Friday, November 30, 2012

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.



Thursday, November 22, 2012

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 virginianuscan 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 purpureashould 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.

Tuesday, November 20, 2012

The Pros and Cons of Vitamin Supplementation, Part 1 of 3

Yesterday one of my students posted a question about vitamin supplementation on a forum for one of our courses. He suggested that by recommending that taking a low potency multivitamin and mineral supplement in one of my lectures I was taking a more reductionistic stance compared to the more holistic perspective that I usually espouse. I decided to provide an in-depth answer because it is a very important question that I am sure will come up for a lot of my students. Not only do I want to be very thorough in my explanation for the purpose of explaining the course material, it is also important to me to provide my students with the best information that I can to help them to make healthy choices in their own lives. Once I got into it, I realized that there are a lot of layers to this question and my response became quite lengthy. Since this is an important topic and I have been considering doing a post on it at some point, I decided to post my answer on this blog for the benefit of anyone who is interested. Due to the length I have decided to post it in three parts.

The first thing that I would like to say is that I don't believe in adhering rigidly to any particular ideological framework. It's a great big mysterious world out there and what we know has barely scratched the surface of what can be known, never mind what simply can't be known by the rational mind. It would be ignorant and/or arrogant for me to believe that the world is going to completely correspond to any particular human rational paradigm. As a practitioner of a healing profession, what matters the most to me is that something works. Although I acknowledge that approaching healing and herbalism from within the context of an holistic paradigm usually works best both in terms of clinical outcomes as well as supporting a healthier relationship with the world that we live in, that doesn't mean that a lot of useful information hasn't come from reductionistic medical science. I may often interpret it in a different way than most scientists do, but I won't deny it's value. If it works, it works!

Supplementation is very complex issue. There are a lot of opinions on this, but the research is very incomplete and what is available is often contradictory. There are probably going to be many people who disagree with me on this. That's fine! As with anything I've posted in this blog, the best I can do is offer what has worked for me in my life and in my practice. It's up to the readers to decide if they want to try it out and see if it works for them.

Supplementation: Good, bad or just a waste of money?

I agree that it is possible that for many people supplementation might not be necessary if they eat an ideal diet most of the time and live a healthy lifestyle. So lets start there. What exactly is a healthy diet? There are many traditional diets that have evolved around the world that represent what historically has worked best for a particular group of people, with a common genetic background, living a particular way, in a particular environment, in a preindustrial world. Presumably they will have over many generations developed a diet that worked well for them. It wouldn't necessarily have been the best diet in an ultimate sense, but the best diet based on what was available in the region where they lived.

Now let's fast-forward to the contemporary Western world. In North America we have a very diverse population who mostly come from other regions of the globe. We eat food that we purchase. It is mostly trucked in from other areas and isn't very fresh. The varieties of fruits, vegetables and animals that we eat have been extremely hybridized and a growing number will soon be genetically engineered. These varieties have been developed not based on their nutritional quality, but rather on characteristics demanded by industrialized agriculture, like the ability to resist "pests" and diseases, to ripen slowly in an artificial environment when harvested prematurely, not bruising easily, having a certain uniformity of appearance, etc. Most of our food is produced in dead soil that has been depleted of many of its trace minerals, using toxic pesticides, herbicides and fungicides. Most of the food we eat is also heavily denatured by food processing methods and has a lot of additives to preserve it and give it flavour. On top of this, we live an extremely sedentary lifestyle compared to our ancestors.

