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Active Hydrogen
Adrenal Extracts
Alanine
Alpha-Linolenic Acid
Alpha-Lipoic Acid
AMP
Amylase Inhibitors
Arginine
Bee Pollen
Beta Carotene
Beta-glucan
Betaine
Beta-Sitosterol
Biotin
Borage Oil
Boron
Bovine Cartilage
Bovine Colostrum
Brewer's Yeast
Bromelain
Calcium
Capsaicin
Carnitine
Carnosine
Chitosan
Chloride
Chlorophyll
Chondroitin
Chromium
CLA
Cobalt
Coenzyme Q10
Copper
Creatine
Cysteine
DHA
DHEA
DMAE
EGCG
Evening Primrose Oil
5-HTP
Fiber (Insoluble)
Fiber (Soluble)
Fish Oil
Flavonoids
Fluoride
Folate
Fumaric Acid
GABA
Gamma-Linolenic Acid
Glucomannan
Glucosamine
Glutamic Acid
Glutamine
Glutathione
Glycine
Grape Seed Extract
Histidine
HMB
Hydroxycitric Acid
Indole
Inosine
Inositol
Iodine
Ipriflavone
Iron
Isoleucine
Lactase
Lecithin
Leucine
Lipase
Lutein
Lycopene
Lysine
Magnesium
Malic Acid
Manganese
Mannose
Melatonin
Methionine
Methoxyisoflavone
Molybdenum
MSM
N-Acetyl Cysteine
NADH
Naringin
Niacin
Octacosanol
Oligosaccharides
Olive Leaf Extract
Ornithine
Oryzanol
PABA
Pancreatic Enzymes
Pantothenic Acid
Phenylalanine
Phosphatidylserine
Phosphorus
Phytic Acid
Policosanol
Potassium
Pregnenolone
Probiotics
Propolis
Psyllium
Pyridoxine
Pyruvate
Quercetin
Resveratrol
Retinol
Riboflavin
Ribose
Royal Jelly
SAMe
Selenium
Shark Cartilage
Silicon
Sodium
Spirulina
Spleen Extracts
St. John's Wort
Strontium
Sulforaphane
Sulfur
Taurine
Thiamine
Tocopherol
Tea Tree Oil
Tyrosine
Usnic Acid
Valine
Vanadium
Vinpocetine
Vitamin A
Vitamin B1
Vitamin B2
Vitamin B3
Vitamin B5
Vitamin B6
Vitamin B9
Vitamin B12
Vitamin C
Vitamin D
Vitamin H
Vitamin K
Whey Protein
Xylitol
Zinc
Abalone Shell (shi jue ming)
Abutilon Seed (dong kui zi) Acanthopanax Bark (wu jia pi) Achyranthes (niu xi) Aconite (fu zi) Acorus (shi chang pu) Adenophora Root (nan sha shen) Agkistrodon (bai hua she) Agrimony (xian he cao) Ailanthus Bark (chun pi) Akebia Fruit (ba yue zha) Albizzia Bark (he huan pi) Albizzia Flower (he huan hua) Alfalfa (medicago sativa) Alisma (ze xie) Aloe (lu hui) Alum (bai fan) Amber (hu po) Ampelopsis (bai lian) Andrographis (chuan xin lian) Anemarrhena (zhi mu) Antelope's Horn (ling yang jiao) Apricot Seed (xing ren) Areca Peel (da fu pi) Areca Seed (bing lang) Arisaema (tian nan xing) Ark Shell (wa leng zi) Arnebia (zi cao or ying zi cao) Arnica (arnica montana) Artichoke Leaves (Cynara scolymus) Ash bark (qin pi) Ashwagandha (withania somniferum) Aster (zi wan) Astragalus (huang qi) Aurantium (zhi ke [qiao]) Bamboo Juice (zhu li) Bamboo Shavings (zhu ru) Belamcanda Rhizome (she gan) Benincasa Peel (dong gua pi) Benincasa Seed (dong gua xi/ren) Benzoin (an xi xiang) Bilberry (yue ju) Biota Leaf (ce bai ye) Biota Seed (bai zi ren) Bitter Melon (ku gua) Bitter Orange Peel (ju hong) Black Cohosh (sheng ma) Black Plum (wu mei) Black Sesame Seed (hei zhi ma) Bletilla (bai ji) Boneset (ze lan) Borax (peng sha) Borneol (bing pian) Bottle Brush (mu zei) Buddleia (mi meng hua) Buffalo Horn (shui niu jiao) Bulrush (pu huang) Bupleurum (chai hu) Burdock (niu bang zi) Camphor (zhang nao) Capillaris (yin chen hao) Cardamon Seed (sha ren) Carpesium (he shi) Cassia Seed (jue ming zi) Catechu (er cha) Cat's Claw (uncaria tomentosa) Cephalanoplos (xiao ji) Celosia Seed (qing xiang zi) Centipede (wu gong) Chaenomeles Fruit(mu gua) Chalcanthite (dan fan) Chebula Fruit (he zi) Chinese Gall (wu bei zi) Chinese Raspberry (fu pen zi) Chrysanthemum (ju hua) Cibotium (gou ji) Cinnabar (zhu sha) Cinnamon (rou gui or gui zhi) Cistanche (rou cong rong) Citron (xiang yuan) Citrus Peel (chen pi) Clam Shell (hai ge ke/qiao) Clematis (wei ling xian) Cloves (ding xiang) Cnidium