Why Your Digestive System is Where Health Begins

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Introduction to the Gastrointestinal System

The role of your gastrointestinal (digestive) system and its contribution to health and disease should be the cornerstone of treatment.

The average human being will consume 30 to 50 tons of food and host more microbial cells in the gut than human cells in the entire body.

We all know that achieving Health has much to do with Nutrition and optimizing nutrient intake, but simply eating the right food does not mean you'll fully digest and absorb it.

The GI tract is tasked with the responsibilities of extracting the appropriate nutrients we need to thrive, maintain an appropriate balance of healthy bacteria and decide what is to be excreted.

Because of the association between the GI tract and the rest of the body, dysfunctions in the gastrointestinal tract can lead to many, seemingly unrelated, chronic health conditions that can really only be addressed by improving gut health.

There's a reason why the most common phrase used with Functional Medicine, Naturopathic or integrative medical communities is “Health the Gut First!”.

    In fact, nearly every major physiological system of the body is directly connected to the gut.
    Let's discuss a few of the major connections…

The Gut-Brain Axis

Whether it's mood disturbance, depression, anxiety, panic attacks, behavioral problems or cognitive decline, not addressing the Gut would be a major mistake in attempting to treat these conditions.

It’s interesting when we address bacterial overgrowths in patients, there is a dramatic change not only in overall health, but mood disorders as well.

This is due to the strong connections between the Gut and the Brain.

Most brain disorders such as depression and anxiety are thought to consist of imbalances in brain chemistry such as serotonin, dopamine and GABA.

Did you know that over 90% of Serotonin is produced within the gut? It also turns out that dopamine and GABA are heavily influenced by the microbiome. [1, 2]

This is exactly why abnormal gut function has been tied to several brain disorders, including depression, anxiety, autism, attention deficit disorder (ADD), and attention deficit hyperactivity disorder (ADHD).

The connection is particularly strong with autism.

Up to 84 percent of children with autism have gastrointestinal symptoms, and there’s a strong association between autism and gut disorders such as celiac disease. [3] 

Studies have also shown that intestinal permeability and bacterial overgrowth or abnormal bacteria in the intestine are more common in autistic children than healthy children without autism. [4] 

The anecdotal experience of thousands of parents around the world and my own clinical experience suggest that children on the autism spectrum often respond very well to interventions that improve gut health and reduce gut inflammation.

So either way you look at it, there is a very intimate connection between your gut and your brain starting all the way back to when you were just a few cells in the womb.

The nervous system is the very first system to develop in the body and it actually hardwires itself into your gut through what is known as the enteric nervous system (ENT). 

The ENT plays a large role in relaying information to the brain about what’s happening in your gut, which helps control secretions and blood flow to allow you to properly digest and absorb your food.

The Gut-Heart Axis

Several risk factors have been identified for the development of cardiovascular disease.

This includes family history, age, gender, ethnicity, socioeconomic status and the gut microbiota.

It's now well established that patients with heart failure have both structural and functional changes of the gut. [5]

Aside from the obvious impacts of the digestive system on risk factors of heart disease such as obesity [6], cholesterol [7, 8], toxic burden [9], inflammation [10] and nutrient deficiency [11], the digestive system contributes to heart disease via dysbiosis [12], small intestinal bowel overgrowth [13], underlying chronic infections [14, 15, 16, 17] and intestinal permeability (leaky gut) [18, 19].

Suffice it to say, in the era of precision and functional medicine, personalized characterization of the gut microbiome in heart disease patients may be useful for individualized risk and treatment decisions.

The Gut-Skin Axis

More than 3,000 distinct types of skin disease have been identified, and skin diseases are extremely common in the industrialized world.

  • 79-95% of adolescents and 40-54% of adults in Western societies have acne
  • 25% percent have dermatitis
  • 11% have eczema
  • 5% have rosacea
  • 1% have psoriasis

Yet while skin conditions may seem like a fact of life for those of us living in the industrialized world, anthropological studies have found that they are rare or virtually nonexistent in hunter–gatherer cultures [20]. 

This suggests that most skin disorders are influenced primarily by environmental – rather than genetic – factors and that changes in nutrition and lifestyle may be sufficient to prevent and even reverse them in many cases.

The skin is influenced by other organs in the body, and this is especially true of the skin and the gut.

As far back as the 1930s, researchers had connected emotional states like anxiety and depression to changes in the gut microbiota, which they theorized promotes local and systemic inflammation and skin disease [21]. 

These pioneering early theories have been confirmed by modern studies showing strong associations between skin conditions (like acne, eczema, and psoriasis) and both mental health problems and digestive disease.

