SECRET 7: GET SMART WITH SUPPLEMENTS
The Promise
In one month of increasing your intake of one or more of these nutrients, you will:
think more clearly, more quickly and more creatively
remember more
notice an improvement in mood
In one year, you will:
notice a more even, consistent good mood
find that you are less likely to forget where you put your keys, cell phone and children
feel less stressed
sleep better
note continued improvements in your mental clarity, problem-solving skills and reaction times
Ten years from now, you will:
be at a lower risk for developing memory loss, dementia or even Alzheimer’s disease
continue to be happier and less stressed
A day without my supplements is a day destined for some unknown health disaster; I just don’t feel completely safe without them! I make my family take them, too. Not too long ago, my daughter’s friend told her mom, “If parents discipline their kids because they care, then Lauren’s mom [that’s me] must really love her, because she makes her take those nasty vitamins every day!”
Do I really need to take supplements to feel and think my best? Researchers at Tufts University might answer that question by saying nope, not if you eat really, really well (which I try to do). “Food is a complex package of vitamins, minerals, fiber and thousands of phytonutrients that are essential to health. With rare exceptions, there just isn’t the evidence to support supplements over food in optimizing health or preventing disease,” says Alice H. Lichtenstein, D.Sc., lead researcher on the Tufts commentary.
Jeffrey Blumberg, Ph.D., also at Tufts’ Friedman School, agrees that food comes first: “That’s why they are called supplements, not substitutes.” But, he adds, there is plenty of evidence that supplements can fill in nutritional gaps in not-so-perfect diets—and maybe even lower risks for certain mood and mind conditions, such as depression and dementia. Besides, most nutrients are just as well absorbed from supplements as from foods, and some are even better taken in pill form!
For one thing, most people don’t eat as well as they should and are marginally nourished in vitamins or minerals critical to their mood, minds and energy levels. Case in point: many women still fall far short of optimal levels for folic acid although even white bread and Pop Tarts are fortified with this B vitamin. Then there are studies that show people who supplement suffer less from a host of ills—ranging from premenstrual syndrome (PMS) to depression—compared to nonsupplementers. “It is self-evident that the immediate solution to this huge problem is for people to both improve their diets and also take dietary supplements to fill in the many large gaps between their current intake and the recommended amounts,” concludes Dr. Blumberg.
It doesn’t get any easier than taking a pill. With no side effects and some potentially amazing results, I don’t understand why everyone doesn’t take at least a multiple vitamin and mineral supplement. That’s exactly what I told Chris, a dear friend and mother of two teenage boys.
For years, Chris dealt with dry skin patches on her face. She’d tried changing cleansers and bought expensive moisturizers, but no matter what she did, the dry skin wouldn’t go away.
“Then, my mom came to visit. We always give her our master bedroom because the bathroom is more convenient for her. I forgot to get my proper cleansers and moisturizers from my bathroom, and, not wanting to wake my mother at 11:00 p.m. to rummage for my stuff in my bathroom I used any old soap in the boys’ bathroom, and had to skip my usual moisturizing routine, knowing full well that my crazy skin would go nuts. Except that it didn’t. No dry patches. No extra products, and my skin is smooth. The only difference in my routine that I could figure out was that I had taken Elizabeth’s advice and just started taking a multiple. After three weeks, my skin issue is no longer an issue!”
Chris’s story is one of many that have over the years convinced me to continue taking supplements. Yet faced with a wall of pills, powders and potions, it’s a bit daunting trying to choose the right ones. Here’s the lowdown on which supplements really might help improve your disposition and keep track of where you put your keys today and your memories tomorrow. Some might even be a help when dieting.
The Natural High
The right supplements taken in the right amounts can fill in the nutritional gaps on the days when you don’t eat perfectly, and provide a helping hand when the body fails to make enough of some mood-boosting chemicals.
One Pill a Day
Most of your dietary woes are soothed if every day you eat at least eight servings of fresh fruits and vegetables, six servings of whole grains, three glasses of calcium-rich milk or soy milk, and two servings of extra-lean chicken, fish or legumes. Sounds reasonable, but there’s a catch—finding anyone who does that is about as likely as trying to find someone who can walk on water.
The irony is most of us think we’re eating pretty well. A Gallup poll conducted by the American Dietetic Association found that 90% of women surveyed said their diets were healthful. Most of them are delusional, since every national nutrition survey dating from the 1960s to the present repeatedly and consistently finds that most Americans don’t come close to adequate, let alone optimal. Only one in every 100 people meet even minimum standards of the proverbial “balanced diet.”
Even if you ate perfectly, no diet can realistically provide optimal amounts of certain nutrients. Take, for example,
Vitamin E. You need at least 100 IU of this vitamin daily to cut the risk for memory loss and possibly Alzheimer’s. Are you willing to eat 8 cups of almonds, ¾ cup safflower oil or 62 cups of fresh spinach every day to meet this need?
