Why I call the blog “docere”

Docere, the origin of the word Doctor, means to teach or show in Latin. It is one of the six principles of naturopathic medicine. I strongly believe that everyone should play an active role in their own health care. Often people come to me with a diagnosis that they don’t understand. Or a prescription they are taking simply because they were told they had to. Or worse they come in after having been told they have a chronic life-long condition for which there is no cure.

I strive to use language that everyone understands to explain anatomy, physiology and biochemistry. I hope to empower each person to understand their own bodies so they can make decisions about what they put into them. Visits are a little longer so we have time for this education. Another way I educate is through this blog. If you have a question you would like me to address here, contact me.

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Winter-time immune support for children

(This was originally sent to patients through my online dispensary, and as such included a link to log in to view and order the specifically recommended products. If you would like a unique link, please email me at jaie@illuminatinghealth.com)

At my house we’re settling into the school routine, it’s getting cooler outside, and the noses have started to drip almost non-stop. Like many children, mine are picky eaters. When they were infants I had more success giving them supplements and herbal tinctures, but now that they are older they’ll refuse if it doesn’t taste good. We just did an extensive taste test of immune support supplements. Below are my kid-approved recommendations.

But first, a review of the best ways to avoid illness: focusing on the “basics” and practicing good hand-washing techniques.

For children, the “basics” include:

Children thrive with routine. Of course we have activities and family events that disrupt our routine, but we try to stick to our schedule at least five nights of the week. For my toddler and kindergartener, we aim for dinner at 5pm, bathtime at 6pm and lights out at 7pm.

Physical activity every day, preferably outside. Aim for an hour or more if you can! Our elementary school is near a park. The weather has been so nice these last few weeks that we’ve all enjoyed running around together after pick-up.

Sufficient sleep
. Infants and toddlers six months to two years old need 12-14 hours of sleep per day (including naps), preschoolers aged two to five years old need 10-12 hours each night and elementary school kids need 10-11 hours of sleep each night. If you have to get up at 6:30 in the morning have lights out at 8pm.

nutritious diet with whole foods, organic produce, grass-fed meat, and whole milk products. Minimize sugars and artificial colors. We are still struggling to pack school lunches that are both healthy and kid-approved. But there are a few staples that they’ll always eat: my daughter loves broccoli and cauliflower and my son loves fruit leathers.

Wash hands every time you come inside, after using the bathroom and before eating. Teach kids to sing a song to themselves while they soap their hands and have them to wash the fronts, backs and in-between the fingers!

Supplement recommendations:

Every day my kids take a probiotic and an omega 3 fatty acid. During the allergy seasons we add on a natural anti-histamine and anti-inflammatory to decrease post nasal drip. And during the fall/winter cold season we rotate through a variety of immune support herbs. I give most of these at bedtime right before we brush teeth.

Daily probiotic, Ther-Biotic Children’s Chewable. Probiotics decrease frequency and severity of colds and support gut health.

Daily omega 3 fatty acid, Omega-3 Fishies. After five years I have finally given up on liquid fish oils. The kids would take them erratically and I have stained more of their shirts than I care to admit. Our dentist strongly recommends against gummy vitamins, but this isn’t really a gummy and the kids love it.

Seasonal allergy relief, D-Hist Jr. This is effective and tasty.

The kid-approved immune support includes Sea Buddies with vitamin A, zinc and elderberry, Kids Defense Drops with echinacea, elder, bayberry, Immune Glycerite with hawthorne, linden, ginkgo, and Immune Support Liquid with zinc, elder, larix and lemonbalm. I rotate through these (not using one longer than a month) to maintain the effectiveness of each herb. I also sometimes double up on dosing or combine products if the kids seem to be getting sick.

These supplements are safe with limited side effects for most kids. If you have any questions don’t hesitate to contact me.

In Health!

Dr Jaie

Posted in Food as Medicine, Healing Power of Nature, Prevention, Supplements | Leave a comment

Cold and Flu Season Preparedness

(This was originally sent to patients through my online dispensary, and as such included a link to log in to view and order the specifically recommended products. If you would like a unique link, please email me at jaie@illuminatinghealth.com)

With cold and flu season rapidly approaching, I am often asked how I am able to ward off so many colds throughout the season. After all, I see sick patients and have young kids in school and daycare with near constant runny noses.

