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Aging Well with
Naturopathic Medicine
Jen Green
Hallie Armstrong, Diana Quinn,
Naturopathic Doctors
Beaumont Integrative Medicine
[email protected]
Royal Oak 248-551-9990
Troy 248-964-9200
What is Naturopathic Medicine
Licensed Naturopaths are the general practitioners of natural
A licensed Naturopath has completed four years of pre-med,
four years of graduate school at an accredited Naturopathic
medical college, and has successfully passed North Americanwide licensing exams (NPLEX).
Our scope includes nutrition, herbal medicine, homeopathy,
lifestyle counseling and mind-body medicine.
Training includes a Western medical understanding of the body
eg. differential diagnosis, physical diagnosis, lab work, pathology,
microbiology etc.
We have a focus on evidence based complementary and
alternative medicine (EBCAM).
Goals with Healthy Aging
Maintain healthy immune system, wound repair,
stamina, mental wellness, tolerance to environmental
stressors, sensory acuity, flexibility and nutrient
Prevent and minimize the impact of cardiovascular
disease, stroke, neurodegenerative disease, macular
degeneration, osteoporosis, osteoarthritis, cancer and
And according to Robert Rountree MD: “Aging well
means enjoying this emotional depth and experience
that comes with time while keeping the body and mind
healthy enough to do the things we want to do and
maintaining the freedom to enjoy life.”
Aging is a breakdown in the ability to self repair
Injuries include oxidative stress, inflammation,
lipotoxicity, glucose toxicity and environmental
According to Robert Rountree MD “Glucotoxicity is the longterm total burden of sugar . When we eat too much sugar, then
the mitochondria leak a lot of free radicals that damage tissues.
Some of those damaged tissues will go on to damage other
tissues in what is called the propagation process.
High levels of fructose are converted in the liver to triglycerides,
and those triglycerides basically pack the liver with fat, which
then interferes with insulin sensitivity. So, glucotoxicity
contributes to lipotoxicity”
Recommendation: Eat whole unprocessed foods. When
indulging in alcohol or high sugar foods, combine with protein,
fat and fiber to minimize the impact on blood sugar. Avoid fatfree foods high in sugar. Say no to candy and pop. Say yes to
The Mediterranean Diet.
Decrease trans-fatty acids which are found in processed food,
baked goods and anything that has crackled when you fry it.
Transfatty acids increase heart disease[i].
Decrease arachidonic acid in pork, red meat and peanuts.
Arachidonic acid fuels inflammation, decreases efficacy of COX
inhibitors (goes to LOX) and contributes to mucous, edema and
lung constriction.
Steam foods, stir-fry in water and add oil at the end, and olive oil
to sauces after high heat cooking is complete. Fiber fiber fiber 
Include omega 3 oils which preferentially replace bad fats in cell
membranes. Take fish oil, use cold-pressed olive oil liberally and
eat walnuts. Use canola, organic butter or coconut oil for high
heat cooking.
[i] Association between trans fatty acid intake & 10-year risk of coronary heart disease in the Zutphen Elderly Study: a prospective population-based study.
By Oomen CM, Lancet, 2001 Mar 10; Vol. 357 (9258), pp. 746-51
Environmental Exposures
Persistent low level environmental toxins may have larger
impacts than acute high level exposures with respect to aging
The total toxic burden increases slowly over time
Consider screening for heavy metals with a urinary heavy metal
test following oral DMSA.
Pesticides in well water increase risk of Parkinsons
(NEUROLOGY TODAY January 21, 2010)
Recommendation: Use a water filter, avoid heating in plastic,
take shoes off at the door, avoid lawn pesticides, use green
cleaning products, choose organic meat, dairy, eggs and oil
(higher on the food chain so accumulate more toxins), avoid
high mercury fish such as tuna. Water! Water! Water! to support
elimination of toxins (early in the day to avoid night urination) .
Conventional vs. Organic
Necessary for all body functions eg. digestion, body-temperature
maintenance, electrolyte balance, detoxification
May benefit people with respiratory diseases (by thinning
mucous secretions), urinary tract infections (by increasing their
urine flow and removing bacteria), back, and may help reduce
cancer risk of the colon, kidneys, bladder.
Increased requirements with sweating, sun exposure, diarrhea or
vomiting, certain medications
An Environmental Working Group analysis of tap water tests
from 1998 through 2003 for 1,446 communities across Michigan
shows 69 pollutants were found in drinking water across the
Consider getting a carbon block or reverse osmosis filter system
for drinking water.