Calcium. This mineral might help soothe the grumps in women seized with PMS. In fact, as calcium intake goes up, so does mood for these women. The latest calcium recommendation to curb that bad mood is 1,000 to 1,200 milligrams daily, which is easy enough if you drink four glasses of milk or soy milk daily. For those people who shun milk, meeting this quota means consuming 6 ounces of tofu, a can of salmon with the bones, and 2 cups of black bean soup every day.
Folic acid. This B vitamin is critical to mood and memory, but even though white flour and all the junk food made from it are now fortified with folic acid, intakes still fall short for a huge section of the population. You need at least two servings every day of foods rich in folate, like greens. But when researchers at the University of California, Berkeley investigated women’s intake of dark green leafies, they found almost 9 out of every 10 women failed to include even one serving on any one of four days!
Vitamin D. Frankly, I don’t know where anyone gets enough of this vitamin, since even drinking four glasses of fortified milk or soy milk daily won’t meet current needs for most people, and the amount of time you must spend in direct overhead sun without sunscreen is totally unrealistic, especially in the winter. Yet not getting enough of this vitamin is a big mistake if you battle mood, memory or possibly even weight issues.
Happy, fit people know that to improve their moods, sharpen their minds, lift energy and fill in nutritional gaps while dieting, it’s a smart idea to take a moderate-dose, balanced multivitamin and mineral supplement. There is even evidence that a moderate-dose multi can lessen depression, improve mood, reduce stress and anxiety and soothe troubled emotions.
This makes sense since most vitamins and minerals are assembly-line workers in the brain. For example, the B vitamins convert glucose into energy for the brain and also help build some of the nerve chemicals that then tell you to cry at a sad place in a book or laugh at the right spot in a movie. Vitamin D protects nerves in the brain from degenerating. Vitamin E protects brain cell membranes from aging. Iron ensures your brain gets enough oxygen. Iodine ensures normal brain metabolism. The list goes on and on.
Supplements versus Food
Sure, you still need to eat right, but nutrition and supplements are not an either-or issue. The two enhance each together, not cancel each other out. You don’t always get optimal amounts of all the vitamins and minerals from food, just as pills don’t contain everything that food has to offer.
For one thing, supplements can replace the vitamins and minerals, but they will never supply the thousands of other health-enhancing phytonutrients obtained from real foods. Second, while a well-chosen supplement can improve some of the nutritional shortcomings of a good diet, it can’t compensate for bad eating habits. You know deep down in your heart that you can’t live on French fries and hamburgers, then take a vitamin E supplement and think you’re doing fine. So eat right, but also take a multi as a good safety net for those days when you eat well, but not well enough.
What should you look for in a multi?
Select a broad-range multiple vitamin and mineral supplement. Choose one that contains vitamins A, D, E and K, all of the B vitamins (vitamins B1, B2, B6, B12, niacin and folic acid), and the trace minerals (chromium, copper, iron, manganese, selenium and zinc).
Ignore chloride, pantothenic acid, biotin, potassium, choline and phosphorus since the diet either already supplies optimal levels of these compounds or supplements contain too little to be useful. Also ignore nickel, iodine, vanadium and tin, since it’s not clear whether they’re essential for people.
Read the column titled “Daily Value” on the back label. Look for a multiple that provides approximately 100%, but no more than 300% of the Daily Value for all nutrients provided. You want a “balanced” supplement, not one that supplies 2% of one nutrient, 50% of another, and 600% of another.
Supplement your multi. All one-pill-a-day multiples are short on calcium and magnesium, so consider taking a calcium-magnesium supplement if you consume less than three glasses of milk and several servings of magnesium-rich soybeans, wheat germ and dark green leafy vegetables each day. Look for one that supplies these two minerals in a two to one ratio, such as 500 milligrams of calcium to 250 milligrams of magnesium.
The Top Five Most Frequently Asked Questions About Supplements
1. How can I cut down on cost without sacrificing quality? Avoid the “extra” ingredients, such as lipoic acid, enzymes, primrose oil or inositol, to name only a few. These extras add cost, not value, since they are either worthless or supplied in amounts too low to be of use. Also, avoid the “natural” products; they’re costly and usually provide no added benefit over other supplements. Then purchase bigger or “economy size” bottles when the unit price saves you money, and use the supplements before the expiration date.
2. Are time-release vitamins and chelated minerals better than regular supplements? No. These products are more show than substance. Most time-release supplements dissolve too slowly to be completely absorbed. Taking your multiple in divided doses throughout the day is a better, and less expensive, alternative. There is no convincing evidence that chelated or colloidal minerals are any better absorbed or used by the body than other minerals.
3. When’s the best time of day to take a supplement? The time of day is not as important as what you take them with. Most nutrients are best absorbed when taken with meals and taken in divided doses throughout the day. Take a multiple with iron at a different meal than your calcium supplement, since these two minerals compete for absorption.
4. What do the letters USP mean on a supplement label? United States Pharmacopeia or USP is a nongovernmental standard-setting body. This seal of quality means the supplement should dissolve within the digestive tract, is made from pure ingredients and contains the amount of nutrients listed on the label.