Seed (she chuang zi) Codonopsis (dang shen) Coix Seed (yi yi ren) Coptis (huang lian) Cordyceps (dong chong) Coriander (hu sui) Corn Silk (yu mi xu) Cornus (shan zhu yu) Corydalis (yan hu suo) Costus (mu xiang) Cranberry (vaccinium macrocarpon) Cremastra (shan ci gu) Croton Seed (ba dou) Curculigo (xian mao) Cuscuta (tu si zi) Cuttlefish Bone (hai piao xiao) Cymbopogon (xiang mao) Cynanchum (bai qian) Cynomorium (suo yang) Cyperus (xiang fu) Dalbergia (jiang xiang) Damiana (turnera diffusa) Dandelion (pu gong ying) Deer Antler (lu rong) Dendrobium (shi hu) Devil's Claw (harpagophytum procumbens) Dianthus (qu mai) Dichroa Root (chang shan) Dittany Bark (bai xian pi) Dong Quai (tang kuei) Dragon Bone (long gu) Dragon's Blood (xue jie) Drynaria (gu sui bu) Dryopteris (guan zhong) Earthworm (di long) Eclipta (han lian cao) Elder (sambucus nigra or sambucus canadensis) Elsholtzia (xiang ru) Ephedra (ma huang) Epimedium (yin yang huo) Erythrina Bark (hai tong pi) Eucalyptus (eucalyptus globulus) Eucommia Bark (du zhong) Eupatorium (pei lan) Euphorbia Root (gan sui or kan sui) Euryale Seed (qian shi) Evodia (wu zhu yu) Fennel (xiao hui xiang) Fenugreek (hu lu ba) Fermented Soybeans (dan dou chi) Flaxseed (ya ma zi) Fo Ti (he shou wu) Forsythia (lian qiao) Frankincense (ru xiang) Fritillaria (chuan bei mu) Gadfly (meng chong) Galanga (gao liang jiang) Galena (mi tuo seng) Gambir (gou teng) Gardenia (zhi zi) Garlic (da suan) Gastrodia (tian ma) Gecko (ge jie) Gelatin (e jiao) Genkwa (yuan hua) Germinated Barley (mai ya) Ginger (gan [sheng] jiang) Ginkgo Biloba (yin xing yi) Ginseng, American (xi yang shen) Ginseng, Asian (dong yang shen) Ginseng, Siberian (wu jia shen) Glehnia (sha shen) Glorybower (chou wu tong) Goldenseal (bai mao liang) Gotu Kola (luei gong gen) Green Tea (lu cha) Gymnema (gymnema sylvestre) Gynostemma (jiao gu lan) Gypsum (shi gao) Halloysite (chi shi zhi) Hawthorn (shan zha) Hemp Seed (huo ma ren) Homalomena (qian nian jian) Honey (feng mi) Honeysuckle Flower (jin yin hua) Honeysuckle Stem (ren dong teng) Houttuynia (yu xing cao) Huperzia (qian ceng ta) Hyacinth Bean (bai bian dou) Hyssop (huo xiang) Ilex (mao dong qing) Imperata (bai mao gen) Indigo (qing dai) Inula (xuan fu hua) Isatis Leaf (da qing ye) Isatis Root (ban lan gen) Java Brucea (ya dan zi) Jujube (da zao) Juncus (deng xin cao) Kadsura Stem (hai feng teng) Katsumadai Seed (cao dou kou) Kelp (kun bu) Knotweed (bian xu) Knoxia root (hong da ji) Kochia (di fu zi) Lapis (meng shi) Leech (shui zhi) Leechee Nut (li zhi he) Leonorus (yi mu cao) Lepidium Seed (ting li zi) Licorice (gan cao) Ligusticum (chuan xiong) Ligustrum (nŸ zhen zi) Lily Bulb (bai he) Limonite (yu liang shi) Lindera (wu yao) Litsea (bi cheng qie) Lobelia (ban bian lian) Longan (long yan hua [rou]) Lophatherum (dan zhu ye) Loquat Leaf (pi pa ye) Lotus Leaf (he ye) Lotus Node (ou jie) Lotus Seed (lian zi) Lotus Stamen (lian xu) Luffa (si gua luo) Lycium Bark (di gu pi) Lycium Fruit (gou qi zi) Lygodium (hai jin sha) Lysimachia (jin qian cao) Magnetite (ci shi) Magnolia Bark (hou po) Magnolia Flower (xin yi hua) Maitake (grifola frondosa) Marigold (c. officinalis) Massa Fermentata (shen qu) Milk Thistle (silybum marianum) Millettia (ji xue teng) Mint (bo he) Mirabilite (mang xiao) Morinda Root (ba ji tian) Mugwort Leaf (ai ye) Mulberry Bark (sang bai pi) Mulberry Leaf (sang ye) Mulberry Twig (sang zhi) Mullein (jia yan ye) Musk (she xiang) Myrrh (mo yao) Notoginseng (san qi) Notopterygium (qiang huo) Nutmeg (rou dou kou) Oldenlandia (bai hua she she cao) Omphalia (lei wan) Onion (yang cong) Ophicalcite (hua rui shi) Ophiopogon (mai dong) Oroxylum Seed (mu hu die) Oryza (gu ya) Oyster Shell (mu li) Passion Flower (passiflora incarnata) Patrinia (bai jiang cao) Pau D'Arco (tabebuia avellanedae) Peach Seed (tao ren) Pearl (zhen zhu [mu]) Perilla Leaf (su ye) Perilla Seed (su zi) Perilla Stem (su geng) Persimmon (shi di) Pharbitis Seed (qian niu zi) Phaseolus (chi xiao dou) Phellodendron (huang bai) Phragmites (lu gen) Picrorhiza (hu huang lian) Pinellia (ban xia) Pine Knots (song jie) Pipe Fish (hai long) Plantain Seed (che qian zi) Platycodon (jie geng) Polygala (yuan zhi) Polygonatum (huang jing) Polyporus (zhu ling) Poppy Capsule (ying su qiao) Poria (fu ling) Prickly Ash Peel (hua jiao) Prinsepia Seed (rui ren/zi) Prunella (xia ku cao) Prunus Seed (yu li ren) Pseudostellaria (tai zi shen) Psoralea (bu gu zhi) Pueraria (ge gen) Pulsatilla (bai tou weng) Pumice (fu hai shi) Pumpkin Seed (nan gua zi) Purslane (ma chi xian) Pyrite (zi ran tong) Pyrrosia Leaf (shi wei) Quisqualis (shi jun zi) Radish (lai fu zi) Realgar (xiong huang) Red Atractylodes (cang zhu) Red Clover (trifolium pratense) Red Ochre (dai zhe shi) Red Peony (chi shao) Red Sage Root (dan shen) Rehmannia (shu di huang) Reishi (ling zhi) Rhubarb (da huang) Rice Paper Pith (tong cao) Rose (mei gui hua) Rosemary (mi die xiang) Safflower (hong hua) Saffron (fan hong hua) Sandalwood (tan xiang) Sanguisorba Root (di yu) Sappan Wood (su mu) Sargent Gloryvine (hong teng) Saw Palmetto (ju zong lu) Schefflera (qi ye lian) Schisandra (wu wei zi) Schizonepeta (jing jie) Scirpus (san leng) Scopolia (S. carniolica Jacq.) Scorpion (quan xie) Scrophularia (xuan shen) Scutellaria (huang qin) Sea Cucumber (hai shen) Sea Horse (hai ma) Seaweed (hai zao) Selaginella (shi shang bai) Senna (fan xie ye) Shiitake (hua gu) Siegesbeckia (xi xian cao) Siler Root (fang feng) Slippery Elm (ulmus fulva) Smilax (tu fu ling) Smithsonite (lu gan shi) Sophora Flower (huai hua mi) Sophora Root (ku shen) Spirodela (fu ping) Stellaria (yin chai hu) Stemona (bai bu) Stephania (fang ji [han]) Sweet Annie (qing hao) Teasel Root (xu duan) Tiger Bone (hu gu) Torreya Seed (fei zi) Tortoise Plastron (gui ban) Tremella (bai mu er) Trichosanthes Fruit (gua lou) Trichosanthes Root (tian hua fen) Trichosanthes Seed (gua lou ren) Tsaoko Fruit (cao guo) Turmeric (jiang huang) Turtle Shell (bie jia) Tussilago (kuan dong hua) Urtica (xun ma) Uva ursi (arctostaphylos uva-ursi) Vaccaria Seed (wang bu lui xing) Valerian (jie cao) Veratrum (li lu) Viola (zi hua di ding) Vitex (man jing zi) Walnut (hu tao ren) Watermelon (xi gua) White Atractylodes (bai zhu) White Mustard Seed (bai jie ze) White Peony (bai shao) Wild Asparagus (tian men dong) Windmill Palm (zong lu pi/tan) Xanthium (cang er zi) Zedoary (e zhu) 
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Understanding Drug-Nutrient Interactions: An Overview
By Brandon Blood, DC and Todd Mexico, DC "As Americans consume increasingly complex combinations of prescription medications and nutritional supplements, the concern for adverse events attributable to interactions between them increases accordingly." — Christopher Borgert, PhD, president of Applied Pharmacology and Toxicology - Gainesville, Fla. If you are one of the nearly 80 percent of chiropractors who recommend and sell nutritional supplements to patients, it is important to understand the basic mechanisms of these potential interactions and the at-risk population so you can act accordingly. Between 1994 and 2006, the number of adult Americans who reported using at least one nutritional supplement jumped from 42 percent to 53 percent, according to the CDC.1 Most experts