Multivitamin Side Effects? Yes.

While opening a container of multivitamins and swallowing a couple seems like a pretty easy task, it is not done properly patient after patient.

There are side effects with most anything you consume - including multivitamin side effects.



Multivitamin side effects range from:

• upset stomach
• constipation
• diarrhea
• flushing
• poor sleep
• too much energy followed by a crash
• nausea or dizziness
• headache
  

Common Issues with Sleep:
I see this constantly with patients in the teaching clinic. There are so many causes to poor sleep that it can by a nightmare to determine the cause with people. I tend to start out this way:

Me: "How is your sleep? Do you tend to toss n turn or wake every now and then?"
Them: "Yes actually. I do. Im not stressed either."
Me: "When do you take your multivitamin?"
Them: "At night right before bed."

Doh.

Folks folks folks. Multivitamins are loaded with B vitamins which are utilized to enhance energy. Why take them before bed? To suffer?

When to take a multivitamin:
Take them in the morning with your breakfast. If you take them with food, you likely will have less stomach upset. If you take them in the morning, you will have energy during the day and may actually sleep better during the night. If the multivitamin says you can take without food, then you may be able to. Ask your doctor.

Fillers in Multivitamins = BAD
Why do we care what color a pill is? You realize how many pharmaceutical drugs contain artificial food coloring? How many supplements contain food coloring?

Avoid it will ya? Do you drink paint? No. Ok. Then don't eat that crap either. Seriously it is not healthy.

Other fillers:
Sugar, Sucralose, Aluminum. All bad in my book. Ask your doc about the specifics.

There are good multivitamins on the market - loads of them. There is no need to consume colored ones.

Read the labels. Fillers may lead to multivitamin side effects.

Capsules or Pills?
Some say capsules are better. Some say pills are better. I believe it all depends on the manufacturer, the ingredients, fillers and...your digestion. If you tend to belch, bloat or uhmm fart after taking in food, you may be low on hydrochloric acid. If you are low in this, then your absorption of the vitamins may be significantly reduced.

Constipation Diarrhea and multivitamins:
If you take multivitamins on an empty stomach, this may happen. It also may cause diarrhea depending on what is going on in your gut.

A multivitamin is super rich in vitamins. This concentrated product needs to be broken down and absorbed by the body. A highly concentrated substance signals the body to bring in a lot of water to dilute it. This flood of water into the digestive tract may lead to diarrhea.

The opposite may happen. A highly concentrated product still signals the body to bring in water to dilute it. However, the product binds all of the water. This leads to constipation.

What to do?
If your multivitamin says to take X number of capsules a day, then spread them out with breakfast and lunch. Definitely not dinner right? Good. I want that clear. Do not take multivitamins at night unless you want to stay awake.

Taking the multivitamins with food may help relieve the constipation or diarrhea. Also not taking a slew of your other pills at the same time may help relieve this also. If your digestion is weak, read the blog post I wrote about low hydrochloric acid.


Can I take multivitamins with other pills?
Again, taking too many different pills at once may tie into the diarrhea and constipation issue also. So keep that in mind as many pills may equal many issues.

If you take other pills, ask your doctor what they recommend in terms of taking multi's around other pills.

In terms of a nutrient absorption approach:
Multivitamins with Iron: if you take this type and you also take a calcium/magnesium supplement, you should take the multivitamin in the morning with food and take the calcium/magnesium supplement at lunch with food. If you need to take calcium/magnesium a few times during the day, then you may also take it before bed with a slight meal. Some say to take calcium/magnesium on an empty stomach. Ask your doctor what they recommend.

The biggest issue is the iron preventing absorption of the calcium. So folks, if there is a multivitamin that has iron in it and calcium - you are not getting the calcium. Sad fact.

If you are taking a multivitamin that has more than 500mg of vitamin C and also has vitamin B12, you are not going to get the vitamin B12. More than 500mg of vitamin C blocks the absorption of B12.

There are other blocking pathways as well but these are two key players.

Pass this blog post to all your friends. They will love you for it. We all love to sleep. Sleeping uninterrupted is bliss. Having energy during the day is also a bonus. I guess no nausea, vomiting, constipation or diarrhea is pretty good also.

Good luck out there.

Valentine's Day Gifts? Herpes, Toxins & Heart Issues

Gettin to be that time of year. Bustin out the chocolates, jewels, perfumes, flowers and who knows what else.

