|Robert L. Blum, MD, PhD|
In 2009 I reviewed the just released health book TRANSCEND
How does one know that a drug, vitamin, or nutritional supplement really works?
I showed how the arduous process of evaluating medical evidence works in my essay
For those readers who just want the bottom line I will show the evidence grades
that the Natural Standard has assigned to some of the nutritional supplements mentioned in TRANSCEND. My prior essay discusses the detailed process by which Natural Standard assigns their grades. Here I'm just providing a quick overview of their recommendations for some common indications - largely to provide balance to Ray's and Terry's enthusiastic endorsements.
Unfortunately, Natural Standard’s reviews are not available to the public. However,
if you want to see a careful scientific review of your favorite vitamin or supplement you can look
it up on the website of the National Center for Complementary and Alternative Medicine (NCCAM). This is NCCAM’s A-Z Search Page.
Omega-3 Fatty Acids (Fish Oil, EPA, DHA)
Fish Oil gets an A Evidence Grade for preventing
Fish intake gets a B grade for preventing cardiovascular disease
in those that don't have it already. (Note: that's fish not fish oil.)
Fish oil gets a C grade for preventing atherosclerosis and strokes and
It gets Cs and Ds for a host of other diseases (arrhythmia, cancer, angina, diabetes).
I personally take EPA/DHA.. The American Heart Association and the FDA
(Flash news item as of January 2010: JAMA reports association
Vitamin E (tocopherols, tocotrienols)
Vitamin E gets a D Evidence Grade (!!!) for Cancer Prevention,
Heart Disease Prevention, and Stroke Prevention. Recall that a D Grade
Vitamin E gets a C grade (unclear or conflicting evidence)
TRANSCEND, to their credit, does discuss the studies that caused
Vitamin D gets a B grade for Osteoporosis prevention.
(Addendum 2013: Vitamin D has gotten a lot of favorable publicity. I hike with my
shirt off for 30 minutes daily carrying a 15 lb. weight in each hand. Obviously,
Multivitamins are not listed among either the Natural Standard's
or NCCAM's reviews. I can see why. Which do you include and how much of each?
To me the most impressive aspect of decades of clinical research on vitamins is the failure to show any significant benefit. Ray and Terry need to cite the evidence that
I've stopped taking multivitamins. There have been too many studies showing
(Addendum 2013: Calcium is another mineral supplement that's in trouble.
Coenzyme Q10 gets a B grade for hypertension (yoga gets an A !).
For dozens of other indications, CoQ10 gets only a C: chronic fatigue syndrome,
cancer prevention, heart attack prevention, angina, heart failure, Parkinson's.
This is one supplement I've studied a lot, since I take statin drugs to lower my cholesterol.
I am quite convinced that statins lower your plasma level of CoQ10
and that taking CoQ10 raises it. The real question is whether intramitochondrial
CoQ10 is lowered enough in statin patients to cause symptoms.
I'm not certain but this drug is part of my daily regimen. If I didn’t take statins, I wouldn’t take it.
By the way, if your doctor advises you to take statins for high LDL-cholesterol, I would
Grape Seed Extract
Grape Seed Extract gets A grades for edema and for chronic venous insufficiency and B grades for vascular fragility and prevention of diabetic retinopathy.
However, for cancer prevention and as an antioxidant it merits only a C. (I tried to take this capsule a few years ago and had to stop - it felt like a bomb going off in my esophagus.)
Alpha-Lipoic Acid rates a B for angina and peripheral vascular disease
but only a C for dementia, depression, exercise performance, fatigue, and memory.
I had high hopes for this drug since I'm generally a fan of UC Berkeley’s Bruce Ames whose research backs it. Ames has studied mitochondrial function for years and founded a company, Juvenon, that sells Alpha-Lipoic Acid in combination with Acetyl-L-carnitine, another drug on the TRANSCEND list. Since I'm always looking for a safe energy or cognitive enhancer, I tried Juvenon. It seemed to work for a few days then I was back to baseline.
This seems to be another drug that works in the lab but doesn't stand up to prolonged clinical scrutiny.
Resveratrol merits only a C grade for prevention of cardiovascular disease and breast cancer, and as an anti-aging tonic. I do not take this drug, although I'm very interested in research done at Sirtris by David Sinclair of Harvard that showed life extension in a variety of lab animals when given huge doses. Sirtris was acquired by Glaxo for 700 million dollars.
Since then the whole world is watching and drinking red wine. I don't.
The above Evidence Grades are those assigned by the Natural Standard, whose methodology for reviewing supplements I describe in my accompanying essay:
robert, blum, md, phd, stanford, kaiser, brain, neuroscience, cognitive, science, psychology, memory, creativity, consciousness, self, improvement, genius, artificial, intelligence, ai, machine, computer, learning, vision, cognition, robotics, future, automated, discovery, kurzweil, singularity, biotechnology, health, medicine, coronary, cardiac, emergency, scan, mri, drugs, thinking, evidence, bayes, global, humanity, knowledge, ancient, wisdom, positive, values, planet, earth, ecology, environment, population, control, biosphere