5. Can I trust the claims on the label? Usually not. Claims that a product is “complete,” “balanced,” “high potency” or “specially formulated,” contains “extra antioxidants” or is a “multivitamin or multimineral” have little to do with the real formulations. Claims that a supplement will cure, treat or even prevent any health condition are more hype than fact.
Antioxidants for an Antiaging Brain
Your body “rusts” when exposed to little oxygen fragments called free radicals or oxidants. Our bodies and brains are exposed to these troublemakers when we breathe air pollution and tobacco smoke, eat fatty foods and are exposed to pesticides. Even if you lived in a pristine world, your body still would be making free radicals during normal metabolic processes. (See Chapter 5 for more about antioxidants and free radicals.)
Luckily, your body has an anti–free radical arsenal, called antioxidants. These are the housekeepers that sweep up oxidants and flush them out of the body. Antioxidants defend cells from aging and protect tiny blood vessels that transport nutrients to brain cells, keeping them elastic and free of “debris.” Since 20% of the heart’s output goes to the brain, all of these benefits mean improved blood flow and better thinking.
The trick is to maintain an antioxidant arsenal equal to or better than the onslaught of free radicals. As we get older, oxidative damage to tissues, including the brain, intensifies, so that a 30-year-old person needs more antioxidants than a teenager, and the required dose increases even more with every passing decade. If you want to protect your brain, you must build a huge antioxidant arsenal, then replenish it daily.
And it works. People who feast on antioxidant-rich foods and supplements throughout the day also have the highest blood and tissue levels of these dogooders and the lowest risk for developing dementia, depression or even Alzheimer’s disease. They live the longest, they think the clearest and they are the happiest. Even their sex lives improve!
From Vitamins to Phytonutrients
You probably already know that vitamins C and E and other nutrients like selenium are big-time antioxidants that reduce the risk for memory loss. They work much better as a team than supplied alone.
There are literally thousands of compounds in real foods, like herbs, whole grains, legumes, and colorful fruits and vegetables, called phytonutrients. They aren’t vitamins or minerals. Instead, they are compounds with potent antioxidant abilities, especially when supplied as teams. There are the flavonoids in citrus, anthocyanins in red cabbage and cherries, lycopene in tomatoes and watermelon, lutein in spinach, sulforaphane in broccoli, ellagic acid in berries and sulfur compounds in garlic, to name only a few.
Not only do these phytonutrients protect the brain and body from free radical damage, but they also tickle the genetic code within all your body’s cells, turning on the natural production of your body’s own antioxidants, which then protect your brain 24/7 from damage. In other words, taking a vitamin C pill is great, but short-lived, while getting enough of the right mix of phytonutrients means your brain is protected around the clock.
What’s this got to do with supplements?
First, if you don’t load the menu every day with real or super mood foods, it’s a good idea to take an antioxidant supplement that contains vitamin C and vitamin E. Aim for at least 250 milligrams of vitamin C and at least 100 IU of vitamin E. Take it in divided doses if you can, since nutrients are best absorbed and best used in the body when they are supplied in small, frequent doses.
Second, skip supplements that pride themselves on supplying a smattering of a few phytonutrients, like lutein or lycopene. They are a scam. No one even knows how much of each phytochemical we need or how they work in tandem.
Third, there are a few new supplements on the market that actually do work, such as Protandim. They aren’t antioxidants themselves, but they contain a mix of phytonutrients that turn on your body’s production of its own antioxidants. They work to reduce free radicals and potentially protect your brain. Supplements like Protandim are a whole new approach to cellular health. They naturally increase your body’s production of two antioxidant enzymes that aid in eliminating free radicals in your cells, helping to decrease cellular damage and promote healthy aging and immune function.
While all the 40+ nutrients are critical to your happiness quotient, a few vitamins, minerals and other compounds are superheroes in the fight against depression, fatigue, memory loss, and more. Here’s the short list on the ones most important to your mood.
B Good to Yourself
If you feel down in the dumps, too pooped to play or can’t remember your own name, then it just might be that you aren’t getting enough of the B vitamins.
That’s what Darlene, a teacher in Albuquerque, learned after suffering debilitating exhaustion and depression. She brushed it off—and the 25-pound weight gain that accompanied it—as the start of premenopause. Her physician put her on a stew of medications, from antidepressants to thyroid hormones. “Sure, the drugs helped improve my mood,” she says, “but I wanted to get to the root of the problem, so I found a doctor who was willing to work with me on alternative approaches.”
As Darlene slowly weaned herself off the antidepressants, she replaced them with supplements of B vitamins, along with omega-3 fats and several other nutrients known to affect mood (such as calcium, magnesium, vitamin D, zinc and vitamin E). “The transition was seamless. I felt energized, positive, eager to get up in the morning, yet was finally off all medications!” What’s more, the weight dropped off without her even trying.
The Bs are everywhere in the brain. Some B vitamins, especially vitamins B1, B2, and pantothenic acid, help release energy to brain cells so you can think straight. Some Bs, like vitamin B6 and folic acid, are star attractions in making nerve chemicals that keep you happy (like serotonin). Other Bs, like vitamin B12, build the insulation sheath around brain cells that allow messages to travel lickety-split from one cell to another. Include enough of these in your diet and you think fast, feel good and have lots of energy.