Oxidative Stress
In a study of 20,000 participants, the mortality risk for
people who are nonsmokers, who exercise regularly,
have a moderate alcohol intake, and who have a plasma
vitamin C level > 50 mmol/L (indicating fruit and vegetable
intake of at least five servings a day), was the equivalent of being
14 years younger in chronologic age, compared with people who
engaged in none of these behaviors.
Don’t smoke and avoid second hand smoke
Minimize alcohol use
Exercise Regularly
Khaw K-T, Wareham N, Bingham S, et al. Combined impact of health behaviours and mortality in men and
women: The EPIC-Norfolk Prospective Population Study. PLoS Med 2008;5(1):e12;correction:2008;5(3)e70.
Antioxidants- Eating the Rainbow
Eat seven servings of fruit and vegetables daily
Yellow-red-orange vegetables and fruits
Red-purple-blue vegetables and fruits
Broccoli, cauliflower, Brussels sprouts, cabbage, collard greens
Lycopene – tomatoes, guava
Lutein – tomatoes, red peppers, green leafy vegetables
Anthocyanidins – berries, grapes
Dark leafy greens
Cruciferous vegetables
onion, garlic
Green, white, red, black tea
Quercetin, Hesperidin
Drink organic green tea and eat blueberries
If supplementing, consider food or herb-based
antioxidants eg. New Chapter brand Supercritical
Antioxidants, Green drinks eg. Enzymatic Therapies
Earth’s Promise, New Chapter Berry Greens, Designs
for Health Paleogreens.
Extra vitamin C is helpful, but be aware that chewable
vitamin C promotes tooth decay if you don’t brush
after 
Antioxidant concentrations (Vitamin C, E and beta carotene) in
the blood correlate positively with physical performance and
strength in the elderly[i].
Vitamin C and E in combination decrease risk of Alzheimers
Low vitamin C and E levels are also found in Parkinsons
Vitamin E has been shown to help with memory/cognition in
elderly women (70-79 yrs)[iv]. The only concern with Vitamin E
is that it can increase bleeding in high doses (so stop it 1 week
before surgery), and it may also increase severity of respiratory
infections[v] (so stop taking it during an acute cold or flu). Make
sure patients are taking mixed tocopherols or vitamin E
succinate rather than plain alpha tocopherol.
Antioxidant References
[i] Antioxidants and physical performance in elderly persons: the Invecchiare
in Chianti (InCHIANTI) study. By Cesari M, Am J Clin Nutr, 2004 Feb; Vol.
79 (2), pp. 289-94
[ii] .Reduced risk of Alzheimer disease in users of antioxidant vitamin
supplements: the Cache County Study. By Zandi PP, Cache County Study
Group, Arch Neurol, 2004 Jan; Vol. 61 (1), pp. 82-8
[iii] Plasma levels of antioxidant vitamins C and E are decreased in vascular
parkinsonim.By Paraskevas GP, J Neurol Sci, 2003 Nov 15; Vol. 215 (1-2),
pp. 51-5
[iv] High-dose antioxidant supplements and cognitive function in communitydwelling elderly women By Grodstein F. AM J CLIN NUTR, Apr 1, 2003;
77(4): 975-84
[v] Vitamin E increases severity of respiratory infections. By: Gaby, Alan R..
Townsend Letter for Doctors & Patients, Feb/Mar2003 Issue 235/236, p32,
Supplement Considerations
in the Elderly
Good quality multivitamin – capsule, powder or liquid instead of
tablet because of absorption issues/possible low stomach acid
Multivitamin should contain selenium 200mcg for glutathione
support, chromium 200mcg for blood sugar stabilization, zinc
for wound repair, and a B complex. Consider cancer risk when
deciding whether to use natural or artificial folic acid.
Do not supplement with iron unless iron deficiency is present
because iron can increase inflammation (eg joint pain). Use
ferrous glycinate/Gentle Iron instead of ferrous sulfate if
"Ten-year trends in vitamin intake in free-living healthy elderly
people: the risk of subclinical malnutrition," Toffanello ED,
Inelmen EM, et al, J Nutr Health Aging, 2011; 15(2): 99-103.
Fish Oil
Fish oil decreases inflammation, lubricates the bowels,
improves memory[i], decreases heart disease and
stroke[ii][iii], helps address mild to moderate depression
[v], lowers blood pressure[iv], improves bone density
[vi] and helps prevent cancer.
