Orthomolecular compounds Flashcards
What did Linus Pauling define as orthomolecular and what is orthomolecular medicine
“The right molecules in the right amounts”
Preventing and treating disease by providing the body with optimal amounts of substances which it also produces.
PREVENTION OVER CURE.
OPTIMAL NUTRITIONAL ENVIRONMENT WILL REDUCE DISEASE.
Coenzyme Q10 - what are the functions and therapeutic uses
- Energy production: highest quantities in muscle cells
- Fatigue
- Fibromyalgia: daily use 300mg in divided doses)
- Antioxidant: fat soluble antiox, inhibits peroxidation of cell membrane lipids and neutralises free rads produced by mitochondria.
o Decreases with age due to ROS and impaired mitochondrial function
o Depletion can result in mitochondrial dysfunction - Preventative or addresses fibromyalgia, T2DM, CVD, neurodegenerative disease, cancer
- Periodontal health: diseased gums have low levels of CoQ10 due to lipopolysaccharides from gingivalis bacteria triggering oxidative stress/mitochondrial dysfunction.
- Perodontitis 50-80mg/day
- Fertility: protects sperm from oxidative stress. Low CoQ10 can drive age associated oocyte deficits.
- 200-300mg/day for 6 months increases sperm health
- 100-600mg for ovarian health
- CV health: crucial for cardiac muscle function.
o Protects against endothelial dysfunction and therefore atherosclerosis
o Reduces LDL oxidation
o Inhibits Nf-kB activation
o Increases superoxide dismutase activity (preserves NO activity and vasodilator) - Hypertension, angina pectoris, heart failure, post-myocardial infarction
- 60-300mg/day
What is the recommended dose of CoQ10 for healthy ageing
100-200mg day
What is the recommended dose of CoQ10 for periodontal disease
50-80mg
What is the recommended dose of CoQ10 for male and female fertility
Male: 200-300mg for 6 months
Female: 100-600mg for ovarian health
What is the recommended dose of CoQ10 for Statin support
90-300mg/day
What is the recommended dose of CoQ10 for CV health
60-300mg/day
What enzyme does statins inhibit and what does this prevent the production of
HMG CoA reductase
Mevalonic acid, which goes on to synthesise cholesterol and CoQ10
What drug does CoQ10 increase the effects of
warfarin
Alpha Lipoic Acidn(ALA): what are the two forms and which is more potent
Natural R-form
Synthetic S-form
R-ALA 10x more potent
What are the main food sources of ALA
Plant: brassicas, spinach, potato, carrots, beets, tomoatoes,
Animal: red meat, organ meats
Name the functions and therapeutic uses of ALA
Energy production: key conenzyme to convert carbs into energy in mitochondria in krebs cycle. Fuels cells eg spermatozoa
Therapeutic use: fatigue, chronic fatigue syndrome, mitochondrial support, sperm health
Antioxidant: POTENT fat and water soluble antioxidant. Anti inflammatory.
regenerates other antioxidants eg E C CoQ10. Upregulates expression of glutathione. Improves sperm motility
Therapeutic use: infertility 600mg daily
diabeetes, diabetic neuropathy
Alzheimers - slows decline 600mg daily 1+ years, MS, healthy aging
Insulin sensitising: improves insulin sensitivity/resistance/fasting blood glucose, HbA1c
Therapeutic use: DM 300-1200mg/day
Metal chelating: chelate Fe, Mercury, Cu, lead, Zn
Therapeutic use: infertility, alzheimers, peripheral neuropathy
Peripheral neuropathy: Supplementation reduces oxidation of myelin sheath - improves neuropathic sensory symptoms inc pain, burning, prickling, of feet and legs. Dose: 600mg/day
Weight loss:
- reduces oxidative stress that promotes fat storage
- suppress appetite via influence on AMPK enzyme in hypothalamus where appetite regulated
- increases energy expenditure and reduces fat synthesis - 1800mg/day
-
How should ALA supplements be taken
empty stomach to optimise bioavailability
Rare adverse effects - skin allergy/GI symptoms
What are the interactions to be aware of with ALA
Biotin - may compete for transport across cel membrane.
Increased risk of hypoglycaemia in medicated diabetic patients due to additive effect.
GLUCOSAMINE: what is it and where is it most concentrated
an aminosugar - high concentration in joints or cartilage
Name the mycopolysaccharides that glucosamine is required for the synthesis of
Glycoproteins, glycolipids, glycosaminoglycans (GAGs)
What do mycopolysaccharides do
they are important structural components of tendons, ligaments, cargilage, synovial fuid, mucous membranes, structures in the eye, BV and heart valves.
What are the two forms of gluosamine supplementation and how bioavailable is it
Highly bioavailable.
- Glucosamine sulphate: from marine exoskeletons. Absorbed better. Found in synovial fluid and required for GAG synthesis.
