Healing Bone Fractures, Part 1 of 5

Things have really slowed down in my life and I haven't been able to post anything for a few weeks. That's because on January 30th I badly broke my lower right leg! Even though I'm an outdoorsy kind of person, I figured if I made it this far in my life without breaking any bones, maybe I never will. Well, it turns out I was wrong!

The Niagara Escarpment along the east side of the Saugeen (Bruce) Peninsula not far from where we were hiking.

We were hiking along a trail near the Niagara Escarpment on the Saugeen (Bruce) Peninsula. This area is characterized by lots of dolomite rock outcroppings. Normally we would have been snowshoeing, but we got a couple of days of unseasonably warm weather and it rained a lot. The amount of snow went from 45 cm (1.5 feet) down to about 5 cm (2 inches), making it much more easy to walk in boots. While we were hiking, I stepped with my left foot into a crevice in the rock that I couldn't see because it was covered in snow. It was quite deep. I never hit bottom and all of my weight came down on my right shin on the rock. I have a clean break in my fibula just below my knee, but my tibia was shattered just above my ankle. I'll spare you the details of how we got out of there, but it was quite a trip! Had there still been enough snow to snowshoe, my foot wouldn't have fit into that crevice.

This is more like the terrain where we were hiking (and the right season!).

Because of the severity of the fracture, I needed surgery. They weren't able to get me into surgery until the following day. The injury occurred around noon on the 30th and I didn't get into surgery until around 4:30 pm on the 31st. I had to have a 25 cm (10 inch) plate screwed into my tibia to hold the pieces together. I have no cast because I need to be able to move and stretch the tendons and ligaments in my ankle and knee so they don't tighten up too much while I'm off my leg.

Here are a couple of x-ray views of my leg with the plate taken the morning after my surgery.

It's a pretty messy affair and I suspect that I will need to have surgery again at some point to remove it.

According to the surgeon, this kind of fracture takes about four months to heal. If I'm lucky, three months at the absolute minimum. During this time my leg can't bear any weight. Once it is strong enough to bear weight, I will require a month or two of physiotherapy to get the strength back in my leg. So, he's predicting that this process is going to take 4-6 months.

What the surgeon doesn't know, because it's outside his paradigm, is that I have tools available to me to accelerate the healing of my leg. I have a basic protocol for treating bone fractures that I have used to help heal other people. This is the first time I'm going to be using it on myself!

I am going to use this as an opportunity to provide an example of how to heal a bone fracture. I will provide details of exactly how I am treating this on an ongoing basis, and updates as to how my healing is progressing. The important thing to keep in mind is, although I am following a basic protocol, it needs to be fine-tuned for each specific situation. If four different people came to me with similar fractures, I would treat each person slightly different depending on their specific needs, constitution, history, etc. What I am describing is how I have adapted this protocol to my own specific needs. Nevertheless, it will provide a good example of how I treat this kind of injury.

The protocol that I use is very complex. It requires five different components all of which are important: herbal treatment, both systemic and local; homeopathic treatment; supplements that help our body heal tissue damage and rebuild bone tissue; physical therapy; and dietary adjustments to support the healing of this type of injury.

I am going to begin by providing details of what I used in the interim when I didn't have everything available to me to complete the protocol. Then I will document what I am using and my progress in a continuing series of posts.

In the early evening on the day of the fracture, when it became apparent that the surgery wasn't going to happen that day, I had myself checked out and we went back to the cottage we were renting where I knew I would be more comfortable and be able to eat some good food and make use of whatever herbs and supplements I had on hand. My partner, Monika, tried to find some of the additional remedies I needed but was only able to obtain homeopathic Arnica in a 30C potency. Homeopathic Arnica is an essential remedy for any kind of sudden traumatic injury. It reduces swelling, bruising and pain, and supports the healing process. While we were still there and through the evening I took it every hour. I didn't sleep very well and took it every couple of hours through the night as well, and continued taking it every hour the next day up until my surgery. I resumed it when I awoke on Friday.

Mountain arnica (Arnica montana) is mostly used topically by herbalists because it is very irritating and mildly toxic when taken systemically.
It should only be used systemically by experienced herbalists. In homeopathic potencies this is not an issue.

Homeopaths rarely use homeopathic remedies in combination with other modalities. Although I am not a homeopath, I have a good understanding of the system and sometimes use homeopathic remedies in combination with herbs, especially for the treatment of acute conditions. In order to treat a situation holistically, I have found that it is best if we address it on as many different levels and in as many different ways as possible. The more severe the injury or illness, the more important it is to do this.

At the cottage I also had available to me a general herbal tonic formulation containing 1:5 fresh herb tinctures that provided some benefit in terms of reducing inflammation and pain, increasing circulation and supporting the healing process. It also contained some liver herbs that would help protect me from the side-effects of all the medications I was going to have to take before and after the surgery. I upped the dose from 3 ml into the acute dosage range at 6 ml. Because I was going to have to fast the following day before my surgery, I only had one dose before my dinner, but I resumed it as soon as I returned from the hospital after my surgery. I also had some supplements including vitamins C (calcium ascorbate), D and E, zinc, polyphenols, and a good quality low potency multivitamin with a very good trace mineral complex. I took one of everything and two vitamin C with my dinner, and resumed these when I returned after my surgery as well. The last thing I had is a herbal sedative which I travel with because sometimes I have difficulty sleeping when I'm in an unfamiliar environment. I took this before bed and a couple more doses through the night. I didn't sleep very well that night, mostly because I had to sleep on my back which I never do, but it did help me sleep a bit and reduce the pain and inflammation.

Up to this point, except for the insane pain when I actually broke my leg, as long as my leg didn't get banged or twisted the pain wasn't that bad. The Arnica was definitely a factor in this.

After the surgery, the doctor wanted me to stay another night to make sure I didn't end up with a kind of serious swelling that can occur with this kind of injury, or an infection, and that my pain was under control. However, I was determined to get out of there as quickly as possible so that I could get onto the remedies that I needed. I stopped dosing myself with the intravenous hydromorphone (a semi-synthetic derivative of morphine) as soon as I woke up so that they would see that I was managing the pain and asked to be disconnected from everything. The surgeon saw I was doing OK and I managed to get out by 1 pm. He gave me a prescription for a drug containing 300 mg of acetaminophen and 30 mg of codeine phosphate. I didn't fill the prescription. We did pick up a product containing 500 mg of acetaminophen without the codeine. I took one tablet on Friday evening shortly before bed when the pain in my leg got pretty intense for a few hours. That was all I used.

It is important to note that we should not use non-steroidal anti-inflammatory drugs (NSAIDs), such as acetylsalicylic acid, ibuprofen and naproxen, to treat the pain and inflammation associated with bone fractures as these drugs interfere with bone formation. Drinking alcohol also interferes somewhat with bone formation. This is mainly a concern for moderate to heavy drinkers, nevertheless, it is best drink very little or not at all. Smoking has a more pronounced negative impact on bone formation than alcohol.

We went back to the cottage and stayed for the next three days. Some friends were coming up for the weekend and we asked them to bring me some additional homeopathic remedies. At this point my interim protocol was as follows:

Homeopathics: Arnica 200C, Hypericum 200C and Symphytum 200C taken individually, four pellets per dose alternated throughout the day every 1-2 hours so that I was taking each remedy 4 times per day. Hypericum is a specific for nerve damage and nerve pain. Although I did not have any numbness or tingling, indicating that there probably wasn't any nerve damage from the original injury, there was a risk of nerve damage resulting from the surgery. Symphytum is a specific for healing bones. I tend to use Hypericum and Symphytum both in homeopathic form and in crude tincture form as you will see later. The two forms taken together are very synergistic, working much better than either the tincture or homeopathic individually.

Common comfrey (Symphytum officinale) is a specific for bone fractures, both in herbal and homeopathic forms.

Crude herb preparations must be used carefully as it contains pyrrolizidine alkaloids, which are liver toxins.

This is not an issue when taken in homeopathic potencies.

