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Expert Pearls

Abdominal Pain

Abruptio Placenta

Acne

Addiction

Adenomatous Polyps

Adrenoleukodystrophy (ALD)

Adult Respiratory Diistress Syndrome (ARDS)

Age Related Macular Degeneration

Aggression

Aging

AIDS/HIV

Akathisia (Neuroleptic-Induced)

Alcoholism

Alexithymia

Allergic Rhinitus

Allergies

Alzheimer’s Disease

Amenorrhea

Amyotrophic Lateral Sclerosis (ALS)

Anal Fissure

Anaphylaxis (Exercise-Induced)

Anemia (megaloblastic)

Anger (substance abuse)

Angina Pectoris

Anklyosing Spondylitis

Ann Allergy

Anticoagulation Therapy

Antioxidants

Anxiety

Anxiety (substance abusers)

Aphthous Stomatitis

Arrhythmias

Arthritis (polyarthritis)

Asthma

Atherosclerosis

Atopic Dermatitis / Eczema

Atrial Fibrillation

Atrophic Vaginitis

Attention-Deficit /Hyperactivity Disorder

Autism

Autoimmune Disease

Back Pain

Barrett's Esophagus

Behavior (violent)

Behavior Disorder

Behcet’s Disease

Benign Prostatic Hypertrophy (BPH)

Blepharitis

Bone Loss

Breast Feeding

Bronchiectasis

Burns

C-Reactive Protein (lowering)

Cancer

Candidiasis (oral)

Cardiac Function

Cardiomyopathy (idiopathic)

Cardiovascular Disease

Cardiovascular Surgery

Carotid Atherosclerosis

Catabolic State

Cataract

Celiac Disease

Cellulite

Cerebral Atrophy

Cerebral Hypofusion

Cerebral Palsy

Cerebral Vascular Disease

Chemoprevention

Cholestasis

Cholesterol Lowering

Chromium

Chronic Disease

Chronic Obstructive Pulmonary Disease (COPD)

Cirrhosis

Clostridium Dificille (diarrhea)

Cognition

Colic (infantile)

Common Cold

Complex Regional Pain Syndrome (CRPS)

Constipation

Contraception

Coronary Artery/Heart Disease (see also cardiovascular disease)

Cough

Cough (URI)

Cow’s Milk

Critical Illness

Crohn’s Disease

Cystic Fibrosis

Deafness

Delirium

Dementia

Dental Caries

Depression

Diabetes Mellitus

Diabetic Neuropathy

Diarrhea

Diet (general)

Docosahexaenoic Acid (DHA)

Down Syndrome

Dry Eye Syndrome

Dysfunctional Gut Syndrome

Dyslexia

Dysmenorrhea

Dyspepsia

Dysplasia (cervical)

Ear Infection

Eczema

Encephalopathy

Endothelial Function

Enteritis (radiation-induced)

Enuresis (nocturnal)

Epilepsy

Epitaxis

Erectile Dysfunction

Erythema Nodosum

Erythroderma

Estrogen Metabolism

Exercise

Exercise (duodenal ulcer)

Falling

Fatigue

Fibrinogen (lowering)

Fibrocystic Breast Disease

Fibroids (uterine)

Fibromyalgia

Fibrosis

Folic Acid

Fracture

Fracture (hip)

Fragile X Syndrome (FXS)

Gastroesophageal Reflux Disease (GERD)

Gestational Diabetes

Gingivitis (see also periodontal disease)

Glaucoma

Gout

Grave’s Disease

Grave’s Ophthalmopathy

Growth and Development

Halitosis

HDL Cholesterol (elevating)

Headache

Headache (sleep disorder)

Hearing Loss (Presbycusis)

Heart Failure

Heart Rate Variability (HRV)

Helicobacter Pylori

Hemodialysis

Hepatic Detoxification

Hepatic Fibrosis

Hepatic Hepatitis

Hepatic Steatosis (non-alcoholic fatty liver disease)

