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Expert Pearls
Letter "N"
Categories beginning with "N"

Nausea and Vomiting

Nausea and Vomiting (post-surgery)

Necrotizing Enterocolitis (NEC)

Nephrolithiasis

Nephropathy

Nephropathy (IgA)

Neural Tube Defect (NTD)

Neurologic Disorder

Neuromuscular Disease

Neuropathic Pain

Neuropathy

Neuropsychiatric Disorder

Neuropsychological Function

Niacin Therapy

 

Entries beginning with "N"

Nausea and Vomiting (post-surgery) - acupressure - 32885 / 44184

Acupressure - P6 (Sea Band™). [Can J Anaesth. 2005 Aug;52(7):703-9. 32885/ 44184 (1/2006)] Summary Interview

Nausea and Vomiting (post-surgery) - ginger - 44145

Ginger 1 gm/d (1 gm dried ginger root powder). [Am J Obstet Gynecol, 2006; 194(1):95-99. 44145 (05/2006)] Summary Interview

Nausea and Vomiting - ginger root - 48398

Ginger root powder capsules (1000 or 2000 mg per day) in 3 divided doses (1st dose: 1 hr before start of
chemotherapy infusion; 2nd dose: 3 hrs after start of chemotherapy infusion; 3rd dose: 8 hrs after start of
chemotherapy infusion).
[Pediatr Blood Cancer, 2010, Sep 14; [Epub ahead of print]. 48398 (4/2011)] Summary Interview PubMed

Necrotizing Enterocolitis (NEC) - Probiotics

Probiotics in preterm neonates [metanalysis of different strains used - Bifidobacterium breve, Lactobacillus GG, Saccharomyces boulardii, Bifidobacteria infantis, Bifidobacterium bifidus, Lactobacillus acidophillus, Lactobacillus casei and Bifidobacterium lactis .5 to 6 x 109 1 to 2 times daily. [The Lancet, 2007; 369 (9573):1614-20. 45458 (8/2007)] Summary Interview

Nephrolithiasis - Calcium

Calcium restriction is not beneficial in calcium oxalate stones. Restriction may increase stone risk by 1) increasing oxalate excretion and 2) causing bone resorption. [Clinical Science, 1997;93:257-263. 28618 (1998)] Summary Interview

Nephrolithiasis - Diet

Diet - increase water intake; normalize protein and caloric intake. [Clinical Science, 1997;93:257-263. 28618 (1998)] Summary Interview

Nephrolithiasis - Diet - 2

Diet with normal calcium intake (1000 mg/d) and reduced animal protein and sodium cut risk of recurrent stones in half compared to low calcium (400 mg/d) and normal animal protein and sodium intake. [N Engl J Med, January 20, 2002;346(2):77-84. 38750 (2002)] Summary Interview

Nephrolithiasis - Diet - 3

Dietary approach for calcium oxalate stones: reduce animal fat (correlates with oxalate excretion), sodium (calcium excretion), coffee and tea (rich in oxalate); reduce weight (increased calcium excretion) by reducing protein and carbohydrate intake; increase calcium from calcium-rich mineral water 100-200 ml per hour, low fat milk (calcium), low fat cheeses (calcium) and seaweed (rich in calcium and magnesium) which binds oxalate intestine. [Eur Urol, 2000;37:140-144. 34864 (2000)] Summary Interview

Nephrolithiasis - Diet - 4

Dietary factors that may be of benefit: vegetable protein instead of animal protein (reduced acid load); calcium citrate (does not enhance crystallization of calcium salts), calcium carbonate blocks oxalate absorption; vitamin B6 and magnesium citrate may prevent calcium oxalate stone formation by lowering the metabolic production of oxalic acid and inhibiting its crystallization respectively; sugars restriction can decrease endogenous oxalic acid production and urinary calcium excretion; soft drink reduction may reduce the acid environment and reduce calcium excretion. [N Engl J Med, January 20, 2002;346(2):77-84. 38750 (2002)] Summary Interview

Nephrolithiasis - Diet - 5

Dietary factors are to reduced fat which binds to calcium forming soaps and leaves less calcium to bind with oxalate; normal, not low, calcium diets should be recommended to bind oxalate in the intestine. [Urol Int, 1998;61:192-195. 32611 (1999)] Summary Interview

