Author: Stephanie Figon, MS, RDN, LD

Founder of NutriScape.NET. As a dietitian since 1992, Steph Figon has had experiences in consulting, 15 years in clinical, and has operated a private practice nutrition counseling office for since 2011. The RDNutriScape Instagram

How Can You Detect Diabetes? Test Your Blood Sugar (HbA1c) Now!

Hemoglobin A1c

What is an A1c Test?
An A1c test is usually used to diagnose diabetes or prediabetes or to check on how well controlled your blood sugar is. Other names for an A1C are glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C, or HbA1c test.

Hemoglobin is the protein in your red blood cells that carry oxygen and makes your blood bright red. A hemoglobin A1C test measures the percentage of the hemoglobin protein in your red blood cells that has glucose bonded to it. Since your red blood cells live 2-3 months, it gives you a rough average of what your blood sugar has been over the past 2-3 months.

A1C test results usually correspond with the following “Estimated Average” blood sugar levels:

6% 126 mg/dL
7% 154 mg/dL
8% 183 mg/dL
9% 212 mg/dL
10% 240 mg/dL
11% 269 mg/dL
12% 298 mg/dL

Why Do You Need To Know Your A1c
Avoid Complications if You Have Diabetes
The higher your A1C level is, the more worried you should be about diabetes complications. This makes sense because when the proteins in your blood are getting glucose attached to them, all the other proteins in your body are being damaged in the same way.

The results of an A1C test also help your doctor or other health care provider know if it’s important to add a new blood sugar medication or adjust the dose of medications you are taking.

Monitor Your Progress in Reversing Prediabetes
If you have a family history of diabetes or your physician has been raising the alarm that you need to lose weight and exercise to avoid diabetes, an A1c test can give you an excellent idea of how well your efforts have been working.

Monitor your diabetes treatment plan. The result of your first A1C test also helps establish your A1C level is starting out–a baseline. Your physician will then repeat your A1c 2-4 times a year to monitor your diabetes treatment plan.
How often you need the A1C test depends on the type of diabetes, your treatment plan, how well you’re meeting treatment goals, and your physician’s clinical judgment.

About the Test
The A1C test is a simple blood test and it shouldn’t require fasting if it is the only test being done that day.
The blood sample is taken by inserting a needle into a vein in your arm.

Diagnosing Diabetes and PreDiabetes:
Diabetes Is an A1c of 6.5%
An A1c of 6.5% or more meets the diagnostic criteria for diabetes if it is confirmed with another A1c or a fasting blood glucose of >126 mg/dl. If you have been diagnosed with diabetes and succeed in lowering your A1c below 6.5%, Great! Unfortunately, we wouldn’t be able to say you don’t have diabetes anymore.
You would be considered to have very well-controlled diabetes.

Prediabetes Is An A1c of 5.7% to 6.4%
When your blood sugar gets to this level, there is clearly insulin resistance and/or a lack of insulin present in your system. This definitely sounds like bad news to anyone hearing it for the first time. And yet, many times it is just the kind of wake-up call that turns on the motivation full blast. And for good reason–the Diabetes Prevention Program Study provided proof that people who exercise and lose just 5% of their body weight are able to delay the onset of type 2 diabetes by as much as a decade!

An A1c Below 5.7% is Considered Normal.
The “normal range” for A1c is 4.6%-5.7%. But, here’s a secret: If you ask most endocrinologists what they would want for their own A1c to be, most would answer that they would want a 5.0%.

The A1c Target
The goal for A1c should be individualized for every person based on their age, and other risk factors but an A1C level of less than 7% is a common treatment target. A lower A1c target provides better protection for your kidneys, your brain, and your nerves and blood vessels.

A1C and self-monitoring
Even though an A1c gives your doctor a pretty good idea of your risk for complications, you still need real-time glucose self-monitoring information to make food and exercise decisions on a daily basis.

Factors that Can Throw Off Your A1c Results
Any condition that interferes with the routine production of red blood cells will have an effect on A1C test results. These include anemia, pregnancy, and blood loss. Less commonly, some people have hemoglobin variants that are more common in those of African, Mediterranean, or Southeast Asian descent.

Instructions
The Hemoglobin (Hb) A1c Blood Test does not require any fasting or other special preparations.  Normal medications may be taken before the test. 
 

Why Do I Still Have Thyroid Symptoms? Reverse T3 May Explain It

Thyroid

Your doctor says your thyroid test is normal, but you have the Symptoms of hypothyroidism including:

  • Fatigue
  • Weight gain
  • Constipation
  • Brain fog
  • Muscle aches
  • Depressed mood

If this sounds like you, you might want to have a thyroid test that includes “Reverse T3”.

What is Reverse T3?

Reverse T3 is an inactive form of T3 that fits into the cell receptors where regular T3 normally plugs in and performs its function. With the reverse T3 blocking the receptors, you can end up with normal blood levels of TSH and T3, but without the T3 being able to perform its function.

The Reverse T3 Blood Test May Give You Some Answers

The Thyroid #2 Essential Blood Test Panel includes Reverse T3 along with the usual thyroid labs including TSH, Free T3, Free Serum Thyroxine (T4). Reverse T3 is a biologically inactive form of T3 (aka triiodothyronine). It is normal for your body to convert T4 to T3 and RT3 in a certain ratio, but there are times when the amount converted to RT3 (the inactive form) rises.

You may be making too much of the inactive Reverse T3 if:

  • Your body is under physical or emotional stress. Cortisol increases the amount of Reverse T3 you produce.
  • You take drugs such as amiodarone and glucocorticoids. These medications can cause increased RT3 levels.

The T3 to T4 Ratio

But elevated RT3 levels alone may not be enough to tell you there is a thyroid condition because stress can cause levels to rise. So, a more accurate assessment is possible by entering both the Reverse T3 result and the free T3 test result into an equation to evaluate the ratio between RT3 and free T3 levels.

Here’s a calculator: Calculate the T3 to Reverse T3 Ratio.

Menopausal Hot Flashes: What Foods Help and Are Supplements Effective?

Women going through menopause often experience problems with hot flashes (flushing), vaginal dryness, and irritability or depression related to low estrogen levels. Natural compounds have been shown to be helpful for reducing these symptoms and many women are looking for relief in over-the-counter (OTC) supplements to lessen their symptoms.

