Orthomolecular Medicine/ Natural Health Products

The safety of over-the-counter niacin. A randomized placebo-controlled trial.

Anonymous — Tue, 24 Aug 2021 15:42:03 +0000

The safety of over-the-counter niacin. A randomized placebo-controlled trial. Anonymous (not verified) Tue, 08/24/2021 - 11:42

BACKGROUND: Niacin is widely available over the counter (OTC). We sought to determine the safety of 500 mg immediate release niacin, when healthy individuals use them as directed. METHODS: 51 female and 17 male healthy volunteers (mean age 27 years SD 4.4) participated in a randomized placebo-controlled blinded trial of a single dose of an OTC, immediate-release niacin 500 mg (n = 33), or a single dose of placebo (n = 35) on an empty stomach. The outcomes measured were self-reported incidence of flushing and other adverse effects. RESULTS: 33 volunteers on niacin (100%) and 1 volunteer on placebo (3%) flushed (relative risk 35, 95% confidence interval (CI) 6.8-194.7). Mean time to flushing on niacin was 18.2 min (95% CI: 12.7-23.6); mean duration of flushing was 75.4 min (95% CI: 62.5-88.2). Other adverse effects occurred commonly in the niacin group: chills (51.5% vs. 0%, P

Author

Mills E, Prousky J, Raskin G, Gagnier J, Rachlis B, Montori VM, Juurlink D.

Citedate

2003-01-01

Citation

BMC Clin Pharmacol. 2003;3:4.

Affiliations

Canadian College of Naturopathic Medicine

Publication

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=280687&blobtype=p…

Taxonomy

Orthomolecular Medicine/ Natural Health Products

Vitamin B12 (cobalamin) deficiency in elderly patients.

Anonymous — Tue, 24 Aug 2021 15:42:02 +0000

Vitamin B12 (cobalamin) deficiency in elderly patients. Anonymous (not verified) Tue, 08/24/2021 - 11:42

Vitamin B12 or cobalamin deficiency occurs frequently (> 20%) among elderly people, but it is often unrecognized because the clinical manifestations are subtle; they are also potentially serious, particularly from a neuropsychiatric and hematological perspective. Causes of the deficiency include, most frequently, food-cobalamin malabsorption syndrome (> 60% of all cases), pernicious anemia (15%–20% of all cases), insufficent dietary intake and malabsorption. Food-cobalamin malabsorption, which has only recently been identified as a significant cause of cobalamin deficiency among elderly people, is characterized by the inability to release cobalamin from food or a deficiency of intestinal cobalamin transport proteins or both. We review the epidemiology and causes of cobalamin deficiency in elderly people, with an emphasis on food-cobalamin malabsorption syndrome. We also review diagnostic and management strategies for cobalamin deficiency. PMID: 15289425

Author

Prousky JE.

Citedate

2004-01-01

Citation

CMAJ, 2004;171(3):251-9.

Affiliations

Canadian College of Naturopathic Medicine

Publication

http://www.cmaj.ca/content/171/3/251.long

Taxonomy

Orthomolecular Medicine/ Natural Health Products

The treatment of migraines and tension-type headaches with intravenous and oral niacin (nicotinic acid): literature review.

Anonymous — Tue, 24 Aug 2021 15:42:02 +0000

The treatment of migraines and tension-type headaches with intravenous and oral niacin (nicotinic acid): literature review. Anonymous (not verified) Tue, 08/24/2021 - 11:42

BACKGROUND: Migraine and tension-type headaches impose a tremendous economic drain upon the healthcare system. Intravenous and oral niacin has been employed in the treatment of acute and chronic migraine and tension-type headaches, but its use has not become part of contemporary medicine, nor have there been randomized controlled trials further assessing this novel treatment. We aimed to systematically review the evidence of using intravenous and/or oral niacin as a treatment for migraine headaches, tension-type headaches, and for headaches of other etiologic types. METHODS: We searched English and non-English language articles in the following databases: MEDLINE (1966-February 2004), AMED (1995-February 2004) and Alt HealthWatch (1990-February 2004). RESULTS: Nine articles were found to meet the inclusion criteria and were included in this systematic review. Hypothetical reasons for niacin's effectiveness include its vasodilatory properties, and its ability to improve mitochondrial energy metabolism. Important side effects of niacin include flushing, nausea and fainting. CONCLUSION: Although niacin's mechanisms of action have not been substantiated from controlled clinical trials, this agent may have beneficial effects upon migraine and tension-type headaches. Adequately designed randomized trials are required to determine its clinical implications. PMID: 15673472

Author

Prousky J, Seely D.