Nephrolithiasis - Eicosapentaenoic acid

Eicosapentaenoic acid (EPA) 1800 mg/d reduced urinary calcium excretion in stone formers. [Eur Urol, 2001;39:580-585. 38323 (2001)] Summary Interview

Nephrolithiasis - Magnesium, citrate, vitamin B6

Supplements of magnesium, citrate and vitamin B6 may be inhibitory while vitamin D and PTH may increase risk. [Clinical Science, 1997;93:257-263. 28618 (1998)] Summary Interview

Nephrolithiasis - Phytate

Phytate 120 - 300 mg/dy or diet high in legumes, nuts and cereal grains. [Eur Urol, 2001;39:580-585. 38323 (2001)] Summary Interview

Nephropathy (Contrast-Induced) - n-acetylcysteine - 50370

N-acetylcysteine may be beneficial in a wide range of conditions with oxidative stress and depleted intracellular glutathione including acetaminophen overdose, diabetic atherothrombosis, cystic fibrosis and contrast-induced nephropathy. It’s effectiveness may be dose-dependent with the degree of glutathione depletion. In acetaminophen overdose dosing has been three consecutive intravenous infusions of 150, 50, 100 mg/kg respectively each over 1 hour and oral and nebulized doses between 700-2800 mg/d. [Pharmacol Ther. 2014 Feb;141(2):150-9. 50370 (6/2014)] Interview PubMed

Nephropathy (IgA) - Eicosapentaenoic acid/Docosahexaenoic acid

Eicosapentaenoic acid (EPA) 1.9 g/d and docosahexaenoic acid (DHA) 1.4 g/d. [J Am Soc Nephrol 1999;10: 1772-1777. 33182 (1999)] Summary Interview

Nephrophathy (Contrast-Induced) - n-acetylcysteine - 50370

N-acetylcysteine may be beneficial in a wide range of conditions with oxidative stress and depleted intracellular glutathione including acetaminophen overdose, diabetic atherothrombosis, cystic fibrosis and contrast-induced nephropathy. It’s effectiveness may be dose-dependent with the degree of glutathione depletion. In acetaminophen overdose dosing has been three consecutive intravenous infusions of 150, 50, 100 mg/kg respectively each over 1 hour and oral and nebulized doses between 700-2800 mg/d. [Pharmacol Ther. 2014 Feb;141(2):150-9. 50370 (6/2014)] Interview PubMed

Neural Tube Defect (NTD) - Homocysteine elevation

Homocysteine elevation due to possible methionine synthase dysfunction and lower vitamin B12 levels increase risk. [The Lancet, January 21, 1995; 345:149-51. 21660 (1996)] Summary Interview

Neural Tube Defect (NTD) - Multivitamin

Multivitamin containing .4 mg folic acid. [JAMA, April 10, 1996;275(14):1093-1096. 24560 (1997)] Summary Interview

Neural Tube Defect (NTD) - Multivitamin - 2

Multivitamin containing .4 mg folic acid. [The Lancet, January 21, 1995;345:149-51. 21660 (1996)] Summary Interview

Neural Tube Defect (NTD) - Obesity

Obesity (body mass index > than 29 kg/m2) doubled the risk for neural tube defects. [JAMA, April 10, 1996;275(14):1093-1096. 24560 (1997)] Summary Interview

Neural Tube Defect (NTD) - Periconceptional folic acid

Periconceptional folic acid prevents 70% of neural tube defects. [Eur J Clin Nutr, 1995;49:787-793. 24065A (1996)] Summary Interview

Neurologic Disorder - Antigliadin antibodies

Antigliadin antibodies recommended screen. [The Lancet, February 10, 1996; 347:369-371. 24229 (1997)] Summary Interview

Neurologic Disorder - Antigliadin antibodies - 2

Antigliadin antibodies disappear from the blood in 3-6 months; improvement or stabilization occurs at about 2 years from the introduction of gluten-free diet. [The Lancet, February 10, 1996;347:369-371. 24229 (1997)] Summary Interview

Neurologic Disorder - Celiac disease

Celiac disease screening. [Am J Med, March 1, 2004;116:312-317. 42425 (01/2005)] Summary Interview

Neurologic Disorder - Gluten

Gluten sensitivity common. [The Lancet, February 10, 1996;347:369-371. 24229 (1997)] Summary Interview

