Following a comprehensive review, Campbell et al. concluded that, regardless of its therapeutic efficacy as an antidiabetic drug, the use of metformin results in a reduction in all-cause mortality, including cancer and cardiovascular disease.

Dr. Alfonso Galán González – Neolife Medical Team

Metformin and Microbiota 

Metformin also alters our microbiota – the bacteria that live with us in symbiosis in our gut – and this action is a determining factor in both its positive hypoglycemic and “anti-aging” effects. 

The numerous health benefits associated with the use of metformin in treating patients with type 2 diabetes (DM2), together with data from preclinical animal studies, such as in the worm (nematode) C. Elegans and in mice, have prompted research into whether metformin also has effects as an anti-aging drug capable of increasing our longevity. In fact, several clinical trials such as MILES (Metformin In Longevity Study) and TAME (Targeting Aging with Metformin) have been designed to evaluate these potential benefits of metformin as an anti-aging drug and to overcome the doubts that the current evidence raises. 

In this blog post, we would like to explain in a simple way what we know today about its influence on the state of health and longevity in humans and other species and the mechanisms proposed for these actions.

Metformin

Metformin is an antidiabetic drug, specifically a synthetic biguanide, which is used orally and improves insulin sensitivity. It is a first-line hypoglycemic drug for the treatment of type 2 diabetes mellitus (DM2). Metformin was first synthesized in 1922 when the purported medicinal properties of a plant, the French lilac () were investigated. Metformin was introduced to treat DM2 in France in 1958, and today, more than 60 years later, it is still used daily by some 150 million people worldwide. 

It is an inexpensive, safe drug (the main adverse effect, which occurs in 20-30% of patients, is intestinal discomfort)… and it is effective. 

The use of metformin leads to weight loss in many patients and lowers HbA1c (glycated hemoglobin or glycosylated hemoglobin, a fundamental marker for monitoring DM2, and which indicates the evolution of our blood sugar levels in the last 2-3 months).  

Its use was strongly supported by the publication in 1998 of the UKPDS study, a 20-year prospective, randomized, multicenter study of patients with DM2 on metformin, which reported cardiovascular benefits of its use.  

Because metformin is so widely used, there is an opportunity to determine whether metformin has anti-aging properties.  

And what do we call anti-aging? We could say, and we hope you agree with us on this definition, that something has an anti-aging effect if it positively affects the duration of health, the period of life spent in good health and free of crippling diseases.

In this blog post, we are going to summarize what is typically very complex information, which might help us answer, …or not, the question of whether metformin has other positive effects on the aging process, in addition to its effects as a hypoglycemic agent.  

The presumed relationship between metformin and aging

Based on a systematic review of 53 studies, with a total population of more than 400,000 people, Campbell et al. concluded that, regardless of its therapeutic efficacy as an antidiabetic drug, the use of metformin results in a reduction in all-cause mortality, including cancer and cardiovascular disease2. This seems like a very interesting starting point in the investigation of the properties of a drug, doesn’t it? 

AMPK and mTOR

Metformin appears to act on the AMPK and mTOR metabolic pathways (which we have described extensively here). Specifically, it activates the AMPK pathway and inhibits signaling through the mTOR pathway. This mTOR pathway has important functions in the regulation of cellular metabolism, including nutrient signaling and IGF-1 (Insulin-like growth factor 1) mediated growth. Signaling through mTOR is associated with accelerated aging, and dysregulation of mTOR signaling is also associated with cancer progression, inflammatory and neurological diseases, as well as DM2.  

AMPK functions as an energy sensor that coordinates multiple signals related to energy production and the control of glucose and lipid metabolism. 

It is worth noting that AMPK sensitivity decreases with age, which furthers the argument that AMPK activators, such as metformin, may delay aging. 

Microbiota

Studies conducted on worms (C. Elegans) and mice, indicate that adding metformin to the diet may delay aging and increase the life expectancy of these beings. 

However, we also know that in these studies with C. Elegans, very high concentrations of metformin were used, which would be equivalent to about 5 kg of metformin daily for a human being. For an idea of magnitude here, the usual doses for treating type 2 diabetes (DM2) are between 850 mg and 2 g/day. 