Citedate

2005-01-01

Citation

Nutrition Journal, 2005;4:3.

Affiliations

Canadian College of Naturopathic Medicine

Publication

http://www.nutritionj.com/content/4/1/3

Taxonomy

Orthomolecular Medicine/ Natural Health Products

Natural health product-drug interactions: a systematic review of clinical trials.

Anonymous — Tue, 24 Aug 2021 15:42:02 +0000

Natural health product-drug interactions: a systematic review of clinical trials. Anonymous (not verified) Tue, 08/24/2021 - 11:42

Interactions between natural health products (NHP) and prescription medications are of increasing concern. This paper aims to identify all clinical trials of NHP-drug interactions. To determine the prevalence and outcomes of clinical investigations of NHP-drug pharmacokinetic interactions, electronic databases were searched from inception through March 2004, as well as reference lists from published reports and experts in the field for unpublished studies. Eligible studies were clinical investigations of the interaction between a NHP and the metabolism of a regulated medication in humans. Studies were excluded that only investigated the metabolism of an NHP or examined food-drug or NHP-NHP interactions. Two reviewers selected studies for inclusion and independently extracted data. Forty-seven trials were identified, studying an average of 14 participants/study (95% confidence interval [CI] 11-18), examined drug interactions with 19 different herbal preparations. All trials were pharmacokinetic studies, 41 of healthy volunteers and 6 of patients. Ten different herbal medicines as well as 5 different traditional herbal concoctions were studied. Potentially clinically significant drug interactions were observed with St. John wort (16/24 studies), garlic (2/5 studies), and American ginseng (1 study). Research on NHP-drug interactions is limited in number and scope. With the exception of St. John wort, clinicians and the public do not have information that permits strong inferences about interactions between NHPs and conventional medications. PMID: 16175124

Author

Mills E, Wu P, Johnston BC, Gallicano K, Clarke M, Guyatt G.

Citedate

2005-01-01

Citation

Ther Drug Monit. 2005;27(5):549-57.

Affiliations

McMaster University

Taxonomy

Orthomolecular Medicine/ Natural Health Products

Milk thistle and indinavir: a randomized controlled pharmacokinetics study and meta-analysis.

Anonymous — Tue, 24 Aug 2021 15:42:02 +0000

Milk thistle and indinavir: a randomized controlled pharmacokinetics study and meta-analysis. Anonymous (not verified) Tue, 08/24/2021 - 11:42

OBJECTIVES: To determine whether ingestion of milk thistle affects the pharmacokinetics of indinavir. METHODS: We conducted a three-period, randomized controlled trial with 16 healthy participants. We randomized participants to milk thistle or control. All participants received initial dosing of indinavir, and baseline indinavir levels were obtained (AUC(0-8)) (phase I). The active group were then given 450 mg milk-thistle extract capsules to be taken t.i.d. from day 2 to day 30. The control group received no plant extract. On day 29 and day 30, indinavir dosing and sampling was repeated in both groups as before (phase II). After a wash-out period of 7 days, indinavir dosing and sampling were repeated as before (phase III). RESULTS: All participants completed the trial, but two were excluded from analysis due to protocol violation. There were no significant between-group differences. Active group mean AUC(0-8) indinavir decreased by 4.4% (90% CI, -27.5% to -26%, P=0.78) from phase I to phase II in the active group, and by 17.3% (90% CI, -37.3% to +9%, P=0.25) in phase III. Control group mean AUC(0-8) decreased by 21.5% (90% CI, -43% to +8%, P=0.2) from phase I to phase II and by 38.5% (90% CI, -55.3% to -15.3%, P=0.01) of baseline at phase III. To place our findings in context, milk thistle-indinavir trials were identified through systematic searches of the literature. A meta-analysis of three milk thistle-indinavir trials revealed a non-significant pooled mean difference of 1% in AUC(0-8) (95% CI, -53% to 55%, P=0.97). CONCLUSIONS: Indinavir levels were not reduced significantly in the presence of milk thistle. PMID: 15666173

Author

Mills E, Wilson K, Clarke M, Foster B, Walker S, Rachlis B, DeGroot N, Montori VM, Gold W, Phillips E, Myers S, Gallicano K.

Citedate

2005-01-01

Citation

Eur J Clin Pharmacol. 2005;61(1):1-7.

