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Q & A

Can you get any smarter than you already are?
IN THE TOPIC: BRAIN HEALTH
Fatigue has wrongly been viewed in our society as “the price you pay” to get ahead, or even by some as a “badge of honor” to climb that ladder in corporate America, earn that title of “surgeon”, or get those straight A’s in the classroom. For some, fatigue is simply the result of all the distractions of modern day living—always one more email to read, another topic to surf on the web, or another video game to master. The boom in caffeine consumption across America probably tells us something about how much sleep people are getting.
In the military aviation environment as well as the civilian workforce, experts recognize this view of fatigue costs lives through its effect on brain performance–your memory, communication, patience, and ability to make good decisions. The effects of fatigue on brain performance are similar to drinking alcohol. A new study suggests that an afternoon power nap may boost your ability to process and store information tenfold! However, this is only if you dream while you’re asleep. The study, conducted at the Center for Sleep and Cognition at Beth Israel Deaconess Medical Center, in Boston, Massachusetts reveals the importance of naps and the dream (“or REM”—Rapid Eye Movement) period. “In the dream…the brain tries to figure out what’s important and what it should keep or dump because it’s of no value.” Also, did you know that during REM is when your body releases the most growth hormone? Did you know that alcohol and certain drugs can interfere with your ability to dream while sleeping even though you are “asleep” or the drug “makes you sleepy”? Bottomline, quality sleep and REM is critical to your brain’s “smartness” as well as your overall physical health.
What nutrients can make you smarter? Fish oil that is high in the Omega-3s called EPA/DHA seem to play a critical role both throughout fetal development, early infancy/childhood, and into adulthood affecting mood and cognition. DHA seems especially critical in cognition and memory specifically. Why? These fatty acids seem to have a critical role in neuronal cell function through allowing the cell wall to remain “fluid”. This allows them to transmit important signals and optimize the health and function of neurons and other cells.

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What oil in fish lowers triglycerides?
IN THE TOPIC: TRIGLYCERIDES
Bottom Line Up Front: Omega-3 EPA/DHA in fish oil lowers triglycerides. Triglycerides are an important component of your total cholesterol and a major risk factor for heart disease. Therefore, when looking at fish oil supplements to reduce cholesterol and triglycerides, you want to choose fish oil supplements with the highest concentration of EPA and DHA per capsule but balancing the cost factor as well (the higher the concentration of EPA and DHA in each fish oil capsule, the higher the cost because of the added manufacturing steps required). You can get this information by carefully reading the “Nutritional Facts Label” on the back of the supplement but be sure to also read the serving size (some read “2 capsules”).
Fish Oil as a Drug to Lower Triglycerides: There is a drug now on the market that is nothing more than highly concentrated fish oil Omega-3 EPA/DHA (46% EPA and 38% DHA) that is prescribed to lower triglycerides. There is another drug that is pure EPA which is used to treat “clogging” of the heart vessels and reduce triglycerides. So, there is no doubt that fish oil high in Omega-3 EPA/DHA will reduce triglycerides. But remember to always read the label because not all fish oil supplements are high in EPA/DHA.
Bonus Fact: Even if you don’t have high triglycerides or are already taking another drug to lower your cholesterol, consider talking to your doctor about adding fish oil high in Omega-3 EPA/DHA to your daily regimen for added wellness and reduce the “clotting” tendency of the blood.

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What is the role of fish oil in high cholesterol?
IN THE TOPIC: CHOLESTEROL
Bottom Line: Fish Oil contains 2 important fatty acids called EPA and DHA (eicosopentaenoic acid and docosahexaenoic acid) which lower your triglyceride level (part of your total cholesterol calculation) and have a host of other benefits for your heart. 1-5 grams per day of fish oil has been shown to lower triglycerides by 20-50%! Fish oil high in EPA and DHA is so powerful, there is a prescription fish oil drug on the market now that doctors can prescribe for elevated triglycerides that contains high amounts of EPA/DHA in each capsule (about 840mg per capsule). The dose of the drug is 4 grams (4 capsules) per day.
Why is this important? Reducing your cholesterol reduces your risk for developing heart disease. Triglycerides are an important component of your total cholesterol (the other 2 components are LDL and HDL). Fish oil also slightly increases your HDL which is your good cholesterol. This is an added benefit to consuming fish oil. Although slight increases in LDL have been reported in some patients, this has not been shown to be clinically relevant.
Background: Remember that the beauty of fish oil is that it is a natural substance found in a supplement or a diet rich in oily fish (or now in a drug as well). It has a lot of other benefits for your heart besides the reduction in cholesterol such as lower inflammation and lower “stickiness” of the blood and clotting tendency. You don’t want to wait until you have high cholesterol to be pro-active and do a great thing for your heart: add fish oil to your diet. The fact that it is a drug should tell you that something about the power of fish oil to treat but I prefer to prevent when possible.
Before You Use: They key is to checking the EPA and DHA levels of the fish oil supplement you use in each capsule. Not all fish oil supplements have high levels and most are quite low. Remember to also check the serving size when reading the nutritional label to ensure you divide by two if it says “2 capsules.” For cholesterol reduction, get a high EPA/DHA ratio and while balancing cost, try to get a high concentration of total EPA/DHA per capsule.

