Shakeology Endorsement

"After evaluating the independent study, analyzing the ingredient list I have to
say Shakeology has no competition in the marketplace as either a meal
replacement or stand alone dietary supplement.  With it's well balanced and all
inclusive bled of vitamins, pre- and probiotics, super foods and adaptogen herbs
it has the ability to make "right" was is "wrong" in the average diet of most
Americans."

JP Saleeby, MD
BeachBody/Product Partners
Medical Advisory Board
4/22/2010

Why Lovaza?

It never ceases to amaze me what BigPharma gets away with. The recently introduced Lovaza (Omacor) which is a Omega-3-Fatty Ethyl Ester compound manufactured and promoted by GlaxoSmithKline is nothing new to nutritionally minded physicians (but new to traditional MDs) and does it come with a price.

The cost is a whopping $150.80 average retail cost for a month supply with a dose of 2-grams daily (double that for the recommended 4-grams per day regiment). Consider similar pharmaceutical grade fish-oil n-3FA products such as Vita Sanus Opti-EFA where a 2-gram/d regiment would only cost $39.00/month.

From the Lovaza Site http://www.lovaza.com/benefits-of-lovaza/prescription.html :

• LOVAZA uses a 5-step purification process that helps remove mercury and other environmental toxins that can be present in fish oil and ensures reliable concentration of EPA and DHA in every capsule
  
  
• The FDA-approved dose of LOVAZA is 4 capsules per day. It could take up to 14 capsules per day of an omega-3 supplement to provide the same amount of EPA and DHA found in 4 capsules of LOVAZA
  
  

Nice illustration of purification process.... so what. Non-FDA approved pharmaceutical grade n-3FA supplements go through pretty much the same process to detox fish oil of heavy metals and increase the EPA and DHA content. As far as GSK's 14 caps vs 4 caps, that is absolutely false.. with Opti-EFA for example, a 4-gram dose you would only need 8-gel caps compared with 4 of the Lovaza.

By definition pharmaceutical grade:

Pharmaceutical grade fish oil has the following characteristics:

•	Concentration of EPA and DHA > 60%
•	Ratio of EPA/AA > 25:1
•	Concentration of PCBs <>

From http://vitasanus.com/vsn_products/opti_efa.htm


Furthermore given that Lovaza advertises that one gram (one gel cap) has 1 gram of n-3FA and 465 mg of EPA and 375 mg of DHA, the VS Opti-EFA trumps its EFA & DHA content with an equivalent one gram (2-gel caps) equivalent dose having 600 mg of EPA and 400 mg of DHA. All at a much more comfortable cost. You will spend over $150/month for Lovaza when you can spend under $40/month for Opti-EFA or similar brands and get a bigger bang for your buck on DHA/EPA content. Do the math, it is a no brainer.

Low TSH is Safe in bHRT

Is it safe for patients taking thyroxine to have a low but not suppressed serum TSH concentration?

Graham Leese & Robert Flynn

University of Dundee, Tayside, UK.

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For patients taking thyroxine replacement guidelines generally recommend aiming for a target TSH within the laboratory reference range. The evidence for this guidance is generally based on an extrapolation of data from patients with endogenous subclinical thyroid disease. We aimed to examine the safety of having a TSH which was either suppressed (≤0.03 mU/l), low (0.04–0.4 mU/l), ‘normal’ (0.4–4.0 mU/l) or raised (>4.0 mU/l) in a population-based cohort of patients all of whom were treated with thyroxine.

We used a population-based thyroid register (TEARS) linked to outcomes data from hospitalisation records, death certification data and other datasets between 1993 and 2001. The endpoints of cardiovascular disease, dysrhythmias and fractures were assessed. Patients were categorised, using a time weighted mean of all TSH recordings.

