Laurie Budgar

January 22, 2010

16 Min Read
20 top supplements

You know the drill: One day vitamin X is the latest and greatest, and the next day it’s getting skewered in the media. It’s tough for consumers to stay on top of the latest research behind dietary supplements, so they turn to you.
To help you become customers’ go-to resource, we talked to health experts and scoured the medical journals to find out which supplements show the most promise for customers’ top health concerns, such as brain health, digestive health, immunity, allergies and sleep. Within each condition, we designated a standout supplement that had the most support from experts and research. As always, customers should consult a health care practitioner before starting a new therapy.

Andrew Weil, MD
Weil is founder and director of the Arizona Center for Integrative Medicine at the University of Arizona. His latest book is Why Our Health Matters (Hudson Street Press, 2009).
Mark Blumenthal
Blumenthal is founder and executive director of the American Botanical Council, based in Austin, Texas, and editor of The ABC Clinical Guide to Herbs (American Botanical Council, 2003).
Laurie Steelsmith, ND, LAc
Steelsmith is a licensed naturopathic physician and acupuncturist who practices in Hawaii, and author of Natural Choices for Women’s Health (Three Rivers Press, 2005).

Ongoing research shows that supplements can affect many brain functions, from mood to cognition.

Omega-3 fatty acids
These essential fatty acids—particularly DHA and EPA—continue to wow experts, partly because research now shows that EFAs can help prevent the cognitive decline commonly seen in Alzheimer’s disease.
How they work: Omega-3 fatty acids “promote optimal communication between nerve cells,” Weil says, “in part by supporting brain-cell membrane health and decreasing inflammation.”
What’s new: Steelsmith thinks krill oil—extracted from tiny shrimp-like crustaceans in the Antarctic—will play an increasingly important role in brain health. In addition to high levels of EPA and DHA, she says, “krill oil is rich in phospholipids, which are important in healthy nerve- and brain-cell function.”

Answering customer questions about omega-3s
Q: Can omega-3s help people who aren’t worried about Alzheimer’s?
A: Yes. Research supports omega-3 use for mental health too. “In countries where people regularly consume food high in omega-3 fatty acids, the incidence of depression and bipolar disease is lower than in other parts of the world,” Weil says.

Q: What type of omega-3 product should I take?
A: Weil recommends supplements that provide EPA and DHA in a ratio of 3-to-1 or 4-to-1. EPA may be more effective than DHA in many clinical circumstances and better still if at least a small amount of DHA is also employed.

Q: Are there any contraindications with omega-3 use?
A: Omega-3s can thin the blood and contribute to easy bruising and bleeding, Weil cautions. And like all supplements, tell your physician if you’re taking them, especially prior to surgery.

An Ayurvedic plant traditionally used to stimulate memory, bacopa is also known as Brahmi. “The herb has shown some possible anti-anxiety effects,” says Blumenthal, but published clinical trial evidence for that use is limited, he emphasizes.
How it works: Bacopa seems to lessen the effects of oxidative stress and prevent brain-cell death, researchers note.
What’s new: Studies in 2008 and 2009 showed that bacopa may help protect against Alzheimer’s disease. People who took 300 mg daily of bacopa also had improved working memory and lower incidences of depression and anxiety. Organix South, a Bowling Green, Fla.-based company, includes bacopa in its new Sleep Ease formula.

Ginkgo (Ginkgo biloba)
This well-studied remedy may benefit older people with memory deficits or early dementia, according to Weil.
How it works: Ginkgo may possibly increase blood flow to the brain. Extracts standardized to 24 percent ginkgo favone glycosides and 6 percent terpene lactones are best to use, according to Weil. He cautions that ginkgo can thin the blood and therefore may be contraindicated for people who are taking anticoagulants.
What’s new: The National Institutes of Health give ginkgo a grade of A for its beneficial effect on Alzheimer’s disease and dementia, but the NIH and most recent research reviews suggest the need for additional well-designed studies.

