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Perspectives for Better Neurological Care

 

                    C. Robert Adams, M.D.

                            Board Certified Neurologist

       109 N. 15th St., Ste 14, Norfolk Ne. 68701 Phone: 402-371-0226 Toll Free: 888-516-2398

                                                 3900 Dakota Ave, Sioux Sioux City, NE . 68776

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2.                  Chondrotin glucosamine – The journal of American Medical Association clarified that multiple research trials on this supplement have “moderate to large effects” in benefit as regards to symptoms of degenerative arthritis.
On a practical basis, chondroitin glucosamine lessens stiffness and aching in the hips and knees but also in the shoulders, neck and back.  It won’t give you “new joints” but will help preserve what joint function you have left.

 

3.                  Calcium plus magnesium is a better way to maintain your bones than calcium alone.  In particular, tropical punch or cherry Rolaids, or equivalent, provide several benefits that calcium alone does not.

a.       This combination is less constipating.

b.      This coats your stomach to help keep from getting ulcers and lessening tendency towards gastritis.

c.       Magnesium is beneficial as regards to muscle function and even helps as regards to some problems of migraine, etc. 

DOSE:  2 tablets twice a day or more if desired.

 

4.                  Triple Omega 3 Oils or the combination of essential oils including fish oil, flax seed oil and borrage oils pretty much keep you covered in lessening progression of atherosclerosis and coronary artery disease and cerebral vascular disease.
DOSE:  1 cap twice a day.

 

5.                  Iron Replacement is an important either by itself or a multiple vitamin.
Iron deficiency is one of the most under recognized, under treated, and symptomatic vitamin or supplement deficiencies commonly seen.  Iron deficiency occurs because of dietary deficit as with lack of red meat, with menstrual bleeding, with GI tract bleeding, etc. Identification of iron deficiency can be deceptive.  You can be drastically iron deficient with an essentially normal blood count or hemoglobin.  Your serum iron can be “normal”.  The only absolute way to identify iron deficiency is to check a serum ferritin.  A low serum ferritin absolutely indicates significant iron deficiency.  Serum ferritin ideally should be above 50 for ideal health.  A serum ferritin of around 20 suggest almost no iron stores in the body and no iron reserves with severe iron deficiency.
DOSE:  Ferrous gluconate or ferrous sulfate 1 tablet daily, or with gastric intolerance, Slo-fe, or other less irritating generic equivalent.
Severe iron deficiency and intolerance of oral iron replacement may prompt need for the physician to order IV Venofer (iron).

6.                  B₁₂ (cyanocobalamin) – This is the one vitamin that is commonly mal-absorbed or poorly absorbed in the GI tract requiring IM or parenteral administration.
Lack of B₁₂ can cause problems of peripheral neuropathy; imbalance and mental slowing, even dementia.  Dissolvable tablets or “oral” B₁₂ can not take the place of B₁₂ shots.  These neurologic symptoms can occur even in the absence of B₁₂ related anemia or blood dyscrasia.

 

7.                  Vitamin D – is almost universally deficient in individuals living in colder climates.  To prevent osteoporosis and in fact provide optimal bone health for your joints, supplemental daily vitamin D can often be very helpful.
DOSE: 1000 units daily for supplement as long as there is adequate calcium and magnesium in the diet and as long as someone does not already have a problem with hypercalcemia or some other hormonal contraindication.

 

8.                  Gingko Biloba – absolutely positively proven in multiple studies to improve peripheral blood supply (lessen intermittent claudication).  It has minor and probably insignificant blood thinning effects.  Drug related bleeding complications can occur in the setting of other blood thinning agents such as aspirin, Plavix and Coumadin.  However, ginkgo does not tend to cause bleeding complications by itself.
Avoid ginkgo in uncontrolled or labile hypertension as is can sometimes affect the blood pressure.  However, someone with hypertension on ginkgo would likely need the hypertension treated with medical management irregardless of the ginkgo use.
Ginkgo can sometimes be helpful in stimulating the brain and facilitating concentration and mental focus.

 

9.                  Melatonin – The simplest and often best OTC substance to facilitate natural sleep.  The use of melatonin merely supplements the body’s natural production of melatonin.  The brain produces melatonin to help regulate natural circadian rhythm.
Melatonin is known as the “jet lag” drug as it can be helpful when taken by individuals who have shifting schedules or that work at night. 
DOSE: 3 mg at bedtime though, this can be doubled if insomnia persists.
This is a non-addicting approach to sleep regulation and can be used on a regular basis.

 

10.              St. John’s Wort – probably some beneficial anxiolytic and antidepressant effects can be obtained in some individuals with this drug.
Medication interactions are always to be watched for but are usually not a practical problem.
DOSE:  Usually is 300 mg once or twice a day.  It should be noted this is sometimes better tolerated in the elderly than other potent psychoactive medications.

 

11.              Coenzyme Q10 – May very well help to slow progression of Parkinson’s disease or other neurologic conditions and possibly help as regards to optimal health of peripheral vascular and peripheral nervous system.
DOSE:  Usually is 100 mg twice a day (or even much higher doses are often taken).

 

12.              Vitamin C – Is probably not helpful or useful or worth the expense particularly if someone gets even a minimal amount of fruit or juice in their diet or if they take a multivitamin.

 

13.              Vitamin E –Studies have absolutely been mixed but the bottom line is that it is not helpful and could be deleterious. 

 

14.              Vitamin A – Amount in excess of that in a multiple vitamin are absolutely harmful.  It can cause pseudotumor cerebri or increased intracranial hypertension.

 

15.              Pyridoxin B₆ – is absolutely harmful in doses higher than that found in a multiple vitamin.  It can bring out peripheral neuropathy.

 

16.              Echinacea – In repeated and multiple studies is not shown to be definitively helpful as regards to “boosting the immune system”.

 

17.              “Eye Vitamins” – may help maintain vision and lessen macular degeneration.  These supplements are worth trying as long as the systemic problems of diabetes, hypertension, and hyperlipidemia are addressed.

 

18.                 Folic Acid – taken alone this has been shown not to be any more helpful than taking a multiple vitamin with folic acid in it (Centrum).



Rev. 4/20/07

Last modified: 08/04/09