180 West Le Point Street, Suites A & B * Arroyo Grande, CA 93420 * Phone: 805-481-3442 * Fax: 805-481-3443 * info@middlepathmedicine.com *
Hours: Mon - Fri: 8:30 am - 6 pm,  Sat: 10 am - 2 pm (*Retail Store Only) Please do not e-mail pharmacy refills. Have your pharmacy fax your refill request.
Supplements Newsletter
Healthy Living Tips from Middle Path Medicine (MPM)
Multivitamin Misconceptions
By Gary E. Foresman, MD

The goal of today’s article is to introduce you to basic heath care information and educate you about the risks and benefits of multivitamin (MVI) supplementation. Every day our media is littered with advertisements telling us why we ‘need’ to take medicines, often with side-effect profiles that boggle the mind. Reporters, meanwhile, pen articles on why not to take “dangerous” MVIs. I know the advertising works as people ask about how to start taking these medicines, yet clearly avoid nutritional assistance as it might somehow impair the effectiveness of those wonderful medicines.

Let’s actually look at what the data tells us. In the most-quoted category we have the Women’s Health Initiative (involving 161,808 postmenopausal women) trial which proves convincingly that postmenopausal women who take Centrum-like MVIs for 8 years have absolutely no harm or benefit. This trial still gets front-page billing as proof that all MVIs are unnecessary, despite being published two years ago and involving a small segment of society. Another interesting article from Journal of the National Cancer Institute in May of 2007 sources an NIH trial of 295,344 men followed for five years. Self-proclaimed MVIs users had a 32% higher rate of aggressive prostate cancer. In two trials prospectively looking at MVIs and the risk of breast cancer, one found no association and one found a 19% increased risk. So if you look at these few trials, you should appropriately wonder about the value/safety of MVIs.

What is the rest of the story? Read More
Announcements

We have many more articles like these ones available on our All Articles page if you wish to learn more about what Dr. Foresman has written

Gary Michael's Multi-Vitamin Misconceptions:
The Good, the Bad, and the Ugly Revisited
At every Free Community Health Update Dr. Foresman holds, he comments on how much good, or how much harm, Multi-Vitamins can do to our bodies. Each time he mentions Multi-Vitamins, he says: “If the two things you are most concerned about when getting a Multi-Vitamin are whether or not it is cheap and easy, then do not get anything at all. You will save the most money, and that would be the healthiest choice you could make.” Dr. Foresman also consistently refers people to the Nutrisearch Comparative Guide to Nutritional Supplements, by Lyle MacWilliam MSc, FP which we carry at the Middle Path Medicine Supplement Shop. This guide lists supplements that are scientifically rated and compared to determine what the best brands are and what brands consistently fall short.
If you are getting a Multi-Vitamin without the guidance of a medical professional, then it is important that you refer to either our Supplement Shop and its employees or this book to make sure you are helping your body and not harming it.
In this article, I have compiled two lists, the first with the 4-5 star Multi-Vitamins you should consider, and the second with the 0-2 star Multi-Vitamins which studies have shown again and again harm those who take them or (at best) do absolutely nothing. These are only some of the Multi-Vitamins listed, especially in the extensive 0-2 star list, so please refer to the Comparative Guide if you do not see your Multi-Vitamin listed.


4-5 Star Multi-Vitamins (A-Z):

These are the well-formulated Multi-Vitamins that studies have shown to vastly improve your health in countless ways with consistent use. There are substantially fewer good-quality, well-formulated Multi-Vitamins and they cost a bit more due to all of the thorough research, planning, and formulating that goes into these supplements. A few of them are:

•Douglas Laboratories (Ultra PreventiveX)
•Healthy Wize Vital Nutrients
•NSI (Synergy Men’s Version 2)
•Ortho Molecular (Alpha Base)
•Pure Encapsulations
•Source Naturals (Life Force Multiple)
•USANA Health Sciences Essentials
•Vitamin Research Products
•DaVinci Laboratories (Spectra Multi Age)
•Pure Essence Labs (Life Essence)

We carry several of these Multi-Vitamins because Dr. Foresman has researched every one of them far more than a typical store can (because he is an MD with the authority and knowledge-base to do so) and agrees with the assessment that the Comparative Guide has provided. Although we are a small business, we are lucky enough to be able to share a Buy One, Get One FREE discount on our Source Naturals Life Force Multi. Priced at $31.79 (with tax) for two months’ worth, it costs only $0.53 a day to substantially reduce cardiovascular mortality, cancer risk including (but not limited to) breast, prostate, and colon cancer, myocardial infarction, infections, and overall-mortality. Should you decide not to invest in your health, please at least avoid the potentially harmful Multi-Vitamins listed below.