Such doses in humans would be fatal, and the same would be expected for the C. Elegans, but in them, it appears that the toxicity is offset by the effects of metformin on the microbiota and inhibition of bacterial folate metabolism. 

These same effects have, of course, been investigated in humans. And indeed, metformin also alters our microbiota – the bacteria that live with us in symbiosis in our gut – and this action is a determining factor in both its positive hypoglycemic and “anti-aging” effects, as well as in its negative gastrointestinal adverse effects. In fact, metformin is only absorbed, it has a bioavailability of 50%, with half of what we ingest being eliminated with our bowel movements. 

Metformin, in another action that occurs in the intestine, elevates the release of GLP-1 or incretins. Incretins are part of an endogenous system involved in the physiological regulation of blood sugar. They increase insulin release in the presence of glucose, decrease glucagon release (a hyperglycemic hormone), and regulate appetite. 

This effect of metformin on the intestine is likely to be significant, so much so that metformin does not work by any route apart from orally. 

GDF15 

We also now know that metformin raises levels of something called GDF15 (Growth/differentiation factor-15) involved in weight loss and positive cardiovascular effects. In fact, in a study based on a proteomic analysis of plasma from 240 healthy, disease-free humans in the age range of 22 to 93, GDF15 was identified as the protein that correlates most positively with chronological age and is also known to reduce appetite. 

Mitochondria

Metformin seems to play an important role in the regulation of mitochondrial function and to exert a kind of quality control. It helps to eliminate damaged mitochondria and enhance mitophagy, a special form of autophagy that recycles poorly functioning mitochondria. The mitochondrion, as we may recall, is at the very core of aging, as we reported here.

Endothelial function

The endothelium (the innermost layer of our arteries) plays a fundamental role in the regulation of vascular function and is a source of a molecule like nitric oxide (NO), a vasodilator and signaling agent. Endothelial dysfunction is an early marker of cardiovascular disease. 

If we ask ourselves whether metformin can have a direct anti-aging effect on the endothelium, the answer based on clinical and preclinical data should be a clear YES, although it is true that the clinical data on this effect are difficult to separate from its effect on lowering blood sugar and improving insulin sensitivity.

Metformin directly protects the endothelium from hyperglycemia-induced dysfunction and premature senescence. 

Therefore, if it protects us from the progression of vascular diseases, we can safely say that it increases our disease-free life expectancy. 

Inflammation

Inflammation is related to all diseases associated with aging, and the aging process itself involves an inflammatory state that has come to be called Inflammaging. Several elemental studies using different cell types have reported that metformin inhibits the activation of the NF-kß inflammatory signaling pathway and downregulates the production of proinflammatory cytokines and genes that encode for the inflammatory response.

Autophagy

Autophagy is a necessary process for getting rid of damaged proteins and organelles at the cellular level and plays an important role in the regulation of cellular aging. We know that calorie restriction, which is quite popular right now, is a powerful inducer of autophagy. 

There appears to be a relationship between autophagy and metformin, but it is not clear that it can occur at the doses we would use in humans. 

Cancer

Diabetes has been associated with a higher risk of developing several types of cancer, and a retrospective study published in 2005 reported that type 2 diabetic patients treated with metformin had a lower risk of developing cancer and pointed to a possible link between metformin and the tumor suppressor LKB13. Its effect on the AMPK pathway has also been linked to its antiproliferative effects. 

The truth is that there is quite a bit of literature supporting these effects…but not all of them. 

And so, further studies, which are ongoing, are needed to prove this important link and whether it is due to metformin or simply secondary to its effects as a hypoglycemic, insulin sensitizer, or its inhibition of the mTOR pathway.

Neurological function

Diabetes causes hyperglycemia and hyperinsulinemia, and increases oxidative stress, vascular disease, and inflammation…and yes, all of these things are linked to cognitive impairment. 

There is pretty solid evidence that links the use of metformin in type 2 diabetics with cognitive improvements. The search for the precise molecular mechanism that mediates it is underway. 