Herbs: I continued taking the tincture formulation I had with me at a higher dose until I was able to get home and formulate something specific for my injury. I took 6 ml in a bit of water on an empty stomach 10-15 minutes before each meal. I also continued to take the sedative formulation, 6 ml before bed and additional 3 ml doses through the night, if necessary.

Supplements: Making the best use of the supplements that I had available, I took the following (these are the doses of the nutrients that are particularly important for bone repair as provided by the individual products I had available to me):

• With breakfast: Vitamin A 3,500 IU, beta-carotene 7,500 mg, vitamin C 1,325 mg (from calcium ascorbate), vitamin D2 200 IU, vitamin D3 1,000 IU, vitamin K1 50 mcg, vitamin K2 10 mcg, calcium 152 mg (ascorbate), copper 0.5 mg (citrate), manganese 0.5 mg (citrate), zinc 5 mg (citrate), selenium 50 mcg (chelate), boron 0.35 mg (chelate), lutein 0.5 mg, bioflavonoids 100 mg (citrus extract), quercetin 100 mg, anthocyanidin 100 mg (mixed berry extract).
• With lunch: Vitamin C 1,200 mg (from calcium ascorbate), vitamin D3 1,000 IU, calcium 137 mg (ascorbate), quercetin 100 mg, anthocyanidin 100 mg (mixed berry extract).
• With dinner: Vitamin A 3,500 IU, beta-carotene 7,500 mg, vitamin C 1,325 mg (from calcium ascorbate), vitamin D2 200 IU, vitamin D3 1,000 IU, vitamin E 200 IU (mixed tocopherols), vitamin K1 50 mcg, vitamin K2 10 mcg, calcium 152 mg (ascorbate), copper 0.5 mg (citrate), manganese 0.5 mg (citrate), zinc 20 mg (citrate), selenium 50 mcg (chelate), boron 0.35 mg (chelate), lutein 0.5 mg, bioflavonoids 100 mg (citrus extract), quercetin 100 mg, anthocyanidin 100 mg (mixed berry extract).

Some of these are ingredients from a multivitamin that I took with breakfast and dinner. It is a good quality low potency multi with an excellent trace mineral content. It does not contain iron, calcium or magnesium because iron should only be taken when absolutely necessary and the amount of calcium and magnesium that can be included in a multivitamin is too low to be relevant. I did not list all of the ingredients of the multivitamin, only those that are important for bone repair. However, the full range of nutrients in the multi are important to support healing in general. In addition, I was also taking omega-3 fatty acids in the form of organic flax seed oil, 2-3 teaspoons taken throughout the day mixed in food (but not heated).

Other: From the moment I was able to stand after my injury I spent a lot of time wiggling my toes to help with circulation and to keep my feet as flexible as possible. Most other forms of movement were not possible until a few days after my surgery due to the severe swelling of my leg. Whenever I was sitting (always with my leg up to reduce swelling), a periodically massaged my knee and lower thigh to help prevent them from tightening up as much as possible. I was also doing deep breathing exercises in which I focused on "feeling" the life force energy or qi circulating through my body, particularly in my leg.

This is the end of my first post on the ongoing saga of my leg. In Part 2 I will provide the details of the complete protocol that I put myself on once I returned home.

More Bad News About BPA, Postscript

Just after I did my last post on BPA this came out:

http://www.sciencedaily.com/releases/2013/01/130124183630.htm

It seems that substances like BPA have epigenetic effects, influencing gene expression in ways that not only affect anyone exposed to it, but also future generations. So, it's bad enough that we're filling our bodies and the environment with it, but even if we could completely eliminate it from the environment today, it will still have a lasting influence on our children and grandchildren! I think that's plenty of reason to do our best to minimize exposure to this and similar chemicals, and demand that industry and governments start taking a more cautious and responsible approach to what can be used in products and dumped into our environment!

More Bad News About BPA (and Friends!)

Bisphenol A.

Bisphenol A (BPA) is one of many toxic chemicals that is known to be an endocrine disruptor and associated with a growing number of recognized negative health consequences. Although most of the research has focused on its estrogenic properties, a new study indicates that it can affect thyroid hormone levels in baby boys:

http://www.scientificamerican.com/article.cfm?id=lowered-thyroid-hormones-found-in-baby-boys-exposed-to-bispenol-a

In addition, it was recently discovered that a metabolite of BPA (a substance produced when BPA is metabolized or processed by our body) is even more estrogenic than BPA itself:

http://www.sciencedaily.com/releases/2012/10/121004200905.htm

BPA is found in many types of plastics and known to leach into foods and liquids stored in anything that contains it. One of the greatest sources of BPA is the plastic on the inner lining of canned foods and beverages that is used to prevent the contents of the cans from coming into contact with the metal that the can is composed of. Other major sources include thermal papers such as those used for cash register receipts and in fax machines. In studies where blood samples have been taken to determine the level of BPA in the blood and tissues of the subjects participating in the studies, cashiers tend to have among the highest levels because the BPA in receipts can be absorbed through our skin. Sadly, because thermal papers are included as a source of paper for recycling, paper that has post-consumer recycled content tends to have BPA as well.

Cigarette filters are another major source of BPA for smokers, providing another good reason to quit! It is also found in polycarbonate plastics, which includes the large plastic bottles that contain water for water dispensers, Nalgene drinking bottles, and many of the mixed bag of "Other" plastics that are labeled as #7.

BPA has been in use since the 1950s. As with so many other industrial chemicals, we have all been taking part in a continuous experiment on the toxicity of these chemicals, as have our animal and plant brothers and sisters.

This green frog (Rana clamitans), and all of the other beautiful beings that we share this planet with,

would love us to stop dumping endless amounts of toxic stuff into their (and our) environment!

It is insane that industries are allowed to use these things without adequate testing. As more research is done, we are beginning to comprehend some of their detrimental effects, but we still know virtually nothing about how all of these toxins interact in our bodies because almost all of the research is conducted on individual chemicals in isolation. Another major concern is that scientists are prone to linear thinking. That means that they assume that if a chemical seems to be safe at a particular dose, it will be even safer at a lower dose. However, recent research indicates that sometimes chemicals can be more toxic at very low doses than at higher doses:

http://www.scientificamerican.com/article.cfm?id=environmental-regulator-launches-new-effort-to-monitor-hormone-like-chemicals

http://www.sciencedaily.com/releases/2013/01/130122191412.htm

http://www.sciencedaily.com/releases/2012/07/120711210241.htm

Natural systems are incredibly complex and what we know is infinitesimally small compared to what there is to know. Things don't work in Nature the way they do in the artificial environment of a lab. There is very little in Nature that occurs in nice, neat linear patterns.

With the growing awareness of the harmful effects of BPA, many manufacturers are now offering "BPA Free" products. Well consider this: BPA has a function! If you take it out of something it must be replaced with something else. Unless these substances are added directly to foods or beverages for human consumption, there is very little regulation of them. That means that manufactures will just add some other chemical with little to no research on its potential harmful effects. And guess who are going to be the unwilling subjects in the longitudinal study on their harmful effects? That right ... all of us!

So, it turns out that in most of the "BPA Free" products out there the BPA has been replaced by a closely related substance called bisphenol S (BPS). There is considerably less research on BPS compared to BPA, but the research is starting to be done and (surprise!) it's looking like BPS might be just as bad as BPA:

http://www.scientificamerican.com/article.cfm?id=bpa-replacement-also-alters-hormones

Bisphenol S.

Ideally, regulatory agencies should be adhering to the precautionary principle, that is, that nothing should be allowed to be implemented outside a lab until we are certain that it will not have any negative consequences on the natural world (including us!). Or, as our Native American brothers and sisters would say, until we are sure that it will not have any negative consequences for the next seven generations.

Since the regulatory agencies don't get it (and are heavily influenced by industry), we need to think (and act) for ourselves. If we learn that something is bad for us and/or the environment, it makes sense to avoid it as much as possible - or it's supposedly "safe" replacement (e.g. avoid consuming things in cans as much as possible even if they are "BPA Free" and stick to glass bottles, or better still, make it fresh or can it ourselves). On the positive side, with a little education and effort, there are a lot of unhealthy things out there that we can avoid, and there are a lot of healthy choices that we can make as well.

