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MINERALS

BORON (2-3 MG/DAY)

Boron is very helpful at improving bone strength—especially when combined with adequate magnesium. It may also help cognitive function. One researcher/professor gave half his class boron and the other half placebo for the semester, and the boron group did much better!

CHROMIUM (200-500 MCG/DAY)

Chromium (and glutathione) is critical for proper insulin function and preventing diabetes and it can also decrease many of the symptoms of hypoglycemia. It can even be useful in treating some cases of depression, particularly when carbohydrate craving is a prominent symptom. A study of 113 people found that chromium supplements reduced depression-related cravings for sweets and starches, and provided an overall general improvement in depressive symptoms.

Some physicians feel that it also helps cause weight loss.

COPPER (500 MCG)

Copper is a “double-edged sword.” Although critical for antioxidant production (such as SOD—superoxide dismutase, one of the body’s natural free-radical scavengers that reduce pain and inflammation) it also is a potent free radical trigger and is quite toxic in excess. For example, one study showed that men in the highest 25% of serum copper values were 50% more likely to die during the study when compared to subjects in the lowest quartile. To strike an optimal balance, I recommend ½ mg/day of copper.

IODINE (150-250 MCG/DAY)

Optimal iodine levels are critical for both healthy thyroid and breast tissue function. Iodine deficiency with secondary goiters used to be endemic in the U.S. until wheat flour, and to a lesser degree salt, had iodine added to them. This eliminated much of the problem until flour makers started adding bromine instead of iodine. This not only resulted in iodine intakes dropping by as much as half in the last decade but the switch can worsen the effects of iodine deficiency, as bromine may block thyroid function.

One of the main problems caused by iodine deficiency is hypothyroidism—which can cause a host of problems. These include not only fatigue, weight gain, and pain, but also infertility and miscarriages. Low maternal iodine may cause hyperactivity disorder with a loss of 18 points in IQ score in their children.

Iodine deficiency is also a common trigger for breast tenderness and fibrocystic breast disease, and I routinely supplement women who have these with iodine. It has even been suggested that seaweed, which is high in iodine, may lower breast cancer risk.118

In fact, one of the upcoming studies planned by our foundation will be to check iodine, bromine and fluorine levels (all related chemical “halides” which compete with one another) in tissue samples of women with breast cancer, fibrocystic breast disease, and healthy breasts. We suspect that low iodine, or excessive levels of bromides and fluorides which may inhibit iodine, are factors that unnecessarily increase breast cancer risk.

LITHIUM

The neurological effect of the lithium ion Li+ makes some lithium salts useful as a class of mood stabilizing drugs, mostly for bipolar disorder. Therapeutically useful amounts of lithium (about 0.6 to 1.2 mmol/l) are only slightly lower than toxic amounts (>1.5 mmol/l), so the blood levels of lithium must be carefully monitored during treatment to avoid toxicity.

An important point that is often ignored is that at much lower doses, lithium is actually an important and natural nutrient. It helps protect brain function against injury from neurotoxins, improves mood, decreases aggressiveness and even has anti-viral properties. It is usually left out of multi-vitamins because of confusion between its use as a nutrient at a very low dose (5-10 mg a day) and its use as a medication with significant side effects at 30-90 mg (300-900 mg of lithium carbonate) daily.

MAGNESIUM (200 MG)

Magnesium is involved in hundreds of different body functions but is routinely low in the American diet as a result of food processing. The average American diet supplies less than 300 milligrams of magnesium per day, while the average Asian diet supplies over 600 milligrams per day. I generally recommend taking 1,800 milligrams of malic acid and 200-450 milligrams of magnesium glycinate a day for eight months and then cutting back to 200 mg. If diarrhea and cramps are not a problem, you can take up to twice this amount. If your magnesium level is low, your muscles will stay in spasm and your fibromyalgia will not resolve. This is one of the reasons that taking magnesium is so critical. In addition, magnesium is important for the muscles’ and body’s strength and energy. Most of your magnesium is inside your cells and the blood test only measures the magnesium in your blood—making blood tests an unreliable measure. I suspect that magnesium has trouble getting into the cells in people with CFS/FMS. When CFS/FMS is properly treated, the magnesium may then be better able to get inside the cells. The cells then soak it in like a thirsty sponge and your blood level may even drop—despite taking large amounts of oral and even intravenous magnesium. So keep in mind that magnesium blood tests do not drop below normal until severe magnesium depletion occurs and everyone with CFS/FMS, fatigue, or muscle achiness should take magnesium. An exception is if you have kidney failure with a blood creatinine level over 1.6 milligrams per deciliter (mg/dL)—very rare in CFS/FMS (I’ve never seen this in a CFS patient). If you get uncomfortable diarrhea from the magnesium, cut the dosage back and then slowly increase the dose as is comfortable.