Exercise

This is where we wish to place the focus of this article. 

Exercise activates AMPK, which in turn increases glucose uptake in muscles and improves insulin sensitivity, helping to offset the negative effects of obesity, diabetes, and cardiovascular disease, thereby reducing morbidity and improving health. And metformin, as we have mentioned above, has incredible effects on our health. 

Therefore, given that both exercise and metformin can improve glycemic control and that both mediate their effects through the activation of AMPK, if we combine the two, we should have an additive effect, right? 

Unfortunately, that does not appear to be the case. 

A prospective, double-blind, randomized, and controlled study in which men and women with prediabetes were put on an exercise regime for 12 weeks with placebo and metformin, or placebo only, or metformin only, reported the following results:

Both metformin and exercise improved skeletal muscle insulin sensitivity by 55% and 90%, respectively, but the combination resulted in only a 30% improvement.  

The results were similar for the effects on systolic blood pressure and C-reactive protein (CRP) -a marker of inflammation- which were reduced by 7 to 8% with metformin and exercise versus 20 and 25%, respectively, which were lowered separately. Additionally, metformin attenuated the exercise-induced increase in VO2max4. 

Additional questions about the benefits of combining metformin and exercise come from two studies with older adults. Konopka et al. reported that metformin (2000 or 1500 mg/day for those who experienced gastrointestinal discomfort) attenuated exercise-induced increases in insulin sensitivity and also reduced exercise-induced increases in mitochondrial respiration5.  

In the MASTERS (Metformin to Augment Strength Training Effective Response in Seniors) study, metformin, despite an increase in AMPK signaling, slowed the strength exercise-induced muscle hypertrophy response in healthy men and women over 65 years of age who participated in a supervised progressive resistance exercise training program for 14 weeks after a 2-week metformin treatment (1700 mg/day or placebo)6. 

And so, in view of these results, all the positive effects of metformin that we are enumerating could be overshadowed by apparently minimizing the positive adaptations that the anti-aging and pro-health measure par excellence, exercise, has on our bodies. 

Ongoing studies

There are mainly two ongoing studies that will give us that answer as to whether we may consider metformin an anti-aging drug. 

The Metformin in Longevity Study (MILES) is a double-blind study in which subjects act as their own placebo control group. It began in October 2014 and was conducted in 14 elderly participants with glucose intolerance to determine whether metformin (1700 mg/day) can cause physiological and transcriptomic changes in muscle and adipose tissue after 6 weeks of treatment. It also determined which pathways are affected by metformin and outlined possible molecular intermediates involved in metformin’s action mechanism. 

We already have data on the results of this study, although the conclusions have not been published. Preliminary analysis of the MILES results indicates that metformin can indeed induce anti-aging transcriptional changes in the tissues studied. 

The Targeting Aging with Metformin (TAME) study is a multicenter, double-blind, placebo-controlled trial that is planned to involve 14 research centers in the US and will enroll 3000 non-diabetic individuals aged 65 to 80 who will receive 1700 mg of metformin daily for 6 years. Follow-up will be at 3.5 years. 

Its objectives are: 

1. Clinical outcomes, measured as the occurrence of new age-related chronic diseases
2. Functional outcomes, such as changes in mobility
3. Biomarkers of the aging process such as inflammation and senescence  

After all this being said, as you can see, the jury is still out on whether we may consider metformin an anti-aging drug. The final results of these studies may give us the definitive verdict. We also need to know if the above mentioned study regarding exercise + metformin is really so, as it would be an almost insurmountable obstacle for its consideration as an anti-aging therapy.

BIBLIOGRAPHY

(1) Mohammed I, Hollenberg MD, Ding H, Triggle CR. A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan. Front Endocrinol (Lausanne). 2021 Aug 5;12:718942. doi: 10.3389/fendo.2021.718942. PMID: 34421827; PMCID: PMC8374068.


