I have been asked to list the five supplements that I would take if I were limited to five only.  Of course, I do, in fact, take more than five, which you can see on the Daily Program page, which are the supplements I take.  But, I realize that there are people who are unable or unwilling to take as many, and not just for financial reasons, but because they have an aversion to it.  And it’s the same for me: there is a limit to how much I can spend, and a limit to how much I can comfortably take without it getting arduous.

I realize that to some people it seems like I take a whole lot of supplements.  Yet, there are plenty of people who take a lot more than I do.  And, there is a specific, concrete purpose behind every supplement I take.

Yet, I think this is a good exercise, and I’m glad it was suggested. So, here are my top 5 supplements if I were limited to just 5.

Extend Core Multi- this is the multivitamin/mineral supplement that I take from VRP.  It is not ultra-high potency, but it is very broad, and very well formulated, and with the highest quality ingredients. For instance, it has the MTHF form of folic acid and the P5P form of Vitamin B6.  Of course, I am conscientious about eating a wholesome diet.  But, even though I am, I still value being covered by this comprehensive nutritional formula, and I’ll give you an example of a reason why: zinc.

Zinc is a marginal nutrient in many people’s diets, including those who try to eat healthfully. There are factors that can interfere with zinc absorption, such as plant fiber, oxalic acid, and phytic acid. Some people avoid grains and legumes because of phytic acid, but there are other foods that have it, such as nuts. The highest phytic acid food that I know of is the brazil nut. Similarly, some people avoid spinach due to oxalic acid, but the fact is that all fruits and vegetables contain oxalic acid- it’s ubiquitous.  Spinach just happens to be higher in it than most.  It’s interesting that vegetarians have been found to have a lower zinc status than omnivores. And they have been found to have lower taste acuity- which is a sign of zinc deficiency.  I eat a lot of plant food and am practically vegan.  So, I worry about getting enough zinc, and I am glad to get the 15 mgs of highly absorbable zinc in my Extend Core multi.  It’s the kind of nutritional insurance that I’m looking for.

Sublingual Vitamin B-12- you need only read the previous blog to know why I am including this supplement on my short list. It’s been found that older people have very little ability to absorb Vitamin B12- from food or from swallowed supplements. The older stomach does not produce enough Intrinsic Factor- a compound which facilitates the absorption of Vitamin B12 through the gut. We know now that sub-optimal Vitamin B12 status is affecting millions of Americans, particularly older ones.  Sublingual Vitamin B-12 bypasses the stomach and goes directly from mouth to blood.  I am not going to repeat the previous blog again here, but please read it if you haven’t, and I hope you will take it very seriously.  This supplement is quite inexpensive, and I know from experience that it can be, not just beneficial, but life-saving.

Coenzyme Q10-H2- this is essentially a vitamin, but it is not officially listed as a vitamin because the body can make it to some extent.  However, with aging, the body makes much less of it, and blood levels often decline markedly with age. What is worsening the situation in the present day is that millions of people take statin drugs, which besides interfering with cholesterol production (which is their intended purpose) also put the brakes on CoQ10 production.  I don’t take statin drugs, but I still take CoQ10, and the H2 form is the best form of it. CoQ10 is an energy supplement; it facilitates mitochondrial energy production in the cells, including the muscle cells, and where it factors in mightily is the heart.  I don’t know if you realize that your heart runs on the burning of fatty acids- not glucose.  And the direct oxidation of fatty acids by the heart hinges on CoQ10.  And remember that your heart is the muscle that never gets to rest- except to the extent that it rests between beats.   I see CoQ10 as a very good supplement choice for those middle-aged and older.  The one we offer is the highest quality one, which is made by a Japanese firm- Kaneka- although it’s actually manufactured here in Texas now, where I live.  It is the only all-natural, yeast fermented CoQ10 in the world, and it is state -of-the-art.  Coenzyme Q10 is considered an anti-aging nutrient, and the research about that is very impressive. Rats age a whole lot better and a whole lot slower when they are given Kaneka CoQ10.

