Last week, we touched based on fish oil with a focus on the oxidation and freshness of them. It was astonishing to find out how many of you read it and based on the requests from some of you, I’ve decided to look at the evidence behind using fish oil this week and whether you can benefit from taking it. Because it seems like a common question, I’ve been getting from some of you in the past week.

Before we dig deeper, we need to know what we mean by “fish oil” and why it is so special. Well, first, fish oil consists of omega-3 fatty acids. The 2 primary omega-3 fatty acids that we will be talking throughout this email are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).

Fatty fish such as salmon, sardines and mackerel are packed with those omega-3s. Our body does not produce omega-3 fatty acids; hence the only way we could obtain it is through the food that we eat.

For people who dislike fish, DHA and EPA can be obtained from plant-based food that is rich in another type of omega-3 fatty acid, alpha-linolenic acid (ALA) because our body can theoretically convert ALA to DHA and EPA. An excellent example of these include flaxseeds, chia seeds, walnuts, pumpkin seeds and canola oil.

Some of you might ask me if our body can convert ALA into DHA and EPA, does that mean that I can obtain my omega-3s from purely plant-based products because I don’t like fish?

My answer to this question might not be as straight forward as it might seem. Although, our body can convert ALA into DHA and EPA, relying heavily on plant-based food rich in ALA has 2 problems:

1. Every omega-3 clinical study to date is conducted on DHA and EPA from either fish or fish oil. In other words, there isn’t any evidence suggesting ALA has the same benefits as EPA and DHA.
2. Although our body can convert ALA into EPA and DHA, the conversion rate is very low for it to be significant. Studies have shown that approximately 8% of dietary ALA is converted to EPA and only up to 4% is converted further to DHA.

Hence, I would say the answer is no. I believe oily fish or omega-3 supplements are still the best sources in delivering omega-3s.

Now, we all have an of understanding of what omega-3s are, let’s dig deeper and look at some of the evidence available out there regarding the beneficial effect of omega-3s.

Fish oil first captured the attention of scientists when research suggesting Scandinavians and Japanese had lower rates of heart disease. The scientists thought it had to do with their diet as they were the cultures that ate more fish than others. This eventually led to researchers wanting to know whether taking fish oil without eating fish might produce the same effect.

The clinical trials suggest mixed results. Some studies suggesting fish oil can help with heart problems while some didn’t prove the same results. 2 factors could contribute to these mixed findings:

1. A lot of people who are diagnosed with heart problems are already on multiple medications that are prescribed to treat or manage their conditions and hence may obscure the potential benefits of omega-3s supplements.
2. Many people these days are aware of the benefits of eating fish and are eating more today than they once did and hence could hinder the real effect of omega-3 supplements.

Although results are mostly varying between studies, the evidence for fish oil can still be found. In an observational study in someone who has already had a heart attack or at high risk of having one, a modest consumption (approximately 250mg/day EPA & DHA) of fish oil may reduce the risk of future heart attacks and death from sudden cardiac arrest.

For the prevention of death caused by a heart attack, the evidence suggests that some consumption of fish oil (approximately 250mg/day EPA & DHA) is better than none, but a higher consumption may not substantially reduce the risk further.

A similar study found that people with high cholesterol and is taking cholesterol-lowering medication, the odds of having heart attacks can be cut by taking a high dose of EPA only supplements.

Besides heart health, fish oil is also found to a slight benefit in relieving symptoms of rheumatoid arthritis by having an anti-inflammatory effect. The study also indicates that high doses of DHA in people who have a higher risk of getting Alzheimer’s disease may be beneficial.

Some of you might ask me if the evidence of the benefit of fish oil is there, then wouldn’t it be better than just eating fish?

Eating fish is a fantastic way of increasing your omega-3 intake. I usually strongly suggest my patients to try to consume omega-3 through their diet. According to the heart foundation, an adult should consume 2 to 3 servings of oily fish per week. Adults who eat less than the recommended weekly intake may consider taking a daily fish oil supplement (approximately 1g/day). When fish oil is used, it should contain both EPA and DHA. A 1g/day supplement usually contains between 200mg to 800mg of EPA &DHA.

It is crucial to bear in mind that even for people who eat seafood regularly, it can be challenging to get enough omega-3 from diet alone. Unless you are eating oily fish such as salmon, mackerel or sardines, seafood options such as prawns, mussels or cod contain almost no omega 3 fatty acids.

The bottom line is that if you’re already taking fish oil at a recommended dose, and you are benefiting from it, then there’s no research to suggest you should not to take it. But make sure you don’t overdo it. However, if you are not taking fish oil but are thinking of increasing your EPA and DHA intake, then I would strongly recommend trying it from your plate first.