Magnesium absorption is very difficult, which is why I like to use the glycinate forms. Let’s discuss some of the key functions of magnesium.

For starters, magnesium is simply critical for life. For example, 1 study showed that subjects who were in the highest 25% of serum magnesium values had a 40% decreased risk of dying during the study (with a 40% decrease in cardiovascular mortality and a 50% decrease in cancer deaths), compared to subjects whose magnesium levels were in the lowest 25% of the population!

Magnesium helps build bones, regulate body temperature, produce proteins and release energy stored in muscles. Because of the latter, magnesium deficiency causes muscle spasm/shortening, contributing markedly to fibromyalgia, migraine headaches, and other pains. In addition to magnesium deficiencies role in pain, it also likely contributes to the brain fog. A study by the Massachusetts Institute of Technology researchers found that magnesium helps regulate a key brain receptor that plays an important role in learning and memory. The finding indicates that magnesium deficiency may result in a reduced ability to learn and memorize, while a cognitive function may be improved by an abundance of magnesium.Magnesium:

  • Helps protect against osteoporosis.
  • Is associated with decreased inflammation levels (CRP-C Reactive Protein). offering further heart protection.
  • Is associated with a 23% lower risk of colon cancer.132
  • Improves asthma.
  • Decreases the frequency of migraine headaches. In fact, the quickest and most effective way to eliminate a migraine headache is by giving 2 grams of magnesium IV over 5-10 minutes.
  • Helps children with hyperactivity and attention deficit disorder when combined with vitamin B6.

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Magnesium is critical in over 300 reactions in our body, yet around half of the magnesium in our food is lost during processing — resulting in magnesium deficiency being largely universal in the Western world. Even having a little more magnesium in the water supply has been shown to significantly decrease the risk of heart attack deaths. Meanwhile, magnesium causes tight muscles to relax, improves heart function, improves sleep, and increases energy.

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MANGANESE (2-4 MG)

Manganese is an essential trace nutrient in all forms of life.

Most organisms living in the presence of oxygen use it to deal with the toxic effects of superoxide. The human body contains about 10 mg of manganese, which is stored mainly in the liver and kidneys. The classes of enzymes that have manganese cofactors include oxidoreductases, transferases, hydrolases, lyases, isomerases, ligases, lectins, and integrins. The best known manganese-containing polypeptides may be arginase, the diphtheria toxin, and Mn-containing superoxide dismutase (Mn-SOD).

Mn-SOD is the type of SOD present in eukaryotic mitochondria, and also in most bacteria. Manganese is also important in photosynthetic oxygen evolution in chloroplasts in plants (photosynthesis). Most broad-spectrum plant fertilizers contain manganese.

Though adequate amounts are helpful, too much can be toxic to the brain and nerves.

MOLYBDENUM (250 MCG)

This mineral can be helpful for those with allergies, especially sulfite sensitivities (e.g., found in wine). It may also help detoxify acetaldehydes, which are made by yeast.

PHOSPHORUS

Phosphorus is a key element in all known forms of life. Phosphorus is a component of DNA and RNA, as well as ATP, and is an essential element for all living cells. Phosphoric acid made from elemental phosphorus is used in food applications such as some soda beverages (especially Colas). It is also used in the processing of meat and cheese, in toothpaste, to soften water and to prevent pipe/boiler tube corrosion. Because of this, phosphorus deficiency is rare in the American diet.

Due to its reactivity with air and many other oxygen-containing substances, phosphorus is not found free in nature but it is widely distributed in many different minerals.

An average adult human contains a little less than 1 kg of phosphorus, about 85% of which is present in bones and teeth in the form of apatite, and the remainder inside cells in soft tissues. A well-fed adult in the industrialized world consumes and excretes about 1-3 g of phosphorus per day in the form of phosphate.