Weil says that PS, as it’s commonly referred to, is “considered by many to be a brain-specific nutrient ... and appears to help reverse age-related cognitive impairments, and may improve memory and concentration in normal adults.” Steelsmith says brain cells naturally manufacture this fat “when you have enough folic acid, vitamin B12 and essential fatty acids in your diet.” Supplemental PS, which comes from soybeans, may increase the anticoagulant effects of blood-thinning medications, so it should be used with caution, Weil says.
How it works: “PS helps to increase acetylcholine, the neurotransmitter that is important in memory,” Steelsmith says.
What’s new: A 2008 study showed that people who took PS after mental stress showed greater degrees of relaxation, as measured by brain waves.
Blumenthal says supplements have an edge on pharmaceuticals, which often rely on proton pump inhibitors, for improving gut health. “PPIs work by blocking an enzyme that produces stomach acid, necessary for proper digestion, so, in theory at least, PPIs [can] make it more difficult for people to fully digest their food.”

While probiotics are commonly thought of as bacteria, the category also incorporates some yeasts, like Saccharomyces boulardii, which Steelsmith strongly recommends. “It has been shown to treat and prevent diarrhea in children and adults.”
How they work: Probiotics promote a balance of healthy microorganisms in the intestines, Steelsmith says. S. boulardii also increases SigA, an important immune cell for intestinal health.
What’s new: Probiotics are increasingly being used for allergy support and immunity, with solid research supporting both.

Answering customer questions about probiotics
Q: Does it matter what kind of probiotic I take for digestive issues? A: Yes. “Potential benefits are strain-specific,” Weil says. “Not all strains will survive passage through the stomach to have any effect in the gut. In general, choose products containing Lactobacilli, Bacillus coagulans or Bifidobacteria, and that contain at least 1 billion colony-forming units per dose.”
Q: Are probiotics safe for everyone or should some people avoid them? A: Weil says people with immune deficiency or those who are taking immune-suppressive drugs should use caution with probiotics.

Q: Are probiotic yeasts OK to take if I have an overgrowth of Candida? A: Yes. Unlike Candida, probiotic yeasts are not pathogenic. “This friendly yeast actually makes the gut healthier,” Steelsmith says.

Artichoke leaf extract
Traditionally used for heartburn, this bitter herb is a favorite of Blumenthal’s for its effect on the liver as well. “It increases digestion of rich, fatty foods,” he says.
How it works: Blumenthal says ALE helps the liver increase bile production, which breaks down fats.
What’s new: A 2008 study of 131 adults showed ALE significantly reduced total cholesterol levels after 12 weeks.

Deglycyrrhizinated licorice
Weil considers DGL a staple for treating gastroesophageal reflux disease. “DGL is licorice without the component that can elevate blood pressure,” he says.
How it works: “When DGL tablets are chewed and swallowed, the resultant paste lines and soothes the GI tract and promotes the health of the lining,” Weil says.
What’s new: Many studies throughout the years have found that DGL is effective. Enzymatic Therapy DGL Ultra comes in a new German chocolate flavor that avoids the bitter licorice aftertaste.

Peppermint oil capsules
“Numerous studies show that peppermint oil can help relieve intestinal cramping and spasms frequently seen with [irritable bowel syndrome],” Weil says. He and Blumenthal recommend using enteric-coated capsules because the coating allows the capsule to pass through the stomach acids and make its way to the intestine.
How it works: Peppermint oil helps relax smooth muscle in the gastrointestinal tract, which prevents spasms.
What’s new: A 2007 study found that peppermint oil’s benefits persist for up to four weeks after the end of treatment, which was 225 mg two times daily for four weeks, possibly due to the oil’s antibacterial effects.
With swine flu dominating this winter’s headlines, everyone is concerned about staving off viruses and bacteria. Research is starting to uncover some promising supplements for a host of immunity-related conditions as well as other concerns.

Weil says medicinal mushrooms—including maitake, shiitake, reishi and agaricus—are powerful supplements for a weakened immune system, and can be taken alone or in combination. Steelsmith says reishi mushrooms are also beneficial for people with allergies.
How they work: “Medicinal mushrooms contain specific polysaccharides
(complex sugars) called beta glucans that appear to be responsible in part for their antiviral and possible anticancer activity,” Weil says. Steelsmith adds that reishi mushrooms have a strong antihistamine effect.
What’s new: Active hexose correlated compound—a proprietary extract made from five different medicinal mushrooms—may be able to prevent infection with H1N1 flu, according to an independent 2006 rodent study. A small human study in 2008 found that AHCC increased markers for immunity.
Answering consumer questions about mushrooms
Q: Do I have to take mushrooms in supplement form, or can I just eat them?
A: “All but reishi mushrooms are edible and delicious,” Weil says.

