Orthomolecular Compounds Flashcards
1
Q
what does orthomolecular means and who invented the term?
A
Orthomolecular mean the right molecules in the right amount. Orthomolecular compounds are naturally synthesised by the body but additional amount can be sourced from diet or supplements
Linus Pauling
2
Q
what does orthomolecular medicine describes?
A
preventing and treating disease by providing the body the optimal amount of substances it also produce => optimal nutritional environment will reduce disease
Emphasis on prevention, restoration and maintenance of health through nutrients normally present in the body
3
Q
explain how you can use orthomolecular compounds for healthy ageing?
A
ageing process = free radical exposure, chronic inflammation, low sleep, heavy alcohol, poor nutrition, pollution …
reversing ageing with use of CoQ10, ALA and antioxidants
4
Q
what is CoQ10 ?
A
Present in every cell’s mitochondria - plays a key role in ATP production
Exist in an oxidised form (ubiquinone) and reduced form (ubiquinol) ==> good antioxidant because can give an electron and oxidise itself and not create oxidative damage
5
Q
what factors reduce CoQ10?
A
ageing, drugs (statins), smoking, CVD
6
Q
Food sources of CoQ10>
A
Plant: nuts (peanuts and pistachio), sesame seeds, olive oil, oranges, strawberries, avocado, cauliflower, brocoli
Animal: meat, poultry, fish (SMASH), eggs
7
Q
what cooking method to avoid for CoQ10 and why?
A
15-30% of CoQ10 is lost when food is fried => fat soluble
8
Q
5 functions of CoQ10?
A
- energy production => CoQ10 needed for Electron Transport Chain
- antioxidant => Potent fat soluble antioxidant inhibits the per oxidation of cell membrane lipids. Neutralise free radical produced by mitochondria
- Periodontal health => need for CoQ10 increase with diseased gum because create oxidative stress and mitochondrial dysfunction
- Male and Female fertility => CoQ10 protects sperm from oxidative stress (are very susceptible to OS because have a lot of DHA in their membrane). Low CoQ10 can drive ageing oocytes and infertility in woman
- CV health => coq10 key to cardiac muscle function as requires high ATP production. Protects against endothelial dysfunction and atherosclerosis.
9
Q
Why is it important to increase CoQ10 with ageing? What dosage?
A
CoQ10 naturally decrease with ageing
Dosage = 100-200 mg/ day divided
10
Q
Consequences of CoQ10 depletion
A
fibromyalgia, type 2 diabetes, CVD, neurodegenerative diseases and cancer
11
Q
dosage of coq10 for periodontitis?
A
50-80mg/day combines with mouth health routine
12
Q
dosage of coq10 for female and male reproductive health
A
male 200-300mg for 6 months
female 100-600mg
13
Q
why CoQ10 is important for Cardio vascular health?
A
CV health => coq10 key to cardiac muscle function as requires high ATP production. Protects against endothelial dysfunction and atherosclerosis.
=> reduces LDL oxidation
=> inhibit NF-KB (protein that controls pro inflammatory cytokines production)
=> increase superoxide dismutase activity (preserve NO activity helpful for HBP)
14
Q
Explain the problem with statins and CoQ10?
A
Statins drugs are used to reduce cholesterol, but they also reduce CoQ10 because both compound are synthesise via the same pathway (the Mevalonate pathway).
Statins block the HMG-CoA enzymes and stop the Mevalonate pathway.
recommend client on statin to supplement CoQ10
15
Q
which enzyme stop statins and which pathway does it affect?
A
HMG-CoA enzymes
Mevalonate Pathway
16
Q
what dosage of CoQ10 for someone on statin?
A
90-300mg/day
17
Q
CoQ10 supplementation, safety, adverse effect and interaction?
A
Safety: safe - no research on pregnant women (appart on woman at risk of preeclampsia and reduced it greatly - 200mg/day for 20 weeks)
Adverse effects: nausea, diarrhoea, appetite suppression, heartburn, abdominal discomfort. => reduce dose to 100mg divided
Interaction: may decrease warfarin effects s coq10 structure similar to vitK
18
Q
Therapeutic uses of CoQ10 and associated dosage?
A
- Fatigue, Fibromyalgia (300mg in divided doses / day
- Healthy ageing (100-200mg / day)
- Periodontitis ( 50-80mg / day)
- Male sperm health (200-300mg/day) and Female egg health (100-600mg/day)
- Hypertension, angina pectoris, congestive heart failure (60-300mg /day)
19
Q
What is ALA (Alpha Lipoic Acid)?
A
ALA is an organosulphur compound synthesised by human, plants and animals
20
Q
what are the two forms of ALA? which is more potent?
A
R-form (natural) and S-form (synthetic). The R-form is 10x more potent
21
Q
ALA food source?
