David S. Parnas, M.D. 203-849-1222

STARTERS: As a "basic minimum" every adult is recommended to take a multi-vitamin every morning with breakfast plus a "balanced" anti-oxidant supplement such as CVS brand PROVITE with food (one cap/day for non-smokers only; smokers consult Dr. Parnas or a skilled practitioner). Please also note that vitamins A, D. E, & K absorb only with fats in the food you eat.

ANTI-OXIDANTS:(every body needs for heart, vision & stroke protection, "nice skin" etc.)

VITAMIN-C: is taught to every doctor in medical school as the cure for scurvy (a disease where all the body's scars and wounds reopen. Was first described in sailors away at sea for long periods without fresh fruit or vegetables). It's ability to interact with vitamin-E and maintain or restore that vitamin's ability to act as an antioxidant may be it's most significant other contribution to overall health. Highly soluble in water it is "pee'd" out at a rapid rate so replenishment several times a day is necessary in @ 250 mg doses. Overdose can over time increase risk of kidney stones or gout in certain individuals. Also has been shown to "clog" arteries at high dodes but "unglog" at more moderate doses (see Cardiovascular Health for more detailed explanantion). Deficiency is also now shown to be associated with gall stone formation (4/00).

: the VITAMIN-E is the principal antioxidant in our diets. Not yet absolutely proven ability to reverse cardio- vascular disease morbidity but recommended by Dr. Parnas at doses in the 400 iu per day range. Doses of 800 iu and higher have been shown to sometimes have paradoxical pro-oxidant activity and cause cholesterol to form blockages in arteries as well as liver damage and [skin] dermatitis. Synthetic forms (ex: d,l-tocopherol) contain several inactive forms of the anti-oxidant and 2 forms [alpha- & gamma-] that are beneficial but not found in significant quantity in most fruits or vegetables. Vitamin-E has been shown to reduce development of prostate cancer. The Vitamin-E ACETATE form may help reduce progression of certain breast cancers (as opposed to Vitamin-E SUCCINATE that may increase those same breast cancer types.). There is evidence it may also reduce some menopausal symptoms, fibrocystic breast pain and esp. Alzheimer's disease (senile dementia). The latter, in a study published in the New England Journal of Medicine, suggested higher doses be used in the elderly and should be discussed with a physician familiar with the studies and the biochemistry of anti-oxidant vitamins to avoid potential toxicity. Has been seen to interfere with anticoagulants ("blood thinners") so consult your doctor for a safe doses if using Coumadin, Persantine, Plavix, aspirin.

VITAMIN-A: includes the carotenoids which are a group of related antioxidant substances associated with health of mucous membranes, joint linings, skin and the gut. Some are not soluble in water so overdoses will tend to "stick around" in your liver esp. and early overdose. problems include hair loss, and bad skin rashes. Studies released in 01/02 suggest risk of aggravated bone loss, esp. in women using the higher ranges of "otherwise safe doses". For the insoluble forms max safe doses are estimated below in international units per day:

ZINC: synergistic antioxidant metallic trace element that works with others above, @ 15 mg/day is good. Has also been demonstrated in at least one conducted study to help with sore throats due to bacterial infection but not with "cold" or "flu". For this purpose dose is @ 50 mg in lozenge form every 2-3 hours up to 3 days maximum. Excessive use leads to skin rash and other metal toxicity symptoms.

SELENIUM: another metalic trace element that aids those above as antioxidant; need no more than 200 mcg/day. Beware of selenium in the form of a complex with methionine- this is a potentially dangerous compound that is metabolized to homocysteine (see cardiovascular risks on Healthy Guidelines page)

ALPHA LIPOIC ACID: is especially important as an anti-oxidant that keeps skin appearing youthful and protects intracellular mitochondria (where we make our "energy") so is an "anti-aging" nutrient. Best taken @ 25 mg/day

PYCNOGENOL: sourced from the bark of one species of pine tree it is classed with bioflavinoids and other misc. anti-oxidants seems to confer added benefit to cardiovascular health.

THE B VITAMINS: use only in the AM to avoid insomnia- these are high "energy" . Take w/ food. In the absence of definitive pathology a good choice is B-100 complex, one/day.

PANTOTHENIC ACID (B-5 or Pantanthanate): helps generate "energy" in the mitochodria of each cell in your body. Also important in conversion of thyroid hormone to it's "active" form in each cell and in permitting synthesis of adrenal & steroid hormones used for immune system, sex, energy plus neurotransmitters for your brain/nervous system.

BIOTIN: An essential for hair, skin & nails. Normally 150mcg/day but is safe in doses up to 2-3 mg/day if needed for treatment of specific conditions as discussed with a knowledgable health professional.