The good thing is that we can make positive health choices up to a point. So let's say we decide to do that. There are things we can do that will benefit everyone. We can eat exclusively fresh, organically grown, heirloom varieties of foods that we have grown ourselves or come from local organic farmers. We can eat everything in a whole, natural, minimally processed form and prepare all of our food ourselves. We can also do our best to eat a healthy, balanced diet. What does that look like? Well, there are many opinions out there but very few of them are backed up by the facts. The time-tested traditional diets don't necessarily apply because people in contemporary Western society will mostly be of different genetic stock, living in a different climatic and ecological region, and living a different lifestyle. Also, the foods associated with a particular traditional diet might not be available locally and therefore need to be transported long distances which could compromise their nutritional quality. Finally, the amount of variation in constitution, personal and family history, and lifestyle between different people living in our society will likely result in a greater diversity of individual nutritional needs than was typical in the past.

You've got to love that fresh, local produce!

If we look to the nutritional literature, mostly we are going to get confused. There are many authors and movements promoting various diets. Most of these are rationalistic diets. By that I mean that some person arrived at a set of nutritional principles through some combination of personal experience and rational deduction and has then extrapolated their conclusions and is advocating their particular dietary regimen as being the best diet for everyone. These diets are usually completely unsupported by the research literature or sometimes might seem to be partially supported if we selectively choose what research we want to accept.

Sometimes people who follow these diets do feel better for awhile. It is even possible that for a very small percentage of people some of them actually work. But usually people feel better because the diet is somewhat of an improvement over what they were eating before. Most of these diets are not healthy in the long run for most people. Nevertheless, they appeal to members of our society because we have been trained to live our life in our heads. We have forgotten how to listen to our body and the world around us. So if I can provide the right argument to a person with the right background, I can convince them that a particular diet is good for them and they will follow it based on a belief system rather than by listening to their body. Over the years I have met so many people who were obviously unhealthy but continued to rigidly adhere to some dietary philosophy.

Fortunately, there is some excellent research out there on what constitutes a good diet for people of a diversity of genetic backgrounds living in the contemporary industrialized world. Most of the results of this research have only become available in the last decade or so because they are the results of studies that followed the diet and general health of tens of thousands of people over decades. By far the best book out there that summarizes the data from these studies is Eat, Drink and Be Healthy by Walter Willett. You can also find a more popularized and slightly different take on the literature in Michael Pollan's In Defence of Food. I strongly recommend both of these books to anyone who is interested in healthy eating. The latter is a bit more holistic, but the former is more comprehensive. Andrew Weil's Eating Well for Optimum Health is also pretty good, but it came out before a lot of the data was available and he has some definite personal biases that bleed through that are not necessarily supported by research. The great thing about Walter Willett is that he isn't just someone writing about this stuff. He is one of main scientists overseeing these studies and interpreting the data. He's also more open-minded than most scientists. He doesn't get into some issues like organic agriculture, presumably because he is a well-respected scientist with a distinguished reputation and he won't step outside of what is actually supported by research. However, unlike other scientists, he doesn't condemn things that are not supported by research. He just sticks to the facts that are available at this time. So if you want to know what the research says without a lot of personal bias and filler, his book is the best that I've come across.


The last thing I want to say about this is that the research tells us what works for most of the people most of the time. However, everyone's body and situation is unique. Walter Willett's recommendations are excellent guidelines and leave a lot of room for experimentation. They are a good starting point but we also have to learn to listen to our body, because what works best for us right now might not be ideal a month or a year or a decade from now. Everything in life changes. To stay healthy in a changing world we need to keep an open mind and heart, be vigilant and ready to adapt to change as it presents itself. There is no one static end point that we are striving to reach.

OK, so let's say we eat a good diet that works for us. It is organic, local as much as possible and we eat only whole foods that we prepare from scratch. We also need to minimize the amount of time we spend sitting in front of a computer, TV, or whatever, and be as active as possible: walk and bike instead of driving everywhere and get an intensive aerobic exercise on a very regular basis, if not daily. The truth is, living this way takes a lot of commitment and discipline and even the most dedicated among us aren't going to be able to live up to this standard 100% of the time. Regardless of our level of dedication, the time commitment alone makes this very difficult. So we have to acknowledge that this is an ideal to work towards but most of us probably won't be able to fully realize it. We don't want to beat ourselves up about it either. We need to do the best we can with the resources available to us and when things don't work out the way we want them to, learn from it and adapt. That being said, let's say that we are able achieve our ideal or even get close to it without stressing ourselves out in the process. Is there then any need of supplementation?

