We're going to talk about supplements basic supplements 101 five supplements
that can impact cardiovascular health
now we all know again if you've heard that once you've heard it 100 times
you can't supplement your way out of a lifestyle problem
there's no question if you need to lose 30 pounds of body fat
supplements are not going to get you there but supplements can help
and they help a lot of people in a lot of different places
for example there's been a lot of information that's come out recently
about vitamin D3 and COVID so let's start off talking a
little bit about vitamin D3 it's a major supplement for
cardiovascular health it helps us regulate insulin levels it
promotes cardiovascular health immune system function brain function
and nervous system function there are two major forms of it one is
called D2 the technical name is ergocalciferol
it's produced by plants when exposed to ultraviolet light for example mushrooms
fortified foods cholecalciferol D3 is by far
more active a lot of people use D2 because they say well it's
kinder and gentler the problem is it takes
a lot of D2 to have any impact at all and again I think that just washes out
the effort in my patients with myself I use
cholecalciferol vitamin D3 as I mentioned it's biologically active it's
produced in humans and animals when skin is exposed to sunlight
but here's a problem there's significant variation
of that production of vitamin D3 from exposure to skin
do not do not rely on exposure to the sun to be your only source of
vitamin D3 get checked I get a lot of husband and
wife patients and typically I'll see a husband who's
retired out playing golf four times a week three times a week
his vitamin D3 deficient and a wife that stays indoors all day
who's got great vitamin D and neither one of them are supplementing and it
just makes no sense now I will tell you
it's so common to see a problem with relative deficiency in vitamin D3 that I
recommend that people just go ahead and start
with 5,000 international units supplementation
even while they're waiting to get their blood level back
nobody's gotten into trouble with D3 at 5,000
international units now what are some sources of it
oily fish such as salmon mackerel sardines
I did a video recently on kippers a lot of history behind
kippers and I won't go into detail on that right now that's a bunny hole that
I'll save you from you can also get it from liver and egg
yolk the target vitamin D3 levels that we recommend
are 60 to 80 nanograms per milliliter you look at a lot of standards a lot of
standards are still looking at 20 to 40 I don't recommend being satisfied with
keeping it that low too high doses can cause toxic effects
excessive blood serum levels like 125 nanograms or more have been linked to
adverse side effects I have a video of a patient that came to
see me she was taking 50,000 international
units that's a weekly pill that a doctor had
given her to be taken once a week she didn't know
that and she was taking it once a day and I
think her initial levels when she came to see me
was like 145 I mean it was a huge number she was having some kidney function
problems when we saw that number the lab reported it to us immediately I called
the patient explained the situation she stopped that
immediately we watched her kidney function return to
normal and again she shared her story on our videos
is vitamin D good for cardiovascular health persons with less than 30
nanograms were up to five times greater risk for
developing diabetes than people with greater than 50 less than
1,000 international units is not going to have much of an impact on
preventing prediabetes or type 2 diabetes so you see a study here we will
plan to put this content on the blog soon it'll take a few weeks because
we've got other stuff in the pipeline but again it'll help you
understand and be able to go back and look up questions you may have about
D3 K2 we've talked about K2 a couple of times
you get a lot of questions about subtypes MK4
they have MK4 all the way up to MK13 the difference in those subtypes is the
difference in the chain length you may remember I showed you
some of the chain lengths earlier in the presentation in the intro
you can obtain these vitamin K2 from meat eggs cheese
natto and again it affects bone growth bone loss
affects osteoblasts and activates osteoblasts and inhibits osteoclasts
one way we used to remember the difference between those two
in med school is the b in blasts can remind you that that's building
so an osteoblast is building bone and c is cutting so c is cutting away bone
osteoclasts it actually activates osteocalcin and
MGP a matrix Gla protein again
some of the details on how vitamin K2 actually works is it good for
cardiovascular health there's a doctor in I think the
Netherlands Joline Buelens she's been involved in several studies
demonstrating that K2 has a preventive impact
on prediabetes and we go into those some of those studies on the blog if you
want to take a look a meta-analysis showed that vitamin K2
reduced type 2 diabetes risk by 7% with each 10
microgram increment it increased insulin sensitivity via osteocalcin
metabolism it improved insulin resistance
via anti-inflammatory properties and lipid-lowering effects
suppressed inflammation via inactivation of
the NF-kB signaling pathway you see those red
faces you know we're getting ready to talk
about niacin niacin is a major supplement for
cardiovascular health niacin is the only thing prescription or
non-prescription that positively impacts all of the blood lipids all of the
cholesterols the generic name for vitamin B3
forms like nicotinamide niacinamide nicotinamide riboside it's niacin
that's the generic name it's naturally present in many foods
it's added to some food products and available as a supplement nicotinamide
niacinamide it was discovered in 1936 it's part of the WHO list of essential
medicines it's an over-the-counter treatment for
pellagra pellagra is a very very serious skin a dermatitis
nicotinamide riboside no flush niacin was discovered in 1944