B-6: reputed to relieve carpal tunnel syndrome which it may help by causing diuresis (makes you "pee" more) and so reduces swelling if there is any present. For this reason may also be helpful in PMS. Doses of @ 150-600 are used for this purpose though it is warned that some people develop "tingly" nerves and lose sensation in hands & feet above doses of 150 mg/day. Unknown if lasting nerve damageresults in some but documented cases all seem to have total recovery. Please discuss with your doctor before try.

B-12: used to synthesize new red blood cells and only available from animal source foods or supplements. Also "gives you energy". Stored in body long term and only tiny doses needed in daily nutrition except to help defeat certain disease states such as high homocysteine (see cardiovascular risks on Healthy Guidelines page)or pernicious anemia. Dietary absorption may be reduced in those with reduced "stomach acid" or taking certain "anti acid" medications.

FOLATE (Folic Acid) now required by law as supplement in all flour and baked goods in the U.S. (as of Jan 1, 1998) that was publicised as a step to reduce by (several hundred a year) neural tube (spinal) defects in newborns but was projected by the NIH to also reduce heart attack and stroke deaths by about 310,000 over a 10 year period by diminishing homocysteine levels (with vitamins B-12 & B-6, see Healthy Guidelines page)

TRACE MINERALS:

also include zinc & selenium, above, plus others

CHROMIUM: much talked about catalyst for sugar & insulin utilization by the body. Note that chromium is carcinogenic and that there are also reports of kidney failure from doses of 400 mcg/day and up. Safe dose prob less than 200/day and best used shortly before major exercise. Benfits only really proven in diabetic men thus far. Some consider as an "anti-aging" agent but if it gives you cancer it would also be "anti-longevity". An excellent "safe source" is from yeast. (Consider two spoonfuls of Brewer's yeast in a "health shake" with vitamin rich vegetable juices as an adjunct to your diet hard to go wrong with).

MAGNESIUM: (as of 11/99) has been shown to improve sugar/insulin utilization in 2 large study of urban, (non and) diabetic black males. Also used in conversion of thyroid hormone to it's active form and needed for deposition of calcium into bone (see "OF INTEREST TO WOMEN" page). Too much magnesium results in diarrhea and muscle soreness/stiffness. Magnesium and esp. Magnesium Taurate have been found helpful for migraine headaches & depression in some patients.

CALCIUM: Healthy young adults require 1,000 mg/day plus vitamin-D, magnesium. etc. for good bone health, more during prenancy. See our page "Of Interest to Women" for age related and other details.

OMEGA-3 OILS AND FREE FATTY ACIDS

Are touted for cholesterol lowering, anti-arthritic, menopausal symptom altering & a variety of other purposes. They are all strongly oxidating and shouldn't be used without anti-oxidant vitamins to "balance" them. Although they may all be helpful in some of the above problems we recommend fish oil (micro-distilled to remove mercury and other toxins from the sea) or less so Flax seed oil (for persons who cannot tolerate fish oil but your body has to convert this several steps biochemically and has only limited enzymes to accomplish that so most is wasted or stored as fat). These are best taken at the beginning of each day's largest meal. WE DO NOT RECOMMEND evening primrose and black currant oils which contain some pro-inflammatory Omega-6 fatty acids so are like taking a step back for each 2 forward. Borrage oil apparently contains a carcinogenic chemical so we also do not recommend that one.

ECCHINACEA, GOLDENSEAL and ASTRALAGUS are useful herbal medications to be taken 3-4 times daily on the first three days of an infection or cold. More frequent use my result in Lupus or Asthma just as use at "critical times of year" may increase sensitivity to springtime pollen or autumn hayfever & mold allergens.

GINSENG: is a pleasant and apparently safe stimulant that doesn't appear to raise blood pressure or give many people insomnia or "jitters". It takes about 6 weeks of regular use before most people feel an effect and in ancient Chinese medicine was recommended primarily to men.

GINKO BILOBA: has a reputation for increased blood flow and mental function for persons over 65 years of age. The observations from small early studies that suggested those conclusions have not been duplicated in the newer larger studies so based on the scientific research Dr. Parnas cannot now recommend this herbal product to anyone. Also seen to interfere with anti-coagulant medicines ("blood thinners") sometimes dangerously.

GINGER: good for calming the tummy, may have additional uses in certain types of arthritis. "Warms up" the body in higher doses, beware.

SAM-e: though may provide relief of osteoarthritic pain also probably will increase risk of stroke and heart attack by increasing homocysteine levels so not recommended.

Dr. Parnas & his family mostly prefer Thorne Research brand Vitamins: http:/www.thorne.com

We strongly endorse THE PROFESSIONAL PHARMACY with branches in Norwalk (203-866-3372) and Greenwich as a source for vitamins and supplents. They also deliver or ship directly to you. Additionally they have a special service supplying (standard or "customized") first aid, medical and related safety/emergency kits for factories and offices and a subdivision that specializes in marine/air service for boats, ships and planes. Physician consultations are available with practitioners in Greenwich, Norwalk & Westport for prescription items, or more complex issues including foreign travel, etc.

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