I know physicians traditionally have looked skeptically at the world of micronutrients.
You know the bit: Americans have the most expensive urine in the world.
It hasn't helped that we've seen the crazes come and go for various vitamins, such as Vitamin E.
I occasionally interviewed the doc who bought nutritionist credentials for his dog to show how useless the credentials were.
Skeptic or Believer?
More recently I sense a shift in opinions on the value of supplements.
Vitamin D3 (cholecalciferol ) is a great example. This fat-soluble vitamin, which the body produces when exposed to direct sunlight, regulates absorption of calcium and phosphorus and is involved in normal immune system function. You need the sunshine vitamin to build strong bones and teeth.
Deficiency in this vitamin seems to play a role in a long list of diseases. Prostate cancer is one.
When I was diagnosed with Gleason 6 prostate cancer in 2010, I took a personal interest in D3 because I read that men with advanced prostate cancer often were severely deficient in D3.
At the time, my urologists tuned out my concern about D3 and most anything having to do with nutrition, other than steering me away from red meat and towards lots of vegetables and fruits.
I persuaded my primary care physician to test me.
My results were shocking.
The U.S. Institute of Medicine defines a normal D level as 20 ng/mL. Mine was in single digits: 7.
Not surprising in a way. I live in Chicago, where there is a surfeit of sunshine for a good part of the year. This is true for most of us who live north of Atlanta.
But 7? Not lucky.
My PCP put me on a single dose of 20,000 units of D3 once a week for a couple months and transitioned me to 2,000 units of D3 per day and that brought me up to a low, but satisfactory level.
Supplement Odyssey
I recently had another adventure in supplement land.
I saw a community ophthalmologist because my eyes were driving me nuts with itching and wateriness. Five years ago, his former partner, an optometrist, had diagnosed me with a combination of blepharitis, mild dandruff of the eyelashes; eye allergies, and, finally and most importantly, meibomian gland dysfunction (MGD), blockage of the eye glands that secrete oils that mix with tears.
Without adequate healthy oil, tears evaporate quickly like raindrops in the desert. MGD is the leading cause of dry eye.
I was having an especially uncomfortable spring. I am allergic to tree pollen. So I went to see the eye doctor. He prescribed an ocular antibiotic.
Then, he hit me with a shocker. Out of left field, he diagnosed rosacea of the eyelid.
I knew what rosacea was, but had no clue about rosacea of the eyelid. I was stunned to read how it carried a risk of blindness in extreme cases.
I continued my Google research and found an academic ophthalmologist in Chicago, Marian Macsai, MD, at NorthShore University HealthSystem, who had researched rosacea of the eyelid.
The thought of potential blindness focuses your attention, which is why -- as an ever cautious individual -- I decided to see her. I had to wait a couple months and almost backed out. I'm glad I didn't.
Macsai examined my eyes and immediately concluded I didn't have rosacea of the eyelid.
Relief.
She stopped the antibiotic, which she said was too powerful.
The "I" Word
Then, she evoked the I-word: inflammation. She said I had severe inflammation of the eyes.
Inflammation is the connect-the-dot buzzword these days. It links my diagnoses of prostate cancer, heart disease and diabetes. Now, I was diagnosed inflammation in the eyes.
She recommended a non-prescription special blend of fish oil. I had been taking fish oil to prevent MIs for more than a dozen years. But she said a different brew could not only help my heart, but likely my eyes, too.
I was dubious.
But the manufacturer, PRN/Physician Recommended Nutriceuticals had research to back its claims and a refund if the formulation didn't work within 60 days.
I ordered the DE, dry-eye blend, and started taking four capsules a day with meals.
I suddenly noticed a change. My eyes stopped itching. I seemed fine.
I had a follow-up visit with Macsai after 2 months.
She beamed when she looked at my eyes. She could see that an oily film coating my eye as healthy tears were being formed and that my Meibomian glands were reopening.
Score another one for supplements.
I Am What I Eat
I wrote recently in 51˶ about seeing Natalie Ledesma, MS, RD, CSO of the University of California, San Francisco and Smith Integrative Oncology, who specializes in prostate cancer. I visited her while I was on vacation to help sort out contradictory advice I received on nutrition for prostate cancer and heart disease, on one hand, and diabetes, on the other. I am coping with all these inflammatory conditions.
Ledesma suggested I undergo a micronutrient testing to determine if any supplements could help me to better control my blood sugar and potentially improve my health in other ways. I underwent a blood draw for the SpectraCell Micronutrient Test, a comprehensive test of the biochemical function of vitamins, minerals, amino acids and antioxidants. It seemed like the best way to find out my specific nutritional deficiencies and not take a typical shotgun approach to choosing a wide array of nutrients.
The MNT test retails for more than $1,500. I was surprised to find Medicare covered nearly all of it. My cost would be $88.
Ledesma said we would balance the nutrients and address any borderline or deficient nutrients.
SpectraCell explains its MNT testing this way:
- A mixture of lymphocytes is isolated from the blood.
- These cells are grown in a defined culture medium containing optimal levels of all essential nutrients necessary to sustain their growth in cell culture.
- The T-lymphocytes are stimulated to grow with a mitogen (phytohemagglutinin) and growth is measured by the incorporation of radioactive thymidine into the DNA of the cells.
The growth response under optimal conditions is defined as 100%, and all other growth rates are compared to this 100% level of growth.
For example, the lab says it removes vitamin B6 from the medium and stimulates the cells to grow by mitogen stimulation. Growth is measured by DNA synthesis and the rate of growth is dependent only upon the functional level of vitamin B6 available within the cells to support growth. For Vitamin B6 a growth rate of at least 55% of the growth rate observed in the optimal (100%) media is considered normal. Results less than 55% are considered to indicate a functional deficiency for Vitamin B6. Each nutrient has a different reference range that was established by assaying thousands of apparently healthy individuals.
SpectraCell found I had two functional deficiencies: lipoic acid and Vitamin K2.
Lipoic what? I drew a blank on that though I was familiar with the K vitamins.
My functional deficiency in alpha lipoic acid may be a key to understanding my diabetes.
Ledesma said taking alpha lipoic acid likely would help me: "[Supplementation] would be worth doing to see it that would further improve your blood sugar regulation. I would be really happy to see that."
Me, too.
She recommended I take the more bioavailable stabilized R-lipoic acid. I ordered it from Designs for Health.
K2, produced in the liver, primarily aids in the formation of clotting factors and bone proteins. SpectraCell notes K2 "promotes the prevention and reversal of arterial calcification, plaque progression and lipid peroxidation. Deficiency may increase the risk of calcification of arterial walls, particularly in individuals on vitamin D supplementation (Vitamin D promotes calcium absorption)." So maybe a deficiency may help explain my STEMI.
Bacteria in our guts produce about 50% of our K2. (I am undergoing microbiome testing that may provide some insights on this.)
MNT found my Vitamin D level in a summer with lots of sun exposure plus 2k units was borderline but still better than my original level.
Ledesma recommended Vital Nutrient's combo K2 (menaquinone) 7 +D3 with 150 micrograms of K2 and 2,000 units of D3.
She explained: "Vitamins D and K work very synergistically. There is little research for vitamin K and blood sugar control although vitamin D has been shown to help with insulin resistance. Both D and K are vastly important for their anti-inflammatory roles, for immune function, bone health and cancer. I think it would be important to make sure that we boost up your system."
Likewise, she also tuned up my multiple vitamin.
The new supplements set me back about $150 a month, making my urine no doubt among the most expensive but, I hope, also among the healthiest.