So problems with the skin are almost always a symptom of a deeper problem somewhere else (e.g., the gut or the brain), and you can get the best results if you keep that in mind and address both nutritional and lifestyle strategies.

The Gut-Oral Axis

Although our mouth only takes up a small amount of space, when it comes to impacting the rest of your body, it can play a major role in overall health.

We've always known that the mouth is important due to its function (digestion/absorption), but research is starting to shed light on a previously underappreciated player in overall health: the oral microbiome.

The oral microbiome is incredibly complex with the average adult harboring about 50-100 billion bacteria in the oral cavity, which represent about 200 predominant bacterial species and there are specific associations with oral health and disease [20].

It might seem counter intuitive to think about bacteria in your mouth impacting your body as a whole, but studies have linked changes in the oral microbiome to everything from the health of your heart to your chances of having problems with your memory.

In a fascinating study presented at the American Heart Association’s Scientific Sessions in 2012, two daily doses of L. reuteri appeared to have helped keep key cholesterol-bearing molecules in the blood in check [21].

Another study discussed how our microbiome influences health and ultimately how well we age. In short, there are links between the oral microbiome, aging and alzheimer's disease [22].

The Gut-Liver Axis

Fatty liver disease has reached epidemic proportions in the developed world, including the U.S. and Canada.

But did you also know that the microbes that inhabit your gut can have a profound effect on the health of your liver and vice/versa?

The short version of this story involves imbalances in the good versus bad bacteria in your gut (dysbiosis), which then triggers inflammation [23]. 

This inflammation then leads to a leaky gut and a chain reaction of bad biochemistry which results in inflammation of the liver [24].

This process is made worse by the fact that there is a direct route from the GI tract to the liver, known as the portal vein.

This portal vein then allows undesirable content in the gut to be deposited directly into the liver, contributing to more inflammation and congestion.

All of this can lead to the development of liver disorders including :

  • Liver Cirrhosis
  • Hepatocellular Carcinoma (HCC)
  • Primary Sclerosing Cholangitis (PSC)
  • Nonalcoholic fatty liver disease (NAFLD)
  • Alcoholic liver Disease (ALD
  • Primary Billiary Cholangitis (PBC)

 

The Gut-Immune Axis

The gastrointestinal system plays a central role in overall immune function [25].

Mechanically speaking, it's the first line of defense when it comes to protecting the body from dangerous pathogens (bacteria, protozoa, fungi, viruses) or toxic substances.

Research points to a bidirectional relationship between the gut and the brain, with the immune system acting as a bridge [26].

Evidence suggests immune cells can use neurotransmitters to communicate with cells in the nervous system, and that nerve cells may have surface receptors that receive these signals.

Nerve cells may also produce a wide range of immune molecules themselves, while immune cells probably release neurotransmitters.

The Gut-Hormone Axis

We've already discussed all the connections between the major systems of your body and the gut.

It should be clear that alterations in the gut environment are significantly involved in the development of various diseases including GI disease, metabolic syndrome, oral diseases, liver disease, skin pathologies, autoimmune disease, and nervous system disorders [27].

It should be no coincidence that the gut plays a strong role in the regulation of hormones including both stress and sex hormones.

In fact, recent studies suggest that gut microbes play another crucial role in the human body by regulating circulating estrogen levels [28]. 

Another example has to do with our “feel good hormones” such as serotonin and dopamine.

For instance, our gut manufactures about 90 percent of the body’s serotonin and gut conditions (such as leaky gut) throw this production off balance [29]. 


Summary

If you're interested in optimizing your health and finding a doctor willing to help you get there, I'd be happy to help.

To get started, simply visit https://www.drdaniel.com/membership

Got Questions? Interested in taking ownership of your health and working with Dr. Daniel? If so, Schedule a Complimentary Consult Below:

What Is Functional Medicine?

Home > Functional Medicine

What is Functional Medicine

One of the most common questions I get asked is, “What's Functional Medicine?

Functional Medicine is a systems based approach of fusing modern medical testing and diagnostics, with the safety and efficacy of natural medicine treatments and therapies.

Functional Medicine is the future of medicine – and it’s available right now.

Functional Medicine consists of a treatment of WHY? not WHAT?

This part is worth repeating to ensure that the philosophy of Functional Medicine sticks in your head.

Functional medicine doesn’t ask, “What disease do you have and what drug should you use?” but, “Why do you have those symptoms and how can we fix the root causes and optimize your health?”