Estrogen-like Compounds in Food

There are a number of natural compounds in foods that have been studied and are found to be helpful for reducing these symptoms because of their estrogen-like effect in the body.

Isoflavones

Soy and red clover (Trifolium pretense) contain isoflavones, which have a mild estrogenic effect in the body.

Research shows that it may take 3 to 6 months for soy isoflavone extracts to have a significant effect.-5-

Some women may not be able to absorb the isoflavones they consume. About 95% of isoflavones are bound to sugar, forming glycosides. These glycosides need to be broken down by microbes in the gut before the isoflavone can be absorbed. -2-

Black Cohosh

Black cohash has also been found to reduce menopausal symptoms although it is not well understood what compounds are responsible for its effectiveness. -2- Supplements are made from the roots and rhizomes of a plant in the buttercup family, Cimicifugia racemosa.

Supplement Quality

As with all supplements, it’s important to know that there is very little independent oversight in the supplement industry to make sure that supplements are free of contaminants and that ingredients and amounts are correct.

Breast Cancer Risk

There may also be concern for women with breast cancer. The American Cancer Society advises women with estrogen-receptor-positive breast cancer to avoid supplements containing isoflavones, although foods containing soy have been found to be safe. -8-

Isoflavones in Soy Foods

Soy based foods also contain biologically active isoflavones. Studies have shown that consuming 20g to 60 g per day of soy protein can decrease hot flashes -9- 9. Natural medicines in the clinical management of menopausal symptoms. Natural Medicines Comprehensive Database website. Tempeh, miso, and tofu, soy flour, soy protein and edemame (soy beans). However, soy oil and soy sauce do not contain these isoflavones.

Improving Fertility and Insulin Resistance with Supplements For PCOS

PCOS Nutrition Supplements

Overview

Polycystic ovarian syndrome (PCOS) is a hormonal disorder that that affects about 6% to 10% of women. PCOS not only causes menstrual and fertility issues, but also mental health issues, obesity, type 2 diabetes, insulin resistance, and metabolic syndrome. (11)

Hormonal medications like birth control pills are often prescribed for PCOS, as well as metformin for insulin resistance.

The supplements listed below help with some of the underlying problems of women suffering from PCOS.

Acknowledgment and Disclaimer

This article cites research compiled by other sources. These include Natural Medicines Database, the Fullscript organization, and others. Product links are chosen based on the best fit with the published research, however, this site is meant for educational purposes only. Individuals are advised to consult a Registered Dietitian Nutritionist or healthcare professional about diet and nutritional supplement intake.

Purchase of any products linked in this article earns affiliate fees that help support the web development expenses of The NutriScape Project. Thank you for your support.

Omega-3 with Vitamin E 

Omega-3 with Vitamin E 

1000 mg of omega-3 with 400 IU vitamin E (8)

(22)

  • Overweight women with PCOS showed increased total antioxidant capacity levels when given 2 g of omega-3 with 400 IU of vitamin E (23)
  • Lipid profile and oxidative stress improved and women with PCOS . They showed decreased serum triglycerides, LDL, and total/HDL, and increased plasma total antioxidant capacity when supplemented for 12 weeks (22)
  • Systematic review of 9 trials found omega-3 fatty acids may improve insulin resistance in patients with PCOS (26)  

Vitamin D

Vitamin D: 1000 IU to 4000 IU per day for a minimum of 12 weeks  (14)(7)

  • In a systematic review of 11 studies, it was found that continuous supplementation of vitamin D up to 4000 IU per day was associated with improved insulin sensitivity. (16 Łagowska 2018 )
  • A Vitamin D Dose of 4000 IU per day was more effective than 1000 IU in decreasing total testosterone and increasing total antioxidant capacity in insulin-resistant PCOS patients (14 Jamilian 2017)

Berberine

Berberine is extracted from Chinese medicinal herbs and has been used as an insulin sensitizer.

500 mg per day, for a minimum of 3 months (5 )

  • Berberine lead to decreases in the waist circumference, total cholesterol (TC), triglycerides (TG), and LDL cholesterol, as well as increase in HDL cholesterol in women with PCOS.(25)  
  • In a review of 9 randomized controlled trials, berberine was found to be comparable to metformin as demonstrated by no significant differences found between them in alleviating insulin resistance, improving glycolipid metabolism or reproductive endocrine condition (17)
  • Berberine is considered unsafe in pregnancy because it crosses the placenta and causes uterine contractions according to the Natural Medicines Database. Product literature does advise against taking Berberine if you are pregnant or nursing. Nevertheless, infertile women with PCOS undergoing In Vitro Fertilization experienced an increase in live birth rate when given berberine. (1

Chromium Picolinate

Chromium picolinate200 µg, per day, minimum 8 weeks (12 )(13)

  • Women with PCOS who took 200 micrograms of chromium for 8 weeks had lower blood glucose, improved insulin sensitivity, and improved markers for cardio-metabolic risk. (15)
  • A review of 7 randomized trials found chromium supplementation decreased BMI, fasting insulin, and free testosterone concentration in women with PCOS. (10
  • Chromium supplementation improved pregnancy rate by 16.7%, decreased prevalence of acne by 20.0%, improved oxidative stress, increased total antioxidant capacity and decreased hirsutism. (13)

Inositol

Inositol

1-2 g inositol (myo-inositol and d-chiro-inositol), minimum 3 months (6))(19)(21)

  • Myoinositol was found to improve increase estradiol, and alleviate insulin resistance (27 )
  • Women with PCOS given 1200 mg of d-chiro-inositol twice daily had improved insulin sensitivity. (4)
  • Myoinositol and d-chiro-inositol both improved ovarian and metabolic functions in women with PCOS. A study compared 6 months of supplementation with 4g of myo-inositol(MI) or 1g of d-chiro-inositol(DCI). The research found myoinositol was better for metabolic function and di-chiro-inositol was better for decreasing hyperandrogenism. (21)
  • A trial of women taking 2g of inositol twice per day for 3 months found that the ratio 40:1 MI/DCI was ideal for restoring and normalizing ovulation in PCOS patients. (19)
  • Combined myoinositol and d-chiro-inositol was more effective after 3 months of treatment than myoinositol alone. (20)

