Supplement Detective

By Curtis Alexander, Pharm.D.
America’s Natural Pharmacist

Summary: A number of small studies have looked at Oolong tea & weight loss and have shown some small benefit.  Oolong tea can increase your energy expenditure and calories burned – but only slightly.  Don’t believe the claims that you can burn 20 pounds in 30 days.

Q: Can I drink Oolong tea for weight loss?  Will it really help that much?

A: For the most part, when someone says Oolong, weight loss tea seems to be what comes to mind.  And that’s probably for two main reasons.  Number one, several small studies have shown that, yes there can be some small weight loss with Oolong tea.  Secondly, none other than Oprah and Rachel Ray have personally endorsed Oolong tea as a viable weight loss supplement.

The first point I brought up is a reputable one.  The studies seem to show that there can be some benefit – but it is small.

But, too many people in this country, particularly women, place far too much weight in what Oprah or Rachel Ray say.  But, in a way it makes sense, because both of these women have publicly struggled with their weight and have yo-yoed at times on fad diets, losing weight, gaining more back, etc.  In short, I don’t think they are the best source of information on the subject.

So, let’s focus on the objective data that we have on Oolong tea and weight loss so you can get a realistic expectation of what you can expect.

1. Oolong tea has shown to raise energy expenditure in studies.  As the name implies, oolong tea causes you to burn more energy.  But again, it’s not a lot.  On average you’ll burn about 3% more energy than you would if you hadn’t consumed any tea.  You’re talking about 60 to 70 extra calories.
2. Oolong tea doesn’t contain as much caffeine as green tea.  So, it was compared to green tea thinking that it was the caffeine that was causing the weight loss.  Oolong tea still produced more energy expenditure than green tea which suggest it’s effects are related to it’s polyphenol content – which is much higher than green tea.  Polyphenols are compounds which are believed to have antioxidant properties.
3. Almost all Oolong tea on the market which is specifically labeled for weight loss is overpriced – and that’s being nice.  I’ve seen prices as high as $40 for a 30 days supply – that’s a rip-offf.  If you want to try Oolong, just by regular Oolong tea.
4. Don’t believe the weight loss claims of 20 pounds in 30 days.  As I showed in the studies above the weight loss will be minimal – supplemental.  If you are eating naturally with sensible exercise it might be worth trying to supplement a bit with Oolong.  Again, because of the caffeine content you wouldn’t want to get carried away with it.  You can always have too much of a good thing.

By Curtis Alexander, Pharm.D.
America’s Natural Pharmacist

Summary: Glycolic acid lotion is actually an exfolliant which can help shed the outer layer of dead skin cells revealing the newer skin cells underneath and possibly help create a more ‘youthful’ appearance.  Glycolic acid preparations are also used for acne and to reduce scarring.  Glycolic acid lotions that are sold over the counter contain much lower concentrations than what you’ll find in a dermatologists office for safety reasons.

Q: Glycolic acid lotions are touted as natural and they can help women look younger by lessening fine lines and wrinkles.  Do you believe the claims?

A: There are all sorts of glycolic acid products – from lotions to face peels.  The biggest difference in what they can be used for and by whom is based on their final concentration in the bottle.  So, a lotion – as you described – will have different properties than what a lot of manufacturers call face peels.

But, first things first.

Glycolic is the smallest alpha-hydroxy acid (AHA) known.  It’s natural source is from sugar cane.  Because it is the smalles AHA it’s ideal for getting into small skin pores to do it’s job.  But, at the end of the day and no matter what concentration the glycolic acid body or face lotion ends up being – it’s still an exfoliant.  An exfoliant’s job is to basically sluff off the very top layer of skin cells – which are the dead cells.  Skin cells have a life cycle, and, after about 30 days the newer skin cells age and migrate towards the top of the skin layer.  As they do they become more acidic.  Women, especially those who’ve reached menopause, can have difficulty shedding this outer layer on their own.  The skin appearance can become blotchy and the skin tougher so you can’t see the new skin below.

An exfoliant basically allows you to show the newer, more youthful skin cells underneath.  Resulting in a younger appearing skin in many cases.

But, exfoliant’s – no matter if they are natural of not – can cause problems too.  Probably the biggest one if over-exfoliating which can lead to redness and irritation.

Glycolic Acid Claims

Now, as far as do I believe the claims of glycolic acid manufacturers … it depends on the claims.  As far as these products being able to penetrate the skin and acting as an exfoliant – YES, I think it’s pretty well established in that regard.  But, as far as being touted as an anti-aging cream and making you look 20 years younger in 20 days, obviously that’s a little beyond the pale.  But, all in all – especially for older women and those who have reached menopause I think a glycolic acid lotion or other similar product is relatively safe and not terribly expensive – so it’s worth a shot.

Keep in mind that the glycolic acid lotions are much different from the ‘peels’ you might have heard about.  The FDA has required that any glycolic acid product that is sold over the counter must stick to two criteria:

1. The final glycolic acid concentration is less than 10%
2. The final pH of the product is greater than 3.5 (the lower the pH, the more acidic something is).