Folic Acid: Nature’s Blues Buster
As many as one in every three Americans doesn’t get enough folic acid, the B vitamin important in making sure your brain cells multiply correctly, in boosting levels of the brain-building omega-3 fat DHA and in ensuring your brain makes enough of the feel-good chemicals serotonin and SAM-e (more on this later in this chapter). Low intake of this B vitamin alone increases the risk for being depressed by up to 67%.
People who are serious about getting enough folic acid are the ones most likely to be happy, mentally sharp and at low risk for dementia, depression and Alzheimer’s. If they are depressed, increasing their folic acid speeds recovery. Better yet, folic acid is better absorbed from supplements than from food, so you can rest assured you are getting enough when you take it in pill form.
A word of caution: large doses of supplemental folic acid can mask a vitamin B12 deficiency, so to be on the safe side, take extra B12 if you are supplementing daily with more than 400 micrograms of folic acid.
Vitamin B6: The Good Mood Vitamin
More than one in four people with depression are deficient in vitamin B6. Boosting intake, either from food or supplements, often is all it takes to see an improvement in their moods. Vitamin B6 (along with vitamin B12) combined with antidepressant medications even provides a better mood boost than medications alone.
B6 also seems to help people cope better with stress. For example, women with premenstrual syndrome (PMS) often feel stressed out and crabby before their periods. Or it might be connected to the form of birth control they choose. Birth control pills partially block vitamin B6 activity in the body, so nerve cells are unable to manufacture adequate amounts of serotonin.
Take a supplement that contains 5 milligrams (but no more than 150 milligrams) of vitamin B6 if you aren’t vigilant in getting several B6-rich foods into your daily diet, such as chicken breast, bananas, fish or whole grains.
Vitamin B12: Maximum Brain Support
The mind shuts down without vitamin B12. It might even start shrinking! You need this B vitamin to ensure your brain cells can send messages back and forth quickly, so you have no trouble putting two words together, remembering a friend’s name or staying quick-witted. It’s no wonder that studies, like one from the University of Oxford, repeatedly find that you lose your ability to think, remember and react in direct proportion to your B12 levels. Even happy people tend to tumble into depression when B12 levels are low. Studies show that people with markers for low vitamin B12 status have a more rapid drop-off in mental function at younger ages compared to people with optimal vitamin B12 status. In fact, many researchers speculate that doubling a person’s vitamin B12 levels by taking supplements could slow cognitive decline by one-third or more.
Even people who are tested for vitamin B12 and are found to be in the low-normal range could be deficient, according to a study from the University of Oxford. Tamara knows firsthand how powerful an influence vitamin B12 has on mood. She had battled serious depression for five years despite taking a variety of antidepressant medications. In desperation and at the age of 42 years, she turned to her doctors one more time for help. Routine blood tests had shown she wasn’t anemic or even low in B12, but her doctor decided to put her on supplemental vitamin B12 and folic acid anyway. Within weeks, her depression completely vanished. A year later, she was still blues-free. “I’ve not had a miserable day since,” she adds.
Many studies also find that people living in nursing homes because of memory loss often improve beyond anyone’s wildest dreams when they are given high doses of vitamin B12.
The older you are, the more vitamin B12 you need, with young people needing as little as 2 micrograms a day, while anyone over the age of 50 years needs at least 25 micrograms, maybe more. It would be difficult to get that much from diet alone, and besides, vitamin B12 is another nutrient better absorbed from supplements than from foods. You might even need to take shots instead of pills.
Vitamin B12 requires a substance in the stomach, called Intrinsic Factor, for absorption. Ample stomach acid is needed to trigger intrinsic factor, but acid often decreases as a person ages and definitely decreases when people take antacids or other medications for heartburn. Consequently, risk for vitamin B12 deficiency increases steadily as some people get older. Increased supplemental intake of this vitamin can offset this reduced absorption in many cases, but some people might require vitamin B12 shots, especially if they are on heartburn medications or have low stomach acid.
Gimme a D!
Vitamin D is no longer just for strong bones. In fact, it might be useful for a whole host of ills, from diabetes, multiple sclerosis, cancer and heart disease to boosting your immune system, curing chronic muscle pain and fibromyalgia and preventing depression, anxiety and even memory loss. There are even suspicions that a deficiency increases the risk for obesity. What’s more, you possibly need a whole lot more than you think. Happy, fit people place this vitamin at the top of their to-do list.
Up until recently, vitamin D’s only known job was to help prevent bone loss associated with diseases like osteoporosis and rickets. That’s because vitamin D is critical for the absorption of calcium and also ensuring the mineral gets deposited into bones. If you’re low on vitamin D, it’s a given you’ll only absorb about 10% of the calcium you consume, which is a surefire way to end up with osteoporosis later in life, even if you take lots of calcium. Getting enough vitamin D and calcium can significantly improve a woman’s chances of avoiding osteoporosis.
While we used to think only bones were sensitive to vitamin D, experts are finding that almost every tissue in the body has receptors for vitamin D, suggesting that it works its magic everywhere in the body.