Here are a few key differences between Functional Medicine and Conventional Medicine:

  • Functional Medicine is health-oriented rather than disease-oriented. This means that doctors of Functional Medicine are interested in building health, not simply fighting disease.
  • Functional Medicine is patient-centered. It focuses on you, the person, rather than what’s easy or convenient for the doctor.
  • Functional Medicine is biochemically individualized whereas Conventional Medicine prescribes the same drugs for every person with the same condition.
  • Functional Medicine has a proactive, preventive approach while Conventional Medicine is more reactive to problems that arise.

Conventional Medicine is Important, But…

In fact, I thank God every day that we have doctors, nurses and physicians trained at saving lives when a situation is critical.

Whether it's traumatic injuries, sudden and unexpected health emergencies, broken bones and raging infections – medical care is hands down the best at treating emergencies.

However, conventional medicine is not the approach we need to prevent, treat, and reverse chronic disease.

It is definitely not the best approach to treat depression, autoimmune disease, diabetes, arthritis, gut dysfunctions or any other chronic condition.

It’s more important now than ever before to understand Conventional Medicine’s inherent incompetence when it comes to these chronic diseases because despite all the advancements in medicine today, we are in the midst of the worst chronic disease epidemic in human history.

Let’s take a look at the unhealthy reality of today:

  • A billion people suffer from diabetes and obesity combined (1).
  • 30% of kids aged 2-19 are now obese.
  • Obesity rates have quadrupled in the past 30 years (2).
  • Even though more people are taking statins and blood pressure medications than ever before, 600,000 people die of heart attacks every year (3).
  • 1 in 4 women and 1 in 6 men have an autoimmune disease.
  • More than 50% of US adults take prescription drugs.
  • 40% of the elderly take more than five medications and more than 90% take over the counter drugs daily (4).
  • The number of people diagnosed with depression increases by 20% each year (5).

If these facts alarm you, then you’re not alone.

And if they don’t alarm you, it’s because poor health has become so widespread that it’s normalized. And that is alarming!

This is the first time in modern history that our lifespans are decreasing and unfortunately, it’s almost certain that things will get worse before they get better (6).

We currently have the first generation of kids in modern history with shorter expected lifespans than their parents.

If you believe health care is bankrupting us, imagine the situation that your children will face.

The cost of diabetes alone is $250 billion a year and this disease is set for exponential growth worldwide.

To put that into perspective, the World Health Organization estimates that the cost of ending world hunger – ending it! – is $30 billion per year.

We should be reversing and preventing chronic disease, while doing minimal harm – not simply treating it.

And all the statistics that I’ve mentioned show that we’re doing the exact opposite.

The ineffectiveness and outright danger of treatment itself is horrifying.

Studies in The British Medical Journal, the Journal of American Medical Association, and John Hopkins all suggest that medical care and treatment is the third leading cause of death (7,8,9)!

These studies have found that medical errors are responsible for 200,000 deaths, $77 billion in extra costs, 8 million hospitalizations, and 77 million extra drug prescriptions.

Why is Current Healthcare So Ineffective?

Because it’s not health care!

Its Sick Care or Disease Management.

If you have high blood pressure, high cholesterol, or depression and you’re taking a medication to treat it, you’re simply being managed.

By taking medication, you’re not working towards actually healing your body.

Even if you’re happy with the fact that a particular drug makes you feel a certain way or lowers your blood pressure, it may be impossible to understand what other effects that drug is having on your body.

Drugs don’t just suppress your symptoms, they also suppress functions.

NSAIDs (non-steroidal anti-inflammatory drugs) are a good example of what I’m talking about.

Many people take these over-the-counter medications to cope with joint pain, arthritis, and inflammatory conditions.

NSAIDs are effective for alleviating pain, but they also reduce blood flow to your cartilage.

Your blood carries all the nutrients your body needs to be healthy and also carries powerful immune substances vital for tissue repair.

So while NSAIDs may help you cope with joint pain in the short-term, they also contribute to joint damage and play a central role in continuing a vicious long-term cycle of chronic illness.

The common behavior of habitually taking NSAIDs (and other similar behaviors) is why so many people are walking around with what can be referred to as “FLC syndrome.”

That’s short for “Feel Like Crap syndrome.”

And regardless of how common FLC syndrome may be, you don’t have to accept it. It’s not normal and it’s not something you deserve to endure.

It should be obvious that a paradigm shift is desperately needed in order to turn this whole sick care system into one that actually supports health.

I’m just one doctor in this movement to create that kind of change, but there are many others like me with the same goal.

We want to empower you to help change the future of medicine by taking your health into your own hands and standing up for all the things that are right with you, rather than just treating symptoms of what's wrong.

