Effects of Lavender Aroma on Sleep Quality in Healthy Japanese Students. Perceptual and Motor Skills, 114(1), 111–122. https://doi.org/10.2466/13.15.PMS.114.1.111-122 -C Kang, J., Kim, S. Y., Hwang, H., & Ji, J. (2013). The Effect of Probiotics on Prevention of Common Cold: A Meta-Analysis of Randomized Controlled Trial Studies. Korean Journal of Family Medicine , 34 (1), 2-10. https://doi.org/10.4082/kjfm.2013.34.1.2 – A Lei, T., Shih, C., Liu, J., Lin, Y., & Yeh, L. (2017). Effect of Probiotics and Prebiotics on Immune Response to Influenza Vaccination in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients , 9 (11). https://doi.org/10.3390/nu9111175 – A Lillehei, A. S., & Halcon, L. L. (2014). A systematic review of the effect of inhaled essential oils on sleep. Journal of alternative and complementary medicine (New York, N.Y.) , 20 (6), 441–451. https://doi.org/10.1089/acm.2013.0311 – A Mah, J., & Pitre, T. (2020). Oral magnesium supplementation for insomnia in older adults: A Systematic Review & Meta-Analysis. BMC Complementary Medicine and Therapies , 21 . https://doi.org/10.1186/s12906-021-03297-z – A Mokhtari, V., Afsharian, P., Shahhoseini, M., Kalantar, S. M., & Moini, A. (2017). A Review on Various Uses of N-Acetyl Cysteine. Cell Journal (Yakhteh) , 19 (1), 11-17. https://doi.org/10.22074/cellj.2016.4872 – A O’Leary, F., & Samman, S. (2010). Vitamin B12 in health and disease. Nutrients , 2 (3), 299–316. https://doi.org/10.3390/nu2030299 – A Olsson, E. M., von Schéele, B., & Panossian, A. G. (2009). A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta medica , 75 (2), 105–112. https://doi.org/10.1055/s-0028-1088346 – B Panossian, A., Wikman, G., Kaur, P., & Asea, A. (2009). Adaptogens exert a stress-protective effect by modulation of expression of molecular chaperones. Phytomedicine : international journal of phytotherapy and phytopharmacology , 16 (6-7), 617–622. https://doi.org/10.1016/j.phymed.2008.12.003 – Porter, K., Hoey, L., Hughes, C. F., Ward, M., & McNulty, H. (2016). Causes, Consequences and Public Health Implications of Low B-Vitamin Status in Ageing. Nutrients , 8 (11). https://doi.org/10.3390/nu8110725 – A Ran, L., Zhao, W., Wang, J., Wang, H., Zhao, Y., Tseng, Y., & Bu, H. (2017). Extra Dose of Vitamin C Based on a Daily Supplementation Shortens the Common Cold: A Meta-Analysis of 9 Randomized Controlled Trials. BioMed Research International , 2018 . https://doi.org/10.1155/2018/1837634 – A Shackebaei, D., King, N., Shukla, B., & Suleiman, M. S. (2005). Mechanisms underlying the cardioprotective effect of L-cysteine. Molecular and cellular biochemistry , 277 (1-2), 27–31. https://doi.org/10.1007/s11010-005-4817-y White, D. J., Klerk, S. D., Woods, W., Gondalia, S., Noonan, C., & Scholey, A. B. (2016). Anti-Stress, Behavioural and Magnetoencephalography Effects of an l-Theanine-Based Nutrient Drink: A Randomised, Double-Blind, Placebo-Controlled, Crossover Trial. Nutrients , 8 (1). https://doi.org/10.3390/nu8010053 – B Williams, J. L., Everett, J. M., D’Cunha, N. M., Sergi, D., Georgousopoulou, E. N., Keegan, R. J., McKune, A. J., Mellor, D. D., Anstice, N., & Naumovski, N. (2020). The Effects of Green Tea Amino Acid L-Theanine Consumption on the Ability to Manage Stress and Anxiety Levels: a Systematic Review. Plant foods for human nutrition (Dordrecht, Netherlands) , 75 (1), 12–23. https://doi.org/10.1007/s11130-019-00771-5 – A Yeh, L., Shih, C., Liu, J., Lin, H., Liu, M., Lei, T., & Lin, Y. (2017). The influence of prebiotic or probiotic supplementation on antibody titers after influenza vaccination: a systematic review and meta-analysis of randomized controlled trials. Drug Design, Development and Therapy , 12 , 217-230. https://doi.org/10.2147/DDDT.S155110 – A Zhang, H., Yeh, C., Jin, Z., Ding, L., Liu, B. Y., Zhang, L., & Dannelly, H. K. (2018). Prospective study of probiotic supplementation results in immune stimulation and improvement of upper respiratory infection rate. Synthetic and Systems Biotechnology , 3 (2), 113-120. https://doi.org/10.1016/j.synbio.2018.03.001 – C Disclaimer: The content provided is not intended to be for medical diagnosis or treatment, and is not meant to provide you medical or professional advice. Consult with your healthcare provider to determine if this plan is right for you. 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. We make no representation or warranty, express or implied, including, without limitation, any warranty of merchantability or of fitness for a particular purpose, and you assume full responsibility for the use of the content and products, and agree that Fullscript and its content providers are not responsible or liable for any claim, loss, injury or damage arising from your use of the information. Statements regarding dietary and other health care supplements have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease.