I believe that the answer to that question is yes for reasons that I will explain below. But first, getting back to the original question, I find the suggestion that recommending supplementation might be a more reductionistic approach very interesting. It's definitely a perspective that I have heard many times. What is interesting about it is that historically, it is primarily the reductionists who came from this point of view. In the past and to some extent in the present, most reductionistic medical practitioners and scientists have said supplementation is completely unnecessary as long as we eat a good diet with lots of variety. What they usually mean by a "good diet" is a typical North American diet with a bit more variety. "Just follow the Canada Food Guide" was a common response. In truth, most of the people who the public sought dietary information from knew almost nothing about nutrition. So what does Walter Willett say about supplementation? In recognition of the fact that we aren't always going to eat the perfect diet and that there are still a lot of unknowns concerning nutrition, nutrient availability and individual requirements, he recommends that everyone take a low potency multivitamin "for insurance". He also slams the American and Canadian food guides and explains the politics involved in how they are developed.

I think that based on Walter Willett's reasoning alone, it is probably a good idea to take a low potency multivitamin and mineral supplement. The truth is that we can never know exactly what our nutrient requirements are from moment to moment and whether or not what we are eating is fulfilling all of them. However, let's consider a couple of important factors that I haven't discussed yet that are also relevant to this issue. Firstly, people in contemporary Western society are living with some level of chronic stress throughout most of their lives. This is something that our hunter-gatherer ancestors didn't have to deal with except usually for short periods of time. The current situation began with the development of city states and empires and reached peak levels in the last century, particularly in the last four decades  and every year it is getting worse!


Today we are also living in a world that is becoming increasingly more toxic. On a daily basis we are exposed to thousands of chemicals most of which have only existed since World War II. They are chemicals that the human body never had to deal with over the course of our evolutionary history. Even if we live and grow our own food way out in the country and live in a building made of natural materials we can no longer avoid them. We've inherited them in our body from previous generations, both literally and via epigenetic influences that are passed down from generation to generation. No matter where we go they are in our air, water and soil. Even if we practice strict organic agricultural practices, they are still in our food because they are in the air, water and soil. They are in wild game even in the remotest regions of the world. We are also constantly being exposed to various forms of radiation that are broadcast around the globe. Every year as we overload the capacity of the frequencies that we are using we exploit additional frequencies. Pretty soon we will be bombarded with radiation from the entire electromagnetic spectrum!

These factors increase the various kinds of stress in our lives. It is my belief that even if we are able to accurately determine and follow the best diet and lifestyle for ourselves most of the time, some supplementation is probably necessary for optimum health.

This is the end of my first post on this topic. In Part 2 I will look at some specific issues concerning the quality of supplements, then in Part 3 I will explain what I personally recommend as a basic supplement regimen.


Friday, November 16, 2012

The End of an Era!

Wednesday was a typical day for me in many ways. I spent the better part of the day teaching a class like I have thousands of times before. But what was different about this past Wednesday was it wasn't just any weekly class. It was the last one!

This past January we began the process of converting most of the content that I used to teach in a weekly class format into online courses. On Wednesday I taught the last class of the last course for the last group of students who are going through our program in the weekly class format. Afterwards I did what I do at some point almost every afternoon: I took my dogs for a walk through the fields and forest on the land where I live. As always, I sat down in one of my favourite spots and spent some time just being. While I sat there I also contemplated how much things have changed since I started teaching.

