Nutrition in the Office
NUTRITION
SUPPLEMENTS
Lynn Toohey, PhD
Dr. Lynn Toohey organizes seminars, acts as a nutritional consultant to Nutri-West (www.nutriwest. com) and authored the Functional Health Evaluation program that analyzes blood tests and DNA raw data (www.FHEcloud.com). Dr. Toohey can be reached at drtooheyiaynutri-west.net with any questions.
Patients need to be educated about chain companies and health-food store supplements that offer discounted products without intense testing for content and toxins.
I am frequently asked, what kind of nutritional supplements do you recommend for the office to sell to patients?” That will depend, of course, on the types of patients seen and their individual needs. However, some staples definitely need to be stocked that cover basic needs for optimal health maintenance. I conversed with chiropractor, author, and trial expert witness Dan Murphy, DC, about staples needed for everyday health, and he suggested eight essentials. This article is about those eight essentials, what they are used for, why they meet the criteria of being essential for everyone, why they merit a sp on every clinic’s shelf, and why essential to choose the right supplement supplier.
When choosing your supplements, remember that quality is imperative and dealing with a quality supplier makes a difference in your patient’s health. Patients need to be educated about chain companies and health-food store supplements that offer discounted products without intense testing for content and toxins. Negative stories stem from a lack of vigorous testing about calcium supplements with high lead content (calcium is a good binder of lead, but you don’t want to ingest the lead with the supplement) and others that don’t contain what they claim on the label.
Well-established, ethical companies utilize independent testing labs and have high standards for potency, purity and accuracy. They have certificates of analysis, deal in quality nutrients, and, when necessary, filter something like fish oil to the nth degree to offer molecular distillation.
When choosing a supplier, you must look for certain things so you can educate patients on why they should buy supplements from your office instead of the bag of “sale” supplements they bring in for you to check out. Does the supplement company offer only one product or single nutrients that anyone can sell? Do they offer synergistic formulas that were obviously formulated for a certain purpose to take advantage of synergistic health effects? Does the company have a board of experts that back their nutritional research both scientifically and clinically? Is the company run and regulated by the federal Good Manufacturing Practice Act (GMP)? Choose a company that cares about you and your patients, and one that recognizes that practitioners hold the key to improving the health of their patients.
A multivitamin and mineral: There are recommended amounts of major vitamins and minerals because we need them to survive. Often the needs of a patient call for at least the minimum amount of the essential vitamins and minerals to make sure they are replete in everything. Holes in the vitamin and mineral repertoire can be the root cause for symptoms causing patient complaints.
A case in point would be someone complaining of fatigue, weakness, brain fog, and anxiety. Low folate levels can cause all those symptoms, and frank deficiency of folate can contribute to neurological issues. It is important to supply adequate folate either in the diet or with supplements and to supply an active form of folate for people who don’t activate folic acid well. These people carry a gene variant called methyl-tetrahydrofolate reductase (MTHFR) that interferes with their ability to activate folic acid; they must take a supplement in the form of 5-MTHFolate to help them overcome this gene variant. People who carry this gene variant make up 50% of the population, so it is not rare. The practitioner can analyze their DNA raw data to pinpoint this gene variant, or the patient can supplement with 5MTHFolate and most likely see a difference in how they feel.
Another B vitamin that is important to get in the activated, methylated form is vitamin B-12. Although cyanocobalamin is the most common form of vitamin B-12, methylcobalamin is an activated, methylated form ready to go to work in the body. Dr. Dan Murphy stresses that a multivitamin should not contain copper because people are more likely to get too much than not enough. Just as iron is not good in excess, copper can be viewed as a culprit for affecting optimal health and our lifespan, unless someone is suffering from a copper deficiency. Offering a copper-free multivitamin and mineral supplement with activated B vitamins for genetically challenged individuals is a sign that the company you work with keeps up with research to accommodate people looking to achieve optimal health.
To make sure that everything runs smoothly with enzymes (many vitamins and minerals are cofactors for critical reactions), hormones, immune system, nervous system, etc., covering the bases first with these crucial elements is always a good plan.
...it is necessary to start with the basics and tweak for individual concerns to create an optimal health plan.
Probiotics: Our good bacteria are responsible for maintaining a healthy microbiome that secretes a multitude of signaling units, such as neuropeptides, neurotransmitters, hormones, etc. The microbiome communicates with the brain via the brain-gut-microbiome axis, and it has been shown that probiotics can be helpful in many instances one would think were mainly associated with the brain.
For instance, in May 2020, a meta-analysis of well-controlled clinical trials was published. Reviewers reported positive effects of working probiotics into protocols and noted, “It is essential that probiotics could be more involved in the treatment of patients” (Chao et al., 2020).