Flu & Cold Prevention
First and foremost, hand washing after each contact is of utmost importance. This means washing your hands often throughout the day. I wash every time I come inside the house or office, before I eat, and after every bathroom break.

The Basics
These “basics” are so important for our physical and mental health. And while seemingly simple they are actually very difficult to do daily. I personally struggle with getting to bed early enough, instead tending to stay up late reading.

– Sleep
: Get enough sleep! Most adults need between 7-9 hours per night. Remember that if you don’t get enough sleep one night you need to “catch up” that sleep in the next few nights.

– Eat Plenty of Fruits and Vegetables
: Aim for at least 5 servings per day, and ideally eat 7-10! A serving of raw leafy greens is one cup and for other vegetables (and cooked greens) a serving is half a cup. A fruit serving is also half a cup and most of the time a single piece of fruit (one apple, one banana) is one serving. Consider snacking on fruit and vegetables, making smoothies, or eating a big salad for breakfast.

Natural Remedies That Help Block Colds & Flu

My favorite preventive strategies are the natural remedies I have come to depend on to stay as healthy as possible during the winter months. I’ve linked my favorite products to this message for your benefit. MRS Mushroom Formula is a mushroom blend that supports natural immunity. Vitamin D3 at 5,000IU and Vitamin C at 2000mg daily provides another boost to the immune system. I take these three daily in the fall/winter season.

At the first sign of sickness: 

When you first feel that tickle of illness, or maybe when you are traveling and need a little extra boost, take a few doses of EHB. “EHB” stands for the immune active constituents in echinacea, goldenseal and garlic. I recommend two capsules before a flight, or every four hours when you are sick.

A few tips for when you have the flu: 
The first is Oscillococcinum by Boiron. Taken at the first sign of flu-like symptoms (whether you have the flu or not), this homeopathic remedy can help temper some of the worst symptoms, including the fever and body aches. I add to this Elderberry syrup by Gaia. This high antioxidant fruit extract, has anti-infective properties against the flu virus. It actually prevents it from spreading from cell to cell. In studies that looked at its efficacy against influenza strains A & B, Elderberry was found to shorten the duration of the flu from the typical 7 days to 4 days. That’s 3 days less of flu-like symptoms! In comparison, the medications on the market to treat the flu only shorten its duration by 1 day.

These supplements are safe with limited side effects for most adults. Please be in touch if you are concerned about potential interactions with prescription medications, are pregnant or wanting to become pregnant, or are breastfeeding.

Here’s to getting through cold and flu season unscathed by a big one! May you ward off most colds that come your way, and get through any that you succumb to as fast as possible.

In Health!
Dr Jaie

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Adrenal Testing

One way to test adrenal function is to measure the hormones that the adrenal glands produce. The most common hormone that we check is cortisol which can be measured in blood, saliva or urine. Because cortisol is released in a circadian pattern throughout the day, multiple checks might be needed to fully assess adrenal function.

There are certain types of severe adrenal dysfunction that require measuring aldosterone and renin (the two hormones that keep the balance of sodium and potassium in the blood). This test is usually done if you have high blood pressure and good reason to suspect primary adrenal insufficiency.


Image source: A Manual of Laboratory and Diagnostic Tests by Frances Fischbach Diagnos-Techs Webinar, 2013

Sometimes medical doctors will perform an ACTH stimulation test. ACTH, or AdrenoCorticoTropin Hormone, is the hormone that comes from the pituitary gland and is involved in the HPA axis that controls adrenal function. In a healthy person ACTH will stimulate the adrenal glands to produce cortisol.  By measuring baseline cortisol levels, then giving a shot of ACTH and then re-measuring cortisol we can see if the adrenals are responding properly. Conversely sometimes medical doctors will perform a dexamethasone suppression test. Giving dexamethasone should lower cortisol levels. This test is used to further evaluate people who have high cortisol.

Naturopathic doctors frequently use salivary cortisol testing to evaluate adrenal function. The patient will collect four samples of saliva throughout the day. These samples will show the circadian rhythm of cortisol. It should be highest in the morning and then slowly drop down through the day. In addition, these tests often measure DHEA, one of the androgens produced by the adrenal glands. Cortisol has an inverse relationship to DHEA.