The Misuse of Antibiotics In Infants

My last post was on the affect of toxicity prior to and during pregnancy and its affect on the next generation. On a similar theme, in this one we're looking at the importance of a healthy population of microorganisms in in the digestive tract of infants and it's impact on their future health. Let's begin with this:

http://www.sciencedaily.com/releases/2012/11/121108195409.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Feedfetcher

This study demonstrates that the use of antibiotics in infants has the potential to result in long-term changes in their gut flora. This has very important implications. Anyone who is familiar with some of the information on gut flora is likely to be aware of their importance for healthy digestion. However, recent research indicates that healthy gut flora are very important for the proper development of many important aspects of our health. Healthy gut flora is necessary for the normal development and maintenance of our immune system. For example, imbalances of gut flora early in life, such as those caused by the use of antibiotics, can lead to the development of autoimmune conditions such as allergies [see: http://www.sciencedaily.com/releases/2012/05/120507141146.htm]. More recently, evidence from animal studies suggests that infant gut flora also influences the development our nervous system as well [see: http://www.scientificamerican.com/article.cfm?id=the-neuroscience-of-gut], and it doesn't end there. The more research that is done on gut flora, the more amazing and important they become!

Herbs such as oregano (Origanum vulgare) can be effective alternatives to antibiotics.

However, contrary to popular belief, the tincture (especially of the fresh herb) is the

preparation of choice. Oregano essential oil is not recommended for internal use.

Antibiotics are very powerful drugs. They should only be used for the treatment of very serious, life-threatening infections for which natural treatments might not work quickly enough, or in situations where for some reason natural treatments might not be recommended. This is particularly true for infants, for whom the long-term detrimental affects of antibiotics are more profound. Although I can not definitively back this up with hard statistics, based on my knowledge and experience I don't think it would be an exaggeration to say that more than 99% of the time that antibiotics are prescribed for use in humans there use is unnecessary or inappropriate, and they are misused to an even much greater degree by the agricultural industry! Their abuse has led to innumerable negative health and environmental consequences including a growing proportion of microorganisms that have developed a resistance to their actions. So now they often don't work even in situations where their use is required.

Among other things, probiotics are very important for the prevention and treatment of infections, as well as to help restore the gut flora in situations where the use of antibiotics is unavoidable. That being said, it is not always possible for parents to be able to discern when herbal or other treatments are appropriate, or what treatment will be effective. With a little bit of knowledge some degree of self-treatment is possible, but it is important to have access to an experienced herbalist or other natural health practitioner whom you can consult with that can properly assess the situation if self-treatment isn't proving to be effective. For more information on the treatment of infections, see my previous post Treating Respiratory Infections which also includes links to several articles that I wrote on this topic. You can also find a fair bit of information on the use of probiotics for the prevention and treatment of infectious conditions as well as more detailed information on the treatment of infections, including in infants and children, in our online lecture Immune Support and the Natural Treatment of Colds and Flu. There is also some useful information in my previous post Probiotics and Fibre.

Lactobacillus delbrueckii ssp. bulgaricus is an important probiotic species that is used to make yogurt.

Many of the factors that I recommended for women who are planning to get pregnant in my previous post, Providing a Healthy Start for the Next Generation, will have a positive influence on the gut flora of their children when they are born. In addition, breastfeeding is also very important for the normal development of our intestinal microflora [see: http://www.sciencedaily.com/releases/2012/04/120429234641.htm]. I recommend that infants are nursed exclusively until they are 5-6 months old, and then foods introduced one at a time. Difficult to assimilate foods, such as animal proteins, dairy products, nuts and gluten containing grains should not be introduced until after one year. Whenever possible, it is also preferable that infants not be completely weaned until they are at least one year old as well. Of course, it is essential that nursing mothers engage in healthy diet and lifestyle practices while they are nursing, both for their own benefit as well as for the health of their child.

The importance of healthy gut flora is something that can not be stressed enough. It is one of the essential elements of maintaining our overall level of health and well-being. Along with a healthy diet and lifestyle, the use of good quality probiotic supplements periodically is very important to help keep our gut microflora in balance. Also essential for healthy gut flora is a strong, healthy digestive system and good elimination. Unfortunately, there are many factors that are difficult to control that can have a negative affect on the population of microorganisms that normally live in and on our body. This is why it is essential that we do our best to address those factors that we can control to some degree.

The roots of many plants from the Aster family, such as Jerusalem artichoke (Helianthus tuberosus),

contain polysaccharides that promote the growth of beneficial gut flora.

It is ironic that better nutrition, sanitation and hygiene were the most important factors that led to the reduction in infectious disease in the last 150 years - much more so than any advances in medicine. However, we have now gone too far towards the opposite extreme. As one of the researches indicated in an article that I linked to above, our obsession with hygiene is killing us. Remember, sterile means dead! Devoid of life! It's time we stopped dosing ourselves with antibiotics and antibacterial substances, from chlorine to triclosan to copper. Everywhere you look you can see it: antimicrobial soap and personal hygiene products, hand sanitizers, antimicrobial clothing... The net effect of all of this is that the microbes are getting stronger and we are getting weaker. Regular exposure to microorganisms is part of life and is necessary to maintain a strong immune system. Believe it or not, the number of microorganisms that live in and on our body outnumber our body cells by a factor of ten to one! So where does our body end and the rest of the world begin? We are really an ecosystem living in an ecosystem. We have been using antibiotics and antiseptics to indiscriminately kill off the other organisms that co-inhabit our body when we know almost nothing of their purpose. They are part of us and we part of them. This is another example of the human species out of balance. One of the many benefits of living in greater harmony with nature through the choices that we make each day is that we not only help to create an internal and external environment that supports the health and well-being of our cells, tissues, organs, and body as a whole, it also helps to create an environment that supports the life of the many organisms that we are meant to live with. In response, they do the same for us. It's a win-win situation. What more could we ask for?

Providing a Healthy Start for the Next Generation

Here's a discussion from Scientific American that references a couple of studies on chemicals that have been detected in umbilical cord blood:

http://www.scientificamerican.com/article.cfm?id=chemicals-umbilical-cord-blood

This has very important implications for the health of our children. First, let's put it into context. The blood of a mother and her child is separated by the placental membrane. One of the functions of this membrane is to prevent waste products and toxins in a mother's blood from entering the blood of her developing child. It is intended to protect the child, but is not 100% effective. Today there are thousands of toxic chemicals in our water, food and environment. Many of them will end up in our body fluids and tissues. Although our body has very efficient mechanisms for breaking down and eliminating these toxins, the level of toxicity that we are exposed to significantly exceeds our capacity to eliminate them much of the time. This is further exacerbated by the fact that the majority are synthetic or semi-synthetic chemicals that, until recently, the human body has never been exposed to. Just as our general mechanisms of detoxification are not capable of fully protecting us from this toxic chemical onslaught, similarly the placental membrane is not able to fully protect a developing child.

When 232 or 287 (depending on the study) chemicals are detected in umbilical cord blood, we need to keep in mind two things: firstly, this only represents a percentage of the chemicals in a mother's tissues as some would have been filtered out by the placental membrane; and secondly, that there are many more chemicals that could potentially be found in umbilical blood that these studies didn't test for. There is no study that has ever attempted to detect every possible known environmental toxin in umbilical cord blood, or in the human body for that matter. So, in reality, there could be two or five or ten times the number of chemicals that were found in these studies.

Medical professionals often claim that we shouldn't be concerned about this because these chemicals are usually at "acceptable levels". This is ridiculous because our understanding of the affects of these chemicals is insufficient to be able to determine what actually constitutes an acceptable level, especially concerning the affects of long-term exposure. We know even less about the potential affects on a developing child, and virtually nothing about how all of these chemicals interact in our body because the toxicological studies from which the "acceptable levels" are determined almost always focus on a single chemical. Fortunately, some medical researchers are beginning to sound the alarm. Unfortunately, the majority of doctors are still not aware of or unwilling to discuss this with their patients [for example, see: http://www.scientificamerican.com/article.cfm?id=should-doctors-warn-pregnant-women-about-environmental-risks].