Fish oil: The long-chain fatty acids in fish oil, EPA (eicosapentaenoic acid), and DHA (docosahexaenoic acid) are responsible for most of the health benefits, which are many. The fatty acids incorporate into the cell membranes of almost all cells, increasing their fluidity and flexibility, supporting the immune system, and producing favorable byproducts (prostaglandins and leukotrienes) that support the inflammatory response. The fluidity increases the efficacy of many cell components, such as mitochondria and the insulin receptor.
A well-controlled clinical trial reported a supportive effect of fish oil on insulin, blood lipids, and inflammation and additionally correlated supplementation to healthy gene expression of immune-activated cytokines (Jamilian et al., 2018). As a staple formula for the clinic shelf, be sure that the fish oil is pharmaceutical grade for quality and molecularly distilled so that you aren’t paying for the toxins that came already bound to the fish oil.
Vitamin D: It has been shown repeatedly that vitamin D supplementation deserves its place in the top eight essential supplements for the clinic, and that the amount provided in a multivitamin and mineral may not be the optimal amount to guarantee support of many systems, especially the immune system. Vitamin D enhances calcium absorption and utilization for bones, whether it’s in the growing stage or the stage of preservation.
Vitamin K: Vitamin K is usually associated with being a blood-clotting vitamin, and it is contraindicated for people on blood thinners since those medications interfere with vitamin K (some people choose a natural route of keeping blood uncoagulated with a protocol that includes fish oil, among other things). The reason vitamin K makes the top eight is because calcium can be deposited in arteries, joints, and kidneys without K2-4 and K2-7.
Remember the big media splash years ago with a study insinuatmg calcium was associated with heart trouble? Calcium isn’t bad for you; vitamin deficiencies are bad for you. One thing that study failed to account for was the people on blood thinners (common) who were most likely deficient in vitamin K. It is important to take a complete vitamin K supplement that includes K2-4 and K2-7.
Magnesium: Magnesium is another nutrient that keeps calcium balanced and in solution. Additionally, magnesium is necessary for over 700 life-sustaining enzymatic reactions to occur. Magnesium is frequently underrated and overlooked, and yet supplementation above and beyond a multivitamin is recommended to support all those reactions, including energy production, heart and brain function, blood vessels, etc. Magnesium supplementation supports sleep, and good sleep is necessary to initiate toxin and metabolic waste removal in the brain at night (Chong et al., 2022).
Coenzyme Q10: CoQlO is part of the electron transport system in the mitochondria that basically translates food into energy. CoQlO enhances mitochondrial function; it makes the top eight because where are we without energy for biochemical reactions, energy to move, or energy to cope?
In addition to maintaining a healthy life, mitochondria are the biological epicenter of aging; it has been said that we are only as young as our mitochondria. Endogenous production of CoQlO drops off as we age, and it is even more important for those over 40 to supplement. PQQ (pyrroloquinoline quinone) acts very synergistically with CoQlO for those wanting to go a little beyond the basics.
Iodine: Iodine is an afterthought for most people, but it is an important antioxidant that binds to insidious toxic chemicals, such as chlorine, fluoride, and bromine (to name a few), which are present in our environment. Ever eaten bakery goods (bromine), taken a shower (chlorine), or brushed your teeth (fluoride is present in most toothpaste and drinking water)? Then supplementing with iodine is a pretty good idea.
In conclusion, it is necessary to start with the basics and tweak for individual concerns to create an optimal health plan. Making sure that the basics are covered before supplementing for particular scenarios ensures no gaping holes are in the nutritional repertoire. Some people, of course, need to go beyond a basic protocol, but the suggestions put forward here are what could be considered essential for everyone. Putting your faith in a trusted company that provides quality assurance is critical to be able to offer your patients nutritional health.
References
1. Chao, L., Liu, C., Sutthawongwadee, S., Li, Y., Lv, W„ Chen, W„ Yu, L„ Zhou, J„ Guo, A., Li, Z„ & Guo, S. (2020). Effects of probiotics on depressive or anxiety variables in healthy participants under stress conditions or with a depressive or anxiety diagnosis: A meta-analysis of randomized controlled trials. Frontiers in Neurology, 11, 421. https:// doi.org/10.3389/fneur.2020.00421
2. Jamilian, M., Samimi, M., Mirhosseini, N., Afshar Ebrahimi, F., Aghadavod, E., Taghizadeh, M., & Asemi, Z. (2018). A randomized double-blinded, placebo-controlled trial investigating the effect of fish oil supplementation on gene expression related to insulin action, blood lipids, and inflammation in gestational diabetes mellitus: Fish oil supplementation and gestational diabetes. Nutrients, 10(2), 163. https://doi. org/10.3390/nu 10020163
3. Chong, P. L. H., Garic, D., Shen, M. D., Lundgaard, I., & Schwichtenberg, A. J. (2022). Sleep, cerebrospinal fluid, and the glymphatic system: A systematic review. Sleep Medicine Reviews, 61, 101572. https://doi.Org/10.1016/j. smrv.2021.101572