Whatever you do, it is always a good idea to talk to your doctor or pharmacist before starting fish oil. This is because sometimes, fish oil may not be suitable in certain conditions or with certain medications.

To your health,

Chris

Pharmacist

The post Is fish oil supplement a waste of time? appeared first on Eastmed Pharmacy.

While my regular patient was waiting for her prescription, she asked me whether I have watched the most recent episode of “The Check-Up” from TV One.

Unfortunately, I haven’t been watching much TV in a long time. Life has taken its toll on me and I’m still trying to find the sweet spot between work and leisure. So I said to her that I hadn’t even heard of that show!

Anyway, she went on saying she will never take fish oil again after watching the show!

That got my curiosity going and I said to myself…Okay, now I’ve got an excuse to watch some TV tonight..yahooooo!!!

So, I went home immediately after work, took off my shoes, said hello to my wife and jumped straight in front of my computer. I went to the TVNZ on demand site to watch the recent episode of “The Check-Up”.

I fast-forwarded to the segment where it talked about omega 3 fish oil. The scientist on the show discussed how they have tested 36 products on the New Zealand market and 90% of them exceeded at least one of the limits of oxidation that they tested. Also, they found out that most of the products tested contained less than the amount of omega 3 specified on the label and only 3 products had as much as what it claimed to have or more.

Before I move on, we need to make sense of what fish oil oxidation is.

Have you ever come across that old bottle of fish oil capsules that was sitting in your cupboard for years and when you open the lid, there was this strong fishy smell? This is because the fish oil you’ve got is off! Normal fish oil should not have a fishy smell or taste to it. So, this led to the next questions why many fish oil products do not smell nice when they are off? Well, this comes from an element with which we are all quite familiar with: Oxygen.

Fish oil in its raw form is very sensitive to oxygen. If the fish oil is exposed to oxygen over a significant period, it will most likely undergo oxidation and turn rancid. After some research, I found out that when fish oil is wild-caught and harvested, it is usually transported to a factory to be refined and bottled. This process is usually short to prevent oxidation. Some manufacturers will also add antioxidants to prevent the fish oil from being oxidised.

Now going back to the show.

The findings were a huge shock to me. No wonder my patient said she will never take fish oil again! However, my curious mind didn’t stop here. I kept asking myself…” surely there’s more to this”. So, I started searching on the web trying to find out more about oxidation in fish oil and I came across a more recent study that tested 47 fish oil supplements purchased at retail in New Zealand. The study shows that 91% met the amount of DHA & EPA claimed on the label, according to strict Global Organization for EPA and DHA Omega-3s (GOED) standards, while most also met regulatory limits for oxidation.

The results are in stark contrast to findings from the scientist featured in the show, which was published in 2015, which claimed that only 9% of the fish oils in New Zealand market met label claims for EPA and DHA, and 17% were below the oxidation limits.

The author of the new study indicates a high level of confidence in the accuracy of the obtained test results because multiple accredited laboratories tested the samples were able to obtain similar results on oxidative status and omega-3 content.

The author of the new study also suggests that the replication study results show that fish oil supplements in the New Zealand market contain the correct content of EPA and DHA are not excessively oxidised. Hence, consumers can feel confident that fish oils they can purchase are quality products.

The purpose of me sharing my findings with all of you is not to undermine the “The Check-Up” programme. But, what I truly believe is that we should consider all the evidence available before we make our judgement or decision.

So if you ask me is it still worth taking omega fish oil. My answer would be …. Based on available evidence, fresh oily fish such as salmon, mackerel, and sardines are always the best sources of omega 3. According to the heart foundation, it is recommended to eat fish at least twice a week.

For people who are unable or dislike fish then taking omega 3 supplements seems to be a reasonable alternative. Some plants are rich in another type of omega 3 fatty acid, alpha-linolenic acid, which the body can convert to DHA and EPA. Good examples of these are flaxseeds, chia seeds, walnuts, pumpkin seeds, canola oil.

So, shall I ditch the fish oil I’ve got? I’ve had it in my cupboard for at least 6 months

I always ask my patients to do a “sniff test”. The most obvious sign that your fish oil supplement has gone off is when it starts to smell fishy (rancid). If you are still not sure, then another trick is to touch the bottle. Sticky residue is usually a sign of advanced rancidity and could indicate the contents inside are starting to turn on you. The last test you could do is pour out a little oil between your fingers and check for tackiness. If it feels sticky, toss it.

One trick to keep your fish oil supplements for longer is to keep them in the fridge after opening because cold temperature can slow down oxidation.

I hope you are not put off by fish oil. I do believe if it is used correctly, it can be beneficial.