(2) Campbell JM, Bellman SM, Stephenson MD, Lisy K. Metformin Reduces All-Cause Mortality and Diseases of Ageing Independent of Its Effect on Diabetes Control: A Systematic Review and Meta-Analysis. Ageing Res Rev (2017) 40:31–44. doi: 10.1016/j.arr.2017.08.003  

(3) Evans JMM, Donnelly LA, Emslie-Smith AM, Alessi DR, Morris AD. Metformin and Reduced Risk of Cancer in Diabetic Patients. BMJ (2005) 330:1304–5. doi: 10.1136/bmj.38415.708634.F7 


(4) Malin SK, Braun B. Impact of Metformin on Exercise-Induced Metabolic Adaptations to Lower Type 2 Diabetes Risk. Exercise Sport Sci Rev (2016) 44:4–11. doi: 10.1249/JES.0000000000000070


(5) Konopka AR, Laurin JL, Schoenberg HM, Reid JJ, Castor WM, Wolff CA, et al. Metformin Inhibits Mitochondrial Adaptations to Aerobic Exercise Training in Older Adults. Aging Cell (2019) 18:e12880. doi: 10.1111/ acel.12880 

(6) Walton RG, Dungan CM, Long DE, Tuggle SC, Kosmac K, Peck BD, et al. Metformin Blunts Muscle Hypertrophy in Response to Progressive Resistance Exercise Training in Older Adults: A Randomized, Double- Blind, Placebo-Controlled, Multicenter Trial: The MASTERS Trial. Aging Cell (2019) 18:e13039. doi: 10.1111/acel.13039 

La entrada Metformin: An Anti-Aging Drug? se publicó primero en Neolife.

The importance of maintaining optimal vitamin D levels after menopause

The decrease in female sex hormones causes fragility and loss of bone mass, which increases the risk of developing osteoporosis and fractures, a common occurrence in women over 50 years of age. However, let’s look at how we can minimize this impact on women’s bone health.

Dr. César Montiel – Neolife Medical Team

Menopause is a vulnerable stage, from a nutritional point of view, because energy expenditure decreases (due to changes in body composition and decreased activity), while the needs for some nutrients such as vitamin D increase (1, 2). Loss of ovarian function has a profound impact on female bone health. The decrease in bone mineral density accelerates in the year prior to the last menstrual period and in the following two years (5). Although the etiology of osteoporosis is multifactorial, vitamin D intake, from the diet and from supplements, appears to have a key impact on the maintenance of bone mineral density, prevention of fractures and falls (3-4).

Vitamin D plays a central role in calcium metabolism, so adequate intake, either through the diet or by cutaneous synthesis in response to sunlight, is essential for lifelong health. Parathyroid hormone or parathormone (PTH) regulates the production of 1,25 dihydroxyvitamin D and the formation of the active form of vitamin D necessary for calcium homeostasis. Chronic vitamin D deficiency leads to secondary hyperparathyroidism with higher bone turnover, progressive bone loss, and higher risk of fracture due fragile bones (5, 6).

The prevalence of vitamin D deficiency in the general population and especially in post-menopausal women is significant and is currently considered an important public health problem. This deficiency may have key consequences not only for bone health, but may possibly play a role in autoimmune, neoplastic, infectious, and cardiovascular diseases (6-7).

From a metabolic point of view, modern life has supposed for women, an increase in the prevalence of diseases such as obesity, insulin resistance, and diabetes, mediated by an increase in the amount of visceral fat. High-calorie diets, sedentary lifestyles, and all the unhealthy lifestyle habits of our urban life have contributed to this increase in pathologies that in the long run dramatically increase the risk of suffering a cardiovascular event.

In urban areas, 50% of women over 50 years of age suffer from this metabolic syndrome. This means that half of all women suffer from excess visceral fat at the abdominal level.

Moreover, vitamin D deficiency is considered to be the most frequent medical problem worldwide, intensifying after menopause (65% of postmenopausal women have severe vitamin D deficiencies).

Recent studies (1, 2) link vitamin D deficiency to the appearance of chronic diseases like high blood pressure and type 2 diabetes, which exponentially increase patients’ vascular risk. On the opposite side of the spectrum, patients with high vitamin D levels have a rate of cardiovascular events that is up to 51% lower than the normal population’s.