Fish Oil- I don’t have any interest in eating fish. It is not my thing. But, I do take my Pro Omega fish oil from Nordic Naturals every day. This Norwegian company goes way high up in the Arctic and harvests very small fish- the likes of sardines and anchovies- which are quite pure to begin with, but then they purify the oil from these fish down to one part per trillion to make sure it’s contaminant-free.  It’s an amazing and highly advanced technical process, and the resulting oil hardly seems fishy at all, and it doesn’t repeat on you. There are very few fish oils as good as this- if any.

Of course, the purpose of taking fish oil is to obtain the long-chain polyunsaturated fatty acids, EPA and DHA, which do not occur in plants. What occurs in plants is a shorter-chain fatty acid, ALA, which can, to a limited extent, be converted into EPA and DHA. However, the older you get, the less able you are to do this. And for some strange reason, older men, which includes me, have practically no ability to do it.  It’s odd that such a gender difference should exist- but it does.  Therefore, taking flax seed or flax oil in the hope your body will convert it, is not a good bet, especially if you are an older man.  The only alternative is to take an algae-derived supplement of DHA. However, it’s not very practical because the potency is low, with only 100 mgs DHA per capsule, and it is completely lacking in EPA. On a unit basis, it’s very expensive.  If a person adamantly refuses to take a fish oil supplement because they are unwilling to consume anything from fish, then the DHA from algae should be taken instead.  But, I personally take the fish oil, and that is what I recommend.

I realize that the ProOmega fish oil from Norway is expensive, and there are cheaper ones. And I don’t say that you can’t find a cheaper one that is still good. But, don’t just buy the cheapest fish oil you can find. That’s fine for something like Vitamin C. But when it comes to fish oil, there is the worry about mercury and other contaminants, and there is also the worry about rancidity. Rancid fish oil is definitely not good for you. I have 100% confidence in the ProOmega that I take. If you don’t take that one, make sure you are getting a good one. Otherwise, you are defeating the whole purpose of taking it, and you may do yourself more harm than good.

Vitamin D3- 5000 IUs- the research on Vitamin D has been growing, and it is absolutely astounding. This pro-hormone not only protects our bones, but it is invaluable to the heart, the immune systems, for the prevention of cancer, and much, much more.  And we know now that the amount needed is much greater than previously believed. Most people need at least 5000 IUs daily to reach optimal blood saturation.  So, even though there is a small amount of Vitamin D3 in my Extend Core multi, I also take an additional 5000 IUs every day.

Note that this is not a vegetarian product. It is derived from the lanolin of sheep, usually.  There is a so-called vegetarian Vitamin D called Vitamin D2 or ergocalciferol.  But, it is not natural Vitamin D; it is rather a Vitamin D drug-analog.  In other words, it is a Vitamin D-like drug.

Like Dr. John Cannell, who heads the Vitamin D Institute and is considered a leading authority in the world on Vitamin D, I am totally opposed to the use of Vitamin D2. It is not as effective as natural Vitamin D3. It is not as safe as natural Vitamin D3. And it has actually been shown to have some anti-Vitamin D effects.  There is no safe alternative to Vitamin D3. It is simply the only way to go.

As for sun exposure, studies have shown that very few people can reach optimal Vitamin D levels through sun exposure alone. In Hawaii, it was found that among people getting 11 or more hours of sun exposure per week, that over half of them still had a sub-optimal blood level.  If that's true of Hawaii, what does it say about other places? Furthermore, with aging, we lose the ability to make the active form of Vitamin D through sunning.  We may continue to make cholecalciferol from exposing our skin, but that is not the active form. of Vitamin D. That is the dormant form, or you might say the storage form. That compound has to be tweaked by the liver and the kidneys to make it potent- a process that declines a lot with aging.

Note that I consider it a very good idea to check your blood level of Vitamin D once a year to make sure that you are staying withn the optimal range which is between 50 and 100. I do that every year without fail. In fact, I’ll be doing it soon because I do it every year in April. And I recommend that you do it as well.

But, just as low Vitamin B-12 status is needlessly hurting millions of people, the same is true of Vitamin D deficiency.  Don’t let it happen to you.