2 Star and Below Multi-Vitamins (A-Z):

These are the “Centrum-like” Multi-Vitamins that studies show hurt people from imbalances and poor quality vitamins. If you are taking a Multi because it is cheap and/or easy (one-a-day) like most of the multi-vitamins in this list, the cheapest, easiest, and SAFEST thing to do is to take nothing at all. They may be cheaper, but they come at a far greater cost.
This is a very small list I compiled for you, there are many, many more in the book that I did not include. Again, these are excerpted from the Nutrisearch Comparative Guide to Nutritional Supplements, by Lyle MacWilliam MSc, FP, which we carry at the Middle Path Medicine Supplement Shop. Some of these products actually got 0 stars. Please be careful with what you put inside yourself!

•Centrum
•CVS Pharmacy
•Equaline
•Equate
•Garden of Life
•GNC
•Herblife
•Isagenix
•Kirkland
•Life
•Longs
•MegaFood
•Nature Made
•Nature’s Life
•Nature’s Way
•Now
•One a Day
•Puritan’s Pride
•Rite Aid
•Safeway
•Solgar
•SunMark
•Target
•Vitamin Power
•Vitamin Shoppe
•Vitamin World
•Vitasmart
•Walgreens
•Wild Oats

We refuse to carry any of these brands because of the countless studies that show how damaging their supplements can be to our customers. Everything we carry is individually researched to ensure that we are selling top-quality supplements and nothing that could increase mortality rate and risk of cancer.

There are innumerable poor-quality supplements available at a typical health food store, each bottle making promises and taking advantage of trends in the media. The 4-5 star multi-vitamins are not easy to find or distinguish among all of the cheap and harmful ones. It’s smart to consult someone who has training and knows about nutrition before taking supplements. Your average grocery store employee most likely has no idea what applications each supplement has. Please don’t ask the typical cardiologist or oncologist or dermatologist for nutrition help as that is not their line of study. Follow the link to learn more about Supplement Misconceptions.
Read Your Journey to Health and Healing and Middle Path Medicine’s webpage to see if Gary E. Foresman, MD is the right doctor and guide for you. With his vast knowledge of Internal Medicine and extensive education in all aspects of nutritional support, Dr. Foresman hand selects every item in our Supplement Shop. This ensures that his patients and our customers have access to the best, giving you the confidence that you are taking truly well-studied supplements intended for optimal human health and healing.
As a reminder, our Supplement Shop is open to the public, which means you don’t have to be a patient—come by any time and say hi!

Wishing you a good life during Your Journey to Health & Healing.
-Gary Michael


Be sure to check out our Homepage and Classes & Events page for updates on upcoming seminars, released monthly Newsletters, sales, and much more!
What did the IOM do with my RDI?
By Gary E. Foresman, MD

Do we all need the same amount of air, water, and food? Do race, sex, and lifestyle play no role in determining the adequacy of any nutrient for any specific individual? Why, especially in a country of individuality and the pursuit of that which is best, do we have organizations such as the IOM (Institute of Medicine) distributing edicts regarding RDIs (Recommended or Reference Daily Intake)? Most importantly, who are these people from the IOM, and what is their agenda? Why do we listen to them? Where did the old RDAs (Recommended Daily Allowances) come from, and how did they transform into these RDIs, DRIs (Dietary Reference Intakes) and EARs (Estimated Average Requirements)? What is the relevance of an RDI, and why does it have any meaning in our life?

The Food and Nutrition Board (FNB), a subdivision of the US National Academy of Sciences (NAS), developed the RDAs in 1941 during a time of food rationing to ensure that people could survive on less and still be free of deficiency diseases. Knowing that 60 mg per day of Vitamin C could prevent scurvy was a good thing! While updated every 5-10 years, very little has changed in the direction of improving health, and only the continued goal of acute nutritional deficiency prevention has been maintained. The IOM, founded in 1970, the medical subdivision of the NAS, took over for the FNB and states its mission as “adviser to the nation to improve health”.