There were a total of 16 426 patients on thyroxine replacement (86% female, mean age 60 years) with a total follow-up of 74 586 years. Cardiovascular disease, dysrhythmias and fractures were increased in patients with a high TSH (adjusted hazards ratio 1.95 (1.73–2.21), 1.80 (1.33–2.44) and 1.83 (1.41–2.37) respectively), and patients with a suppressed TSH (1.37 (1.17–1.6), 1.6 (1.1–2.33) and 2.02 (1.55–2.62) respectively), when compared to patients with a TSH in the laboratory reference range. Patients with a low TSH did not have an increased risk of any of these outcomes (HR: 1.1 (0.99–1.123), 1.13 (0.88–1.47) and 1.13 (0.92–1.39) respectively.

People on long-term thyroxine with a high or suppressed TSH are at increased risk of cardiovascular disease, dysrhythmias and fractures. People with a low but not suppressed TSH did not have an increased risk of these outcomes in this study. It may be safe for patients treated with thyroxine to have a low but not suppressed serum TSH concentration.

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Endocrine Abstracts (2010) 21 OC5.6

CardioFactor / PreFight by AdapTx Labs

AdapTx Labs CardioFactor. Supplement formulated by Dr. Saleeby for the MMA arena. Athletic enhancement, stamina and strength, safe and legal.

PreFight by AdapTx Labs, formulated by Dr. Saleeby as an adjunct to CardioFactor for training and better recovery times.

Can Chia help with stamina? I know CardioFactor can.

I recently had a patient ask a question the other day about agents to fight fatigue. He was wondering the effects of Chia seed. My response was there are better proven supplements that can improve stamina and shorten recovery time:

A thousand years ago, chia was prized by the ancient Aztecs as a food for energy, endurance, strength and good health. For many generations, natives of the southwestern deserts of what is now part of the United States depended on wild chia seed as a staple food and a source of remedies. According to a book by James Scheer (a nutritionist/writer), historian Harrison Doyle, who, in the early 20th century lived with various tribes in the Americas, wrote that "it was nothing for tribesmen to run for 24 hours on a tablespoon of chia seed and a gourd of water." Unfortunately, is really nothing more than testimonial and anecdotal evidence to date on chia and stamina. More research is required. The real research findings are with adaptogen and other eastern and western herbs. While chia has the potential, more research (double blinded studies) are needed to "prove" its worth in stamina and endurance and fatigue fighting properties.

I have researched and formulated two products for a niche market (Mixed Martial Arts fighters). It was developed as a me-too supplement already in use by endurance cyclists but with a focus on MMA and a very unique formulation never before seen on the market. Besides strength, these fighters rely on endurance, to outlast their opponents should a match go beyond 2 rounds. I developed two products one called CardioFactor and the other PreFight. Both products were very well researched with quite a substantial backing of evidence via scientific study and not just "hear say" or subjective testimonials.

If you are interested in learning more, the products are manufactured in the USA by AdapTx Labs and can be purchased online. I will disclose that my financial interest with this product was in the research and formulation of these products. https://www.adaptxlabs.com for more information.

AdapTx Labs products:

Serving Size: 2 Capsules PREFIGHT
Amount Per Serving
Vitamin B3 (Niacinamide USP) 20 mg
Vitamin B6 5 mg
Adaptogen HotMixTM
Jiaogulan 98% (Leaf)
Yerba Mate (20% caffeine) (Leaf)
Panax Ginseng (80% extract) (Root) 750 mg *



Serving Size: 4 Capsules CARDIOFACTOR
Amount Per Serving
Rhodiola rosea (min 3.0% total rosavins) (root) 3000 mg *
Cordyceps sinesis (min 7% cordycepic acid) (mycelia biomass) 600 mg *
Mitochondrial MatrixTM
Suma (Pfaffia paniculata) (root)
Acetyl-L-Carnitine
L-Citrulline Malate
Resveratrol (min 20%) (root) 1,100 mg *




JP Saleeby, MD
www.saleeby.net
www.CarolinaMobileMD.com

Niacin for HDL-C

A recent reader of my DocSaleeby & Wellsphere blog was concerned about his abnormal ECG showing evidence of possible myocardial injury and his cholesterol. He wanted to know if he should start back on high dose Niacin.

