Author: Joan Haynes, NMD

Not Coping Well With Stress? You Might Have a Progesterone Deficiency.

by Joan Haynes, NMD

Women with low progesterone often have symptoms of insomnia, PMS, anxiety, irritability, breast tenderness, food cravings, hot flashes, irregular menses, infertility, uterine fibroid, low thyroid, low adrenal function and a host of other symptoms.

Progesterone’s main job during child bearing years is to prepare and maintain the uterus for pregnancy. Progesterone also affects brain function. It produces a sense of calmness and helps promote rejuvenating sleep. But when progesterone levels are low, the body can feel it has too much estrogen, even though estrogen levels can be normal. This is known as “estrogen dominance”.

When woman are under stress, their progesterone gets robbed to feed the cortisol (stress) pathway. This can leave us less able to handle stress and we may find ourselves anxious, overwhelmed and extra grouchy with those we love. We may also end up with adrenal fatigue,which often goes hand-in-hand with low progesterone. These may be the first symptoms of perimenopause and can happen years before other symptoms start to occur.

Testing

Low progesterone levels can be easily determined with saliva or urinary hormone testing.
Read more in my article Testing for Hormones: The Big Five.

No Need to Suffer there is Help for You

If you aren’t feeling yourself, come in and we can see if low progesterone and/or low cortisol are making you feel out of sorts. We can talk about ways to restore your hormone balance naturally, perhaps using bioidentical progesterone, herbs, supplements and dietary changes.

Tired? You Might Have Low Iron

By Joan Haynes, NMD

Fatigue can have many causes, but a fairly easy cause to figure out and treat involves iron. Iron deficiency is an under-recognized cause of fatigue and can be missed on standard lab work.

Symptoms which may be linked to iron depletion are:

  • Fatigue
  • Poor work productivity
  • Poor attention and memory
  • Sore tongue
  • Poor condition of skin or nails
  • Hair loss
  • Restless leg syndrome
  • Cracks on the corners of mouth
  • Pica – cravings for non-foods such as ice or even dirt

Iron does some important things in the body:

  • Carries oxygen to tissues
  • Needed in the mitochondria which makes energy
  • Helps synthesis of thyroid hormone
  • Converts tyrosine to dopamine (one of our feel good neurotransmitters)
  • Important in immune function

Testing

Most clinics order a CBC (Complete Blood Count) which will pick up the advanced form of iron deficiency anemia with a low hematocrit and/or hemoglobin (the color and volume of your red blood cells). But an earlier form of low iron levels can be detected with a serum ferritin test. The “normal” range for serum ferritin is broad, from 8 – 250 ng/mL, but hair loss, fatigue and other symptoms can occur when the number gets below 90.

Uncover the Cause of the Low Iron

Besides just identifying the problem, we need to discover and address the causes of the iron deficiency. It could be the patient just doesn’t eat enough iron-rich foods, but it could be something more serious. For example: heavy menstrual bleeding, low stomach acid, celiac disease, low B-12 and folate levels, hidden bleeding in the colon (a potential sign of colon cancer), small intestinal bacterial overgrowth (SIBO), chronic disease, inflammation, high lead levels and more.

Iron Supplements

Many people complain about gastrointestinal symptoms when taking supplemental iron, usually the ferrous sulfate form. But there are easier forms to absorb. At Boise Natural Health Clinic we use iron bis-glycinate with Vitamin C, between meals. It can take months for iron levels to come back up.

Iron absorption is inhibited by:

Low stomach acid, acid blocking medication, H. pylori infection, coffee, tea, soy products, wheat bran, wheat gluten, oat, nuts, casein, egg white, whey protein, some herbal teas.

Iron absorption is enhanced by:

Hydrochloric acid and vitamin C

Caution is advised with iron supplementation can be toxic, it is the leading cause of poisoning in children. In general, men and non-menstruating women should not take iron supplements or even a multi with iron in it unless they test low.

If you are suffering with any of the above symptoms, come in for a visit with and we’ll do a thorough health history and run labs to discover if iron deficiency, or something else, could be contributing to you not feeling well.

 

Could Your Symptoms be Due to a Lack of Water?  Sometimes it’s That Easy!