Summary

If you're interested in optimizing your health and finding a doctor willing to help you get there, I'd be happy to help.

To get started, simply visit https://www.drdaniel.com/membership

Got Questions? Interested in taking ownership of your health and working with Dr. Daniel? If so, Schedule a Complimentary Consult Below:

10 Questions to Ask Your Doctor

Home > Functional Medicine

Have you ever been frustrated by the American health care system?

Have you ever been so angry at a doctor or upset at how you were treated by a medical facility?

If so, you're not alone!

There is a growing culture of people who are tired of being sick and leaving their health in the hands of big medicine.

These are people who’ve suffered for too long and know that there’s a better way. They see a future where you are in control of your own health and medication is not the only solution that’s offered.

This is the future of medicine – but it’s available now.

We live in a time where you can radically transform your health by being proactive and creating a partnership with your doctor.

But if you're serious about doing this, then the first step is of course to find a doctor who's invested in your health.

In this article I'm going to share with you 10 Questions to ask your doctor to determine how invested they are in your health.

These questions are not meant to provoke or irritate your doctor.

But if your doctor is unwilling to answer these questions and or cannot offer any satisfactory answers, then I’d consider looking for a new doctor or someone who is interested in helping you achieve Health, without a Prescription!

10 Questions to Ask Your Doctor

1. Are you willing to work with me as a partner in my health?

No one can ever truly know your body better than you. And if your doctor is unwilling to act as a partner and continue a dictator role in your health, I’d fire them and move on.

2. What’s your point of view on nutrition and health? Do you think food is medicine?

If your doctor doesn’t recognize that fact that food is the best medicine, then they need to go back to medical school and get updated on the information available.

3. Are you willing to give me copies of my test results and explain to me what they mean?

The reason we’re asking these questions is to make sure that your doctor is willing to work with you, to be detail oriented problem solve your health issues and not simply dismiss you as another patient.

4. If I don’t have any symptoms, how are you going to help me stay healthy?

Prevention is the best medicine! So if your doctor is clueless on how to treat you proactively… look for another one. Just because you’re not sick, doesn’t mean you’re healthy. It’s very common for me to find problems in people who have “normal” lab ranges but are far from “optimal”.

5. How would you treat me if you didn’t have your prescription pad?

Medications can save lives, but it’s best reserved for critical or emergency medicine. In order to treat chronic disease (which is what most people end up suffering from), your doctor must understand the lifestyle, nutritional changes, and supplementation therapies that can create a foundation for health. If she or he has no idea how to treat you without their prescription pad… find a new doctor.

6. How do you feel about the role of vitamins and supplements in health?

It’s hard to optimize nutrient status without using vitamins and supplements. Considering modern lifestyle, soil depletion, the storage and transportation of food, genetic alterations and increasing levels of toxicity in our environment – it’s nearly impossible to achieve optimal nutrient status without supplementation. Therefore it’s so important that your doctor has an understanding of how to use vitamins and supplements therapeutically.

7. Do you believe food allergies or sensitivities can cause health problems such as arthritis, asthma, sinus problems, irritable bowel disease and/or autoimmune diseases?

It is now well established that the digestive system – your gut – contains between 80-90% of your immune system. Imbalances in the microbiome, fungal overgrowth, bacterial infections, parasites and food sensitivities all contribute to a wide range of symptoms (joint pain, fatigue, bloating, inflammation, rashes, etc.). So finding a healthcare practitioner who understands that root causes of these conditions can begin in the gut is crucial.

8. What can you recommend to protect my brain from premature aging and memory loss?

Current research in cognitive decline, Alzheimer’s and dementia, all point to mitochondrial health. The mitochondria are the energy producing centers of every single cell in your body. Your doctor should understand how to assess and correct for mitochondrial dysfunction.

9. How would you treat high cholesterol? Do you believe high cholesterol is the problem?

It’s a scientific fact that high cholesterol is not the enemy. Sugar, flour, processed foods and uncontrolled inflammation are at the root of heart disease; not dietary fat/cholesterol. It’s important to team up with a doctor who is current on the latest research of the #1 cause of death in the U.S.

10. Do you think chronic illnesses such as heart disease, diabetes or osteoporosis is reversible?

Your doctor should understand that these chronic diseases can be reversible with diet, lifestyle and targeted supplementation. Your health is within your control and having a doctor who also understands this is essential for a healthy doctor-patient relationship.

I’m so excited to be a part of your journey to better health. Thanks for joining me and if you ever have any questions or need clarification, please feel free to reach out to me.