there's still significant debate about just how well
that works is niacin good for cardiovascular health
recommended for patients with significant Lp(a) it also
increases HDL it's not recommended to take niacin
supplement if you don't have any cardiovascular
risks niacin's most common side effect is
flushing yes and to counter the flushing there are a lot of different things a
lot of people like the flushing they say gives me a jump in the morning other
people will take a shower so they'll take the niacin
about 10-15 minutes before they take the shower there's a couple of extended
release forms Rugby brand and Enduracin we find that
our patients and I myself tolerated those two very well and
tolerate Enduracin about the best it's a it's got a wax
matrix so what's happening is you're getting a
slower release of that niacin there were trials of
giving it with a chemical called laropiprant that led to the
AIM-HIGH studies and the HPS2-THRIVE studies
studies which showed that actually it didn't work and here's what appears to
be the case the laropiprant the chemical that
decreases the flush also appears to decrease
the impact on Lp(a) and the other lipids
so let's move on from niacin talk about bergamot for a minute
and again we've got separate videos on each of these and actually in
I think all cases more than one video on my
bergamot video I talked about a brand or a type of bergamot called Bergamet
it's in Calabria Italy beautiful area the birthplace of Valter Longo bergamot
orange farmers there and basically they were
getting beat up by the economy the purchase price for bergamot oranges
why because the organic chemists had figured
out a way to make artificial bergamot so in
in addition to being a supplement it's also used in things like perfumes
and teas and you only get a few drops of the oil out of a typical bergamot orange
so again when you could make it artificially
that really began to have an impact on the farmers
they got together formed a farmer's cooperative got a couple of grants from
the government and actually did some
research some science which indicated and showed
gave really good evidence that the natural bergamot was a much
better product so let me get back to script here bergamot is the oil of
citrus bergamia it's a fruit grown in southern France
southern Italy it's been known and prized for centuries
in things like Earl grey tea and perfumes is it good for
cardiovascular health medical evidence that bergamot positively impacts both
blood glucose and cholesterol levels like statins bergamot
oil has the same impact on the enzyme HMG CoA reductase
bergamot's also been shown to have anti-inflammatory and
antioxidant effects it improves LDL HDL and several other things too much
bergamot oil on the skin can cause rashes you know every solution
can create a whole set of problems and yes there's actually been a death
reported by huge bergamot exposure
to skin I think it was with some kids that were playing at the bergamot farms
and did not know the danger of this concentrated bergamot oil
when you talk about bergamot usually berberine comes up
very similar in impact berberine is a traditional Chinese herb
extract it was used in China as an over-the-counter for bacterial
diarrhea it was also found to decrease blood glucose
it was originally made from Rhizoma coptidis which is very expensive
now it's made from Berberis amurense the barberry plant
if you're a plants person plants man you may recognize that barberry there
is berberine any good for cardiovascular health yes there's studies out there
there's science there's true evidence indicates that yes it is drops
hemoglobin A1c by two points which is about the same that you'll see
with metformin a meta-analysis by Lan and associates
indicated that berberine has comparable therapeutic effect on type 2
diabetes hyperlipidemia and hypertension with no serious side
effects how strong is that meta-analysis and do I just I get this question all
the time do I recommend that people just not use metformin and use
berberine or even bergamot instead no neither one of them is as strong you
do see some science which indicates that yeah
they thought it would had similar impacts I don't think it does
not in my experience with patients now the other question that you get
though is can I use them together and the answer
is yes for sure you can use them together and
I personally do considering the relatively low cost
compared with other first-line medicines and treatments berberine has been seen
as a good alternative especially in lower
socioeconomic populations for treatment of type 2 diabetes
hyperlipidemia hypertension over a long time period now berberine's
half-life remember is 4.8 hours so if you're going to try to have
a significant impact with berberine you should probably take it
twice a day not once now as we talk about common supplements
one of the big ones especially in terms of diabetes
is very very commonly used item we're showing cinnamon on here one
of the other items that we talk about is Gymnema silvestre
magnesium fiber or psyllium curcumin there's a bunch of these that we have
just not covered yet and if you have more interest in going
deeper in terms of supplements and their impact the true science behind
supplements rather than somebody's opinion take a look at our
supplements webinar it's about an hour of time where we go
much deeper into the supplements that are available and we go into
a deeper Q&A
continue to get great feedback regarding the webinars
and here's why you know on the internet when you hear a webinar you expect for
somebody to try to sell you something we're not doing that we're trying to
tell you something people are coming in with their labs from Quest inflammation
panel OGTT insulin survey response
and then they're finding out do I have inflammation do I have insulin
resistance and where does that fit in terms of other folks
we're getting ready to start one for CIMT as well
so again people are really excited about finding out
their own status looking forward to seeing you there
thanks