Joan Haynes, NMD

Did you know that 75% of Americans are chronically dehydrated?   

Here are 5 warning signs and symptoms of chronic dehydration, and tips on optimizing your water intake so you can feel your best all year long.  

  1. Fatigue
    Dehydration is the number one cause of daytime fatigue. Dehydration of the tissues causes enzymatic activity to slow down (slowing the metabolism.)
  2. Constipation
    When chewed food enters the colon, the body absorbs excess water via the colon walls, allowing the stool to form properly. In chronic dehydration, the body sacrifices the ideal consistency of the stool in order to give water to more vital parts of the body. The result: hard dried out stool that is difficult to pass.
  3. Excess weight
    Thirst is often confused with hunger. One glass of water shut down midnight hunger pangs for almost 100% of the dieters studied in a University of Washington study.
  4. Pain
    Pain can be a localized sign of dehydration. Headaches are commonly caused by lack of adequate water. Preliminary research indicates that 8-10 eight-ounce glasses of water a day (half of that coming from food and drinks other than plain water) could significantly ease back and joint pain for up to 80% of sufferers.
  5. Brain-fog
    A mere 2% drop in body water can trigger fuzzy short-term memory, trouble with basic math, and difficulty focusing on the computer screen or on a printed page. Obvious signs of dehydration include dry mouth, crinkled skin, excessive thirst, or absence of urination for over 6 hours. These are more serious symptoms and need to be corrected immediately.

Tips to Optimize Water Intake

  1. How much is enough?
    Thirst is not always a reliable indicator, so it’s good to keep track. Experts disagree on the exact amount of water each person needs. A commonly used calculation is to divide your weight in pounds by two, then convert this figure to ounces, and drink that many ounces of water daily. Example: 150 pounds/2 = 75 ounces of water per day. A simpler version is the 8-10 (8 oz) glasses per day rule. Learn to read your body’s signs, be willing to experiment, and you will find the right amount for yourself.
  2. What counts?
    Contrary to popular belief, caffeine is only a mild diuretic so a cup or two of coffee and/or tea can count toward your total fluid intake. Avoid energy drinks that often have huge amounts of caffeine and sugar. Alcohol subtracts from your daily fluid total, as it is a diuretic and will cause dehydration. In general, filtered or spring water is best but if you are having trouble getting it down, consider using some diluted fruit juice or lemon slices to add some flavor.
  3. What are the best times to drink?
    Good times to drink water are on rising, at least 1/2 hour before meals and 2-3 hours after. If you don’t like waking at night to urinate, stop drinking after 6 pm.  It is recommended by some health experts that you not drink much water with meals as it is thought to dilute the digestive juices.
  4. When is more needed?
    You need more if the temperature is hot or if you exercise. A general rule is to add an extra 2 glasses per day for every 5°F over 85°F if you are at rest, and more if you exercise.
  5. What about electrolytes?
    Adding electrolytes is important with exercise, in hot weather, and if you have become dehydrated. Electrolytes increase water absorption, and replace vital minerals lost in sweating. Instead of Gatorade, consider a healthier version called Recharge available in natural food stores. Coconut water is a good (although expensive) option. Another option is to eat salty snacks on heavy exercise days.  Some people hydrate regularly, but still feel thirsty and dehydrated and adding electrolytes work wonders for them.  

Here is my own favorite way to get myself to drink water regularly and to rehydrate if I’ve gotten low:

Steph Davlantes

This tasty drink goes down much easier than water, rehydrates me quickly, relieving muscle tension and headache, and increasing my energy and alertness.

In a quart mason jar or large glass, fill it 80-90% of the way with filtered water.

Fill the remaining 10-20% with Simply Lemonade (or another grocery store lemonade with real lemons and real sugar – you can use other brands or other juices, the little bit of sugar is important to absorb the water more quickly, so don’t use just lemon juice for best effect.)

Add 1/8 – ¼ teaspoon salt (I prefer Celtic sea salt or an electrolyte supplement).   

I find that adding a (reusable) straw and ice in warm weather helps me drink more. 

What is a “Leaky Gut”?