Summary

If you're interested in optimizing your health and finding a doctor willing to help you get there, the questions above should prove valuable in finding the right person.

Don't settle for anything less.

 

Got Questions? Interested in taking ownership of your health and working with Dr. Daniel? If so, Schedule a Complimentary Consult Below:

How Can Functional Medicine Help Me?

As many of my patients know, I run a busy chiropractic office in Austin, Texas… but I also have a thriving Functional Medicine practice that allows me to consult with and help people all over the US and abroad.

Still, many of my you have been asking me questions surrounding functional medicine and what it entails.

My philosophy to health is pretty simple: Move Well, Eat Healthy and Cultivate Happiness.

As a chiropractor, my goal is to make sure that your spine is healthy, your joints are mobile and you have no physical limitations in movement. Functional Medicine allows me to address the other 2 components: eating well and cultivating happiness.

In this article, I'd like to discuss my approach and how it works.

Conventional medicine has a doctor for every part of your body. There are cardiologists for your heart, gastroenterologists for the digestive system, neurologists for the brain and nervous system, podiatrists for your feet, and ophthalmologists for your eyes.

Due to specialization, conventional medicine often focuses on individual body systems, rather than trying to understand the whole person and ultimately that individuals underlying causes of disease and chronic illness.

In light of this, symptoms are used to name a disease and find a corresponding drug. That's typically your treatment.

  • High blood pressure gets you blood pressure lowering pills.
  • High cholesterol, gets you cholesterol lowering pills.
  • Infections of any kind almost always get you antiobiotics
  • Imbalanced hormones, gets you hormone replacement therapy.
  • Etc. Etc. Etc.

Basically, your symptoms are treated with no regard for the “cause”.

In functional medicine, the goal is to view your body as an interconnected whole, within a larger environment.

In other words, your health is the sum of all nongenetic (your external environment) and genetic (internal environment) exposures in your lifetime, starting from the moment of conception to death. It encompasses the food we eat, the air we breathe, social interactions, lifestyle choices and inherent metabolic and cellular activity.

Functional Medicine doctors recognize that in order to treat one part of the body, all other parts must also be considered. This breaks apart artificial divisions of the body.

What Functional Medicine Addresses

I have a hierarchy of importance for which factors to address when starting with a patient:

  1. Diet, Lifestyle and Environment.
  2. Nutrient imbalance, gut and HPA-axis
  3. Cellular Dysfunction, Toxic Burden, Hormone Imbalance
  4. Chronic Infections and Immune Dysregulation
  5. Treating symptoms for diseases that cannot be fixed

Diet, Lifestyle and Environment 

As a good rule, any doctor interested in improving health should begin with diet, lifestyle and environment. It is what it is and there's no way to self-medicate, supplement or artificially create what life requires.


Nutrient Imbalances, Gut Infections or Dysbiosis and HPA-axis

There are two reasons why we address this next:

First, these factors are often at the root of, or at least strong contributors, of other pathologies such as hormone imbalances (Low T, Thyroid problems, PCOS, etc), cellular dysfunction (Energy balance, Diabetes, Heart Disease, Weight) and immune dysregulation (autoimmune disease, cancer, arthritis, tissue repair).

Second, even if there are other problems occurring, this will lead to a significant clinical improvement towards helping any other condition.

I believe that up to 80% of health problems can be addressed by simply getting #1 (Diet, Lifestyle, Environment) and #2 (Nutrient imbalances, gut infections or dysbiosis and HPA-axis) in check.

Cellular Dysfunction, Toxic Burden, and Hormone Imbalance

In some cases we have to dig deeper. This involves assessing methylation, heavy metals, mold/biotoxins, impaired detoxification, thyroid, sex and metabolic hormones. Again, most of these problems can be addressed by improving diet, lifestyle, nutrient imbalances, gut health and stress.

Chronic Infection and Immune Dysregulation

Some patients have infections (Lyme, co-infections, parasites) that are pretty nasty and almost always require a more specialized and even integrated (Medical Prescription) approach.

How can you get started?

If you're interested in a functional medicine consult, here's my flow:

The consult has 2 parts: A 20 minute case review and an hour to 2 hour case review

STEP ONE: INITIAL 20 MINUTE CONSULT

After purchasing an initial consult, we will setup a time for us to meet over the phone or in person. During this 20-minute appointment, I will interview you to determine which lab tests to order for your Case Review, based on your chief complaints and your history.

This appointment has two purposes: to make sure that I have all of the information needed to gain a comprehensive understanding of the factors affecting your health and to give you a head start on your treatment before you meet with me.