Hepatitis (Viral)

Hepatitis C

Hepatoxicity

Hereditary Hemorrhagic Telangiectasias

Hirsutism

HIV

Homocysteinemia/Homocystinuria/Hyperhomocysteinemia

Hospitalization

Hyperactivity

Hyperbilirubinemia

Hyperparathyroidism

Hypertension

Hypertension (ocular)

Hypertriglyceridemia (see triglyceride lowering)

Hypothyroidism

Ideation (paranoid)

Immune Function

Infection

Infertility (female)

Infertility (male)

Inflammation

Inflammatory Bowel Disease

Insomnia

Insulin Resistance/Hyperinsulinemia

Intermittent Claudication

Intestinal Permeability

Irritable Bowel Syndrome (IBS)

Ischemic Heart Disease

Kidney Failure / Insufficiency

Kidney Stone

Kidney Transplantation

Lactation (see breast-feeding)

Lactic Acidosis

Lactose Intolerance

Lead Excess/Poisoning

Leukemia

Leukemia - Myelogenous

Libido

Lipoprotein (a) (lowering)

Liver Disease

Longevity

MATHS

Meibomian Gland Dysfunction

Melanoma

Melatonin

Memory

Menopausal Symptoms

Menopause

Menstrual Pain

Mental Function

Mercury Exposure/Toxicity

Metabolic Syndrome

Microalbuminuria

Migraine Headache

Mind-Body

Miscarriage

Mitochondrial Cytopathy

Mitral Valve Prolapse

Mobility

Mood Disorders

Mortality

Mortality (from cardiovascular disease)

Motion Sickness

Mucositis (radiation-induced)

Multiple Sclerosis

Muscle Damage (exercise-induced)

Muscle Pain

Muscle Soreness

Muscle Strength

Muscle Wasting

Muscular Dystrophy

Myelofibrosis

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Myopathy (skeletal)

Myositis

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

Obesity

Obsessive Compulsive Disorder

Obstructive Sleep Apnea Syndrome

Ocular Disorder

Osteoarthritis

Osteoporosis

Otitis Media

Pain

Pain (musculoskeletal)

Pain (Neuropathic)

Pancreatitis

Panic Disorder

Parkinson's Disease

Pelvic Pain

Pemphigus (bullous)

Periodontitis /Periodontal Disease

Peripheral Vascular Disease

Pernicious Anemia

Pet Therapy

Peyronie's Disease

Phenylketonuria

Physical Performance

Phytoestrogens

Pityriasis Rubra Pilaris

Platelet Aggregation

Pneumonia

Poisoning

Polycystic Ovarian Syndrome

Portal Hypertension

Pre-Eclampsia

Pregnancy

Premature Delivery

Premature Graying

Premature Infant

Premature Rupture of Fetal Membranes (PROM)

Premenstrual Syndrome

Probiotics

Prostatitis

Psoriasis

Psychomotor Development

Pulmonary Artery Hypertension

Rabies

Radiation Exposure

Renal

Restless Leg Syndrome

Retinitis Pigmentosa

Retinopathy

Rheumatic Disease

Rheumatic Disease

Rheumatoid Arthritis

Rhinitis (allergic)

Salicylate Intolerance

Sarcoidosis

Sarcopenia

Satiety

Schizophrenia

Seasonal Affective Disorder (SAD)

Seizures

Selenium

Sepsis

Serous Otitis Media (see otitis media)

Sexual Activity/Behavior

Shock (septic shock)

Sickle Cell Anemia

Silicone Breast Implant Syndrome

Sleep Disorder

Smoking

Soy Foods

Stress

Stroke

Substance Abuse

Sudden Infant Death Syndrome

Suicide

Sunburn

Surgery

Syndrome X

Systemic Lupus Erythematosus (SLE)

Testosterone Replacement Therapy

Thalassemia

Thromboembolism

Thyroiditis

Tinnitus

Toxicity

Trans Fatty acids

Transplantation (renal)

