July 6, 2020

New study demonstrates selenium reduces antibody levels in Hashimoto’s patients

Hashimoto’s is one of the most common autoimmune diseases. Autoimmunity can occur a few different ways, but eventually the thyroid gland progressively becomes underactive due to antibody and cell mediated autoimmune processes.

Environmental triggers are what integrative doctors mainly work with in functional medicine to healthy address the dysfunction in autoimmune disease. These can be food triggers such as gluten or food sensitivities that can trigger inflammation as well as anything coming in with the food such as toxins or molds. In addition, the nutrient status of the person. This can be antioxidant status, vitamins, essential fatty acids, vitamin D, etc. Also, gut health. This includes “leaky gut” and dysbiosis. There are also toxins that can be affect the status of the immune system. These are heavy metals, xenobiotics, as well as the total toxic burden in the body.

According to a study published last month in Advanced Biomedical Research, researchers demonstrated that selenium reduces antibody levels in patients with Hashimoto’s thyroiditis.

In this study, seventy patients ranging from 18 to 60 years of age with Hashimoto’s were divided into two groups. One group received 200 mcg of selenium with levothyroxine and the other group received a placebo along with the medication. Laboratory assessment included serum selenium levels, TSH, freeT4, free T3, and thyroid antibodies at baseline and three months later.

As a result, the mean thyroid peroxidase antibody level was significantly lower after treatment in the selenium group. Selenium is involved in the metabolism and regulation of thyroid hormones and is an antioxidant which has protective properties. 

Another nutrient to consider is inositol. Myo-inositol is a second messenger regulating several hormones such as insulin and TSH.

A previous study published last year in the European Review for Medical and Pharmacological Sciences demonstrated that inositol at 600 mg a day and selenium at 83 mcg per day significantly reduced TSH levels in Hashimoto’s patients with subclinical hypothyroidism and increased thyroid hormone concentrations. In addition, there was a reduction in TPO and thyroglobulin antibody concentrations.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Kachouei A, Rezvanian H, et al. The Effect of Levothyroxine and Selenium versus Levothyroxine Alone on Reducing the Level of Anti-thyroid Peroxidase Antibody in Autoimmune Hypothyroid Patients. Advanced Biomedical Research. 2018 January 22;7:1. doi: 10.4103/2277-9175.223735

New review investigates exercise, diet, and supplementation on the immune system and aging

As the body ages, the immune system changes and goes through a remodeling process. There is a reduction in immune cell functions which can lead to an increasing risk of infection, viral reactivation, and increased risk of autoimmune disease and cancer. These changes are affected by exercise, muscle mass, and nutritional status.

In addition, chronic low grade inflammation has been shown to contribute to almost all chronic disease and has been correlated with aging. After 40 years of age the body’s cells are typically less able to produce antioxidants and soak up free radicals making them more susceptible to damage and death.

According to a review published last month in Nutrients, researchers investigated the effects of exercise, diet, and supplementation on the immune system and aging.

 Numerous studies have demonstrated the benefits of exercise on aging and the immune system. Exercise has been shown to increase natural killer cell function. In addition, cross-sectional studies in older adults in highly trained individuals, runners, and cyclists have showed improved function of the adaptive immune system including improved T-cell proliferation, reduced inflammation, and decreased thymus output.

Dietary intake of polyunsaturated fatty acids are also essential for overall health as well as impacting immune function. Studies on omega-3 fatty acid supplementation had dosing ranges of 2 to 3.3 grams per day over a duration of 3 to 6-month period. Supplementation with omega-3 fatty acids significantly reduce kynuerinine levels. Kynuernate is a metabolite of tryptophan, which is elevated in chronic low grade inflammation.

Accumulating research also demonstrates the association of the gut microbiome to health status and aging. There is evidence that age-related changes in the gut microbiome may be related to elevated inflammatory makers and other geriatric conditions such as sarcopenia, frailty, cognitive decline secondary to reduced short chain fatty acid production. Also, the immune system has a tendency to decline with age which makes one more susceptible to infections as well as increasing the risk of chronic disease. Probiotics have the potential to rebalance gut microbiota and modulate gut immune response inhibiting the NF-κB pathway. Probiotics control microbial populations, alter cytokine expression, increase secretory IgA, increase natural killer cell activity, and reduce the risk of infections.