Also something to watch out for is the possible side effect of increased sun sensitivity after using glycolic acid products.  A recent study showed that these products can make you more sensitive to the suns UV rays so be careful when you are outside.  Again, glycolic acid is technically a drug and all drugs can have side effects.

By Curtis Alexander, Pharm.D.
America’s Natural Pharmacist

Summary: It appears that ginseng benefits mental functioning in healthy patient as well as Alzheimer patients.  The extent to which it helps is still open to debate.  Ginseng is relatively inexpensive, comes in a lot of different dosage forms and is relatively safe.  There are precautions you’ll need to take and you’ll want to make sure that you’re taking the right form of ginseng for your needs.

Q: I know this probably sounds silly but as I get older I notice I forget things easier and just don’t feel as mentally sharp.  It’s nothing serious according to my doctor just, as he puts it “normal aging”.  But, I want to try.  I started looking around and have read that one of the benefits of ginseng is improved mental functioning.  The reason I’m asking you is that this was only one of the dozen ginseng health benefits listed.  It just sounds a little too good to be true.  But I’d like your opinion.

A: You’re right about the lists of ginseng benefits.  It’s pretty broad and all-encompassing.  In fact, Ginseng is a natural treatment that has been used in China for thousands of years and was highly recommended there for increasing wisdom and enlightening your mind.  If that’s the case then I recommend we give a lifetime supply to congress.

Now … enough wishing.  Let’s see was ginseng can do for your mental functioning – or, as the medical community calls it – your cognitive function.

After looking at the evidence it’s clear to me that ginseng can not only help in this area (or, at the very least, can be considered promising), it’s inexpensive and seems to be very well tolerated.

Some of the studies looked at patients who had full blown Alzheimer’s disease, which you’ve said you don’t and that your doctor considers you fine.  Nonetheless, these patients were taking prescription drugs and the ginseng was added on.  The patient’s who had the ginseng in addition to prescription drugs tested better on the mental acuity tests.

Another study looked at healthy 40 year old’s.  Now obviously, this isn’t the best slice of patients to probably study but, as you told me – your doctor considers you healthy – so this might be a good comparison.  Basically, the study found that while there wasn’t a significant difference between the two groups in memory or concentration.  The group that received the ginseng showed a tendency to faster simple reactions and their abstract thinking proved to be significantly better than the control group.

So, again, it’s a promising trend that I’m spotting with ginseng.

Now, some other questions that need answered.

Ginseng Types and Dosing

A lot of people don’t realize that there are actually 3 subsets of ginseng readily available on the market.  American ginseng, Asian ginseng (Korean, Red or Panax) and finally, Siberian (Eleuthero) ginseng.  If I had to make a recommendation or choose a formulation for myself, it would be the Asian ginseng.  Not because it’s more effective but it seems to come with less problems if a patient has diabetes or high blood pressure.

The important thing for you to remember is that the studies and reviews I’ve seen of cognition have either used American or Asian ginseng.  This is due to the fact that these two subsets of the ginseng family have ginsenosides.  Basically, it’s believed that the ginsenosides are the ‘active ingredient’ in ginseng.

The next hurdle is how much you should take or if ginseng tea benefits in the same way the raw root or capsules do?

You can get ginseng in a number of different forms: raw or dried root, fluid extract and tinctures or standardized extracts which are by far the most common.

Most of the standardized extracts contain 4-5% of ginsenosides I talked about above.  Keep in mind that there are about 20 subsets of ginsenosides.  The normal dose is 100mg to 200mg once to three times daily depending on your response.  Which, may take six to eight weeks to really start seeing results.

If you take the root, either dried or raw, a ‘normal’ dose would be 1 to 2 grams once daily.

Because tinctures and extract are all variable you’ll have to refer to the bottles directions to get an accurate dose.

Also keep in mind that ginseng is not without possible side effects and that it’s wise idea to start out with a lower dose for a few days and then work yourself up to see how you’ll respond.  Some of the more common side effects with ginseng are insomnia, restlessness, headache and stomach upset.

By Curtis Alexander, Pharm.D.
America’s Natural Pharmacist

Summary: The claimed aloe vera juice benefits range from curing asthma to helping weight loss.  There are human studies showing promise in certain disease states.  Most of the claims I’ve come across extremely exaggerate the effects of aloe vera juice.

Q: I have a friend who claims that aloe vera juice benefit’s a bunch of different diseases.  Of course, she’s selling the juice so I understand her excitement.  But, I’m a bit skeptical and frankly, the juice is expensive.  Do you really think there are any health benefits of aloe vera juice?

A: Like I’ve said a lot of times before, there are usually two camps when it comes to any sort of supplements: either they are the greatest thing since sliced bread and can literally cure any disease imaginable or they are a complete waste of money and are a scam.

Usually the truth is somewhere in between.

Aloe Vera Juice Health Benefits

As far as your friends claim to benefiting a bunch of different diseases here is what I’ve found.