We now know that vitamin D aids in the prevention and/or treatment of gum disease, diabetes, insulin resistance, arthritis, multiple sclerosis, hypertension and certain cancers, including colon, breast, pancreas and prostate cancers. Vitamin D also reduces the incidence of falls by up to 60% in seniors. A few very recent studies even suggest that vitamin D is critical for brain function in general, helping to boost not just mood, but also memory, reaction times and thinking.
In addition, we know that a deficiency of this vitamin is typically found in people who have risk factors for obesity, such as heart disease, diabetes and high blood pressure. It also is clear that overweight people are prime candidates for a vitamin D deficiency.
Happy, fit people also might get their mood boost from this vitamin. People prone to the blues have low levels of vitamin D, while happy people’s vitamin D levels are much higher. Even healthy, relatively happy people report a mood boost when they add extra vitamin D to their diets. The research is strongest for people battling seasonal affective disorder, or SAD, whose mood worsens as the seasons progress from fall through winter. For years, the only known cause was thought to be lack of sunlight. But it might be vitamin D these people lack.
Vitamin D really isn’t a vitamin at all. It’s a hormone. You don’t need to get it from your diet, since your body can make vitamin D if it’s exposed to sunlight long enough. When it comes to SAD, it might not be the lack of sunlight that causes the winter blues, but rather the lack of sunlight means the body can’t make enough vitamin D, which otherwise would have sparked a perkier mood through the winter months.
That’s what the research shows. Deficiencies of vitamin D escalate from 38% to 60% from fall to spring in people who battle SAD. Give them extra doses of vitamin D, and voilà! Their mood improves and anxiety drops. Although not yet studied, winter depression typically goes hand in hand with weight gain. Sidestep the blues and you might have a better chance of fitting into a swimsuit by spring.
A Cure for Muscle Aches?
Depression and muscle aches also might be a sign you are low in this vitamin. In fact, the depression, as well as the muscle and bone aches in a vitamin D deficiency, mimic the symptoms of fibromyalgia. Boost intake of this vitamin and the pain vanishes, while mood improves. Researchers suspect that up to 90% of unexplained chronic muscle pain could result from poor vitamin D status.
D-ficient?
Your body can make vitamin D, so why worry about whether you’re getting enough? Maybe because most Americans are deficient! In fact, more than 60% of Americans are woefully low in this vitamin. Nearly half of all people who take a supplement and think they are fine are actually deficient. That’s because four very important factors affect how well and how much vitamin D we make and, therefore, whether we are at risk for deficiency.
1. Age: Our bodies make vitamin D when skin is exposed to UVB sunlight. However, a person’s ability to manufacture vitamin D decreases with each passing decade, so by the time people enter their senior years, their bodies make as little as 20% of the vitamin D they made in childhood. In short, the older they are, the greater the risk for deficiency.
2. Location: People living north of the latitude running generally through Los Angeles and Atlanta typically are sun deprived and, consequently, low in vitamin D, especially during fall and winter. A recent study from the University of Georgia found that 75% of young girls had low blood levels for vitamin D, potentially placing them at risk for disease. If that many young girls living in sunny climates are low, it’s no wonder researchers suspect that everyone living in the north is low in vitamin D.
3. Skin Color: Melanin is the pigment that gives skin its color. Greater amounts of melanin result in darker skin. The high melanin content in darker skin reduces the skin’s ability to produce vitamin D from sunlight, which explains why African-Americans with a high level of melanin in their skin are 10 times more likely to be vitamin D deficient compared to fair-skinned people. Some studies suggest that older adults, especially women, in these groups are at even higher risk of vitamin D deficiency.
4. Sunscreen: Sunscreen blocks harmful UVB rays that cause skin cancer. That’s a good thing. But sunscreen also blocks the skin’s ability to make vitamin D. Even a sunscreen with an SPF of 8 blocks vitamin D by 97.5%. So people who lavishly use sunscreen can develop a deficiency, even if they are out in the sun all day.
Who Doesn’t Get Enough?
If you live anywhere above an imaginary line drawn between Los Angeles, California, and Atlanta, Georgia, you probably are not getting enough sunlight during the fall, winter and even spring months to ensure optimal vitamin D intake.
How Much Do You Need?
Up until recently, vitamin D was considered one of the vitamins that could be toxic, so safe intake limits were set very low, or about 200 IU to 600 IU a day, depending on age. But all the studies showing vitamin D lowers risk for everything from muscle pain to depression have used amounts far in excess of what people typically consume and, in many cases, much more than the current daily recommendations. As a result, many experts are calling for a change in the recommendations, which were set back in 1997 and are considered outdated and too restrictive.
According to researchers at Harvard, a supplement containing 1,000 IU a day would be helpful to the vast majority of Americans. The likelihood of toxicity at this dose is nonexistent. Hey, fair-skinned people’s bodies can manufacture 15,000 IU or more in as little as 30 minutes of unprotected sunbathing in the middle of July, so 1,000 IU is a pretty safe dose to consider! Of course, you should always consult your physician before taking any supplement, but for people living in the north or anyone over the age of 50, some type of vitamin D supplement is well worth pondering.