Previous research has demonstrated how the gastrointestinal tract changes with aging and how this impacts overall health. As one ages, the gut has an increase in interleukin 6 (IL-6) which causes the immune system to release IL-6 and trigger inflammation.

Increased levels of IL-6 directly lead to increased intestinal permeability with no physical differences seen in its structure. They also showed there was an association with a decreased immune response to microbes with aging, which may contribute to an increased susceptibility to infection.

Probiotics help encourage microbial diversity, especially if the probiotic supplement is of mixed species. In ecological terms, it is more stable to have diverse populations in any ecosystem. The same is true for the gastrointestinal microbiome.

These results suggest that nutritional supplements including both omega-3 fatty acids and probiotics can significantly reduce established biomarkers of systemic inflammation in middle-age and older adults. Other nutrients to consider for aging and inflammation and the immune system include tocotrienols, geranylgeraniol, resveratrol, quercetin, and specialized pro-resolving mediators.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Weyh C, Kruger K, et al. Physical Activity and Diet Shape the Immune System during Aging. Nutrients 2020, 12(3), 622.

Study demonstrates antiviral effect of quercetin by inhibiting virus entry

Quercetin, a polyphenol, has been shown to have both strong antioxidant as well as anti-inflammatory properties. It is one of the ubiquitous flavonoids found in many Chinese herbs, fruits, and vegetables. Common foods include blueberries, red onions, broccoli, cauliflower, kale, and many nuts. Research has demonstrated that quercetin supplementation has anti-hypertensive, anticoagulant, and anti-hyperglycemic properties.

A previous study demonstrated that quercetin could protect patients from dying from severe complications associated with the H1N1 influenza A virus, however, the mechanism was unknown.

According to a study published in Viruses, researchers investigated the effects of quercetin as an anti-viral agent. There have been several other infections such as the H1N1 swine flu, H5N1 avian influenza, and H7N9 influenza virus, which can lead to acute respiratory distress syndrome, pulmonary compromise, and death. Due to the lack of drugs to treat these infections, natural compounds are a major area of anti-viral research discovery.

The life cycle of the influenza virus consists of viral attachment, entry, replication, and release.

This study demonstrated that quercetin can inhibit the entry of an influenza virus in the early stage of infection measuring the inhibition in a cell infection model. This is the initial step of the viral replication cycle. In addition, the research team noted that this inhibitory effect was increased when the virus was pre-incubated with quercetin. It is also important to note that quercetin being an antioxidant and having anti-inflammatory properties reduces the expression of pro-inflammatory cytokines and lung inflammation in mice.

As a result, quercetin may provide an inexpensive natural polyphenol for prevention and treatment of influenza infections. It may also be considered in combination with other therapeutics and drugs, which could have an increased anti-viral effect, reduce drug dosage, and fewer side effects. As a dietary supplement, quercetin is often consumed between 200 mg to 1200 mg. Other anti-viral compounds to consider include vitamins A, vitamin C, vitamin D, zinc, monolaurin, melatonin, resveratrol, and geranylgeraniol.  Vitamin C specifically has been shown to improve the absorption of quercetin and increase plasma levels.

 By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Wu Wenjiao, Li Richan, et al. Quercetin as an Antiviral Agent Inhibits Influenza A Virus (IAV) Entry. Viruses. 25 December 2015;8(1).

New study demonstrates lutein and zeaxanthin improve cognitive function in young healthy adults

A wide variety of research has shown the beneficial effects of diet on nearly every aspect of brain function and overall health. Lutein is selectively incorporated into the macula as well as the brain. Lutein levels in the macula and the brain have been associated with better cognition.

Previous research has demonstrated the benefits of lutein and zeaxanthin on eye health and some research is emerging on their benefits on cognition in older adults.

According to a study published 3 days ago in Nutrients, researchers demonstrated that supplementation with lutein and zeaxanthin improve cognitive function in young, healthy adults.