My response:

Niacin may be one of the most potent agents out there for elevating HDL-C. However, once myocardial muscle (heart muscle) is damaged it goes through changes as all damaged tissue does, resulting in fibrosis and loss of elasticity, etc. and this cannot be reversed. Once heart muscle is damaged it cannot be repaired, hence the formation of scar tissue which hinders wall motion (as seen on ECHO) and in severe cases aneurysm formation. Prevention by plaque formation, stabilization of plaques, and reduction with the use of natural or synthetic statins (extract of fermented yeast of red rice or pravostatin for example) to reduce LDL-C is proven effective.

Raising HDL-C as a scavenger lipid is also proven and may be more beneficial to lowering LDL-C. If an ECG shows myocardial damage then it is wise to see a cardiologist to be studied further (Cath, ECHO, stress test) to determine the extent of you Coronary Artery Disease (CAD), as lipids are only one risk factor. You may have small coronaries, stable and/or unstable plaque formation (genetically predisposed), or other processes (hypercoagulable state) that may need specific attention and therapeutics. I recommend a daily dose of Aspirin (ASA 81mg) to all my patients over 45 if they are able to tolerate. For more on CADz, read my blog at www.DocSaleeby.blogspot.com

In good health,

JP Saleeby, MD

Thyroid function and diet

I recently had a patient ask me how diet and/or supplements could affect thyroid function. This particular patient has mild hypothyroid, but was reluctant to start on any hormone therapy (natural or synthetic). This was some advice given her on her quest for a better balanced thyroid function with just diet/herbal control:


Researchers have identified that the isoflavones in soy act as potent anti-thyroid agents, and are capable of suppressing thyroid function, and causing or worsening hypothyroidism. Soy is a phytoestrogen, and therefore acts in the body much like a hormone, no surprise that it interacts with the balance of the thyroid's hormonal systems. High consumption of soy products (either by high dose soy supplements or a high concentration of soy and soy-products) in our diet can be detrimental. Very high doses have been proven to cause goiter. I would suggest limits on soy and soy-based foods. In adults, just 30 mg of soy isoflavones per day is the amount found to have a negative impact on thyroid function. This amount of soy isoflavones is found in just 5-8 ounces of soy milk, or 1.5 ounces of miso. So use these products sparingly and definitely NOT daily.

Of course Iodine is very important to thyroid function. Low iodine intake can cause goiter and low thyroid hormones, but in America we have iodinated (iodized) salt to help obliterate this cause of hypothyroid. Make sure you use occasional iodinated salt in you cooking (most processed foods with salt in them don't use iodinated salt). And also a good source of Iodine is sea food (cod, sea bass and shellfish). Kelp is a vegetarian source of iodine.

Additionally, the lauric acid in coconut oil has a stimulant affect on thyroid function. This was discovered in the 1940's, so using coconut oil in your cooking or taking it as a daily supplement may help stimulate higher levels of T4 and T3 naturally.

With fluoridation of water (and fluoride toothpaste) we can see an impact on iodine. Fluoride displaces iodine in the body, so intake of iodine (by iod. salt and seafood) is important to counter the unavoidable fluoridation of municipal water systems and toothpaste.

Some herbals that have a history of increasing thyroid function are: bladderwrack, iceland moss, oat straw, saw palmetto berries, calamus root. There are preparations out there that have these as single or grouped supplements for thyroid health.

A 1/4 teaspoon of iodized table salt provides 95 micrograms of iodine. A 6-ounce portion of ocean fish provides 650 micrograms of iodine. Most people are able to meet the daily recommendations by eating seafood, iodized salt, and plants grown in iodine-rich soil. Recommendations for females age 14 and older: 150 mcg/day of iodine.

JP Saleeby, MD
www.saleeby.net
www.CarolinaMobileMD.com

Moving Carolina MD practice to Uzbekistan

JP & Sharon have decided after much contemplation and planning to move to Uzbekistan. We are moving mostly because we like their flag. Or was it their exceptional health care system?

PS: Oh, don't worry....April Fools!