A
Plant: brassicas, spinach, potato, carrot, beets, tomato, pears, brewers’ yeast
Animal source: Red meat, organ meat
22
Q
7 functions of ALA
A
- Energy production: ALA is a key coenzyme in Krebs cycle
- Antioxidant: ALA is a potent fat and water soluble antioxidant. ALA can regenerate other antioxidants (vit E, C, Glutathione and CoQ10) + up regulate glutathione expression
- Reproduction: protects sperm DNA, fuel for sperms
- Insuline sensitivity: improve insulin resistance and fasting blood glucose and HbA1c
- Heavy metal chelator
- Peripheral neuropathy: reduce oxidation of myeline sheath
- promote weight loss via: reduce Oxidative stress (fat storage), suppress appetite through influence on AMPK in hypothalamus, increase energy expenditure at rest
23
Q
Therapeutic use and dosage of ALA?
A
- fatigue, chronic fatigue syndrome, mitochondrial support
- sperm health, infertility (600mg/day)
- Diabetes, diabetic neuropathy
- Alzheimer’s (600mg / day), MS, healthy ageing, peripheral neuropathy
- Diabetes mellitus (300-1200mg/day)
- Weight management 1800mg/day
24
Q
how to take ALA supplements?
A
On empty stomach to increase bioavailability 1h before or 2h after food
25
adverse effects of ALA and interactions?
- Rare adverse effect: allergic reaction (skin rash) and GI symptoms)
- Interaction with Biotin as compete for transport across cell membrane
- increase risk of hypoglycaemia in medicated diabetic patients (additive effect)
26
What nutrient deficiency should you be mindful off with ALA supplementation?
Biotin - compete for transport
27
What medication interaction exist with ALA supplements?
Diabetic medication - additive effect - monitor blood sugar levels closely as there is a risk of hypoglycaemia
28
What HbA1c results should be?
Below 6% - someone with diabetes should be kept below 6.5% or less.
29
What is glucosamine? What is it required for?
Glucosamine is an amino sugar naturally present in most body tissues - high concentration in joints and cartilages
Required for the synthesis of glycoproteins, glycolipids and glycosaminoglycans (GAGs)
30
Glycoproteins, glycolipids and glycosaminoglycans (GAGs) are structural components of what? (Glucosamine)
tendons, ligaments, cartilage, synovial fluid, mucous membrane, eye, heart valve and blood vessels
31
In what form can glucosamine be supplemented ? x2
- G6P (glucosamine-6-phosphate) and NAG (N-Acetyl-Glucosamine)
- Glucosamine sulphate (not vegetarian or not suitable for seafood allergies)
- Glucosamine hydrochloride - created synthetically from corn
32
what is NAG converted to?
Hyaluronic acid (HLA)
33
What is Hyaluronic acid (HLA) important for?
component of synovial fluid (lubricate the joints)
34
2 therapeutic uses of Glucosamine ? and dosage
OSTEOARTHRITIS
- glucosamine stimulates the metabolism of chondrocytes (cartilage making cells) and synovial cells in the synovial tissue - slows down joint degeneration
- pain reduction similar to NSAIDS
- reduce inflammation by inhibiting Interleukin-1 (pro-inflammatory cytokines)
- less effective for severe long standing osteoarthritis
- more effective combined with chondroitin and MSM Methylsulfonylmethane
Dosage - 1500mg/day in 3 doses of glucosamine sulphate
IBD and INTESTINAL PERMEABILITY
- NAG supports the GI epithelial barrier by enhancing mucin functionality (altered with people with IBD)
- NAG reduce biofilm formation associated with IBD
- NAG can be used in intestinal permeability
Dosage - 3-6g/d for children. 6g/d for adults in 3 doses of NAG
35
Therapeutic use of Glucosamine for osteoarthritis (mechanism)?
- glucosamine stimulates the metabolism of chondrocytes (cartilage making cells) and synovial cells in the synovial tissue - slows down joint degeneration
- pain reduction similar to NSAIDS
- reduce inflammation by inhibiting Interleukin-1 (pro-inflammatory cytokines)
- less effective for severe long standing osteoarthritis
- more effective combined with chondroitin and MSM Methylsulfonylmethane
36
therapeutic use of glucosamine for IBD (mechanism)?
IBD and INTESTINAL PERMEABILITY
- NAG supports the GI epithelial barrier by enhancing mucin functionality (altered with people with IBD)
- NAG reduce biofilm formation associated with IBD
- NAG can be used in intestinal permeability
Dosage - 3-6g/d for children. 6g/d for adults in 3 doses
37
Glucosamine supplement caution, adverse effects and interactions?
Caution: seafood allergies
Mild adverse effect: GIT symptoms (nausea, heartburn, diarrhoea, constipation), drowsiness, skin reaction and headache
Interaction: potential increase of warfarin anticoagulant effect
38
what is chondroitin sulphate ?
