By Jack Challem
Copyright 1998 by Jack Challem, The Nutrition Reporter™
All rights reserved. This article originally appeared in Let's Live magazine.
I've been taking vitamin supplements for almost 30 years-beginning with vitamins E and C and now a virtual panoply of micronutrients. I've read thousands of scientific articles on how vitamins promote health and prevent disease, and I've been lucky enough to interview some of the most knowledgeable physicians and researchers in this field. At 47, I'm in relatively good health and attribute a big part of my well being to a reasonably good diet and hefty doses of nutritional supplements.
But there are two questions I've wondered about. Have I been taking the right supplements? And have I been taking enough of them?
Much of what I take is based on tantalizing scientific research and clinical findings. The rationale is this: nutrients are the biological building blocks of our bodies, and our health generally reflects the quality of the these building blocks. The late Nobel laureate Linus Pauling, Ph.D., believed that we should take vitamin and mineral supplements to achieve optimal health, and the research has borne him out. For example, there's strong evidence that high intake of some supplements, such as vitamins E and C and coenzyme Q10, will greatly reduce the risk of heart disease and cancer.
Like many other people, I've also taken a few supplements on less scientific "gut feelings." Years ago I suffered from dandruff-a nuisance condition, but one that hinted at some underlying problem, since this is not the normal condition of skin. I happened to read that the B vitamins might help prevent dry, flaking skin. I was already taking a B-complex supplement, and because there was no harm in doing so, I increased the dose by about five times. Within a few days, my dandruff disappeared and has never returned. A lot of people, suffering from arthritis or insomnia or dozens of other conditions, go about supplementing much the same way. They read that a certain supplement helps a particular condition, or hear about a person's positive experience with it, and they try it. If the supplement works, they keep taking it; if it doesn't, they try something else.
So supplementing is, in large part, a personal process of trial and error with virtually no risk-and a good chance of "side benefits." To convey the flavor of a more scientific approach, Hugh D. Riordan, M.D., recently invited me to get a comprehensive nutritional workup at his clinic in Wichita, Kans. It was an opportunity to discover whether I had on the right track with my diet and supplements, and it would give me a chance to make a mid-life correction.
The result turned out to be a revealing, objective assessment of my diet and how my body was handling my supplements. While I was doing a lot of things right, I discovered there were a few problems brewing. I learned a better way to supplement, and I left with the feeling that everyone should get a nutritional workup.
Dietary Analysis
Driving up to Riordan's clinic on a sunny Monday morning, I couldn't help but notice the winding road. Riordan explained that this was intentional and designed to slow down drivers. A sign reinforced the message: destress to 25 mph. The clinic, known more formally as the Center for the Improvement of Human Functioning International, or simply the Bright Spot for Health, was founded in 1975 with seed money from a local philanthropist interested in natural health.
The center consists of eight snow-white geodesic domes connected by underground hallways. The domes are extraordinarily energy efficient, naturally recirculating warm air in winter and cool air in summer. They're clustered on one part of a 92-acre site, once farmland and now a nature preserve. Inside are offices for doctors and other staff, a comprehensive analytical laboratory, a medical library, and a cafeteria serving natural foods.
As a "patient," I spent more than a full hour discussing my medical history with Riordan-a sharp contrast to the hurried visits at my regular doctor's office. Riordan explained that my dietary analysis found , on average, I was eating about 1,700 calories daily. That wasn't bad. But to my surprise, 44 percent of those calories were from fats of one type or another-way above the 30 percent amount most nutritionists recommend. (The average American diet is about 40 percent fat.) Many of the fats I ate were "good fats," such as monounsaturated fats from olive oil and avocados. However, my intake of linoleic acid (an omega-6 fatty acid from vegetable oils) was about four times higher than it should have been.
I was also eating too much protein-an average of 85 grams, or about 20 percent, of my daily calories. The RDA for someone my age and weight is only 56 grams of protein. My total carbohydrate intake was 155 grams/day, or about 36 percent of my diet. This was low, compared with recommendations of 55-70 percent. Furthermore, about one-third of my carbohydrates were refined. Riordan recommended that I eat more complex carbohydrates (e.g. beans and whole-grain breads) and cut back on refined carbohydrates (e.g, rolls, muffins, and pastas).
