Stay up-to-date with current research on supplements.
Chiropractic care focuses on natural healing. Prescribing “medication” isn’t any different. Patients look to you to recommend the best products and formulations for their health—which oftentimes means the newest, most innovative products.
So what is new regarding natural medicine, particularly with omega-3s, probiotics, curcumin and turmeric, and CoQ10—which are among the most sought-after supplements these days?
Product delivery systems are advancing to optimize how the body absorbs omega-3 fatty acids, reports Christopher Oswald, DC, CNS, an advisory board member of Nordic Naturals. The body can absorb up to 95 percent of healthy fats in a concentrated, triglyceride-form of omega-3.1 But new formulations are on the horizon, such as emulsions, which continue to allow clinically relevant dosing while providing an excellent tasting and easily absorbed liquid fish-oil supplement.
In addition to new formulations, researchers’ understanding of how essential fatty acids work in the body continues to expand. Recently, much study has focused on resolution physiology. Certain eicosanoids derived from omega-3 fatty acids—termed specialized pro-resolving mediators (SPMs)—have been shown to help the body appropriately manage the inflammation cycle.
The ability to resolve an inflammatory event is a key to overall health maintenance. There are even links between these SPMs and the healthy metabolism of cholesterol.2
In practice, a common recommendation is 2,000 mg of eicosapentaenoic acid and docosahexaenoic acid (fatty acids in omega-3 fats, found in cold water fish), but at times higher levels are indicated. The American Heart Association, for example, recognizes the benefits of up to 4,000 mg for individuals with hypertriglyceridemia.
Terry Lemerond, president of EuroMedica, points out that while omega-3s are important, they are not the only nutrient from fish with benefits. “There are naturally occurring phospholipids and peptides to consider as well,” he says. “These components can make a big difference, but they are not available from most supplemental sources.”
You won’t find peptides in krill oil or most fish oils. But they are extremely important to support emotional well-being, cognitive health, and blood-vessel flexibility and strength.
Phospholipids are already well-studied on their own, and Lemerond believes that will continue. “The research on peptides from food sources is becoming more aggressive, and could end up being the next frontier in natural medicine and supplement formulations,” he says.
Lemerond is excited about omega-3 supplements sourced from fresh salmon. These polyunsaturated fatty acids (PUFAs) are bound to phospholipids for excellent absorption, and provide brain-friendly peptides that have been shown to relieve anxiety.
These supplements are only available in tablet form now, but soon should be available as capsules, too. Omega-3s are appropriate for a variety of health protocols including cognitive and neurological support; cardiovascular health; skin, hair, and nail support; and for providing essential fatty acids.
In the past several years following the completion of the Human Microbiome Project, there’s been a tremendous increase in the understanding of human microbiota and how these bacteria keep the body healthy.3
“New formulations focus on core groups of bacteria that are found in the gut, but one thing that has become apparent is that variety is very important,” Oswald says. “With the vast array of microbiota species found in the human digestive tract, it is important to choose a probiotic product with a healthy variety of bacterial species.”
Among the products currently in development, a select group are “Certified for Sport” by NSF International. “With the unique stressors athletes and active individuals undergo, good digestive health is essential to healthy immune function and overall well-being,” Oswald says. “An added benefit of these products is that they do not need to be refrigerated, so they are great for travel.”
In other probiotic news, Ryan Bentley, DC, MD, PhD, chief medical officer at Humarian Research Lab, reports on the nutraceutical industry’s first fermented toxin-scavenging Lactobacillus. This formula uses a naturally occurring fermentation process that allows for beneficial modifications to the bacterium’s cell wall. During this process, bacteria are trained by repeated passes of mixed toxins from mold (mycotoxins) and other toxic substances bound to “bad” bacterial cell walls, called endotoxins, which are also known as Lipopolysaccharides (LPS).
They are released when the bad bacterium ruptures or disintegrates. The strains ultimately selected can thrive in a toxin-challenged environment, as they inherently seek and destroy toxins.
In addition, newly introduced probiotic products have been designed for women and children. Some are targeted for overweight and obese women, and for those with type 2 diabetes. These products can provide clinical vaginal and urinary tract support and help with weight loss, Bentley says.
Children’s formulations are used to populate flora in children who have taken antibiotics, were delivered by cesarean section, or were not breast fed. They are also used for treating diarrhea, constipation, colic, and helping those in need of immune support.
Meanwhile, Ashton Dugger, sales and marketing special projects supervisor for Master Supplements, acknowledges that while the mainstream media is pointing to the relationship between gut health and mood, there is also a surge in various fields of research for autoimmune diseases and related challenges regarding probiotics.
“While formulations vary across the field of manufacturers, stand-out companies focus on a few key things: strain compatibility, inclusion of prebiotics within a formula, deep delivery of live strains, and potency of colony-forming units within each capsule to ensure efficacy of strength,” Dugger says.