To you and your family’s health

Chris

Pharmacist

The post Is My Fish Oil Supposed to Smell FISHY?? appeared first on Eastmed Pharmacy.

Continuing on the theme of sleep I’ve been covering the last few weeks, I want to share with you an interesting question from a patient of mine:

“I’ve been reading about tart cherry – I saw it in a health advertisement recently as a natural sleep remedy which is also suitable for children – what do you think Chris? Should I buy some for my family?”

Some of you may be familiar with tart cherry, but for those of you that are not, I’ll give you a brief overview:

Cherries can be divided into sweet or tart varieties. There are two main types of tart cherries – morello and amarelle.

Montmorency tart cherries date back to ancient Rome where the fruit was used for food and the wood to build equipment. It’s a variety of amarelle and is the most common constituent of “medicinal” cherry products.

Tart cherries are claimed to reduce symptoms of gout, arthritis and fight cancer. They are also said to help us sleep which is what I’ll focus on. Tart montmorency cherries are rich in phytonutrients, including anthocyanins, that give cherries, grapes, black currants and other berry fruits their red colour. They also contain melatonin, which if absorbed, may have sleep regulation properties.

Our sleep and wake cycles are strongly influenced by melatonin produced by the brain. More of the hormone is produced in the dark than in the light. This natural source of melatonin influences our core body temperature and helps to promote sleep.

There have been limited clinical research studies investigating cherry extracts on sleep, most of the evidence for tart cherries come from small studies. They have shown that tart cherries were associated with a reduction of insomnia severity and an increase in total sleep time. However, there have been no studies involving children, therefore the efficacy and safety of cherry extracts are not known.

The studies found that the amount of melatonin in the cherry extracts was very small – smaller than the level found to have an impact on our sleep! There may be a different way than tart cherries helps our sleep that we don’t know about yet.

Do tart cherries interact with my medicines?

It can interfere with some medicines including blood thinners – if you’re thinking of starting a product talk to myself or one of the team members to make sure it’s ok.

Could I just eat cherries instead?

Tart cherries have a short season and can be difficult to source in New Zealand. They are more readily available as juice, capsules, lozenges and sachets.

So, is it worth trialling a tart cherry product?

I think that if you are having difficulty sleeping and have tried sleep hygiene techniques (see my last email for details) then trialling a product for one or two weeks could be helpful. I recommend keeping a sleep diary to track if there had been any improvement in your sleep during this time. If there has been no improvement or you begin to experience adverse effects then stop the tart cherry product.

As always you can speak to myself or a team member for recommendations or alternatives if it’s not right for you.

Sweet dreams,

Chris

Pharmacist

The post The FRUIT that could help you sleep?! appeared first on Eastmed Pharmacy.

“So Chris, what do you think about taking magnesium? My friend told me that it helps her with sleep.”

I’m glad you asked, I often talk with my patients about the importance of magnesium and the under-recognised role it plays in sleep and overall health.

I’ve seen many of my patients’ sleep benefit greatly from increasing the intake of magnesium either through diet or supplements.

Magnesium deficiency is common among adults. In particular, the elderly are more vulnerable to magnesium deficiency. Women are also at higher risk for low magnesium. Some medicines, for example, heart and indigestion (Proton Pump inhibitors – omeprazole) medicines can affect the way we absorb magnesium from our diet. It’s not uncommon for those people to have less than optimal magnesium levels.

One of the roles magnesium plays in our body is to assist us in having a restful sleep. Low magnesium levels can throw our quality sleep off course, hence affecting our energy levels. The problem with magnesium is that our body does not produce it naturally nor store it. This means that the magnesium your body needs must come from outside sources (e.g. eating the right food or supplements).

“What kind of food shall I eat to receive magnesium?”

You can increase your magnesium levels by eating dark leafy greens, seeds & nuts (e.g. sunflower and sesame seeds, cashews and almonds), broccoli, legumes, dairy products, meat and unprocessed whole grains. They are all rich in magnesium.

“How does magnesium improves my sleep?”

Magnesium has a widespread role in the body’s functioning. So it’s no surprise that sleep can also be affected by the level of magnesium in our body.

Insomnia is a common symptom of magnesium deficiency. People with a low level of magnesium often experience restless sleep and frequent waking during the night.

A deeper and restful sleep can be achieved by maintaining adequate levels of magnesium. Magnesium increases the level of GABA – a neurotransmitter that encourages relaxation and promotes sleep. People with low GABA levels usually find it hard to relax.

Research indicates that supplementing with magnesium in people with poor sleep or restless-leg syndrome can improve sleep quality.