By Dr. Joan Haynes, NMD

“Leaky gut” is also known as “increased intestinal permeability”.  Our intestinal tract is a semipermeable membrane, allowing very small molecules through in order to absorb nutrients.  Inflammation causes more permeability in the lining of the gastrointestinal tract and incompletely digested food particles, toxins, and waste get through into the blood stream.  The immune system then has the task of dealing with those invaders and can result in a variety of symptoms.

leaky gut

Causes of Leaky Gut:

  1. Stress and age
  2. Infection or imbalance of the microorganisms in the gastrointestinal tract
  3. Irritation from chronic constipation
  4. Overuse of non-steroidal anti-inflammatory drugs (NSAIDs) like asprin and ibuprophen (Advil)
  5. Food intolerances, particularly gluten
  6. Pro-inflammatory foods such as alcohol, sugar, and highly processed foods

Symptoms of Leaky Gut:

  1. Digestive issues that might be labeled as irritable bowel syndrome (IBS) such as gas, bloating, discomfort, diarrhea.
  2. Seasonal allergies, chronic sinus congestion, asthma
  3. Autoimmune diseases such as rheumatoid arthritis, Hashimoto’s thyroiditis, lupus, etc
  4. Chronic fatigue syndrome
  5. Chronic achiness, arthritis, fibromyalgia
  6. Chronic headaches
  7. Mood issues such as depression, anxiety, ADD, ADHD, mental fogginess
  8. Skin issues such as acne, rosacea, eczema, psoriasis
  9. Food sensitivities and intolerances
  10. Difficulty losing weight

Possible Testing for Leaky Gut:

There is no definitive testing, so often we are using clinic symptoms and history to help diagnosis. Sometimes though we need more information and one or more of these labs can be useful:

  1. Food sensitivity testing can be useful – if more than a couple of foods show up positive on an IgG blood test, leaky gut is strongly suspected.
  2. Stool testing for gastrointestinal infections.
  3. Lactulose and mannitol test. The patient drinks a premeasured amount of these non-metabolized sugars and the degree of permeability is reflected in the levels of the sugars recovered in a urine sample collected over the next 6 hours.

How to Heal a Leaky Gut:

  1. Diet – sometimes a general anti-inflammatory diet is enough, but other times people need to identify and remove specific food intolerances using a formal elimination-rechallenge program or food sensitivity testing through a blood test. See Are Foods Causing Your Symptoms.
  2. Sometimes using digestive enzymes or hydrochloric acid (to be used cautiously) can help breakdown foods into smaller particles.
  3. The amino acid L-glutamine is useful to heal the gut which is often given with other herbs and nutrients. At BNH we often use a Metagenics product called is UltraInflammX, a medical food shake high in glutamine, easy to assimilate protein, carbs and healthy fat, along with nutrients and anti-inflammatory herbs such as turmeric, ginger and rosemary.
  4. Bone broths and green vegetable drinks are useful for easy nutrient assimilation.
  5. Probiotics and fermented foods.
  6. Stress reduction if needed. See What is Adrenal Fatigue.

Recommended Thyroid Book by Wentz

by Joan Haynes, NMD

Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause

by Izabella Wentz, PharmD, FASCP

Hypothyroidism is one of the most common health conditions we see at Boise Natural Health.  In 20 years of treating this condition, I’ve attended my share of classes and read numerous books and professional articles about thyroid function.  This book was great reading which confirmed that I’ve been on the right track in my practice, and also provided me with a wealth of new insight that my patients are already benefiting from.

Pharmacist Izabella Wentz gives a great overview of current theories about thyroid function and autoimmune disease in general.  Whether you are a newly diagnosed thyroid patient or one who has been on medication for years, it will behoove you to keep up with the latest medical advancements and treatment options.

If you like scientific detail like me, this book goes into specifics about how the thyroid works and what happens when it stops working well.  Wentz describes how “the body becomes stuck in a vicious cycle of immune system overload, adrenal insufficiency, gut dysbiosis, impaired digestion, inflammation, and thyroid hormone release abnormalities.”  Wentz discusses how to remove triggers and repair the body.  You learn how to maximize your thyroid function as well as your overall health.

One chapter I particularly appreciated was “Iodine Controversy” in which Wentz discusses the cautious use of iodine, which she describes as a “Goldilocks” supplement.  If there is too little, thyroid levels will be low.  Take too much, however, and the thyroid can become overactive.  I’ve seen this a number of times with new patients coming in with a wildly overactive thyroid induced by toxic doses of self-administered iodine.