In this study researchers assessed cognitive function of 51 young healthy individuals ages 18 to 30.  These individuals were randomized into supplement and placebo groups. Macular pigment optical density (MPOD) was measured as well as cognitive function using the CNS Vital Signs testing platform. MPOD and cognitive function were measured every four months for one year of supplementation. As a result, supplementation increased MPOD significantly over the course of the year compared to the placebo group. Researchers demonstrated that lutein and zeaxanthin increases in MPOD which resulted in significant improvements in spatial memory, reasoning ability, and complex attention.

In addition to supplementation, avocados are a great bioavailable source of lutein, containing approximately 0.5 mg of lutein. A study published earlier this year in August demonstrated that avocado consumption increases macular pigment density.

Other brain supportive nutrients to consider are GPC, CDP-choline, gingko biloba, and phosphatidylserine, and fish oil. GPC and CDP-choline are water soluble forms of choline that can cross the blood brain barrier and support brain health. These help make more acetylcholine, neurotransmitters, as well as phosphatidylcholine in the cell membranes. In addition, phosphatidylserine is an essential nutrient for brain function and is not found in the diet.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Renzi-Hammond LM, Bovier ER, et al. Effects of a Lutein and Zeaxanthin Intervention on Cognitive Function: A Randomized, Double-Masked, Placebo-Controlled Trial of Younger Healthy Adults. Nutrients. 2017 November 14;9(11).  pii: E1246. doi: 10.3390/nu9111246.

New study demonstrates quercetin improves metabolic features of PCOS

PCOS is associated with irregular menstrual periods, infertility, obesity, diabetes, excess hair growth, acne, and other hormonal difficulties. Researchers compared the effects of lifestyle changes alone or with placebo to lifestyle combined with metformin. They found that lifestyle modification combined with taking metformin resulted in increased weight loss. As a result, there was a lower body mass index (BMI), and improved menstruation.

In a new study published six days ago in Cell Journal, researchers demonstrated that oral quercetin supplementation improves the metabolic features of PCOS patients by upregulating adiponectin and Amp-activated protein kinase (AMPK). Adiponectin signaling regulates fatty acid metabolism and glucose by activation of AMPK.

Pharmaceutical interventions provide some improvements but they do not correct many of the underlying factors and have side effects that may not be tolerated by patients. Many PCOS patients are overweight and have dietary habits that exacerbate the condition.

This randomized clinical trial consisted of 84 patients with PCOS. They were randomly assigned to two groups. One group received 500 mg quercetin twice daily for 12 weeks and other group received a placebo.

As a result, researchers demonstrated that oral quercetin supplementation significantly increased the expression of adiponectin receptors and AMPK.

Quercetin supplementation enhanced AMPK level by 12.3% compared with the placebo group.

Other nutrients to consider to support PCOS:

Studies have shown that an inositol deficiency is common in women with PCOS. There appears to be a reduced ability to process, metabolize, and effectively use inositol from foods which is a distinctive characteristic feature of PCOS. As a result, the nutritional requirements of PCOS patients may not be met by a simple change in the diet and that inositol should be viewed as a conditionally essential nutrient in these women.

Myo-inositol and D-chiro-inositol are both essential for patients with PCOS. The conversion of myo-inositol to D-chiro-inositol is of interest because errors here have been strongly involved in PCOS patients. Strong evidence supports that the body makes D-chiro-inositol from myo-inositol and more evidence suggests that some people are less able to make this conversion than others.  Along this spectrum, people who are completely unable to convert myo-inositol to D-chiro-inositol are only going to benefit from supplementation with D-chiro-inositol. Other people who make the conversion, but with less than optimal efficiency, may benefit from large doses of myo-inositol. And, other individuals in between, might see the best results from a blend of the two. Since this conversion is impaired in individuals with PCOS, it is important to always include D-chiro-inositol with myo-inositol supplementation. D-chiro-inositol is the more potent form of inositol for supporting insulin resistance, however, myo-inositol is need for oocyte quality and maturation. Therefore, supplementing with D-chiro-inositol alone cannot not fulfill myo-inositol’s roles that are specific and different from D-chiro-inositol, since it does not convert to myo-inositol.