View protocolInflammation Improvement
Inflammation can have both positive and negative health effects. Acute inflammation works with the immune system to address infectious and non-infectious cellular damage. ( 1 ) However, when inflammation becomes chronic, it can seriously impact health. For example, studies have shown a correlation between chronic inflammation and all-cause, cancer, cardiovascular, and cerebrovascular mortality. ( 10 )( 12 ) Curcumin ( Curcuma longa ) 600–1,000 mg, total per day, minimum 8–10 weeks ( 4 )( 13 ) Curcumin decreased C-reactive protein (CRP) (-0.58 mg/l), tumor necrosis factor-alpha (TNF-α) (-3.48 pg/ml), interleukin 6 (IL-6) (-1.31 pg/ml), and malondialdehyde (MDA) (-0.33 umol/l), and increased superoxide dismutase (SOD) activity (20.51 u/l) and total antioxidant capacity (TAC) (0.21 mmol/l). ( 3 ) In patients with various chronic diseases, curcumin decreased CRP (-3.67 mg/l) and hs-CRP concentrations. ( 4 ) Compared to placebo, curcumin decreased IL-6 by ~49%, TNF-α by ~63%, and MDA by ~38% in patients with diabetes mellitus. ( 13 ) Omega-3 fatty acids (EPA/DHA) 2.5 g, total per day, minimum 12 weeks ( 7 )( 15 ) In patients with various health conditions, omega-3s moderately decreased serum CRP, as well as IL-6 and TNF-α with a smaller effect. ( 5 ) Compared to placebo, omega-3 supplementation decreased total serum cortisol by 19% and IL-6 levels by 33% during a stressful event, and CRP by ~30%, IL-6 by ~22%, and TNF-α by ~16% in patients with chronic kidney disease undergoing hemodialysis. ( 7 )( 15 ) Probiotics 1.6 × 109 CFU, total per day, minimum 8 weeks ( 8 )( 11 ) Prebiotics and probiotics modulate the intestinal microbiome and decrease oxidative stress and inflammation by increasing intestinal anaerobes and maintaining the integrity of the intestinal barrier. ( 6 ) Compared to placebo, a multistrain synbiotic reduced TNF-α by ~6% and hs-CRP by ~10% in postmenopausal females with obesity and a history of hormone-receptor-positive breast cancer. ( 11 ) Compared to placebo, Lactobacillus rhamnosus GG reduced IL1-Beta and lipopolysaccharide concentrations by ~ 35% and ~30%, respectively, in patients with CAD. ( 8 ) Quercetin ≥ 500 mg, total per day, minimum of 8 weeks ( 2 )( 9 )( 14 ) In individuals with chronic diseases, quercetin had a large effect on decreasing IL-6 and a smaller effect on decreasing serum CRP. ( 9 ) Quercetin decreased TNF-α and IL-6 in females with polycystic ovarian syndrome . ( 14 ) Compared to placebo, quercetin increased serum TAC by ~20% in post-myocardial infarction patients. ( 2 ) Evidence rating The following protocols were developed using only a,b,c -quality evidence Learn more about our rating scale References Chen, L., Deng, H., Cui, H., Fang, J., Zuo, Z., Deng, J., Li, Y., Wang, X., & Zhao, L. (2018). Inflammatory responses and inflammation-associated diseases in organs. Oncotarget , 9 (6), 7204–7218. https://doi.org/ 10.18632/oncotarget.23208 Dehghani, F., Sezavar Seyedi Jandaghi, S. H., Janani, L., Sarebanhassanabadi, M., Emamat, H., & Vafa, M. (2021). Effects of quercetin supplementation on inflammatory factors and quality of life in post-myocardial infarction patients: A double blind, placebo-controlled, randomized clinical trial. Phytotherapy Research , 35 (4), 2085–2098. https://doi.org/ 10.1002/ptr.6955 (B) Dehzad, M. J., Ghalandari, H., Nouri, M., & Askarpour, M. (2023). Antioxidant and anti-inflammatory effects of curcumin/turmeric supplementation in adults: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials. Cytokine , 164 , 156144. https://doi.org/ 10.1016/j.cyto.2023.156144 (A) Gorabi, A. M., Abbasifard, M., Imani, D., Aslani, S., Razi, B., Alizadeh, S., Bagheri-Hosseinabadi, Z., Sathyapalan, T., & Sahebkar, A. (2022). Effect of curcumin on C-reactive protein as a biomarker of systemic inflammation: An updated meta-analysis of randomized controlled trials. Phytotherapy Research , 36 (1), 85–97. https://doi.org/ 10.1002/ptr.7284 (A) Kavyani, Z., Musazadeh, V., Fathi, S., Hossein Faghfouri, A., Dehghan, P., & Sarmadi, B. (2022). Efficacy of the omega-3 fatty acids supplementation on inflammatory biomarkers: An umbrella meta-analysis. International Immunopharmacology , 111 , 109104. https://doi.org/ 10.1016/j.intimp.2022.109104 (A) Lopes, R. de C. S. O., Balbino, K. P., Jorge, M. D. P., Ribeiro, A. Q., Martino, H. S. D., & Alfenas, R. D. C. G. (2018). Modulation of intestinal microbiota, control of nitrogen products and inflammation by pre/probiotics in chronic kidney disease: A systematic review. Nutricion Hospitalaria , 35 (3), 722–730. https://doi.org/ 10.20960/nh.1642 (A) Madison, A. A., Belury, M. A., Andridge, R., Renna, M. E., Rosie Shrout, M., Malarkey, W. B., Lin, J., Epel, E. S., & Kiecolt-Glaser, J. K. (2021). Omega-3 supplementation and stress reactivity of cellular aging biomarkers: An ancillary substudy of a randomized, controlled trial in midlife adults. Molecular Psychiatry , 26 (7), 3034–3042. https://doi.org/ 10.1038/s41380-021-01077-2 (B) Moludi, J., Kafil, H. S., Qaisar, S. A., Gholizadeh, P., Alizadeh, M., & Vayghyan, H. J. (2021). Effect of probiotic supplementation along with calorie restriction on metabolic endotoxemia, and inflammation markers in coronary artery disease patients: A double blind placebo controlled randomized clinical trial. Nutrition Journal , 20 (1), 47. https://doi.org/ 10.1186/s12937-021-00703-7 (C) Ou, Q., Zheng, Z., Zhao, Y., & Lin, W. (2020). Impact of quercetin on systemic levels of inflammation: A meta-analysis of randomised controlled human trials. International Journal of Food Sciences and Nutrition , 71 (2), 152–163. https://doi.org/ 10.1080/09637486.2019.1627515 (A) Proctor, M. J., McMillan, D. C., Horgan, P. G., Fletcher, C. D., Talwar, D., & Morrison, D. S. (2015). Systemic inflammation predicts all-cause mortality: A glasgow inflammation outcome study. PloS One , 10 (3), e0116206. https://doi.org/ 10.1371/journal.pone.0116206 Raji Lahiji, M., Zarrati, M., Najafi, S., Yazdani, B., Cheshmazar, E., Razmpoosh, E., Janani, L., Raji Lahiji, M., & Shidfar, F. (2021). Effects of synbiotic supplementation on serum adiponectin and inflammation status of overweight and obese breast cancer survivors: A randomized, triple-blind, placebo-controlled trial. Supportive Care in Cancer , 29 (7), 4147–4157. https://doi.org/ 10.1007/s00520-020-05926-8 (B) Sharif, S., Van der Graaf, Y., Cramer, M. J., Kapelle, L. J., de Borst, G. J., Visseren, F. L. J., Westerink, J., & SMART study group. (2021). Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes. Cardiovascular Diabetology , 20 (1), 220. https://doi.org/ 10.1186/s12933-021-01409-0 Usharani, P., Mateen, A. A., Naidu, M. U. R., Raju, Y. S. N., & Chandra, N. (2008). Effect of NCB-02, atorvastatin and placebo on endothelial function, oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus: A randomized, parallel-group, placebo-controlled, 8-week study. Drugs in R&D , 9 (4), 243–250. https://doi.org/ 10.2165/00126839-200809040-00004 (B) Vaez, S., Parivr, K., Amidi, F., Rudbari, N. H., Moini, A., & Amini, N. (2023). Quercetin and polycystic ovary syndrome; inflammation, hormonal parameters and pregnancy outcome: A randomized clinical trial. American Journal of Reproductive Immunology , 89 (3), e13644. https://doi.org/ 10.1111/aji.13644 (B) Valle Flores, J. A., Fariño Cortéz, J. E., Mayner Tresol, G. A., Perozo Romero, J., Blasco Carlos, M., & Nestares, T. (2020). Oral supplementation with omega-3 fatty acids and inflammation markers in patients with chronic kidney disease in hemodialysis. Applied Physiology, Nutrition, and Metabolism , 45 (8), 805–811. https://doi.org/ 10.1139/apnm-2019-0729 (B) Disclaimer: The content provided is not intended to be for medical diagnosis or treatment, and is not meant to provide you medical or professional advice. Consult with your healthcare provider to determine if this plan is right for you. 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. We make no representation or warranty, express or implied, including, without limitation, any warranty of merchantability or of fitness for a particular purpose, and you assume full responsibility for the use of the content and products, and agree that Fullscript and its content providers are not responsible or liable for any claim, loss, injury or damage arising from your use of the information. Statements regarding dietary and other health care supplements have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease.