Affiliations

McMaster University

Taxonomy

Orthomolecular Medicine/ Natural Health Products

Disclosure of natural product use to primary care physicians: a cross-sectional survey of naturopathic clinic attendees.

Anonymous — Tue, 24 Aug 2021 15:42:02 +0000

Disclosure of natural product use to primary care physicians: a cross-sectional survey of naturopathic clinic attendees. Anonymous (not verified) Tue, 08/24/2021 - 11:42

OBJECTIVE: To determine factors that predict disclosure of natural product use by patients to their primary care physicians. METHODS: An 18-item survey about health care use and communication was distributed to patients who presented to the Canadian College of Naturopathic Medicine in March 2003. We examined correlations between responses and created a multivariable logistic regression model to explore which factors were associated with patients' discussion of natural product use with their primary care physicians. RESULTS: The survey was given to 198 patients, 174 of whom responded (response rate, 87.9%). Most respondents (161 [92.5%] of 174) made use of natural products, and many (61 [41.5%] of 147) reported that they did not discuss natural product use with their primary care physician. The most significant factor predictive of patients having discussed natural product use with their primary care physician was having their primary care physician ask about natural product use (odds ratio, 18.77; 95% confidence interval, 5.06-69.62). Most respondents (107 [69.9%] of 153) indicated that their primary care physician did not ask about natural product use. CONCLUSIONS: An important number of patients who visit a naturopathic clinic do not disclose natural product use to their primary care physicians. Our findings suggest that disclosure rates could be improved by physicians taking a more active role in asking their patients about natural product use. PMID: 15887429

Author

Busse JW, Heaton G, Wu P, Wilson KR, Mills EJ.

Citedate

2005-01-01

Citation

Mayo Clin Proc, 2005;80(5):616-23.

Affiliations

McMaster University

Taxonomy

Orthomolecular Medicine/ Natural Health Products

Meta-analysis of flavonoids for the treatment of haemorrhoids.

Anonymous — Tue, 24 Aug 2021 15:42:00 +0000

Meta-analysis of flavonoids for the treatment of haemorrhoids. Anonymous (not verified) Tue, 08/24/2021 - 11:42

BACKGROUND: The aim of the study was to evaluate the impact of flavonoids on those symptoms important to patients with symptomatic haemorrhoids.METHODS: A comprehensive search strategy was used. All published and unpublished randomized controlled trials comparing any type of flavonoid to placebo or no therapy in patients with symptomatic haemorrhoids were included. Two reviewers independently screened studies for inclusion, retrieved all potentially relevant studies and extracted data.RESULTS: Fourteen eligible trials randomized 1514 patients. Studies were of moderate quality and showed variability in the results with potential publication bias. Meta-analyses using random-effects models suggested that flavonoids decrease the risk of not improving or persisting symptoms by 58 per cent (relative risk (RR) 0.42 (95 per cent confidence interval (c.i.) 0.28 to 0.61)) and showed an apparent reduction in the risk of bleeding (RR 0.33 (95 per cent c.i. 0.19 to 0.57)), persistent pain (RR 0.35 (95 per cent c.i. 0.18 to 0.69)), itching (RR 0.65 (95 per cent c.i. 0.44 to 0.97)) and recurrence (RR 0.53 (95 per cent c.i. 0.41 to 0.69)).CONCLUSION: Limitations in methodological quality, heterogeneity and potential publication bias raise questions about the apparent beneficial effects of flavonoids in the treatment of haemorrhoids. PMID: 16736537

Author

Alonso-Coello P, Zhou Q, Martinez-Zapata MJ, Mills E, Heels-Ansdell D, Johanson JF, Guyatt G.

Citedate

2006-01-01

Citation

Br J Surg. 2006;93(8):909-20.