As with any nutrient, just because some is good doesn’t mean more is better. Vitamin D is a fat-soluble vitamin, which means the body doesn’t get rid of it when it is in excess, but rather stores it for future use. Build up too high a store and you could end up with kidney stones or even start stockpiling calcium in your heart or arteries, places that shouldn’t be hardened with bone minerals!
You can play on the safe side and have your level of this vitamin measured next time you are going in for a blood draw anyway. Ask to be tested for 25-hydroxy Vitamin D. A value below 20 nanograms is low, 20 to 30 nanograms is borderline and 30 to 50 nanograms is optimal. Have the test in November, because if you are low then, it is a sure thing you’ll be full-blown deficient by spring.
Light, Food and Supplements
Where are you going to get your D? You have three choices: 1. spend time in the direct sun, 2. eat lots of foods rich in this vitamin and 3. take a supplement. The first option is near impossible. Either you live south of Los Angeles and Atlanta and have not heeded the warnings to use sunscreen to prevent skin cancer, or you are at risk for a vitamin D deficiency. The second option also is difficult, since so few foods naturally contain much vitamin D and fortified foods are limited to no more than 100 IU per serving. That means you must drink 10 glasses of milk a day to get the latest recommended intake of 1,000 IU a day. Not likely.
That leaves supplements. If you live in hot, sunny climates and drink some milk or soy milk, then aim for 400 IU from supplements to fill in the gaps. For everyone else, talk to your physician about taking a supplement of 1000 IU a day.
Iron Up, Ladies
If you are a woman who feels down in the dumps or downright depressed much of the time, or if your energy level has taken a nosedive, rather than reach for another cup of coffee to get yourself through the day, try a little iron therapy.
Iron deficiency is the number one most prevalent nutrient deficiency, with estimates as high as 50% of women of childbearing age to 80% of active women being iron deficient. It’s almost a given if you are between the ages of 13 to 50, have been pregnant in the past two years, consume less than 2,000 calories daily, menstruate heavily or exercise frequently and vigorously that your iron levels are low. In contrast, seldom do men or postmenopausal women need to worry about iron; they should consider supplements only if blood tests show they are deficient, and even then only with physician monitoring.
Give Me Oxygen, or Give Me Death!
What’s the big deal with iron? This little trace mineral is the key oxygen carrier in the blood. Without enough iron, the tissues literally suffocate for oxygen and the signs of deficiency reflect this: you are fatigued, feel sluggish, can’t concentrate and are likely to come down with every cold and flu bug that passes by. You also are more prone to depression, postpartum depression, stress, anxiety, irritability, lethargy and memory loss. If you are a student, you have trouble retaining information, doing well on tests or even staying awake during class. If you exercise, you might notice that you can’t recover as quickly from an exercise session, your muscle strength is declining and you tire easily.
Those symptoms might sound like anemia, but it’s not likely you are anemic. Anemia is the final stage of iron deficiency. For months, years, even decades, you can be iron deficient and never progress to anemia. In fact, only about 8% of women actually become anemic, while anywhere between 20% and 80% of women are iron deficient. Long before the onset of anemia, tissue iron reserves are drained.
Request the Right Test
Your doctor typically only checks for anemia, drawing blood for hemoglobin and hematocrit tests. These tests pick up full-blown anemia, while more subtle iron deficiency goes unnoticed. That’s why if you suspect iron deficiency, you should request a more sensitive test called the “serum ferritin” test. And don’t be satisfied with a diagnosis of “you’re fine.” Ask for the value. A value of less than 20 mcg/l means you are iron deficient.
It happened to me when I was pregnant with my first child. I was an avid runner, averaging 40 or more miles a week, but now I could hardly make it up the short flight of stairs to my office in San Diego. When I complained to my doctor, he shrugged it off. “Of course you are tired, you’re pregnant. Your blood-work looks fine, just take it a little easier.” I knew how I felt wasn’t normal, so I ordered my own serum ferritin test. Instead of the optimal value of 20 or higher, my value was a measly 4 micrograms. When I returned to my doctor’s office and showed him the results, his attitude changed. “Well, I’ll be. You are iron deficient.” He put me on prescription iron supplements and within two weeks I was bounding up the stairs to my office again.
That experience convinced me how subtle, yet devastating, low iron can be. I knew how to eat right, yet even I was deficient. How many more women who weren’t trained to be as nutrition savvy as me were slugging it through the day, getting by with coffee and colas to stay awake, when really what they needed was a good kick in their iron intake? From then on, I asked every teenage girl and woman who came to me complaining of muddled thinking or feeling drained of energy to go back to their doctors and demand a serum ferritin test. You know what? Every single one of them that took the test found they were iron deficient.
Ironclad Rules
The best plan to avoid iron deficiency is prevention, but women must get much more aggressive about their iron intakes, since currently most of us average only about half our daily needs. Premenopausal women should consume several iron-rich foods daily, including extra-lean meat, fish, poultry and super mood foods like cooked dried beans and peas, dried apricots, dark green leafy vegetables and whole grains. They also should
1. Consume a vitamin C–rich food with every meal. Try orange juice, a tossed salad, broccoli or most fruits. Vitamin C dramatically improves the absorption of iron and counteracts some of the inhibitors in foods, such as phytates in whole grains and tannins in tea and coffee.