In medicine, low phosphate syndromes are caused by malnutrition, by failure to absorb phosphate, and by metabolic syndromes which draw phosphate from the blood (such as re-feeding after malnutrition) or pass too much of it into the urine. All are characterized by hypophosphatemia, which is a condition of low levels of soluble phosphate levels in the blood serum, and therefore inside cells. Symptoms of hypophosphatemia include muscle and neurological dysfunction, and disruption of muscle and blood cells due to lack of ATP. Too much phosphate can lead to diarrhea and calcification (hardening) of organs and soft tissue and can interfere with the body's ability to use iron, calcium, magnesium, and zinc.

POTASSIUM (2,000+ MG/DAY; MULTIVITAMINS ARE LIMITED TO 55 MG BY FDA)

Potassium ion is a nutrient necessary for human life and health. It is important for neurons in the brain and nerves, and for influencing the osmotic balance between cells and the interstitial fluid. It is important for allowing muscle contractions and sending of all nerve impulses. Potassium+ ions are larger than sodium ions, and the ion channels and pumps in cell membranes can distinguish between the two types of ions, actively pumping or passively allowing one of the two ions to pass, while blocking the other.

A shortage of potassium in body fluids may cause a potentially fatal condition known as hypokalemia, typically resulting from diarrhea, increased diuresis and vomiting. Deficiency symptoms include muscle weakness, paralytic ileus, ECG abnormalities, decreased reflex response and in severe cases respiratory paralysis, alkalosis and cardiac arrhythmia.

A deficiency of potassium is rare in healthy individuals eating a balanced diet since it is common in most fruits, vegetables, and meats. Diets high in potassium can reduce the risk of hypertension. The 2004 guidelines of the Institute of Medicine specify a dietary reference intake of 4,000 mg of potassium, though most Americans and Europeans consume only half that amount per day. Individuals suffering from kidney diseases may suffer adverse health effects from consuming large quantities of dietary potassium. End-stage renal failure patients undergoing therapy by renal dialysis must observe strict dietary limits on potassium intake since the kidneys control potassium excretion, and buildup of blood concentrations of potassium may trigger fatal cardiac arrhythmia.

The FDA limits the amount of potassium that can be added to multivitamins to very low levels (55 mg) for this reason. To get a healthy amount of potassium, eat a banana and drink a 12 oz glass of V-8 or tomato juice daily.


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SELENIUM (200 MCG)

Selenium is critical for optimal immune function. This is important to both eliminate the many infections seen in CFS/FMS and also to prevent cancer. For example, a meta-analysis of 3 studies suggested that selenium may decrease the risk of colon cancer by ~ 1/3.

Selenium was also shown to increase longevity and decrease cancer frequency in several studies.

Selenium is an antioxidant, and deficiency is associated with a shorter life, thyroid deficiencies, and immune dysfunction.

In fact, low selenium is one of the problems that cause an underactive thyroid with normal blood tests, as it is critical for converting inactive thyroid to the active form.

SODIUM

Although we may not think of salt as a nutrient, it is essential to life.

Sodium is present in sodium chloride (table salt) and is necessary for the regulation of blood and body fluids, transmission of nerve impulses, heart activity, and certain metabolic functions. Interestingly, although sodium is needed by animals, it is not needed by plants and is generally toxic to plants. A completely plant-based diet, therefore, will be very low in sodium.

Sodium ions play a diverse and important role in many physiological processes. It is important for central nervous system function, which depends on the sodium ion motion across the nerve cell membranes. Sodium is the primary cation in extracellular fluids in animals and humans. These fluids, such as blood plasma and extracellular fluids in other tissues, bathe cells and carry out transport functions for nutrients and wastes. Relative loss of body water will cause sodium concentration to rise higher than normal, a condition is known as hypernatremia. This ordinarily results in thirst. Conversely, an excess of body water caused by drinking will result in too little sodium in the blood (hyponatremia). The hypothalamus usually works well to cause drinking or urination to restore the body's sodium concentrations to normal.

In humans, high salt intake was demonstrated to attenuate nitric oxide production. Nitric oxide (NO) contributes to vessel homeostasis by inhibiting vascular smooth muscle contraction and growth, platelet aggregation, and leukocyte adhesion to the endothelium. The human requirement for sodium in the diet is about 500 mg per day, which is typically less than a tenth as much as many diets "seasoned to taste." Most people consume far more sodium than is physiologically needed.