Red clover (Trifolium pratense) is an excellent herb for detoxification. It is also a specific

for helping to protect women from toxins that are hormone disruptors.

One of the things that I've noticed in the last thirty years, in my practice, in the research literature, and in life in general, is that chronic illnesses are significantly on the rise. More importantly from the perspective of this discussion, they are affecting people at younger ages with each successive generation. One of the primary reasons for this is that each generation develops in the presence of whatever toxic chemicals are able to pass through the placental membrane and then after birth they continue to accumulate additional toxicity from the air they breathe, the water they drink, the food they eat, from things they put on their body and use in their home, and from other sources in their environment. By the time they start having children, their body fluids and tissues are likely to be considerably more toxic than those of their parents when they were born. The accumulative affect of this is the gradual erosion of the level of health and vitality of the entire human population from one generation to the next.

Until recently it was assumed that unless a substance has the capacity to produce a genetic mutation and is present at a critical stage of embryonic development when the mutation is more likely to occur, the relative risk of the substance is fairly low. However, in recent years there has been a growing body of research on epigenetic factors. This concerns the capacity of a substance to affect gene expression, even if it doesn't affect the genes themselves. Only a small percentage of the content of our chromosomes is actually DNA. Much of it is made up of substances that turn our genes on and off. Recent research has demonstrated that environmental toxins have the potential to affect gene expression. What is even more disturbing is that the affect can potentially last for many generations [for example, see: http://www.sciencedaily.com/releases/2012/03/120302101821.htm]. This means that even if we could somehow eliminate all toxicity in a particular generation by the time they begin to have children, some of the epigenetic affects of exposure to toxicity in previous generations will continue to be passed down to the next generation. Each generation is being affected by the accumulation of toxicity in the their parents, grandparents, great grandparents, etc., along with the affects of the toxicity that they are exposed to on a day-to-day basis. The affects of this toxicity doesn't just involve altered gene expression and potential damage to DNA. Toxins affect our cells and tissues in many ways including: interacting with the receptor sites of hormones, neurotransmitters and other chemical messengers; promoting oxidation of enzymes and cellular structures; chemically altering or binding to substances in our body cells and fluids and thereby changing their chemical properties; and altering the functioning of, irritating, damaging or killing our cells by other known and unknown mechanisms.

Sadly, few prospective parents are aware of this. On the positive side, there is a fair bit that can be done about it, although many parents are not willing to take the time or make the effort. One of the major challenges that I see in my practice is that women often come to me after deciding to get pregnant looking for support during their pregnancy, but they haven't considered the need for adequate preparation before getting pregnant. They tend to come to me around the time they want to start trying to get pregnant. As a result, some of them are somewhat discouraged when I recommend as a bare minimum six months, but preferably one year to prepare.

Ideally, beginning one year before they start trying to get pregnant, both parents should be eating a good diet consisting of lots of vegetables and fruits, and whole, natural, minimally processed foods that are certified organic as much as possible. They should also get lots of exercise, reduce stress and minimize exposure to toxicity in their diet, lifestyle, home and work environments. I also recommend eliminating the use or consumption of cigarettes, cigars and social drugs, and also minimizing or eliminating consumption of caffeine and alcohol. If they do continue to consume some caffeine and/or alcohol, these should be eliminated at least a couple of months before they start trying to get pregnant. The women should also not be consuming these while trying to get pregnant, and for the duration of time that they are pregnant and nursing. The men should continue to not consume these while their partner is trying to get pregnant. Once she is pregnant, it doesn't matter as much for him, but I still recommend sticking to this as much as possible to help support his partner.

During the year of preparation, the male partner should go on a herbal detox formulation for about nine months. Then, about three months before his partner starts trying to get pregnant, he should switch to an adaptogenic formulation and continue taking this until she gets pregnant. For more information on detoxification, here are links to two articles that I wrote for Vitality Magazine that discuss detoxing from slightly different perspectives:

http://vitalitymagazine.com/article/prescription-for-a-healthy-liver/

http://vitalitymagazine.com/article/herbal-allies-for-spring-liver-cleansing/

Although the focus of both of these articles is on the liver, they provide a lot of useful information that is relevant to any kind of detox. For anyone who is interested in learning about detoxification in greater detail, I will be including a lecture on detoxification in our series of online lectures at some point in the next couple of months. You can find more information on this and other lectures here:

http://www.livingearthschool.ca/h-generalcourses.htm#OLS

For more information on adaptogenic formulations, here is a link to another article:

http://vitalitymagazine.com/article/adaptogen-herbs/

Artist's conk (Ganoderma applanatum) is an excellent adaptogenic fungus

that helps support the reproductive system in men.

Women who are preparing to get pregnant should do a detox for the first six months, then alternate a detox formulation with a female reproductive tonic. The information on detoxification in the articles that I linked to above is also relevant for women. In addition, here is another article that discusses this from the perspective of the female reproductive system and addresses female reproductive tonics as well:

http://vitalitymagazine.com/article/restoring-hormonal-harmony-with-fertility-friendly-herbs-and-lifestyle/

Motherwort (Leonurus cardiaca) is one of my favorite female reproductive tonics.

Although this article is on fertility issues, the information is relevant to anyone who is trying to get pregnant whether they are having fertility difficulties or not. The issue of fertility and preparation for pregnancy will also be discussed in more detail in an upcoming online lecture. Anyone who is interested can check out the link above.

There are a lot of important things that need to be considered when it comes to having children. Among the more important considerations are what we need to do to give our children a healthy start. Many prospective parents in our society begin planning well in advance to make sure that they are financially capable of supporting a child. For the benefit of our children, it is important that we put at least as much time and energy to help bring them into the world with a strong, healthy body.

Happy Solstice!

Welcome winter!

The winter solstice has come and gone and the world hasn't ended yet! There were a lot of doomsday predictions floating around out there concerning the ending of the cycle of the fifth sun according to the Mayan calendar. Fortunately, most of that information was based on misinterpretations of the teachings of the Mayan prophesies.

Although much of the popular information about this time was inaccurate, there have been some positive outcomes resulting from all of the hype. There were probably more people gathered with their families, friends and communities around sacred fires around the globe honouring this sacred time than has occurred for centuries. One of primary reasons that we face global ecological, social and spiritual crisis at this time is because the dominant paradigm of our society sets us apart from the world that we live in. We live in a dangerous illusion that we are separate from the world and have lost touch with our interconnectedness with the life of our Earth Mother and all of the plant, animal and other beings that we share our lives with - including our fellow humans! Honouring the sacred cycles, places, medicines, and all of the gifts of this life through prayer and ceremony is an important and necessary prerequisite if we are to bring about the potential global shift in consciousness of the new cycle of the sixth sun. Even if we don't believe in the Mayan prophecies, a significant consciousness shift is essential if we are to avert global disaster, including possibly even our survival as a species.

How long do we have? Who knows! It's a big, awesome, mysterious world that we live in and it is ignorant and arrogant to think that we've got it all figured out. But the signs are all around us and it's time that we get our individual and collective heads out of the sand and heed the warnings. The way we live is unsustainable. Period. Whether we put our faith in reason, science and technology, or believe that we are going to be saved by aliens or some kind of divine intervention, we are only fooling ourselves. We can not heal ourselves if we are not in a healthy, harmonious relationship with the world. The changes that need to occur must come from us as individuals, as communities, and our society as a whole. It is all about who we are and how we interact with the world. It is all about relationship. Contemplating at this time of the winter solstice, the beginning of the natural new year, the shift from fall into winter (or spring into summer in the Southern Hemisphere), provides us with a beautiful reminder of this. However misguided, all of the hype about the end of the world has brought a lot more people to that place of contemplation. The truth is, the world as we know it has to end, for the sake of our children, grandchildren and great grandchildren, and all of the other beautiful beings that we share this life with. It's time to reconsider our priorities; to get in touch with what is really important in life.