- Glucosamine hydrochloride: synthetically produced from corn
Name the two forms of glucosamine naturally present in the body
There are two forms naturally present in the body:
Glucosamine-6-Phosphate (G6P)
N-Acetyl-Glucosamine (NAG): converted to hyaluronic acid (HLA) as needed, this is an important component of synovial fluid.
What are the therapeutic uses for glucosamine
Osteoarthritis: slows joint degeneration and prevents joint space narrowing by stimulating metabolism of chondrocytes in cartilage, synovial cells and synovial tissue.
Decreases inflammation by inhibiting cytokines eg interleukin 1
Pain reduction comparable to NSAIDs (glucosamine Supphate relieve felt 4-8 weeks) but less effective for sever.long standing osteoarthritis.
Best combined with chondroitin and MSM.
DOSE: 1500mg/day
IBD and intestinal permeability: NAG supports GI epithelial barrier by enhancing mucin functionality which is dramatically altered in those with IBD. (Mucins are proteins that forom barrier and prevent bacterial overgrowth).
NAG reduces biofilm formation
NAG used in intestinal permeability
DOSE: 3-6g/day children. 6g/day adults divided into 3 doses.
What are the cautions with glucosamine supplementation and possible drug interaction
most are produced from crustaceans - seafood allergy
Mild adverse reactions
Warfarin - increases effect.
Chondroitin Sulphate: what is it and what is its main function
A type of glycosaminoglycan (GAG) and major component of the extracellular matrix of many connective tissues, such as cartilage and joint connective tissue.
Provides resistance to compression by thickening synovial fluid (acts like a sponge in cartilage, attracting water molecules to help maintain the structure and elasticity of the tissue. )
What is the primary therapeutic use of chondroitin sulphate
Osteoarthritis: protects cartilage from degradation by:
- reducing degradative enzymes
- decreasing inflammation (reduces inflammatory mediators such as COX-2
- increasing hyaluronic acid synthesis/enhancing joint lubrication
What’s the recommended therapeutic dose of chondroitin sulphate
DOSE: 200-400mg two to three times a day OR
1000-1200 mg daily as single dose
What are the cautions regarding condroitin sulphate supplementation
Absorption rate is just 8-18%
May exacerbate asthma as people with asthma have higher levels of chondroitin antibodies in the airway.
Interaction: increase effectiveness of warfarin.
Methyl Sulfonylmethane (MSM) (methyl sulfonil methane): what compound is it a major source of , to create what amino acids
source of sulphur used by plants to create amino acids cysteine and methionine.
What plant foods is MSM found in
Animal: cows milk
Plant: green leafy veg, alfalfa sprouts, algae, fruits, veg, grains.
What are the 4 therapeutic uses of methylsulfonylmethane (MSM)
Osteoarthritis: alone or with chondroitin/glucosamine to reduce swelling, pain and improve joint function.
Anti inflammatory properties - inhibits secretion of cytokines and COX-2
Sulphur is component of cartilage - protective effect on cartilage.
DOSE: 500mg 3x day
CV health: reduces homocysteine levels (by donating methyl groups) and reduces lipid peroxidation, protecting teh vascular endothelium from damage.
DOSE: 3g/day - benefits at 28 days)
Tissue repair: decreases oxidative stress and inflammation, helping to repair GI mucosal injury and reduce chronic GI inflammation
Supports tissue healing after injury (can be topical)
DOSE: 2g two to three times daily
Immune modulator: immune regulating and antioxidant properties help with seasonal allergies and reduce inflammation.
Inhibits NF-kB activity, down regulates inflammatory cytokines
DOSE: 2.6 g day for season allergies.
Betaine / trimethyl glycine (TMG) - what is its main role
methyl donor, facilitating conversion of homocysteine to methionine. (homocysteine is marker for CVD)
What are optimal blood levels of homocysteine
below 9umol/L. Excess of 14 is link to high risk of health concerns.
What are the food sources of betaine/TMG
Beets; wheat bran; sweet potato, spinach
Animal source: seafood, turkey
What are the functions and therapeutics uses of betaine
CV health/atherosclerosis: aids conversion of homocysteine to methionine by an enzyme that uses betaine as a methyl donor - BETAINE HOMOCYSTEINE METHYTRANSFERASE (BHMT)
DOSE: 6g daily (split over 2 doses) For best results pair with 1mg folate.
Skeletal muscle performance: reduces fat and increaases muscle mass. Improves muscle endurance, body composition, arm size.
DOSE 2.5g daily
Fatty liver disease: can improve function in non-alcoholic fatty liver disease.
DOSE 3g twice daily
Dimethyl glycine: what is it
it is trimethyl glycine/betaine after it has donated one methyl group during methylation of homoecysteine - only exists for seconds!
What is the therapeutic use of dimethyl glycine
AUTISM - in 50% of cases can improve behaviour, eye contact, frustration tolerance and speech. Reduces seizures.