Currently most allopathic medical doctors do not recognize this more “mild” but still disabling type of adrenal dysfunction. They do recognize a serious acute adrenal insufficiency also known as Addison’s disease. Please know that when you ask your medical doctor to check your adrenal function, he or she is most likely only going to rule out this serious type of dysfunction.

More Information:

And, as always, if you want a comprehensive individualized approach to your health, please schedule a free fifteen minute in-person or telephone consultation.


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Understanding adrenal dysfunction

Cortisol is released in response to stress. Stress is physical or emotional, real or perceived. To the body, all stress is the same. Stress can be your boss yelling at you, a car speeding towards you or an infection. Here are other common causes of stress:

  • Anger/fear

    stressed guy

    Image by: SalFalko via photopin cc

  • Worry/anxiety
  • Depression
  • Overwork
  • Excessive exercise
  • Not enough sleep
  • Poor digestion
  • Chronic illness
  • Chronic allergies
  • Surgery
  • Injury
  • Inflammation
  • Infection
  • Chronic pain
  • Toxic exposure
  • Hypoglycemia
  • Nutritional deficiencies

Maladaptive Stress Response In a healthy individual the stress response is balanced by a relaxation response. The body strives to be in balance or homeostasis. There are three phases of adrenal dysfunction. Put simply, in the first phase the body is constantly in a stress/alarm state and produces too much cortisol and epinephrine. In the second phase, cortisol and DHEA continue to be elevated suppressing inflammation and immune responses. The third phase is one of exhaustion. There is less DHEA and cortisol and more epinephrine, thus the “tired and wired” phase. Patterns of Dysfunction Elevated Cortisol

  • High blood sugar
  • Insomnia
  • Irrational thoughts
  • Poor digestion
  • Weakened immune function

Low cortisol in morning, higher cortisol at end of day

  • Fatigue
  • Low blood sugar
  • Inflammation
  • Insomnia and difficulty falling asleep, second wind, wired and tired
  • Sweet and salt cravings
  • Mood changes

Fluctuating Cortisol

  • A combination of symptoms, often changing day to day.
  • Overall a sign of weak adrenal function and HPA axis dysregulation

More Information:

And, as always, if you want a comprehensive individualized approach to your health, please schedule a free fifteen minute in-person or telephone consultation.

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Signs and symptoms you might have less than optimal adrenal function

Most of us in today’s society are under more stress, both physical and emotional, than our bodies are evolutionarily prepared for. I usually assume that my patients have some level of adrenal dysfunction. The most common symptom is fatigue. And that is also one of the most common reasons people come to see me.

Here are some other symptoms of adrenal dysfunction:

  • Feeling “wired and tired”

    ed hardy & splash two II

    Image by SalFalko via photopin cc

  • Developing new allergies or sensitivities, or worsened allergic reactions
  • Having chronic allergic conditions, like asthma, eczema
  • More or new chemical intolerances
  • Nervousness, anxiety, irritability
  • Difficulty concentrating, especially before lunch
  • Easily confused
  • Weakness or less stamina
  • Alternating constipation and diarrhea
  • Frequent illnesses and infections
  • Slower recovery from illnesses and infections
  • Feeling overwhelmed more often
  • Lightheadedness when you stand up
  • Less interest in doing things
  • Frequent sighing
  • Generally feeling unwell, or “never well since…”

I think of the adrenal glands as the “keystone” of the endocrine or hormonal system. Therefore if there is another hormonal imbalance occurring like perimenopause or hypothyroid, then those symptoms could be worsened by poor adrenal function.

  • Increased PMS symptoms
  • Decreased sex drive
  • Unresponsive hypothyroidism, or persistence of hypothyroid symptoms despite treatment with  thyroid hormones

Many people say that these feeling are causing them to be more irritable to their partners, roommates, children and co-workers. They might have less productivity at work. In general they are feeling “burnt out.”

cat sleeping

Image by kevin dooley via photopin cc

Sleep is disrupted because the hypothalamus, pituitary and adrenals all have a circadian rhythm. People with less than optimal adrenal dysfunction are often tired at 9 or 10pm, but they don’t go to bed then. If they stay up past 11pm they might get a “second wind” and not be able to fall asleep until well past midnight. They usually don’t feel rested in the morning and might have a difficult time getting out of bed. They don’t really “wake up” until 10am. Often they feel better after lunch, but then have an afternoon energy drop.