References

  1. (An 2014) https://pubmed.ncbi.nlm.nih.gov/23869585/ (C)
  2. (Ashoush 2016) https://pubmed.ncbi.nlm.nih.gov/26663540/ (B)
  3. Bozdag, 2016 https://pubmed.ncbi.nlm.nih.gov/27664216/ (A)
  4. (Cheang 2008)https://pubmed.ncbi.nlm.nih.gov/18803944/ (C)
  5. Cicero 2014) https://pubmed.ncbi.nlm.nih.gov/24728953/ (C) 
  6. Colazingari 2013) https://pubmed.ncbi.nlm.nih.gov/23708322/ (C)
  7. Dastorani https://pubmed.ncbi.nlm.nih.gov/30286768/ (C)
  8. Ebrahimi 2017 https://pubmed.ncbi.nlm.nih.gov/28407657/ (B)
  9. Fang 2017 https://pubmed.ncbi.nlm.nih.gov/28107851/ (A)
  10. Fazelian 2017) https://pubmed.ncbi.nlm.nih.gov/28595797/ (A)
  11. Gilbert 2018) https://pubmed.ncbi.nlm.nih.gov/30099747/ (A)
  12. Jamilian 2015. https://pubmed.ncbi.nlm.nih.gov/26279073/ (B)
  13. Jamilian 2016 https://pubmed.ncbi.nlm.nih.gov/26613790/ (B)
  14. Jamilian 2017). https://pubmed.ncbi.nlm.nih.gov/29186759/ (B)
  15. Jamilian 2018 https://pubmed.ncbi.nlm.nih.gov/29307112/ (C)
  16. Łagowska 2018 https://pubmed.ncbi.nlm.nih.gov/30400199/ (A)
  17. Li 2018 https://pubmed.ncbi.nlm.nih.gov/30538756/ (A)
  18. Nasri, 2017 https://pubmed.ncbi.nlm.nih.gov/28235206/ (B)
  19. Nordio 2019 https://pubmed.ncbi.nlm.nih.gov/31298405/ (C)
  20. Nordio 2012 https://pubmed.ncbi.nlm.nih.gov/22774396/ (C)
  21. Pizzo 2014 https://pubmed.ncbi.nlm.nih.gov/24351072/ (C)
  22. Rahmani 2017 https://pubmed.ncbi.nlm.nih.gov/27619403/ (B)
  23. Sadeghi 2020 https://pubmed.ncbi.nlm.nih.gov/30961460/ (C)
  24. Abootorabi 2018 https://pubmed.ncbi.nlm.nih.gov/29271278/ (C) 
  25. Wei 2012) https://pubmed.ncbi.nlm.nih.gov/22019891/ (C)
  26. Yang 2018https://pubmed.ncbi.nlm.nih.gov/29580250/ (A) 
  27. Zeng 2018 https://pubmed.ncbi.nlm.nih.gov/29052180/ (A)

Best Nutritional Supplements for Womens’ Infertility: The Real Research on What Works

infertility supplements

Acknowledgment and Disclaimer

This article cites research compiled by other sources. These include Natural Medicines Database, the Fullscript organization, and others. Product links are chosen based on the best fit with the published research, however, this site is meant for educational purposes only. Individuals are advised to consult a Registered Dietitian Nutritionist or healthcare professional about diet and nutritional supplement intake.

Purchase of any products linked in this article earns affiliate fees that help support the web development expenses of The NutriScape Project. Thank you for your support.

Overview

About 10 to 15% of couples are challenged with infertility. (12) One of the contributing factors may be hormonal dysfunction in women. (2) Correcting levels of hormones may improve pregnancy success and cut the risk of miscarriage. (7)(20)(23)

Research suggests that hormone-disrupting environmental chemicals (endocrine disruptors) may be responsible for increased rates of miscarriage and reduced live birth rates in couples who are encountering infertility. (5) Hormonal dysfunction is also seen in polycystic ovarian syndrome (PCOS). Low serum vitamin D also seems to be related to hormonal disturbances. (1)(5) Improving the quality of maturing eggs with supplemental inositol also shows promising results. (3)(20)

A careful reading of the research suggests that the supplements listed below are shown affect a variety of factors associated with female fertility.

Registered Dietitian Nutritionist

Myo-inositol

Myo-inositol

4000 mg per day for at least 2 months (3)(11)(13)

  • Women who received myo-inositol supplementation while participating in IVF treatment had better ovarian responses. (3)
  • Supplementation of myo-inositol three months before in vitro insemination resulted in an increased pregnancy rate. (13)
  • A review of 10 randomized trials concluded that “Inositol appears to regulate menstrual cycles, improve ovulation and induce metabolic changes in polycystic ovary syndrome”. (20)
  • Myo-inositol improves sensitivity to the fertility drug, clomiphene citrate, as shown by increased ovulation and pregnancy rates.(21)
  • Infertile PCOS patients undergoing intrauterine insemination (IUI) who received myo-inositol had increased rates of pregnancy, and took less time to get pregnant. (11)

Vitamin D3

Vitamin D

Vitamin D in the ingredient library 

5000 per day for 6 months (8)(9) for deficiency.

Vitamin D deficiency is defined as a blood level below 20 ng/mL (50 nmol/L). About 4 out of 10 US adults are considered deficient in vitamin D but the level was even higher at 7 out of 10 for Hispanics and ~ 8 out of 10 for African Americans. Therefore, vitamin D testing is very important for a woman trying to get pregnant. Vitamin D Testing is available here without a visit to the doctor. Consult with a registered dietitian nutritionist about the right supplement dosage for you.