“There are many magnesium supplements out there. How do I know which one to choose?”

The number of magnesium products available in the market makes it relatively difficult to find the one that’s right for you. Besides different brands of magnesium supplements, magnesium is also available in numerous forms – including:

· Magnesium carbonate

· Magnesium chloride

· Magnesium citrate

· Magnesium oxide

· Magnesium phosphate

· Magnesium sulphate

· Magnesium diglycinate

I usually suggest my patients avoid salt forms of magnesium for 2 reasons:

1. The absorption rate between different salt forms of magnesium varies greatly. Most magnesium salts are only absorbed to the extent of about 5 to 10%.
2. People poorly tolerate salt forms of magnesium because it has a laxative effect. This explains why many people can experience loose bowel motions when they take magnesium supplements.

The form of magnesium I believe is better absorbed and tends not to cause diarrhoea is an amino acid chelate form (e.g. magnesium aspartate). By attaching an amino acid structure to a magnesium molecule, it makes the mineral less foreign to our body (as our body is made up of building blocks of amino acids). Hence, allowing magnesium to be recognised by the body as such, so they’re absorbed much faster and more efficiently into the bloodstream compared to the salt forms.

The following is what I usually tell my patients to look for when deciding on a magnesium supplement:

1. Magnesium amino acid chelate for enhanced absorption and reduced stomach intolerance.
2. Added L-glutamine for muscle repair and recovery.
3. Added B vitamins to support energy production and mental focus (do not choose a magnesium supplement containing B vitamins if you intend to use it for sleep – as mentioned in my last email).
4. Added sour cherry to improve sleep duration, efficiency and quality.
5. Added vitamin B6 for the relief of PMS including muscular pains and cramps.

As always, talk to one of our pharmacists or your doctor if you are intending to start magnesium supplements. This is because magnesium supplements may not be ideal for certain people with specific health conditions or certain medicines.

Sweet Dreams,

Chris

Pharmacist

The post If you are thinking of trying magnesium supplements – you NEED to read this!!! appeared first on Eastmed Pharmacy.

My article last week about vitamin B12 sparked great interest. I’ve been seeing many of you in the pharmacy asking about what you should be taking to boost your vitamin B12 levels.

One thing I should stress is that low iron and vitamin B12 levels are only the tips of the iceberg when it comes to lack of energy and tiredness. Many other factors could potentially contribute to it including the type of medication you are taking. So do not jump into conclusions straight away without exploring other contributing factors. Although supplementing with iron and vitamin B12 doesn’t usually cause any harm if you are taking them according to the recommended dose, it doesn’t do any good either if your body doesn’t need it. So always talk to one of us before picking any iron and vitamin B12 supplements off the shelves.

Speaking of lack of energy, I think you might find this case interesting which I came across last week.

A long-standing patient of mine came in last week after reading my email asking me if she should start taking some Vitamin B12.

I asked her: What makes you think you need vitamin B12?

She replied: I have been feeling very tired for the past couple of weeks. After reading your email, I decided to give it a go to see if it might help because the vitamin B complex I’m taking at the moment contains only a very small amount of vitamin B12.

I asked her further: So, do you mind telling me why are you taking vitamin B complex?

She said: I’ve been very stressed at work lately and I thought the vitamin B complex “stress relief” formulation might help. It did help to relax me.

I asked her more: So how often do you use it?

She replied: I have been taking it for the past 2 weeks, usually with my dinner.

I then asked: So how has your sleep been lately?

She said: I find it a little harder to get to sleep lately and some nights I woke up in the middle of the night and couldn’t fall back to sleep. I guess it’s because of my stress?

I replied: I think stress plays a role here but I also noticed a few things that I picked up from our conversation that might also be contributing to your tiredness lately.

First of all, I think it is fine to supplement with vitamin B complex during this stressful time of yours. However, I believe the time of your dose might be one of the reasons why your sleep pattern was disrupted.

Vitamin B complex tends to boost energy and increase attention, so taking them at night can lead to restlessness and insomnia. I would suggest you take it in the morning instead.

I asked: Before you go to sleep, do you usually allow your body to wind down first?

She replied: I usually take a bath most night but lately I haven’t been. I have been working in front of my computer up until bedtime.

I replied: I think that could also be another reason why your sleep quality has been greatly affected.

I usually suggest not to use your phone or the computer at least an hour before bedtime because the blue light emitted from those devices could affect our sleep.

Light affects our biological clock by turning off the melatonin production line. So, when we look at the light exposure that we have from those devices in the evening, that’s something to be very aware of because by looking at our phones or working in front of the computer in the evening, we are telling our brain its morning not evening. Subsequently, we won’t be producing enough melatonin to help us fall asleep.