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What is SAMe?
IN THE TOPIC: DEPRESSION
SAMe is a chemical (S-adenosylmethionine) that is found naturally in the body and brain but it can also be made in the laboratory. Concentrations are highest in childhood but then decrease with age. SAMe plays an essential role in more than 100 biochemical reactions within the body. It contributes to the synthesis and metabolism of hormones, neurotransmitters (signaling molecules in the brain), phospholipids (structural building blocks of cells walls). It plays a role in pain, depression, liver disease, and other conditions. People who don’t make enough SAMe naturally may be helped by taking SAMe as a supplement. SAMe increases a brain chemical called serotonin. Many common medications for depression also increase the brain chemical serotonin. SAMe supplementation may also work by altering cellular membrane fluidity, increasing transmission of signals. Neuroimaging studies and EEGs (brainwave analysis) confirm that SAMe affects the brain similarly to conventional antidepressants.
Background: SAMe has been available as a dietary supplement in the US since 1999, but it has been used as a prescription drug in Italy since 1979, in Spain since 1985, and in Germany since 1989. Researchers discovered the potential usefulness of SAMe for treating osteoarthritis by chance. They were studying SAMe’s effect on depression when the patients they were following reported an improvement in their osteoarthritis symptoms. SAMe supplementation may be beneficial in osteoarthritis due to analgesic (pain blocking) and anti-inflammatory effects as well as its possible role in re-building damaged cartilage.
Uses: SAMe is used for depression, anxiety, heart disease, fibromyalgia, osteoarthritis, bursitis, tendonitis, chronic lower back pain, dementia, Alzheimer’s disease, slowing the aging process, chronic fatigue syndrome (CFS), improving intellectual performance, liver disease, and Parkinson’s disease. It is also used for attention deficit-hyperactivity disorder (ADHD), multiple sclerosis, spinal cord injury, seizures, migraine headache, and lead poisoning. Some women use SAMe for premenstrual syndrome (PMS) and a more severe form of PMS called premenstrual dysphoric disorder (PMDD).
It seems most effective as “nutritional armor” for depression and osteoarthritis. It is safe for most people. Don’t take it if you have been diagnosed with bipolar disorder, however. I am exploring the use of SAMe with Omega-3 EPA/DHA fish oil and neurofeedback for brain health.

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What is melatonin?
IN THE TOPIC: HORMONES
Melatonin is a hormone found naturally in the body and is produced by a gland in the center of the brain called the pineal gland. It is secreted when you visually see that it is becoming dark outside to trigger you to get sleepy and regulate your normal sleep patterns and keep your “internal biological clock” on time. Melatonin can also be found in over the counter supplements (or prescription medicine in some countries) and therefore can be made synthetically in a laboratory. It is most commonly available in pill form, but melatonin is also available in forms that can be placed in the cheek or under the tongue. These other forms allow the melatonin to be absorbed directly into the body. I have found melatonin works great in my pilots and professional athletes to help them maintain their operational readiness when changing time zones due to travel schedules or having problems sleeping for other reasons. It improves the quality of sleep versus prescription drugs which can decrease the quality of the sleep and have more side effects (being a detriment to performance upon awakening).

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How is melatonin used?
IN THE TOPIC: HORMONES
People use melatonin to adjust the body’s internal clock(what is called a “circadian rhythm”) which is maintained normally by melatonin secreted from a gland in the brain when your eyes see it is becoming dark outside. Think of your circadian rhythm has being a whole host of biological functions inside that occur based on what time it is in your sleep wake cycle. If a battery keeps a clock working, melatonin does likewise for your body’s hormonal systems. It is my first line choice for anyone having trouble with sleep in combination with good sleep hygiene techniques.
It is used for jet lag, for adjusting sleep-wake cycles in people whose daily work schedule changes (shift-work disorder), and for helping blind people establish a day and night cycle. I use it extensively in pilots in the US military to help reduce the downtime from jet lag and improve operational performance. It is also useful when people have odd jobs and don’t get exposed to normal cues of sunlight and darkness and have trouble falling asleep at night. I also recommend it in professional athletes I work with because it is non-addictive and has fewer side effects without leaving you “groggy” and unable to perform your best the next day. Melatonin is also used for the inability to fall asleep (insomnia); delayed sleep phase syndrome (DSPS); insomnia associated with attention deficit-hyperactivity disorder (ADHD); insomnia due to certain medications; and sleep problems in children with developmental disorders including autism, cerebral palsy, and mental retardation. It is also used as a sleep aid after discontinuing the use of benzodiazepine drugs and has much fewer side effects than this prescription sleep aids.
Other interesting uses: reducing anxiety before surgery, helping decrease symptoms in people who are quitting smoking, improving the effectiveness of certain cancer medications used to fight tumors.
Dosages: For insomnia: 0.3-5 mg at bedtime is a typical dose. In children with insomnia due to delayed sleep onset, melatonin 5 mg at 6:00 PM daily. In children with developmental disorders (including cerebral palsy, autism, and mental retardation), melatonin 5 mg at 8:00 PM daily. For jet lag: 3-5 mg at bedtime is commonly taken on the arrival day at the destination, continuing for 2-5 days.

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What is creatinine?
IN THE TOPIC: BLOOD
Creatinine should not be confused with creatine, the popular dietary supplement. Creatinine is a break-down product of creatine phosphate found in muscle (which your body needs for energy conversion and gets from your diet or a dietary supplement), and is usually produced at a fairly constant rate but is dependent on body mass. As a breakdown product of the energy system of muscle, creatinine is not useful to the body and is mostly removed through the kidneys through filtering urine. If there is a problem with renal function (kidney function), blood levels will rise and therefore, measuring serum (from blood) creatinine is a simple test and it is a common indicator of renal function.

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