Trauma

Triglycerides (lowering)

Tuberculosis (Mycobacteria)

Ulcer (duodenal)

Ulcer (gastric - helicobacter pylori)

Ulcer (pressure)

Ulcerative Colitis

Upper Respiratory Infection (URI)

Uric Acid

Urinary Tract Infection

Urticaria (chronic)

Uveitis

Vaginitis

Vegan / Vegetarian Diet

Ventricular Function

Very Low Birth Weight Infants

Veterinary Medicine

Violence

Vision

Vitamins

Vitiligo

Warts

Warts (genital)

Weight Gain

Wilson Disease

Xerostomia (Dry Mouth)

 

Vitamin A - Hepatoxicity/ Cirrhosis

Hepatoxicity: cirrhosis -vitamin A intake about 400 x 106 IU/d; non-cirrhotic portal hypertension - 150 x 106 IU/d; 20 x 106 IU/d the lowest dose observed to induced liver damage. [Am J Med, April 1995;98(4) 424. 22235 (1995)] Summary Interview

Vitamin B1 - Red cell transketolase

Red cell transketolase is best assessment test. [J Am Coll Nutr, 1988;7(1):61-67. 29204 (1998)] Summary Interview

Vitamin B12 - Aging

Aging - maybe 5 to 10% of elderly individuals may be deficient with neurologic damage, without megaloblastic anemia or a high MCV. [Am J Clin Nutr, 1994;60:2-11. 20547 (1996)] Summary Interview

Vitamin B12 - Methylmalonic acid

Methylmalonic acid elevated in the absence of anemia and macrocytosis may indicate a vitamin B12 deficiency. [Am J Clin Nutr, 1994;60:2-11. 20547 (1996)] Summary Interview

Vitamin B12 - Vitamin B12

Vitamin B12 647 mcg/d or more P.O. normalized biochemical markers of B12 insufficiency (methylmalonic acid) [Arch Intern Med, 2005 May 23;165(10)1167-72. 43594/43599 (3/2006)] Summary Interview

Vitamin B12 - Vitamin B12 - 2

Vitamin B12 deficiency is common in autoimmune thyroid disease. [Am J Med Sci; 2006; 332(3):119-22. 45530 (12/2007)] Summary Interview

Vitamin B12 - Vitamin B12 - 3

Vitamin B12 needs to be supplemented in vegan diet. [J Nutr Med, 1994;4:431-439. 21878] Summary Interview

Vitamin B12 - Vitamin B12 - 4

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

Vitamin B6 - Pyridoxal phosphate

Pyridoxal phosphate and pyridoxal are the best assessments tests. [Biochemical and Metabolic Biology, 1994; 52:10-17. 20478 (1996)] Summary Interview

Vitamin C - Neurologic disorders

Neurologic disorders - 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

Vitamin D - Aging

Aging - deficiency is common in the elderly. Risk factors include lack of sunlight, medications, malabsorption and surgery. Vitamin D deficiency has been associated with bone loss, increased risk of fractures, muscle weakness, pain and impairment of immunologic function. Vitamin D 30 minutes of sunlight 2 to 3 times a week; vitamin D2 100,000 IU every 3 months or vitamin D3 800-1600 I.U./d. [J Am Geriatric Soc, 1995;43: 822-828. 22863 (1996)] [J Am Geriatric Soc, 1995;43: 822-828. 22863 (1996)] Summary Interview PubMed

Vitamin D - Chronic disease

Chronic disease - benefits to blood pressure, bone, cancer prevention, multiple sclerosis, osteoarthritis and other chronic conditions. [Am J Clin Nutr, 1999;69:842-856. 32120 (1999)] [Am J Clin Nutr, 1999;69:842-856. 32120 (1999)] Summary Interview

Vitamin D - Hypovitaminosis D (1)

