Abnormalities in the bacteria in the gut has now been linked to obesity, high triglycerides and low HDL (good cholesterol). Since lipid lowering medications and antibiotics can affect the  gut microbiome, patients on these types of medications were excluded from this study. Using new sequencing technology, the researchers found that healthy lipid levels were associated with increased microbial diversity, and 34 microbial taxonomies associated with BMI and blood lipids were identified. Since the microbiome is affected by diet and drugs,  an individual’s microbiome may modulate diet and drug pharmacokinetics and as such is considered a key element in designing personalized medicine and precision medicine.

More research needs to be done, but it is clear to me, from reading multiple articles from varied sources that this will play an important role in our health in the future.

I am recommending probiotics for everyone but we should be aware that not all probiotics are equal and there are no standard formulations.


Berberine supplements are promoted for lowering blood sugar, blood pressure and cholesterol. They are found in BARBERRY< OREGON GRAPES< and GOLDENSEAL.

Multiple small medical studies have shown a decrease in glucose and cholesterol after using for 3 months. There was one study that actually found it to be as good as METFORMIN, the most commonly prescribed diabetes drug in the world. Other studies showed mild weight loss, probably secondary to increasing insulin sensitivity.

Before you jump on the bandwagon, more studies need to be done. There are also some safety issues. It could cause liver problem and should not be used by pregnant women.

Also, if taken with prescription medications, there could be an unsafe drop in blood sugar as well as blood pressure. Berberine can interact with many common drugs (Lovastatin, Viagra, Halcion, Paxil, Tramadol, Effexor, Zofran, Codeine, Advil, Celebrex,  Dextromethorphan and others) causing an increased risk of side effects.

If this is a supplement that you want to try, please discuss this with us before you go out and buy it.



Indoor and outdoor pollutants can lead to acute respiratory infections, heart disease and skin problems. It is thought that pollutants compromise the immune system, which is further compromised if you have deficiencies of certain micronutrients.

From a scientific point of view, this is what occurs: Airborne pollution leads to increased pulmonary intake of reactive oxygen species (ROS). When we inhale, particulate matter (PM) enters the respiratory (lung) system, causing coughing and sneezing. The finest particulate matter, PM2.5, travels all the way to the alveoli and causes local and systematic harm, including increased oxidative stress and increased inflammation. In addition, there is evidence of specific mechanisms whereby PM2.5, traffic-related or combustion-related air pollution exposure can affect the cardiovascular system.

Micronutrient intake is important with regard to the sensitivity of an individual to air pollution ; it affects the composition and quantity of antioxidants in the respiratory tract lining fluid (RTLF) of the lungs. The older you are, the more likely it is that you could have a micronutrient deficiency, which is probably the reason elderly people are 2-10 times more likely to die of an infection than younger people.



Vitamin A is important for innate, cell-mediated immunity and antibody response. Retinoic acid in particular imprints protective T-cells and B-cells into intestinal tissues.

Vitamin D, in the active form of 1,25(OH)2D3, is a potent immunomodulator. In addition, it enhances innate immunity by increasing the differentiation of monocytes into macrophages.

Vitamin E is a key, fat-soluble antioxidant capable of protecting cell membranes from oxidative damage. It also enhances T-cell-mediated functions. Vitamin E is an integral component of the alveolar surface of the lung and directly affects lung function.

Vitamin C is a key, water-soluble antioxidant which helps maintain the redox balance inside cells. It also helps regenerate vitamin E as well as stimulating the transit of neutrophils and monocytes. Vitamin C is particularly important inside the lungs to help counter the presence of inhaled oxidative substances.

Vitamins B6, B12, and folic acid modulate immune function by means of nucleic acid and protein biosynthesis.

Selenium has an important role in redox regulation via glutathione peroxidases by removing excess ROS. Zinc, iron, and copper are critical components of enzymes which are required for the correct functioning of immune cells.


Intracellular micronutrients can be tested by a simple blood test that we draw in the office. If you would like to be checked, call our office. 941-747-2090




A recent study looked at eye pressure in glaucoma patients using glucosamine supplements. They discovered that eye pressure went up when taking glucosamine and dropped back down when it was stopped.

There are also many medications that should be avoided in glaucoma patients. If you are taking glucosamine for arthritis and have glaucoma, you might want to discuss this with your eye doctor.



University of Minnesota Medical School


Alzheimer’s disease was first discovered in 1907. The disease is caused by a build-up of beta-amyloid and intercellular hyperphosphorylated tau strands in the brain. This then leads to progressive cognitive impairment and ultimately, death. Currently there are no effective ways to prevent or effectively treat this type of dementia. (Mild cognitive impairment (MCI) is common in people aged over 60 years, but only 12-15% of the sufferers of this condition will progress to full blown Alzheimer’s disease.)

