Your health questions answered by leading doctors and
nutritionists
‘One of my friends takes both
glucosamine and MSM. I am just taking glucosamine chondroitin. Is
there any particular reason for taking MSM with glucosamine? And
what are the additional benefits?’
N Masterton, Shropshire
The beneficial effects of glucosamine may be improved by combining
it with other substances needed during regeneration of cartilage
such as chondroitin, MSM (methyl-sulphonyl-methane) and vitamin C.
In general, each of the main supplements taken for joint problems
helps two out of three people, and it is a question of trying one
for, say, 3 months, to evaluate your response. Many people respond
well to taking glucosamine alone and, as this is the cheapest
option, I usually suggest someone starts with this first. Then, if
they are not entirely happy with the response, they can move up a
level and combine glucosamine with chondroitin, or MSM, or both.
MSM helps to stabilise the connective tissues found in cartilage,
tendons and ligaments and also appears to have an anti-inflammatory
action to reduce pain and swelling. If you are satisfied with
glucosamine plus chondroitin alone, then there is no particular
need to take MSM too. If you are feel there is still room for
improvement you could add in MSM to see if this provides additional
benefit. If inflammation is a particular problem, you might also
consider omega-3 fish oils, green-lipped mussel extracts or
devil’s claw. It is not always obvious which supplements will
suit which people so you may need to experiment with combinations
to find the right one for you. This will not always be the same
combination that suits your friends and neighbours.
Dr Sarah Brewer
‘I have read that fat-soluble
vitamins including A, D and E, where excess intake is stored rather
than excreted, can be harmful if too much is taken. I now see that
in your 50 Plus product, each tablet contains well over 100% RDA of
these three vitamins. Surely this, plus more taken via, one hopes,
a healthy diet, gives too high a daily level of these
vitamins?’
L Sargent, Middlesex
One would hope that an individual would get all the nutrients they
need from a healthy diet; however, this ideal is not often a
reality. Sometimes a healthy diet doesn’t provide the RDA of
a particular vitamin. The recommended daily amount is the quantity
of a nutrient that is needed to keep most people fit and healthy
and to help them avoid nutrient deficiency. This is where
supplements come into play, to ensure that someone is getting
enough of the nutrients they need. Looking at vitamins A, D and E
it is true that when taken in excess they may cause problems.
However, long-term daily intake from supplements of 2300mcg of
vitamin A, 10mcg of vitamin D and 800mg of vitamin E is believed to
be safe. In fact the safe upper limit is even greater for the
intake from diet and supplement combined. Using vitamin E as an
example, a normal diet provides on average between 7.2 - 9.9mg; the
safe maximum supplement intake is 800mg. However, the total amount
from both diet and supplement believed to be safe is 1000mg. The
amounts contained within the 50 Plus multivitamin are within the
safe upper limits even, if hopefully, you eat a healthy diet.
Dr Rob Hicks
‘I am 77 and have been taking
Retinex for sometime as an aid to macular degeneration. I have
recently been diagnosed with arterial fibrillation and prescribed a
beta blocker and aspirin (75 mg p/d). Is it alright to continue
with Retinex tablets. The Retinex has considerably helped my eyes
and I should be extremely grateful for your advice.’
M Anderson, London
Retinex contains lutein and zeaxanthin - two pigments found
naturally in yellow, orange, red and dark green fruits and
vegetables such as sweetcorn, spinach, pumpkin and tomatoes. Lutein
is also found in egg yolk, contributing to its rich yellow-orange
colour. Lutein and zeaxanthin are vital for healthy vision and to
help protect against age-related macular degeneration and
cataracts. They protect the eyes partly because of their
antioxidant activity (which neutralises harmful chemical reactions
involved in light detection) and partly because their yellow colour
filters out harmful light at the blue end of the spectrum. There do
not appear to be any significant known drug interactions with
either lutein or zeaxanthin.
Dr Sarah Brewer
‘I have heard that taking evening
primrose oil helps with PMS. What daily dose should I be taking and
should I be taking an increased dose at certain times of the month.
Is there any other supplement that might help?’
Sally Gethings, Wiltshire
EPO is a natural source of essential fatty acids, specifically the
omega-6 fatty acid gamma linoleic acid. This fatty acid is involved
in the manufacture of prostaglandin E1, which can reduce the
activity of prolactin - a hormone which may be responsible for
symptoms of PMS. Research confirms that EPO can relieve the
symptoms of PMS. For example, one British study found that 67% of
women with PMS treated with EPO became symptom free, while another
22% had significant relief. In another study abdominal swelling and
breast discomfort were eradicated in 95% of those treated. But you
need to take EPO for at least 6 to 8 weeks before you can expect to
feel improvements. The usual dose is 500mg twice daily, throughout
the month. Another natural supplement which may inhibit the
secretion of prolactin is Agnus Castus or Chasteberry. Recent
research from Germany showed a 52% reduction in PMS symptoms with a
dried extract of this plant. You should also make sure that your
diet is rich in magnesium, calcium and potassium, which are
important in keeping PMS at bay. Finally Vitamin B6 can reduce
general PMS symptoms and particularly depression. The recommended
dose is up to 100 mg/day
Dr Trisha Macnair
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