So, these are my top 5 supplements for optimal health, and if you have any questions, don’t hesitate to write to me at This email address is being protected from spambots. You need JavaScript enabled to view it. .

 Dr.Jeffrey Stuart M.D. and nurse Sally Pacholok R.N. have released the second edition of their book: Could It Be B-12? An Epidemic of Misdiagnosis. In it, they claim that a substantial amount of physical and mental disability in the elderly is being written off as general age-related decline when it is actually the manifestation of a Vitamin B-12 deficiency. They claim that millions of people are needlessly suffering and dying from this common vitamin deficiency, and often their symptoms are misdiagnosed as MS, Alzheimer’s, senile dementia, depression, chronic fatigue and other conditions that are mimicked by Vitamin B-12 deficiency.  

"The shame is that the problem is easy to spot, easy to treat, easy to cure, and costs very little money," say Stuart and Pacholok, co-authors of the only book on the subject. "But that's only if your doctor diagnoses you before it's too late. Unfortunately, that rarely happens."

Their message is catching on. Dr. Oz just did an entire show on Vitamin B-12 just last month (January 2012).

Stuart and Pacholok say the entire national health crisis (and the related financial burden from expensive treatments for misdiagnosed disease as well as malpractice lawsuits) could be greatly relieved with a simple change in the standard of medical care that would encourage health care professionals to test for B-12 deficiency in all elderly people, and especially those who show symptoms of the diseases that a deficiency of Vitamin B-12 mimics.

"If insurance companies and our government knew how much money they were needlessly spending they would get on board immediately," Pacholok says. "Standardized testing and treatment of people found to be deficient, as well as those who are asymptomatic but in the gray zone (B-12 levels between 200-450pg/ml, considered normal by many doctors), would save them billions of dollars each year."

Pacholok, a leading authority on Vitamin B-12 deficiency, warns that if you are B-12 deficient, standard multivitamin pills will NOT help. The reason? Most people are deficient because their digestive systems do not effectively absorb the vitamin. When you swallow Vitamin B-12 it must combine with a carrier substance known as Intrinsic Factor in order to be absorbed. Elderly people usually stop producing this stomach secretion. The result is that you absorb little or none of the Vitamin B-12 that you swallow.

"If you're deficient, swallowing a multivitamin is like adding a teaspoon of water to an empty swimming pool," Pacholok says.

The preferred way to take an oral vitamin B-12 supplement, Pacholok says, is by sublingual or micro-lingual absorption, where the vitamin dissolves under the tongue and directly enters the bloodstream. Some patients, however, may still require B-12 injections.

Stuart and Pacholok have done dozens of TV, radio and print interviews including CNN Headline News and Redbook. The first edition of their book, Could It Be B-12? An Epidemic of Misdiagnoses, was released in 2005, and is now available in an updated second edition from Quill Driver Books.

 

  

This is a fabulous book to read, and I say that not only because Andre has had such a fascinating and highly improbable life, but also because the book is extremely well written.  I was shocked with the superb quality of the writing, considering that Andre is a high school dropout.  But then at the end, I discovered that Andre got help from a Pulitzer Prize winning author: J.R. Moehringer.  And Andre said that he had wished to list Moehringer as a co-author, but the latter wouldn’t hear of it. So, I don’t know how much of the actual writing to attribute to Andre and how much to attribute to Moehringer, but what I can tell you is that the book is superbly written and a delight to read.  And I don’t doubt that the fundamental essence of the book is Andre, all Andre, and he makes quite an impression.

The first thing that jumps out at you is that Andre’s path was chosen not by him but by his father, an Iranian immigrant who in his youth had been an Olympic boxer for Iran but who became enamored with tennis.  He pushed all of his children into tennis, but it quickly became apparent that the one with the most talent was the youngest, Andre.  And from an early age, he made Andre eat, drink, and sleep tennis.  Andre had no normal child. Andre said he didn’t even like tennis. He even said he hated tennis. He said he would have rather played soccer. But he was forced to play tennis, hours and hours every day. Then, at the age of 13, he was sent away from his home in Las Vegas to Florida to attend the Nick Bollittieri tennis academy, and Nick quickly figured out that he had a prodigy on his hands.  And the rest, as they say, is history.