Hypovitaminosis D is inversely related and more prevalent in diabetes mellitus and carotid atherosclerosis. [Clin Endocrinol (Oxf). 2006 Nov;65(5): 593-597. 45399 (1/2007)] [Clin Endocrinol (Oxf). 2006 Nov;65(5): 593-597. 45399 (1/2007)] Summary Interview PubMed

Vitamin D - Hypovitaminosis D (2)

Hypovitaminosis D is inversely related to heart failure and sudden cardiac dealth in coronary artery disease patients. [J Clin Endocrinol Metab, 2008 August 5; [Epub ahead of print]. 46572 (9/2008)] [J Clin Endocrinol Metab, 2008 August 5; [Epub ahead of print]. 46572 (9/2008)] Summary Interview PubMed

Vitamin D - Hypovitaminosis D (3)

Hypovitaminosis D was found in more than half of the patients on a general medical ward. [NEJM, March 19, 1998;338(12):777-783. 29471 (1998)] [NEJM, March 19, 1998;338(12):777-783. 29471 (1998)] Summary Interview PubMed

Vitamin D - Levels

Levels of 25 hydroxy vitamin D3 below 31 ng/ml are insufficient and below 10 ng/ml are deficient. [J Bone Mineral Res, 2005;20(8):1327-1333. 43486 (8/2005)] Summary Interview

Vitamin D - Supplementation

Supplementation - Everyone should supplement with vitamin D3: 500-600 IU/d for infants, 1000 IU/day for children and 2000 IU/d for adolescents and adults. Vitamin D2 is less effective than vitamin D3 for cancer prevention. Everyone who takes vitamin D supplements should drink 6-8 glasses of fluids per day, and should take care to avoid dehydration and possible risk to kidney stones. [J Steroid Biochem Molec Biol, 2007;103(3-5):708-711. 45265 (2/2008)] Summary Interview

Vitamin D - Supplementation - 2000 IU

Supplementation - 2000 IU of vitamin D3 orally for everyone aged 5 and older, plus 10-15 minutes daily in the sun between 10A.M. and 2 P.M., if skin type permits (easily tan, rarely burn) in the summer season. Sun exposure beyond 15 minutes isn’t usually helpful for vitamin D synthesis, unless heavily pigmented skin. Surface area is important so shorts and, if necessary, a small top are best for exposure. [Am J Prev Med, 2007 Mar;32(3):210-6. 45894 (7/2007)] [Am J Prev Med, 2007 Mar;32(3):210-6. 45894 (7/2007)] Summary Interview

Vitamin D - Supplementation - serum 25

Supplementation - serum 25(OH)D levels between 40-60 ng/ml are the target range. This will require at least 2000 IU/day of vitamin D3, and a few minutes (5-15 minutes) in the sun around noon when season allows. Duration of exposure depends on skin type, but more than 15 minutes is rarely needed. 40% of the skin area should be exposed. A hat with a broad brim should always be worn when spending more than a few minutes in the sun. Sun screens prevent photosynthesis of vitamin D and should be avoided during the first 5-15 minutes of exposure. [J Steroid Biochem Molec Biol, 2007;103(3-5):708-711. 45265 (2/2008)] Summary Interview

Vitamin D - Toxicity (1)

Toxicity is exaggerated. Consuming more than 40,000 IU/day for many months with circulating calcium levels increasing. [J Steroid Biochem Molec Biol, 2007;103(3-5):708-711. 45265 (1/2008)] Summary Interview

Vitamin D - Toxicity (2)

Toxicity is exaggerated. Consuming more than 40,000 IU/day for many months with circulating calcium levels increasing. [Am J Clin Nutr 1999;69:842-856. 32120 (1999)] Summary Interview

Vitamin D- Cancer

Cancer - incidence rates of cancers of the breast, colon and ovary are much lower in sunny places in the world; cancers of the kidney and endometrium are lower in sunny regions; inverse associations of serum 25(OH)D with cancers of the breast and ovary; and a study showing vitamin D levels reduce colon cancer risk. [J Steroid Biochem Molec Biol, 2007;103(3-5):708-711. 45265 (2/2008)] Summary