Q: How safe are they for people with autoimmune diseases?
A: Steelsmith says reishi mushrooms are fine because they modulate the immune system rather than just boosting it. Customers should consult a health care practitioner about others.
Dried yeast fermentate
Marketed by Embria Health Sciences under the brand name EpiCor, this modified brewer’s yeast (Saccharomyces cerevisiae) product came about serendipitously, Blumenthal says, by a company making animal feeds. “They found out that the people working in the factory had a lower incidence of claims for a number of diseases than people working in the office. They found out that airborne yeast—an ingredient in some of their animal feeds—increases immune-system function.” Independent research in 2008 confirmed that people who took EpiCor had significantly fewer cold and flu-like symptoms, and their symptoms lasted a shorter time.
How it works: The company’s own research indicates that EpiCor raises the levels of antibodies in the mucus membranes, and also increase the production, activity and efficiency of several types of immune cells.
What’s new: An independent 2009 study showed EpiCor is also useful in alleviating the nasal congestion associated with allergies.

“Elderberry has been used to treat colds and flus for centuries in Europe,” Steelsmith says. Furthermore, “it tastes good and can easily be taken as a tablet, syrup or chewable pill.” She cautions pregnant or nursing women against it, however.
How it works: Research shows the flavonoids in elderberry have antiviral properties not found in other fruits.
What’s new: Steelsmith says a 2009 study reported that the “flavonoids found in elderberry can bind to the H1N1 virus and block its ability to infect host cells,” which shows elder-berry’s antiviral capabilities. NOW Foods has a new elderberry powder capsule with zinc, which also supports the immune system.

Pelargonium sidoides
Marketed in the U.S. as Umcka and ViraClear by Integrative Therapeutics, this homeopathic remedy is “one of the most helpful over-the-counter remedies” for combating the flu, Steelsmith says.
How it works: Steelsmith says the herb’s polyphenols stimulate the immune system. “Its active compounds also prevent bacterial adhesion, which could prevent secondary bacterial infections.”
What’s new: A 2009 study found that people with acute sinusitis recovered more quickly when treated with pelargonium. Other studies have found it effective in treating acute bronchitis and tonsillitis in children.

Vitamin D
Well known for its impact on bone health, “a wealth of research now shows that vitamin D plays an important role in many bodily processes, including immune-system function,” Weil says. “I prefer the form called cholecalciferol, or vitamin D3, to ergocalciferol (vitamin D2)” because vitamin D3 is more readily used by the human body than D2, which needs to be converted to D3 for the body’s use.
How it works: “Its actions are myriad and not yet fully understood,” Weil acknowledges. “But its role in immune function has been clearly demonstrated.”
What’s new: A 2009 review confirmed that vitamin D helps upregulate the immune system and protect against infectious microorganisms, but also suggested that the sunshine vitamin could help protect against various autoimmune diseases. Because studies have shown a high prevalence of deficiency among children, Jarrow has introduced new vitamin D products for kids: Yum-Yum D3, in both gummy and liquid forms. Nordic Naturals also has a new vitamin D3 softgel in a carrier of organic extra virgin olive oil, which is rich in oleic acid, a heart-healthy omega-9.
If all the insomniacs in the U.S. got together, they could have a killer slumber party. The National Sleep Foundation reports that an estimated 70 million Americans have at least some trouble falling or staying asleep. A number of herbs and supplements have been found effective in helping to combat this common problem.
All three of our experts recommended this herb to reduce the amount of time it takes to nod off.
How it works: According to the NIH, no single compound in valerian has been identified as the active agent. However, the NIH reports that valerian seems to have sedative properties, and it may increase the amount of GABA (gamma-aminobutyric acid), a compound in the brain that prevents the transmission of nerve impulses.
What’s new: Valerian seems to be especially effective when combined with hops, according to a 2007 study. Blumenthal recommends using Enzymatic Therapy’s Alluna product.

Answering consumer questions about valerian
Q: Can I get addicted to valerian if I take it for a long time?
A: “Dependency is possible,” Weil says, “so the remedy should be used for no longer than two weeks at a time.”