Honouring the medicine: Queen Ann's lace (Daucus carota) in winter.

In our community we honoured this sacred time of the winter solstice in ceremony. We offered thanks for the blessings of the fall and the year that has passed, and offered our prayers for the winter and year that is beginning. Our ceremonies will continue for the next couple of days. I am so grateful to be given the precious gift to live to see the beginning of another winter and another year. I offer my prayers of healing to all of the people of this world, both the human people and the other than human people. May it be a year of greater love, peace, healing and harmony!

Treating Respiratory Infections

The antibiotic amoxicillin is commonly prescribed for the treatment of respiratory infections. However, a recently published study [see: http://www.sciencedaily.com/releases/2012/12/121218203351.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Feedfetcher] has found that this antibiotic is not effective for the treatment of most of these kinds of infections. This is not surprising. For one thing, most respiratory infections are caused by viruses and antibiotics are not effective for the treatment of viruses. However, this study found that amoxicillin is not even effective for most respiratory infections where a bacterial infection is a factor.

This is a pretty serious concern considering the over-use and misuse of antibiotics these days, which is leading to the development of more antibiotic-resistant strains of bacteria. Antibiotics are very powerful drugs and should only be used as a last resort in very serious illnesses. Had they been used in this way since their discovery, they would still be very effective medications and the prevalence of antibiotic-resistant strains of bacteria would be minor. The prescription of amoxicillin for common respiratory infections is another example of the misuse of these drugs. Although the major responsibility here lies with medical practitioners, it is also the case that many people seek medical attention for minor infections and often expect to be given some kind of medication. So, some of the responsibility lies with the public as well. This is an even bigger problem in many developing countries where antibiotics can often be purchased over-the-counter.

I realize that in some cases even common respiratory infections like colds and flu can be very serious. But this is usually only the case for people whose immune function is compromised in some way. Governments and medical practitioners would do a lot more for public health if they focused on dealing with the real issues, like poverty, environmental degradation, and educating people about nutrition and lifestyle issues, rather than on band aid pharmaceutical "solutions". With health care issues such as these, "an ounce of prevention" isn't worth a "pound of cure", it's worth a ton of cure!

Common purple coneflower (Echinacea purpurea) is one of the most

common herbs used for the treatment of respiratory infections.

There are also various natural means to improve our overall health and vitality, and the functioning of our immune system that can be implemented by anyone with some basic knowledge. These include many natural remedies such as herbs. This topic tends to be very popular at this time of year as we move into cold and flu season (at least in the Northern Hemisphere). I'm not going to write another long post in several parts on this one because a fair amount that I have already written on this topic is readily available online on the Vitality Magazine website. Because this topic is so popular, they tend to ask me to write something about it every couple of years and there are at least six articles on this topic archived on their website. Each time they ask me to discuss it from a slightly different angle. There is a lot of overlap between these articles, but each one focuses on different things and collectively they cover a lot of ground. Here are links to a few of them:

From November 2002: http://vitalitymagazine.com/article/herbs-for-cold-and-flu/

From Novermber 2003: http://vitalitymagazine.com/article/herbs-for-immunity/

From December 2005: http://vitalitymagazine.com/article/abcs-of-immunity/

For anyone interested in this topic from the perspective of treating children, there is an article from September 2007: http://vitalitymagazine.com/article/back-to-school-immune-boosting-for-kids/

Also, for those who are interested, we have just launched the first in an ongoing series of online lectures. This first one is on the treatment of colds and flu, since it is an important topic at this time of year. The lecture format allows me to cover certain things in much greater detail than can easily be done in a blog post or an article. You can find more information on this and other lectures here:
http://www.livingearthschool.ca/lectureseries.html

Finally, I would like to send out good medicine to everyone on this winter solstice (or summer solstice, if you live in the Southern Hemisphere)!

The Pros and Cons of Vitamin Supplementation, Part 3 of 3

This is the third of three posts on this topic. Part 1 was posted on November 20th, Part 2 on November 22nd.

I would like to begin here by first clarifying some of the statements that I made in Parts 1 and 2 concerning manufacturers and retailers of natural health products. I referred to certain aspects of their formulating strategies as marketing gimmicks and also suggested that in some cases manufacturers were engaging in deceptive practices concerning the quality and forms of the ingredients in their products. Sadly, this is sometimes the case and it can be very difficult for consumers to discern the relative quality of products and information that are out there.

Before looking at some of the challenges for consumers who are looking for quality information and products, I would like to put this into a broader context. Natural healing practitioners and the natural health products industry have long been innovators in terms of challenging the status quo, developing effective therapeutic protocols, and making many excellent products available. Many of these very effective therapies and products have been ignored by mainstream medicine and often challenged as ineffective or even harmful. It is true that in some cases they were, but these challenges from reductionistic medical practitioners and scientists were largely based on a perspective that anything that is not backed up by clinical studies doesn't exist. The fact that a significant proportion of mainstream medical practices and uses of drugs are not supported by clinical studies doesn't seem to matter. What matters is that many proponents of mainstream medicine will attack anything that challenges their paradigm. Nevertheless, many of the medicines and methodologies that have been used by traditional peoples or developed by practitioners of natural healing have since been scientifically verified. When they are, the scientists who do the research often claim to have "discovered" these new treatments and don't acknowledge their origins or that they once vehemently denied their efficacy and the credibility of those who used them. That being said, just like any aspect of society where there is money to be made and ego gratification to be obtained, not everything out there in the natural healing and health products world is necessarily good for us.

Varro Tyler was a respected scientist considered to be one of the worlds leading authorities on medicinal plants. He once wrote that
mad-dog scullcap (Scutellaria lateriflora) is "a nearly worthless and essentially inactive plant". Recent research has begun to verify its
traditional uses. Any experienced herbalist that has ever used this herb knows that, stuck in his reductionistic, materialistic world view,
Tyler might have known a bit about the chemical constituents of plants, but he knew very little about medicinal herbs.

Back in the 60s and 70s, the natural foods and health products industry was largely made up of grassroots idealists who believed in what they were doing and tried their best to live it. Sure, there was still some questionable information and products out there, but most of it was pretty basic and sound. If we were to take a tour of the typical health food store at that time we would have found mostly staples, the essentials of a good diet: lots of unprocessed or minimally processed whole foods. The selection of supplements was for the most part pretty basic and uninteresting. What was sometimes lacking was a good variety of organic produce, meats and dairy products. Fortunately, organic agriculture has grown significantly since then and this is no longer the case.

In the late 70s and early 80s things began to change. The industry started growing at an incredible rate and the diversity of products increased similarly. On the food end, the shelves started filling with products that looked very similar to those on the shelves of regular supermarkets. On the positive side, this was an important indicator that natural products and healing modalities were becoming more mainstream and a growing segment of the population was starting to take their health more seriously. These products provided a lot more diversity and choices for consumers and they formed a very important bridge for people who were starting to change their diet, enabling them to purchase healthier products that were very similar to what they were already consuming. However, the downside was that the shelves of health food stores and eventually mainstream supermarkets as the momentum continued through the 90s were mostly filling up with slightly more natural and healthy junk foods. Although these products are better than their mainstream counterparts because they don't contain numerous additives and are usually made from mostly whole food ingredients, often organically grown, most of them are still for the most part processed foods. They are a healthier alternative but they are not whole, natural, unprocessed foods, which is ideally what our diet should consist of. You will find most of the real health foods in the bulk foods and produce departments of these stores, which of late tend to be taking up a smaller and smaller proportion of the floor space. I'm not saying that these products don't have any value. They are a step in the right direction and have lots of benefits over mainstream food products including those I mentioned above. I even eat some of them myself and recommend them to my clients to help them transition to a healthier diet. What I am saying is that many of these foods are not as "natural" as people tend to think they are.