Vitamin E- Supplementation

Supplementation with alpha-tocopherol decreased cellular gamma-tocopherol, whereas mixed tocopherols (containing mainly gamma) increased both alpha- and gamma-tocopherol in serum and cells. [Am J Clin Nutr, 2006 Jan;83(1):95102. 44155/44447 (2/2006)] Summary Interview PubMed

Vitamin K - bioavailability - 39149

Bioavailability - vitamin K1 from food is approximately two to five fold less bioavailable than vitamin K1 from supplements. [Curr Opin Clin Nutr Metab Care, 2001;4:483-487. 39149 (2002)] Summary Interview PubMed

Vitamin K - deficiency - 36503/23088

Deficiency is common if defined as Gla-content of the bone protein osteocalcin being below normal. [Ann Rev Nutr, 1995;15:1-22. 36503/23088 (1995)] Summary Interview PubMed

Vitamin K - half-life - 39149

Half-life of vitamin K2 in plasma is significantly longer than K1, allowing for longer availability to extrahepatic tissues, like bone, than vitamin K1. [Curr Opin Clin Nutr Metab Care, 2001;4:483-487. 39149 (2002)] Summary Interview PubMed

Vitamin K - osteocalcin - 36503/23088

Functions as a cofactor in formation of Gla-residues in 3 bone proteins: osteocalcin, matrix Gla-protein and protein S synthesized by bone forming osteoblasts. These three Gla-proteins increase the calcium-binding capacity of the organic matrix of the bone. Vitamin K may stimulate osteoblast differentiation and reduce osteoclast activity (bone resorption). [Curr Opin Clin Nutr Metab Care, 2001;4:483-487. 39149 (2002)][Ann Rev Nutr, 1995;15:1-22. 36503/23088 (1995)] [Curr Opin Clin Nutr Metab Care, 2001;4:483-487. 39149 (2002)][Ann Rev Nutr, 1995;15:1-22. 36503/23088 (1995)] Summary Interview PubMed

Vitamin K - Synthesis

Synthesis - Vitamin K1 is synthesized by plants, vitamin K2 is produced by bacteria. [Curr Opin Clin Nutr Metab Care, 2001;4:483-487. 39149 (2002)] Summary Interview PubMed

Vitamin K - Undercaboxylated osteocalcin

Undercaboxylated osteocalcin - vitamin K assessment. [Maturitas, 2002 Mar 25;41(3):211-21. 43720 (12/2005)] Summary Interview PubMed

Vitammin D - Levels (optimal)

Levels (optimal) - 25 hydroxy vitamin D3 20 ng/ml deficient; 40 ng/ml sufficient; and 60 ng/ml optimal [Am J Prev Med, 2007 Mar;32(3):210-6. 45061/45894 (7/2007)] [Am J Prev Med, 2007 Mar;32(3):210-6. 45061/45894 (7/2007)] Summary Interview

Vitiligo - folic acid, vitamin b12 - 29529

Vitamin B12 (cyanocobalamin) 1 mg and folic acid 5 mg in tablets b.i.d. for three months. [Acta Derm Venereol (Stockh) 1997;77:460-462. 29529 (1999)] Summary Interview PubMed

Vitiligo - zinc - 50314

Zinc in two 220-mg zinc sulfate (100 mg elemental zinc in the two capsules) capsules per day for teenagers and adults, and 10 mg/kg of body weight from elemental zinc in the form of zinc sulfate syrup (10 mg elemental zinc / 5 cc of syrup) for children with topical corticosteroids. [Indian J Dermatol, 2011 Sep-Oct;56(5):480–484. 50314 (5/2014)] Interview PubMed

Vitramin D - Insufficiency elderly

Insufficiency is common, especially in the elderly, due to lack of food sources and poor sun exposure. [Am J Clin Nutr 1999;69:842-856. 32120 (1999)] [Am J Clin Nutr 1999;69:842-856. 32120 (1999)] Summary Interview PubMed