[i] Alzheimer's Disease is Largely Preventable. By: Grant, William B.. Townsend Letter for Doctors & Patients, May98 Issue 178,
p72. Thirteen-Year Prospective Study between Fish Consumption, Long-Chain n-3 Fatty Acids Intakes and Cognitive Function,"
Jesse Guyot E, Peneau S, et al, J Nutr Health Aging, 2011; 15(2): 115-20.
[ii] Changes in fatty acid composition, platelet aggregability and RBC function in elderly subjects with administration of low-dose
fish oil concentrate and comparison with younger subjects By Terano T, Nippon Ronen Igakkai Zasshi, 1994 Aug; Vol. 31 (8),
pp. 596-603)
[iii] The effect of the short-term administration of fish oil on serum lipoproteins in old people. By Lehtonen A, Gerontology,
1989; Vol. 35 (5-6), pp. 311-4
[iv] A low-sodium diet supplemented with fish oil lowers blood pressure in the elderly. By Cobiac L, J Hypertens, 1992 Jan; Vol.
10 (1), pp. 87-92
[v] "The effect of low-dose omega 3 fatty acids on the treatment of mild to moderate depression in the elderly: a double-blind,
randomized, placebo-controlled study," Tajalizadekhoob Y, Sharifi F, et al, Eur Arch Psychiatry Clin Neurosci, 2011 Feb 12
[vi] Protective effects of fish intake and interactive effects of long-chain polyunsaturated fatty acid intakes on
hip bone mineral density in older adults: the Framingham Osteoporosis Study," Farina EK, Kiel DP, et al, Am
J Clin Nutr, 2011 March 2
Omega 3 Fatty Acid
Fish Oil Considerations: Quality of Supplement
 Third-party testing eg.
 Hexane free
 Free of oxidative damage
 Free of heavy metals and impurities
Good brands include Carlson Labs, Nordic Naturals, Designs
for Health.
Goal is at 900mg of EPA and 400 DHA.
Algae EPA – EPA/DHA concentrations in fish are
derived from the algae they consume; consider Algae
EPA supplementation for vegetarians
Eggs – chickens fed flax (ALA)
Simonopoulos AP, Salem N. n-3 fatty acids in eggs from range-fed Greek chickens. N Engl
J Med. 1989;331:1412.
Dietary Fish
Wild caught vs. Farmed fish: Farmed fish has lower
omega-3:omega-6 ratio than wild fish
Good fish (low mercury fish that are high in omega 3 fatty
acids) include anchovies, sardines, herring, wild Atlantic
salmon, Sable fish, whitefish, flounder, haddock, farm-raised
rainbow trout & catfish.
Avoid tuna fish, shark, swordfish, tilefish and king mackerel
because of mercury contamination.
If pregnant or a young child, avoid grouper, marlin, orange
roughy, bass (sea and large mouth), halibut, red snapper,
spanish mackerel, bluefish, lobster, pike and walleye.
Canned fish: Canned salmon EPA:AA ratio 25:1, EPA 5x
higher than tuna
Ginsberg G., Toal B. Quantitative approach for incorporating methylmercury risks and omega-3 fatty acid benefits in developing
species-specific fish consumption advice. Environ Health Perspect 117:267–275 (2009).
See also
van Vliet T, Katan MB. Lower ratio of n-3 fatty to n-6 fatty acids in cultured than wild fish. Am J Clin Nutr. 1990;51:1-2.
Vitamin D
Vitamin D is a common deficiency in the elderly community[i].
It is endemic in Michigan.
Statins further decrease absorption of fat soluble vitamins
(vitamin A,D,E, K).
Supplementation with vitamin D 800 IU/day decreases falls[ii].
Vitamin D deficiency is linked with osteoporosis, hypertension,
asthma, diabetes, seasonal depression, frequent viral infections,
cancer, and autoimmune conditions.
Evidence from epidemiologic studies and small clinical trials
suggests an association between 25(OH)D concentrations and
systolic blood pressure, risk for CV disease-related deaths,
symptoms of depression, cognitive deficits, and mortality.