Also, essential fatty acids should be consumed in our diets for overall health, but most individuals with insulin resistance are deficient. Fish oils improve insulin sensitivity and reduce inflammation. 

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Rezvan N, Moini A, et al. Oral Quercetin Supplementation Enhances Adiponectin Receptor Transcript Expression in Polycystic Ovarian Syndrome Patients: A Randomized Placebo-Controlled Double-Blind Clinical Trial. Cell Journal. 2018 Jan;19(4):627-633. doi: 10.22074/cellj.2018.4577. Epub 2017 Nov 4.



A new review demonstrates acetyl-l-carnitine significantly decreases depressive symptoms

Acetyl L-carnitine is one of the most researched brain nutrients that has been shown to quickly enhance mental focus and energy. It has a similar structure as acetylcholine, and therefore, acetyl l-carnitine can stimulate acetylcholine receptors in the brain. The acetyl group allows it to cross the blood brain barrier, which does not occur with L-carnitine.  Acetyl-l-carnitine will support the brain as well as everything else that l-carnitine can do.

Carnitine is abundant in animal muscle tissue, including red meats. Its main function is to transport fatty acids across the mitochondrial membrane for fatty acid oxidation. Supplementation of carnitine has been studied in many areas including metabolism, cardiovascular disease, and sports enhancement.

According to a new review published last Wednesday in Psychosomatic Medicine, researchers demonstrated that acetyl-l-carnitine can significantly reduce depressive symptoms and an insufficiency of acetyl-L-carnitine can play a role in the risk of developing depression, suggesting dysregulation of fatty acids transport across the mitochondria.

In this study, researchers reviewed 12 random controlled trials (RCTs), 11 in which acetyl-l-carnitine was a monotherapy. In nine studies, there was a total 791 individuals, 231 treated with acetyl-l-carnitine, 216 people treated with placebo and 20 individuals with no intervention. As a result, the analysis showed that acetyl-l-carnitine significantly reduced depressive symptoms. The other 3 RCTs compared acetyl-l-carnitine vs. antidepressants. There were 162 individuals for each group. Acetyl-l-carnitine demonstrated similar effectiveness compared to antidepressants in decreasing depressive symptoms.

Most people associate acetyl L-carnitine with preventing age-related memory decline and slowing Alzheimer’s, however, it is also very effective for increasing mental focus, energy, and optimizing brain health. Acetyl-l-carnitine increases dopamine which enhances focus and motivation. Most individuals dose acetyl-l-carnitine between 500 mg and 3000 mg a day depending on the application. This is one of those nutrients individuals feel an increase in focus and energy within about 15 to 20 minutes. There are no side effects and only long term benefits on brain health and function.

Other brain supportive nutrients to consider are GPC, CDPcholine, gingko biloba, and phosphatidylserine, and fish oil. GPC and CDP-choline are water soluble forms of choline that can cross the blood brain barrier and support brain health. These help make more acetylcholine, neurotransmitters, as well as phosphatidylcholine in the cell membranes. In addition, phosphatidylserine is an essential nutrient for brain function and is not found in the diet. Research has demonstrated that phosphatidylserine improves depressive symptoms, memory, and behavior.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Veronese N, Stubbs B, et al. Acetyl-l-carnitine Supplementation and the Treatment for Depressive Symptoms: A Systemic Review and Meta-analysis. Psychosomatic Medicine. 2017 October 25.


New study demonstrates glutamine decreasing intestinal permeability in runners

There has been increased evidence on the prevalence of intestinal permeability in athletes the last year and a half. I shared previous studies on heavy exercise induced intestinal permeability in athletes.

When one thinks of nutritional supplements in athletes, they usually think of nutrients that increase enhance energy and sports performance. However, athletes commonly suffer from gut issues that are often not identifies or addressed. ‘Leaky gut’ occurs from dysfunction in the intestinal barrier.  This intestinal barrier in the gut is only one cell layer thick. It is essential for the absorption of nutrients and preventing large molecules and bacteria from getting into the blood stream.

This is a particular problem for those taking part in heavy exercise or any form of vigorous strength training, such as CrossFit athletes, strongman competitors, and powerlifters, which can lead to gut issues in athletes as well as more serious conditions like inflammatory bowel and autoimmune disorders.