Despite this, we forget that salt is supposed to have many of the other minerals present in sea salt, such as iodine. Most salt has had all of the minerals besides sodium and chloride removed. Iodized salt (rarely used in food processing) has a bit of iodine added back in. For home use, we recommend that sea salt be used (for example Celtic Sea Salt).

As an aside, the concept that high salt intake is harmful has been proven to be wrong (except in conditions like heart failure where low salt is needed). Repeated studies have shown that the more salt people eat, the longer they live.

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ZINC (15-25 MG/DAY)

Zinc has been shown to be deficient in FMS and is very important as it is critical for optimal immune and antioxidant function.

Recurrent infections cause high zinc losses and, as discussed above, this is seen in AIDS as well as in FMS. Zinc is also very helpful for the rest of the population and critical in CFS/FMS where the low zinc levels probably contribute to the many infections.

The poor immune function caused by zinc deficiency may have other ramifications as well. According to research published in the Journal of the National Cancer Institute. People with the highest zinc levels were 79% less likely to develop esophageal cancer than those with the lowest zinc levels.

Zinc may also help with cognitive function, even if taken with stimulants that can help in CFS. One study gave 44 children with ADHD either 55 mg of zinc or placebo each day for six weeks along with their Ritalin (which I think is overused in ADD and underused in CFS). While the behavior of all of the children improved during the study, those who had taken zinc had a more marked improvement. The study's authors believe that zinc may play a role in regulating the production of dopamine in the brain, which is often low in CFS/FMS. Dopamine is associated with feelings of pleasure and reward and has been linked to ADHD by other scientists. In addition, a study of seventh graders showed that 20 mg a day of zinc improved school performance with improved memory and attention span.

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Antioxidants

This category is so important that I am beginning the discussion of nutrition with 2 key antioxidants. Although necessary for life, oxygen is incredibly toxic. In fact, the greatest mass extinction in the history of the planet occurred when algae (which create large amounts of oxygen) began to grow in the seas. Putting large amounts of oxygen into the air, it is estimated that they drove over 95% of animal species then living into extinction—as oxygen is that toxic. Oxygen results in the production of toxic “free radicals,” which set up ongoing, self-sustaining chain reactions of molecular damage. Antioxidants end these chain reactions and are critical to life. Species that developed anti-oxidant defense systems and actually learned to thrive on oxygen survived the coming of algae. Doing so, however, is quite literally like playing with fire!

People with CFS/FMS are under increased oxidative stress. The importance of this problem is reflected in the work of Dr. Paul Cheney. This noted CFS expert believes that a major component of chronic fatigue syndrome stems from the heart muscle working poorly because of inadequate energy production. He theorizes that this occurs because the body's mitochondrial energy furnaces are unable to adequately handle oxygen free radicals and therefore shut down energy production. Antioxidants are the key tools that your body uses to neutralize free radicals. One antioxidant, called "glutathione," is especially critical. For over a decade we have talked about how glutathione deficiency may be one of the single most critical common denominators causing CFS and fibromyalgia. This theory has also been supported by the brilliant work of Rich Van Konynenburg, Ph.D. He proposes a number of triggers for glutathione depletion, including a block in the methylation cycle.

In addition to being critical for the production of energy, antioxidants also seem to be very important for maintaining health and youth. In fact, doctors who specialize in "anti-aging medicine" use antioxidants (as well as bioidentical hormones) as key tools.

Although supplementation can be critical, there are ways that are even more fun to get your antioxidants. This is why when I recommend avoiding sugar, I also add the three magic words “except for chocolate!” Chocolate’s high levels of antioxidants (especially dark chocolate), as well as it’s containing a natural mood enhancer, are the reasons for this recommendation. For example, according to the results of a study conducted at Cornell University, the concentration of cancer-fighting antioxidants in hot cocoa was significantly higher than those in red wine, green tea, or black tea.

Chocolate has other fringe benefits. Children born to women who regularly ate chocolate during their pregnancies were more likely to be “sweet natured.” Researchers at the University of Helsinki in Finland asked 300 pregnant women to track their stress levels and chocolate consumption. When their children were six months old, their moms were surveyed on their babies' behaviors. The results showed that babies born to stressed women who ate chocolate daily smiled more frequently, laughed more often, and showed less fear of new situations than babies of stressed women who did not indulge in chocolate. Taking high levels of antioxidants during pregnancy also decreases the risk of the baby having asthma.20 I guess that eating chocolate is simply a sacrifice that we need to make for our children!