The exact lab testing ordered after the Initial Consult depends on your individual circumstances, but may include:

  • A comprehensive blood chemistry panel. This is the single most efficient, effective and affordable tool for quickly evaluating your health. It screens for a wide range of conditions, including several types of anemia; gut, viral and bacterial infections; insulin resistance and hypoglycemia; liver and kidney issues; and thyroid and adrenal problems. It offers important clues for how to structure and focus your treatment to get the best results. It also provides a baseline of biomarkers that can be used to objectively track the progress of your treatment over time.
  • Additional blood tests for specific conditions, such as high cholesterol, hypothyroidism, autoimmune disease and gluten sensitivity.
  • Advanced stool testing to screen for parasites, fungal overgrowth, bacterial infections, intestinal inflammation, dysbiosis and a deficiency of beneficial gut bacteria.
  • Urine organic acids testing to screen for small intestinal bacterial overgrowth, fungal overgrowth, problems metabolizing fat or carbohydrates, B-vitamin status, methylation issues, detoxification capacity, oxidative stress and neurotransmitter metabolism.
  • Urine hormone testing for adrenal and sex hormone status.

You will also be provided the Case Review health history paperwork to complete.

This paperwork includes:

  • A detailed health and medical history questionnaire
  • A survey of your chief complaints and most important health goals
  • An assessment of your most troubling and frequently experienced symptoms
  • A diet survey and questionnaire
  • A survey of your current supplements and medications

Once we’ve received your lab results and completed the Case Review paperwork, I will give you specific protocols to start working on before moving on to part 2: the case review consultation.

This typically occurs between 60 and 90 days after the Initial Consultation, because some of the labs we use take up to 8 weeks to deliver the results to us after receiving your sample.

STEP TWO: THE CASE REVIEW CONSULTATION

The Case Review Consultation is a 60-minute to 120-minute in-person, phone or video appointment.

Prior to the consultation, I will have reviewed the results from the labs that were ordered along with your Case Review paperwork, medical history, diet and supplement survey, assessment forms and relevant prior lab work. I will also create a Report of Findings, which is broken into three parts:

  • A summary of the underlying patterns that are contributing to your symptoms.
  • An outline of the suggested treatment plan, including dietary, supplement and lifestyle recommendations.
  • Recommendations for further testing (this will typically be minimal, if necessary at all, because of the completeness of the Case Review process)

During this visit, I will present the Report of Findings as well as your treatment plan. I will also review all of your test results with you and answer any questions you have about the findings or the treatment plan.

The Most Common Worst Supplements You Might be Taking Part 3

In previous articles I discussed 2 of the most common, but worst supplements you could be taking for your health. These supplements included Iron and Calcium.

Certainly these 2 nutrients are important for our health… but when it comes to supplementing with iron and calcium, it can be detrimental to your health.

For example, iron is a pro-oxidant, which causes oxidative stress and when present in large amounts can literally lead to organs and tissue damage. Calcium is associated with a 139% increased risk of heart attack and a 20% higher risk of stroke.

In this article, I'd like to finish up my series of the “Most Common Worst Supplements” you may be taking by discussing Vitamin E, Vitamin A (Beta Carotene) and Folic Acid.

Vitamin E (Alpha-Tocopherol)

Let’s talk about vitamin E. Vitamin E is a potent fat-soluble anti-inflammatory vitamin that protects us from free radicals and tissue damage. It’s also involved in immune function, cell signaling, regulation of gene expression, and other metabolic processes.

There are three different types of vitamin E, or isomers. There are phenols, tocopherols, and tocotrienols. Alpha-tocopherol is the form that most supplements contain. While vitamin E is an important nutrient to get in the diet, I definitely don’t recommend supplementing with it, with the possible exception of tocotrienols.

Now, before we proceed it's important to have some understanding of the difference between synthetic vitamins and whole food or natural isomers of vitamins.

When checking vitamin labels, natural vitamin E is usually listed as the “d” form followed by “alpha-tocopherol”.  On the other hand, synthetic vitamin E will be listed as “d” followed by an “l” or dl-alpha-tocopherol”.

This is important when it comes to understanding research outcomes.

At best, dl-alpha-tocopherol (synthetic vitamin E) shows no benefit, but in several studies, it actually shows harm. For example, in a meta-analysis in JAMA with 230,000 total participants, vitamin E supplementation caused increased risk of death from all causes. Another review of 78 randomized controlled trials with almost 300,000 total participants found that vitamin E supplementation increased mortality by a small but significant margin.

So, again, you want to aim for whole-food sources of vitamin E only.