agree that currently, as many as 60 percent of American adults use at least one nutritional supplement. It is also well-documented that at least 50 percent of U.S. adults take one prescription medication, and that close to 20 percent take three.2 Several reports have also demonstrated that many prescription drug users are also taking nutritional supplements in conjunction with these medications. In fact, over 50 percent of people using at least one nutritional supplement combine this use with a drug.3 Put into perspective, if these 2006 statistics are true today, then at the very least, 15 million Americans are at risk for a potential drug-nutrient interaction.4 Patients Most at Risk While it is important to consider the potential for drug-nutrient interactions with all of your patients, those at highest risk include patients with a chronic disease process (e.g., inflammatory condition); patients on multiple medications; patients with genetic variances with drug metabolism; patients with impaired organ function; patients at the end of the age spectrum; and patients who consume nutritional supplements on a chronic basis. Mechanisms of Interaction Drug-nutrient interactions occur in the body through a pharmacokinetic or pharmacodynamic mechanism. A pharmacokinetic interaction occurs because of one of the following mechanisms:4
Pharmacokinetics is also the focal point of research on drug-nutrient interactions, as these mechanisms are responsible for the disposition of the drug / nutrient as it is processed in the intestine and liver. It is important to understand that a pharmacokinetic interaction can be antagonistic or synergistic and that any substance (natural product) may interact with a drug by altering any one or combination of these systems. Pharmacokinetic interactions most commonly occur because the nutritional supplement has an impact on one of the following drug-metabolizing enzymes or drug transporters, causing either an increase in the drug's toxicity or decrease in the drug's efficacy, both of which can have an impact on the patient's health: Drug-metabolizing enzymes: cytochrome P450 (CYPs); uridine diphosphoglucuronyl transferases (UGTs); and glutathione S-transferases. Drug transporters: P-glycoprotein; organic anion transporting polypeptides (OATPs). A pharmacodynamic interaction is the result of an additive, synergistic or antagonistic effect of the supplement's physiological properties in combination with the drug's properties. A classic example is when medications that have antiplatelet activity are combined with a nutritional supplement with antiplatelet activity, potentially leading to increased bleeding. Not all drug-nutrient interactions result in a negative outcome. Many supplements may be recommended as a beneficial addition to help improve the target action of a medication based on their pharmacodynamic properties. It is important to analyze all of the medications and nutritional supplements patients consume. It is perhaps equally important to document results in a manner that exhibits due diligence from a medicolegal standpoint. If you make supplement recommendations, every patient history should include questions about drug-nutrient use and advice should be dispensed accordingly. References
Drs. Todd Mexico and Brandon Blood, who are both 2006 graduates of Palmer College of Chiropractic Florida, are the president and vice president, respectively, of eMedFx.com. Dr. Mexico practices in Baldwinville, Mass., while Dr. Blood maintains a practice in Canton, Ohio. |
Nutritional Wellness News Update:
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