I am not going to go through his whole life and career, although it’s fascinating. If you said that his life course was a one in a million shot , that would be a gross understatement.  It was more like a one in a billion shot.  But, my purpose, as always, is to focus on the health aspects of his life.  So, that’s what we’ll do here, but again, his personal story, his climb to the top, is most inspiring to read about, and I highly recommend this book.

The first health lesson that you get from the book is that tennis is hard on the human body. Andre was plagued with numerous injuries. And towards the end of his career, he was in constant, excruciating pain.  The only thing that kept him on the court was cortisone shots and anti-inflammatory drugs.  And towards the end, even his father, who had pushed him so hard, pleaded with him to quit.  But, he kept going, and it was partly because he had already started his charitable educational foundation which he needed to fund and promote.  So, he wanted to stay active in tennis for that reason. But, the brutality of the sport on him, the toll on his body, was severe.  He was racked with pain like an old man with arthritis. The plain truth is that the human body is not a rubber band.  It wasn’t meant to stretch and lunge and reach and twist and pull and do all the things you do in tennis- and in a jolting, bolting, erratic manner.  Tissues tear from that. And then they swell.  And that hurts. A lot.

So, the lesson is: if you enjoy playing tennis, go ahead and play- some.  But don’t play every day. Don’t play too long. And don’t play too hard. And don’t try to do everything that a professional player does.  Play within your limits, and I mean your bodily limits. Let the ball go sometimes. Don’t always try to get to it. Nobody is paying you. It doesn’t make sense for you to hurt yourself over this like Andre did.

Andre Agassi was one of the all-time greats of tennis; there is no doubt about that.  In raw numbers, his accomplishments were legion.  But, what he was not was: very consistent.  Many times he unexpectedly lost when he should have won handily.  Of course, it went the other way sometimes too, but  still, as he pointed out: the letdowns and disappointments always seemed to register more profoundly.

So why, when he had so much natural talent and was so amazingly gifted- was his career so erratic and inconsistent?

Well, I can’t assume to be able to answer that, but some things did jump out at me.

He mentioned quite a few times in the memoir taking sleeping pills. He would take them before a match if he was nervous. He would take them on long flights just to knock himself out during the long plane ride. And sometimes, he would take a double dose if a single dose wasn’t enough.  He didn’t say which drug he took, but I’ll guess it was either a benzodiazepine tranquilizer or one of the newer sleep drugs, such as Ambien.  Either way, the effects of doing that can’t be good for physical and mental performance.  And, he also mentioned becoming heavily dependent on coffee, and that’s not surprising because clearly, he had a chronic sleep deficit, and taking sleeping pills does not rectify a sleep deficit.

I know we are hearing a lot of good things about coffee lately, for instance, that it’s full of antioxidants and that it deters diabetes.  I don’t doubt that some of it is true because coffee is a bean, a legume, and legumes are very high in antioxidants, polyphenols, and other protective compounds. However, caffeine is a stimulant drug, and it is never healthy to use a stimulant drug to counteract fatigue.  That’s what Andre did during his career, and it had to take a toll.

And like everybody, Andre had his share of personal stress-and I mean besides the stress of a top-flight tennis career.  He had his family problems, his mother’s and his sister’s cancers, and there were tragedies that affected his closest friends and their children, and he took all these things very hard.  Then, there was his doomed first marriage to actress Brooke Shields.  And like many others, Andre resorted to regular alcohol use in order to cope with his despair, and occasionally, he resorted to hard drugs.  There is no balance or stability to the body that comes from doing that.  And, it could not have lent stability to his tennis game either.  Am I suggesting that his playing may have been more consistent without those bad influences? Yes, that is what I’m saying.