Aloe has been studied in a number of different disease states.  Many of these studies were in the animal model (i.e., they studied them in rats, guinea pigs and monkeys).  While this is promising – it’s a heck of a leap to saying it can help humans.

Secondly, these studies also involved supraphysiological doses in many cases.  Before your eyes glaze over – all that means is that the doses were extremely high.  Often times much higher than any human could tolerate or even consume.

Despite these drawbacks there is some evidence out there that makes aloe look promising for certain disease states.

Here’s a quick rundown on some diseases and conditions that I think aloe might possibly help with:

1. Digestive Problems. Aloe has a long history of use in a number of digestive disorders.  Primarily constipation and ulcers.  The raw aloe gel was taken internally in Mexico and the Rio Grande area of Texas as long as 300 years ago.  A human study did follow up and show that there was some truth to the old wives tales.  However, the study only involved 12 patients and was not placebo controlled but did show complete healing of duodenal ulcers.  Let me note though that duodenal ulcers can often times heal on their own.
2. Heart Disease. While the main study in human was large (5000 patients) it was also not placebo controlled (nor did it appear to control for dietary fluctuations).  So it’s not generally accepted in the scientific community – and in particular – doctors.  But, the 5000 patients were given a natural fiber supplement called isabgal (a local Indian plant) and aloe gel as a beverage.  The end result of the study was a decrease in all major cholesterol markers (triglycerides and total cholesterol) and an increase in HDL cholesterol.  Decreased fasting blood glucose and post-meal blood sugar levels in diabetics.  And a decrease in chest pain (angina) attacks.Of course, was this from the aloe or the isabgal plant?  Again, it was a poorly designed study but, possibly promising.
3. Immune System. In patients with bronchial asthma their white blood cells have a tough time destorying invading organisms like bacteria.  This is called phagocytosis.  When these patients were given a mixture of amino acids from the aloe plant the phagocytic activity of their white blood cells was improved.Finally, aloe (or at least an isolated part of the aloe plant) has been shown to exhibit antiviral activity and enhanced immune function in AIDS patients.

These are pretty much the highlights of the human studies that are fairly reputable.  If I were to boil it down to the ‘take-home’ points I’ve discovered about aloe vera juice here’s what I’d say:

• There are some instances where I’d say aloe is promising – namely the disease states I mentioned above.  But they are by no means hands-down, proven to cure anything.
• Aloe appears to be safe – which is something that very few resources talk too much about.  One area you want to be careful is that aloe can be (depending on how you take it and the concentration that you take it at) a very powerful laxative.
• Most of the claims that I saw online (and you were right, they claim aloe vera juice can darn near cure anything) have no evidence supporting their use.  If there is evidence – it’s based off rat or monkey studies.  I agree, that’s promising – but it’s a reach and irresponsible to say it can cure those things.
• What about the sugar content of aloe vera juice?  This is hardly ever mentioned but sugar is an immune system killer.  So, does a juice cancel out the immune system benefits of aloe?  I don’t know for sure but that’s one of the reasons I’m not real fond of juices of any sort.
• What is the actual aloe content of the juice?  In most of the human studies I saw the concentration of aloe in their preparations wasn’t large.  Often times 1%.  So, maybe you don’t need a concentrated form of aloe.

by Curtis Alexander, Pharm.D.
America’s Natural Pharmacist

Summary: A vasectomy procedure is a sterilization method for men that should be considered, for practical purposes, permanent.  The procedure for vasectomy is usually completed with local anesthetic in under an hour in the doctor office.  The majority of men report satisfaction with their decision.  But the men who have problems have them bad and it can be a long, agonizing recovery period that can last for a year or even permanently.

At some point in time most couples, or sometimes even individuals, opt to look into sterilization.  Often times, because women were the ones who bore the brunt of child carrying and rearing the man is ‘volunteered’ for a sterilization procedure.  The vasectomy.

I opted for the vasectomy and was very comfortable with it…until the night before the procedure.

Out of curiosity I went online to see exactly how the procedure would be performed as I had not decided on an open-ended or closed-ended procedure.  In a closed-ended procedure the doctor closes both sides of the cut vas defrens.  In the open the doctor only closes of one side of each vas leaving the ’supply’ sides open.  In theory, the sperm that are released are consumed and destroyed by your body.

This was something that wasn’t discussed ahead of time by my doctor.  In fact, I didn’t even meet with my doctor before the procedure.  It was as simple as calling up the nurse, setting an appointment and then looking at a vasectomy procedure video they sent me via email.  For a guy who is a pharmacist that should have been a big red flag right there.

It wasn’t until I got online that I started discovering some guys really have problems with vasectomy procedures.

Vasectomy Issues

Now, before I get into my specific reasons for not getting a vasectomy let me say two things:

1. Most guys, and by most I would say 85% to 90%, have little or no problems other than the tenderness that comes from this kind of procedure.
2. Guys who do have problems seem to get them bad.  By that I mean their reports show bruising of the testicular sack, testicle tenderness for up to a year or more out and a lot of other unpleasant things.  In fact, many men who have the tenderness state that it is not the kind of pain you can ever get rid of no matter how you sit, etc.  It is just always there.  There can be auto-immune reactions when a mans system has to handle eliminating more sperm.  In short, your body has had it’s plumbing realigned and so now your body has to get rid of more sperm that has no where to go.  So, the cells in your body ‘chew up’ or destroy the extra sperm.  Sometimes this causes immune system problems.