In addition, gastrointestinal discomfort is a common complaint among endurance athletes who participate in marathons and triathlons as well.

In a study published last Friday in the European Journal of Applied Physiology, researchers demonstrated that acute supplementation with glutamine mitigates intestinal permeability in runners.

It makes sense to consider BCAA power with glutamine or glutamine powder prior or during exercise to prevent gastrointestinal barrier dysfunction.

Also, other studies have demonstrated that oral supplementation with colostrum decreases intestinal permeability.

These findings demonstrate the importance of colostrum and glutamine in preventing leaky gut and are important nutrients to consider for athletes. When working with athletes, there is often a disconnect between fitness and health. For those individuals that have a sensitivity to dairy and cannot use colostrum, serum-derived bovine immunoglobulin/protein isolate (SBI) is a great alternative to normalize the gut microbiota and decrease gut permeability. The other advantage of this for athletes is the addition protein content with BCAAs levels superior to whey and provides high levels of IgG which reduces inflammation decreasing mucosal damage.

I work with many of these athletes. Due to the stresses they put on their bodies and increased metabolic demands, many often have debilitating gut issues and inflammatory bowel diseases.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS Source: Pugh JN, Sage S, et al. Glutamine supplementation reduces markers of intestinal permeability during running in the heat in a dose-dependent manner. European Journal of Applied Physiology. 2017 Oct 20.

New study demonstrates a multivitamin can improve symptoms in children with ADHD

According to a study published 2 weeks ago in The Journal of Child Psychology and Psychiatry, researchers demonstrated that supplementation with a multivitamin and mineral formula can improve aggression and emotional regulation in children with ADHD.

This was the first randomized, placebo controlled trial of children with ADHD not on medication.

In this study 93 children ages 7 to 12 years of age were given either a multivitamin/mineral formula or placebo for 10 weeks.  During this time researchers obtained data from their parents, teachers, and doctors. They measured ADHD symptoms, levels of aggression, mood, emotional regulation, general functional and impairment.

As a result, 47% of the children taking them multivitamin/mineral formula improved “much” or “very much”. This was in comparison to 28% in the placebo group. In addition, 32% of the children who received the supplement demonstrated improvements in attention, however, there were no changes in impulsivity or hyperactivity.

This study showed that a multivitamin/mineral formula can improve emotion, attention, and general functioning in children with ADHD. Twice as many children in this study had severe mood dysregulation and were randomized to the supplement group, which showed a clinically significant improvement compared to the placebo group.

Previous research has demonstrated specific nutrients and their positive impact on ADHD symptoms such, as essential fatty acids, carnitine, and phosphatidylserine. Optimal nutrition is important for brain health and this influences emotions and behavior which can impact ADHD symptoms. Gut dysfunction, food sensitivities, food dyes, processed foods, and low intake of fruits and vegetables can play a role.

The bottom line is we need optimize every child’s nutrient status based upon testing and support accordingly and we cannot forgot supporting these children with essential fatty acids. Addressing insufficiencies can optimize brain function as well as possibly prevent and alleviate some of the symptoms associated with ADHD without harmful side effects.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Rucklidge JJ, Eggleston MJF et al. Vitamin-mineral treatment improves aggression and emotional regulation in children with ADHD: a fully blinded, randomized, placebo-controlled trial. The Journal of Child Psychology and Psychiatry. 2017 October 2.


Resveratrol improves insulin sensitivity and glucose control in patients with diabetes

Resveratrol is a polyphenol with powerful antioxidant and anti-inflammatory properties.  It has been widely publicized for its cardiovascular, anti-carcinogenic, and anti-aging benefits.  

Resveratrol activates sirtuins, which can increase insulin sensitivity and protect against oxidative damage. Previous research with resveratrol has demonstrated improvements in dysglycemia and insulin sensitivity, however, there has been some inconsistency in results.

According to a new review published 3 weeks in Nutrition & Metabolism, researchers demonstrated that resveratrol does improve glycemic control and insulin sensitivity in individuals with type II diabetes.