  • Women deficient in vitamin D had lower pregnancy rates and lower live birth rates than women who had adequate vitamin D levels. (4)(8)(15)
5000 IU 2000 IU

Prenatal multivitamin

Prenatal multivitamin formulation with 800 mcg folic acid, beginning 4-6 weeks before conception. (1)(6)

  • Studies found supplementation of multivitamin for 28 days before conception increased fertility from 2.7% to 3.8%, and reduced the risk of birth defects. (6)
  • Micronutrient supplementation improved pregnancy and live birth rates when administered during in-vitro fertilization (IVF) therapy (2)

NAC

N-acetylcysteine (NAC) for Women with PCOS

Women with PCOS 1800 mg per day, for 8-12 weeks (19)(22)

  • Women with PCOS who received NAC had higher rates of pregnancy, improved ovulation and peak endometrial thickness (14) when compared to those treated with metformin or clomiphene citrate alone. (19)
  • Ovulation and pregnancy rates improved in infertile women with PCOS (22)

References

  1. Agrawal 2012,  https://pubmed.ncbi.nlm.nih.gov/22138521/ 
  2. Arhin 2017,  https://pubmed.ncbi.nlm.nih.gov/28919239/
  3. Caprio 2015b,  https://pubmed.ncbi.nlm.nih.gov/26067283/ 
  4. Chu 2018, https://pubmed.ncbi.nlm.nih.gov/29149263/ 
  5. Conforti 2018,  https://pubmed.ncbi.nlm.nih.gov/30594197/ 
  6. Czeizel 1994,. https://pubmed.ncbi.nlm.nih.gov/7979565/ 
  7. Czeizel 1994b,  https://pubmed.ncbi.nlm.nih.gov/8588492/ 
  8. Dennis 2012,  https://pubmed.ncbi.nlm.nih.gov/22508713/ 
  9. Dennis 2017,  https://pubmed.ncbi.nlm.nih.gov/28698476/ 
  10. Dongre 2015, https://pubmed.ncbi.nlm.nih.gov/26504795/ 
  11. Özay 2017, https://pubmed.ncbi.nlm.nih.gov/28277112/ 
  12. Lerchbaum 2012, https://pubmed.ncbi.nlm.nih.gov/22275473/ 
  13. Lisi 2012,  https://pubmed.ncbi.nlm.nih.gov/22823904/ 
  14. Maged 2015,  https://pubmed.ncbi.nlm.nih.gov/26291797/ 
  15. Moridi 2020, https://pubmed.ncbi.nlm.nih.gov/20089454/ 
  16. Pundir 2018,  https://pubmed.ncbi.nlm.nih.gov/28544572/ 
  17. Rolland 2017,  https://pubmed.ncbi.nlm.nih.gov/28724178/ 
  18. Salehpour 2012,  https://pubmed.ncbi.nlm.nih.gov/22540635/
  19. Shang 2015, https://pubmed.ncbi.nlm.nih.gov/25638341/ 

Post-Exercise Pain and Recovery: What Supplements Really Work?

Post exercise pain supplements

Acknowledgment and Disclaimer:

This article cites research compiled by other sources. These include Natural Medicines Database, the Fullscript organization, and others. Individuals are advised to consult a healthcare professional about diet and nutritional supplement intake.

Muscle Building Can Involve Post-Exercise Pain and Inflammation

Many dietary supplements are marketed to athletes to reduce pain and inflammation after exercise and to improve recovery. Much of the local inflammation and muscle soreness occurs within 24 to 48 hours after exercise. This article discusses the supplements that have been found in research to be helpful for athletes encountering post-exercise pain.

These include:

  • Collagen improves the strength and elasticity of connective tissues. (Dressler 2018)
  • Curcumin reduces inflammatory markers and might shorten recovery time from exercise. (Fang 2020)(Suhett 2021)
  • Magnesium is shown reduce inflammation and cortisol levels.
  • Branched-chain amino acids (BCAAs). BCAAs have been found to help to reduce blood chemical markers of exercise-related damage. (Khemtong 2021)

Collagen

Usual Dosage-5 to 15 g per day for 3 months.

  • Collagen makes ligaments and tendons stronger and more elastic. That is important for holding your muscles and joints in place. Ankles are almost 70% collagen. (Dressler 2018)
  • Researchers found that taking collagen at 5 to 10 grams per day over 12-24 weeks improved knee issues in young athletes. (Clark 2008)(Zdzieblik 2017)
  • Dressler found that 5 to 15 grams per day of collagen improved ankle instability in athletes over 3 to 6 months and improved the number of ankle sprains over a 6 month follow-up. (Dressler 2018)

Curcumin

Usual Dosage- 180 mg Theracurmin® for 7 days (Suhett 2021)

  • There have been 2 review studies that have shown curcumin to reduce inflammatory markers, decrease pain, and improve muscle recovery in athletes. (Fang 2020)(Suhett 2021)
  • Curcumin dosage contained in supplements varies widely depending on the specific product extracts and formulation. (Suhett 2021
  • Although curcumin is “generally recognized as safe” by the US FDA, there are reports of mild problems including gastrointestinal disturbances, fever, pitting edema, and throat infection in a study of people taking curcumin supplements. (Sahebkar 2016)

Magnesium

Usual Dosage- 300 to 500 mg per day for 7 weeks (Heffernan 2019)

  • There are over 300 enzymes in cellular metabolism that depend on magnesium. Cells can’t reproduce, build protein molecules or produce energy without it. So it makes perfect sense that it should improve performance in athletes.
  • Athletes are probably at greater risk of magnesium deficiency than the general population since many don’t meet the estimated average requirement and higher intensity exercise may cause an increased magnesium requirement. (Molina-López, 2012
  • Not all studies show a benefit from magnesium supplementation, but a 2019 systematic review found that magnesium supplementation improved measures of strength, inflammation, DNA damage, and cortisol when provided in doses of 300 to 500 mg per day. (Heffernan 2019)
  • Although it is not often a problem, it is important to know that doses at or above 360 mg per day can contribute to diarrhea. (IOM 1997)

Omega-3 fatty acids

Usual Dosage- (EPA/DHA), 3 g of EPA+DHA in 2:1 ratio for 8 weeks (Ochi 2018)

  • EPA and DHA each have unique anti-inflammatory effects. (Calder 2017). Research is mixed on whether they decrease post-exercise muscle soreness and improve range of motion. A 2020 review found that trials showing improved recovery tended to have a dose of over 2 g EPA+DHA with a duration over eight weeks, and study populations of untrained participants rather than elite athletes. (Thielecke 2020
  • A 2020 review of studies in athletes showed that most randomized trials of fish oil showed reduced inflammation and, muscle soreness. (Thielecke 2020
  • Adverse effects are mostly involving nausea and fish oil taste, but it’s important to consider that high omega-3 consumption may prolong bleeding time (Meydani 1991). On the other hand, the FDA has recognized that intakes of up to 3 g per day of omega-3 fatty acids is generally recognized as safe even with these effects on bleeding risks. (US FDA 2004)

BCAAs

Usual Dosage ~440 mg/pound/day (i.e., 14 g for a 160 pound athlete) for 3-10 days (Fouré 2017)

  • There is some contraversy about whether BCAAs help athletes build new muscle, (Fouré 2017) (Wolfe 2017)(Churchward-Venne 2014), but they have been shown to cut down on muscle soreness and markers of oxidative damage.
  • A 2017 systematic review of athletes take 440 mg per pound of body weight for 10 days beginning before exercise, there would be reduced markers of skeletal damage. (Fouré 2017)
  • A recent meta-analysis, (Fedewa 2019), showed a fair reduction of post-exercise muscle soreness with supplementation of BCAAs.
  • No adverse effects of have been noted when BCAAs are supplemented at these levels.