In worst case scenarios men report that the vasectomy was the worst decision they ever made and that their sex lives were ruined because of a lack of sex drive due to the pain that does not go away.  Also, some men report that their testosterone levels plummeted after the procedure.  I originally didn’t know how much weight to put in this but if you consider that it is possible to have scarring from the procedure, which in turn can damage the cells producing testosterone it’s plausible.  However, the final word on this subject from numerous sources is conflicting.

In short, the most troublesome and common long term or permanent side effect of a vasectomy is the often dull, sometimes sharp and pointing pain in the testicles.

Often times men report that the only way to relieve the pain is to get a vasectomy reversal which is not always 100% successful, is much more complicated surgically and is not covered by insurance.  The cost estimates I have seen have been $6,000 to over $8000.

While the brochures say there should be no change physically for you.  Many men also report that their orgasms are less intense than before.

Some of this is anecdotal and you probably can’t put much in it.  But even some of the studies they’ve done about vasectomies clearly show there can be problems.  Your decision is whether or not you are willing to take those chances.

After exhausting all my options and reading up on everything I felt that there was probably a 3% to 10% chance of bothersome, long term side effects from the procedure.  Granted, that’s not real high but when you are talking about an area as sensitive as that one I eventually elected not to roll the dice.

Another Option

There are also other sterilization options that your wife might be interested in.  One is called Essure.  It’s basically a walk-in procedure that is about as invasive as the vasectomy itself where ‘plugs’ – for lack of a better term – are inserted in the womans fallopian tubes and over time they essentially become part of the fallopian tube  and block them.  Within 3 months the woman should be sterile. Unlike the vasectomy, Essure is definitely NOT reversible.

Both my wife and I looked into this option and she elected not to have it done as she was uncomfortable with things being inserted in here and so forth.  There was no fight from me as I could totally understand.  Also, after you read around a bit I found evidence that the side effects with Essure, while rare, could also be very troublesome for the woman.  Not worth it.

I think the point is is that my wife and I are very holistic people.  While we don’t want anymore children we also don’t want to take the chance of having the kind of side effects that can come from sterilization procedures like a vasectomy.  Yes, it could be more ‘convenient’ but it could also be a long term, painful and regrettable decision.  When it involves that area that’s not a decision I take lightly.

If you are a man also be aware that some people will just think you are being a wimp.  “Your wife has done all the painful stuff and all you have to do is get a couple of snips and some sore balls for a week and you won’t do it?” will likely be a common reaction behind your back.  Is that something you can deal with?

I know that people probably feel that way about my decision and I understand that.  But they simply aren’t very well informed and they also don’t know me very well if they think that it’s the actual procedure that scares me.

Vasectomy Resources

At any rate, this is just one man’s view who decided not to get the vasectomy performed.  If you’d like some more non-biased resources about making the decision that is right for you check out these sights:

http://www.vasectomy-information.com/

Also, here are some stories that I think are must-reading for any man considering a vasectomy.  I don’t put them here to change your mind or scare you but simply to give you the other side of the fence that the glossy four colored brochures in your doctor’s office don’t:

http://www.vasectomy-information.com/stories/featuredstory.htm

also…

http://www.vasectomy-information.com/stories/tony3.htm

As an aside, I also know at least a half dozen men personally who’ve had the procedure without any sort of physical or mental fallout.  They had the procedure done and would likely do so again.  One guy did say that his orgasms are a little different.  Not bad, just different and a little less intense.  Other than that it was a great decision for them.

I also met one man who did have long-term complications from the procedure.  It is better now but the pain lasted for over a year.  I don’t know if he is 100% back to normal but the procedure definitely caused complications for him.

The point is also ask around on your own to a lot of guys.  You’ll likely find most men in the happy camp and a few stragglers in the ‘it was a terrible decision and I’d never do it again’ camp.  I didn’t want to take the chance on falling into the latter group.

The most important thing for you in making this decision is to not take it lightly.  Either you or your wife.  So don’t.  Read up.  Educate yourself.  And then make the decision that is right for you.

Update: I recently got an email from Dr. A. Ellis, M.D.  He elected to have the surgery performed and had extreme complications from it.  In his own words he said “it was the worst decision I ever made in my life.”  He developed PVPS (Post Vasectomy Pain Syndrome) and opted for a vasectomy reversal procedure which cost him $8,000 out of pocket because insurances do not cover it.

The end result?  The reversal procedure did NOT work.  He still has pain and is taking pain killers to deal with the fallout.  He said he has not had a pain free day in over 2 years.

He started his own website where he talks about the little talked about problems with vasectomies at http://www.painaftervasectomy.org/ .  He also cites a number of studies and survey’s that were performed on men who had vasectomies.  Interesting stuff that you often hear little about.