Warts - zinc - 40123

Zinc 10 mg/kg up to 600 mg/d as zinc sulphate (150 mg elemental zinc) in three divided doses. [Br J Dermatol, 2002;146:423-431. 40123 (2003)] Summary Interview PubMed

Weight Gain - catechins - 42642

Catechins 690 mg in 1 bottle/d oolong tea (from green tea extract).
[Am J Clin Nutr, 2005;81:122-129. 42642 (04/2005)] Summary Interview PubMed

Weight Gain - creatine - 32700

Creatine 20 g/d loading dose x 5 days then 2-5 gm/d (questionable benefit for ‘sprinting' exercises).  
[Clin J Sports Med 1998;8(4):286-297. 32700 (1999)] Summary Interview

Weight Gain - probiotics - 50091

Enterococcus faecium IS-27526, a novel probiotic isolated from dadih, an Indonesian traditional fermented buffalo milk, at 108 cfu/day in freeze dried form taken with 125 ml Ultra High Temperature low fat milk (UHT) as carrier which activated the freeze dried EFIS, allowing it to stand for 30 minutes prior to consumption to activate the dormant EFIS in freeze dried form, in a single dose, had significant positive effects on humoral immune response, salivary sIgA, in underweight pre-school children, and on weight gain of pre-school children.
[Anaerobe, 2011 Dec;17(6):496-500. Epub 2011 Jul 5. 50091 (6/2012)] Interview PubMed

Weight Gain - whole grain - 42315

Whole grain consumption was inversely correlated with weight gain. If men increased their intake of whole grains by 40 gm/d (amount in 1 cup brown rice), they would gain 1 kg LESS weight than their counterparts over time. 
[Am J Clin Nutr, 2004;80:1237-1245. 42315 (01/2005)] Summary Interview PubMed

Wilson’s Disease - ceruloplasm - 20382

Ceruloplasm is a guide. It affects the index of suspicion when it is low, which is about 90% of the time. About 10% of patients have a normal ceruloplasmin and about 10% of carriers of the gene have a low ceruloplasmin, even though they will never be ill. It is not diagnostic. [Arch Neurolology June 1994;51:545-554. 20382 (1996)] 1996 Summary Interview PubMed

Wilson’s Disease - copper - 20382

24 hr urine copper is best assessment; > 100 mcg/ 24 hours in a well-performed test is virtually diagnostic of Wilson's disease. The "gold standard" for diagnosis is the quantitative copper in a liver biopsy. [Arch Neurolology, June 1994;51:545-554. 20382 (1996)]

Wilson’s Disease - copper, zinc - 20382

Urinary copper and zinc (24 hr collection) for follow-up/monitoring of therapy every 6 months. [Arch Neurology, June 1994;51:545-554. 20382 (1996)] Summary Interview PubMed

Wilson’s Disease - tetrathiomolybdate - 20382

Tetrathiomolybdate 20 mg t.i.d. with meals and 20 mg t.i.d between meals. Treat for 8 weeks and then switch to zinc acetate maintenance therapy (used for neurologic symptoms and acutely ill patients). [Arch Neurology, June 1994;51:545-554. 20382 (1996)] Summary Interview PubMed

Wilson’s Disease - zinc acetate - 20382

Zinc acetate -150 mg/d of elemental zinc in 3 divided doses 1 hour away from meals. For young patients use 25 mg, 3 times a day (used for chronically ill patients). [Arch Neurology, June 1994;51:545-554. 20382 (1996)] Summary Interview PubMed

Xerostomia (Dry Mouth) - green tea, catechins, polyphenols, MighTeaFlow® - 50968

Green tea catechins in the form of lozenges (MighTeaFlow® ~ 12.5 mg each) up to one every 4 hours significantly increased unstimulated and stimulated saliva output compared to baseline and partially restored salivary function in patients with xerostomia. [Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Oct;118(4):447-454. 50968 (11/2015)] Interview PubMed
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