[i] High prevalence of vitamin D insufficiency in healthy elderly people living at home in Argentina. (eng; includes abstract) By
Oliveri B, Eur J Clin Nutr, 2004 Feb; Vol. 58 (2), pp. 337-42
[ii] A randomised, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after
hip fracture: The Nottingham Neck of Femur (NONOF) Study. (eng; includes abstract) By Harwood RH, The Nottingham Neck
of Femur (NONOF) Study, Age Ageing, 2004 Jan; Vol. 33 (1), pp. 45-51
AND, Alfacalcidol reduces the number of fallers in a community-dwelling elderly population with a minimum calcium intake of
more than 500 mg daily. By Dukas L, J Am Geriatr Soc, 2004 Feb; Vol. 52 (2), pp. 230-6
[5]Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 1999;69:842–856.
Extraskeletal effects of vitamin D in older adults: cardiovascular disease, mortality, mood, and cognition. Barnard K, ColónEmeric C. Am J Geriatr Pharmacother. 2010 Feb;8(1):4-33. Review.
Vitamin D Recommendations
Screen 25 OH Vitamin D routinely and aim for a serum
level of 40-60.
Any brand of D3 is fine, but taking it with a fatty meal
or fish oil improves absorption.
Use 2000 IU daily[v].
Watch for cumulative dosing between multivitamin,
calcium supplements and plain vitamin D.
Numerous brands now offer Vitamin D drops in 400,
1000 and 2000 IU/drop. Good to decrease number of
pills and for anyone with swallowing issues.
Vitamin D and Brain health
According to Dr Perlmutter, Vitamin D
supplementation is essential in Alzheimers and
Parkinsons because it is a membrane-bound
antioxidant that enhances neurotrophins,
increases hippocampal density (rodent),
supresses expression if inflammatory cytokines
and is antimicrobial.
Perlmutter links herpes simplex infection with
Supplementing calcium alone eg. Caltrate or
CalciChews can create a magnesium deficiency!!!
2 g/day of calcium (citrate) decreased Mg
absorption and plasma Mg levels in healthy
volunteers. Clin Sci 1967;32:11-18
Calcium supplements should be balanced with
magnesium in a 2:1 ratio and a maximum of
500mg calcium is absorbed at once.
Forms of Calcium
Calcium carbonate is mildly constipating
Calcium citrate can encourage bowel
Calcium glycinate and hydroxyappatite are bowel
neutral and well-absorbed
Coral calcium is a poor choice environmentally
Dietary sources of calcium include dairy, tahini,
seaweeds, almonds, calcium-enriched foods and
green leafy vegetables.
Magnesium helps insomnia (if taken away from calcium), reduces
heart palpitations, reduces blood pressure, supports cardiac &
bone health, helps to normalize glucose metabolism & stabilize
According to Dr Alan Gaby, Magnesium is a cardioprotective
nutrient that; inhibits platelet aggregation, dilates blood vessels,
has anti-arrhythmic activity, is required for ATP synthesis,
promotes intracellular potassium uptake, possibly lowers BP and
increases HDL-C.
Magnesium Deficiency is common: NHANES 1999-2000: 50%
of Caucasians consumed < 75-80% of the RDA; Mg intake was
about 25% lower in African Americans than in Caucasians. - J
Nutr 2003;133:2879-82
Forms of Magnesium
Magnesium oxide and magnesium hydroxide
(milk of magnesia) are laxatives
Magnesium glycinate/chelated magnesium is
bowel neutral and helps with chronic pain and
muscle stiffness
Magnesium taurate has an affinity for the heart
Dietary sources: soy, nuts, sunflower & pumpkin
seeds, beans, avocados, leafy green vegetables,
Stomach Acid
Antacids can wreak havoc on the acid barrier to infection and
protein/mineral absorption. Dose vitamins/minerals away from
Stomach acid naturally declines as we age, which can cause
excess bloating and gas, poor protein digestion and poor mineral
absorption (calcium, magnesium, zinc etc).
Bitters: The esophageal sphincter can be re-educated to close
properly by using herbal bitters for 2-3 weeks. Use Herbpharm
“Digestive Bitters” or Nature’s Answer “Bitters with Ginger” 3-4
drops before meals. Discontinue immediately if heartburn is
aggravated. Bitters often retrain the sphincter to close in
response to stomach acid/food rather than staying lax.
Careful with reducing stomach acid blockers because many
people experience rebound hyperacidity
Deep phase sleep (high melatonin) is when the body
repairs tissues
Melatonin activates the immune system, helps to
prevent and treat cancer and seems to increase HDL
levels in peri and post menopausal women.