There is now some evidence that nutrients could play a role in delaying the onset of cognitive decline. Higher intakes of vitamins and minerals, consumed as foods or supplements, are associated with lower risk of developing cognitive deficits, while blood serum levels for folic acid, vitamin A, B6, vitamin B12, C, E, D, K, thiamine, β-carotene & DHA tend to be lower in Alzheimer’s patients. Anti-oxidant activity of these nutrients is likely to play a role and it has been shown that vitamin E levels are 75% below the recommended levels in the USA and UK. There have been several studies looking at Vitamin E over the years, and it looks like it might be able to delay the onset of Alzheimer’s by 7 months.

What’s interesting is that the benefit was only seen in patients taking Vitamin E in the absence of existing prescription drug therapies.

It should be noted that high doses of vitamin E may be associated with an increased risk of heart disease and prostate cancer.

More studies are obviously needed.


There are NO medications that work great for nerve pain. The most common ones, like CYMBALTA, NEURONTIN and LYRICA offer some relief to some people but results are very variable. Narcotics are commonly used but normally just cause addiction and constipation. Physical therapy and exercise can also be beneficial but once again there are many patients that do not get relief.

Because of the relative ineffectiveness of conventional therapy, many people look into supplements. The ones that have been studied the most include FISH OIL (anti-inflammatory benefits), CURCUMIN (also anti-inflammatory properties). ALA (alpha lipoic acid) and GLA (gamma-linolenic acid ) are 2 supplements that have been studied that has shown mild success when compared to placebo.

Be aware that supplements are often no better than prescriptions, and because they are not FDA approved, you may not be aware exactly what you are getting.


Probiotics are very popular, not only in patients who have GI problems, but they have also have been found to help prevent inflammation and heart disease as well as possibly improving mood and stress.

A lot of people try to avoid gluten (wheat, rye, and barley) if they are allergic to gluten but many people, especially athletes find they just feel better when going  gluten free even though they have no sensitivities to it.

A new report states that gluten is found in as many as 50% OF ALL PROBIOTICS-so gluten free may be meaningless when choosing a probiotic –and could potentially make celiac disease worse.

Yes, I do believe that probiotics can be a great supplement for everyone (refer to my recent blog about the “MICROBIOME”). The only problem is that there are so many choices and we really don’t have any standardizations. So once again, it’s buyer beware.



Ann Rheum Dis doi:10.1136

Although many patients use glucosamine/chondroitin products for joint pains, there have been very few studies in the medical journals supporting its use….until now. This study, which took place in Europe from the University of Maryland, compares glucosamine/chondroitin to Celebrex in patients for 6 months. The results showed no difference in pain relief, stiffness or joint swelling in 80% of all patients.

This is an interesting finding since Celebrex is not a heart healthy medication and can be associated with bleeding ulcers and kidney disease.

I am not aware of any side effects from using glucosamine/chondroitin products.

When using glucosamine products, please try them for at least 2 months. Also, not all patients will respond to these supplements.



Researchers at Cornell University have been able to reduce blood sugar in rats by using probiotics. (Probiotics are the “good bacteria” they help keep your gut healthy). They discovered that certain strains of lactobacillus secrete Glucagon-like peptide 1 (GLP-1), a hormone that releases insulin in response to food. After 90 days on the probiotics, the rats showed a 30% decrease in sugar when compared to the control group. The theory behind this is that the probiotic was able to convert the rat’s upper intestinal lining to cells that worked like the beta cells in the pancreas (which secretes insulin). Although this study needs more research, it is nice to know that new and creative ways to treat diabetes are on the horizon.

Anxiety and probiotics

Probiotics contain helpful bacteria and assists in the balancing of microorganisms in the human body. In the past, I have written about the benefits of probiotics in helping gas, bloating and diarrhea, as well as potentially preventing  heart disease and lowering cholesterol. It is known that chronic GI disorders are associated with anxiety and depression. There was a study a few years back in mice which showed that chemically induced inflammation in the bowel increased anxiety and when given probiotics, the anxiety decreased. There was a human study in Canada that showed improvements in anxiety, anger and depression as well as lowering the stress hormone cortisol in people who took probiotics for 30 days after breakfast. It is interesting that prebiotics (complex sugars to promote the growth of probiotic bacteria) may lower cortisol levels but have no effect on stress.

There are many different probiotic brands available without a prescription. The ones I recommend the most are VSL3, Align and Florastor although there are many others that will work as well.

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