People with poor adrenal function often crave salty and fatty foods. They might drink too much caffeine to get going, but often caffeine makes them more tired.

More Information:

And, as always, if you want a comprehensive individualized approach to your health, please schedule a free fifteen minute in-person or telephone consultation.


Much thanks to Martin Milner, ND; NCNM Endocrinology Class Notes; Spring 2010

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An overview to adrenal function

Your adrenal glands sit on top of your kidneys at about the level of the 12th thoracic vertebrae. They are endocrine glands which means that they make hormones. The brain regulates hormone production through an interactive system called the HPA axis. The letters stand for hypothalamus, pitutitary and adrenals. The hypothalamus and pituitary are specific parts of the brain.


Image by dalehugo via photopin cc

The adrenal glands have two parts: an inside called the medulla and an outside called the cortex. The outside or cortex has three different functions. It makes glucocorticoids, mineralocorticoids and androgens.

The primary glucocorticoid is cortisol. Cortisol helps maintain blood sugar levels between meals and is a powerful anti-inflammatory. The adrenal glands make cortisol in response to stress, exercise and low blood sugar. We make the most cortisol in the 6th-8th hours of sleep. When we measure cortisol we often measure it first thing in the morning to see it at its highest levels.

The mineralocorticoids, specifically aldosterone, play a role in kidney function. They help control the balance of sodium and potassium in our blood. Keeping them in balance affects our blood volume and blood pressure.

Androgens are the “male” sex hormones, including testosterone and DHEA. These hormones are made by both the adrenal glands and the ovaries or testes. In women, the primary source of DHEA is the adrenal glands.

The inside of the adrenal glands, the medulla, makes epinephrine and norepinephrine. These neurotransmitters are released in response to stress and stimulate the body to go into “fight or flight” mode.

The hypothalamus, pituitary and adrenals respond to stress. The hormones they produce help our bodies adapt to stress. But unfortunately, most of us are under more and more stress, and these systems begin to malfunction.

Are you under stress

Image by stopherjones via photopin cc

More Information:

And, as always, if you want a comprehensive individualized approach to your health, please schedule a free fifteen minute in-person or telephone consultation.


Reference: Endocrinology & Naturopathic Therapies, Dirk Wm. Powell, ND

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Food Allergy, Sensitivity or Intolerance?

What’s the difference between a food allergy, a food sensitivity and a food intolerance?

I often hear people using these terms interchangeably but they describe different responses that the body has to food. The symptoms can be the same which can make it hard to tell which one you might have. But treatment varies, so knowing which one you have is important.

The symptoms of food allergies, intolerances and sensitivities overlap quite a bit. In addition, those symptoms can be vague and located anywhere in the body which makes it particularly difficult to diagnose. The most common symptoms are centered around the digestive tract: nausea, vomiting, diarrhea, constipation, heartburn, or gas. I’ve also seen skin reactions like acne or eczema, headaches, increased PMS cramping, and fatigue. The list of symptoms of food sensitivities could go on and on.


Food allergy?

The term allergy describes a specific type of immune response. People can be allergic to pets, pollens, grasses, foods, etc. The most common foods that trigger a true allergic reaction are peanuts and shellfish. The allergic response can be serious and even life threatening. That’s why people with allergies might carry an epi-pen and why many elementary schools are completely peanut-free. For a child with a peanut allergy even touching a table where a peanut butter sandwich had been lying could be enough to trigger a serious response.


Image by Darwin Bell via photopin cc

Allergies trigger a type 1 immune hypersensitivity response. This involves T cells, B cells and mast cells. The first time someone is exposed to an offending food (an allergen or antigen) their body creates antibodies or immunoglobulins, specifically immunoglobulin E, IgE. These IgE antibodies then locate themselves on mast cells. After that every time someone is exposed to that particular allergen the IgE antibodies trigger the mast cell to release histamine. The histamine causes local blood vessels to dilate which causes symptoms like runny nose, runny eyes, throat swelling, etc. This reaction is immediate, happening with just a few minutes. Blood and skin prick tests are good ways to diagnose an allergy.


Food intolerance?