On the positive side, my daily sugar intake was a scant 7 grams, adding up to 5 pounds per year. The average American eats about 150 pounds of sugar each year. Similarly, my sodium intake was only 1,240 mg/day-on the low end of what's considered a safe and adequate range. I rarely salt my food. However, I was consuming too high of a ratio of sodium to potassium. Riordan said eating more complex carbohydrates should increase my potassium intake.
My dietary analysis (not including supplements) showed that I was obtaining the Recommended Dietary Allowance (RDA) of nearly all vitamins and minerals. My food intake of vitamin C was 90 mg/day, 50 percent more than the RDA, and my intake of several other nutrients appeared high as well. According to the dietary analysis, my intake of vitamin B12 and zinc were more than three times the RDA, and my vitamin A consumption was almost five times the RDA.
Blood Tests Reveal the Truth
Eating RDA levels of vitamins and minerals, however, didn't guarantee that my body was absorbing or using them, Riordan said. So the next step in my nutritional workup was having blood drawn to measure levels of vitamins, minerals, and essential fatty acids. These blood tests would indicate which nutrients made it passed the gastrointestinal tract and were available to cells and tissues. More surprises awaited me: I wasn't absorbing everything as well as I could have been.
Although my dietary analysis showed me consuming 100 percent of the RDA for vitamin B1-and I was taking an additional 50 mg in supplements (33 times the RDA)-my blood levels of B1 were a meager 38 percent of normal. Either my body wasn't absorbing B1 very well, or I had a high requirement for it. Another peculiarity was that my blood levels of vitamin C were only normal and not high-even though I take 12-14 grams (200 times the RDA) of vitamin C daily. My body seemed have a high requirement for vitamin C as well.
There were still other surprises. Although I took fish oil capsules, high in eicosapentaenoic acid (EPA) and docosahexanaenoic acid (DHA), my blood EPA levels were very low. For some reason, my body was not absorbing EPA very efficiently. In addition, my blood levels of gamma-linolenic acid (GLA) were also low. For some reason, perhaps because of a sluggish enzyme, my body was not efficiently converting alpha-linoleic acid to GLA. Riordan recommended eating some flax seed to boost EPA levels and taking evening primrose oil supplements to boost GLA levels.
The worst problem, however, was with my mineral levels, which I had assumed were all right. My blood levels of magnesium and selenium were in the low-normal range, and my zinc and chromium levels were very low. A hair analysis of mineral levels confirmed these low levels and identified low levels of still other minerals. Riordan recommended that I take higher dosages of mineral supplements and try other, more absorbable forms. I recalled what other experts had said over the years: as important as vitamins are, don't forget about minerals.
The Value of a Nutritional Workup
The value of getting a nutritional workup, particularly the blood tests, became obvious to me in an instant. Without testing, I would not have learned that my vitamin B1 levels were low, that some of my fatty acid levels were seriously imbalanced, and that my mineral levels were pretty much a disaster-even though I ate RDA levels of these nutrients and took supplements. My health problems today are relatively minor-but these deficiencies and imbalances, if left uncorrected, could set the stage for serious health problems in coming years.
Through all this, I learned that a person doesn't have to be sick to benefit from a nutritionally oriented physician and a comprehensive nutritional workup. Some people, such as Charles Thomas, Ph.D., research director of Pantox Laboratories, In San Diego, say that the best time to get a nutritional workup is actually when you're well.
It's hard to go wrong with dietary supplements. Modern, highly refined foods make it difficult to obtain optimal nutrition, and supplements can compensate for dietary omissions and prime our bodies' cells to function at their best. Without supplementing, depending on my diet alone for nutrients, I would have achieved RDA levels for intake, but because of some inefficient absorption I would have been malnourished. A nutritional workup gave me an scientific assessment of my diet, my supplements, and how my body was handling all these nutrients. With this knowledge, I'm now adjusting my diet and supplements, and I plan to get retested in a few months to see if I'm on the right track. Getting a nutritional workup can do the same for you.
Getting Tested: What To Expect
The good news is that it's easier than you might think to find a nutritionally oriented physician.
The bad news is that you'll probably have to pay for the doctor's consultation and tests out of your own pocket. Most insurance companies and health maintenance organizations (HMOs) won't pay for nutritional testing or vitamin supplements, even when they're recommended or prescribed by a physician.
If you suffer from a chronic disease, a comprehensive nutritional workup and blood tests may cost you $1,000-$2,000. That may seem like a lot of money, but it may be a small price to pay for getting well. Hugh D. Riordan, M.D., of Wichita, Kans., points out that many patients come to him as a last resort after conventional, insurance-paid treatments failed to help them. You might be able to work out a payment plan with the doctor, or just put it on a charge card and pay it off over time.