This review consisted of 9 RCT studies, dosing ranges from 8 mg/d to as high as 3 g/d with a duration of 4 weeks to 12 months. The overall results demonstrated that resveratrol significantly reduces fasting glucose levels but only at a dosage of 100 mg/d or more. In addition, HOMA-IR, fasting insulin levels, and blood pressure was also reduced by resveratrol.

In addition, a previous study published earlier this year in the International Heart Journal, researchers demonstrated resveratrol’s benefits in improving arterial stiffness and reduced oxidative damage in patients with type II diabetes. This study used the same dosage of 100 mg which has been shown to reduce fasting glucose levels.

Resveratrol can act through several mechanisms, including binding and activating estrogen receptors to increase nitric oxide bioavailability and facilitate the vasodilatation. In addition, it decreases reactive oxygen species production in vascular endothelial cells. Oxidative stress is elevated in chronic disease such as obesity and diabetes. 

These results support resveratrol supplementation as a potential strategy for improving glucose control and insulin sensitivity as well as mitigating arterial stiffness and reducing blood pressure and oxidative damage with patients with type II diabetes.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Zhu X, Wu C et al. Effects of resveratrol on glucose control and insulin sensitivity in subjects with type 2 diabetes: systematic review and meta-analysis. Nutrition & Metabolism. 2017 Sept 22;14:60.



New study demonstrates the importance of vitamin K and cardiovascular function in teens

According to a new study published Sunday in The Journal of Nutrition, researchers demonstrated that there is a 3.3 times greater risk heart enlargement in healthy teens who consumed the least vitamin K1. This form of vitamin K is predominantly found in green leafy vegetables such as, spinach, cabbage, and lettuce.

Interestingly, approximately 10% of the teens have some degree of left ventricular hypertrophy according to the research team. This is the first study exploring associations between vitamin K, heart function, and structure in young healthy individuals. These results suggest early interventions to ensure adequate vitamin K1 in young people could improve cardiovascular development as well as reduce future cardiovascular disease risk.

This study consisted of 766 teens ages 14 to 18 years of age. They found that those who consumed the least amount of vitamin K1 had an increased overall size and thickness of the left ventricle.

In addition, only 1/4 of the teens in this study met the current adequate intake levels of the Food and Nutrition Board of the Institute of Medicine. There is also evidence that vitamin K levels are lower in obese and overweight children.

Vitamin K plays a significant role in blood clotting, cardiovascular health, and optimal bone health. It is essential for the production of osteocalcin.

The Framingham Offspring Cohort Study also found an association between higher vitamin K1 levels and lower lipid levels in the blood.

Vitamin K should be met with the intake of K1 from food sources and supplementation since some K1 will convert to K2-MK-4. There has been a lot of hype and promotion of K2 (MK-7) but keep in mind there are no proprietary forms of K1 and K2 (MK-4). Vitamin K2 (MK-7) does convert to K2 (MK-4).

There is also no evidence for an ideal ratio between D and K1 or K2. The bottom line is we need to optimize each of these based on testing.

Most people I find need anywhere form 5,000-10,000 IUs/day of vitamin D and about 1-2 mg of K1 since most people do not eat enough vegetables as we have seen in this study to get enough K. This is also the amount that carboxylates osteocalcin. This was a patient’s lab report I received back on Wednesday.

As you can see the patient has a vitamin K insufficiency. I never give vitamin D without vitamin K. About 70% of my patients have vitamin K insufficiencies. It seems to be as prevalent as magnesium deficiency. In addition, I have personally have found vitamin K1 supplementation to be much more successful at lowering undercarboxylated osteocalcin levels than K2 (MK-7).

It makes sense to supplement with all three forms of vitamin K [K1, K2(MK-4, and MK-7)] and not get hung up on the marketing hype of one proprietary form.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Mary K Douthit, Mary Ellen Fain, Joshua T Nguyen, Celestine F Williams, Allison H Jasti, Bernard Gutin, Norman K Pollock. Phylloquinone Intake Is Associated with Cardiac Structure and Function in Adolescents. The Journal of Nutrition, 2017; jn253666 DOI: 10.3945/jn.117.253666