Natural foods and health products are not on the fringe any more. They are mainstream and they are big business! In this industry it is almost impossible for small grassroots companies to survive these days. Most of the smaller companies have been swallowed up by medium sized companies or gone out of business. A growing number of the medium sized companies are being purchased by mega corporations. A significant portion of the industry is now owned by major food and pharmaceutical companies. This shouldn't surprise anyone because it is the same pattern that is unfolding throughout the global economy. These corporations aren't stupid. Natural foods and health products have been one of the fastest growing sectors and they want a piece of the pie, or all of it if they can get it! To this end, it's much easier to acquire an established company than to start from scratch. What this means is that natural foods and health products have arrived. They have been legitimized. In many ways this is a good thing, but what it means for this industry is that it is now infused with corporate values. Although many people that work in this industry still have a lot of the idealism that was characteristic of the past, a growing number of them aren't there because they believe in it. They are there because it's a good business.

With the infusion of corporate values into the natural foods and health products industry comes a lot of sophisticated strategies aimed at increasing the bottom line. Sometimes this translates into cutting corners on product quality. It has also resulted in some unscrupulous marketing strategies such as greenwashing.

One of the things that tends to characterize people who are interested in improving their health is their hunger for information. Companies in this sector have used this to their advantage by flooding the market with information on various dietary strategies, nutrients, herbs, and other related topics and products. It is not an exaggeration to say that most health-related information that is available in magazines and a significant amount in books is essentially advertorial of one kind or another. Some of the information might still be useful, but it is very difficult to determine what is good quality information when most of it is at best very biased, and sometimes completely inaccurate. To make matters worse, the people who consumers rely on for information, natural health product retailers, typically get most of their information from sales representatives, product literature, and a lot of those magazines that are publishing advertorials. I'm sure the majority of the people working in health food stores sincerely want to help their customers, but most of the information that they have access to is dubious and they usually don't have the necessary training to be able to filter out the good stuff from the bad stuff. Even natural healing practitioners often buy into a lot of the inaccurate information that is out there. This is particularly true of practitioners who sell natural health products because they are obtaining a lot of their information from product literature as well.

Once more I want to emphasize that I am not suggesting that most natural health products are poor quality or that manufacturers, distributors and retailers are deliberately trying to deceive consumers. Although it is true that a lot of the dubious information out there ultimately comes from someone who is attempting to manipulate consumers in order to increase their profits, most of the people down the line really believe that this information is accurate and helpful to people – and some of it is! The challenge is that most people don't have the tools to be able to assess the quality of the information. As an herbalist, I can honestly say that most of the information out there on herbs is inadequate and often inaccurate. However, unless you are an experienced herbalist you aren't going to be able to recognize this. Everyone can't be an herbalist. That is why one of the most important roles of herbalists is as educators. We need to get good quality information out there to help people to be able to make informed choices.

Now let's get back to the original point. It can be very difficult to determine what constitutes a good supplement regimen. On the one hand, we have extreme supplement advocates who, whether for business or ideological reasons or both, would have everyone popping hundreds of pills per day. At the other end of the spectrum we have old school reductionists and food purists who believe that supplementation is unnecessary unless a deficiency is confirmed. In between we have just about every other possible opinion.

In considering a person's nutrient requirements there are basically four different ways of looking at it:

1. Based on the minimum amounts required to prevent a deficiency disease. This perspective used to be common among medical doctors and dietitians. It is less so today as it is now clear that there are other negative health consequences that can be demonstrated when a person's intake of a particular nutrient is low well before the point where the symptoms of a deficiency disease will manifest.
2. Based on the amounts that occur in a "normal" diet of a "healthy" population. This is more typical of medical doctors and dietitians today. It is problematic because what is average is not necessarily what is natural or ideal. What is currently considered "healthy" by practitioners and advocates of mainstream medicine is probably not as healthy as they would like to believe.
3. Based on optimum requirements for overall level of health and well-being. This is difficult to determine and could vary considerably between different people.
4. Based on therapeutic doses. This is not something that should be advocated for daily consumption. When the dose of an individual nutrient is increased beyond the range that it is utilized for nutritional purposes, its action becomes less nutrient-like and more drug-like. Taking nutrients in therapeutic doses can be an effective element of an overall treatment protocol, but it is not nutrition.

Many medicinal herbs and spices, such as rosemary (Rosmarinus officinalis), are loaded with nutrients and antioxidants.

In my clinical practice I have found that what works best is to strive for optimum nutrient requirements. This should primarily be accomplished through eating a good diet as I discussed in the first part of this series. In particular, it means eating lots of vegetables and moderate amounts of fruit. However, for reasons that I stated previously, namely variations in individual requirements and the high levels of stress and toxicity that are endemic in contemporary Western society, I have also found that some level of supplementation is preferred if one wants to achieve some level of optimum health and well-being. The basic regimen that I recommend is as follows:

1. A low potency multivitamin and mineral supplement as I discussed in part 2 of this series, taken once a day with breakfast. This helps to ensure that we are getting what we need on a daily basis. The higher levels of B complex vitamins and certain minerals also help to address increased nutritional requirements due to stress, as well as provide some level of support for immune function.
2. To help protect our body from the harmful affects of toxicity and support immune function, I recommend some degree of supplementation with antioxidants. I primarily recommend vitamin C, 400-600 mg once or twice a day. If only taken once a day it should be taken with dinner to separate it from the vitamin C taken at breakfast as a component of the multivitamin. It is best to take vitamin C in the form of mineral ascorbates rather than ascorbic acid because the diet of most people in our society tends to be acidic and ascorbic acid will increase our acid load. Mineral ascorbates are not acidic. Calcium, magnesium or mixed mineral ascorbates are best. Sodium ascorbate is not recommended because we already tend to consume way more sodium than is good for us. It is also important that a vitamin C supplement contain a decent dose of antioxidant polyphenols, such as flavonoids, anthocyanins and proanthocyanidins. These are mutually synergistic with vitamin C. I also recommend vitamin E. 200 IU is sufficient for most people. It should be natural vitamin E, preferably in the form of mixed tocopherols. Vitamin E works best if taken together with 50-100 mcg of the mineral selenium. The vitamin E and selenium are best taken once per day with dinner. They must be taken with a meal that contains fat.
3. For people who live in the temperate regions of the northern and southern hemisphere, I recommend supplementation of vitamin D. Typically, I recommend 2,000 IU per day from October to March (April to September in the southern hemisphere), and 1,000 IU in April and September (March and October in the southern hemisphere). Anyone who does not spend much time outdoors should take 1,000 IU in the summer as well. However, anyone who wants to implement a healthy lifestyle should try to spend as much time as possible being active outdoors – in a natural setting as much as possible. For vitamin D production and many other reasons, it is best not to wear sunglasses all of the time when outdoors during the summer. Sunglasses aren't good for our eyes anyway. Of course, these recommendations are reversed for people living in the southern hemisphere where the seasons are opposite. Also, keep in mind that requirements of vitamin D supplementation is going to be lower at high altitudes and higher for darker skinned people. It's also going to be lower for people who traditionally eat foods that are high in vitamin D such as fish liver.
4. In the contemporary Western diet, the fat content of our diet tends to be high in saturated fats of animal origin and plant-based oils that are high in omega-6 fatty acids. Ideally we need to reduce these and increase the proportion of monounsaturated and omega-3 fatty acids. Traditionally, animal fats in our diet came from seafood or wild game and livestock that ate a natural grass-based diet. Today, livestock are primarily fed an unnatural diet designed to speed up their growth rate and fatten them up. They are also a lot less active. The result is that their tissue contains more fat and it is primarily saturated with very little omega-3. Consumption of large amounts of fish and wild game is no longer recommended due to environmental contamination and ecological issues. As a result, the easiest way to increase omega-3 consumption is through the use of plant-based vegetable oils. By far the best source is organically grown, raw flax seed oil that has been processed without exposure to heat or oxygen, stored in dark bottles and refrigerated. Other plant sources tend to have lower levels of omega-3 relative to omega-6, monounsaturated and saturated oils. Consuming nuts and other foods that contain them is still good in moderation. Olive oil, which is a mostly monounsaturated oil, has been found to have many health-promoting benefits as well. Nevertheless, we still need to increase the omega-3 oils in our diet and flax seed oil is the best option. I don't recommend fish oils because they are subject to environmental contamination and because of the way they are processed they tend to be rancid. Although the negative health consequences of consuming rancid oils has been given less attention than trans-fats and animal source saturated fats, it is almost certain that rancid oils pose almost as much of a health threat as trans-fats. The other issue with fish oils is that several major studies that have looked at the amount of fish and other marine animals that are being harvested from the ocean have unanimously concluded that commercial fishing at anything close to current levels is completely unsustainable. The omega-3 issue has been given a lot of attention in recent years and many foods are now claiming to be "fortified" with omega-3 oils. This is another marketing gimmick. Omega-3 oils are extremely unstable in the presence of light, heat and oxygen, and adding them to various processed foods means that they will be rancid. As a result, I recommend a dietary supplement of 1-2 teaspoons of good quality flax seed oil per day. This should never be cooked but can be added to cooked foods on our plate as long as they are consumed right away. It is important to recognize that consumption of polyunsaturated oils increases our daily requirements for vitamin E and selenium.