Because Wentz’s book adheres to the naturopathic principle of treating the whole person to restore balance, it is an easy book to recommend to those wanting to learn more about optimal thyroid health.

Useful Cancer Information Resources

Cancer Treatment Centers of America: CTCA integrates Naturopathic Physicians and Medical Oncologists in their hospitals. This page illustrates supportive ways naturopathic medicine can fit into conventional oncology.

Oncology Association of Naturopathic Physicians: This resource explains naturopathic medicine and oncology and how it can help fight against cancer. Dr. Haynes is a member of OncANP and regularly attends continuing education seminars sponsored by the association.

The Cancer Connection Idaho: Completely free organization that provides support for people with cancer.

MD Anderson Cancer Center has an incredible data base to look up information about cancer. You can access the Natural Medicines comprehensive data base there. Just type in any therapy you are wondering about.

Livestrong at the YMCA is a free exercise program for cancer patients. You can do classes or work with a trained specialist individually.

Medical Research – A Disturbing Corruption

Doctoring Data: How to sort out medical advice from medical nonsense

by Dr. Malcolm Kendrick

Book Review by Dr. Haynes

Almost all of the medical research is funded, conducted, and reported by the corporations with vested interests.  Dr. Kendrick has been studying the problems in medical research for over 30 years.  After reading his book, I will never look at health news or published research in the same way again.  It turns out we simply can’t believe what we are being told.

Dr. Kendrick’s book was compelling and his witty, irreverent writing makes it a fun, if disturbing, read.   He explains the basics of understanding a study and then shows us how to question data we’ve previously taken as fact.  He tackles cancer, heart disease, blood pressure, hormone replacement therapy and more.  He shares that the popularly accepted “cholesterol hypothesis” has been disproven for many years but continues to thrive due to profits made from statin medications.

As a naturopathic physician, people often expect me to be skeptical about Big Pharma medicine.  But questioning the current medical system is not limited to those practicing alternative medicine.  Both the New England Journal of Medicine and the Lancet are the most well respected, peer-reviewed medical journals in the world.  Here’s what their own editors have to say about the state of medical science today:

 “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.  I take no pleasure in this conclusion which I reached slowly and reluctantly over my two decades as an editor of the New England Journal of Medicine.” Dr. Marcia Angell, editor of the New England Journal of Medicine

“The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analysis, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.” Dr. Richard Horton, the current editor-in-chief of the Lancet

With all this doubt about truth in medical research, what is a patient to do?  I strongly believe in the tenants of Naturopathic Medicine and use them as guiding principles with all of my patients (see a more detailed description):

  1. First Do No Harm – primum non nocere
  2. The Healing Power of Nature – vis medicatrix naturae
  3. Discover and Treat the Cause, Not Just the Effect – tolle causam
  4. Treat the Whole Person – tolle totum
  5. The Physician is a Teacher – docere
  6. Prevention is the best “cure” – praevenire

I encourage all patients and practitioners interested in being savvy consumers of medicine and advocates of their own health to read Dr. Hendrick’s book.  It is one of the most informative books I’ve come across and is enjoyable to boot!

Testing for Toxic Chemicals In Your System

by Joan Haynes, NMD

Could your chronic illness or allergic reactions be related to ongoing exposure to toxic chemicals? A newly available and finally affordable lab test (only $219) screens for the presence of 168 different toxic chemicals all from a single urine sample. Exposure to these compounds has been linked to allergic reactions, cancer, obesity, infertility, fibromyalgia, heart disease, diabetes, ADHD, autism, autoimmune disorders and more. 

We all know that our modern world is full of pollutants. But did you know that chemicals do not have to be proven safe prior to being introduced into use? The new documentary The Human Experiment, narrated by Sean Penn, is available on Netflix and I strongly recommend you watch it. It demonstrates how thousands of untested chemicals are ubiquitous in our everyday products, our homes, our food, and in us. 