He addressed the subject of diet quite a bit. Growing up, he was raised on the typical, standard American diet, nothing special, and plenty of junk food.  At that stage, there was no thought whatsoever given to the role of diet.  And then as a teenager when he went off to the tennis academy in Florida, again, it was the typical, standard American diet: meats, dairy products, processed carbs, desserts, etc.   But later, UNLV conditioning coach Gil Reyes became his trainer, and Reyes started to take charge of Andre’s diet, cutting back on the junk food.  That was good, but Reyes, though nutritionall- minded, did not have an appreciation for the vast importance of unrefined plant foods. The diet was still mostly animal-based.

I am not suggesting that a strict vegetarian diet would have best served Andre’s needs as an elite tennis player.  It would be very presumptuous for me to suggest that, and I’m not suggesting it. But, what I am suggesting is that making his diet “plant-strong” would have been very useful and supportive to his career.  Relying heavily on unrefined plant foods would have been very advantageous to Andre, and it’s a shame that nobody urged him in that direction.

One interesting thing is that Gil Reyes developed his own electrolyte replacement drink which he called Gil Water. Andre never revealed what the exact composition of it was, but it sounds like it was a proprietary, homemade Gatorade.  And Gil really pushed it on him hard, pouring it into him, before, during, and after matches.

You get the impression from reading the book that Andre was mostly miserable during his life and career- that his crushing defeats and disappointments caused more pain and agony than his victories brought joy- and it wasn’t until he met and fell in love with tennis great Steffi Graf (and for him, but not her, it was love at first sight) that he truly found happiness.   And reading of it, you truly feel happy for him because throughout, he comes across as very likeable and decent and honorable and deserving.  I was always an Andre Agassi fan, but now , from reading the book, I’m even more so.

But, from the health standpoint, it strikes me that spurious ideas about diet worked against him, and spurious notions about the effect of pharmaceuticals harmed him more than he realized then and perhaps now.  Unfortunately, even elite athletes fall for the lure of pharmaceutical drugs- and it hurts them, just as it does everybody.

In his latest newsletter, Dr. Ravnskov tackles the subject of statin drugs and diabetes. Be aware that the statin mania is so out of hand that you’ve got physicians like Dr. Esselstyn not only putting people on cholesterol-free diets, but also putting them on a statin drug. It’s not enough to eliminate cholesterol from their diet, they also have to put them on a drug that cripples the body’s production of cholesterol. And don’t think that the latter action (taking the statin drug) is just a continuation, an extension of the first action (adjusting the diet). Those two actions are worlds apart, and the latter action of prescribing the statin is not just extreme but truly reckless. Now listen to Dr. Ravnskov:

“It is well established that patients with diabetes run a greater risk of developing cardiovascular diseases. In Sweden and in most other countries, cholesterol-lowering treatment is prescribed routinely to all diabetics- whether their cholesterol numbers are high or not, and failure to do so is seen as professional negligence. But there are a number of observations that should have stopped this practice long ago:”

“First, at least fourteen studies have shown that high cholesterol is not a risk factor for patients with diabetes. If you are in doubt, go to chapter 4 in my book “Ignore the Awkward!” There you will find the references to these studies. The reason is probably because high cholesterol protects against infections- a common problem for diabetic patients. As readers of my books know, there is strong evidence that  lipoproteins are able to bind and inactivate all kinds of bacteria and virus. You can read more about that in a paper that I published together with Kilmer McCully, the discoverer of the association between high homocysteine and atherosclerosis.”

“A critical and well-informed reader may possibly say that the small effect from statin treatment is not due to cholesterol-lowering, but to their other effects, and this is true. If so, statin treatment perhaps may benefit a diabetic in other ways. But here comes the next warning: Statin treatment may cause diabetes! Several of the statin trials ended up with more diabetics in the treatment group. For instance, in the JUPITER trial, 3 per cent got diabetes, but it was only 2.4 per cent among the controls. The authors wrote that this small risk was more than balanced by the benefits. Then what was the benefit?

In the control group 2.7% died; in the treatment group, the figure was 2.2%. The trial was stopped after less than two years- so excited were they about that small positive result. But, the question is:  what would the results have been after 10 years? How many would have gotten diabetes over that longer interval? Here is a clue. Look at this recent report from a study called the Women’s Health Initiative.”