In men, taking even low dose antioxidants (120 mg of ascorbic acid, 30 units of vitamin E, 6 mg of beta-carotene, 100 µg of selenium, and 20 mg of zinc, vs. placebo for an average of 7.5 years) can prolong life.21 Men in the antioxidant group were 1/3 less likely to have died by the end of the study.

As one of many other examples, antioxidants such as Vitamin C can decrease the hearing loss that accompanies aging.22 In addition, it is estimated that 300,000 cases of macular degeneration (35% of cases), a leading cause of blindness, could be prevented simply by supplementation with antioxidants and zinc!23 Anti-oxidants also protect against stomach cancer,24 help in the treatment of liver disease,25 are associated with a decreased risk of hip fractures,26 and may protect against strokes.


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VITAMIN C (500-1,000 MG/DAY) 

Thanks to low carb diets, scurvy is starting to make a come back. In a study done at the University of Arizona and published in the American Journal of Public Health, it was found that men and women aged 25 to 44 often fail to take in adequate amounts of vitamin C and are at high risk of getting scurvy. Because the disease is seldom considered by 21st-century healthcare practitioners, people presenting with scurvy symptoms such as fatigue, limping, bleeding gums, or swollen extremities are often misdiagnosed and medicated for other disorders.

Vitamin C is well known as a critical nutrient, being important for proper immune, adrenal and antioxidant function, so I will not spend much time on it. I recommend you get at least 500 Liposomal mg/day. To help encourage you to take it, too little vitamin C in the bloodstream has been found to correlate with increased body fat and waist measurements. Nutrition researchers from Arizona State University report that the amount of vitamin C in the bloodstream is directly related to fat oxidation—the body's ability to use fat as a fuel source—during both exercise and at rest. 

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VITAMIN E (100 UNITS/DAY) 

This critical antioxidant serves many functions, but more is not always better. Many nutrients (such as beta-carotene) are part of a larger “family,” so taking very high doses of only one type can actually suppress the others and become problematic. This is the case with vitamin E as well, as there are many types of tocopherols. Research suggests that taking over 150 units a day can actually be problematic,33 so I recommend taking 100 units a day as the optimal level in multi-vitamins. If you are taking higher levels to treat a specific problem, take it for only a few months and use natural vitamin E (mixed tocopherols) which contain all of the different types of vitamin E.

Although more is not better, deficiency is a significant problem. For example, research suggests that 91% of 2-5-year-olds are vitamin E deficient. Taking vitamin E (200 units twice a day) can also significantly reduce the severity and duration of menstrual period pain. Writing in the British Journal of Obstetrics and Gynaecology, the researchers say: "The use of vitamin E for dysmenorrhoea [painful periods] in adolescent women is attractive because of the marked effect we have demonstrated, coupled with the absence of significant side effects from vitamin E in therapeutic doses." Peter Bowen-Simpkins, of the Royal College of Obstetricians and Gynaecologists, notes: "This is particularly exciting because such treatment is readily available over the counter, is free from side effects, avoids the use of hormones or pain relievers and appears to be very effective."

Vitamin E in optimal doses (~ 100 units a day) may also be cancer protective. Two studies presented at the 2004 annual meeting of the American Association of Cancer Research found that people who had a high intake of dietary vitamin E or who had high levels in their bloodstream were the least likely to have cancer. In one of the studies, vitamin E supplements in addition to a vitamin E-rich diet lowered the bladder cancer risk. In the other, men with the most vitamin E in their systems had the lowest risk of prostate cancer. This was also discussed in another study published in the Journal of the National Cancer Institute, where high blood levels of vitamin E cut the risk of prostate cancer by about 50%,36 and a third study which showed that vitamin E caused prostate cancer cells to “self destruct.”37 Adequate vitamin E may also decrease the risk of breast cancer.

Given the above, one could argue that you’d need to be demented not to get adequate antioxidant support. I guess it’s not surprising then, that in a study on 1,033 people aged 65 years and older, low plasma levels of vitamin E were found to be associated with a more than doubled risk of becoming demented and of suffering from cognitive impairment!