Supplement Products

Fullscript products:

Collagen: Vital Proteins Collagen Peptides. Take 1-2 scoop, once / day for 3 months

Curcumin: Take 2 capsules, once / day for 1 week

Curcuminoids 475mg
  • Magnesium: Magnesium (Glycinate) Pure Encapsulations. Take 2-4 capsules, once / day for 2 months in divided doses, with meals.
  • Omega 3: ProOmega® 2000 Nordic Naturals. Take 1-2 gel, once / day for 2 months.
  • Branched Chain Amino Acids: Pure Encapsulations. Take 1 scoop, once / day for 10 days mixed with of water or juice.

Amazon Products:

Vitamin A, E, and Beta Carotene Blood Test Panel

Vitamin E

A Vitamin A, E, and Beta Carotene Blood Test Panel is ordered to find out if you have excessive or deficient vitamin A, Beta Carotene, or Vitamin E levels in your blood.

The Vitamin A Test

Vitamin A is a group of substances that help in vision, reproduction, cell division, and bone growth. It also helps stem cells differentiate into different types of basic tissues.

Vitamin A helps to regulate the immune system, by making white blood cells that destroy harmful bacteria and viruses. Vitamin A may also help white blood cells fight infections more effectively.

The Beta Carotene Test

Beta Carotene is a substance that can be made into vitamin A in the body. It’s found in carrots, apricots, sweet potatoes, pumpkin, cantaloupe, winter squash, mangos, collard greens, spinach, kale, broccoli, and other oranges, red, and dark green fruits, and vegetables.

The Vitamin E Test

Vitamin E is a group of fat-soluble compounds that have certain antioxidant activities. Antioxidants protect cells from the damaging effects of free radicals. Free radicals damage cells and may contribute to the development of cancer and cardiovascular disease. Free radicals react rapidly with oxygen to form reactive oxygen species (ROS) that go on to damage cells. The body is also exposed to free radicals from air pollution, cigarette smoke, and ultraviolet radiation from the sun.

Vitamin E is a fat-soluble antioxidant that stops the production of ROS that is formed when fat is oxidized. Scientists are investigating whether vitamin E might aid in preventing or delaying the chronic diseases associated with free radicals. 

Diet Culture: Why It Is Wrong

Woman weighed on weighing scale tied up with tape measure

What is Diet Culture?

It involves weight stigma–a societal belief that people in larger bodies are less intelligent, more self-indulgent, and less deserving of respect. It involves status judgements favoring people in thin bodies even though many people in thin bodies have done nothing to deserve that privilege. Internally, it involves shame. Diet culture believes everyone can achieve the same weight loss with the same effort. Christi Harrison, author of Anti-Diet, puts it this way:

Diet culture is a system of beliefs that worships thinness and equates it with health and moral virtue.

Christi Harrison

Weight Management and Diet Culture

Diet Culture Is Wrong

Unlike the rest of the diet industry and much of society, dietitians have long understood how difficult the problem of weight management is.

Science has only just begun to grasp an understanding of the complex physiology of weight regulation. Not only are there powerful appetite regulation hormones at work, but the body can adjust it’s calorie requirements to thwart weight loss.

Meanwhile, society’s ignorance continues to glorify thinness and devalue people in larger bodies. So many beautiful human beings have been devastated by psychological self-punishment prompted the diet culture in society.

Not All Discussions of Weight Involve Diet Culture

Just as a person with PTSD can be triggered by a loud noise, any person with a traumatic weight history might be similarly triggered when their medical provider brings up their weight.

And diet culture warriors may easily misunderstand and mistakenly attack medical providers who work to help patients/clients achieve health benefits associated with weight loss.

NutriScape articles will discuss the physiologic benefits of weight loss, and particular health behaviors and foods. As you read, understand that there is absolutely no motivation to moralize about these things. Dietitians just don’t think like that. Rather, we want to provide people with effective tools to address health issues.

Weight Loss Can Provide Metabolic and Quality of Life Benefits

Dietitians are the first to recognize that thin people are often far from healthy and people whose weight falls in the obese category are sometimes eat better and exercise more than their thin counterparts and truly are healthier.

Yet, metabolic and quality of life benefits of weight loss for many individuals is undeniable. Extra weight drives inflammation and diabetes. It is regrettable that sometimes in attempts to push back against diet culture, there is a denial of the benefit of weight loss.

We don’t advocate dieting. Most people who diet don’t lose weight, and most people who lose weight do not keep it off. Dietitians have known it since the 50’s, but the diet industry has conspired to keep it a secret.

The body always tends to regain weight–that’s why it’s so important to develop a positive relationship with food and a positive view of your body regardless of weight. It is absolutely critical that attempts at weight loss must not be associated with the psychologically harmful ideas of diet culture.

What makes something “diet culture” is the thoughts, NOT behaviors.

Most of the tools proven effective for weight loss and maintenance are the exact same tools used by people practicing toxic diet culture. A food diary can be used as a tool for mindful eating, but it could also be used with a philosophy of perfectionism which produces nothing but guilt and shame.

Likewise, weighing yourself can be part of a self-nurturing daily ritual with positive affirmations and an attitude of “what can I do to nurture myself today” or it can be done with a toxic diet culture psychology where the daily weight obsession leads to either immense pride or devastating shame.