Image by cwbuecheler via photopin cc

A food intolerance is not an immune response at all. Instead it’s when the body is unable to properly digest a food, usually because it is missing an enzyme. For example people who are intolerant to dairy do not have lactase, the enzyme that breaks down the lactose protein found in milk. Individuals could be intolerant to sulfites, fructose, or other food additives.


Food sensitivity?

A food sensitivity is sometimes called a non-IgE reaction. That’s because it involves the immune system, but not the IgE antibodies. Immunologically it is usually a type 4 hypersensitivity reaction involving T cells, macrophages, cytokines and other inflammation mediators. What’s important to know is that while an offending food (an antigen) will start the response, the cells that are triggered are not specific to that food. This immune response is sometimes called a delayed reaction, and in fact the symptoms can appear 72 hours later. This makes it particularly difficult to pinpoint which food might be causing the symptoms. Nine out of ten people with a food sensitivity will be sensitive to dairy, eggs, soy, gluten, or corn.

This is what I would miss the most.

This is what I would miss the most.
Image by stusic via photopin cc


The best way to identify a food intolerance or sensitivity is to avoid the probable foods for a period of time and then eat them again and note any symptoms. The symptoms might not appear until 2-3 days after the food is eaten. In my practice I recommend an elimination/reintroduction diet to help people identify food intolerances and sensitivities.


Treatment options:

For a true food allergy, one should avoid the food they are allergic to forever.

For a food intolerance, in general it’s best to avoid those foods. It can be okay to eat a little bit occasionally, as long as you take appropriate digestive enzymes at the same time to help your body digest the food. I prefer 100% plant-based enzymes.

Identifying a food sensitivity is just the first step in a longer process of gut repair. Since a sensitivity is often caused by some sort of “leaky gut” that allowed the food proteins to come into contact with the immune system too soon, we want to strengthen the gut. The gut repair process can take months to years. My gut repair protocol uses 4 R’s. Remove the offending food completely from your diet. Restore proper function (this is individual and would address specific symptoms like constipation, heartburn or acne). Repopulate the gut with good bacteria. And last but most importantly, repair the lining of the small intestine.

If you have more questions about food allergies, intolerances and sensitivities, you can contact me, or schedule a free fifteen minute chat which can be in person in my Philadelphia office or via phone/Skype. I look forward to helping you illuminate your own health.

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Let’s talk about Multivitamins!

Part of a series profiling individual and popular supplements. Read earlier posts about why you might need supplements and how to choose a good quality supplement.

Multivitamins are not standardized, but most contain approximately 100% of the recommended daily allowance (RDA) of many vitamins and minerals. No multivitamin contains 100% RDA of calcium, magnesium, potassium, or phosphorus as those are bulky ingredients.

This is not an endorsement of Trader Joe's multivitamin.

This is not an endorsement of this product.
Image by KevinElliottChi via photopin cc


There are many reference ranges that refer to appropriate daily intake (RDA is but one of these). What is optimal for one person varies from another based on size, age, gender, race and diet. Therefore it is probably best to look at actual quantity and not percentages.

While I often recommend a multivitamin for “insurance,” I do think we should rely on our food to provide sufficient vitamins and minerals.

Best Practices:

  • Cook your own food & give yourself time to eat. When you smell and see the food that you are preparing, you prime your stomach and digestive system, which allows you to absorb the nutrients much more readily. Take time to relax before and as you eat your meals. Chew your food thoroughly. Stress will decrease your ability to digest your food.
  • Eat as little processed food as possible. Processing removes many nutrients from food and adds many compounds that are foreign for the body.
  • Minimize animal protein. When you do chose to eat animal products, eat organic, grass-fed animals.
  • Eat complex carbohydrates instead of simple carbohydrates. Unprocessed complex carbohydrates have fiber and minerals. They take a long time for the body to digest, leveling out blood sugar levels. This lightens the load on the pancreas, diminishing the physiological progression towards insulin sensitivity and diabetes. Simple sugars, on the other hand, are broken down quickly, thus increasing the work load on the pancreas, and increasing the incidence of blood sugar spikes.
  • Use healthy fats. Healthy fats are important for maintaining healthy, fluid cellular membranes and regulating the inflammatory cascade. The majority of fat consumption (<20% of the diet) should be in the form of unsaturated fats. Good fats include butter, coconut oil, olive, sesame and peanut oils.
  • Eat a cruciferous vegetable every day. This includes members of the Brassica family: broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, kale, kohlrabi, mustard, rutabaga, turnip, bok choy, arugula, horseradish, radish, wasabi, watercress and maca.
  • Eat a rainbow of foods. Flavonoids are found in the skins of fruits and vegetables and are important for cellular protection. An increase in the risk of cancer has been correlated with a decrease in flavonoid intake.
Rainbow Cake

Not this kind of rainbow!
Image by Jess and Colin via photopin cc


Food-derived multivitamins, are they worth it?