Neurologic Disorder - Gluten-free diet

Gluten-free diet improves cerebral hypofusion. [Am J Med, March 1, 2004;116: 312-317. 42425 (01/2005)] Summary Interview

Neurologic Disorder - Gluten-free diet - 2

Gluten-free diet in celiac disease can improve neurologic function. [The Lancet, February 10, 1996;347:369-371. 24229 (1997)] Summary Interview

Neurologic Disorder - Vitamin C

Vitamin C is beneficial by protecting neurons against the neurotoxic effects of glutamate; is an inhibitor at the dopamine receptor; is a powerful antioxidant and is the main defense of the brain against toxic free radicals (FORs); works in tandem with vitamin E. Vitamin E is found mostly in the glia and ascorbate in the neurons. These antioxidants also act on the gene expression of other antioxidant systems. [J Royal Soc Med, May, 1996;89(5):241. 24982/24872 (1997)] Summary Interview

Neuromuscular Disease - alpha lipoic acid, ATP Fuel, carnitine, coq10, mitochondria, nadh - 50467

hronic diseases of all types, including aging, result in some type of mitochondrial dysfunction. Key mitochondrial supportive nutrients (ATP Fuel®) and therapeutic dose ranges include: L-Carnitine varying from 140 mg to over 2 g per day with most recommendations in the range of 1-2 g per day in divided doses. Up to 6 g per day of dietary supplementation of L-carnitine is safe; CoQ10 has been used in doses up to 1.2 g per day. Frequent daily doses are 30-300 mg per day; Alpha lipoic acid at 200 to 600 mg per day; Microcarrier-stabilized NADH varies from 10-30 mg per day; and Lipid Replacement Therapy (NTFactor®) at 1-2 g of stabilized phospholipids. [Altern Ther Health Med. 2014 Winter; 20 (Suppl 1):18-25. 50467 (9/2014)] Interview PubMed

Neuromuscular Disease - Creatine monohydrate

Creatine monohydrate 10 gm/d for five days followed by 5 gm/d for five days. [Neurology March, 1999;52:854-855. 31840 (1999)] Summary Interview

Neuropathic Pain - epa, dha - 47740

EPA ≥ 400 mg and DHA ≥200 mg per capsule, starting at 1-2 capsules per day titrating up to as high as 2 capsules for every 50 pounds of body weight in divided doses. Capsules may be frozen and taken with food to minimize gastrointestinal side-effects. [Clin J Pain, 2010;26(2):168-72. 47740 (3/2010)] Summary Interview PubMed

Neuropathic Pain - methylcobalamin, vitamin b12 - 50007

Methylcobalamin, the neurologically active form of vitamin B12, I.M. at 100 to 1000 mcg every day or every other day, for 1-2 weeks, followed by a maintenance dose of 100 to 1000 mcg every 1-3 months diminished feet pain and OCD symptoms. [Gen Hosp Psychiatry, 2012 Jan 6. [Epub ahead of print] 50007 (2/2012)] Interview PubMed

Neuropathy (anti-retroviral) - acetyl-l-carntine - 44095

Acetyl-l-carntine 3 gms/d. [HIV Clinical Trials, 2005; 6(6): 344-350. 44095 (4/2006)] Summary Interview PubMed

Neuropathy (diabetic) - diet - 21878

Diet - vegan diet which excludes any food or drink that comes from animal, fish, meat, milk or eggs; excludes refined foods such as free fats (oil, shortening or margarine, etc.); free carbohydrates (sugar, syrups, starch, etc.); or refined cereals (white rice, white flour, etc.); or refined legumes (soy protein isolate or soy protein concentrate products). Eat only whole nuts, beans, seeds, whole grains, fruit and vegetables. [J Nutr Med, 1994;4:431-439. 21878 (1996)] Summary Interview

Neuropathy (diabetic) - gamma-linolenic acid - 28204

Gamma-linolenic acid (GLA) 480 mg/d. [Diabetes, 1997;46(Suppl. 2):S90-S93. 28204 (1998)] Summary Interview PubMed

Neuropathy (diabetic) - vitamin b1 - 25833

Vitamin B1 (benfothiamine) 3 x 100 mg/d for 2 to 3 weeks and thereafter a dose of 1 to 2 x 100 mg/d benefitted diabetic polyneuropathy. [Exp Clin Endocrinol Metab, 1996;104:311-316. 25833 (1997)] Summary Interview PubMed