She said: Oh…I see.

I replied: I think if you change the dosing time of your vitamin B complex and allow your body to wind down with no exposure to blue lights emitting from your phone or computer devices and with minimum exposure to household lights at least an hour before bedtime. Then I think you’ll sleep better and won’t feel as tired.

Try it first and let me know whether it helps before we find a supplement for you

When it comes to sleep, many patients of mine have asked what’s the best way of managing insomnia without using any drugs.

I like to think sleep is a sensory experience. I usually look at the 5 senses in the bedroom that could be contributing to promoting sleep or detracting from sleep.

1) Sight (which I’ve mentioned in the above conversation with my patient)

2) Sound – listening to soothing music (with no lyrics) for 10 minutes before you turn in for the night can help reduce stress and anxiety, help you fall asleep more easily. The key is to choose tunes you like that have a slow beat (classical or soft jazz).

3) Smell – an unpleasant smell can disturb your sleep. A room that smells musty can prevent you from falling asleep naturally. Surrounding yourself with a scent you like could help you drift off.

4) Taste – The things you eat or drink before sleep can disrupt your sleep. I always suggest stopping caffeine intake at 2 pm because caffeine has a “half-life” of about 8 hours, which means that its level is reduced, but still somewhat effective in your system after this time. Caffeine is a stimulant, and it will prevent you from either falling asleep or have a good quality sleep.

Alcohol is also another contributing factor to bad quality sleep. While alcohol can make you sleepy, it also detracts you from a good sleep by keeping you from reaching the deep stages of sleep, dehydrates you and awakens you in the middle of the night (usually to go to the bathroom)

5) Touch – the temperature of your bedroom can also affect your sleep. It is recommended that the optimum temperature for sleeping is between 18 to 19 degrees Celsius.

By following the 5 senses technique on how to sleep better, you will put yourself on the road to improved rest and greater health.

If you have insomnia or bad quality sleep and are running out of ideas, please try the above suggestions first before considering taking prescription medicines. If you have any concerns about your sleep in general, please do not hesitate to contact one of our team or myself to gain more valuable advice.

To you and your family’s health

Chris

Pharmacist

The post My sleep is terrible…what can I do??? appeared first on Eastmed Pharmacy.

It’s a common complaint for most of us living busy lives trying to juggle work, family and leisure. There are many reasons for us to be tired and I find my patients are always quick to assume that tiredness must mean a lack of iron. This could be true but without blood tests to confirm iron deficiency, it’s difficult to determine if someone is iron deficient – especially if they eat a balanced diet.

Another less well-known deficiency that could be causing tiredness and lack of energy is a deficiency in vitamin B12 – also known as cobalamin. This vitamin is incredibly important because it is involved in the production of red blood cells and plays a crucial role in maintaining the health of nerve cells.

Everyone needs vitamin B12 but older people and vegans or vegetarians are particularly at risk of being vitamin B12 deficient.

Veganism is becoming popular amongst teenagers and young adults – they may not be aware of the additional supplements required following this dietary lifestyle.

You may be asking: why is this?

Vitamin B12 and all of the B vitamins are water-soluble, meaning that the body does not store them, so we must consume them daily. Vitamin B12 is mainly found in meat, eggs and dairy products. Plants don’t contain B12.

Older adults can have poor diets and vegan/ vegetarian diets can exclude animal products. Approximately 10% of those over 75 could be B12 deficient.

Also, those with intestinal problems such as Crohn’s Disease or inflammatory bowel disease could be at risk.

Some medicines can also lead to B12 deficiency such as anti-seizure medicines – come in and see us if you’re concerned.

“Now I can imagine you’re asking this: why does my body need B12?”

This is an important question which links to the symptoms of tiredness. All B vitamins help the body convert food, specifically carbohydrates, into fuel (glucose), which our body used to produce energy. Vitamin B12 works closely with vitamin B9 (also, called folate) to help make red blood cells. Lack of B12 can cause red blood cells to be abnormally large and not function properly – they’re unable to transport oxygen efficiently around the body which can lead to tiredness and exhaustion.

Other symptoms can include mouth ulcers, muscle weakness and confusion.

“What should I do if I think I’m lacking B12?”

The first step is to see your GP who can confirm B12 deficiency with a blood test. If you are deficient then they can replace the B12 with an injection of it into the muscle. If possible, increasing your intake of meat, salmon, milk, cheese and eggs can also help prevent B12 deficiency.

“I’ve seen B12 tablets at some pharmacies – should I buy them if I think I’m B12 deficient?”