While I don't fully support this day as it is grossly commercialized, I like the idea. However, I prefer the day of March 8th - called Women's Day in Russia. This one I do celebrate - well because my wife is Russian. If your lady is Russian or Eastern European, and you don't know about this - now you do. Get out on March 8th and treat her like a woman. She'll love ya even more.

Tangent. Sorry.

Common Valentine's Day Gifts and Dangers with them:

Jewelry: I dont believe jewels will make her sick. It may make you sick from the cost but I actually think she'll be so happy that her immune system will be on overdrive.

Chocolate: Besides the obvious fillers, food coloring, preservatives and high saturated fat content clogging her gorgeous cardiovascular system and funking up her smoothly figured liver, there is another hidden danger of chocolate: Herpes outbreaks. Yes that sucks. Why does that happen? Well, chocolate is very high in arginine and low in lysine. Arginine in high amounts may lead to a herpes outbreak. We see this in the clinic all the time during this period. In fact, I'm already seeing it as people are eating more chocolate. Other foods that are high in arginine are nuts and peanuts. So careful. Don't want a herpes outbreak on such a passionate day do we?*

Perfumes: Ahh the aroma of her. Her natural smells are the best right? Good. Keep it that way. If she kinda smells a bit, go for natural deodorants, bathing salts, oils and she may want to avoid dairy products. Dairy products make many people a bit funky smelling. I for one fall into that category. If you know you've gotta have the perfume or bath salt or something that smells good, make sure you understand the toxicity of that product. The Environmental Working Group has done that job for you already. Choose from their suggested safe perfume product list. She will appreciate your concern. Trust me on that one.

On those notes, have a wonderful happy sexy Valentine's Day - and a healthy one at that.

*Ok - herpes outbreak. I got you freaked out. Sorry. Chocolate doesn't cause herpes but it may stimulate the herpes virus to replicate. So you may want to consider limiting chocolate, nuts and peanuts for her and you. If you do really gotta have chocolate, get to the health store and pick up some lysine. Ask your doctor how to dose it or check it out from a good source. So if you have or she has a history of cold sores, herpes simplex I or II - this blog post is for you.

Sleeping Poorly? Try this.

I've been sleeping off and on for years now and didn't realize why.
I got married.

While marriage is great, it also brings compromises. One compromise of mine:

Sleeping with the window closed.

I used to sleep with the window wide open all night all year long.

Our master bedroom is stuffy with heavy air filled with carbon dioxide. Id like to measure how much.

Lately, we have been sleeping with the window open and I've been sleeping wonderfully all night through and waking rested. My wife sleeps like a rock either way.

So if you suffer from constant waking at night, you may be lacking oxygen. Open your window. That just may do the trick.

If it doesn't, there may be other factors waking you up frequently at night:

• not enough protein before sleep causing low blood sugar swings which wake you up


• sleep apnea caused by food allergies, being overweight, soft palate weakness, nasal polyps, aspartame loaded softdrinks


• anxiety


• and others...

Try opening your window. I bet you'll sleep better.

Rheumatoid Arthritis: Dietary Management

Studies have shown over and over again that rheumatoid arthritis can be effectively managed in many individuals by simply what they eat. If those with rheumatoid arthritis eat according to what the research shows, then drugs may not have to be taken any longer and further joint destruction may not occur.


To summarize the studies:

• high arachidonic acid leads to inflammatory, unstable cell membranes which flare RA patients
• fish oil has shown to be effective in reducing arachidonic levels and thereby lowering inflammation
• vegan diets have shown to be effective in reducing symptoms in rheumatoid arthritis patients
• removing gluten containing foods has shown to be useful
• not eating dairy and cheese has shown considerable improvement in rheumatoid arthritis
  
• eliminating food intolerances/allergens has been shown to be useful
• poor intestinal health leads to increased food allergens causing rheumatoid arthritis
  

Read the full studies:

• Rheumatoid arthritis and food: a case study

• Vegan Diet Free of Gluten improves Rheumatoid Arthritis

Read additional research abstracts:

IgA rheumatoid factor and IgG dietary protein antibodies are associated in rheumatoid arthritis.

School of Biological Sciences, University of Sussex, U.K.