View protocolCholesterol Improvement
Based on current research findings presented below, the ingredients in this protocol have demonstrated efficacy in improving cholesterol profile and potentially cardiovascular outcomes. High cholesterol is one of the key markers when evaluating risk of cardiovascular disease, stroke, and related problems. According to the National Health and Nutrition Examination Survey (NHANES), in 2015-2016, 12.5% of adults had high total cholesterol, with men having a higher rate of prevalence. In conjunction, 18% of adults had low high-density lipoprotein (HDL) cholesterol. ( 14 ) Achieving a healthy cholesterol serum level has a valuable impact on decreasing risk for these events, and every bit helps. A decrease of 1 mmol/L in total cholesterol correlates with lower ischemic heart disease mortality. ( 15 ) Problems with blood pressure amplify the risks found with dyslipidemia, and were found to proportionally impact risk reduction when lowering cholesterol. ( 15 ) Red yeast rice Red yeast rice ( Monascus purpureus) 1200-2400 mg, once per day, minimum 8 to 12 weeks ( 10 ) Patients with dyslipidemia who were unable to continue statin use due to myalgia experienced decreased low-density lipoprotein (LDL) cholesterol by 43 mg/dL (1.11 mmol/L) at 12 weeks, and 0.90 mmol/L at 24 weeks, when taking 1800 mg twice daily, compared to baseline and placebo ( 1 ) A meta-analysis showed weighted mean difference in total cholesterol levels decreased by 0.91 mmol/L, triglycerides by 0.41 mmol/L, and LDL cholesterol by 0.73 mmol/L as well as increased high-density lipoprotein (HDL) by 0.15 mmol/L ( 10 ) Monocolin K-rich red yeast rice was found to be more effective in lowering total cholesterol and LDL cholesterol when compared to GABA-rich red yeast rice in patients with hyperlipidemia ( 24 ) A meta-analysis showed that in a number of small trials, red yeast rice was found to have similar effects to statins in ability to improve cholesterol profile ( 12 ) Coenzyme Q10 (CoQ10) 200 mg, once per day, minimum 3 months ( 23 ) Systematic review and meta-analysis of seven trials found supplementation effective in reducing triglyceride levels observed with consistent supplementation ( 20 ) Meta-analysis of eight trials found total cholesterol decrease of 1.07 (standardized mean difference) and HDL increased by 1.30 (standardized mean difference) in patients with coronary artery disease ( 6 ) Patients with dyslipidemia supplemented with 120 mg of CoQ10 for 24 weeks experienced a decrease in blood pressure, serum triglyceride, and LDL cholesterol; as well as an increase in total antioxidant diastolic blood pressure, and ApoA-I, demonstrating in an overall decrease in cardiovascular disease risk factors, when 120 mg per day ( 26 ) After supplementing with 200 mg for 1 week, an increase in serum CoQ10 correlated with improved HDL cholesterol as well as inhibition of monocyte-derived macrophage foam cell formation, suggesting overall improvement in cardiovascular health ( 25 ) Omega-3 fatty acids 2-4 g, total per day, minimum 3 months (Dose varies greatly based on EPA/DHA content) ( 23 )( 5 )( 9 ) By reducing VLDL, both EPA, and DHA when administered independently resulted in reduced fasting circulating triglyceride levels ( 13 ) Systematic review of six studies found supplementation of EPA or DHA greater than 2 g per day (with greater than or equal to 90% purity) was found to have a triglyceride concentration lowering effect, with DHA having a more significant impact at decreasing triglyceride concentration ( 5 ) Systematic review and meta-analysis found when given omega-3 fatty acids during statin therapy, an improvement in decreasing total cholesterol was demonstrated ( 2 ) Fasting serum triglyceride decreased by 25.9%, 25.5%, and 30.9% in groups supplemented with 2, 3, and 4 grams of omega-3 fatty acids respectively in patients with severe hypertriglyceridemia ( 8 ) When given in addition to rosuvastatin, 4 g per day of omega 3 fatty acids decreased triglyceride levels by 26.3% (11.4% in placebo) and non-HDL-C by 10.7% (2.2% in placebo), with combined supplementation showing the greatest impact in patients with residual hypertriglyceridemia ( 9 ) Garlic (Allium sativum) 400-600 mg, once per day, minimum 12 weeks ( 22 )( 19 ) Increase in HDL (high-density lipoprotein) in addition to a decrease in alipoprotein B and an increase in the LDL/alipoprotein B ratio was observed after supplementation with 6 g/day aged black garlic for 12 weeks ( 7 ) Supplementation decreased total cholesterol by 11.5%, decreased LDL by 13.8% and increased HDL cholesterol by 11.5% in men aged 35-70 with mild hypocholesterolemiam when given 600 mg per day ( 19 ) Meta-analysis of 14 papers found hyperlipidemia improved as demonstrated by n improvement in total cholesterol ( 21 ) Inflammation decreased as demonstrated by a decrease in arterial stiffness index, high-sensitivity C-reactive protein, LDL cholesterol, and total antioxidant status in obese patients compared to placebo, when given 400 mg per day ( 22 ) A meta-analysis showed that, when use of garlic supplementation was continued for at least 2 months, a decrease in total serum cholesterol by 8% and decreased risk of coronary event by 38% was observed in people 50 years of age ( 17 ) Garlic supplementation in patients with hypertension decreased blood pressure, helped to decrease slightly elevated cholesterol and increase immune function as shown by a decrease in blood pressure, and improvement in blood lipids when treated for a minimum of 2 weeks ( 16 ) L-Carnitine 2 g per day, minimum of 12 weeks ( 4 )( 11 ) Patients with hyperlipidemia demonstrated a decrease in lipoprotein (a) by 19.4% compared to 6.7% in placebo group when supplemented with 2 g per day of L-carnitine for 12 weeks; similar decreases in total cholesterol, LDL, apolipoprotein (b), and triacylglycerols ( 4 ) Decreased oxidation of LDL cholesterol occurred as demonstrated by a decrease in oxidized LDL levels by 15.1 U/L compared to 3.0 U/L in placebo, and LDL cholesterol by 0.45 mmol/L compared to 0.16 mmol/L in placebo in patients with type 2 diabetes when given 2 g per day ( 11 ) Decreases in plasma lipoprotein (a) were observed in hypercholesterolemic patients newly diagnosed with type 2 diabetes when supplemented with 1g twice per day of L-carnitine compared to placebo ( 3 ) 77.8% of patients with elevated Lp(a) experienced a reduction in lipoprotein (a) when supplemented compared to 38.9% in placebo; patients with a higher elevation at baseline experienced more significant decreases in Lp(a) with 2 g per day supplementation ( 18 ) Evidence rating The following protocols were developed using only a,b,c -quality evidence Learn more about our rating scale References Becker, D. J., Gordon, R. Y., Halbert, S. C., French, B., Morris, P. B., & Rader, D. J. (2009). Red yeast rice for dyslipidemia in statin-intolerant patients: a randomized trial. Annals of Internal Medicine , 150 (12), 830–839, W147–W149. https://pubmed.ncbi.nlm.nih.gov/19528562/ (C) Choi, H. D., & Chae, S. M. (2018). Comparison of efficacy and safety of combination therapy with statins and omega-3 fatty acids versus statin monotherapy in patients with dyslipidemia: A systematic review and meta-analysis. Medicine , 97 (50), e13593. https://pubmed.ncbi.nlm.nih.gov/30558030/ (A) Derosa, G., Cicero, A. F. G., Gaddi, A., Mugellini, A., Ciccarelli, L., & Fogari, R. (2003). The effect of L-carnitine on plasma lipoprotein(a) levels in hypercholesterolemic patients with type 2 diabetes mellitus. Clinical Therapeutics , 25 (5), 1429–1439. https://pubmed.ncbi.nlm.nih.gov/12867219/ (B) Florentin, M., Elisaf, M. S., Rizos, C. V., Nikolaou, V., Bilianou, E., Pitsavos, C., & Liberopoulos, E. N. (2017). L-Carnitine/Simvastatin Reduces Lipoprotein (a) Levels Compared with Simvastatin Monotherapy: A Randomized Double-Blind Placebo-Controlled Study. Lipids , 52 (1), 1–9. https://pubmed.ncbi.nlm.nih.gov/27914033/ (B) Innes, J. K., & Calder, P. C. (2018). The Differential Effects of Eicosapentaenoic Acid and Docosahexaenoic Acid on Cardiometabolic Risk Factors: A Systematic Review. International Journal of Molecular Sciences , 19 (2). https://doi.org/10.3390/ijms19020532 https://pubmed.ncbi.nlm.nih.gov/29425187/ (A) Jorat, M. V., Tabrizi, R., Mirhosseini, N., Lankarani, K. B., Akbari, M., Heydari, S. T., Mottaghi, R., & Asemi, Z. (2018). The effects of coenzyme Q10 supplementation on lipid profiles among patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials. Lipids in Health and Disease , 17 (1), 230. https://pubmed.ncbi.nlm.nih.gov/30296936/ (A) Jung, E.