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VITAMIN A (3,500 IU)

Vitamin A is critical for mucosal immunity and zinc function, but be careful not to get too much. Birth defects can occur in women taking over 8,000 units/day, and higher dosing of vitamin A (not beta-carotene) can also aggravate osteoporosis. At doses of over 50,000 units/day, vitamin A can even cause liver injury, so I would only use doses over 8,000 units daily under the supervision of a holistic practitioner. Two examples of when higher doses may be used by your practitioner include acne, which is associated with low vitamin A levels40 and improves with high dose vitamin A plus zinc (which augments vitamin A activity) and heavy menstrual periods during peri-menopause. Called “Dysfunctional Uterine Bleeding (DUB),” the bleeding often resolves without the need for a hysterectomy by taking 50,000 units of vitamin A (with 25 mg zinc) daily for 3 months. It is, of course, important to also treat the low thyroid and low iron, which are 2 other (and more common) important causes of heavy periods.


BETA CAROTENE (3,500 IU)

One of a large family of carotenoids (found in carrots), beta-carotene is the main one added to supplements. In proper dosing, it can be helpful, and higher doses (to a point) are associated with increased longevity.

Because beta-carotene is part of a larger “family,” however, taking very high doses of only one type can actually suppress the others and become problematic. For example, taking 25,000 units a day was associated with an increased risk of lung cancer. So more is not always better!

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BIOFLAVONOIDS (500 MG)

There are many members of this family, which can be found in the white part of citrus fruits just below the peel. They are important for blood vessel integrity and immune function. A high intake of flavonoids has been shown to lower heart attack risk42 and 500 mg a day (of the quercitin form) decreases the symptoms of prostatitis.

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Glutathione (GSH) is a tripeptide and is an antioxidant, protecting cells from free radicals. Glutathione is not an essential nutrient since it can be synthesized from the amino acids L-cysteine, L-glutamic acid, and glycine. While all cells in the human body are capable of synthesizing glutathione, liver glutathione synthesis has been shown to be essential.

Glutathione exists in reduced (GSH) and oxidized (GSSG) states. In the reduced state, it is able to donate a reducing equivalent (H++ e-) to other unstable molecules, such as reactive oxygen species. Glutathione (GSH) participates as a cofactor for the enzyme glutathione peroxidase. It is also important as a hydrophilic molecule that is added to lipophilic toxins and waste in the liver during biotransformation before they can become part of the bile. Glutathione is also needed for the detoxification of methylglyoxal, a toxin produced as a byproduct of metabolism.

An increased GSSG-to-GSH ratio is considered indicative of oxidative stress.

Glutathione taken orally is not well absorbed across the GI tract Unless using Liposomal Glutathione. However, tissue and serum glutathione concentrations can be raised by increased intake of the precursor cysteine, or in chronic conditions, by S-adenosylmethionine (SAMe). Glutathione precursors rich in cysteine include N-acetylcysteine (NAC), glutamine, glycine, Liposomal vitamin C and whey protein, these supplements have been shown to increase glutathione content.

SUPEROXIDE DISMUTASE

The enzyme superoxide dismutase catalyzes the dismutation of superoxide into oxygen and hydrogen peroxide. It is an important antioxidant defense in nearly all cells exposed to oxygen.

SOD can be naturally found in the cytosols of all eukaryotic cells with copper and zinc. It is in chicken liver (and nearly all other) mitochondria. Many bacteria contain a form with manganese (Mn-SOD).

SOD out-competes damaging reactions of superoxide, thus protecting the cell from superoxide toxicity. Superoxide is one of the main reactive oxygen species in cells. The physiological importance of SODs is illustrated by the severe pathologies evident in mice genetically engineered to lack these enzymes.

Mutations in the first SOD enzyme can cause familial amyotrophic lateral sclerosis (ALS). Overexpression of SOD1 has been linked to Down's syndrome.

SOD has proved to be highly effective in the treatment of colonic inflammation in experimental colitis and may be an important new tool for the treatment of inflammatory bowel disease. It is used in cosmetic products to reduce free radical damage to the skin. Having adequate zinc (about 15 mg a day) and copper (1/2 mg a day) are key nutrients responsible for optimal SOD function. Too much copper, however, can actually increase oxidative stress, so more is not better.
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LIPOIC ACID

Lipoic acid, from potatoes, is a helpful antioxidant which restores and supports function of other antioxidants (such as vitamin E) and also can help heal nerve pain (the latter at a dose of 300 mg 2 times a day).