Here is a direct quote from the IOM website in reference to their “Dietary Reference Intakes for Calcium and Vitamin D” guideline published November 30th:  ... Read More
Vitamin D
By Gary E. Foresman, MD

Recently Vitamin D made headlines as low level supplementation of vitamin D averaging approximately 500 units per day leads to a 7% overall decrease in total mortality. This is the first case where vitamin supplementation, even at a low dosage, has proven to decrease the risk of death. So what is vitamin D?

Vitamin D is not actually a vitamin at all it is a steroid hormone produced when the skin is exposed to ultraviolet B radiation. After the formation of previtamin D in the skin, further metabolism occurs in the liver with the formation of 25-hydroxyvitamin D (this is what we measure in the blood stream as the most accurate marker of circulating vitamin D activity), and then conversion to 1,25-dihydroxyvitamin D in the kidneys (this is the cellularly active form of vitamin D). Under the regulation of vitamin D and parathyroid hormone, our body tightly regulates calcium and phosphorus metabolism at the level of the small intestine and kidney. Interestingly, almost all tissues can directly create 1,25-dihydroxyvitamin D, something that was thought only to occur in the kidneys, and it turns out that 1,25-dihydroxyvitamin D controls more than 200 genes, many directly responsible for immune system function and regulation of cell growth. These fascinating discoveries of the role of the steroid hormone vitamin D has lead to its widespread use in so many medical conditions.

Most of the confusion for many physicians and the majority of people is the lack of a clear understanding of what is deficiency, insufficiency, and optimal vitamin D levels. Fortunately, multiple studies now indicate optimal vitamin D levels are actually at ranges vastly higher than what current laboratories list as the reference range. The ranges that I will give you are based upon sound biochemical evidence. The units that I am discussing will be ng/ml. Some labs use nmol/l, to convert between these multiply ng/ml by 2.5 to get nmol/l, or multiply nmol/l by 0.4 to get ng/ml. Deficiency of vitamin D is a level less than 30, insufficiency is a level between 31-50, and optimal is 50-100 ng/ml. Importantly, toxicity does not occur until levels of 150 occur. Given this more accurate definition of D sufficiency, and the understanding that 50% of post menopausal women have vitamin D levels below 30, we know that nearly this entire population is either insufficient or deficient in vitamin D! Dramatically, in pregnant and lactating women who are taking pre-natal vitamins and drinking over two glasses of milk per day, 73% of these women and 80% of their infants were vitamin D deficient at levels less than 20! The severity of vitamin D deficiency in our country is an unrecognized and unfortunately fatal epidemic.  ... Read More
Vitamin E: A Fresh Look at an Old Friend
By Gary E. Foresman, MD

When I discuss those substances in nature with the complexity and diversity of “vitamin E activity”, I find that I often lose my audience. Too professorial and the reader snoozes. Too simple and nothing is learned and people might wander into the grocery store to buy a potentially dangerous supplement. Finding the middle path in all ventures remains my lifelong challenge. Please read on to rediscover a vitamin so dreadfully misunderstood, yet so beautiful in structure and function that we are only beginning to harvest its benefits!

Discovered in 1922 as part of green leafy vegetables, and later as part of wheat germ oil and other oils, vitamin E was initially found to support fertility. The first members of the E family became known as the tocopherols. The name comes from the Greek tokos meaning childbirth, phero meaning to bring forth, and ol to note its alcohol properties. Tocopherols are known as an essential component of the human diet that comes only from photosynthetic organisms. Only later substances with the same fat-soluble vitamin E activity with three extra double bonds in its hydrocarbon tail were found and called tocotrienols. To complete the story, both the tocopherols and the tocotrienols are distinguished by unique side chains and individually are known as alpha, beta, gamma, and delta tocopherols and tocotrienols, giving us 8 distinctive members of the vitamin E family.

Here’s where it starts to get a bit complex, but please hang with me or you won’t understand why nearly everyone misunderstands the scientific literature on the vitamin E family.  ... Read More