These include nuts and seeds primarily but also tomato sauce, cranberry juice, some fruits such as apricots and avocado, and fish such as trout.

The RDA is 15 mg a day. Most Americans get their intake from polyunsaturated vegetable oils. That is perhaps one of the only benefits of these industrial seed oils.

Paleo sources for people who are avoiding those oils or minimizing them, again include nuts and seeds, some greens, and some fish such as trout. It’s important, by the way, to eat foods that contain vitamin E, and any fat-soluble vitamin, for that matter, such as D, K2, and A, with fat because they are fat soluble.

Fat will be necessary to absorb fat-soluble vitamins such as vitamin E, and studies have consistently shown that when fat is consumed, the absorption of these vitamins is much greater.

Vitamin A (Beta Carotene)

Okay. Now let's talk about vitamin A or beta-carotene. Beta-carotene gives plants an orange or yellow color, and this is a precursor for active vitamin A, retinol. Beta-carotene can also be converted into potentially harmful substances, and it can increase the risk of oxidative stress similar to Iron. Studies show that beta-carotene supplementation may increase the risk of heart disease and cancer in people who drink heavily or smoke.

High levels of betacarotene may have anti-vitamin A properties. This means it actually works against active vitamin A by disrupting the metabolism and action of active vitamin A.

Of course, the best option for getting beta-carotene is from food! And this is easy to do on a Paleo-type diet. Foods that are rich in beta-carotene include carrots, tomatoes, sweet potatoes, broccoli, cantaloupe, winter squash, bell peppers, spinach, lettuce, pumpkin, and kale.

However, if you are going to supplement… then make sure your Vitamin A's label reads Betatene or Mixed carotenoid complexes. A complex of beta-carotene will include beta-carotene, lycopene, lutein and other carotendoids.

Folic Acid (Methyl Tetra Hydrofolic Acid)

Finally, let's have a talk regarding Folic acid.

Folic acid is an oxidized synthetic compound that is only found in dietary supplements and fortified foods.

It's now well understood that synthetic folic acid compounds are not metabolized by the body and can actually accelerate the progression of certain cancers. WOW… many physicians regularly recommend this to their patients.

Folic acid is not a natural form of folate found in nature. It was introduced into the food supply to reduce the risk of neural tube defects during a malnourished pregnancy, which it definitely does.

Folic acid can be converted into natural folate, but unfortunately, that conversion is limited in humans.

It undergoes initial reduction and methylation in the liver using dihydrofolate reductase as an enzyme, and if the patient has low activity of this enzyme, she can end up with high levels of unmetabolized folic acid in her system and circulation. A new study was released that found that nearly all babies, children, adolescents, and adults in the U.S. have measurable levels of unmetabolized folic acid in their systemic circulation, so this is a big problem that has only recently been recognized.

Why are high levels of unmetabolized folic acid in the blood problematic?

  1. They can mask vitamin B12 deficiency.
  2. They may lead to the deterioration of central nervous system function, especially in the elderly.
  3. They can cause anemia and cognitive impairment.
  4. They can accelerate the progression of certain cancers, including colon and prostate cancer.
  5. They can depress immune function, and they are associated with increased risk of death from all causes.

Folate, or Methy Tetra Hydrofolic Acid, aka natural folate on the other hand, which is found in foods in nature and in supplements with natural forms of folate is not only very necessary for health but is also safe to supplement with.

If you currently take a multivitamin and its a cheaper type of brand, you may want to make sure to look for folic acid. If it says folic acid on it or it doesn’t specifically mention that it is one of the active forms of folate such as 5-MTHF, metafolin, or folinic acid, then it probably has folic acid and should be avoided.

Foods that are naturally rich in folate include beef liver, and chicken liver is actually the highest source of folate and the best source; also dark, leafy greens such as spinach and collards. Lentils are a good source of folate if your patients tolerate legumes, as are beets, cauliflower, parsley, mustard greens, turnip greens, and even some lettuces.

The Real Food Multivitamin

For all the reasons listed above as well as in my previous articles on the dangers of iron and calcium supplementation, this is why I decided to start my own nutrition company a few years ago (DNA Formulas).

My multivitamin is a food sourced multivitamin made to contain the specific forms of vitamins that are deemed safe and actually necessary for optimal health.

How do you know if you're vitamin is good or bad? I have a quick checklist when it comes to reading labels:

If you're looking for a good multi, consider The Real Food Multivatmin!

The Most Common Worst Supplements You Might be Taking Part 2

I make numerous recommendations with respect to what nutritional supplements, herbs and botanicals a patient should take to improve their health.