NutriScape’s Bottom Line

While the NutriScape Project acknowledges the deep personal pain experienced as a result of weight stigma in our culture, we believe that effective weight management skills can be developed. We also believe that these skills can be developed in a way that is psychologically healthy.

Since our bodies are with us for life, giving up on weight management just isn’t a good option. This is why the NutriScape Project will continue to work to provide effective resources for weight management–without the baggage of diet culture.

Bariatric Surgery: The Supplements Surgeons Say You MUST Have

Bariatric Surgery Supplements

BARIATRIC SUPPLEMENTS:  We help you keep supplements simple by limiting our options to those that meet ASMBS Guidelines for gastric bypass and sleeve procedures. With these options, all you need is multivitamin and a calcium supplement.  Minimal pills and with all the required nutrients included–

Choose a Multivitamin with 18 mg, 45 mg, or 60 mg Iron.  These Are Right For Most Sleeve and Gastric Bypass Patients:

Choose Your Preferred Calcium Supplement (You will need 1200-1500 mg/day including food sources**):

Green Tea Extract: What You Need To Know, Benefits, Recommendations, and Supplement Options

green tea powder in tablespoon and extract in a cup

Green tea contains catechins, a group of polyphenols largely found in tea, cocoa, and berries. These compounds serve as antioxidants along with other nutrients like Vitamin A (beta-carotene), Vitamin C, Vitamin E, and Selenium.

Why Antioxidants are Important

When there is an imbalance between pro-oxidants and antioxidants, oxidative stress results in free radical damage.  This damage is considered to be an underlying cause of many chronic diseases including diabetes, heart disease, and cancer. 

Green Tea in Viral Illnesses

Studies have shown that people consuming more green tea or green tea capsules have lower incidence of influenza, so it has been theorized that these antiviral properties will also work to protect us from other viral illnesses.

Food First–Tea May Be Better than Supplements

While EGCg has been studied most extensively, the whole range of catechins are available from tea in beverage form. EGCg may be only one of the catechin compounds that are producing health benefits of green tea. So, if you like tea, enjoy!

How much Green Tea is enough?

Researchers studying weight, metabolic syndrome, and type 2 diabetes found benefits in people consuming the recommended 3 to 4 cups (8oz) of green tea per day to supply 600-900 mg of catechins per day. 

Green Tea Supplement Options

When catechins are consumed in supplement forms, they are thought to be more bioavailable than in tea beverages, so don’t consume more than the daily dose of 200 mg EGCg in the form of a supplement.

Protocol for Life Balance

200 mg EGCg / 80% Catechins


Now Foods

200 mg EGCg / 80% Catechins

Registered Dietitian/Nutritionists (RDN’s) Are Ready to Help.

Nutrition is foundational to feeling well enough to have the energy for pursuing all other life goals. Given the complexities of balancing age, gender, and medical considerations along with personal food enjoyment, food and supplement choices can get complicated. You can find the practical answers you need by consulting online with an RDN on our telehealth site.

Read More about Green Tea/ EGCg

Read more about related health benefits and food sources for EGCg in an article by registered dietitian, Ainsley Hill. Professionals may want to refer to this article by Carrie Dennett, MPH, RDN, CD.

Why One Multivitamin Is Better Than a Single Nutrient Vitamin

Multivitamins

Remember-It’s Always Food First

The foundations of overall health are nutrition, sleep, physical activity, and healthy relationships. When it comes to nutrition, your body can’t get what it needs from supplements. That’s why the right nutrition strategy is always food first.

Why A Multivitamin Should Be Considered

A good multivitamin is one that provides a wide range of vitamins and minerals. There are over 40 different nutrients and other bioactive molecules we get from foods that each fill a critical role in basic cell functions. Miss any one of them, and it throws a wrench into the molecular machinery. With so many vital trace ingredients, a multivitamin provides a good insurance policy for dietary nutrient gaps.

Why One Multivitamin Is Better Than a Handful of Separate Pills

More Is Not Better

There is always the temptation to think that “if a little is good, more has got to be better.” Not true. While some water-soluble vitamins can be taken at high doses without any problems, many nutrients provide benefits only within a certain dosage range.

Some Nutrients Compete With Others

This is particularly true for minerals that compete for the same absorption sites. For example, if you take too much zinc, it will interfere with iron absorption.

Some Nutrients Depend on Others

A classic example of nutrient interdependency is the relationship between calcium and vitamin D. When there is not enough vitamin D, calcium absorption is reduced. Another: iron is absorbed better when taken with vitamin C.

Single Nutrient Supplements vs. Multivitamins

In the world of natural whole foods, there is a natural balance between nutrients that makes it highly likely that you’ll get what you need if you eat a variety of foods. Most multivitamins generally –more or less– simulate the general vitamin and mineral content of the overall diet.

Many single nutrient supplements are highly focused on one nutrient and are aimed at correcting a suspected deficiency. The most common examples are vitamin D, vitamin B12, and iron, where blood testing can show that there is a clear deficiency. Nutrient deficiencies often come in large groups. Usually, when a person’s overall food intake is missing one nutrient, it’s missing a whole range of other nutrients at the same time. For example, when vegetables are missing, there would be deficiencies in not only vitamin A, but also vitamin C, a whole range of B vitamins, and several minerals.

What’s in the Typical Multivitamin

  • Vitamin A is needed for vision and wound healing.
  • B Complex Vitamins are needed for cellular energy metabolism.
  • Vitamin C is an antioxidant and helps build collagen.
  • Vitamin D is involved in immunity and bone health.
  • Vitamin E is an antioxidant.
  • Vitamin K is involved in blood clotting.
  • Vitamin K2 is involved in bone health.
  • Iron is involved in hemoglobin function.
  • Chromium is involved in blood glucose metabolism.
  • Iodine is involved in thyroid function.
  • Magnesium is involved in muscle contraction and glucose metabolism.
  • Manganese is a cofactor for numerous enzymes.
  • Molybdenum is also a cofactor in many enzymes.
  • Selenium functions as an antioxidant.
  • Zinc is involved in wound healing.

Registered Dietitian/Nutritionists (RDN’s) Are Ready to Help.

Nutrition is foundational to feeling well enough to have the energy for pursuing all other life goals. Given the complexities of balancing age, gender, and medical considerations along with personal food enjoyment, food and supplement choices can get complicated. You can find the practical answers you need by consulting online with an RDN on our telehealth site.