Affiliations

Clinical Epidemiology and Public Health Department, Hospital Sant Paul

Taxonomy

Orthomolecular Medicine/ Natural Health Products

Double agent niacin-its beneficial effect upon the lipid profile, but its adverse effect upon plasma homocysteine: a case report

Anonymous — Tue, 24 Aug 2021 15:42:00 +0000

Double agent niacin-its beneficial effect upon the lipid profile, but its adverse effect upon plasma homocysteine: a case report Anonymous (not verified) Tue, 08/24/2021 - 11:42

Niacin (nicotinic acid) in large pharmacological doses (500 mg or more per day) favorably modifies the lipid profile. Niacin lowers total cholesterol, lowers low-density lipoprotein, raises high-density lipoprotein, lowers triglycerides, and lowers lipoprotein(a). It also modifies other known cardiovascular risk factors such as fibrinogen and C-reactive protein. Unfortunately the hypolipidemic effects of niacin increases plasma homocysteine levels, which would potentially increase the risk of cardiovascular events. A case report is presented to demonstrate niacin's hypolipidemic effects and its ability to markedly raise plasma homocysteine levels. Immediate-release preparations of niacin are safer than slow- or sustained-release preparations. Immediate-release preparations cause a transient cutaneous flush that is more pronounced than slow- or sustained-release preparations. Since niacin preparations can cause hepatic toxicity regular monitoring of transaminases are important. The first symptoms of toxicity typically include nausea and possibly vomiting necessitating discontinuation of the therapy. The rise in plasma homocysteine levels does not appear to be correctable by oral supplementation of B-vitamins. Regular parenteral administration of vitamin B12 seems to be required in order to lower plasma homocysteine when taking large pharmacological doses of niacin. More controlled trials are necessary in terms of primary end points if niacin is ever going to gain wider acceptance among both mainstream and complementary health practitioners. Investigation into the best and most cost-effective method for lowering plasma homocysteine while on niacin therapy requires further study.

Author

Prousky J.

Citedate

2006-01-01

Citation

Queen's Health Sciences Journal, 2006;8(1):34-38.

Affiliations

Canadian College of Naturopathic Medicine

Taxonomy

Orthomolecular Medicine/ Natural Health Products

Clinical Experiences with a Vitamin B3 Dependent Family.

Anonymous — Tue, 24 Aug 2021 15:41:59 +0000

Clinical Experiences with a Vitamin B3 Dependent Family. Anonymous (not verified) Tue, 08/24/2021 - 11:41

A vitamin dependency occurs when there is a defect in the binding of the vitamin-related coenzyme to its apoenzyme. The only way to correct a vitamin dependency is to obtain daily amounts much greater than recommended dietary allowances.I believe that the most common vitamin dependency among patients with metnal illnesses is vitamin B3. These three cases involve members of the same family. Each case improved clinically upon taking megadoses (500-1500mg/day) of the vitamin. A fourth member of this family has schizophrenia. This is significant since recent postmortem biopsies of brain tissues have shown defects in the ability of schizophrenic patients to generate adequate amounts of vitamin B3 coenzymes from tryptophan. Families share simlar genetics and environmental factors, and thus this family likely shares varying degrees of the ability to synthesize adequate amounts of vitamin B3 coenzymes. If schizophrenic genes are common among the entire human population, then the majority of people will suffer from slight-to-severe defects in this biosynthetic pathway.

Author

Prousky J.

Citedate

2006-01-01

Citation

J of Ortho Med, 2006; 21(4): 205-211.

Affiliations

Canadian College of Naturopathic Medicine

Publication

http://orthomolecular.org/library/jom/2006/pdf/2006-v21n04-p205.pdf

Taxonomy

Orthomolecular Medicine/ Natural Health Products

Adaptogenic potential of a polyherbal natural health product: report on a longitudinal clinical trial.

Anonymous — Tue, 24 Aug 2021 15:41:59 +0000

Adaptogenic potential of a polyherbal natural health product: report on a longitudinal clinical trial. Anonymous (not verified) Tue, 08/24/2021 - 11:41

Stress is a risk factor for a number of diseases and is an important predictor of health in general. Herbal medicines have been used as adaptogens to regulate and improve the stress response and there is evidence to support the use of herbal medicines for this purpose. We conducted an open-label longitudinal study on the natural health product, OCTA(c), a compound mixture of eight herbs, to determine its effects on perceptions of stress. Eighteen participants were enrolled in the study and were followed over a period of 3 months. Primary endpoints included scores from four validated questionnaires (SF-36v2, PSS, STAI and BDI-II), serum DHEA, ALT, AST and creatinine all measured at 12 weeks. Seventeen patients completed the study. Except for the physical summary score of the SF36 questionnaire, all the subjective scores indicated a highly significant (P

Author

Seely D, Singh R.

Citedate

2007-01-01

Citation

Evid Based Complement Alternat Med, 2007;4(3):375-80.

Affiliations

Canadian College of Naturopathic Medicine

Publication

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1978233&blobtype=…

Taxonomy

Orthomolecular Medicine/ Natural Health Products