Another trend is to rotate formulas. “This is because the microbiome is diverse and our gut flora is competitive,” Dugger says. “This practice maintains a good balance of Lactobacillus and Bifidobacterium strains as we aim to colonize the entire gut lining. However, practitioners should look closely at patients’ symptoms to determine what strains they need to focus on with each rotation.” For example, for patients with a gastrointestinal problem, you might advise rotating a supplement aimed at the colon with one targeted for the entire gastrointestinal tract.
Curcumin was named the top herb of 2014 by the American Botanical Council. Given this, Lemerond expects to continue to see developments in curcumin formulations and delivery systems throughout the industry.
Curcumin’s surge in popularity in recent years is for a good reason—it does virtually everything. For cellular health, it works along multiple pathways, whereas conventional approaches typically work along one. For a healthy inflammatory response due to exercise, it provides a safe and effective form of pain relief. And for cognitive health, it has been studied for years as a neuroprotective botanical compound.
Part of this development grew out of research and observational studies in India, which showed the differences in cognitive support conferred by curcumin compared to the standard American diet consisting of foods rich in omega-6 fatty acids, preservatives, and sodium. “Understandably, as practitioners and patients in the United States heard about the protective effects of curcumin from turmeric, they wanted a supplemental form,” Lemerond says.
But that was easier said than done, because curcumin by itself is not well absorbed in the digestive tract. And what does get absorbed tends to spike in the bloodstream for only a short time.
To maximize curcumin’s effectiveness, formulations combining BCM-95 curcumin and turmeric essential oils can boost absorption up to 10 times that of plain extracts while helping it stay in the bloodstream longer.
The lipophilic components of tumeric (turmerones) not only boost absorption but also enhance the power of curcumin, in addition to their own health benefits. Research on compounds from turmeric essential oils has shown that turmerones protect against oxidative damage, support healthy cells, and support a healthy inflammation response.4-8
Cue Coenzyme Q10
For many years, CoQ10 has been known as a powerhouse for mitochondria. It’s generally recommended for the over-40 set, as CoQ10 levels tend to decrease with age.9 You’ll now find a variety of new formulations on the market that are developed with athletes and active adults in mind.
It is known that Q-10 facilitates adenosine triphosphate (ATP) production, which is vital for cellular energy. Because it shows promise in addressing certain mitochondrial disorders, it likewise is aimed at improving exercise performance.
When looking to offer your patients natural medicine in the form of herbs and supplements, always consider the tried and true. Yet this is a fast-changing field, so it’s wise to also explore innovative options that may confer superior benefits.
Karen Appold, an editorial consultant in Royersford, Pennsylvania, is dedicated to regular chiropractic care. She has been the president of Write Now Services, which offers writing, editing, and proofreading since 2003. Her experience includes chiropractic marketing. She can be contacted at 610-812-3040, firstname.lastname@example.org, or through writenowservices.com.
1 Laidlaw M, Cockerline C, Rowe W. Comparative bioavailability of omega-3 fatty acids from four different omega-3 supplements (272.6). FASEB J. 2014;28 (supplement): 272.6.
2 Serhan CN, Dalli J, Colas RA, Winkler JW, Chiang N. Protectins and maresins: new pro-resolving families of mediators in acute inflammation and resolution bioactive metabolome. Biochimica et Biophysica Acta (BBA)—Molecular and Cell Biology of Lipids. 2015;1851(4):397-413.
3 National Institutes of Health. “Human Microbiome Project.” http://hmpdacc.org. Last updated August 2015. Accessed August 2015.
4 Murakami A, Furukawa I, Miyamoto S, Tanaka T, Ohigashi H. Curcumin combined with turmerones, essential oil components of turmeric, abolishes inflammation-associated mouse colon carcinogenesis. Biofactors. 2013;39(2):221-32.
5 Yue GG, et al. The role of turmerones on curcumin transportation and P-glycoprotein activities in intestinal Caco-2 cells. J Med Food. 2012;15(3):242-252.
6 Sandur SK, et al. Curcumin, demethoxycurcumin, bisdemethoxycurcumin, tetrahydrocurcumin and turmerones differentially regulate anti-inflammatory and anti-proliferative responses through a ROS-independent mechanism. Carcinogenesis. 2007;28(8):1765-773.
7 Jayaprakasha GK, Jena BS, Negi PS, Sakariah KK. Evaluation of antioxidant activities and antimutagenicity of turmeric oil: a byproduct from curcumin production. Z Naturforsch C. 2002;57(9-10):828-35.
8 Ji M, Choi J, Lee J, Lee Y. Induction of apoptosis by ar-turmerone on various cell lines. Int J Mol Med. 2004;14(2):253-56.
9 Frye RE, Rossignol DA. Treatments for biomedical abnormalities associated with autism spectrum disorder. Front Pediatr. 2014;2:66.