I taught my first course back in the spring of 1987. During the last few years of the 80s I taught sporadically; mostly one off lectures and weekend workshops. In the first half of the 90s I taught much more regularly, but still primarily limited to weekend workshops. Then in August of 1995 I got this idea that maybe there were people who were interested in taking a course run as a series of weekly evening lectures. Thus Healing With Herbs was born. It has gone through a few changes over the years but it is still the primary introductory level course that I teach. I should say it was ... until it went online this past January.

I had wanted to start Healing With Herbs in early September and I was only able to find one lecture room available on such short notice. It was a small room that only held 18 people, but I figured that would be enough. I only had a few weeks to promote the course and this was an experiment anyway. Well, 28 people applied to take the course and I had to turn 10 of them away! I ended up running it again in January and then in April with about 25-30 students in each session. Many of the students asked me to create additional courses, so the following school year I ran Healing With Herbs three times again, but each term I added a new course as well on a different night of the week. This was the beginning of teaching weekly classes for me; the beginning of a phase that ended this past Wednesday.

Here I am teaching a field workshop at
Mono Cliffs Provincial Park in the mid 90s.

By June 1997 some of my students were asking if I would create a complete herbalist program. I contemplated that over the summer and by the fall decided that it was in alignment with what I needed to do. Over the next 12 months I continued to introduce new courses while working on the curriculum for the entire program. After a couple of false starts, Living Earth and the Traditional Herbalist program were finally born in September 1998.

Initially we ran classes on weekday evenings and weekends. By 2000 students started asking for weekly daytime courses and we ran these as well. Within a couple of years enrolment in the evening and weekend courses started to drop and I switched exclusively to weekday courses.

The gradual change in the preferred class schedule of most of my students was interesting. It seems that in the 90s most of my students were working regular full-time jobs. They tended to be older people who were either taking courses for personal interest, or those who weren't happy with their work and were considering changing to a new career that better reflected where they were at in their lives. In the 2000s that started shifting. I was getting some younger students fresh out of high school or university who were still living with their parents. For the first time young people were considering herbalism as a first career! Many of the other students either weren't working full-time, had jobs with flexible hours, or were self-employed.

There were other interesting changes to the demographics of my students over the years. For instance, when I started teaching the age of my students ranged from mid 20s to late 60s with the majority of them being in their mid 30s to late 40s. There was also a 50/50 split between men and women. Over the years the lower age limit dropped as I started getting some students in their late teens and early 20s, and the overall average age dropped as well. In addition, the percentage of women increased. So now the vast majority of my students are women in their early 20s to early 30s. Although I still get a few men in some of my general interest courses, in the last few years I haven't had any commit to the full herbalist program. Since we began putting our courses online in January things have changed yet again. For one thing, there has been a higher percentage of men enrolling. We'll see how many of them end up committing to the herbalist program. I'm sure there are a lot a factors that have led to these changes over the years. I don't claim to understand them all, but I am glad that younger people are being drawn to this path because they are the future!

So now I have come to another major shift. I'm older and most of my students are a lot younger. They have grown up in a very different world than me; a digital world. It's a world of iPhones, text messages, Facebook, Twitter ... and, yes ... blogs! This world means nothing to me, but it's not something I can completely ignore. A big part of my path is to bring the medicine to the people and that means I have to be able to bring it to where the people are. Still, I have no interest in spending endless hours talking or texting on a cellphone, or checking out Facebook. I spend way more time on a computer than I would like to just doing my day-to-day work. I would much rather be out in the woods.

It seems that these days it is becoming increasingly more difficult for the majority of the people who want to learn about herbalism to commit to the more rigid structure of weekly classes. Online courses are becoming more practical and more appealing to people, and they are workable for people with a great diversity of life situations. We also now have the technology to make the experience of doing online courses as close as possible to being in class, with a few added advantages as well (like being able to listen to parts of a lecture over again if you miss anything). Yet I've never been a fan of distance learning courses, not only because there is so much experiential content that can't be done in that format, but because the medicine is a living thing. It can't be learned from a bunch of words. We need to plant our feet firmly on the Earth and be in it!