Melatonin – 3-20mg half hour before bedtime to treat
insomnia. Start with 3mg nightly and slowly increase
every few days until you reach a dose where you sleep
for seven hours and wake refreshed.
Melatonin References
Lissoni P, Chilelli M, Villa S, Cerizza L, Tancini G, Five years survival in
metastatic non-small cell lung cancer patients treated with chemotherapy
alone or chemotherapy and melatonin: a randomized trial. Journal Of Pineal
Research, 2003 Aug; Vol. 35 (1), pp. 12-5
Tamura H, Nakamura Y, Narimatsu A, Yamagata Y, Takasaki A, Reiter RJ,
Sugino N.Melatonin treatment in peri- and postmenopausal women elevates
serum high-density lipoprotein cholesterol levels without influencing total
cholesterol levels. J Pineal Res. 2008 Aug;45(1):101-5. Epub 2008 Feb 19.
Vijayalaxmi; Thomas CR Jr; Reiter RJ; Herman TS. Melatonin: from basic
research to cancer treatment clinics. Journal of clinical oncology : official
journal of the American Society of Clinical Oncology [J Clin Oncol] 2002
May 15; 20 (10), pp.2575-601.
Treat both constipation and diarrhea in elderly patients
Help prevent upper respiratory tract infections in the elderly
Help prevent antibiotic associated diarrhea and yeast infections
following antibiotic use
Supplement Considerations;
 Single versus multiple strains
 Ability to colonize the gut
 Quality control is a huge issue! Trusted brands include Klaire
Labs, Genestra, Orthomolecular Products.
 Must be stored correctly.
Probiotics Improve Bowel Movements in Hospitalized Elderly Patients - The PROAGE Study," Zaharoni H, Rimon E, et al, J Nutr Health Aging, 2011; 15(3): 215-20.
(Address: H. Zaharoni, Harzfeld Geriatric Medical Center, Gedera, 70750 Israel.
2004. Green, J. “Probiotics in Pediatric Health Conditions: A Systematic Review”. Open access copy available at:
Drug-NHP Interactions
Basic steps to avoid interactions:
Don’t take any medication or supplement with absorbent
substances such as: Fiber, Bentonite or Charcoal
Beware of caffeine, charbroiled food, St. John’s wort (Hypericum
perforatum) and grapefruit because they effect liver clearance of
Check drug induced nutrient depletions eg. Magnesium, CoQ10,
melatonin. Drug-Induced Nutrient Depletion Handbook by
Ross Pelton, James B. LaValle, and Ernest B. Hawkins
Pharmacists are our friends!!!!
Case Study: CoQ10 Interactions
Oral Coenzyme Q10 with other anti-hypertensives can provide
an additional blood pressure lowering effect.
Hodgson JM, Watts GF, PlayfordDA, et al. Coenzyme Q10 improves blood pressure and
glycaemiccontrol: a controlled trial in subjects with type 2 diabetes. EurJ ClinNutr.2002;56:1137-42.
Singh RB, NiazMA, RastogiSS, et al. Effect of hydrosolublecoenzyme Q10 on blood pressures and
insulin resistance in hypertensive patients with coronary arterydisease. J Hum Hypertens.1999; 13:203-8.
Administration of coenzyme Q10 to heart transplant candidates
led to a significant improvement in functional status, clinical
symptoms, and quality of life. Study group showed significant
improvement in the 6-min walk test and a decrease in dyspnea,
New York Heart Association (NYHA) classification, nocturia,
and fatigue. However, there were no objective changes in echo
Berman M, ErmanA, Ben-Gal T, et al. Coenzyme Q10 in patients with end-stage heart failure
awaiting cardiac transplantation: a randomized, placebo-controlled study. ClinCardiol.2004;27:2959.
CoQ10 Interactions
Statins can reduce serum coenzyme Q10 levels by blocking the
synthesis of mevalonicacid, which is a precursor of coenzyme
Q10. Statins' effect on coenzyme Q10 appear to be dose-related.
Atorvastatin(Lipitor) 10 mg/day or pravastatin(Pravachol) 20
mg/day doesn't decrease levels of circulating coenzyme Q10 in
healthy people
Mortensen SA, LethA, AgnerE, et al. Dose-related decrease of serum coenzyme Q10 during treatment with HMGCoAreductaseinhibitors. Mol Aspects Med. 1997; 18:S137-44.
BleskeBE, Willis RA, Anthony M, et al. The effect of pravastatinand atorvastatinon coenzyme Q10. Am Heart J.