Chondroitin sulphate is a type og GAG (Glycosaminoglycan)
It is a major component of extracellular matrix of connective tissues (cartilage and joints)
Provides resistance to compression by thickening the synovial fluid
39
How (which therapeutic use) do Chondroitin sulphate and glucosamine work together?
osteoarthritis
- glucosamine stimulates chondrocytes metabolism
- Chondroitin sulphate protects cartilage from degradation and increase hyaluronic acid synthesis (lubrication)
40
which orthomolecular compounds work well together in osteoarthritis? x3
Glucosamine sulphate (dosage 1500mg)
Chondroitin sulphate (dosage 1000-1200mg/day)
MSM (500mg 3x day)
==> combine you get better pain relief
41
1 therapeutic function of chondroitin sulphate? and dosage
Osteoarthritis - protects cartilage
- reduce cartilage degradation enzymes
- decrease inflammation (reduce inflammatory cytokines COX2 and CRP)
- increase hyaluronic acid production
dosage - 1000-1200mg / day
42
what nutrients are needed for cartilage health/ osteoarthritis?
Chondroitin sulphate 200-400mg / day
Glucosamine - 500mg 3x/ day
MSM - 1000-3000mg / day
Vit C - cartilage repair and anti ox / collagen synthesis
Vit K - needed for bone and cartilage growth
Omega 3 Fatty Acids - reduce inflammation - 3000mg/day
Vit D - 1000 iu / day
43
chondroitin sulphate supplementation and safety and interaction?
Supplementation well tolerated - not best bioavailability (8-18%)
Safety: might exacerbate asthma
interaction - potential increase anticoagulant effect of warfarin
44
What is MSM (methyl Sulfonylmethane)?
MSM is a source of sulphur used by plant to create the AAs cysteine and methionine - these AAs are a source of sulphur
45
MSM food sources?
Plant : green leafy vegetables, alfalfa sprouts, fruit, veg and grains
Animal: cow milk
46
4 therapeutic uses of methionine?
Osteoarthritis
- alone or combines with glucosamine and chondroitin sulphate => reduce pain and swelling and improve joint function
- anti inflammatory => inhibit cytokines secretion and COX2
- sulphur is a component of cartilage
Dosage = 500mg 3x/day
CV health:
- MSM reduce homocysteine levels by donating a methyl group (reduce risks of CVD and arthrosclerosis) protects age endothelium from damage
Dosage: 3g per day
Tissue Repair:
- GI => Decrease oxidative stress and inflammation in GI mucosal injury and chronic GO inflammation
- supports tissue healing on skin sulphur donor to keratin
Dosage 2g 2/3 x per day
Immune modulator:
- For seasonal allergies
- down regulate inflammatory cytokines NF-kB
Dosage 2-6g per day for seasonal allergies
47
Supplementation safety, adverse effect and interactions of MSM?
Safe up to 4g per day
Mild GIT adverse effect (nausea, diarrhoea and bloating). Headache, insomnia and concentration
No interaction
48
What is Betaine/TMG trim ethyl glycine?
TMG is the chemical form of Betaine and it occurs naturally in the body
TMG can be formed from choline
TMG saves as a methyl donor, facilitating the conversion of homocysteine in methionine
49
what is homocysteine? Optimal blood levels?
Homocysteine is a sulfhydryl-containing amino acid produced by the demethylation of methionine, an amino acid derived primarily from animal protein.
A biomarker of CVD - elevated homocysteine indicates a person does not methylate well.
Optimal blood levels are below 9mmol/L (excess of 14mmol/L is a high risk of health concern)
50
Betaine food source?
Plant: beets (1-2cups / day or 250ml/day), wheat bran, quinoa, spinach, sweet potato
Animal: seafood and turkey
51
3 therapeutic uses of Betaine?
1. Cardiovascular Health - Betaine can be used as a methyl donor to methylate homocysteine into methionine
Alzheimer, osteoporosis and CVD
Dosage 6g/day
2. Skeletal muscle performance - reduce fat mass and increase muscle mass. Improve muscle endurance, increase creatine conversion to energy in muscles
Dosage 2.5g/day
3. Fatty liver disease - improve liver function in non alcoholic fatty liver disease
Dosage 3g 2x/day
52
Supplements for methylation?
- Betaine 6g/day
- Folate 1g/day
- B12
- B6
53
What is Dimethyl Glycine (DMG)?
Dimethyl Glycine is Trimethyl glycine (betaine) after it has donated one methyl group during the methylation of homocysteine and only exists for seconds at a time
54
Dimethyl Glycine 1 therapeutic use? Dosage? Adverse effect?
Autism - in 50% of cases DMG improve behaviour, eye contact, frustration tolerance and speech.