Online Supplement Resource:

Pure Encapsulations

This is a high-quality multivitamin option that contains a balance of vitamins and minerals including choline, CQ10, inositol, lycopene, alpha-lipoic acid, lutein, and zeaxanthin.

It is appropriate for men or women, adults and seniors.

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DHEA, Anti-Aging Hormone: What is it? Is it Safe?

Also known as dehydroepiandrosterone, DHEA is a hormone made in the brain and adrenals that is known as the anti-aging hormone.

DHEA is banned by sports organizations due to its ability to affect male hormone levels.

The Anti-Aging Hormone

This hormone does decrease as we age. Proponents note that low levels are associated with many forms of illness, however, it’s important to recognize that these associations are not evidence that low DHEA causes these illnesses.

Safety Concerns

Natural Medicines, TM states that DHEA is “possibly safe” when taken by mouth in the usual dose of 50 mg daily for up to 6 months.

It may be unsafe when taken for too long or in too high a dose. The concern is that DHEA may increase the risk of hormone sensitive cancers when higher than normal levels are reached. Apparently, this is possible with the typical 50-100 mg daily dose.

It not considered safe in pregnancy due to the potential for causing higher than normal male hormone levels.

Research on DHEA

DHEA has been found to have some effectiveness for aging skin, depression, and infertility.

DHEA has been studied and found to be possibly ineffective for treating aging, loss of muscle strength and rheumatoid arthritis. Research has not found DHEA to improve cognitive function.

Seek Medical Advice

Given the complex nature of our bodies’ hormonal systems and the potential for increased cancer risk, it is recommended that this particular supplement be taken only on the advice of a physician.

Lab Testing for DHEA Levels

If your physician approves of DHEA supplementation, you will want to have your dosage adjusted according to the amount present in your blood. WalkInLabs allows individuals to request this DHEA test online.

What Coenzyme Q10 Can Do For You And Where You Can Find It

Coenzyme Q10 (CQ10)

Coenzyme Q10 is present in every cell of the body where it helps the mitochondria make energy.

Dietary Sources of CQ10

Foods should always be considered the first source of vitamins, minerals, and other nutritional factors. However, with CQ10, dietary sources contain very minor amounts compared to those found to be effective in clinical studies. According to an article in Critical Reviews of Food Science and Nutrition [1], “The average dietary intake of CoQ 10 is only 3–6 mg” per day. Meat, fish, nuts, and some oils are the best sources of CoQ 10.

Compare this to the typical 100-300 mg dosage range found to be effective in clinical studies. CQ10 supplements dosages generally range between 50 and 300 mg/day and are safe in people taking them for up to 5 years. [2]

Who Should Consider CQ10

According to the Natural Medicines, TM [2] CQ10 deficiency is associated with weakness and fatigue and supplements may be effective in improving several health conditions [*].

Congestive Heart Failure

Population research shows that low CQ10 level seems to be associated with congestive heart failure. In fact, they may even be a predictor of mortality. Most studies use between 30 and 300 mg of CQ 10 daily. A 2017 review of the research concluded that patients with heart failure who used CQ10 had lower mortality and higher exercise capacity improvement than placebo treated patients. [3]

Diabetic Nerve Pain

A randomized trial, the most reliable type of research, showed that 400 mg of CQ10 for 12 weeks improved neuropathic pain in people who had diabetic polyneuropathy. [2]

Fibromyalgia

Natural Medicines, TM reports that fibromyalgia research showed that 400 mg per day of CQ10 for three months reduced pain and sleep disturbances by about a third and fatigue by 20%. Another study showed that 300 mg per day for 40 days reduced pain, fatigue, tiredness, and tender points by around half. And the patients also had reduced depression. [2]

Before Cardiac Surgery or After a Heart Attack

Cardiac bypass surgery is associated with damage due to low oxygen during the surgical procedure. Natural Medicines, TM states that one study of people taking 300 mg per day for two weeks before bypass surgery subjective quality-of-life after three years. Other studies on the lower dose of 100 mg per day showed no effect on cardiac function after bypass surgery. [4]

When heart attack patients were started on CQ10 within 3 days of myocardial infarction, one study found that it reduced cardiac events by about half. [5].

Migraine Headaches

CQ10 has been studied at a dose of 100 mg/day and is effective. American Academy of Neurology Guidelines considers coenzyme Q10 supplementation to be possibly effective for migraine prevention. [6]

Other Health Conditions

Some studies have also found CQ10 to have benefits in multiple sclerosis, certain types of muscular dystrophy, HIV/AIDS, and Peyronie disease.

CQ10 has generally not been found effective in helping fatigue related to chemotherapy, post-polio syndrome, or Huntington’s disease. It is also unlikely to benefit athletic performance.

Although statins are known to reduce CQ10 blood levels, and some studies have found that supplementation of CQ10 improves muscle pain [7], larger studies of the overall literature have not concluded that CQ10 should be routinely recommended [2].

Online Ordering:

Coenzyme Q10 can be ordered online through our affiliate LifeExtension.Com or Fullscript.

Probiotic Use for Diarrhea

probiotic capsules

No doubt about it, probiotics are a big seller and research into the human microbiome suggests that the bacteria in our GI tract is having potentially profound effects on health and disease.  Researchers have made progress recently in identifying the particular strains of probiotic that provide relief of diarrhea.

What Are Probiotics

Probiotics are live microbes (bacteria or yeast) that are intended to have health benefits. Many believe that probiotics can improve digestive issues and may help balance the gut microbiome. Probiotics are not to be confused with “prebiotics”, which refer to fiber substances that the probiotic microbes eat.  In other words, prebiotic (think fiber) feeds the probiotic microbes. 

A Million Strains-Each One With Different Effects

Most people talk about “probiotics” as though they are one thing.  For example, “Doctor, should I take probiotics?”  The problem is that there are huge families of probiotic strains-like Lactobacillus and Bifidobacterium that are each made up of a huge number of individual strains of organisms.  Each probiotic product has its own single strains or blend of strains.  Each product will then have its own individual effects depending on the specific condition it’s being used for. 

