By Dr. Reuben Dinsmore BScH, ND–
Natural supplements, or nutraceuticals, have been given a bad rap lately, which, in some cases, has been absolutely warranted. But natural formulas that actually contain what they claim to contain, and that are formulated to have maximal efficacy can be equal to their pharmaceutical counterparts—but without the laundry list of side effects.
Caution: many natural supplements can interact with prescription medications in various ways. Some supplements can reduce the effectiveness of drugs, and some can actually increase the effectiveness of a medication. Although this might sound like a positive thing, your dose has been carefully selected by your doctor to maintain a certain therapeutic level in the body—a higher level can be harmful. If you are currently taking any prescribed medications, please speak to a health care practitioner who is well-trained in the safety and use of supplements and medications before starting any supplements.
- Statins (the class of drugs prescribed to lower cholesterol) accounted for 3.8 per cent of all money spent on prescription drugs in Canada in 2013. High cholesterol is blamed for heart attacks and strokes via formation of arterial plaques. But the real culprit is inflammation, without which the plaques wouldn’t form in the first place. Bottom line—you can lower cholesterol all you want, but as long as there is inflammation present, plaques can still form.
Some common side effects of statins: muscle pain, cognitive impairment, sexual dysfunction, and increased risk of cancer and diabetes.
Nutraceutricals: Omega-3 fatty acids (best are fish oils from wild-caught sources) and curcumin (the active component in turmeric) are two excellent supplements to lower inflammation. Garlic extracts have been proven to improve cholesterol levels. As well, red rice yeast extract is the natural compound statins were derived from, and works in a similar manner; however, it has been suggested that because of this, some of the same side effects may be seen.
- Five million Canadians suffer from heartburn symptoms weekly. Prescriptions for the acid-blocking drugs PPIs (proton pump inhibitors) accounted for $24 million in BC alone in 2013. Risks of taking these mostly involve nutrient deficiencies from poor absorption due to low stomach acid (see the problem here?) such as bone fractures from poor calcium absorption or anemia from decreased levels of B12 or iron. B12 deficiency can also cause dementia and neurological damage. There has also been a correlation shown between PPI use and C. difficile infection, which causes life-threatening diarrhea; recent research also indicates an increased risk of dementia from long-term PPI use.
Nutraceuticals: long story short, most people don’t have too much stomach acid. The problem is the acid they have is getting into the wrong place (the lower esophagus) where it burns. This can be due to the muscle between the esophagus and the stomach not closing properly, either from poor tone or insufficient stomach acid (which signals the sphincter to close). Limonene – an extract from citrus peel – helps strengthen this muscle and at the same time promotes movement of food downward to the stomach and beyond. DGL – an extract from licorice root – stimulates mucus production in the GI tract, which acts to coat and protect the sensitive lining of the esophagus. And apple cider vinegar is wonderful for increasing stomach acid to healthy levels.
- SSRIs (selective serotonin re-uptake inhibitors) are the most common class of anti-depressant drugs. One in twelve Canadians will experience major depression in their lifetime, but it’s still one of the most poorly understood conditions. Standard treatment protocols typically target neurotransmitter activity (most commonly serotonin). However, new research indicates the underlying cause may actually be inflammation. Either way, natural medicine has you covered.
Nutraceuticals: 5-HTP is used to make serotonin, with the help of vitamin B6. The herb St. John’s Wort has been studied extensively and appears to work in the same way as SSRIs. Both 5-HTP and St. John’s Wort have shown similar efficacy to SSRIs when given for mild to moderate depression. And as I mentioned earlier, omega-3 fatty acids and curcumin decrease inflammation throughout the body, including the brain.
Side effects of SSRIs include sexual dysfunction, weight gain, and worsened/chronic depression. However, St. John’s Wort also has a side effect which should be considered– it affects liver function, which can result in either higher or lower blood medication levels, and for this reason should not be taken with certain pharmaceuticals.
- Hypertension (aka high blood pressure) affects six million Canadians, and is responsible for approximately 13 per cent of all deaths. Various classes of anti-hypertensives include diuretics, ACE inhibitors, and angiotensin II receptor blockers (ARBs). Diuretics increase urine output, which can negatively affect sodium and potassium levels, which can cause muscle cramps. ACEIs and ARBs may both cause a chronic dry cough. All anti-hypertensives can cause dizziness, headache, and low blood pressure.
Nutraceuticals – CoQ10, magnesium, garlic extracts, omega-3 fatty acids, L-arginine, and vitamin C have all been shown to lower high blood pressure by various means. Dandelion leaf is an effective diuretic that doesn’t lower potassium levels.
- Benzodiazepines are a class of drugs most often prescribed for anxiety disorders and insomnia. They work by binding to receptors for GABA, a neurotransmitter in the brain that calms activity of the nervous system. Interestingly, this is the same mechanism by which alcohol acts in the brain. One obvious effect of benzos is sedation – great when the treatment target is insomnia. Not so great when you just want to decrease your anxiety but still function. Other side effects include dizziness, loss of balance, and even cognitive impairment at higher doses. They also have a significant risk of developing physical or psychological dependence, and rebound anxiety when discontinued.
Nutraceuticals – you can take GABA itself (but there’s mixed evidence on whether or not it actually gets into the brain), or herbs such as passionflower (same mechanism of action as benzos), valerian, chamomile, kava—the list goes on. Niacinamide (the non-flushing form of vitamin B3) has been shown to have a similar effect as a benzodiazepine at higher doses.
So now you think you’re ready to ditch all your pharmaceuticals and go natural? Not so fast—the examples used above are by no means the only supplements that have been used effectively for these conditions, and equally as important are diet, exercise, sleep habits, relaxation techniques, and other lifestyle factors.
One final thing to remember: it often takes years for a health condition to reach the point where people finally decide to do something about it. If a condition is severe, or it has advanced to the point where it poses a serious risk of mortality, supplements and lifestyle changes should not be relied on alone. Certain pharmaceuticals can be used on a short-term basis along with the suggestions discussed above, with the understanding that they will be discontinued at the appropriate time and with your doctor’s guidance. The next step: sit down with a naturopathic doctor and work together to develop a personalized approach that takes all your health concerns into consideration.
Dr. Reuben Dinsmore is a naturopathic doctor practicing in Yaletown Naturopathic Clinic, Vancouver, BC. He practises patient-focused functional medicine by incorporating the best of natural health and conventional medicine. His passion is helping patients with issues around stress, sleep, and mood disorders, helping them return to a state of balance and peace.