instalment 8: more useful dietary supplements

As this instalment was posted on 1 January 2022, I offer my best wishes to everyone for a Happy New Year! May it be filled with health and love and fulfilment!

Fish oil capsules

I’ve been taking, every other day, a fish oil capsule (1200 mg, containing 500 mg EPA and 250 mg DHA) in order to make up for only rarely eating fish on my plant-based diet (see instalment 2, on fatty fish, about omega-3 and omega-6 fatty acids and their influence on inflammation). However, after recently viewing the Netflix documentary Seaspiracy, I can no longer in good conscience take fish oil. And it’s really unnecessary. Long-chain omega-3 fatty acids are not made by fish in any case; they are made by algae, and become part of the marine food chain when those algae are consumed by krill which are then eaten by fish. It’s now possible to obtain algal omega-3 fatty acids. However, the relative content of EPA and DHA varies, and I’m still doing the research into which brand of algal omega-3 capsules will provide both quality and value.

Interestingly, fish oil omega-3 supplements have been declared useless in recent research articles that have received widespread publicity. But I disagree with that research and take issue with the publicity; see my essay “When medical research reports negative results, follow the money!”

As a psychiatrist, I initially became interested in omega-3 fatty acids when I learned that insufficient intake predisposed people to depression. Together with the psychiatry residents I was supervising, we put together and presented several conferences on this topic.

Vitamin D

Vitamin D consists of a number of compounds; in humans, the most important are vitamin D3 (cholecalciferol) and D2 (ergocalciferol). As only a few foods contain vitamin D, the most important source is synthesis of D3 in the skin through the action of ultraviolet light. Given the concern about skin cancer, this has become an unreliable source for many people who either avoid sun exposure or use sunblocking agents.

Vitamin D acts directly on immune cells, and its deficiency has been implicated as causative in a number of autoimmune disorders as well as susceptibility to various infections including COVID-19¹. Unfortunately, the evidence that taking vitamin D supplements will actually help is mixed, although this may be the result of influences discussed in When medical research reports negative results, follow the money!.

It does appear, however, that vitamin D supplementation lowers insulin levels², so I feel justified in taking a small dose of vitamin D3 (1000 IU, or 25 mcg) every other day.

Melatonin

Melatonin, a hormone secreted by the pituitary gland, regulates sleep and wakefulness. Melatonin administration has been shown to inhibit insulin release³. As melatonin levels decrease with age, it is possible that the resulting higher insulin levels contribute to the conditions of aging including chronic inflammation.

I take 10 mg of double action melatonin every night, just when I get into bed. Double action refers to a portion which is immediate release and a second portion which is timed release.

Choline

Humans eating diets low in choline develop fatty liver and liver damage⁴. Adequate dietary intakes for adults are considered to be 550 mg per day , but this is based on very little evidence. Since good dietary sources of choline, such as eggs or liver, are not part of my methionine and protein restricted diet, I take a capsule of triple lecithin containing 420 mg of choline, every other day.

Magnesium

Low magnesium intakes and blood levels have been associated with type 2 diabetes, metabolic syndrome, elevated C-reactive protein, hypertension, atherosclerotic vascular disease, sudden cardiac death, osteoporosis, migraine headache, asthma, and colon cancer⁵. The recommended dietary allowance is about 300 mg per day, but less than half the U.S. population consumes the required amount⁶. The richest dietary sources are whole grain cereals, green vegetables, beans, nuts, and seafood⁷. As the healthy kidney is very effective at excreting magnesium, hypermagnesaemia is uncommon.

Supplemental magnesium lowers fasting insulin levels⁸.

Because the low methionine, low protein diet excludes a number of rich dietary sources of magnesium, I take a supplement of magnesium citrate 150 mg every other day.

Boron

Boron affects bone growth, alleviates arthritic symptoms, and is associated with reduced risk for some cancer types⁹. Other beneficial effects have been recently reviewed¹⁰. Although boron is found in fruits and vegetables, especially nuts and pulses, boron deficiency is the second most important micronutrient constraint in crops after that of zinc on global scale.

