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From The August 2000 Issue of Nutrition Science News
Nutrition Q&A With Dan Lukaczer, N.D.
Synthetic Soy
Q: Does Ipriflavone have the same effects as the isoflavones found in soy?
A: Ipriflavone is a synthetic flavonoid based on the well-known isoflavone called daidzein, which is found in soy and other plants. Ipriflavone was first synthesized in the 1930s and has since been thoroughly evaluated clinically, with most of the studies coming from Europe and Japan. Although the overall benefits from Ipriflavone are modest,1 when used in combination with other therapies it seems to be a valuable tool in the treatment of osteoporosis.
Studies show this synthetic maintains bone mass or slows bone loss in women with osteoporosis or who are at risk to develop osteoporosis.2 It appears to work primarily by suppressing osteoclasts, the cells that cause the breakdown of bone. Animal studies suggest that Ipriflavone may also stimulate osteoblasts, the cells that build bone. Better yet, it appears that Ipriflavone does not have the estrogenic effects of stimulating tissue growth in the breast and uterus.3 Natural isoflavones, by contrast, appear to exert some of their action through a weak estrogenic effect. The usual dose of Ipriflavone is 200 mg three times a day with food.
Alzheimer's Nutrient
Q: Can L-carnitine help reverse Alzheimer's disease?
A: Slow Alzheimer's, possibly. Reversing the neurodegenerative condition is less likely. Many nutrients have been examined for their potential in promoting brain health in older adults. One of the most extensively researched nutrients is the amino acid acetyl-L-carnitine. Although the research is far from conclusive, its effect on individuals with Alzheimer's does suggest that it may slow the progression of the disease. The first clinical trial, conducted by researchers at Columbia University College of Physicians and Surgeons in New York City, reported on Alzheimer's disease and L-carnitine in 1992. In this six-month, double-blind, placebo-controlled pilot study of 30 mild to moderately demented patients with probable Alzheimer's disease, the authors reported that acetyl-L-carnitine may retard the deterioration in some cognitive areas in patients with Alzheimer's. At that time they stressed the need for a larger study.4
That larger study was done and reported on in 1998. Its conclusions suggested that Alzheimer's subjects under age 61 might reap the most benefit from acetyl-L-carnitine. In this longitudinal, double-blind, parallel-group, placebo-controlled trial at 24 outpatient sites across the United States, 334 subjects diagnosed with probable Alzheimer's disease were studied. The use of acetyl-L-carnitine at 1 g three times a day provided statistically significant benefit in slowing the cognitive decline in those patients with early onset of the disease—61 years of age or younger.5
Ginkgo: Twice the Leaf, Twice the Dose
Q: What is the best dosage of ginkgo I can recommend to my customers?
A: This seems to be an evolving answer. Most of the early studies with ginkgo (Ginkgo biloba) centered on improving blood flow and oxygen delivery. Claims of benefit range from improved cognitive function in Alzheimer's disease patients to decreased peripheral vascular disease symptoms. Most of these early studies used dosages of 40 mg three times a day (120 mg total). Although often successful, newer studies suggest that doubling that dose may increase the therapeutic efficacy. A 1999 study at Friedrichstadt Hospital in Dresden, Germany, suggests a dosage of 240 mg/day may be more effective in treating peripheral arterial occlusive disease conditions such as poor leg circulation than the commonly recommended 120 mg/day. In that study, 74 patients received either 120 mg/day or 240 mg/day ginkgo for 24 weeks. Results were measured by how long patients could walk with-out feeling pain. The 120 mg/day group increased pain-free walking distance by 60.6 meters (from 105.3 m to 165.9 m), while the 240 mg/day group increased this distance by 107 meters (from 91.3 m to 198.3 m).6
Dementia studies also suggest a similar finding. A 1997 study at Johann-Wolfgang-Goethe University in Frankfurt, Germany, on 74 Alzheimer's patients used 240 mg/day and showed significant improvement in psychometric assessment in a three-month trial.7 Since ginkgo is exceedingly well tolerated and toxicity is very low, I routinely use 240 mg/day when prescribing this herb.
Dan Lukaczer, N.D., is director of clinical services at the Functional Medicine Research Center, a division of Health-Comm International Inc., in Gig Harbor, Wash.
References
1. Ohta H, et al. Effects of 1-year ipriflavone treatment on lumbar bone mineral density and bone metabolic markers in postmenopausal women with low bone mass. Horm Res 1999;51(4):178-183.
2. Head K. Ipriflavone: An important bone-building flavonoid [review]. Altern Med Rev 1999;4:10-22.
3. Adami S, et al. Ipriflavone prevents radial bone loss in postmenopausal women with low bone mass over 2 years. Osteoporos Int 1997;7:119-125.
4. Sano M, et al. Double-blind parallel design pilot study of acetyl levocarnitine in patients with Alzheimer's disease. Arch Neurol 1992;49(11):1137-41.
5. Brooks JO 3rd, et al. Acetyl L-carnitine slows decline in younger patients with Alzheimer's disease: a reanalysis of a double-blind, placebo-controlled study using the trilinear approach. Int Psychogeriatr 1998 Jun;10(2):193-203.
6. Schweizer J, Hautmann C. Comparison of two dosages of Ginkgo biloba extract Egb 761 in patients with peripheral arterial occlusive disease Fontaine's stage IIb. A randomized, double-blind, multi-centric clinical trial. Arzneimforsch 1999;49(110):900-4.
7. Maurer K, et al. Clinical efficacy of Ginkgo biloba special extract EGb 761 in dementia of the Alzheimer type. J Psychiatr Res 1997;31(6):645-55.
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