Here’s just one example: 

2,4-Dichlorophenoxyacetic Acid (2, 4-D)  A very common herbicide most commonly used in agriculture on genetically modified foods, and as a weed killer for lawns.  Exposure to 2, 4-D via skin or oral ingestion is associated with neuritis, weakness, nausea, abdominal pain, headache, dizziness, peripheral neuropathy, stupor, seizures, brain damage, and impaired reflexes. 2, 4-D is a known endocrine disruptor, and can block hormone distribution and cause glandular breakdowns. 

The Categories of Environmental Pollutants Tested by GPL-TOX lab test (168 compounds tested in total)

  • Phthalates
  • Vinyl Chloride
  • Benzene
  • Pyrethrins
  • Xylenes
  • Styrene
  • Otganophosphates
  • MTBE and ETBE
  • 2,4 Dichlorophenoxyacetic Acid (2,4-D)

Recommendations for Detoxifications of Chemicals

First and foremost, we must identify and reduce our exposure to these toxic compounds in our homes and workplaces.   Secondly, working with an expert can be helpful. Naturopathic physicians are trained in accredited medical schools how to biochemically detoxify patients. Customized programs include specific nutritional and herbal supplements to promote the removal of toxins. In addition, we always focus on the whole person, including the gastrointestinal health, nutritional habits, and the mental/emotional factors and lifestyle activities of each individual patient. 

Read more about these toxins, the lab test, and when it is recommended at The Great Plains Laboratory, Inc. To have the test ordered, and for a follow up plan of action, contact Boise Natural Health to schedule an appointment.  

Could It Be Your Gallbladder?

Joan Haynes, NMD

Do you suffer from bloating, gas, belching, or abdominal pain with meals? If so, maybe your gallbladder is causing the symptoms.

The gallbladder is a digestive organ located in the upper right portion of the abdomen directly underneath the liver. The liver makes bile which is stored and concentrated in the gallbladder. As food leaves the stomach and enters the small intestine (duodenum), bile is secreted. The main function of bile is the digestion and absorption of fats. Bile also helps us absorb fat soluble nutrients and eliminate drugs and other compounds such as hormones.

Gallbladder

Symptoms of Gallbladder Dysfunction

Symptoms of Chronic Gallstones

  • Can have no symptoms
  • Abdominal pain following meals high in fat
  • Right sided abdominal pain but can be anywhere in abdomen
  • Radiating pain to the right shoulder
  • Bloating, gas, belching

Symptoms of Acute Cholecystitis (gallbladder attack that may require immediate surgery)

  • Abdominal pain with fever, nausea, vomiting

Tests Used to Diagnose Gallbladder Problems

Adapted from www.webmd.com

There are many choices of tests your doctor may order for you depending on your symptoms. Some are more commonly used than others.

  • Liver function tests (LFTs), which are blood tests that can show evidence of gallbladder disease.
  • A check of the blood’s amylase or lipase levels to look for inflammation of the pancreas. Amylase and lipase are enzymes produced in the pancreas.
  • A complete blood count (CBC), which looks at levels of different types of blood cells such as white blood cells. A high white blood cell count may indicate infection.
  • The use of ultrasound testing which uses sound waves to image the intra-abdominal organs including the gallbladder.
  • An abdominal X-ray, which may show evidence of gallbladder disease, such as gallstones. (not commonly used, may be an incidental finding)
  • A computed tomography (CT) scan that constructs X-ray images of the abdominal organs. This test may follow ultrasound if there are more questions.
  • A HIDA scan. In this test, a radioactive material called hydroxy iminodiacetic acid (HIDA) is injected into the patient. The radioactive material is taken up by the gallbladder to measure gallbladder function. This test also is referred to as
    cholescintigraphy.

Food Allergies and Sensitivities can be a root cause of gallbladder attacks

Since the 1940’s, James Breneman, MD reported that food allergies can initiate gallbladder  attacks and gallbladder disease. One study found that 100 percent of a group of patients were symptom free after following an elimination diet. Dr. Breneman believes that food allergies cause inflammation and swelling of the bile duct, which restricts bile flow from the gallbladder.

At Boise Natural Health Clinic, we offer ways to help identify food sensitivities with lab testing and formal elimination-rechallenge diets.