The short answer is no – you should get the blood test to confirm deficiency first. If you are eating a balanced diet then it’s unlikely that you would be deficient and buying tablets could be a waste of money. However, if you are vegan, vegetarian or on a restricted diet supplementation could be beneficial but it’s best to talk to a nutritionist or GP first. If they agree then see me or another of the eastMED Pharmacy team who can help advise on the best B12 supplement to take.

To you and your family’s health,

Chris

Pharmacist

The post Could this be the reason you’re tired all the time?! appeared first on Eastmed Pharmacy.

Winter solstice is less than a week away on June 22nd and marks the shortest day. It’s a relief to know that the days will start getting longer, it will be a fair few months before we can announce spring and daylight savings!

This reminds me of a query that often comes up in the pharmacy over the winter months – vitamin D – to supplement or not to supplement? It is a popular topic in the media, especially over the winter months. Actually, a customer came to me yesterday to ask about this very thing!

“Chris-“ she said, “I heard on the radio this morning that many people are deficient in vitamin D – should I be worried?”

I replied: “I think about 5% of adults in NZ are deficient but almost 30% have below recommended levels of vitamin D.”
“Anyone potentially could be deficient, but those with dark skin, with liver or kidney disease or living in the South Island, may be more at risk”.

“I heard that vitamin D can help with anxiety, is this true?” she asked.

“Vitamin D is well known to prevent fractures by helping to strengthen our bones. Much research is being undertaken around vitamin D and nearly all major diseases,”
“Some research has suggested a relationship between vitamin D deficiency and vulnerability to depression and anxiety but there are no concrete recommendations yet. There is also research being conducted to investigate whether low levels are associated with increased colds or cases of the flu”

“So, do you recommend a supplement?”

“The best thing about vitamin D is that you can get it free! Sun exposure during the winter months such as a half hour walk or other activity during the middle of the day is recommended but you can still produce vitamin D if your arms, legs and face are exposed to the sun for just a few minutes!”
“Eating foods with vitamin D such as oily fish, milk, eggs or liver can also help, although the amount in foods is much smaller than what you can make through sunlight”

Try this delicious dish which includes natural sources of vitamin D (I made this last night):
Baked teriyaki salmon
Serves 2
Marinade mix:
2Tbsp ea of soy sauce, mirin (Japanese cooking wine), rice wine vinegar
2 tsp ea of sesame oil, grated ginger
Preheat oven to 200 degrees Celsius. Line a baking tray with paper.
Place 2 fresh salmon fillets (deboned) in a bowl with marinade mix above.
Place fillets on the baking tray and pour over remaining marinade.
Bake for 8-10 minutes or until cooked to liking.
Serve with rice and Asian greens. Top with toasted sesame seeds.

“If you are concerned about your vitamin D levels, see your GP to have your levels tested. If your vitamin D levels are low, a supplement may be necessary.”

If you would like more information about vitamin D or supplementation, come in and see either myself or one of the team – we’re here to help!

To you and your health,

Chris
Pharmacist

The post Why aren’t you getting this FREE vitamin YOU can make?? appeared first on Eastmed Pharmacy.

As much as I would like to keep this inner circle only to a selected few like yourself (I consider you all my inner circle of friends) – if you know anyone that could benefit from my emails, by all means, let me know so I could add them to this group.

Anyway, I had a long weekend with my wife celebrating her birthday across the ditch in Sydney. We got back from Sydney on Monday. While I was away, one of my regular customers emailed me after reading my last email regarding vitamin C and wondered if a high dose of it could help with her eczema skin problem that she has been suffering from for years. Particularly, she mentioned how heavy use of steroid creams have left her skin more prone to bruising and bleeding.

Now, before finding out whether vitamin C could help with eczema condition. It is important to understand what eczema is.

There are several different types of eczema. One of the most common types of eczema is called “Atopic dermatitis”. “Atopic” refers to the body’s increased sensitivity to allergens or irritants. “Dermatitis” refers to the inflamed skin.

Eczema happens when our top layer of skin is essentially sleeping on the job. Normally that layer should keep your skin hydrated by locking in moisture and warding off bacteria, irritants, allergens and other substances that can cause aggravation.

If you have eczema, your top layer of skin is not upholding this duty. As a result, you may experience inflammation of the skin because the disrupted skin layer exposes your immune system to irritants. Your immune response can overreact, causing inflammation underneath your skin, which may lead to frequent flare-ups. So those rashes on the surface, together with the symptoms of itchiness, redness, dry and scaly skin are just the signs of a deeper inflammatory disease.