By Curtis Alexander, Pharm.D.
America’s Natural Pharmacist

Summary: Many patients would prefer to have a reliable cold sore remedy outside of prescription drugs.  The first step to treating cold sores is to prevent them by avoiding cold sore triggers.  There are reliable cold sore remedies but be careful about the dose that you take.

Q: What is the best natural cold sore remedy that you know of?

A: One of the funny things about medicine and supplements is that some of the most boring, old and mundane diseases seem to have the fewest answers and options.

I wrote an article on impetigo treatment and in it I talked about some of the options I use to treat it.  But, one of the crudest (and effective) treatments was to apply a sort of salty-paste to the open wound.  Now, you are either a sadist or really desperate to put salt on an open wound of any size.  But, I did it and it worked.

Which brings me to your question about cold sores.  The skinny is that there are all sorts of home remedies and natural supplements reputed as ‘cures’.  Most of that is unadulterated BS.  The fact of the matter is people have been getting cold sores for millenia and we have been searching for reliable remedies for just as long.  Despite not having a “cure” we have been able to run across some things that help shorten the duration drastically – especially if you are looking for a natural cold sore remedy.

Cold Sore Prevention

One of the best remedies is paying attention to your body and learning what some of your triggers are.  This is truly the best remedy you have.  For example, I’ve known people who had no idea that excess sun (or, sun in general) can promote cold sores.  So, they were taking every home remedy for a cold sore that they heard about but not getting any results and dismissing the treatments as failures when they were outside 12 hours a day.

So, here are some common and not-so-common triggers that would be a great first step in learning about and avoiding:

• Stress (i.e., menstrual periods in women or a big meeting, speech, etc. that you’ve been dreading)
• Physical stress (i.e., not getting enough rest.  This is, bar none, one of the WORST things you can do for your immune systems ability to fight disease(s)
• Excessive UV rays
• Recent illness (again, stress related)
• Injury to the lip area
• Coffee
• Cold weather

Remedy for Cold Sore

Below are some of the most common (and not-so-common) cold sore remedies I’ve seen or heard of.  I’ve tried to list them from the most common to the least with my commentary next to them.

Lysine

I have heard a LOT of good things about using lysine for cold sores.  Basically what happens (or, that we think happens) is that the herpes virus which causes cold sores uses a particular amino acid called arginine to grow and replicate.  But lysine, another amino acid, seems to inhibit the herpes virus growth.  Dosing is generally 1,000mg to 3,000mg per day.

The best results are seen in patients who begin taking lysine as early as possible.  In other words, as soon as you begin to feel the tell-tale tingle of a cold sore start taking lysine.  Of course, talk to your doctor first as it’s not wise to take any amino acid in high doses.  And, don’t take this high of a dose of lysine long term.  Lysine will not cure the cold sore – but it will shorten the duration.  Do not use lysine if you are pregnant or nursing.

Vitamin C

I’m a big fan of vitamin C.  Not only is it an antioxidant but it also has antiviral properties.  The problem is people usually don’t take enough.  The recommendations I’ve seen have been anywhere from 300mg to 500mg daily.  This is an extremely SMALL dose to have any effect (taken orally) as an antiviral.  If you are concerned about taking vitamin C orally perhaps consider applying a vitamin C paste or serum topically.

Zinc

You may want to try applying this topically.  I’m a little nervous about anyone who says they are taking high dose zinc everyday to prevent cold sores based on lack of safety data.

Cod Liver Oil/Vitamin D

Most people abhor the taste but this treatment from the old days packs a very nutritional – and immune boosting punch.  Especially considering the healthy amount of immune enhancing vitamin D you get with each dose.  Again, it won’t make it disappear but may shorten the duration and will definitely help you prevent outbreaks in the future.  Avoid using cod liver oil in the spring, summer and early fall or if you are in a year-round sunny area.  You don’t want to get too much vitamin D.

There are other remedies that are touted for cold sores but I either haven’t personally heard positive things about them from patients who’ve used them or else couldn’t find decent evidence supporting their use.

By Curtis Alexander, Pharm.D.
America’s Natural Pharmacist

Summary: There is good evidence showing that applying a Vitamin C serum can help strengthen your skin and minimize wrinkles as well as protecting other nutrients like Vitamin E from oxidation.  Vitamin C serums vary wildly in price.  You may be able to save a great deal of money by making your own natural vitamin C serum.

Q: There is a huge difference in price between a lot of the vitamin C serums for the skin.  Why is that?  Is one really more effective than any of the others or am I being taken by marketing?

A: For the most part, you looking at marketing efforts and brand reputation.  Which, frankly, isn’t worth the extra money.

Let’s take a look at some of the things to look out for with vitamin C skin and eye serums so you can make the best choice for your budget.