Treatment for Acute Attacks

  1. Fever, nausea and vomiting may require immediate medical attention and surgery.
  2. If immediate medical attention is not needed, your Boise Natural Health physician can make other recommendations such as the herb wild yam room (among others) that is antispasmodic, to provide relief of gallbladder spasms and pain.
  3. Specific homeopathic remedies may also be recommended chosen based on your specific symptoms may also provide symptom relief.

Treatment for Chronic Symptoms

Many times a gallbladder ends up being surgically removed. However, it may be possible to preserve your gallbladder and improve long term digestive health with proper care. You may want to consider:

  1. Correct dehydration to increase water content in bile
  2. Identify and remove or desensitize food allergies
  3. Decrease fat in diet and increase dietary fiber
  4. Repair nutritional deficiencies found in gallstone patients – vitamins E and C and omega 3 fish oils for example
  5. Increase solubility of the bile by using nutritional lipotropic (liver supporting) compounds and herbal cholagogues (stimulates bile flow). Your Boise Natural Health physician can customize a formula for you.
  6. Chemical dissolution of gallstones using plant terpenes, bile acids and lecithin

If you’ve had your gallbladder removed, consider the following:

  1. Replace the function of the gallbladder with bile salts. 1 to 2 tablets of professional quality bovine bile salts with each meal improves digestion and the absorption of fats.
  2. Evaluate what dietary and lifestyle factors contributed to the dysfunction of your gallbladder.

Oliver Oil Gall Bladder Flush

At Boise Natural Health, we do not recommend olive oil flushes to treat gallbladder problems. We have been taught that this procedure is dangerous because the large amounts of oil causes contraction of the gallbladder which in turn can cause existing stones in the gallbladder to become lodged in the bile duct causing an emergency situation. Some people see “stones” in the
toilet after doing an olive oil flush. A 2005 study in the Lancet (a much respected medical journal) analyzed the chemical makeup of the “stones”. These are not gallstones, but are soap solids created in the emulsification process of the olive oil.

In Summary

Gallbladder symptoms diagnosed early and will lead to earlier treatment and may function may be restored. If the gallbladder cannot be saved, there is still work to do by identifying the cause of the malady in the first place and supporting digestion for optimal absorption.

Choosing a Good Multiple Vitamin and Mineral Supplement

Joan Haynes, NMD

This article is not intended to tell you which vitamins to buy specifically, but rather how to make an informed decision. You are making a financial choice in your vitamin purchase; choosing the highest quality vitamin makes your purchase worthwhile.

Why do I need to take a multiple vitamin and mineral (MVM) supplement?

In theory, we should be able to receive all the nutrition we need from diet alone. But the fact is that most of us do not.

  • Few of us eat the recommended 5 – 8 servings of fresh fruits and vegetables a day.
  • Our food is often picked before it is ripe and transported long distances.
  • The soil in which our food is grown has become depleted of nutrients.
  • We rely on quick, processed foods with our busy lifestyle.
  • We live in a highly toxic world.
  • We have individual health needs and challenges.

A multiple vitamin and mineral (MVM) supplement does not replace a good diet. There are compounds in food that just can’t be replaced in a pill. Evidence shows that a good diet is still your best tool for staying healthy. However, a good MVM supplement is important insurance for optimal health.

How will I know its working?

You may experience higher energy levels, improved brain function, fewer colds or infections, reduced symptoms and other health benefits, or you may feel nothing.

Just because you may not feel anything doesn’t mean that the higher nutrient levels you are ingesting are not being used by your body. One study has shown that children taking a MVM supplement increased non-verbal intelligence (1). Another has shown that the elderly had significantly fewer infections compared to a placebo group (2). Use of a MVM supplement has also been associated with decreased mortality rates due to cardiovascular disease (3). The evidence for taking a MVM supplement is becoming overwhelming.

How much do I really need to take?

You will notice on supplement bottles the amount of each nutrient followed by the % DV. This number is the percent of the total daily amount recommended by the Federal Drug Administration (FDA). (There are nutrients for which a %DV has not been established.) %DV on labels can be misleading because it is an average amount needed for most healthy people and does not reflect age, gender or health status.

A quality MVM supplement will show a %DV that may exceed or go below 100%. This is because there is a difference between the amount of nutrients needed to ward off illness and the amount needed for “optimum” nutrition. The amounts of nutrients that are recommended by different experts will differ if their goal is to simply avoid signs of nutrient deficiency or if their goal is to allow a person to function at the highest degree possible. The %DV also does not take into account the form of the nutrients and its bioavailability.

