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Other Names: Retinol, Beta-carotene Uses: Eyesight, Aging Dosing: <10,000 IU daily - <5,000 IU if pregnant
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Other Names: Thiamine Uses: Alcohol Dependency |
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Other Names: Riboflavin Uses: Migraines, Cataracts Notes: Diarrhea (large doses) |
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Other Names: Niacin Uses: Increases HDL, Decreases TG Dosing: 1-3g daily Notes: Flushing/itching/headache: >50mg Liver toxicity: >1.5g niacin |
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Other Names: Pantothenic Acid Uses: Stamina Notes: Royal Jelly (bees) |
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Other Names: Pyridoxine Uses: Nausea/vomiting (pregnancy) Notes: Need adequate folic acid Sensory neuropathy at high doses (>1g) |
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Other Names: Folic Acid Uses: Neural tube defects, decreases side effects of methotrexate Dosing: 400mcg QD Notes: May mask pernicious anemia Replenish in chronic alcoholics |
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Other Names: Cyanocobalamin Uses: Pernicious anemia Notes: Consider folate use (masks B12 deficiency) PO equivalent to IM Replenish in chronic alcoholics |
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Other Names: Ascorbic Acid Uses: Common cold, iron absorption Dosing: <2g QD Notes: Kidney Stones (>1g QD) |
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Other Names: Ergocalciferol (D2) Cholecalciferol (D3) Uses: Osteoporosis Fall prevention Dosing: 400 IU 0-12 months 600 IU 1-70 y 800 IU >70 y (may need more) Notes: |
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Other Names: Alpha-tocopherol Uses: Dementia, AMD, Tardive Dyskinesia, CVD/scarring Dosing: <400 IU/Day (unhealthy) Notes: >800 IU/Day increases bleeding risk |
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Other Names: Phytonadione Uses: Bleeding (related to warfarin) Notes: Counteracts warfarin, found in green leafy veggies |
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Uses: Osteoporosis, antacid Dosing: 1000-1200mg/Day Notes: No more than 500mg at a time. Calcium Carbonate: inexpensive/less pills/acid dependent Calcium citrate: expensive/large pills/more pills/acid independent |
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Uses: Anemia Notes: Constipation, Vitamin C helps absorption Separate: Biphosphates/levodopa/methyldopa/antibiotics |
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Uses: Antioxidant, Eye health Notes: Food is the best source |
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Uses: Antioxidant Notes: Better availability in heat-processed food |
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Uses: Constipation, Pre-eclampsia, Headaches/PMS Notes: AE: diarrhea |
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Uses: Common Cold Notes: Avoid nasal gel Beware of cadmium exposure |
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Uses: Weight loss, athletic performance AE's: Prolongs QT interval Potential Cardiac Effects Counseling Points: Related to ephedrine Banned by many sports organizations |
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Uses: Menopause Contraindicated in: pregnancy (causes uterine contractions) Efficacy: Modest AE's: Reports of liver damage (if long-term use; check LFTs periodically) Counseling Points: Doesn't stimulate estrogen-dependent tumors Doesn't work for hot flashes in breast cancer survivors Takes several weeks to take effect |
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Uses: Common Cold Contraindicated in: asthma, ragweed allergy, atopy, allergic rhinitis Efficacy: limited, may decrease cold duration/severity by 10-30% AE's: Well tolerated Counseling Points: No standardization Likely safe, likely ineffective |
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Uses: Weight loss, athletic performance AE's: MI, Arrhythmia, Stroke, Psychosis, Seizures, Death Counseling Points: Do not recommend |
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Uses: Cholesterol (dec. TG's, may inc. LDL) Efficacy: Good AE's: Fishy Burp, halitosis, heartburn, loose stool Counseling Points: Take with meals or freeze caps to minimize AE's May inhibit platelet aggregation Contamination concerns |
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Uses: Menopause(40g/day), Cholesterol, HTN, Constipation Efficacy: Weak evidence AE's: bloating, flatulence, diarrhea Counseling Points: 40g has high fat content and ~200 calories |
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Uses: HTN, Cholesterol Efficacy: Limited (decreases SBP 7-8%) None (recent studies) AE's: Heartburn, flatulence, breath and body odor Counseling Points: Odorless garlic doesn't work as well Interacts with warfarin, antiplatelet agents, anticoagulants. Induces 3A4 at high doses. |
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Uses: Dementia Efficacy: Mild to moderate. Recent trials: not effective. AE's: GI complaints, bleeding (stop 2 weeks before surgery) Counseling Points: Ginkgotoxin can cause seizures (found in seeds) Interacts with anticoagulants and antiplatelet agents (increased bleeding) Takes 6-8 weeks to see improvement |
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Uses: Common cold, Cognitive function, Sexual function, General well-being Efficacy: ?? AE's: Headache, Insomnia Counseling Points: Interacts with: warfarin (increases clotting) anticoagulants (increases bleeding) loop diuretics (diuretic resistance) Bitter orange (prolongs QT interval) |
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Uses: Osteoarthritis Efficacy: Mixed results AE's: Mild GI upset Counseling Points: Derived from exoskeleton of shellfish (not meat); or produced synthetically Allergy issues Sulfate salt used most in RCTs |
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Uses: Common Cold Contraindicated in: nursing mothers Efficacy: none AE's: Well tolerated Counseling Points: Accumulation of active ingredient in breast milk may cause kernicterus in newborns |
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Uses: Weight loss Efficacy: Possibly effective but products of questionable quality AE's: Well tolerated Counseling Points: More is being sold than there are plants in existence |
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Uses: Insomnia Efficacy: Good Counseling Points: Regulates circadian rhythms. High doses may inhibit ovulation. |
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Uses: Menopause Efficacy: Negligible AE's: Headache Counseling Points: Avoid if taking tamoxifen or history of breast cancer. Increased risk of bleeding with antiplatelet agents or anticoagulants |
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Uses: Depression Efficacy: Modest in limited number of RCTs AE's: Well tolerated Counseling Points: Increases serotonin (serotonergic effects). Issues with product quality and cost. |
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Uses: BPH Efficacy: Similar to 5-alpha reductase inhibitors. Inferior to alpha-1 blockers. AE's: Dizziness, HA, GI complaints Counseling Points: Takes 1-2 months to see improvement. |
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Uses: Menopause Cholesterol "reduces the risk of heart disease" (protein) Osteoporosis, Diabetes Efficacy: Modest benefit -- takes up to 2 months to work AE's: Well tolerated Counseling Points: Protein from foods better than supplements (safer, more evidence). Avoid if taking tamoxifen or history of breast cancer. "Unopposed phytoestrogens" probably OK; use food sources instead of supplements |
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Uses: Depression Efficacy: Effective for mild/moderate depression AE's: Nausea, Insomnia, Vivid dreams, restlessness, fatigue, dry mouth, photosensitivity Counseling Points: Similar to SNRI's. Takes 3-4 weeks for maximal effect; taper when discounting. Induces 3A4; benzos, oral contraceptives, protease inhibitors, warfarin |
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Uses: Insomnia Efficacy: Looks good but more trials needed AE's: HA, nervousness, excitability, hepatotoxicity (rare) Counseling Points: Benzo-like effects at GABA receptors. Taper when discontinuing. May inhibit 3A4. |
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