  • All vitamins and minerals used in supplements are derived from synthetic USP nutrients. The manufacturers that claim their products are food-grown, food-derived, or whole-food supplements are simply taking these synthetic USP nutrients and adding them to yeast, soy and/or probiotics and “growing” them. While there are possibly exceptions to this statement, I have not confirmed them.

What else might be in the multivitamin?

  • Often manufacturers will add herbs to their multivitamins. In general, I feel that there is unlikely to be enough of any herb to have a desired positive effect. If you are interested in taking an herbal formula then take something separate that is in a more appropriate dose.
  • Sometimes manufacturers won’t list their exact ingredients, instead listing a proprietary formula. I ALWAYS like to know what I am taking, so I avoid any proprietary formula that doesn’t list individual ingredients.

What to look for in a multivitamin/mineral:

  • Vitamin A: no more than 2,500IU vitamin A, and another 2,500IU beta carotene. Too much vitamin A is associated with bone fractures in older adults and with birth defects in pregnant women.
  • Iron: only menstruating women should supplement iron. Men and post-menopausal women should take a multi that is iron-free.
  • Avoid “oxide” forms of all vitamins: these aren’t well absorbed and in fact can act as laxatives.
  • Vitamin B6: the active form, Pyridoxal 5′-Phosphate (P5P) is preferred.
  • Vitamin B12: the methylcobalamin form is preferred.
  • Vitamin E: mixed tocopheryls preferred.
  • Folate: methyltetrahydrofolate (MTHF), or methylfolate form preferred.
  • Vitamin D: D3, or cholecalciferol form preferred.
  • Iodine: too much or too little iodine is associated with thyroid disease. We are probably getting enough iodine in our foods, so prudent to avoid in supplements.

Read more: (to be updated as they are posted – check back!)


Sources: Linus Pauling Institute accessed 5/14/13

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Choosing Supplements

Choosing good quality supplements is very important! I have people say, “Oh, I took that for a month and never felt better” and when I ask about brand and quality I learn that they have chosen a low quality supplement. As a naturopathic doctor, I spend hours each week looking for the right form/dose/type of nutrient or herb produced by a high quality manufacturer. This time goes directly to my practice members when I make brand specific recommendations.

Supplements are not regulated by the FDA, therefore there is no guarantee that the bottle contains what the label says it does. How can we know what we are taking is safe? There are three main areas of concern: raw materials, the production process and the finished product. Look for:

  • Raw material testing, on either all batches or at an appropriate frequency, to show that the ingredient is what it should be, in the right dose, and is free of contaminants.
  • A third party verifier showing Good Manufacturing Practices. Agencies include US Pharmacopeial Convention, Natural Products Association, etc. (It should be said, though, that the manufacturers pay a fee to have their products verified. Many smaller companies might be in full compliance, but not have this verification.)
  • Finished product testing to look for  potency, stability, and no adulterants or contaminants present.

In addition, here are some common sense tips:

  • Look at what else is in the supplement, often listed as “other, inactive ingredients.” These fillers help in the production process and may make the pill easier to swallow or prettier to look at. They could include things like hydrogenated oils, titanium dioxide, magnesium stearate1, and artificial colors. There will be some, but keep the list as short as possible. If you are dairy, soy, corn or gluten sensitive be extra alert for those ingredients!
  • Just like when you buy groceries, check the expiration date.
  • Check the storage requirements, and follow them. Some supplements need to stay cool, others need to stay dark.
  • Avoid hype! Some labels make outrageous claims. If it sounds too good to be true, it probably is.

For individualized dietary and supplement recommendations, make an appointment.

Read more: (to be updated as they are posted – check back!)


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Do I need to take supplements?

Usually research looks at vitamin and mineral supplementation, but in my practice I use herbal supplements as well. While research is mixed1 about the value of general vitamin supplements, I find that if used appropriately they can be helpful.