Vitamin C Does Benefit Your Skin

There’s nothing wrong with thinking you can use vitamin C on your skin to make your skin look better.  Vitamin C has proven to benefit your skin in two main ways:

1. Vitamin C helps synthesize (or make) collagen.  Collagen is a protein in your skin that has structural properties.  Essentially, making your skins stronger.
2. Vitamin C is a potent antioxidant which is important by limiting the damage of free radicals.

The end result of these two actions is hopefully a reduction in wrinkle lines and improved skin structure and texture.

The Problem With Vitamin C Serums

While no one can deny the scientific benefits of vitamin C, I also can’t deny that a lot of the commercial vitamin C skin care products have their issues – one’s few consumers stop and think about.

Namely, vitamin C itself is pretty unstable.  Meaning, manufacturers have to be very careful about how they prepare the vitamin C serums and it’s exposure to the air or other oxidizing agents.

In short, when vitamin C is in it’s dry powder form it’s stable.  But, when it is mixed (compounded) you can start running into problems.  And, many commercial vitamin C serums have already become oxidized by the time you by them off the shelf.

Are there any ways to tell?

First, you can look at the color.  Often times vitamin C that has been oxidized will take on a yellow to orange tint.  Of course, depending on what the manufacturer used as their mixing ingredients it may be impossible to tell.  If they used a yellow or orange die, you’ll never know.

To further compound and confuse you, when vitamin C first starts to become oxidized there is no color.  The yellow or orange tint I was talking about above is a result of late stage oxidation.

Another thing to look at is the concentration of the product you are thinking about buying.  In short, I’d avoid anything that is less than 10% vitamin C.  Normally, it takes this much anyways to produce much of a protective effect on your skin.

Another problem that I’ve found with vitamin C serums is the results patients actually get.  Based on my unofficial snooping of reviews and feedback from women I’d say it’s around 50% satisfaction rate.  Now, is this a result of poor product selection, unreliable use (i.e., they aren’t applying it regularly or in sufficient amounts)?  I don’t really know. But, vitamin C skin care products – despite the science supporting their use – haven’t lived up to the billing.

My Take on Vitamin C Serum for Your Skin

I think that it’s worth a shot to look at a natural vitamin c serum for improving your skins structure and wrinkles.  However, because of how unstable vitamin C is, I’m pretty leery of many of the commercial products.  There’s frankly no way to ensure that you are getting a product that hasn’t started being oxidized in the bottle.

If you are going to buy a vitamin C eye or skin serum buy a product of at least 10% and buy one without any dyes in it to help you determine when it might be reaching late stage oxidation.

Your second option is to make your own vitamin C serum.  There are all sorts of recipes online that I saw but one of the biggest issues I saw right off the bat was they were 10% serums, or weaker.  The biggest advantage of making your own vitamin C serum is you can make it in very small batches and avoid some of the oxidation issues I talked about above.  Oh, and it will likely save you quite a bit of money.

Summary: Aloe vera acne products are only moderately effective.  However, using the liquid from inside an aloe vera leaf has given good results in my experience.  You’ll want to make sure there are no allergies by testing on a small area first.  Aloe vera is believed to act by effecting your immune system which can help scarring as well as breakouts.

Q: My daughter has moderate acne and has tried quite a few of over the counter acne gels and creams.  But she hasn’t had real good results.  She’s been looking online and said people seem to have good results using aloe vera for acne.  As a pharmacist what have you heard about this – good or bad?  Is it worth the money.

A: One of the hardest things about acne is understanding what is causing it because it can be any number of things: hormonal, stress, poor hygiene, genetics and (one of the biggest culprits in my opinion) poor diet.  With that being said, the best way to attack acne isn’t with any cream or natural treatment – you have to do your best to help your daughter eliminate what is the root cause.

Assuming you have done that let’s look at some of the options you have with aloe vera and acne.

How Aloe Vera Works

While it isn’t totally agreed upon by the medical community at this point – it appears that aloe vera has immunomodulatory properties.  Basically, what this means is that is can modulate, or effect, your immune system.

When you apply it topically (on your skin) it has the ability to effect wound healing as well as inflammation.  This explains why aloe vera may not only help breakouts but also help improve the appearance and healing of acne scars.

Aloe Vera Gels for Acne

There are a number of commercial gels and creams that are sold over the counter in America for acne treatment.

Let me say this, as a pharmacist the feedback I’ve gotten on these types of products has been mixed at best.  For some they work and for some they seem to make the acne worse.

Why this happens I’m not exactly sure but I can tell you this.  Any time a product is prepared commercially there are excipients (a fancy pharmaceutical word for compounds that help the product ‘keep’ longer or allow the main ingredient to mix better, etc.).  Often times a person’s skin can be very sensitive to these extra ingredients.

Also, you could probably take a dozen of these aloe vera acne gels and send them to a lab and get different concentrations of actual aloe vera in the product.  Of course, I haven’t done this and I cannot prove it but it’s not odd to see concentrations vary in over the counter products.

Aloe Vera Plant

This doesn’t mean aloe vera can’t help.  The best results I’ve heard about personally have come from patients who have the actual aloe vera plant at home and use it naturally.