Q: Does valerian have side effects to be aware of?
A: “Occasionally, valerian use may cause GI upset or headache,” Weil says.

Q: How do I know which valerian product I should take?
A: Weil says to look for products standardized to 0.8 percent valerenic acid.

A compound derived from the amino acid L-tryptophan, the supplement also is used to enhance mood and decrease appetite. Steelsmith does not recommended 5-HTP for those on antidepressant medications.
How it works: Steelsmith says that 5-HTP acts as a precursor to serotonin, which is a neurotransmitter that is essential for a good night’s sleep. “It is better than L-tryptophan because 5-HTP can cross the blood-brain barrier and thus increase serotonin in the brain.”
What’s new: A small 2009 study of 18 people found that those who took a product combining 5-HTP and GABA needed less time to fall asleep, slept longer and reported improved sleep quality. NOW Foods’ new vegan 5-HTP 200 mg product also contains other relaxation aids: glycine, taurine and inositol.

A hormone that regulates the normal sleep/wake cycle, “melatonin can be used in supplement form as an occasional sleep aid, and is especially effective against jet lag,” Weil says.
How it works: According to research, the body naturally produces melatonin after the sun goes down, letting us know it’s time to fall asleep. Supplemental melatonin assists with this process.
What’s new: When combined with light therapy, melatonin helps minimize nighttime restlessness in elderly dementia patients, according to a 2008 study.

Along with contributing to a good night’s sleep, this light, silvery metallic element is an oft-overlooked nutrient that helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports
a healthy immune system, and keeps bones strong. Magnesium also helps regulate blood sugar levels, and promotes normal blood pressure, according to the NIH.
How it works: Lack of magnesium inhibits nerve cell communication, which leads to cell excitability. The result: a stressed and nervous person.
What’s new: Several older studies show that magnesium can improve sleep quality and reduce nocturnal awakenings. Natural Vitality, makers of the water-
soluble powdered magnesium supplement Natural Calm, have recently released Osteo Calm, which is a liquid magnesium-calcium product intended
for bone health support.
The misery we call hay fever stems from a biochemical cascade. A number of supplements, though, have shown promise in keeping symptoms at bay. Because allergies are the result of an immune dysfunction, many products that address allergies also boost immunity, and vice versa.
“Data suggest that this botanical remedy may be as effective for some as the conventional antihistamines cetirizine (Zyrtec) and fexofenadine (Allegra),” Weil says.
How it works: Blumenthal says petasin, a compound in butterbur leaf, may block the activities of leukotrienes and histamines—compounds that produce inflammation and allergic response.
What’s new: Research in 2006 showed that butterbur leaf extract improved allergy symptoms like sneezing, nasal congestion and itchy eyes in 90 percent of patients. The formulation used in the research—made by Swiss manufacturer Zeller AG—is expected to be released in the U.S. this year, Blumenthal says.

Answering consumer questions about butterbur
Q: I’ve heard butterbur has dangerous side effects. What’s the truth?
A: Naturally occurring compounds in butterbur—pyrrolizidine alkaloids—are potentially toxic to the liver. Blumenthal and Weil say to look for formulations—like Zeller’s—where the company has extracted the PA during the remedy’s production process.

Q: Is butterbur root as effective as butterbur leaf?
A: No; most research tends to favor butterbur leaf over butterbur root for allergy relief, Blumenthal says.

This herb has long been used in Chinese medicine to promote healthy immune function (and is one of Weil’s favorites), but recent research suggests it could be helpful for allergies too.
How it works: Researchers believe astragalus promotes the production of antibodies, enabling white blood cells to neutralize the allergen so the body doesn’t react to it.
What’s new: Blumenthal cites a 2009 study, which found that a Croatian
preparation of astragalus (Lectranal)
significantly decreased allergy symptoms in study subjects.

This flavonoid found primarily in apples and red onions “can help prevent the development of symptoms if taken for a few months before the start of allergy season, but is not a treatment for acute allergy symptoms,” Weil says.
How it works: Quercetin stabilizes the cells that release histamine in response to allergen exposure.
What’s new: A small Japanese study in 2009 found that people who took a quercetin supplement had much lower incidence of itchy eyes when exposed to cedar pollen

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