Statin-induced myopathy: Coenzyme Q10 might lessen muscular
adverse effects caused by high-dose HMGCoAreductaseinhibitors
ThibaultA, SamidD, Tompkins AC, et al. Phase I study of lovastatin, an inhibitor of the mevalonatepathway, in patients
with cancer. ClinCancer Res.1996;2:483-91.
CoQ10 Negative Interactions
CoQ10 / Warfarin Interactions:
Concomitant use might reduce anticoagulation effects.
Coenzyme Q10 is chemically similar to menaquinoneand may
have vitamin K-like procoagulant effects
Four cases exist of decreased warfarin efficacy likely due to
coenzyme Q10
Preliminary clinical research suggests coenzyme Q10 might not
significantly decrease the effects of warfarin in patients that have
a stable INR
Warfarin-induced hair loss There is some preliminary evidence
that coenzyme Q10 might be helpful for preventing warfarininduced hair loss
Heck AM, DeWitt BA, LukesAL. Potential interactions between alternative therapies and warfarin. Am J Health SystPharm.
SpigsetO. Reduced effect of warfarincaused by ubidecarenone. Lancet. 1994;334:1372-3.
EngelsenJ, Nielsen JD, WintherK. Effect of coenzyme Q10 and Ginkgo bilobaon warfarindosage in stable, long-term
warfarintreated outpatients. A randomized, double blind, placebo-crossover trial. ThrombHaemost. 2002;87:1075-6.
Nagao T, IbayashiS, FujiK, et al. Treatment of warfarin-induced hair loss with ubidecarenone. Lancet.i 1995;346:1104-5.
Putting it all Together:
Assessment & Screening
Quality of sleep (sleep hygeine, deep breathing before
bed, melatonin supplementation if needed)
Emotional fluidity and expression (screen for
depression – then check for hypothyroidism, B12
deficiency, folate deficiency, add fish oil)
Optimal nutrition with appropriate caloric intake
(dentition and food issues, social vs solo eating,
avoiding empty calories, screening for zinc deficiency if
low appetite, use digestive bitters if low stomach acid)
Appropriate dietary supplementation as indicated
(multivitamin, vitamin D, fish oil, calcium/magnesium,
melatonin, probiotic if needed)
Best Medicine = Individualized
Two patients of mine, Betty and Philip – both 82 yrs old
Betty – Diagnosed with senile dementia, history of angina with
stent, frequent night waking, high cholesterol, low HDL, anemia,
high uric acid, chronic constipation, morning headaches, loss of
appetite with low caloric intake, mild depression, cared for by
loving husband.
Philip – Hypertension, gout, gas, breast cancer in 1984,
polynephritis (incomplete bladder emptying) with chronic kidney
failure, kidney stones, headed for dialysis, poor balance,
constipation, recent fatigue, recent anxiety with early night sleep
disturbance since wife passed away, lives in FoxRun
Naturopathic Recommendations for
Cardiac rehab three times weekly for heart health and to improve
Increase water early in the day, try juice on waking to see if low
blood sugar is causing headaches
Switch iron to ferrous bisglycinate
Nutrient-rich smoothies: Coconut milk (medium chain
triglycerides), Whey Cool protein powder, Fish Oil 1 TBSP, ¼
cup cherry juice for uric acid, Calcium magnesium liquid 1 TBSP,
frozen or fresh fruit (especially organic blueberries, raspberries)
Chocolate chewable CoQ10 100mg by ITI
Designs for Health Twice Daily Multi
Vitamin D3 2000IU
Digestive Bitters 4 drops before meals for 2 weeks to try to
stimulate appetite and proper digestive function
Naturopathic Recommendations for
Balance calcium with magnesium, add extra magnesium glycinate
200mg for kidney function
Nettle seed tincture 1 dropper twice daily to improve kidney
function. BUN and Creatinine gradually improving so dialysis
Switched iron to ferrous bisglycinate, constipation resolved
Eliminated daily cabbage and gas resolved
Replace flax oil with fish oil 3000mg/3 capsules
Theanine 200mg before bed eliminated night disturbance and
calms down anxiety. (Patient added melatonin of his own accord)
Increased thyroid dosage after detailed testing (TSH was normal,
fT4 was not). Fatigue better with new thyroid dose.
Amalgamate and streamlined many supplements, especially with
high doses possibly effecting kidney function.
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