Alpha lipoic acid is an antioxidant which has been shown to be especially beneficial for diabetic neuropathy. Another study showed that it was also helpful in relieving "burning mouth syndrome." This syndrome is characterized by chronic pain on the tongue and sometimes the anterior palate and lips without any visible lesions. It is most often seen in postmenopausal women and has characteristics of being neuropathic pain. In a study of 60 patients, half received 200 mg of lipoic acid 3 times a day or a placebo for 2 to 5 months. Ninety-seven percent of the patients improved as compared to 40 percent of those in the placebo group. Thirteen percent had complete resolution of their pain, and another 74 percent had "decided improvement," whereas none of the placebo patients had this level of improvement. Almost all the patients showed some improvement by 2 months, with 73 percent still showing benefit at the end of 12 months despite having stopped the treatment. The fact that lipoic acid helps in several kinds of neuropathies suggests it is worth trying in others as well, especially since it is quite benign and not very expensive.


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Amino acid supplementation, especially with whey protein, has many benefits. Using partially denatured whey protein has been shown to increase glutathione production and has been helpful in CFS. In a study conducted at James Madison University in Virginia and published in the Journal of Medicine & Science in Sports & Exercise, whey protein also increased endurance and decreased the muscle wear and tear that comes with intense exercise.142 Whey protein also coats harmful bacteria, which prevents them from adhering to the gut wall so they are less infectious.

Although all of the amino acids are important, I will focus on the ones that are most critical in CFS/FMS. As is the case with most nutrients, optimal levels are good (and likely better than the RDA) but more is not always better! 

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FISH OIL The two key Omega-3 essential fatty acids in fish oil are eicosapentaenoic acid (EPA) and docohexaenoic acid (DHA), the latter being a major component of brain tissue. Perhaps the old wives tales were right in calling fish "brain food."

Fish oil decreases anger, anxiety, and depression and increased vigor — while improving various types of cognitive and physiological functions, and mood. It fights dry eyes and may help promote heart health while decreasing stroke risk.

Pregnancy

Fish oil intake (containing Omega-3 fatty acid) during pregnancy may boost a baby's growth rate. Research suggests the benefits may extend throughout a child's life — helping prevent asthma, as well as decreasing the risks of bipolar disorder and cancer (in females). It also helps prevent postpartum depression. Many consider fish oil deficiency to be the most important nutritional deficiency in pregnancy but do not want to recommend increasing fatty fish for fear of their having high mercury levels. Taking pure and mercury-free Premium Salmon Oil can help you avoid this problem.

If you would not eat a piece of fish that tastes like the oil, then the oil is rancid and don't use it.

LYSINE (500-1,000 MG)

Lysine helps make L-Carnitine, which is low in CFS and used by the body to burn fat for energy. Carnitine deficiencies can also appear as mental confusion or cloudiness, angina, and weight gain. Lysine is used to fight herpes because it lowers arginine levels (see above), starving the viruses. Unfortunately, the dose needed to do this may also lower growth hormone levels, so in CFS/FMS I prefer to use the anti-viral medications instead of cold sore and vaginal herpes prevention.

METHIONINE (100-300 MG)

Although the amino acid methionine is a key part of the production of SAMe, high levels seem to paradoxically decrease SAMe production and may also be associated with an increased heart attack risk.143 Therefore, I recommend that only low levels be added to supplements.


NAC (N-Acetyl-Cysteine) (250-650 mg) 

NAC is critical for making a key antioxidant called glutathione and for keeping vitamins C and E in their active forms. It has been speculated that glutathione deficiency may be a major “root cause” in CFS. Although taking glutathione by mouth has no effect on blood levels (it simply gets digested), taking NAC, glutamine (1,000 mg/day—which also helps bowel healing), and glycine (500-1,000 mg/day)—the 3 amino acid “building blocks” of glutathione—plus vitamin C can markedly increase glutathione levels. Supplementing these three amino acids is especially important in CFS, as NAC, glutamine and glycine levels decrease by 30-50% in post-viral fatigue (e.g., CFS). For NAC, I recommend 650-1,000 mg daily for 3-4 months and then 250 mg a day for maintenance. Low Glutathione levels may contribute to your immune dysfunction. including low “natural killer cell” activity—as glutathione protects your immune system from harm.