This eastern gray treefrog (Hyla versicolor) is demonstrating
how to immerse ourselves in the medicine!

Traditionally, herbalism and other healing traditions were learned by apprenticing with an elder. That is by far the best way to learn, but for many reasons it doesn't work well in our modern Western world. I've always tried to compensate for the limitations of teaching in a classroom framework as best I can. In particular, I've done my best to incorporate as much experiential content in my courses as possible. During this transition to providing a lot of online courses I will have to develop new ways to accomplish this. Of course, there are still workshops that can't be done online and will run as before. In addition, the remainder of the experiential and clinical content will be incorporated into week long intensive workshops. I actually prefer the longer intensive format to weekly classes. But the most important thing that I wish to convey to all students and herb enthusiasts of the digital world, just as I've had to convey this message in the past, is that to truly get herbalism it is essential that we develop a living relationship with the medicines that we are learning about and using. That means learning where they grow; how to identify them; talking to them; meditating with them; harvesting them; and making various preparations from them. Anything we can do to expand and deepen our relationship with them is beneficial and necessary. Healing comes from our Earth Mother and our interconnectedness with all of the living beings that we share this life with. It doesn't come from books or the Internet! Taking good quality courses with knowledgeable and experienced herbalists is essential for anyone who is serious about this, but connecting with the medicines is just as, if not more important. They are two sides of the same coin.

Welcome to the medicine!

Friday, November 9, 2012

More Support for Exercise!

OK, so I've been an absent parent for awhile and this child of mine is feeling somewhat neglected. The last few months have been really busy and it's easy for me to forget about this blog. It's not something that comes naturally to me.

Things haven't changed that much. I'm still really busy. In the last couple of days I harvested and prepared the following macerations: 2 litres of fresh common burdock root (Arctium x nothum); 6 litres of fresh marshmallow root (Althaea officinalis); 7 litres of fresh maidenhair tree leaf (Ginkgo biloba); 9 litres of fresh rosemary leaf (Rosmarinus officinalis). Welcome to the life of an herbalist!

Common burdock (Arctium x nothum).

So now lets get to the point of this posting. Here's some information on an interesting study that was recently published:

http://www.scientificamerican.com/podcast/episode.cfm?id=exercise-lengthens-life-regardless-12-11-06

This is another study that on some level is verifying the benefits of exercise. Unfortunately, the focus of the study was on life expectancy rather on quality of life indicators. Nevertheless, life expectancy is potentially an indirect indicator of other things. For instance, presumably a big part of the reason that the people in the study who got more exercise lived longer was because they were experiencing a lower incidence or later onset of the kinds of things that can kill us. Those kinds of illnesses also reduce our quality of life. So, some level of increase in quality of life can possibly be inferred. It is, however, possible that some of the subjects got sick with the same illnesses, but they developed more slowly to a level that produced mortality. So it is still possible that some of these people were chronically sick. This wasn't covered in the study but would have been a good parallel line of enquiry that they could have pursued. It is also possible that they did collect this kind of data but haven't analyzed and/or published it yet.

There's a lot of research on the benefits of exercise and these results are to be expected. However, there was one very interesting finding that resulted from this study. The researchers found that people who are obese who exercise regularly live longer than people whose body weight is in the normal range but don't exercise. This is a very important result because it means that for many people inactivity potentially has a greater negative impact on their overall level of health and well-being than obesity. Of course, in the real world the situation is far more complex than that. For instance, inactivity is one of the major causes of obesity. But there are many people who are overweight that exercise regularly and still have difficulty losing weight. There are a lot of reasons why that might be the case, but the important thing here is that they will receive health benefits whether they lose weight or not. It is so easy to get discouraged when we don't see the visible benefits of exercise. The results of this study are an encouragement to keep at it because the benefits are real even if they aren't visible.