-S., Park, S.-H., Choi, E.-K., Ryu, B.-H., Park, B.-H., Kim, D.-S., Kim, Y.-G., & Chae, S.-W. (2014). Reduction of blood lipid parameters by a 12-wk supplementation of aged black garlic: a randomized controlled trial. Nutrition , 30 (9), 1034–1039. https://pubmed.ncbi.nlm.nih.gov/24976429/ (C) Kastelein, J. J. P., Maki, K. C., Susekov, A., Ezhov, M., Nordestgaard, B. G., Machielse, B. N., Kling, D., & Davidson, M. H. (2014). Omega-3 free fatty acids for the treatment of severe hypertriglyceridemia: the EpanoVa fOr Lowering Very high triglyceridEs (EVOLVE) trial. Journal of Clinical Lipidology , 8 (1), 94–106. https://pubmed.ncbi.nlm.nih.gov/24528690/ (C) Kim, C. H., Han, K. A., Yu, J., Lee, S. H., Jeon, H. K., Kim, S. H., Kim, S. Y., Han, K. H., Won, K., Kim, D.-B., Lee, K.-J., Min, K., Byun, D. W., Lim, S.-W., Ahn, C. W., Kim, S., Hong, Y. J., Sung, J., Hur, S.-H., … Kim, H.-S. (2018). Efficacy and Safety of Adding Omega-3 Fatty Acids in Statin-treated Patients with Residual Hypertriglyceridemia: ROMANTIC (Rosuvastatin-OMAcor iN residual hyperTrIglyCeridemia), a Randomized, Double-blind, and Placebo-controlled Trial. Clinical Therapeutics , 40 (1), 83–94. https://pubmed.ncbi.nlm.nih.gov/29223557/ (B) Liu, J., Zhang, J., Shi, Y., Grimsgaard, S., Alraek, T., & Fønnebø, V. (2006). Chinese red yeast rice (Monascus purpureus) for primary hyperlipidemia: a meta-analysis of randomized controlled trials. Chinese Medicine , 1 , 4. https://pubmed.ncbi.nlm.nih.gov/17302963/ (A) Malaguarnera, M., Vacante, M., Avitabile, T., Malaguarnera, M., Cammalleri, L., & Motta, M. (2009). L-Carnitine supplementation reduces oxidized LDL cholesterol in patients with diabetes. The American Journal of Clinical Nutrition , 89 (1), 71–76. https://pubmed.ncbi.nlm.nih.gov/19056606/ (C) Ong, Y. C., & Aziz, Z. (2016). Systematic review of red yeast rice compared with simvastatin in dyslipidaemia. Journal of Clinical Pharmacy and Therapeutics , 41 (2), 170–179. https://pubmed.ncbi.nlm.nih.gov/26956355/ (A) Oscarsson, J., & Hurt-Camejo, E. (2017). Omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and their mechanisms of action on apolipoprotein B-containing lipoproteins in humans: a review. Lipids in Health and Disease , 16 (1), 149. https://pubmed.ncbi.nlm.nih.gov/28797250/ (A) Products – Data Briefs – Number 290 – October 2017 . (2019, June 6). https://www.cdc.gov/nchs/products/databriefs/db290.htm https://www.cdc.gov/nchs/products/databriefs/db290.htm (F) Prospective Studies Collaboration, Lewington, S., Whitlock, G., Clarke, R., Sherliker, P., Emberson, J., Halsey, J., Qizilbash, N., Peto, R., & Collins, R. (2007). Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. The Lancet , 370 (9602), 1829–1839. https://pubmed.ncbi.nlm.nih.gov/18061058/ (A) Ried, K. (2016). Garlic Lowers Blood Pressure in Hypertensive Individuals, Regulates Serum Cholesterol, and Stimulates Immunity: An Updated Meta-analysis and Review. The Journal of Nutrition , 146 (2), 389S – 396S. https://pubmed.ncbi.nlm.nih.gov/26764326/ (A) Ried, K., Toben, C., & Fakler, P. (2013). Effect of garlic on serum lipids: an updated meta-analysis. Nutrition Reviews , 71 (5), 282–299. https://pubmed.ncbi.nlm.nih.gov/23590705/ (A) Sirtori, C. R., Calabresi, L., Ferrara, S., Pazzucconi, F., Bondioli, A., Baldassarre, D., Birreci, A., & Koverech, A. (2000). L-carnitine reduces plasma lipoprotein(a) levels in patients with hyper Lp(a). Nutrition, Metabolism, and Cardiovascular Diseases: NMCD , 10 (5), 247–251. https://pubmed.ncbi.nlm.nih.gov/11213533/ (C) Sobenin, I. A., Andrianova, I. V., Demidova, O. N., Gorchakova, T., & Orekhov, A. N. (2008). Lipid-lowering effects of time-released garlic powder tablets in double-blinded placebo-controlled randomized study. Journal of Atherosclerosis and Thrombosis , 15 (6), 334–338. https://pubmed.ncbi.nlm.nih.gov/19060427/ (C) Suksomboon, N., Poolsup, N., & Juanak, N. (2015). Effects of coenzyme Q10 supplementation on metabolic profile in diabetes: a systematic review and meta-analysis. Journal of Clinical Pharmacy and Therapeutics , 40 (4), 413–418. https://pubmed.ncbi.nlm.nih.gov/25913756/ (A) Sun, Y.-E., Wang, W., & Qin, J. (2018). Anti-hyperlipidemia of garlic by reducing the level of total cholesterol and low-density lipoprotein: A meta-analysis. Medicine , 97 (18), e0255. https://pubmed.ncbi.nlm.nih.gov/29718835/ (A) Szulińska, M., Kręgielska-Narożna, M., Świątek, J., Styś, P., Kuźnar-Kamińska, B., Jakubowski, H., Walkowiak, J., & Bogdański, P. (2018). Garlic extract favorably modifies markers of endothelial function in obese patients -randomized double blind placebo-controlled nutritional intervention. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie , 102 , 792–797. https://pubmed.ncbi.nlm.nih.gov/29604599/ (B) Tóth, Š., Šajty, M., Pekárová, T., Mughees, A., Štefanič, P., Katz, M., Spišáková, K., Pella, J., & Pella, D. (2017). Addition of omega-3 fatty acid and coenzyme Q10 to statin therapy in patients with combined dyslipidemia. Journal of Basic and Clinical Physiology and Pharmacology , 28 (4), 327–336. https://pubmed.ncbi.nlm.nih.gov/28541926/ (C) Wang, T.-J., Lien, A. S.-Y., Chen, J.-L., Lin, C.-H., Yang, Y.-S., & Yang, S.-H. (2019). A Randomized Clinical Efficacy Trial of Red Yeast Rice (Monascus pilosus) Against Hyperlipidemia. The American Journal of Chinese Medicine , 47 (2), 323–335. https://pubmed.ncbi.nlm.nih.gov/30871361/ (B) Yan, X., Shen, T., Jiang, X., Tang, X., Wang, D., Li, H., & Ling, W. (2015). Coenzyme Q10 consumption promotes ABCG1-mediated macrophage cholesterol efflux: a randomized, double-blind, placebo-controlled, cross-over study in healthy volunteers. Molecular Nutrition & Food Research , 59 (9), 1725–1734. https://pubmed.ncbi.nlm.nih.gov/26081100/ (C) Zhang, P., Yang, C., Guo, H., Wang, J., Lin, S., Li, H., Yang, Y., & Ling, W. (2018). Treatment of coenzyme Q10 for 24 weeks improves lipid and glycemic profile in dyslipidemic individuals. Journal of Clinical Lipidology , 12 (2), 417–427.e5. https://pubmed.ncbi.nlm.nih.gov/29454678/ (B) Disclaimer: The content provided is not intended to be for medical diagnosis or treatment, and is not meant to provide you medical or professional advice. Consult with your healthcare provider to determine if this plan is right for you. 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. We make no representation or warranty, express or implied, including, without limitation, any warranty of merchantability or of fitness for a particular purpose, and you assume full responsibility for the use of the content and products, and agree that Fullscript and its content providers are not responsible or liable for any claim, loss, injury or damage arising from your use of the information. Statements regarding dietary and other health care supplements have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease.