The Office of Dietary Supplements of the U.S. National Institutes of Health reports that “Observational evidence combined with the findings from a few small clinical studies in humans suggests that boron might be helpful for reducing the symptoms of osteoarthritis, possibly by inhibiting inflammation”.

It has been reported¹¹ that rats deprived of boron had significantly higher plasma insulin concentrations than rats supplemented with boron, based on research by Bakken et al¹².

It is believed that boron intake needs to be 3 mg/day or higher¹³. The World Health Organization estimates that an “acceptable safe range” of boron intakes for adults is 1–13 mg/day, according to the NIH. I take a supplement of 3 mg every other day.

That does it for the dietary supplements I recommend as part of a regimen to control inflammation!

I note that this is a popular topic these days. Joe Schwarcz had a column on 2021-12-31 in the Montreal Gazette on avoiding chronic inflammation. Go Joe!

In the next instalment, we will look at medications that lower insulin. Can these medications reduce chronic inflammation? Read instalment 9 to find out!

1. Ao T, Kikuta J, Ishii M. The Effects of Vitamin D on Immune System and Inflammatory Diseases. Biomolecules. 2021;11:1624. PMID 34827621 ↩
2. Zhang Y, Xue Y, Zhang D et al. Effect of Vitamin D Supplementation on Glycemic Control in Prediabetes: A Meta-Analysis. Nutrients. 2021;13:4464. PMID 34960022 ↩
3. Srinivasan V, Ohta Y, Espino J et al. Metabolic syndrome, its pathophysiology and the role of melatonin. Recent Pat Endocr Metab Immune Drug Discov. 2013;7:11-25. PMID 22946959 ↩
4. Mehedint MG, Zeisel SH. Choline’s role in maintaining liver function: new evidence for epigenetic mechanisms. Curr Opin Clin Nutr Metab Care. 2013;16:339-345. PMID 23493015 ↩
5. Rosanoff A, Weaver CM, Rude RK. Suboptimal magnesium status in the United States: are the health consequences underestimated. Nutr Rev. 2012;70:153-164. PMID 22364157 ↩
6. Rosanoff A, Weaver CM, Rude RK. Suboptimal magnesium status in the United States: are the health consequences underestimated. Nutr Rev. 2012;70:153-164. PMID 22364157 ↩
7. Ayuk J, Gittoes NJ. Contemporary view of the clinical relevance of magnesium homeostasis. Ann Clin Biochem. 2014;51:179-188. PMID 24402002 ↩
8. Veronese N, Dominguez LJ, Pizzol D, Demurtas J, Smith L, Barbagallo M. Oral Magnesium Supplementation for Treating Glucose Metabolism Parameters in People with or at Risk of Diabetes: A Systematic Review and Meta-Analysis of Double-Blind Randomized Controlled Trials. Nutrients. 2021;13:4074. PMID 34836329 ↩
9. Nielsen FH. Update on human health effects of boron. J Trace Elem Med Biol. 2014;28:383-387. PMID 25063690 ↩
10. Pizzorno L. Nothing Boring About Boron. Integr Med (Encinitas). 2015;14:35-48. PMID 26770156 ↩
11. Dubey P, Thakur V, Chattopadhyay M. Role of Minerals and Trace Elements in Diabetes and Insulin Resistance. Nutrients. 2020;12:E1864. PMID 32585827 ↩
12. Bakken NA, Hunt CD. Dietary boron decreases peak pancreatic in situ insulin release in chicks and plasma insulin concentrations in rats regardless of vitamin D or magnesium status. J Nutr. 2003;133:3577-3583. PMID 14608076 ↩
13. Pizzorno L. Nothing Boring About Boron. Integr Med (Encinitas). 2015;14:35-48. PMID 26770156 ↩

• ← instalment 7: dietary supplements that may be helpful
• instalment 9: prescription medications that may be helpful in certain situations →