2. Emphasize the best iron. There are two types of dietary iron: the iron in meat, called heme iron, and the iron in plants, called nonheme iron. Heme iron is really well absorbed; about 30% of it makes it into the bloodstream, compared to only 2% to 7% of nonheme iron. Consuming small amounts of heme iron in red meat, such as extra-lean beef, with large amounts of nonheme iron, such as chili beans, increases the absorption of nonheme iron. Pork in a vegetable stir-fry and spaghetti with meatballs are other examples.
3. Cook in a cast iron skillet. The iron leaches out of the pot into the food, raising the iron content several hundred-fold, especially with acid foods, like tomato and spaghetti sauce.
4. Select iron-fortified foods. Choose foods with extra iron, such as ready-to-eat cereals or fortified oatmeal.
5. Drink tea and coffee between meals. Compounds called tannins in these beverages, whether they are caffeinated or decaffeinated or herb, green or black teas, block iron absorption by up to 80% when drunk with a meal.
6. Take iron supplements on an empty stomach to improve absorption. The best-absorbed forms are the “ferrous” forms, such as ferrous fumarate or ferrous sulfate.
A moderate-dose iron supplement should be considered when food intake falls below 2,500 calories and serum ferritin levels fall below 20mcg/l. How much? Premenopausal women need 18 milligrams of iron daily, while pregnant women need at least 27 milligrams. (Postmenopausal women and men need as little as 8 to 10 milligrams from food.) Women who are vegetarians, who menstruate heavily or who are on the IUD for birth control might need even higher amounts, up to 25 milligrams.
Unless prescribed by a physician, postmenopausal women should not take supplemental iron or should limit intake to no more than 10 milligrams. Severe iron deficiency may require a higher-dose prescription supplement. Supplements are just as effective as food in raising iron levels in the body, but you are best doing both—eating lots of iron-rich foods and taking a moderate-dose multiple that contains iron.
Iron is one of the few nutrients that can easily be assessed by a simple blood test. Feeling “not up to par” might not be all in your head, so don’t take it lying down!
The Antistress Mineral
Magnesium gets no respect. Other nutrients, like calcium, folic acid or iron, are in the news all the time, and even vitamin D has been getting some press of late. But you never hear about magnesium. Big mistake.
This mineral helps in more than 300 processes in the body. In fact, every cell in your body needs this mineral. That might explain why it helps lower the risk for diabetes, heart disease, high blood pressure, osteoporosis and much more. Yet three out of four Americans don’t get enough.
Why Magnesium?
When it comes to mood, magnesium is a major player. Stress triggers the release of stress hormones that drain magnesium from the body. In turn, low magnesium levels raise stress hormones, escalating the stress response. Studies on animals show that low magnesium intake increases sensitivity to noise and crowding and escalates stress-induced diseases, such as ulcers, while animals fed magnesium-rich diets cope better and are at lower risk for disease. Studies on people under pressure at work to meet ridiculously tight deadlines cope far better when their diets are rich in magnesium but are more likely to freak out if they aren’t.
Women who get crabby, depressed and downright difficult to live with the 10 to 14 days before their periods also need more magnesium. Magnesium levels drop during the last two weeks of the menstrual cycle, which might contribute to PMS symptoms, such as water retention, cramping, headaches and an oversensitive nervous system (feeling crabby, irritable and edgy?). Increasing intake of magnesium helps curb these symptoms—even to recommended levels is enough to see improvement in symptoms for some women.
How Much Do You Need?
You need about 320 to 500 milligrams of this feel-good nutrient every day. That doesn’t sound like much until you realize that most of the magnesium gold mines in the diet are foods many people don’t typically include in generous amounts, such as avocados, oysters, bananas and the super mood foods wheat germ, whole grains, cooked dried beans and peas and dark green leafy vegetables.
If you choose to supplement, look for the best absorbed forms, such as magnesium oxide, citrate or hydroxide. But don’t go overboard on this mineral! It is the active ingredient in Milk of Magnesia, which means that too much can loosen more than your muscles, leaving you in the bathroom rather than at the party.
Sammy Baby
For anyone battling depression, just getting up in the morning can be an overwhelming chore. The thought that there could be a natural solution with no side effects and that it’s as easy as taking a pill is almost too good to be true. But it is. Thirty years of studies show that SAM-e—the user-friendly name for S-adenosylmethionine—is as effective, and maybe even more effective, than some antidepressant medications in relieving the symptoms of depression.
SAM-e (pronounced “sammy”) isn’t a hormone, herb, vitamin or nutrient. It’s made naturally in the body from an amino acid called methionine, which you get from protein-rich foods, along with the assembly-line workers folic acid and vitamin B12.