View protocolMature and Aging Skin Improvement
The ingredients presented below help address a variety of common factors in skin aging such as trans-epidermal water loss and elasticity. As life expectancy increases, concerns surrounding skin and its integrity while aging increase. Dermal changes are to be expected with age, as a variety of factors contribute to cutaneous health. Environmental factors such as sun exposure, air pollution, and lifestyle choices all play a role in eliciting premature aging and damaging skin cells. ( 13 ) Genetic factors such as ethnicity and gender also play a role. ( 5 ) Hydration levels in skin are found to inversely correlate with age. Elasticity determined by collagen production also decreases. Texture may also change with age as the dermis thins and roughness increases. Increased depth and number of sulci (wrinkles) occur as well. ( 5 ) Addressing these common hallmarks of aging skin may help preserve youthfulness and prevent further damage to the skin barrier. Collagen Total of 2.5-10 g per day, minimum 8 weeks ( 2 )( 4) Type I collagen hydrolysate derived from fish has been shown to improve wrinkles and roughness, as well as increase collagen density, skin firmness, skin moisture, and skin elasticity ( 3) ( 10 ) A systematic review of 11 studies found both short and long term collagen supplementation improved wound healing and skin aging factors like elasticity, hydration, and dermal collagen density ( 4 ) BioCell Collagen, collagen from chicken sternal cartilage, improved skin appearance and dryness shown by decreases in facial lines, wrinkles, and crows feet and a 12% increase in skin elasticity and cutaneous collagen content ( 17 ) Skin hydration, collagen density in dermis, and dermal collagen network integrity all improved when given Peptan®F and Peptan®P; additionally ex vivo experiments found supplementation to induce collagen and glycosaminoglycan production ( 2 ) Low-molecular weight collagen improved skin hydration, elasticity and visual assessment of skin wrinkling when compared to placebo ( 10 ) Hyaluronic Acid Oral: 120 mg, once per day, minimum 6 weeks ( 9)( 15 ) Topical: Apply 0.1% hyaluronan formulations, twice per day, minimum 2 months ( 16 ) Oral hyaluronic acid has been shown to increase skin moisture content and skin elasticity ( 7 ) (9) Compared to placebo, greater improvements in wrinkle volume ratio, wrinkle area ratio, and whole sulcus volume ratio were observed when oral hyaluronic acid was administered ( 15 ) High (800k) and low (300k) molecular weight oral hyaluronan supplementation both improved skin moisture content and subjective facial aging symptoms compared to placebo; low molecular weight hyaluronan improved moisture content as early as 2 weeks compared to placebo ( 9 ) When using hyaluronic acid in topical form, twice daily application found all tested molecular weights (50, 130, 300, 800, and 2000 kDa) to improve skin hydration and overall elasticity; additionally, 130 and 50 kDa improved mean and max roughness as well as wrinkle depth ( 16 ) Pycnogenol 75-100 mg, total per day, minimum 30 days ( 6 )( 14) Postmenopausal women experienced improved skin hydration, skin elasticity, and increased mRNA expression of hyaluronic acid synthase-1 (HAS-1); a more pronounced effect was found for those suffering from dry skin conditions ( 11 ) Clinical grading of skin photoaging scores and age spot pigmentation decreased in women with mild to moderate photoaging ( 6 ) Women with melasma experienced a decrease in average area affected and pigmentary intensity when supplemented with pycnogenol; additionally, a general effectiveness rate of 80% was found ( 14 ) Turmeric Turmeric Variable based on form (follow manufacturer’s dose instructions) A systematic review of 18 studies found that skin disease severity improved compared to control in a variety of skin conditions including facial photoaging when using topical and/or ingested turmeric ( 19 ) Herbal combination containing turmeric (but not turmeric extract on its own) decreased transepidermal water loss in skin compared to placebo after four weeks ( 20 ) Hot water extract of curcuma longa improved skin hydration as shown by increased hyaluronan production; additionally, UVB-induced tumor necrosis factor-α and interleukin-1β were inhibited at the mRNA and protein levels ( 1 ) A systematic review of 11 studies found turmeric to improve a variety of skin conditions including facial redness ( 12 ) Astaxanthin 2-6 mg, total per day, minimum 8 weeks ( 8) ( 18) ( 21 ) Male and female subjects experienced improved skin wrinkle and elasticity on crows feet, as well as skin texture, moisture content of corneocyte layer, and corneocyte condition on cheeks; male subjects had improved skin wrinkles, elasticity, and transepidermal water loss on crows feet, as well as moisture content and sebum levels on cheeks ( 18 ) When given in conjunction with 3 g of collagen, 2 mg of astaxanthin per day improved skin elasticity, skin barrier integrity, and transepidermal water loss in photoaged facial skin; gene expression improved as shown by an increase in procollagen type I mRNA expression and a decrease in MMP-1 and -12 mRNA expression ( 21 ) Moisture loss in skin decreased in irradiated skin, while roughness and texture of skin improved in non-irradiated areas when healthy subjects were supplemented with 4 mg of astaxanthin and exposed to UV induced skin deterioration ( 8 ) Evidence rating The following protocols were developed using only a,b,c -quality evidence Learn more about our rating scale References Asada, K., Ohara, T., Muroyama, K., Yamamoto, Y., & Murosaki, S. (2019). Effects of hot water extract of Curcuma longa on human epidermal keratinocytes in vitro and skin conditions in healthy participants: A randomized, double-blind, placebo-controlled trial. Journal of Cosmetic Dermatology , 18 (6), 1866–1874. https://pubmed.ncbi.nlm.nih.gov/30809971/ (C) Asserin, J., Lati, E., Shioya, T., & Prawitt, J. (2015). The effect of oral collagen peptide supplementation on skin moisture and the dermal collagen network: evidence from an ex vivo model and randomized, placebo-controlled clinical trials. Journal of Cosmetic Dermatology , 14 (4), 291–301. https://pubmed.ncbi.nlm.nih.gov/26362110/ (C) Borumand, M., & Sibilla, S. (2014). Daily consumption of the