The process isn’t complicated – but it has been reported to me that it is a bit messy.  Simply take a small amount of the aloe vera leaf and start applying the ‘gel’ from inside the leaf directly to the face.  Your daughter will want to do this at night and then gently wash off in the morning (for obvious reasons).

Here’s a slight caution: while I’ve never personally heard of an allergy to aloe vera – it is possible.  So, before she slathers it over her whole face have her just apply to a small area on her skin (even on her arm or a non-visible area) and see how she responds.  Again, it’s highly unlikely she’ll have any problems but it’s always better to be safe than sorry.

Another quick tip: when your daughter washes her face in the morning what types of cleansers is she using?  Often times harsh cleansers can make the acne worse.  Have her use a very mild soap.  Or, two other natural alternatives like baking soda or even lemon juice (which I’ve had good feedback on).

By Curtis Alexander, Pharm.D.
America’s Natural Pharmacist

Summary: You can use fish oil for weight loss.  However, beware that many claims regarding fish oil pills and weight loss have been taken out of context.  The exact mechanism behind fish oil and weight loss is still debatable.  You may need to adjust your dose of fish oil upwards to achieve some of the weight loss benefits.

Q: Is fish oil really something that can help me lose weight?

A: Let me start by saying this – it does appear that taking fish oil can help you lose weight.  But, there is a lot of misinformation and reaches out there about how much fish oil can help and how it goes about helping you.

For example, there are claims that fish oil pills cause weight loss by killing adipose (fat) cells.  Technically, this has proven to be true in a study published in the Journal of Nutrition.  But, if you read the fine print this study was conducted in vitro – i.e., in glass or a test tube.  This wasn’t a study conducted in actual human beings.

I’m not saying it can’t do that in real life, but for someone to make the jump from an in vitro study to saying it ‘absolutely works’ in humans (in vivo) is a big jump.  And irresponsible.

Fish Oil Pills and Weight Loss – What You Need to Know

Aside from some of the wild claims taken out of context I’m comfortable in saying that fish oil does have weight loss benefits.  It won’t do the job all on it’s own – but, if you are eating naturally it’s certainly going to supplement your weight loss efforts.

Here are the proven basics that it’s going to be helpful for you to know:

1. As I mentioned above, in a test tube, fish oil does cause apoptosis (programmed cell death) in certain fat cells.
2. Some of the claims I read said that you had to focus on the DHA (Docosahexaenoic Acid) content of your fish oil.  While this was the case in the study above where they looked at DHA killing fat cells – the other studies linking fish oil to weight loss included both components of fish oil: EPA (Eicosapentaenoic Acid) and DHA.  A quality fish oil should contain both parts.
3. The dosages of fish oil used in the studies varied.  So there is no specific dosing recommendation.  Typical dosage recommendations that I’ve seen generally fall around 1,000mg a day of fish oil (EPA and DHA).  If I were to make an educated case I would say you’d want to talk to your doctor about upping that a bit to the 1,500mg to 2,000mg a day dose for weight loss.  At least for the first few months as this was the general dosage range that appeared to show positive results.
4. The studies that I looked at (in humans) were placebo controlled – which is good.  It means that one group was taking a ’sugar’ pill which eliminates bias in the study and is really the ‘gold standard’ of any well-designed study.
5. On the downside – the studies were also small.  So the weight loss benefit of fish oil hasn’t been proven on a massive scale yet.  But I’ve seen enough to believe that it will benefit you in that regard.
6. When I started researching this I was encouraged because I saw another claim that fish oil benefited weight loss by improving insulin sensitivity.  This would have been huge.  But, after digging a little more it was clear that this isn’t the case.  In fact, one study clearly stated that there was no improvement in insulin senitivity in their study.
7. Cholesterol markers (triglycerides, VLDL (very low density lipoproteins) were much improved after months on fish oil.

In Conclusion

All in all, I definitely think that fish oil could benefit weight loss efforts.  However, there are also some bogus claims out there about how it actually does it.  So, beware of what you believe.  You may need to take a little higher dose than what’s on your bottle and this is something you should talk to your doctor about first as their are side effects to fish oil.

Also, you need to make sure that the first thing you do is change how you eat.  Focus on eliminating processed foods (immediately improving your omega3:omega 6 ratio), eat natural foods like meats, nuts, fruits and vegetables and exercise (although, contrary to popular opinion, don’t get carried away.  Too much exercise too often will actually set you back).

Summary: If you have had gastric bypass surgery or are planning on it, gastric bypass vitamins are not a luxury. They are an absolute necessity for survival. In fact, one of the leading facilities in the country in regards to this popular procedure actually orders their patients to take a supplement.  Usually, a specialized version of vitamins for gastric bypass patients is not needed.

The gastric bypass is a relatively simple procedure…as far as surgery goes. In it, a large part of your stomach and upper small intestine are ‘bypassed’. Only one problem though, that section of the stomach and small intestine that is now bypassed is where a lot of your nutrients and vitamins are absorbed.