This is the basic supplement regimen that I recommend. In my life and my practice I have found it to be a very useful adjunct to a good diet and healthy lifestyle. It is not going to meet everyone's needs exactly, and I sometimes recommend additional supplements or higher doses for specific issues. For example, anyone suffering from chronic auto-immune or inflammatory conditions will benefit from higher doses of vitamin D and antioxidants, especially ascorbate and polyphenols.

Blueberries are a very rich source of polyphenols such as anthocyanins.

We can also increase the antioxidant content of our diet by increasing consumption of leafy green vegetables, and fruits and vegetables that have a deep orange, red, blue or purple colour. It is not necessary to consume exotic "superfoods". This is also a marketing gimmick. All plants are anti-oxidant to some degree. It's true that some are considerably more antioxidant than others, but pretty much no matter where we live their are fruits and vegetables that are very high sources of antioxidants. For instance, it doesn't get much better than dark blue and purple berries like black raspberries, blackberries, blueberries and bilberries, which grow and are cultivated throughout the temperate regions of the northern hemisphere. It doesn't make sense to consume exotic plants from foreign countries where we don't know for sure whether they are destroying the environment when growing or wild-harvesting them, they must be transported long distances, and they are usually a lot more expensive.

That is my take on supplementation. It's not going to be perfect for everyone, but it's a good basic template which we can work with and fine-tune in order to meet our individual needs. Of course, there are lots of other opinions out there. All I can say is that these recommendations are supported by the limited research that is available, and more importantly, I have found that they work in my life and my practice.

The Pros and Cons of Vitamin Supplementation, Part 2 of 3

This is the second of three posts on this topic. Part 1 was posted on November 20th.

Let's continue this discussion by considering Walter Willett's recommendation that we take a low potency multivitamin and mineral supplement. I qualify that recommendation to mean a good quality low potency multivitamin. The first thing we need to realize is that pretty much the only thing that changes in potency between low, medium and high potency multivitamins is the amount of the B complex vitamins. These are among the most widely supplemented vitamins. They are often marketed as "stress" vitamins because our requirements for B vitamins increases when we are under greater stress – and people today experience a lot of stress! B vitamins are not easy to obtain in high doses from foods. There are a few foods, like liver and certain kinds of yeast, that are relatively high, but eating large quantities of these foods is not necessarily ideal. Firstly, the liver is an organ of detoxification and one of the most toxic organs in the body. Eating the liver of various mammals and fish was a good source of many important nutrients in the past, but these days I don't recommend eating liver or other organ meats on a regular basis or even at all due to their toxicity. Eating brewer's yeast or other kinds of nutritional yeast is also not necessarily the best solution. They need to be eaten in fairly large amounts to provide similar doses of nutrients to those found in supplements and are not a normal component of the human diet in these quantities. Also, many people have sensitivities to yeasts, and they don't necessarily provide B vitamins in the correct ratios that match our daily requirements. I'm not saying that we should never eat these foods, only that it probably isn't ideal to eat them in large quantities or too regularly. Also, if we do eat liver, we should only eat liver from healthy, organically raised livestock. Liver from wild animals is less desirable. Even in the remotest regions it has been known to contain significant quantities of mercury, PCBs and other toxins that come from the activities of the logging and mining industries or arrive in the air, rain and snow. Also, wild game tends to be contaminated with lead if it is killed using bullets that contain lead. Although traditional peoples used as much of an animal as possible to honour the spirit of the animal and because it makes practical sense, unfortunately it is no longer a good idea to eat the organs of wild game on a regular basis.

The flesh of wild game such as white-tailed deer (Odocoileus virginianus) can contain significant toxicity, even in remote areas.

Because consuming B vitamins in larger doses helps people to better deal with the affects of stress, B complex vitamins are very often supplemented, usually in medium to high potencies. This is not something that I recommend, and if we want to approach this from a "holistic" perspective, it is not very holistic. Most B vitamin supplements have the same dose of every B vitamin, usually 25, 50, 75 or 100 mg (mcg for a couple of them). However, our body doesn't use them all in the same amounts and these dosages are grossly in excess of what we need. A good quality B complex will have a range of doses of the individual B vitamins corresponding roughly to the relative amounts that we require. Ideally the dosage range should be between 5-10 mg (or mcg) for the lower dose B vitamins, and 15-25 mg (or mcg) for those required at a higher dose. It depends on the individual vitamin. Even at this dose, no matter how stressed out we are, our urine will still turn bright yellow after we take them. This means that the dose has exceeded our requirements and the excess is being flushed out by our kidneys. Technically, it is only riboflavin that produces this colour in our urine, but if the dose of riboflavin that we are taking is excessive enough to change the colour of our urine, we can be pretty certain that the dose of the others is similarly excessive. We don't want to exceed our requirements by too much because it puts stress on our kidneys to have to filter them out of our blood in large quantities on a daily basis.

Secondly, in order to be efficiently utilized, B vitamins need to be taken together with other nutrients, particularly vitamin C and some of the essential minerals. This is why it is much more "holistic" to take B vitamins in the context of a multivitamin and mineral supplement rather than on their own. In addition, there are probably other nutrient and nutrient-like substances in food that interact with B vitamins and all of the other nutrients in a multivitamin in ways that we haven't even begun to understand. For this reason vitamin supplements should always be taken with a meal so that they are taken together with their natural counterparts and all of the co-factors that work together with them. In particular, fat soluble vitamins like vitamins A, D and E can not be efficiently absorbed unless they are taken with a meal that contains some lipid (oil or fat).

The other rationale for taking a multivitamin and mineral supplement is that some of the most common nutrients that are deficient in our diet are trace minerals. This is because trace minerals are not replenished by the synthetic fertilizers used in commercial farming. Also, the soils of some regions are naturally deficient in certain trace minerals because they don't occur in the bedrock that underlies the soil, which is where most of the minerals in soil come from.

A multivitamin is not a replacement for a good diet. It is a supplement to a good diet. A good diet is essential. However, people in our society tend to experience chronic stress of a moderate to high intensity. This can significantly increase our nutrient requirements. A good quality, low potency multivitamin and mineral supplement is recommended to make sure that we are getting all of the nutrients that we need in sufficient, or preferably optimum amounts on a daily basis.

In addition to a relatively low dose of B vitamins that are in ratios that approximate our daily requirements, a good multivitamin and mineral supplement should also contain the major trace minerals such as zinc, manganese, selenium, copper and molybdenum. The minerals should be in a form that is easily absorbed such as amino acid chelates, citrates and malates. Some forms such as carbonates and gluconates are not as well absorbed. Oxides are particularly not recommended because they promote tissue oxidation. Also, it is preferable to use a multivitamin that does not contain iron. This is because iron is a very powerful oxidizing agent and too much iron in our blood and tissues promotes oxidation and contributes to many chronic health problems. Most people in our society get too much iron because they eat too much meat. Many kinds of meat are very high in iron and it is in a form that is more absorbable than the iron in plant foods and water. Another issue with iron is that the forms of iron found in supplements are usually difficult to absorb. So, the iron in multivitamins isn't the best form to take. As a rule, I recommend iron-free multivitamins and, if there is reason to believe that someone needs an iron supplement, I give it to them separately in a highly absorbable form taken together with vitamin C, which also increases the absorption of iron. Fortunately, most companies offer iron-free alternatives these days.