What does a good multiple vitamin and mineral supplement look like?

Choose Capsules, not Tablets

Capsules: A capsule is usually made of animal or vegetable derived gelatin. Capsules are free of binding agents, glaze, and coloring allowing the nutrients to be more easily available and absorbable.

Tablets: Tablets are made by combining all the ingredients and compressing them together. Sometimes these tablets are then coated with pharmaceutical glaze. To obtain the nutrients, the body has to digest this highly compressed tablet. If you have digestive weaknesses, you may or may not digest the entire vitamin.

An easy test to determine if you are digesting your MVM supplement is to check if your urine turns bright yellow. If your urine is not bright yellow after taking the vitamin, either you are not absorbing the vitamin, or there are not enough B vitamins in the product to spill over into the kidneys.

Number of Capsules

A one-a-day pill cannot give you all the nutrients you need, making it a poor value. The dose of a high-quality encapsulated MVM supplement is usually 6-8 capsules a day.

Age and Gender Specific

Your age and gender, along with your health status will determine the amount of nutrients you specifically require. This is best determined in conjunction with your health care provider. You can also do your own research. We recommend the book Prescription for Natural Cures, by James F. Balch, M.D. and Mark Stengler, NMD

Bioavailable Forms

There are better forms of individual nutrients than others. You get what you pay for. Many lower cost products will use cheaper forms of vitamins and minerals. Unfortunately, many times cheaper forms also mean nutrients which are poorly absorbed or not usable by the body. Below are a few examples of nutrient choices.

  • Vitamin D: Cholecalciferol, D3, is the active form of Vitamin D and is the preferable form.
  • Vitamin E
    • The best form of Vitamin E is d-alpha tocopherol with mixed tocopherols (dalpha, gamma, beta, and delta).
    • The synthetic form of Vitamin E is dl-alpha tocopherol. Note that the difference in labeling is “d” vs. “dl” before the alpha. “dl” is not a healthy choice.
  • Vitamin B12: The best form of Vitamin B12 is methylcobalamin. Cyanocobalamin is the form in most vitamins and is usually fine for most people. If someone has chronic disease however, a methylcobalamin form is recommended.
  • Vitamin B6: The active form of B6 is pyridoxine 5-phosphate. This is usually designated at P-5-P.
  • Minerals: There are many forms of minerals which are bonded to compounds; the physical form of a mineral is usually designated by the last word of the name. Example: magnesium citrate or magnesium oxide. Each form has different amounts of the basic elemental mineral as compared to the size of the whole compound and will determine how absorbable the mineral is.
    • For example: calcium carbonate (this includes coral calcium) is a large molecule with a lot of elemental calcium. The large size of this molecule means that it is not easily absorbed. Calcium carbonate also tends to be constipating for some people. Calcium citrate, by contrast, is a smaller form of elemental calcium, and is much more easily absorbed than the carbonate form. (An interesting note is that certain antacid medications contain calcium carbonate and are marketed as a source of calcium. However, because the purpose of an antacid is to inhibit stomach acid, and stomach acid is necessary for making minerals available for absorption, the body has a harder time actually utilizing the calcium!)
    • Similarly, magnesium oxide is poorly absorbed and causes water to stay in the intestines, thus causing a looser stool. Thus, magnesium oxide can be useful to treat occasional constipation. Alternatively, magnesium citrate is a better choice because it is more easily absorbed. (Caution, however, the citrate form may also cause loose stools for some people.)
    • There are other forms of mineral compound chelates including gluconate, aspartate, asparotate, and lactate. The gluconate form is not recommended.

Hypoallergenic

A good multivitamin will be hypoallergenic, meaning it does not contain wheat, dairy, corn, soy, or artificial dyes or colorings.

Other Ingredients

Before you read what the active ingredients are, read the label for “other ingredients.” Many supplements contain extra ingredients that may cause side effects or impair absorption. If you have lots of unnecessary “other ingredients”, it does not matter how much active ingredients you have, the MVM supplement is already a poor choice. We recommend researching any ingredient that is unfamiliar to you.