collagen supplement Pure Gold Collagen® reduces visible signs of aging. Clinical Interventions in Aging , 9 , 1747–1758. https://pubmed.ncbi.nlm.nih.gov/25342893/ (C) Choi, F. D., Sung, C. T., Juhasz, M. L. W., & Mesinkovsk, N. A. (2019). Oral Collagen Supplementation: A Systematic Review of Dermatological Applications. Journal of Drugs in Dermatology: JDD , 18 (1), 9–16. https://pubmed.ncbi.nlm.nih.gov/30681787/ (A) Dąbrowska, A. K., Spano, F., Derler, S., Adlhart, C., Spencer, N. D., & Rossi, R. M. (2018). The relationship between skin function, barrier properties, and body-dependent factors. Skin Research and Technology: Official Journal of International Society for Bioengineering and the Skin , 24 (2), 165–174. https://pubmed.ncbi.nlm.nih.gov/29057509/ (F) Furumura, M., Sato, N., Kusaba, N., Takagaki, K., & Nakayama, J. (2012). Oral administration of French maritime pine bark extract (Flavangenol(®)) improves clinical symptoms in photoaged facial skin. Clinical Interventions in Aging , 7 , 275–286. https://pubmed.ncbi.nlm.nih.gov/22956863/ (C) Göllner, I., Voss, W., von Hehn, U., & Kammerer, S. (2017). Ingestion of an Oral Hyaluronan Solution Improves Skin Hydration, Wrinkle Reduction, Elasticity, and Skin Roughness: Results of a Clinical Study. Journal of Evidence-Based Complementary & Alternative Medicine , 22 (4), 816–823. https://pubmed.ncbi.nlm.nih.gov/29228816/ (C) Ito, N., Seki, S., & Ueda, F. (2018). The Protective Role of Astaxanthin for UV-Induced Skin Deterioration in Healthy People-A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients , 10 (7). https://pubmed.ncbi.nlm.nih.gov/29941810/ (C) Kawada, C., Yoshida, T., Yoshida, H., Sakamoto, W., Odanaka, W., Sato, T., Yamasaki, T., Kanemitsu, T., Masuda, Y., & Urushibata, O. (2015). Ingestion of hyaluronans (molecular weights 800 k and 300 k) improves dry skin conditions: a randomized, double blind, controlled study. Journal of Clinical Biochemistry and Nutrition , 56 (1), 66–73. https://pubmed.ncbi.nlm.nih.gov/25834304/ (B) Kim, D.-U., Chung, H.-C., Choi, J., Sakai, Y., & Lee, B.-Y. (2018). Oral Intake of Low-Molecular-Weight Collagen Peptide Improves Hydration, Elasticity, and Wrinkling in Human Skin: A Randomized, Double-Blind, Placebo-Controlled Study. Nutrients , 10 (7). https://pubmed.ncbi.nlm.nih.gov/29949889/ (B) Marini, A., Grether-Beck, S., Jaenicke, T., Weber, M., Burki, C., Formann, P., Brenden, H., Schönlau, F., & Krutmann, J. (2012). Pycnogenol® effects on skin elasticity and hydration coincide with increased gene expressions of collagen type I and hyaluronic acid synthase in women. Skin Pharmacology and Physiology , 25 (2), 86–92. https://pubmed.ncbi.nlm.nih.gov/22270036/ (C) Mata, I. R. da, Mata, S. R. da, Menezes, R. C. R., Faccioli, L. S., Bandeira, K. K., & Bosco, S. M. D. (2020). Benefits of turmeric supplementation for skin health in chronic diseases: a systematic review. Critical Reviews in Food Science and Nutrition , 1–15. https://pubmed.ncbi.nlm.nih.gov/32713186/ (A) McDaniel, D., Farris, P., & Valacchi, G. (2018). Atmospheric skin aging-Contributors and inhibitors. Journal of Cosmetic Dermatology , 17 (2), 124–137. https://pubmed.ncbi.nlm.nih.gov/29575554/ (F) Ni, Z., Mu, Y., & Gulati, O. (2002). Treatment of melasma with Pycnogenol. Phytotherapy Research: PTR , 16 (6), 567–571. https://pubmed.ncbi.nlm.nih.gov/12237816/ (C) Oe, M., Sakai, S., Yoshida, H., Okado, N., Kaneda, H., Masuda, Y., & Urushibata, O. (2017). Oral hyaluronan relieves wrinkles: a double-blinded, placebo-controlled study over a 12-week period. Clinical, Cosmetic and Investigational Dermatology , 10 , 267–273. https://pubmed.ncbi.nlm.nih.gov/28761365/ (B) Pavicic, T., Gauglitz, G. G., Lersch, P., Schwach-Abdellaoui, K., Malle, B., Korting, H. C., & Farwick, M. (2011). Efficacy of cream-based novel formulations of hyaluronic acid of different molecular weights in anti-wrinkle treatment. Journal of Drugs in Dermatology: JDD , 10 (9), 990–1000. https://pubmed.ncbi.nlm.nih.gov/22052267/ (C) Schwartz, S. R., Hammon, K. A., Gafner, A., Dahl, A., Guttman, N., Fong, M., & Schauss, A. G. (2019). Novel Hydrolyzed Chicken Sternal Cartilage Extract Improves Facial Epidermis and Connective Tissue in Healthy Adult Females: A Randomized, Double-Blind, Placebo-Controlled Trial. Alternative Therapies in Health and Medicine , 25 (5), 12–29. https://pubmed.ncbi.nlm.nih.gov/31221944/ (B) Tominaga, K., Hongo, N., Karato, M., & Yamashita, E. (2012). Cosmetic benefits of astaxanthin on humans subjects. Acta Biochimica Polonica , 59 (1), 43–47. https://pubmed.ncbi.nlm.nih.gov/22428137/ (C) Vaughn, A. R., Branum, A., & Sivamani, R. K. (2016). Effects of Turmeric (Curcuma longa) on Skin Health: A Systematic Review of the Clinical Evidence. Phytotherapy Research: PTR , 30 (8), 1243–1264. https://pubmed.ncbi.nlm.nih.gov/27213821/ (A) Vaughn, A. R., Clark, A. K., Notay, M., & Sivamani, R. K. (2018). Randomized Controlled Pilot Study of Dietary Supplementation with Turmeric or Herbal Combination Tablets on Skin Barrier Function in Healthy Subjects. Journal of Medicinal Food , 21 (12), 1260–1265. https://pubmed.ncbi.nlm.nih.gov/30457892/ (C) Yoon, H.-S., Cho, H. H., Cho, S., Lee, S.-R., Shin, M.-H., & Chung, J. H. (2014). Supplementating with dietary astaxanthin combined with collagen hydrolysate improves facial elasticity and decreases matrix metalloproteinase-1 and -12 expression: a comparative study with placebo. Journal of Medicinal Food , 17 (7), 810–816. https://pubmed.ncbi.nlm.nih.gov/24955642/ (C) Disclaimer: The content provided is not intended to be for medical diagnosis or treatment, and is not meant to provide you medical or professional advice. Consult with your healthcare provider to determine if this plan is right for you. 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. We make no representation or warranty, express or implied, including, without limitation, any warranty of merchantability or of fitness for a particular purpose, and you assume full responsibility for the use of the content and products, and agree that Fullscript and its content providers are not responsible or liable for any claim, loss, injury or damage arising from your use of the information. Statements regarding dietary and other health care supplements have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease.