First, what are supplements?

  • In short, things that you aren’t getting enough of through diet, so you need to take  in addition, or supplementally.
  • Vitamins. These are organic compounds that your body needs but can’t make itself. Most vitamins are food based, with a few exceptions like Vitamin D.
  • Minerals. These are elements from the earth, like calcium and iron. Plants get minerals from the soil.
  • Herbs. There are hundreds of herbs with medicinal qualities. Sometimes I recommend herbal teas or tinctures (water or alcoholic extracts of the plant) and sometimes I prefer a capsular product.
herbs extracting

Image by henna lion via photopin cc

Supplements can come in a variety of forms. Herbs can be used while cooking, made into a tea, or extracted into alcohol or water. Vitamins, minerals and herbs can also be found in capsules, softgels, tablets, liquids, powders, chewables, gummies, etc. Tablets are cheap and concentrated, but may be difficult to swallow, and there are some concerns about their ability to breakdown. Capsules are easier to swallow and can be opened to mix the ingredients into foods. They are more expensive though and have a shorter shelf-life. Capsules are often made of gelatin which is not suitable for vegans and some vegetarians, though there are veggie-cap alternatives. Softgels are one piece capsules that usually contain a liquid. They are easier to swallow and with a longer shelf-life, but more expensive. Powders and liquids are cheap and offer flexible dosing, but often taste bad. Gummies are a popular alternative for children’s vitamins, and some adults, but I think they should be avoided as they can increase risk for cavities.

rainbow food med

Image by rageforst via photopin cc

How do I know if I need to use supplements?2

  • In general, a well-balanced diet (a rainbow of foods!) with sun exposure or Vitamin D fortified foods is sufficient for most people. But it doesn’t hurt to take a multivitamin with 1-1.5x the Recommended Dietary Allowance. Higher doses of certain nutrients may be unsafe, and should only be done with medical supervision.
  • We also know that our soil is becoming depleted, and even organically grown fruits, vegetables and grains do not contain the same levels of nutrients that they did decades ago.
  • There are certain vitamin deficiency syndromes that can result from inadequate intake of specific vitamins. Scurvy for example from no Vitamin C. In the developed world these deficiencies are more likely to be seen in certain folks: elderly, alcoholics, vegans, etc. But we still don’t fully know how nutrients levels can relate to chronic disease and disease prevention.
  • There are many different reference tables that try to pinpoint just how much nutrient intake we need to be healthy and to prevent disease. We have Recommended Dietary Allowance (RDA), Adequate Intake (AI), Estimated Average Requirement (EAR), and Tolerable Upper Level (UL). Usually we use the RDA which is the “the average daily intake that is sufficient to meet the dietary requirement of nearly all healthy people.”
  • There are blood tests to measure blood levels of nutrients. But these tests may or may not be helpful, as we don’t really know the what the best “normal” value is. People with “low” levels of vitamins may be very healthy, and people with “high” levels may have chronic disease and therefore require more of certain vitamins.
  • Some people have certain gene polymorphisms which mean they are unable to metabolize certain nutrients. These folks might benefit from specific vitamin supplementation.
  • Some people have poor digestion, meaning they aren’t absorbing the nutrients that they are eating. These folks won’t benefit from supplements until they get their digestion optimized.

Which nutrients do conventional medical doctors recommend?

Conventional medical doctors are quite conservative about vitamin and mineral supplementation. They wait until the research is very clear about who needs it, how much is needed, what if they get too much, what if they don’t get it at all, etc. Right now, conventional medical doctors (per standards of care found at UpToDate) are making the following vitamin recommendations:

  • Folic acid for women who are (or are about to become) pregnant. This prevents neural tube defects which could occur in early pregnancy. Folic acid has been associated with increased growth of some cancers, so I don’t recommend this for people who aren’t about to become pregnant.
  • Vitamin D, especially for elderly who are at risk for osteoporosis and falls.
  • Multivitamin, probably won’t help, but unlikely to cause harm.
  • They recommend against Vitamins A, B12, E and C for disease prevention.

Image by selva via photopin cc

For individualized dietary and supplement recommendations, make an appointment.

Read more: (to be updated as they are posted – check back!)


2UpToDate, accessed 5/14/13

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