One of the facts about eczema that I found most people are not aware of, is that topical steroids are only effective in reducing the severity of skin inflammation during an exacerbation. It does not prevent eczema from occurring. The long-term management of eczema that I always suggest is moisturisation. Moisturising your skin will do two things:

1) Help form a protective barrier above your skin to ward off irritants and allergens

2) It will hydrate your skin by locking in moisture.

Hence, it is crucial to find a moisturiser that can moisturise your skin and help you restore the disrupted skin layer.

I will go deeper in the next few emails about the best approach in managing eczema (so stay tuned!)

Now, going back to your question: “Would taking a large dose of vitamin C help with eczema?”

It is important to understand how our body transports and stores vitamin C. As I mentioned in my last email, our body does not have the mechanism to store vitamin C. Hence, we need to replenish it daily. Vitamin C in the skin is normally transported from the bloodstream (it can also be delivered through a topical formulation – which I’m a bit skeptical of).

Transport proteins specific for vitamin C are found on cells in all layers of the skin. Oral vitamin C effectively increases vitamin C levels in the skin. However, when vitamin C levels in the blood are saturated, skin vitamin C concentrations no longer increase. In other words, taking high dose vitamin C may not necessarily strengthen the skin barrier compared to a normal dosage. When we have reached a saturated level of vitamin C in our bloodstream, the excess amount will be excreted through the kidneys in the urine rather than being absorbed further.

In terms of whether vitamin C could improve eczema, I have done some research and could not find any journal articles suggesting clinical evidence to support its use. However, vitamin C may have a role in wound healing which could potentially indirectly assist in the healing of inflamed eczema sites. Vitamin C is necessary for collagen synthesis and the demand for it usually increases during the wound healing process. Some studies have suggested that vitamin C deficiency may result in poor wound healing, and supplementation with vitamin C in people with a deficiency may be beneficial.

If you were to give vitamin C a try, I would suggest not taking more than 2000mg daily. Any dose beyond that could potentially be excreted from the body without added benefit to our health. Too much vitamin C may also cause gastrointestinal symptoms such as diarrhoea and nausea.

Anyway, have a great long weekend everyone!

To your health,

Chris

Pharmacist

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I have to be honest with you, writing a weekly email – even though it may not sound like a lot of work – does take time… well at least for me because I’m not a fast or a clever writer to start with! However, I persist because I consider you all like my inner circle of friends. It‘s my vision to share my knowledge and to inspire you to take action and start living a healthy life you deserve.

Anyway, back to my regular customer – I saw her from across the dispensary standing in front of the supplement section. She was holding her phone close to her face with one finger flicking the screen up and down. I was curious about what she was doing, so I came out of the dispensary and asked if I could be of any help. She then asked me… “Your last email mentioned how vitamin C could help prevent catching a cold during the winter, but you did not mention which one to get.”

I had to interrupt her… “Wait a minute…I don’t think I ever mentioned that vitamin C could prevent us from catching a cold”

She looked at me in a sense of disbelief

I said “Look, there are no supplements or vitamins that can prevent a cold. The flu vaccine could increase your chance of not getting influenza, but they too do not provide 100% protection. However, what vitamin C could do is boost our immunity and reduce the severity and duration of cold or flu if we were unfortunate enough to catch it.”

She then moved on asking, “Oh…I see…So how does vitamin C boost our immunity and ward off colds?”

I replied saying, “That is a very good question. Vitamin C is involved in many parts of the immune system. “

“Firstly, it helps encourage the production of white blood cells known as lymphocytes and phagocytes, which help protect the body against infections.

“Secondly, it helps these white blood cells function more effectively while protecting them from damage by free radicals.”

‘Lastly, it is an essential part of the skin’s defence system, it’s transported to the skin where it can act as an antioxidant and help strengthen the skin barrier.”

“When you have a cold and are not feeling well, the concentration of vitamin C in your immune cells quickly drops. Hence, increasing the intake of vitamin C during a cold could very well improve the function of immune cells and speed up the recovery process.”

She then asked me, “I noticed there are quite a few different brands here. So, which one shall I go for?”

I replied, “Rather than picking a particular brand of vitamin C, I think a better way to pick the right vitamin C is by looking at the formulation, dosage, other minerals incorporated and also consider what you’re trying to achieve.”

“If you intend to boost your immunity during the winter months. Any vitamin C supplements with a dose of between 250mg to 1000mg should do the trick.”

“However, if you are using it to get over a cold, I would tend to go for vitamin C (1000mg) supplement that also contains zinc for a short period. Zinc is an immune-support nutrient that could also give a boost to your immunity.”

The topic of vitamin C, reminds me of a common question I get from customers: how much vitamin C should I consume?

Before we answer the question, it is important to know how our body reacts to vitamin C.