This study sought to determine whether patients with rheumatoid arthritis (RA) were immunologically sensitised to dietary protein (DP). Using an enzyme linked immunosorbent assay (ELISA), antibodies to milk and wheat proteins were measured in 93 unselected out-patients with classical or definite RA. Of these 93, 53 had raised levels of IgG antibodies to one or both dietary proteins (DP). In the DP antibody positive group, 48 patients (90%) also had raised levels of IgA rheumatoid factor (measured by ELISA) while only 7 (17%) of the 40 DP antibody negative patients had detectable IgA RF; P less than 0.02. There was no association between IgM rheumatoid factor and dietary protein antibodies. These results demonstrate that in RA, raised levels of IgA RF are associated with an increased IgG response to antigens which enter the body through the gastrointestinal tract. A breakdown in gastrointestinal tolerance to dietary antigens may play a role in the immunopathogenesis of RA in these patients who might therefore benefit from dietary manipulation.

PMID: 2767736 [PubMed - indexed for MEDLINE]

Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis.

Medizinische Klinik Innenstadt der LMU, Ziemssenstrasse 1, 80336 Munich, Germany. olaf.adam@lrz.uni-muenchen.de

BACKGROUND: Patients with rheumatoid arthritis (RA) improve on a vegetarian diet or supplementation with fish oil. We investigated the effects of both dietary measures, alone and in combination, on inflammation, fatty acid composition of erythrocyte lipids, eicosanoids, and cytokine biosynthesis in patients with RA.

METHODS: Sixty-eight patients with definitive RA were matched into two groups of 34 subjects each. One group was observed for 8 months on a normal western diet (WD) and the other on an anti-inflammatory diet (AID) providing an arachidonic acid intake of less than 90 mg/day. Patients in both groups were allocated to receive placebo or fish oil capsules (30 mg/kg body weight) for 3 months in a double-blind crossover study with a 2-month washout period between treatments. Clinical examination and routine laboratory findings were evaluated every month, and erythrocyte fatty acids, eicosanoids, and cytokines were evaluated before and after each 3-month experimental period. RESULTS: Sixty patients completed the study. In AID patients, but not in WD patients, the numbers of tender and swollen joints decreased by 14% during placebo treatment. In AID patients, as compared to WD patients, fish oil led to a significant reduction in the numbers of tender (28% vs 11%) and swollen (34% vs 22%) joints (P<0.01).>0.01), 11-dehydro-thromboxane B(2) (15% vs 10%, P<0.05),>

CONCLUSION: A diet low in arachidonic acid ameliorates clinical signs of inflammation in patients with RA and augments the beneficial effect of fish oil supplementation.

PMID: 12548439 [PubMed - indexed for MEDLINE]

Effects of high-dose fish oil on rheumatoid arthritis after stopping nonsteroidal antiinflammatory drugs. Clinical and immune correlates.

Division of Rheumatology, Albany Medical College A-100, NY 12208, USA.

OBJECTIVE. To determine the following: 1) whether dietary supplementation with fish oil will allow the discontinuation of nonsteroidal antiinflammatory drugs (NSAIDs) in patients with rheumatoid arthritis (RA); 2) the clinical efficacy of high-dose dietary omega 3 fatty acid fish oil supplementation in RA patients; and 3) the effect of fish oil supplements on the production of multiple cytokines in this population.

METHODS. Sixty-six RA patients entered a double-blind, placebo-controlled, prospective study of fish oil supplementation while taking diclofenac (75 mg twice a day). Patients took either 130 mg/kg/day of omega 3 fatty acids or 9 capsules/day of corn oil. Placebo diclofenac was substituted at week 18 or 22, and fish oil supplements were continued for 8 weeks (to week 26 or 30). Serum levels of interleukin-1 beta (IL-1 beta), IL-2, IL-6, and IL-8 and tumor necrosis factor alpha were measured by enzyme-linked immunosorbent assay at baseline and during the study.

RESULTS. In the group taking fish oil, there were significant decreases from baseline in the mean (+/- SEM) number of tender joints (5.3 +/- 0.835; P < p =" 0.008)," p =" 0.017" p =" 0.036," p =" 0.004)." p =" 0.011)" p =" 0.043)." p =" 0.026).">

CONCLUSION. Patients taking dietary supplements of fish oil exhibit improvements in clinical parameters of disease activity from baseline, including the number of tender joints, and these improvements are associated with significant decreases in levels of IL-1 beta from baseline. Some patients who take fish oil are able to discontinue NSAIDs without experiencing a disease flare.

Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis.

St Helena Hospital, Deer Park, CA, USA.

OBJECTIVE: To demonstrate the effects of a very low-fat, vegan diet on patients with rheumatoid arthritis (RA). DESIGN: Single-blind dietary intervention study.

SUBJECTS AND STUDY INTERVENTIONS: This study evaluated the influence of a 4-week, very low-fat (approximately 10%), vegan diet on 24 free-living subjects with RA, average age, 56 +/- 11 years old. Outcome measurements: Prestudy and poststudy assessment of RA symptomatology was performed by a rheumatologist blind to the study design. Biochemical measures and 4-day diet data were also collected. Subjects met weekly for diet instruction, compliance monitoring, and progress assessments.

RESULTS: There were significant (p <> 0.05). Weight also decreased significantly (p <> 0.05), RA factor decreased 10% (ns, p > 0.05), while erythrocyte sedimentation rate was unchanged (p > 0.05).

CONCLUSION: This study showed that patients with moderate-to-severe RA, who switch to a very low-fat, vegan diet can experience significant reductions in RA symptoms.

Dr Bill Mitchell's Perfect Date

- taken Dec. 06' written by William Engelhardt

“I’ll tell you how to spend the perfect Friday night” Bill said.

The three of us had been sitting in the cafeteria milling over options on how to spend the evening. We had just finished a late afternoon class in which Bill had been teaching, and now slouched lazily on the cafeteria couches in a post class stupor, gazing at an imaginary center hovering a few feet above the floor between the three of us. Although we were all from different generations, we shared something deep in common. The three of us were Pisces, and we all agreed that Friday night was best spent in the company of a woman you loved.

“Yeah”, Bill said still gazing at the imaginary center. “The best way to spend a Friday night is cooking with your girl”. He leaned forward while his vision gained intensity. “But if you really want to score big, you have to bake a pie”. His eyes widened when he said the word pie. “Not just any pie...Apple Pie!” His eyes widened again.

Jimmy and I shifted our gaze towards Bill who was still staring at the imaginary center, but obviously drifting off into another universe as he so often did. This one revolved around baking apple pie from scratch and women.
“First, you have to gather fresh ingredients. Fresh apples are key! You also have to use real butter. Not this imitation crap!” He looked momentarily disgusted. “Then you add cinnamon, etc. See, you gather all the ingredients, and have it ready: the apples, the flour. But You don’t make the pie. You let the woman make the pie. You just help out and talk to them- listen. See, women love to cook and they love to talk. The kitchen is the perfect place for this. But even more so, woman love to bake pie!” His eyes widened again with the word “pie”.

Jimmy and I fixed our gaze once again into the imaginary center, which now had become a kitchen.

“And after the pie is finished, you put it on the counter to let it cool. That’s key! The smell of the crust and the apples and cinnamon filling the room. Good god!” Bill collapsed back into the couch as if the image might be too much to bear.
After pausing for a moment, he continued; “Then you share a glass of wine…talk some more, connect… and the pie….” He rolled his eyes up towards the ceiling for a moment, and drifted deeper into “pie universe”, as did we. He was now at the helm of the “Pie-ship Enterprise” with me and Jimmy as his eager passengers.

“See…”, he began slowly leaning forward once again as if gearing up to reveal some critical piece of information that might one day save our lives; “You serve it with a scoop of vanilla ice cream!”

“Oh yeah!” Jimmy and I chorused in unison with big slobbering grins on our faces.

“Vanilla ice cream is key! You put a scoop on that fresh piece of warm pie and share that first bite with your lady friend, and…. good god!” Bill collapsed back into the couch once again. “Then they’re yours forever!”

We all sighed in unison as if we had just made intense love with god, our gazes again fixed towards the imaginary center.

After a moment of silence spent drifting in Bill’s universe of apple pie and the perfect date, I broke the silence with a suggestion to him that he might substitute walnuts, coconut, and raisins for wheat and butter when making the pie’s crust.

“It’s amazing!”, I said with an unsure enthusiasm. “You don’t even have to bake the crust. You can make it raw!”

Bill shifted his gaze from the imaginary center and looked straight into my soul with his mysterious watery blue eyes. Leaning forward with one eyebrow raised in patient skepticism towards his obviously “green” pupil, he replied: “I’ll believe that when I taste it!”