“More than 150,000 US women age 50-79 were followed for 7-12 years. At follow-up about ten per cent of the women were on statin treatment. Almost ten per cent of the statin-treated women had diabetes, but only six per cent among the non-users. And please recall that no statin trial has ever succeeded in lowering mortality for women.”

“There is a logical reason why cholesterol lowering may lead to diabetes. Like all other organs and structures, the insulin-producing cells need cholesterol, and when less cholesterol is available, less insulin is produced. This was recently demonstrated in a Canadian study.”

“What happens with those who already have diabetes when they start statin treatment? We don’t know because nobody has analysed this question.”

“But, is it really wise to treat diabetic patients with a drug that worsens the function of their insulin-producing cells? And is it wise to try to lower the risk of cardiovascular diseases in people by administering a drug that may cause a disease- diabetes- which increases CVD risk? Or which may cause cancer? And what about the long list of other unpleasant side effects?

40 percent of cancers in women and 45 percent in men are caused by unhealthy lifestyles, say British researchers. I believe that is the highest percentage I have seen reported.  And, I am glad to see it because perhaps more people will realize the importance that lifestyle has in determining their health outcomes.

And there were four lifestyle factors that they considered paramount -- smoking, unhealthy diet, alcohol, and being overweight- and presumably, they were listed in order of importance.

They said that smoking accounts for 23 percent of all cancers in men and 15.6 percent of cancers in women. Of course, the most likely location for smoking-induced cancer is the lungs. However, smoking also causes bladder, kidney, pancreatic, and cancers in many other locations. Every cell in your body is affected by tobacco smoke.

You might be wondering what role they attributed to chemical exposures such as asbestos or work-related chemicals. They said that only 1 in 25 cancers are linked to such exposures.

Only 1 in 33 cancers are linked to infections, they said, such as human papillomavirus, which is considered the most prevalent cause of cervical cancer.

When it came to a lack of fruits and vegetables causing cancer, they found that men were twice as likely to be dietarily deficient in these foods than women.  Do men still think that fruits and vegetables are sissy foods? Very well, more for me.

I don’t think that most people are aware of the carcinogenic effect of alcohol. Unfortunately, we hear a great deal more good news about alcohol than bad, and there is a political reason for it.  We live in a hypocritical world where if one person wants to relax by having a glass of wine, he or she can do so, but if another person would rather relax with a marijuana cigarette, he or she is committing a crime, risking criminal prosecution, the forfeiture of their freedom, property, etc. Keep in mind that I do not drink alcohol at all, and I do not smoke marijuana at all. And I would not smoke marijuana even if it were legal. The only gas I want entering my lungs is pure, fresh air and not any kind of smoke. But, having made myself perfectly clear about that, I will tell you that it is unquestionably true that alcohol causes a great deal more harm, damage, misery, tragedy, and personal and societal ruination than marijuana.

How do you account for such hypocrisy? Well, you can’t. All you can say is that the state is involved; it is something that the state does; and the state is a contradictory, hypocritical, and downright insane institution.  So, don’t even try to make sense of it.

But, since the state is busy waging the valiant War on Potheads, it should not be surprising to learn that the United States is one of the few developed nations in the world that does not to require the labeling of genetically engineered foods. Just think: even in Communist China you get to know if your food was genetically modified. It is required by law over there that they tell you. But, here in the good old USA, that’s one freedom we don’t have. Russia is another country that  requires labeling of GM foods.  You see, Monsanto does not have much power over there like it does here.

Well, I hope you are a health-fooder like me because it's estimated that 70% of processed foods contain some genetically engineered materials. Over 80% of the corn and soybeans grown in the U.S. are now genetically engineered. And if you think that’s a good reason to skip the corn and soybeans and go for the steak instead, what do you think they are feeding the cows? The vast majority of the livestock that Americans consume have been raised on genetically engineered grains. It’s higher than in any other country in the world.

I do not eat meat- at all- but if I did, I would not go to the supermarket to buy it.  Instead, I would seek out special producers who guaranteed high standards of production through every step in the production process and no GM fodder. But, I am very content to live without it.