Vitamin C is a water-soluble vitamin. In contrast to fat-soluble vitamins, vitamin C does not get produced or stored in our body. Any excess amounts of it will be excreted in urine within a few hours after you consume it. Hence, it is quite difficult to consume too much.

According to WHO, the recommended daily amount for vitamin C is 65mg to 90mg a day, and the upper limit is 2000mg a day. I generally wouldn’t recommend more than 1000mg per day. For maintenance during the winter months, 250mg to 500mg should be more than enough while 1000mg should be reserved for only when you have a cold or trying to get over a cold.

In terms of the formulation, there are the traditional chewable tablets and dispersable powder form. However, in recent years, there is a new member of the vitamin C family – the liposomal vitamin C formulation. Liposomal vitamin C is unique because it uses liposome technology to protect vitamin C from being destroyed in the digestive system during digestion. As a result, the absorption of vitamin C dramatically increased meaning that more is being absorbed by our body. There are currently two marketed liposomal vitamin C products in the New Zealand market (Lipo-spheric & Lipo-Sachets Vitamin C). Both products contain 1000mg of Vitamin C.

I’ve tried it myself; it has a distinctive taste to it compared to the traditional orange flavour vitamin C products. And it may not be a liking for some people. If the absorption is true, then the liposomal formulation will provide a slight advantage over the traditional chewable or powder formulations. I think that all the formulations will provide similar results if not the same. Hence, it ultimately comes down to what you want out of it.

If you have any questions about vitamin C please feel free to contact me or one of our team.

To your health,

Chris

Pharmacist

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Chris (on the phone): You don’t sound good mate. Are you feeling alright?
Dom: I think I’m coming down with something. My throat feels scratchy, and a bit sore and my nose is a little bit drippy.
Chris: Are you taking anything for it?
Dom: Nah, I think I’ll be fine aye. Will try to have an early night tonight and sleep it off.
Chris: I think you should give Viralex a try. It is an olive leaf extract. It worked well for me last time when I had a cold aye. It pretty much stopped all my symptoms after using it for two days.
Dom: Nah, I don’t like to take anything. I’m pretty fit, and I think my body can fight it off aye.
Chris: Well, at least take some vitamin C…
Dom (interrupting): I’ll be fine mate!
Chris: Okay…

2 Days later

Dom (on the phone): Maybe I should give Viralex a try aye…
Chris: How are you feeling?
Dom: Not well, I think I’ve got a cold.
Chris: I’ll get some for you then. Also, make sure you drink plenty of water and take some Vitamin C!
Dom: Whatever you say, man…

Yes, that was the dialogue I had with my friend last week. If he were to listen to my advice, he would have recovered from his cold a lot faster rather than it dragging on for the whole week.

We all know that the immune system is one of the most important of the body systems. It’s our defender against foreign invaders such as viruses and bacteria, however, we don’t usually give our immune system enough attention until when we begin to feel run down or can’t shake a cold.

Feeling exhausted and tired, delayed and slow wound healing, and repeated infections are some of the signs that your body’s immune system is not functioning properly.

After working as a pharmacist for more than ten years, I understand the importance of herbal and nutrient supplements in helping to speed up the recovery process and improve our resistance to infections.

Here are some of the most important supplements that I have discovered over the years that could help us through the winter.

Vitamin C
Vitamin C is a classic remedy that has a great immune boosting property. It can be taken as an ongoing basis (as our body is not capable of storing it) to build up our immunity and ward off colds. Numerous studies have suggested that it can help reduce the severity and duration of colds.

Vitamin D
Also known as the sunshine vitamin. Vitamin D can enhance the immune response to bacterial and viruses. Being vitamin D deficient has been linked to recurrent infections.

Zinc
Zinc is an immune-support nutrient that is required for the production of white blood cells – which are the body’s troops responsible for fighting off infections.

Echinacea
Is a herbal supplement that has antimicrobial and antiviral activity. Traditionally, it has been used to support the immune system and provide relief of upper respiratory tract symptoms, sore throat and fevers.

Olive Leaf
Olive leaf also has antimicrobial activity and has traditionally been used to relieve respiratory symptoms such as cough and sore throat.

Andrographis
This herbal supplement can stimulate immunity and has also been found to relieve common cold symptoms such as sore throat, cough, and fever.

Here are a few tips you could do to promote a healthy immune system:
• Eat a balanced diet high in fruits, vegetables and whole grains (low in saturated fat)
• Exercise regularly
• Regular sun exposure (for vitamin D)
• Drink alcohol in moderation
• Get adequate sleep
• Avoid or reduce stress.

Speak to me or one of our team for more information about supplements that can boost your immunity.

To you and your family’s health

Chris
Pharmacist

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