Although in the last few decades there has been a growing number of people in our society who are taking positive steps to implement a healthier diet and/or lifestyle into their lives, we still have a growing segment of the population that are overweight or obese. This is primarily due to diet and lifestyle issues, although we can't ignore the deeper psychological, social and spiritual reasons why people make the kinds of choices that they do. On the surface it is obvious that the typical modern lifestyle is way too sedentary. Our bodies are designed to be on the move most of the time. Things that are misused usually break down. Unfortunately, even among the more health conscious members of our society, there tends to be two distinctive camps: those who try to eat good quality natural food but rarely exercise, and those who get lots of exercise, play sports and eat crap. Diet and exercise are two sides of the same coin. Living a healthy life means eating well and being active. That is why the Harvard Medical School Healthy Eating Pyramid has daily exercise and weight control at the base of the pyramid [See: http://www.hsph.harvard.edu/nutritionsource/files/Healthy-Eating-Pyramid-handout.pdf]. This pyramid represents the best dietary and lifestyle choices that can be recommended based on the research that is out there.

The bottom line is that the modern Western lifestyle is far too sedentary. We need to spend less time sitting at a desk, in front of a computer, watching television, playing video games and driving around in our cars and SUVs; and a lot more time walking, hiking, playing sports and working out. As always, the difficult part is changing the old unhealthy patterns and replacing them with healthy patterns. Once the new patterns are established it gets a lot easier. Most people don't realize how bad they feel until they start doing things that are good for them and feel the difference.

It is also important to keep in mind that we aren't going to be able to maintain a healthy activity and lifestyle regimen if we don't enjoy it. We need to experiment a bit until we find the kind of exercise that we like if we want to be able to sustain it in the long run. Being in nature is always healthy and healing. We spend most of our lives cut off from the real world. So if getting out in a natural environment is an option I highly recommend it.

Sasha doesn't need to be convinced that exercise is good for her!

Before I sign off on this one I'm going to rant a bit on another issue that this study has brought up for me. I do take issue to some degree with the fact that the primary parameter that they are looking at is life expectancy. Our society is obsessed with wanting more of everything without any consideration of quality or consequences. Life expectancy is no exception. Most of us are so afraid of death that we will do anything to extend our life at almost any cost. I don't see any point in living an extra 10 years if we are going to spend it in a nursing home pumped full of drugs. What kind of quality of life can we expect when we force our body to continue functioning beyond it's expiry date? Of course, it is likely that we will live longer and be healthier if we live according to healthy principles. Extending our life naturally by living and eating in a way that promotes greater health and well-being is not the what I'm addressing. It's amazing how much money is pumped into "longevity" research, seeking ways to extend life at any cost. This has got to be one of the most absurd and selfish things that I can imagine. We are already over-populated and a large (and growing number) of us are significantly over-consuming. The goal of our economic pundits and the multinational corporations that they serve is to produce endless amounts of junk as cheaply as possible and make sure that everyone is consuming as much as possible. It doesn't take very much intelligence to realize that this is unsustainable. We are quickly eliminating all of the resources that our children and grandchildren will need in order to survive, not to mention all of the other beings that we share this beautiful planet with. If we find unnatural ways (drugs, stem cells, genetic manipulation, etc.) to increase average life expectancy by 10 or 20 years we will be taking even more from future generations. How about we just learn to be satisfied with what we have and live our life to the fullest? In our society we need to learn to embrace our death; to learn from it instead of pretend that it isn't going to happen. Our lives will be so much fuller and more rewarding if we learn how to live and die with dignity. To live a healthy, well-balanced life, we need to integrate the bigger picture rather than to live our life as if we are the centre of the universe. Of course, whether we intend it or not, our last act of generosity will be to nourish the fungi and bacteria that create the soil for the future benefit of all living beings!

Turkey tail (Trametes versicolor) is a medicinal mushroom that eats wood, not human remains.
But who knows what the tree was eating?