What are the recommended doses of dimethyl glycine for autism
Pre school: 65mg with breakfast
School age: 125mg daily
Gradually increase to 500mg for child and 1000mg adult
Phosphatidylserine - what organ does it play its greatest role in
it’s the most abundant fat-soluble phospholipid in the human brain.
Important for neuronal membrane functions such as - maintenance of cell’s internal environment; cell to cell communication; cell growth regulation
What are the food sources of phosphatidylserine
white beans, carrots, organ meat, mackerel, whole grain barley
What are the therapeutic uses of phosphatidylserine
Alzheimer’s: Improves neuronal membrane functioning; increases acetylcholine, norepinephrine, serotonin, dopamine.
It reduces hippocampal inflammation and increases availability of acetylcholine.
Increases cognitive function and memory (also non-Alzheimer’s related)
DOSE: 300mg daily or 100mg 3xday
Depression: effects cortisol regulation.
DOSE: 100mg 3 times day. Most effective combined with fish oil
ADHD: promotes attention and reduces symptoms, increases short term memory
DOSE: 200mg daily
Stress and insomnia: dampens effects of prolonged cortisol secretion on brain function allowing for netter quality sleep and decreased anxiety
DOSE: 400mg before bed for insomnia
200mg daily for stress
Phosphatidylcholine: what is its primary function (break down the name…)
major structural component of cell membranes, maintaining integrity and fluidity
What compound in food is phosphatidylcholine synthesised from
choline - body only synthesises a small amount and dietary intake is essential.
Name plant sources of phosphatidylcholine
nuts, peanuts, broccoli, spinach, peas, eggs, fish, beef, chicken pork liver
Name the therapeutic uses of phosphatidylcholine
Liver health: prevents fat accumulation in liver/hepato protective reducing oxidative damage
DOSE: min 800mg daily
Neurological health
Ulcerative colitis
Neurological health: neuroprotective as an essential component of neuronal membranes and supplies choline for synthesis of neurotransmitter ACETYLCHOLINE - involved in memory and protective against cognitive decline and dementia.
DOSE: 1-9 grams/day in divided dose.
Ulcerative colitis: establishes protective mucosal barrier and forms a vital part of intestinal mucus.
Part of enterocyte membranes to reduce inflammation.
DOSE: 1-6g/day divided.
Myo-inositol - most predominant of nine different stereoisomer forms of inositol.
What is a stereoisomer
two or more compounds that differ only in the configuration of their atoms.
What are the key functions of myo-inositol (3)
provides structure to body cells
intracellular second messenger
regulates hormones including INSULIN
Name food sources of Myo-inositol
whole grains, fresh fruit, beans, veg, grass fed meats, eggs.
What are the therapeutic applications of myo-inositol
PCOS: it’s characterised by insulin resistance and increased androgens. Myo-inositol improves insulin sensitivity and promotes mobilisation of GLUT4 vesicles.
Increases SHBG to reduce bioavailable testosterone
Improves menstrual cycle regularity, oocyte quality and fertility.
DOSE: 2-3g/day with folate
T2DM: As above. Imroves ability of cells to respond to insulin and helps regulate blood glucose.
DOSE: 4g daily
Anxiety and depression: Linked to CNS receptor signalling systems, including serotonin and dopamine. Decreases anxiety and panic attack frequency and depression symptoms associated with PMS.
DOSE 12-18g/day
What nutrient is reduced by statins and why does this happen
CoQ10 - statins block the enzyme HMGCoA reductase which is responsible for the conversion of HMG CoA (from acetyl Co-A) to mevalonic acid, which goes on to synthesise cholesterol and CoQ10.
CoQ10 - statins function to decrease cholesterol synthesise, and cholesterol and coQ10 are produced by same mevalonic pathway. Statins inhibit HMG CoA reductase which enable the pathway to continue.
Why is alpha lipoic acid so effective as an antioxidant
Both fat and water soluble and easily absorbed. ALso functions intra and extra cellularly. And recycles other antioxidants.
what are three key ways that chondroitin protects cartilage
Reduces enzymes that degrade cartilage.
Inhibits inflammatory cytokines that damages cartilage.
Increases production of hyaluronic acid which acts as lubricant
outline two ways that n-acetyl glucosamine can be of benefit to IBD
Supports the GI epithelial barrier by enhancing mucin functionality - mucins form a barrier that protects the mucous membrane.
Reduces ability of pathogenic bacteria to form biofilms
briefly explain why betaine (TMG) can reduce the risk of CVD
It donates a methyl group for the conversion of homocysteine to methionine
Outline two ways in which phosphatidylserine is beneficial for alzheimers disease
It reduces hippocampal inflammation and increases availability of acetylcholine.
It’s the most abundant fat soluble phospholipid in the brain and improves neuronal membrane functioning increasing neurotransmitters associated with cognitive function and memory.