Sometimes the body doesn’t make enough. This can cause all kinds of problems, since SAM-e acts as the “on” switch for a wide variety of processes. It helps make new cells and repair damaged ones, aids immunity, builds cartilage in joints, helps form the genetic code within cells, makes nerve chemicals like serotonin and dopamine and regulates moods and emotions. This translates into happier moods, quicker thinking, reduced arthritis pain and possibly fewer symptoms of fibromyalgia.
It is with mood that SAM-e works its best magic. Low SAM-e levels are seen in people who are depressed. Raise those levels by supplementing with SAM-e and despair, anxiety and irritability improve, if not vanish.
Numerous studies show that SAM-e works when all else fails. One study found that 400 milligrams a day of SAM-e was even more effective at eliminating depression than mood-altering medications. This supplement bests antidepressant drugs because it starts working within a few days to two weeks, while prescription drugs take much longer. SAM-e also appears to have few, if any, side effects, other than the occasional rare case of indigestion.
SAM-e also might be a smart pill, helping you concentrate and think faster. In one study, a combination of nutrients, including folic acid, vitamin B12, vitamin E and SAM-e, improved quick thinking by 10% in just three months and by 20% at the end of a six-month study. Preliminary evidence also suggests this little pill might help curb Alzheimer’s risk.
Are there any downsides to SAM-e? Yes, but they are few:
While up to 61% of depressed people get relief with this supplement, there is no evidence that it has any effect on mood in people who are already happy. It shouldn’t be taken as a tonic unless you really are blue.
SAM-e is off-limits for anyone with bipolar disorder, since it can escalate manic episodes.
Other than the fact that SAM-e has been used safely in Europe for more than 30 years as an antidepressant, there are few long-term studies, so no one knows for sure whether there might be any serious health hazards from taking it for decades.
It’s expensive, and analyses have found that what is promised on the label is not always what is inside the jar. Some brands have little or no SAM-e in their products, others have too much. To make sure you are getting what you paid for, choose a major brand, like NatureMade, to ensure quality.
How Much Do You Need?
Always discuss with your physician whether SAM-e is right for you. If you get the go-ahead, it typically is recommended that you start with 200 to 400 milligrams a day and up the dosage by 200 milligrams if you don’t see results within two weeks. Some studies have used up to 1,200 to 1,600 milligrams a day. Look for brands that list 1,4-Butanedisulfonate on the label. That’s an ingredient in the patented formulation of SAM-e used in Europe. Also look for products that are enteric-coated, which ensures they remain intact through the stomach and don’t dissolve until they get into the small intestine, where they are absorbed into the bloodstream.
Herbal Remedies for a Bad Mood
- St. John’s Wort: Also called hypericum, this herb curbs symptoms of depression in about one in every two people battling mild depression, SAD and possibly even PMS. No optimal dose has been identified, but a suggested dose is 300 to 1,800 milligrams a day, taken in divided doses. Always discuss this herb with your physician before taking, since it can interfere with some medications, including oral contraceptives, warfarin (Coumadin) and Cyclosporin, and should not be taken with antidepressant drugs.
- Kava Kava: Fans swear this herb calms them down, is a painkiller and helps them think clearly. Kava lactones in kava kava tickle the processing centers for emotions and moods in the brain. But studies have produced mixed results. When kava kava does work, the effective dose appears to be somewhere around 100 milligrams of kava extract taken three times a day. Look for products standardized to contain at least 70% kava lactones (60 to 75 milligrams/capsule). Don’t take this antianxiety herb with prescription medications, when driving or operating heavy equipment, with alcohol or if you are younger than 21 years old, pregnant or nursing.
- Gingko: This root possibly boosts memory and attention, improves circulation, and aids in the treatment of dementia, tinnitus and Alzheimer’s disease. You need at least 120 milligrams a day, preferably in divided doses. Look for products standardized to 24% flavone glycosides and 6% terpene lactones. Gingko might upset your stomach, cause headaches or skin reactions, and it should not be taken by pregnant women, before surgery or in conjunction with blood-thinning medications, including aspirin. Always consult your physician if you are taking any prescription medications.
- Ginseng: Studies on animals show ginseng might aid the nerves and heart and help balance hormones, promote immunity and boost metabolism, improve thinking and memory and even slow aging. Benefits for people are unknown, but possibly include helping control blood sugar in diabetics. You need 0.5 to 2 grams of the dried root, or up to ½ teaspoon ginseng extract or tea taken up to twice daily. Many ginseng supplements contain less active ingredients than listed on the label or are contaminated with lead or pesticides, so stick with reputable brands that are standardized to 4% to 7% ginsenosides. Take for no longer than three months. Pregnant and breast-feeding women or anyone with high blood pressure should avoid ginseng. Diabetics should be monitored by a physician.
Happiness in a Pill
All of these supplements can help improve mood and are relatively safe when taken in the recommended doses. But don’t get carried away. You can’t cover your bases with a pill, so don’t leave common sense and good nutrition waiting in the wings. You must eat really well and supplement responsibly if you want to feel, look, think and act younger than your age!
If you’re hungry for more info on supplements, check out the National Institutes of Medicine Office of Dietary Supplements website at www.ods.od.nih.gov.