If you're in generally good health, blood tests for vitamins and minerals will cost much less. For example, Riordan's clinic sponsors a "Beat the Odds" program based two simple ideas: one, that people with the highest intake of antioxidants and other nutrients have the lowest incidence of disease and, two, a relatively inexpensive way of routinely measuring antioxidants. Through the program (call 1-316-682-3100 for details), you can get blood levels of the major antioxidants measured for $150-$300, an amount that just about anyone can afford. If you can't get to Wichita, other nutritionally oriented physicians can arrange for testing though Riordan's center or other analytical laboratories. - Jack Challem
How to Find a Nutritionally Oriented Physician
Can't find a nutritionally oriented physician? It's not as hard as you think. Call or write one of the following organizations for the name of a physician in your area. If you write, as a courtesy, enclose a long self-addressed envelope with postage for 2 ounces.
American Preventive Medical Association
Post Office Box 458
Great Falls VA 22066
(703) 759-6711
International Society for Orthomolecular Medicine
16 Florence Avenue
Toronto, Ontario Canada M2N 1E9
(416) 733-2117
International Academy of Nutrition and Preventive Medicine
PO Box 18433
Asheville NC 28814
(704) 258-3243
The American College for Advancement in Medicine
(Send a self-addressed envelope with postage for 2 ounces)
Post Office Box 3427
Laguna Hills CA 92654
American Association of Naturopathic Physicians
2366 Eastlake Avenue, Suite 322
Seattle WA 98102
(206) 323-7610
Before and After: 2 More Case Histories
Sandy Schrahl
In 1996, at age 34, Sandy Schrahl of Wichita, Kans., was suffering from fibromyalgia-chronic aches and pains in her back and joints and frequent migraine headaches. She'd also regularly catch colds and flus, a sign that her immune system was run down.
Schrahl went to the Center for the Improvement of Human Functioning International and joined its "Beat the Odds" program, which, for $199, included measuring her blood levels of vitamins A, C, and E and beta-carotene, and urine levels of vitamin C. Her first round of testing, in April 1996, indicated low or low-normal levels of the her major dietary antioxidants. For example, her vitamin A levels were 18 mcg per deciliter of blood, compared with a normal range of 30-80 mcg/dl. Her vitamin C and E levels with in the low-normal range, and her urine vitamin C levels were low.
Hugh D. Riordan, M.D., who founded the center, recommended that Schrahl take a number of supplements, including vitamins C and E and beta-carotene, to increase her antioxidant levels. Motivated, she also made a number of positive dietary changes, such as eating more raw and steamed vegetables. The changes were noticeable in Schrahl's next blood tests, taken 14 months later. Her levels of vitamin A had more than doubled, as did her blood and urine levels of vitamin C. Her vitamin E blood levels increased by about 30 percent.
"I have more energy and feel better all around," she says. "I still has fibromyalgia-it comes and goes, but it's milder and more manageable." She still has migraine headaches, but less frequently, and she hasn't had any colds or lung infections.
Maureen Hergert
Maureen Hergert of Lincoln, Neb., used to describe herself as a "high-energy person." An infection with the Epstein-Barr virus and chronic fatigue syndrome changed that. She suffered from physical weakness, tingling in her arms and legs, digestive disorders, and memory lapses. Hergert was also frustrated with doctors who tried to treat her symptoms but not the cause of her health problems.
When Hergert, 40, was tested last year at the Center for the Improvement of Human Functioning International. her vitamin C levels were extremely low, as were some of her essential fatty acids and amino acids. "Obviously, my body chemistry was not operating at an optimal level," she said.
Riordan, recommended that Hergert eat more protein. She also received intravenous infusions of vitamin C and magnesium, along with supplements of vitamin C, black current seed oil (for essential fatty acids), methionine, lysine, vitamin E, and zinc. Hergert was also treated with the anti-fungal nystatin to deal with a chronic Candida yeast infection triggered by antibiotics.
"I noticed an improvement after a couple of months, but I'm still in the process of recovering," Hergert said. "They didn't just cover up the symptoms. They custom tailored the program for what I needed."
The information provided by Jack Challem and The Nutrition Reporter™ newsletter is strictly educational and not intended as medical advice. For diagnosis and treatment, consult your physician.