And that’s not all.  When it is taken into account that each human being has their own unique mixture of trillions of gut bacteria, it makes perfect sense that a probiotic that works in one person may not have the same effect for someone else.

Research on Probiotics for Diarrhea 

Diarrhea has several major causes including antibiotics, food poisoning, flu, and cancer treatment.  Often, it will resolve within 3 or 4 days without any treatment, but can be serious when it is associated with dehydration.  Many different probiotic strains or combinations have been studied and some have been found to help.   But there are still questions on which ones are effective and how safe they really are for some individuals. 

Antibiotic-Associated Diarrhea

Antibiotics kill off large swaths of the population of a healthy gut microbiome, so it’s no wonder that diarrhea results.  Many patients will develop diarrhea, and for some, it can last months after antibiotics have been stopped.

Some studies have shown that probiotics seemed to work better in younger populations to reduce antibiotic-associated diarrhea.  Seniors tend to have more common antibiotic associated diarrhea, including a severe type of diarrhea related to a particular strain of bacteria called Clostridium Difficile or C. diff.  1

The Best Strains for Decreasing Diarrhea

A review from 2017 found that taking probiotics during antibiotic treatments was associated with about half the incidence of antibiotic associated diarrhea.  They found that the most effective strains were L rhamnosus GG and S boulardii2

Probiotics for Food Poisoning and “Stomach Flu”

Bacteria, viruses, and parasites can cause inflammation in the stomach and intestines that results in diarrhea.  Research on probiotics has shown that Lactobacillus reuteri was able to lessen the duration of this type of diarrhea by about a day. 3

Diarrhea and Cancer Treatment

Many types of chemotherapy and radiation therapy damage the digestive tract and diarrhea is a very common result.  Research has been done on different strains and doses of probiotics, but reviews were not able to find definite evidence of benefit. 4

Irritable Bowel Syndrome (IBS)

IBS is a group of symptoms including bloating, abdominal pain, diarrhea, constipation, or a combination of these.  It affects about 1 in 10 people and is more common in women.

Recently, several strains have been found to make a difference for IBS. 5 The following strains have been found to be effective in randomized trials:

  • B. longum 35624 is the probiotic strain in the products Align®, Align® Chewables, and Align® Extra Strength.
  • L. plantarum 299v is the strain in Ideal Bowel Support®, UltraFlora® Intensive Care and GoodBelly®.
  • Bio-Kult® is a mixture of 13 different strains of probiotic.

Probiotics Are Generally Safe, but Can Have Side Effects

It’s important to note that while probiotics are safe for most healthy people, they are generally unregulated just like vitamins and herbal supplements. Elderly and immune compromised should weigh the risk of side effects.  These can include changes in bowel habits and bloating. 

Probiotics can also change the gut microbiome in ways that have not been studied, and may have unknown risks.

Each Person May Have a Different Result

With each person having their own unique microbial population, each person’s response to a probiotic strain may be different.

Probiotic Potency

Dosage for probiotics are measured in billions of cells, or “cfu” – colony forming units. The age of the bottle will have an effect on how many of the original billions of cells are still alive and able to colonize the gut.

Storage Conditions will also have an effect on the viability of the organisms, and it is not clear whether refrigerated storage is always an advantage for the product’s potency.

Take-Away Messages From the Research: 

  • Antibiotic Associated Diarrhea- the most effective strains were L rhamnosus GG and S boulardii and they seemed to improve the diarrhea by about 50%.
  • For IBS, longum 35624 and L. plantarum 299v as well as the Bio-Kult® probiotic combination have been effective in randomized trials.
  • For Diarrhea related to Cancer Treatments, there was no definite evidence that show probiotics provide a benefit.

Consider How a Dietitian May Be Able to Help

Diarrhea can range from a mild, “once-in-a-while” nuisance to a debilitating problem that keeps a person imprisoned at home for fear of bowel accidents. Chronic diarrhea can have a huge range of causes including Celiac, Irritable Bowel, and Small Intestinal Bacterial Overgrowth–all of which require specific nutritional approaches that can be confusing and complex to make happen in your life.

When diarrhea is affecting your quality of life, it’s time to seek professional help. Consider consulting a gastroenterologist to rule out some medical causes like Crohns, Ulcerative Colitis, and Chronic Pancreatitis.

Celiac can be ruled out with a blood test. Many causes of diarrhea can be highly responsive to changes in the foods you choose.

Dietitians specializing in digestive health can help you work through the mystery of your digestive symptoms and the myriad components of your ever-changing diet to come up with strategies that will improve your quality of life.

You can search for a dietitian specializing in digestive health on NutriScape.NET’s Telenutrition Site.

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Products that may help

It’s easy to see that probiotic supplements are no panacea. Probiotic foods are another option. Dietitians generally recommend that a product be taken for about 3 weeks in order to see if it works. To obtain products noted above, visit this page.

Notice: The NutriScape.NET site is intended for educational purposes and does not constitute the practice of health care advice, diagnosis or treatment. Individuals should seek the advice of a qualified healthcare provider for any questions regarding personal health or medical conditions. Access to independently licensed Registered Dietitian Nutritionists can be found through our telenutrition site.

References:

  1. Jafarnejad S, Shab-Bidar S, Speakman JR, Parastui K, Daneshi-Maskooni M, Djafarian K. Probiotics reduce the risk of antibiotic-associated diarrhea in adults (18-64 years) but not the elderly (>65 years): a meta-analysis. Nutr Clin Pract. 2016;31(4):502-513.)
  2. Blaabjerg S, Artzi DM, Aabenhus R. Probiotics for the prevention of antibiotic-associated diarrhea in outpatients—a systematic review and meta-analysis. Antibiotics (Basel). 2017;6(4):E21.
  3. Patro-Gołąb B, Szajewska H. Systematic review with meta-analysis: Lactobacillus reuteri DSM 17938 for treating acute gastroenteritis in children. An update. Nutrients. 2019;11(11):E2762.
  4. Wei D, Heus P, van de Wetering FT, van Tienhoven G, Verleye L, Scholten RJ. Probiotics for the prevention or treatment of chemotherapy- or radiotherapy-related diarrhoea in people with cancer. Cochrane Database Syst Rev. 2018;8:CD008831.
  5. Clinical Guide to Probiotic Products Available in USA- 2020 Edition.