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The protocol below presents ingredients based on current research findings that might help regulate blood sugar. Berberine 500 mg, three times per day, minimum 12 weeks ( 7 ) Meta-analysis of patients with T2DM given berberine exhibited better reduction in fasting plasma glucose (FPG), postprandial plasma glucose (PPG) and HbA1c levels compared to control; additionally, treatment was found to be more effective when combined with hypoglycemic medication or when given for less than 90 days with a dose less than 2 grams per day ( 13 ) Meta-analysis of 27 randomized controlled trials found berberine combined with hypoglycemics was more effective than hypoglycemic medications alone, and as equally effective as hypoglycemics when used for T2DM, hyperlipidemia and/or hypertension ( 12 ) Systematic review and meta-analysis of 14 randomized trials found berberine combined with lifestyle alterations to be more effective than lifestyle alterations alone; furthermore, berberine enhanced performance of hypoglycemic drugs ( 7 ) T2DM patients with dyslipidemia given one gram per day of berberine decreased FPG and postload plasma glucose, as well as improved lipid profile demonstrated by decreases in triglycerides, total cholesterol and LDL compared to placebo ( 26 ) Chromium picolinate 500 µg, two times per day, minimum four weeks ( 4 ) Current literature confirms a minor reduction in blood glucose when supplemented consistently for four weeks or longer ( 4 ) Chromium supplements should be taken with a carbohydrate-containing meal ( 8 ) Meta-analysis of 13 trials found chromium picolinate supplementation to help with glycemic control in diabetics shown by improvements in FPG and cholesterol ( 22 ) When given 600 mcg per day of chromium picolinate, patients with T2DM experienced improved glycemic control demonstrated by a decrease in fasting glucose concentration by -31.0 mg/dL compared to -14.0 mg/dL in control group ( 19 ) When combined with sulfonylurea, chromium picolinate improved anthropometric markers for body weight, body fat percentage and abdominal fat; additionally, insulin sensitivity improved compared to placebo ( 15 ) 63% of T2DM patients responded to chromium picolinate treatment with improved insulin sensitivity compared to 30% in placebo ( 24 ) Cinnamon 120-360 mg, total per day, minimum 3 months ( 14 ) Systematic review and meta-analysis of 18 studies found cinnamon to be effective in improving glucose as shown by a decrease fasting blood sugar by -19.26 mg/dL compared to placebo ( 17 ) Meta-analysis of 16 randomized controlled trials found cinnamon supplementation to decreased FBG and improve HOMA-IR in patients with T2DM and pre-diabetes ( 6 ) 500 mg of cinnamon bark given twice per day improved BMI, body fat, visceral fat, glycemic control, and lipid profile in patients with T2DM; more pronounced benefits were found in patients with higher baseline BMI ( 25 ) When comparing low dose (120 mg/d), high dose(360 mg/d), and placebo, cinnamon supplementation improved hemoglobic H(1c) and FBG in both low and high dose compared to placebo ( 14 ) Systematic review and meta-analysis of 10 randomized controlled trials found cinnamon to decrease levels of fasting plasma glucose and improve cholesterol levels when supplementing doses from 120 mg/day to 6 mg/day for 4 to 18 weeks ( 3 ) Psyllium husk 5 g, three times per day, minimum 6 weeks ( 21 ) In diabetic patients, demonstrated minor to moderate reduction in blood glucose levels ( 23 ) 15 g daily is a minimum dose and can be titrated up gradually to patient tolerance with no current literature pointing towards an increased benefit of using more than 15 g daily ( 21 ) Meta-analysis of 35 randomized controlled trials found psyllium to be efficacious lifestyle treatment of patients with T2DM; additionally patients with less glycemic control benefited the most significantly ( 9 ) Improved constipation, body weight, glucose and lipid in patients with type 2 diabetes and chronic constipation with (BMI) 20-47 kg/m2 ( 18 ) Insulin sensitivity improved as demonstrated by decrease in FBS, HbA1c, insulin level, C-peptide, HOMA-IR and HOMA-β % compared to control ( 1 ) Probiotics Probiotic with mixed strains, as directed on bottle ( 2 )( 10 ) Meta-analysis of 8 randomized controlled trials found probiotics to be effective to improve metabolic control in patients with T2DM as shown by a reduction in HbA1c and HOMA-Ir ( 10 ) When given a mixed probiotic of seven strains of Lactobacillus, Bifidobacterium and Streptococcus for five weeks, T2DM patients experienced decreased FPG and increased HDL-C ( 20 ) Patients with T2DM experienced decreased HOMA-IR, HbA1c by 0.39%, and improved insulin resistance when given a mixed probiotic for 8 weeks ( 11 ) Systematic review and meta-analysis of 13 clinical trials found probiotics to decrease fasting blood glucose and hemoglobin A1c ( 2 ) Evidence rating The following protocols were developed using only a,b,c -quality evidence Learn more about our rating scale References Abutair, A. S., Naser, I. A., & Hamed, A. T. (2016). Soluble fibers from psyllium improve glycemic response and body weight among diabetes type 2 patients (randomized control trial). Nutrition Journal , 15 (1), 86. https://pubmed.ncbi.nlm.nih.gov/27733151/ (C) Akbari, V., & Hendijani, F. (2016). Effects of probiotic supplementation in patients with type 2 diabetes: systematic review and meta-analysis. Nutrition Reviews , 74 (12), 774–784. https://pubmed.ncbi.nlm.nih.gov/27864537/ (A) Allen, R. W., Schwartzman, E., Baker, W. L., Coleman, C. I., & Phung, O. J. (2013). Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis. Annals of Family Medicine , 11 (5), 452–459. https://pubmed.ncbi.nlm.nih.gov/24019277/ (A) Anderson, R. A., Cheng, N., Bryden, N. A., Polansky, M. M., Cheng, N., Chi, J., & Feng, J. (1997a). Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes , 46 (11), 1786–1791. https://pubmed.ncbi.nlm.nih.gov/9356027/ (C) Bullard, K. M., Cowie, C. C., Lessem, S. E., Saydah, S. H., Menke, A., Geiss, L. S., Orchard, T. J., Rolka, D. B., & Imperatore, G. (2018). Prevalence of Diagnosed Diabetes in Adults by Diabetes Type – United States, 2016. MMWR. Morbidity and Mortality Weekly Report , 67 (12), 359–361. https://pubmed.ncbi.nlm.nih.gov/29596402/ (F) Deyno, S., Eneyew, K., Seyfe, S., Tuyiringire, N., Peter, E. L., Muluye, R. A., Tolo, C. U., & Ogwang, P. E. (2019). Efficacy and safety of cinnamon in type 2 diabetes mellitus and pre-diabetes patients: A meta-analysis and meta-regression. Diabetes Research and Clinical Practice , 156 , 107815. https://pubmed.ncbi.nlm.nih.gov/31425768/ (A) Dong, H., Wang, N., Zhao, L., & Lu, F. (2012). Berberine in the treatment of type 2 diabetes mellitus: a systemic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine: eCAM , 2012 , 591654. https://pubmed.ncbi.nlm.nih.gov/23118793/ (A) Frauchiger, M. T., Wenk, C., & Colombani, P. C. (2004). Effects of acute chromium supplementation on postprandial metabolism in healthy young men. Journal of the American College of Nutrition , 23 (4), 351–357. https://pubmed.ncbi.nlm.nih.gov/15310739/ (C) Gibb, R. D., McRorie, J. W., Jr, Russell, D. A., Hasselblad, V., & D’Alessio, D. A. (2015). Psyllium fiber improves glycemic control proportional to loss of glycemic control: a meta-analysis of data in euglycemic subjects, patients at risk of type 2 diabetes mellitus, and patients being treated for type 2 diabetes mellitus. The American Journal of Clinical Nutrition , 102 (6), 1604–1614. https://pubmed.ncbi.nlm.nih.gov/26561625/ (A) Kasińska, M. A., & Drzewoski, J. (2015). Effectiveness of probiotics in type 2 diabetes: a meta-analysis. Polskie Archiwum Medycyny Wewnetrznej , 125 (11), 803–813. https://pubmed.ncbi.nlm.nih.gov/26431318/ (A) Kobyliak, N., Falalyeyeva, T., Mykhalchyshyn, G., Kyriienko, D., & Komissarenko, I. (2018). Effect of alive probiotic on insulin resistance in type 2 diabetes patients: Randomized clinical trial. Diabetes & Metabolic Syndrome , 12 (5), 617–624. https://pubmed.ncbi.nlm.nih.gov/29661605/ (B) Lan, J., Zhao, Y., Dong, F., Yan, Z., Zheng, W., Fan, J., & Sun, G. (2015). Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. Journal of Ethnopharmacology , 161 , 69–81. https://pubmed.ncbi.nlm.nih.gov/25498346/ (A) Liang, Y., Xu, X., Yin, M., Zhang, Y., Huang, L., Chen, R., & Ni, J. (2019). Effects of berberine on blood glucose in patients with type 2 diabetes mellitus: a systematic literature review and a meta-analysis. Endocrine Journal , 66 (1), 51–63. https://pubmed.ncbi.nlm.nih.gov/30393248/ (A) Lu, T., Sheng, H., Wu, J., Cheng, Y., Zhu, J., & Chen, Y. (2012). Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutrition Research , 32 (6), 408–412. https://pubmed.ncbi.nlm.nih.gov/22749176/ (B) Martin, J., Wang, Z. Q., Zhang, X. H., Wachtel, D., Volaufova, J., Matthews, D. E., & Cefalu, W. T. (2006). Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care , 29 (8), 1826–1832. https://pubmed.ncbi.nlm.nih.gov/16873787/ (C) https://www.cdc.gov/media/releases/2014/p0610-diabetes-report.html#:~:text=People%20with%20diabetes%20often%20use,for%20Disease%20Control%20and%20Prevention.n (F) More than 29 million Americans have diabetes; 1 in 4 doesn’t know . (2019, February 4). Namazi, N., Khodamoradi, K., Khamechi, S. P., Heshmati, J., Ayati, M. H., & Larijani, B. (2019). The impact of cinnamon on anthropometric indices and glycemic status in patients with type 2 diabetes: A systematic review and meta-analysis of clinical trials. Complementary Therapies in Medicine , 43 , 92–101. https://pubmed.ncbi.nlm.nih.gov/30935562/ (A) Noureddin, S., Mohsen, J., & Payman, A. (2018). Effects of psyllium vs. placebo on constipation, weight, glycemia, and lipids: A randomized trial in patients with type 2 diabetes and chronic constipation. Complementary Therapies in Medicine , 40 , 1–7. https://pubmed.ncbi.nlm.nih.gov/30219432/ (C) Paiva, A. N., Lima, J. G. de, Medeiros, A. C. Q. de, Figueiredo, H. A. O., Andrade, R. L. de, Ururahy, M. A. G., Rezende, A. A., Brandão-Neto, J., & Almeida, M. das G. (2015). Beneficial effects of oral chromium picolinate supplementation on glycemic control in patients with type 2 diabetes: A randomized clinical study. Journal of Trace Elements in Medicine and Biology: Organ of the Society for Minerals and Trace Elements , 32 , 66–72. https://pubmed.ncbi.nlm.nih.gov/26302914/ (C) Razmpoosh, E., Javadi, A., Ejtahed, H. S., Mirmiran, P., Javadi, M., & Yousefinejad, A. (2019). The effect of probiotic supplementation on glycemic control and lipid profile in patients with type 2 diabetes: A randomized placebo controlled trial. Diabetes & Metabolic Syndrome , 13 (1), 175–182. https://pubmed.ncbi.nlm.nih.gov/30641692/ (B) Rodríguez-Morán, M., Guerrero-Romero, F., & Lazcano-Burciaga, G. (1998). Lipid- and glucose-lowering efficacy of Plantago Psyllium in type II diabetes. Journal of Diabetes and Its Complications , 12 (5), 273–278. https://pubmed.ncbi.nlm.nih.gov/9747644/ (B) San Mauro-Martin, I., Ruiz-León, A. M., Camina-Martín, M. A., Garicano-Vilar, E., Collado-Yurrita, L., Mateo-Silleras, B. de, & Redondo Del Río, M. D. P. (2016). [Chromium supplementation in patients with type 2 diabetes and high risk of type 2 diabetes: a meta-analysis of randomized controlled trials]. Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral , 33 (1), 27. https://pubmed.ncbi.nlm.nih.gov/27019254/ (A) Sierra, M., García, J. J., Fernández, N., Diez, M. J., & Calle, A. P. (2002). Therapeutic effects of psyllium in type 2 diabetic patients. European Journal of Clinical Nutrition , 56 (9), 830–842. https://pubmed.ncbi.nlm.nih.gov/12209371/ (C) Wang, Z. Q., Qin, J., Martin, J., Zhang, X. H., Sereda, O., Anderson, R. A., Pinsonat, P., & Cefalu, W. T. (2007). Phenotype of subjects with type 2 diabetes mellitus may determine clinical response to chromium supplementation. Metabolism: Clinical and Experimental , 56 (12), 1652–1655. https://pubmed.ncbi.nlm.nih.gov/17998017/ (B) Zare, R., Nadjarzadeh, A., Zarshenas, M. M., Shams, M., & Heydari, M. (2019). Efficacy of cinnamon in patients with type II diabetes mellitus: A randomized controlled clinical trial. Clinical Nutrition , 38 (2), 549–556. https://pubmed.ncbi.nlm.nih.gov/29605574/ (B) Zhang, Y., Li, X., Zou, D., Liu, W., Yang, J., Zhu, N., Huo, L., Wang, M., Hong, J., Wu, P., Ren, G., & Ning, G. (2008). Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. The Journal of Clinical Endocrinology and Metabolism , 93 (7), 2559–2565. https://pubmed.ncbi.nlm.nih.gov/18397984/ (C) Disclaimer: The content provided is not intended to be for medical diagnosis or treatment, and is not meant to provide you medical or professional advice. Consult with your healthcare provider to determine if this supplement plan is right for you. 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. We make no representation or warranty, express or implied, including, without limitation, any warranty of merchantability or of fitness for a particular purpose, and you assume full responsibility for the use of the content and products, and agree that Fullscript and its content providers are not responsible or liable for any claim, loss, injury or damage arising from your use of the information. Statements regarding dietary and other health care supplements have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease.
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