NAC (perhaps by raising glutathione) has other benefits as well. In one study, taking high dose NAC increased the time to muscle fatigue by 30% while preventing a drop in glutathione144 and can even help to protect the heart muscle during a heart attack.145

NAC at doses of 600-3,000 mg/day even significantly decreased symptoms of OCD (obsessive compulsive disorder).146 Other antioxidants may also help OCD.147 NAC also plays a role in detoxification.

Serine (500-1,000 mg)

In one study presented at the Myopain Research Conference in Italy, Serine 500 mg/day significantly decreased symptoms of FMS. It supports antioxidant, brain and immune function.

TAURINE (500-1,000 MG)

Taurine has been shown to increase energy, and can actually be found in a few energy drinks. Unfortunately, most of these “energy drinks” largely contain caffeine and sugar. which are loan sharks for energy and should be avoided.

TRYPTOPHAN (100-500 MG)

Tryptophan is critical for the production of serotonin, which is critical for sleep and also called the “happiness molecule” as serotonin decreases depression. Unfortunately, the law limits what can be added to supplements.

TYROSINE (500-1,000 MG)

Tyrosine is critical for the production of adrenaline and dopamine, 2 neurotransmitters that are often also low in CFS (for you “adrenaline junkie” CFS'ers out there — you know who you are!).

Cofactors

CHOLINE (100+ MG)

This nutrient is critical for brain function and the production of the neurotransmitter acetylcholine. It is also a “methyl donor,” which is helpful in CFS.

Results of animal studies published in the April 2004 issue of the Journal of Neurophysiology have demonstrated that choline exposure in the womb may increase the size of brain cells associated with memory and help them function more efficiently. A pilot study assessing choline supplementation in pregnant women hopes to

Supplements on Cell-Mediated Immunity in Old People,” Gerontology 29 (1983): 305–310.

  1. R.K. Chandra, “Effect of Macro and Micro Nutrient Deficiencies and Excess on Immune Response,” Food Technology, February 1985, pp. 91–93.
  2. S. Chandra, et al., “Undernutrition Impairs Immunity,” Internal Medicine 5 (December 1984): 85–99.
  3. R.K. Chandra, et al., “NIH Workshop on Trace Element Regulation of Immunity and Infection,” Nutrition Research 2 (1982): 721–733.
  4. M.C. Talbott, L.T. Miller, and N.I. Kerkvliet, “Pyridoxine Supplementation: Effect on Lymphocyte Responses in Elderly Persons,” American Journal of Clinical Nutrition 46 (4) (October 1987): 659–664.
  5. S.N. Meydani, M.P. Barklund, S. Liu, et al., “Vitamin E Supplementation Enhances Cell-Mediated Immunity in Healthy Elderly Subjects,” American Journal of Clinical Nutrition52 (3) (September 1990): 557–563.
  6. Bartali B et al. Low Micronutrient Levels as a Predictor of Incident Disability in Older Women, Arch Intern Med. 006;166:2335-2340.
  7. Nachtigal MC, Patterson RE, et al, “Dietary supplements and weight control in a middle-aged population,” J Altern Complement Med ., 2005; 11(5): 909-15.
  8. The relationship between dietary intake and the number of teeth in elderly Japanese subjects,”Gerodontology, 2005; 22(4): 211-8.
  9. Ozgocmen S, Ozyurt H, Sogut S, Akyol O, Ardicoglu O, Yildizhan H. Antioxidant status, lipid peroxidation and nitric oxide in fibromyalgia: etiologic and therapeutic concerns.Rheumatol Int. 2005 Nov 10;:1-6 [Epub ahead of print])
  10. Litonjua AA, Rifas-Shiman SL, et al, "Maternal antioxidant intake in pregnancy and wheezing illnesses in children at 2 y of age," Am J Clin Nutr , 2006; 84(4): 903-11.
  11. Hercberg S. et al. Arch Intern Med. 2004;164:2335-2342
  12. Takumida M, Anniko M, “Radical scavengers: A remedy for presbyacusis. A pilot study,” Acta Otolaryngol, 2005; 135(12): 1290-5.
  13. van Leeuwen R, Boekhoorn S, et al, “Dietary intake of antioxidants and risk of age-related macular degeneration,” JAMA , 2005; 294(24): 3101-7.andhttp://www.medscape.com/viewarticle/520823.
  14. Kim HJ, Kim MK, et al, “Effect of nutrient intake and Helicobacter pylori infection on gastric cancer in Korea: a case-control study,” Nutr Cancer, 2005; 52(2): 138-46.

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