Couple that with the fact you are now consuming just a fraction of the food you once did you run a higher risk of having vitamin deficiencies. In fact, one of the most feared problems for patients is encountering a nutrient deficiency.

Now, I’m not going to use this article as a forum for or against gastric bypass surgery. What I am going to try and accomplish however, is to inform anyone who is contemplating the surgery (or who has already done it) on the importance of using high-quality gastric bypass vitamins and how to select them.

The importance of gastric bypass vitamins was brought to my attention recently by a friend who called me up.

She knows that I’m into natural health and might have a solution to her problem. Or, at the very least, a helpful suggestion.

What was that problem? Her aunt had undergone the procedure and was now in and out of the hospital because of infections. They had her hooked up to all kinds of contraptions and she is now receiving I.V. antibiotics to control the infections that seem to keep popping up.

The doctors don’t think this is related to her gastric bypass surgery. I disagree. And anybody with common sense and an understanding of the human body and nutrition would too.

I think that is why she wanted to hear my thoughts on the issue. I have experience with the western view of medicine but, I also have an understanding and appreciation for the human body and natural therapies.

First and foremost, her aunt is now consuming a fraction of the food that she used to. One side effect of this action is obvious weight loss. Another, less desirable effect, is less nutrients for the body to use for critical functions. One of which is fighting and fending off opportunistic infections. Much like what is happening to her right now.

What was my other suggestion?

Exercise. Even though her aunt has lost weight she said she still doesn’t exercise like she probably should.

And in addition to exercise helping her aunt feel better it will also…

Help Keep Her Immune System Strong

Does any of this sound familiar? It’s the first two pillars of my “Big Three”. Which have basically been ignored in an attempt at weight loss.

That’s why I hope that anyone reading this has a firm understanding of how the human body works. The body basically plays a math game with food. If you have a caloric deficiency (i.e., you use more calories than you consume) there is only one outcome.

However, before you run out and buy some store brand off the shelf there are some things you need to know not only about the procedure itself…but…about gastric bypass vitamins.

A Gastric Bypass Of Vitamins?

But, unless your intake is nutrient dense you run a high risk of nutrient deficiencies. Getting enough nutrients after you have undergone a gastric bypass surgery is physically impossible. That is why I say, and so do other experts, gastric bypass vitamins are essential to your health and survival.

But what constitutes a high-quality gastric bypass vitamin?

That’s why I’ve decided to use this opportunity to explain not only about what makes up a high-quality gastric bypass vitamin…but…help protect you against the misinformation surrounding so-called specialized gastric bypass vitamins.

1. You don’t have to purchase specialized gastric bypass vitamins. A regular, high-quality, high-potency multivitamin will do the trick perfectly. This is not just my opinion, this is also the consensus of surgeons and experts in the gastric bypass field.
   And that is because although absorption is effected, most patients are able to get enough absorption from their multivitamins taken by mouth to avoid having to be given intravenous nutrition therapy (and bypassing the stomach). There is one possible exception though…
2. Make sure you are getting ample amounts of your B-vitamins.Particularly vitamin B-12. There is no hard and fast rule on doses. But because of the way vitamin B-12 is complexed in the stomach and absorbed in the small intestine supplementing is essential.
   I would recommend you get occasional labs drawn just to see where you are at. Some physicians recommend vitamin B-12 injections. I think you would be fine with a quality sublingual B-12 unless you want to get your levels up a lot faster. Than an injection would be preferred.
3. Don’t skimp. You should have at least 25mg of the B-vitamins 1, 2 and 6. Most multivitamins don’t have this. Quality ones will.
   I have patients ask me what the preferred gastric bypass vitamins are. My answer? There isn’t one. Instead I would recommend they choose a high-quality multivitamin based on the short guidelines I set forth above and explained in other parts of this website.

This is really the bottom-line on gastric bypass vitamins. You cannot cut corners with them. It will only cost you your health.

You’re not consuming near the amounts of foods that you once did and you have to make up that deficit somewhere.

And the only realistic way to do it is with supplementation.

Listen, whether or not to undergo a procedure like this is your decision. I can tell you that you can lose weight without doing this. Want proof? O.K. What does the procedure actually do?

It stops you from eating so much.

That’s it. Goal achieved.

But you know what else? You don’t need a radical surgery to accomplish this goal. You can do it on your own. But that isn’t what people want. That’s because it requires a lot of hard work, mental and physical anguish and willpower. In short, it’s hard to do.

We aren’t about hard in this country. No, no. We are a quick fix society. We want it easy and we want it now. Gastric bypass surgery fits the bill perfectly.

The only problem is though after the surgery many people realize it isn’t quite as easy as they thought it was going to be.

My friend’s aunt is now in that group.

In fact, she told her niece that maybe she would have just been better off being fat. She said, “I was a heck of a lot fatter then…but…I was a lot happier too.”

A little food for thought.

At any rate, the choice is yours. But just to reiterate gastric bypass vitamins are needed. But you don’thave to get a specialized gastric bypass vitamin which is often just over-priced marketing gimmicks.

Stick with the basics that are laid out above and you’ll do fine.