The following is not a comprehensive list. Some “other ingredients” to avoid:

  • Glucose, fructose, dextrose, maltodextrose, corn syrup, sucrose, lactose. These are sugars and unless these are added for flavor in children’s chewable vitamins, they are not needed. As soon as possible, wean your child from a chewable to a capsule to minimize their dependence on sugar and risk to their teeth.
  • Sorbitol. This is a sugar alcohol, and although is not purely sugar, it is not beneficial in a vitamin. For diabetics this is an absolute must for avoidance! Sorbitol can also cause diarrhea.
  • NutraSweet, Equal, Aspartame, Sucralose, Splenda. These are artificial sweeteners and are NOT beneficial to the body.
  • Polyethylene glycol. Although non-toxic, this chemical, when used in large dosages, is a treatment for constipation. It is unnecessary for use in highly absorbable vitamins.
  • Mineral Oil. Mineral oil is derived from petroleum and prevents absorption of nutrients. Given these two facts, taking a vitamin with mineral oil does not seem a good choice.
  • Canuba Wax. Canuba wax may inhibit the digestion of the ingredients and make it less absorbable. This is especially true if digestive weaknesses are already present.
  • Dextrin. This is a binding product, making the nutrients less available for digestion.
  • Di-calcium phosphate. Di-calcium phosphate is an excipient (an inactive ingredient) and is not available to the body as calcium. A vitamin labeling both calcium and phosphorus may be counting the di-calicum phosphate as calcium, but it really doesn’t add much to the calcium content nutritionally.
  • Any coloring
  • Any pharmaceutical glaze
  • Magnesium stearate, calcium stearate, stearic acid. These are not nutritional ingredients but rather fats that act as lubricants, they allow the manufacturing process to run faster and prevent the capsulation/tabulating machines from clogging up. Many times, these lubricants are animal based. Each particle of your vitamin can be coated by the lubricant, which then needs to be dissolved before you can access the vitamin. If you have digestive problems such as irritable bowel, a missing gallbladder, or acid reflux, it may be difficult for you to get benefit from your MVM supplement if these lubricants are present.

I always forget to take my multi. How can I remember?

Find a visual trigger and make it a habit:

  • Buy a little shot glass or small candle holder, fill it with your vitamins and set by your usual meal place (we have a basket of free ones at our office)
  • Medication holders – found at drug stores
  • Small baggies – create a week’s worth on Sunday night
  • Involve your family – set out everyone’s supplements at once
  • For a month, create a checklist to record each time you take your supplements

When should I take my MVM supplement?

The best time to take a MVM supplement is when you are eating. This is when your gastrointestinal system is optimally prepared to absorb the nutrients. Many people think they cannot tolerate a MVM supplement but it is simply because they’ve only tried taking it on an empty stomach. Divide your daily dose in half and take it with breakfast and lunch or dinner.

In Conclusion

While good supplements are available at reputable stores, it can be overwhelming even for the most knowledgeable consumer to know what to choose. Choosing a MVM supplement may seem as easy as grabbing one off the supermarket shelves, but with a little knowledge, the one you choose can be the right one for you. Read the labels carefully and make an informed decision. Your health is valuable and making informed choices can help your health and your pocketbook.

The supplements available at Boise Natural Health are professional grade and are manufactured by very reputable companies. We strive to bring you supplements that are thoroughly researched and provide the best available ingredients. Please note, we sell only to current patients. You can look at the following links to see some information provided by some of our manufacturers:

  • Thorne Research http://www.thorne.com/media/supp_facts_2003.pdf
  • Pure Encapsulations http://www.purecaps.com/QualityControl.asp
  • Wise Women Herbs http://www.wisewomanherbals.com/about_our-products.html

References

1 Benton D and Roberts G: “Effect of vitamin and mineral supplementation on intelligence of a sample of school children.” The Lancet 1:140-3, 1988
2 Chandra RK: “Effects of vitamin and trace-element supplementation on immune responses and infection in elderly 
subjects.: The Lancet 340:1124-7, 1992
3 Watkins ML, Erickson JD, Thun MJ, et al. Multivitamin use and mortality in a large prospective study. Am J Epidemiol 152:149–62, 2000