Dosage: preschool age 65mg/day with breakfast
Older children: 125mg daily ==> gradually increase to 500mg for children and 250-1000mg for adult
Initial increase in hyperactivity possible - decrease dose
55
What is Phosphatidylserine (PS) ?
Phosphatidylserine is the most abundant fat-soluble phospholipid in the brain.
The body can synthesise PS but it requires substantial energy expenditure
56
Phosphatidylserine (PS) food sources?
White beans, whole grain barley, carrots, SMASH, organ meats, soy lecithin (high source)
57
Phosphadylserine PS therapeutic use (1) and dosage?
Alzheimer's disease:
- improve neural membrane function (better communication)
- increase acetylcholine, norepinephrine, serotonin and dopamine
- preserve glucose metabolism in the brain
- reduce acetylcholinesterase activity (enzyme that breaks down acetylcholine - key for memory)
- increase cognitive function and memory
- more effective with patients with less symptoms
Dosage: 300mg/day (100mg 3x a day)
58
Phosphatidylserine role with cortisol?
PS regulates cortisol
59
What is the impact of chronic elevated cortisol and which phospholipid can be used?
Chronic elevated cortisol cause changes in mood, deficit in learning and memory, damage to the temporal lobe
PS has been shown to calm down the HPA axis improve neural cell functions and improve production of mood regulating neurotransmitters
60
Therapeutic use and dosage of Phosphatidylserine PS to regulate cortisol? x3
1. Depression - improve mood.
Dosage 100mg 3x a day. More effective combined with fish oil EPA and DHA as PS anchor EPA and DHA into the cell membrane
2. ADHA - promotes attention, reduces symptoms, increase ST memory.
Dosage 200mg/day
3. Stress and insomnia - PS dampens the effects of prolonged cortisol secretion on brain function.
Dosage: 400mg before bed for insomnia
Dosage 200mg daily for stress
61
Phosphatidylserine supplementation safety and interactions
Safe
Possible addictive effect when combines with cholinergic drugs (mimic action of acetyl-choline)
62
What is Phosphatidylcholine (PC) ?
PC is a major structural component of cell membrane (phospholipid), maintain integrity and fluidity.
PC is synthesise from dietary choline
Dietary intake of PC is essential to meet demand
63
Phosphatidylcholine food sources?
Plant: nuts, peanuts, brussel sprouts, brocoli, spinach, peas
Animal: eggs, fish, beef, chicken, pork, liver
64
Phosphatidylcholine therapeutic uses and dosages? x3
1. Liver health: prevents fat accumulation in liver. Use for non-alcoholic fatty liver disease and hepatitis
Dosage: 800mg/day
2. Neurological health: neuroprotective role and supplies choline for the synthesis of acetylcholine
Dosage 1-9g/day divided
3. UC and GIT inflammation: PC plays role in protective mucosal barrier and vital part of intestinal mucous
Dosage: 1-6g/day divided
65
Phopshatidylcholine PC supplementation adverse effect and interactions?
Mild adverse effects - GIT symptoms
Possible addictive when combines with cholinergic drugs
66
What is myo-inositol?
Myo-inositol is the most predominant of 9 stereoisomer forms of inositol. Accounts for 90% of cellular inositol
MI provides structure to body cells
MI acts as an intracellular second messenger
MI regulates insulin
67
Myo-inositol food sources?
Plant: whole grains, beans, prunes, melons and oranges, vegetables (Okra, aubergines)
Animal: grass fed meat, eggs
68
Myo-inositol therapeutic use and dosage x3?
1. PCOS
- myo-insositol improve insuline sensitivity and promotes the mobilisation of GLUT4 (transporter for glucose into skeletal muscle ells and cardiac muscles)
- because we increase insuline sensitivity we increase SHBG and reduce bioavailability of testosterone
- improve menstrual cycle regularity and oocyte quality and fertility
Dosage - 2-3g daily with folate
2. Type 2 diabetes and gestational : improve insulin sensitivity
Dosage 4g/day
3. anxiety and depression: inositol is linked to CNS signalling systems including serotonin and dopamine => decrease anxiety and panic attack. Decrease depression symptoms associated with PMS
Dosage 12-8g daily (because difficult cross BBB)
69
In PCOS which nutrient should myo-inositol used with?
folate
70
What is the role of High insulin in PCOS?
High insulin influence the hypothalamus and increase LH levels that stimulates the ovaries to produce more androgens ==> high androgens
High insulin decrease level of SHBG which role is to bind to testosterone in blood ==> more free testosterone
71
Myo-inositol supplementation safety
safe up to 12g.
Mild GI symptoms
no adverse effect when used pregnant up to 4g (gestational diabetes)
72
Why is ALA so effective as an antioxidant?
Because to is fat and water soluble, function intra and extra cellularly and it recycles other antioxidants like vit E and A