In many cases, supplements are necessary for therapeutic treatment and I believe that many people cannot heal their bodies without them.

However, there are many supplements I know my patients are taking that are unnecessary and even harmful.

Last week I discussed the risk of Iron supplementation and how you should proceed with caution if you're taking them.

This week, I want to continue the discussion with calcium supplementation.

The Risk of Calcium Supplements

Calcium is important for the proper formation of bones and teeth. It plays a role in cell signaling, contractability of muslces and excitation of neurons.

Calcium levels are tightly regulated by parathyroid hormone and vitamin D. If calcium intake isn’t high enough, calcium levels will be maintained at the expense of bone health. That’s something important to understand.

calcium supplementation

The RDA for calcium is 1,000 to 1,200 mg a day, though other experts have suggested that lower levels are probably adequate, especially if vitamin D and K2 levels are sufficient, because those nutrients help to regulate calcium metabolism.

This is exactly why I recommend taking my Vitamin D3+K2 supplement.

Quite honestly, the easiest way for someone to get their RDA of calcium is by consuming an ancestral or paleo based diet.

In short, consuming foods with anti-nutrients, or nutrients that block the absorption of vitamins and minerals, is what is causing massive human nutrient deficiencies in the first place. On a Paleo diet low in anti-nutrients, the need for calcium is lower due to increased absorption of dietary calcium.

As I mentioned, vitamin D and vitamin K2 are both required for optimal calcium absorption. So before taking calcium, make sure that your vitamin D and K levels are optimized!

You should also be aware that higher-protein diets increase calcium absorption, and higher intakes of calcium through supplements but not through diet can lead to hypercalcemia, which can be fatal if left untreated.

Certainly the media has contributed to the popularity of calcium supplementation.

This is especially true with older women wanting to help prevent osteoporosis. Most older women who come into my office are taking calcium.

Unfortunately, the overwhelming research shows that calcium supplementation doesn't reduce fracture rates in the elderly and seems to actually increase them. The same research also indicates that it particularly harms men!

While calcium is a crucial mineral, supplemental calcium has been shown to increase the risk of cardiovascular disease and cardiovascular events. It’s not hard to understand why. We want our arteries to be soft and pliant. When our arteries become calcified and they become brittle and hard, that increases the risk of cardiovascular disease.

Supplemental calcium has a much greater effect on circulating calcium concentrations than dietary calcium.

Humans evolved to get calcium from diet just like all of the other nutrients, and our body has regulatory mechanisms for handling that, even if we’re getting more calcium than we need, but those regulatory mechanisms appear to be less effective with large boluses of supplemental calcium.

So make sure that you are getting adequate amounts of K2 and consuming enough vitamin D and vitamin A because all of those play a role in regulating calcium homeostasis.

calcium supplement risks

Calcium and Cardiovascular Risk

In a study of 24,000 men and women aged 34 to 65 that was published in BMJ in 2012, those who supplemented with calcium had a 139 percent higher risk of heart attack versus those whose calcium intake came from food who had no change in risk.

Meta-analysis in BMJ of 12,000 individuals showed that those taking supplemental calcium had a 31 percent higher risk of heart attack, a 20 percent higher risk of stroke, and a 9 percent higher risk of death from all causes.

Finally, another analysis in JAMA Internal Medicine, also looking at 12,000 participants, found that intake of more than 1,000 mg of supplemental calcium per day increased the risk of death from cardiovascular disease by 20 percent.

So, now you can understand why I’m not a fan of supplemental calcium.

Even without purposefully supplementing calcium, many people may be accidentally supplementing because of fortified foods and multivitamins. Multivitamins almost always have calcium in them.

Foods such as orange juice; cereal; non-dairy milks such as almond milk, rice milk, or soy milk; bread; instant oatmeal; and several other foods are often fortified with calcium.

Best Food Sources of Calcium

best food sources of calcium

I recommend that most patients get their calcium from food if possible, and I’ve listed the food sources of calcium on this slide based on serving size.

Things such as sesame seeds; sardines with the bones in; dairy products, of course; dark, leafy greens such as collard greens and spinach; and sockeye salmon with the bones in are a great source of calcium.

Sardines with bones in and canned sockeye salmon with bones are probably two of the best ways for you to get calcium.

If you're concerned about bone health, then eat the foods listed above and lift heavy things!

Weight-bearing exercise is probably one of the most important things you can do to promote healthy bones.

I promise, if you are consuming enough dietary calcium as well as other synergistic vitamins and minerals such as K2, D, A, and magnesium and performing weight-bearing exercise, there is probably no need to supplement at all, and supplementing would likely do more harm than good.