The last point I would like to make about multivitamins is that many of the companies who like to market themselves as "higher quality" add herbs to their vitamins. This has become a common practice these days and it is bad news for consumers. It is getting very difficult to find decent multivitamins that don't contain herbs. Here I am not referring to concentrated plant-based antioxidant extracts like flavonoids, anthocyanins and carotenoids. These are excellent ingredients to include in a multivitamin and highly recommended. What I am referring to is the addition of popular medicinal herbs like ginseng, Ginkgo and Echinacea to vitamins. For the most part this is a gimmick. Usually the herbs are in forms and quantities that will not provide any medicinal benefit. They are included because they are popular. It is a selling feature that can increase sales and help justify charging higher prices for these products. Sometimes they are included in general multivitamins because the public (with the manufacturers help) will perceive some value to including them. In other cases they are used to give a product a more specialized function, like including traditional female reproductive herbs in multivitamins "for women". Unfortunately, most supplement manufacturers don't consult with experienced herbalists when developing their formulations. So, regardless of their intentions, they often end up including herbs in ways that are inappropriate.

Medicinal herbs such as common purple coneflower (Echinacea purpurea) should not be ingredients in vitamin supplements.

Although foods – especially plant foods – are medicinal to some degree, we have always made a distinction between plants that we eat and those that we reserve for specialized use when we need a more powerful medicinal action than what can be obtained from foods. Even though the herbs in these products are usually in quantities that will not provide any medicinal benefits, ingesting them in these small quantities can still cause our body, or microorganisms living in our body, to adapt to them so that when we really need their medicinal benefits they won't work as well even in the appropriate forms and doses. Medicines should never be abused. They can lose their effectiveness and in some instances they may even be harmful.

I have occasionally come across multivitamins that do contain concentrated extracts of herbs in therapeutic doses. This is still not desirable. Herbs are not meant to be used this way. We use them only when we need them and in the appropriate way. The moral of the story is that any vitamins that we purchase for use on a regular basis should not contain medicinal herbs.

Another issue concerning the use of vitamin supplements is that some vitamins in these supplements are in slightly different forms than those found in foods. In fact, the whole notion of "natural" vitamins is also for the most part an advertising gimmick. The only really natural vitamins are those in whole foods together with all of the other nutrients and co-factors with which they naturally occur. When you buy a "natural" vitamin, if it is a relatively good product the word "natural" really means "relatively complete, in more-or-less natural relative proportions with plant-based co-factors, a few ingredients from natural sources, mostly synthetic". There is a lot of misinformation out there about natural vitamins and manufacturers often go out of their way to promote it. For example, there are many products on the market called "Rosehips Vitamin C 500 mg". Most relatively educated consumers of natural foods have probably read that rosehips are very high in vitamin C. When they see a product called "Rosehips Vitamin C 500 mg" they tend to think that either each capsule contains enough rosehip powder to provide 500 mg of vitamin C or it contains 500 mg of vitamin C that was extracted from rosehips. What it really means is that it contains 500 mg of synthetic vitamin C with some amount of rosehip powder. It could be a very small amount, in which case the ingredient list will say something like "in a base containing rosehips". If it is a more substantial amount, it will specify some quantity, usually 50 or 100 mg. This is very different from how most consumers perceive the product. Although rosehips are a very rich source of vitamin C or ascorbic acid, they still only contain 0.03-1.3%, depending on the source. Therefore the amount of rosehip powder necessary to provide 500 mg of vitamin C is between 38 g (1.3 oz) and 1.67 kg (3.7 lb)! Even at the higher concentration it just wouldn't be possible for someone to eat that every day. It probably wouldn't be good for them either as rosehips have lots of other properties that are potentially problematic at this dose. Extracting vitamin C from rosehips is not practical either. Not only would it be prohibitively expensive, it would be extremely unsound from an ecological point of view to have to use that much rosehip powder to make every capsule of vitamin C. As it turns out, the ascorbic acid molecule is closely related to monosaccharides and can be manufactured very cheaply from glucose. The molecular form of synthetic ascorbic acid is identical to the natural form.

Sweetbriar rose (Rosa eglanteria) is a common wild source of rosehips.

In the case of other vitamins, there are a couple for which the synthetic version is slightly different than the natural form. This usually means that the synthetic form partially or completely consists of isomers of the natural form. These are molecules that have the same chemical formula but are a different shape. In these cases our body, usually our liver, can sometimes convert the alternative isomers to the natural form so they can be used by our cells. In some instances they may need to be converted in our intestines before we can absorb them. These processes are not 100% efficient. That means that for a few vitamins the absorption and utilization of synthetic forms might not be as efficient as their natural counterparts. However, because the amounts found in supplements are significantly greater than those found in foods, even allowing for poorer utilization of some of them, they are still going to contribute significantly to our daily intake. Fortunately, the main vitamin for which this is a concern is vitamin E and most better quality vitamins contain the natural form, d-alpha-tocopherol or d-alpha-tocopherol succinate, rather than the synthetic form, dl-alpha-tocopherol. You will note that I said that some synthetic vitamins "might not" be as efficiently utilized. This is because natural nutrients are not always absorbed efficiently from our food either. In addition, due to common dietary and lifestyle habits, most people in our society suffer from some degree of digestive deficiency. For many of them it is actually easier to absorb and utilize vitamins from supplements than from food. The exception is timed release vitamins. These are intentionally made more difficult to digest so that water soluble vitamins will be absorbed more slowly, otherwise they tend to be flushed out of our body by our kidneys pretty rapidly. Timed release vitamins are not recommended because they are not always digested efficiently. It is better to take smaller amounts of vitamins more often than to take larger amounts in a timed release form.

Still on the natural vs. synthetic and bioavailability issues, there is another kind of supplement that you will sometimes come across that I will briefly discuss. These are usually called "food form" or "food matrix" supplements. The basic philosophy behind these products is that nutrients are better absorbed when they are part of an organic multi molecular matrix similar to how they occur in foods. Supposedly these kinds of supplements are made by force-feeding certain kinds of yeast large amounts of a particular nutrient in its synthetic form and forcing them to convert it to a more natural, organic form. An extract is then made of the yeast which includes these nutrients in a "food form" along with other cofactors found in the yeast. Although the basic idea sounds good, I do not recommend these kinds of supplements for several reasons. Firstly, it is difficult to guarantee that these products actually contain what they claim to contain. Some manufacturers have been know to simply mix synthetic vitamins with yeast or other food extracts, in which case the vitamins haven't really been converted to an organic form. This is particularly an issue in the U.S. where quality control standards are not as stringent as in Canada. So far I am not aware of any companies manufacturing these products in Canada and I have yet to see any of the American products with an NPN (Natural Health Product Number) indicating that they have met Canadian standards. Another concern is that sometimes nutrients of this kind are manufactured by genetically engineering yeasts or other organisms to produce the nutrient in large quantities as a metabolic by-product. Even for those products that are what they say they are, there is no independent research that I am aware of that indicates that this form of nutrient is more bioavailable. In fact, in order for nutrients to be absorbed they must be separated from any organic molecules to which they are attached. For this reason nutrients are usually better absorbed when they occur as closely as possible to their free form state. Finally, these nutrients tend to be a lot more expensive than standard vitamins and minerals even though they contain much lower doses of nutrients. The rationale for the lower doses is that they are supposed to be better absorbed. However, this isn't necessarily the case and even if it is, you are still going to absorb more from a standard supplement that contains a much higher dose - at a fraction the price! The bottom line is, even if some of these products contain what they claim to contain and work as well as they are supposed to, you will get a lot more value for your money purchasing other forms of supplements.

This is the end of my second post on this topic. In Part 3 I will continue this discussion and then explain what I personally recommend as a basic supplement regimen.