Neuropathy (idiopathic) - creatine monohydrate - 31840

Creatine monohydrate 10 gm/d for five days followed by 5 gm/d for five days. [Neurology March, 1999;52:854-855. 31840 (1999)] Summary Interview PubMed

Neuropathy (peripheral) - vitamin b12 - 28725

Vitamin B12 normal ranges should be 600 to 2000 pg/ml. Below 550 to 600 pg/ml deficiencies start to appear in the CSF. Humans are born with serum levels of about 2000 pg/ml, which decline gradually throughout life. [Medical Hypotheses, 1991;34:131-140. 28725 (1998)] Summary Interview PubMed

Neuropathy - acetyl-l-carnitine, chemotherapy-induced - 49654

Acetyl-L-carnitine (ALC) at 3,000 mg per day in 409 women with breast cancer undergoing adjuvant taxane-based chemotherapy increased chemotherapy-induced neuropathy (CIPN). [J Clin Oncol, 2013 Jun 3; [Epub ahead of print]. 49654 (7/2013)] Summary Interview PubMed

Neuropathy - cisplatin - vitamin e - 47824

Vitamin E as alpha-tocopherol at 400 mg per day in a single dose away from meals significantly protected against cisplatin peripheral neurotoxicity and reduced the incidence and intensity of neuropathic signs and symptoms. [Neurology, 2010;74(9):762-6. 47824 (5/2010)] Summary Interview PubMed

Neuropsychiatric Disorder - alpha lipoic acid, ATP Fuel, carnitine, coq10, mitochondria, nadh - 50467

Chronic diseases of all types, including aging, result in some type of mitochondrial dysfunction. Key mitochondrial supportive nutrients (ATP Fuel®) and therapeutic dose ranges include: L-Carnitine varying from 140 mg to over 2 g per day with most recommendations in the range of 1-2 g per day in divided doses. Up to 6 g per day of dietary supplementation of L-carnitine is safe; CoQ10 has been used in doses up to 1.2 g per day. Frequent daily doses are 30-300 mg per day; Alpha lipoic acid at 200 to 600 mg per day; Microcarrier-stabilized NADH varies from 10-30 mg per day; and Lipid Replacement Therapy (NTFactor®) at 1-2 g of stabilized phospholipids. [Altern Ther Health Med. 2014 Winter; 20 (Suppl 1):18-25. 50467 (9/2014)] Interview PubMed

Neuropsychiatric Disorder - alzheimer's disease, green tea, l-theanine - 50428

L-theanine (LT), a non-essential amino acid, increases neuroinhibitory neurotransmitters (GABA and glycine) and reduces norepinephrine. LT may be neuroprotective by inhibiting glutamate release as well as increasing GABA and glycine. LT may help in Alzheimer’s treatment and prevention by reducing amyloid β levels and inhibition of amyloid β-induced neuronal cell death. Dose ranges are from 20-45 mg in a cup of green tea (to a lesser extent black tea). LT has been shown to improve cognitive function in Japanese elderly at 50 mg/d and has been used in schizophrenia in doses of 400 mg/d. 400 mg per day has been shown to be safe. [Nutr Neurosci. 2014 May 28;17(4):145-55. 50428 (8/2014)] Interview PubMed

Neuropsychological Function - Walking

Walking > 1000 steps per day improves mental functioning and memory in cardiac patients. [J Int Med, 1995;238:423-428. 23627 (1995)] Summary Interview

Niacin Therapy - Fibrinogen

Fibrinogen is lowered by 15%; raises HDL-C by 20-40%; HDL2-C, the large HDL particle is raised by up to 100%; a negligible effect on smaller HDL3; LDL-C is lowered by 15-30%; small, dense LDL particles are significantly lowered; triglycerides are lowered by 15-40%; and Lp(a) decreases10-40%. Niacin protocol: Day 1 0.25 gm after lunch, 0.5 gm after dinner and 0.5 gm at night. Day 2 0.25 gm after breakfast, 0.5 gm after lunch, 0.5 gm after dinner and 1gm at night. Day 3 0.25 gm after breakfast, 0.5 gm after lunch, 1gm after dinner and 1gm at night. Day 4 1 gm q.i.d., taken immediately after meals and at bedtime. [J Intern Med. 2005 Aug;258(2):94-114. 43553 (01/2005)] Summary Interview
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