A meta-analysis of more than 210,000 patients confirms a 20% higher risk of these cardiometabolic pathologies.

In January 2018, the journal Maturitas published a cohort study of 463 postmenopausal women, showing that those with low vitamin D levels had a higher risk of metabolic syndrome, hypertriglyceridemia, and low HDL cholesterol (good cholesterol) levels, and that this risk was higher than in the population with low vitamin D levels, i.e., in postmenopausal women the effect of low vitamin D levels was more acute.

These results are consistent with the conclusions obtained in previous research (3, 4), and even in the WHI, in 2002, a possible link between low vitamin D levels and the occurrence of cardiovascular events was already mentioned.
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In these studies, in general, it is observed in a linear and exponential manner that, as vitamin D levels decrease, the risk of the previously mentioned vascular risk factors increases independently.

There are multiple pathophysiological mechanisms that may explain this association. The most logical, and also the most scientifically based, is that vitamin D has a crucial influence both on insulin secretion by the beta cells of the pancreatic islets of Langerhans and on insulin sensitivity by receptors located in skeletal muscle cells and adipocytes. When the concentration of vitamin D decreases, these mechanisms are altered, leading to a lower production of insulin with greater resistance to its action in the periphery, which is what triggers the metabolic syndrome.

Vitamin D deficiency affects the ability of the pancreatic beta cell to convert pro-insulin to insulin. With respect to insulin sensitivity, vitamin D regulates calcium levels in the extracellular space of both skeletal muscle fiber and adipocytes, which facilitates insulin action at that level. Vitamin D deficiency increases resistance to insulin action.

In these studies, levels below 30ng/ml are considered vitamin D deficiency, and levels below 20ng/ml are considered severe deficiency. Levels above 30ng/ml are considered sufficient; however, numerous publications demonstrate the need to reach vitamin D concentrations of around 50-60ng/ml, to prevent the possibility of suffering any of the consequences of vitamin D deficiency.

At Neolife, as with the rest of the biomarkers we study in our patients, we treat our patients to achieve vitamin D levels in a range of excellence that decreases the possibility of the onset of metabolic diseases, thus preventing the possibility of cardiovascular events. Additionally, with a proper diet, regular physical exercise, and the necessary daily amount of calcium and vitamin D, we can minimize the impact of estrogen depletion on women’s bone health after menopause.

BIBLIOGRAPHY

(1) Navia B, Ortega RM. Ingestas recomendadas de energía y nutrientes [Recommended energy and nutrient intakes]. In: Nutriguía. Manual de  Nutrición Clínica en Atención Primaria. Chapter 1. Requejo AM, Ortega RM eds. Madrid: Editorial Complutense. 2006; 3-14.

(2) Riobó P. Mujer adulta y menopausia [The adult woman and menopause]. In: Nutrición en población femenina: Desde la infancia a la edad avanzada. Ortega RM, ed. Madrid: Ediciones Ergón. 2007; 93-100.       

(3) Lowe NM, Ellahi B, Bano Q, Bangash SA, Mitra SR, Zaman M. Dietary calcium intake, vitamin D status, and bone health in postmenopausal women in rural Pakistan. J Health Popul Nutr 2011; 29 (5): 465-70.

(4) Boucher BJ. The problems of vitamin d insufficiency in older people. Aging Dis. 2012; 3(4): 313- 29.

(5) Melton LJ, Chrischilles EA, Cooper C, Lane AW, Riggs BL. Perspective. How many women have osteoporosis? J Bone Miner Res. 1992; 7:1005–10.

(6) Lips P, Hosking D, Lippuner K, Norquist JM, Wehren L, Maalouf G, et al. The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. J ntern Med. 2006; 260(3):245-54.

(7) Ahmadieh H, Arabi A. Vitamins and bone health: beyond calcium and vitamin D. Nutr Rev 2011; 69 (10): 584-98.

La entrada Vitamin D during Menopause se publicó primero en Neolife.

Vitamin D is considered as one of the main hormones in bone metabolism and calcium homeostasis. However, it also develops an essential role in other physiological phenomenal and inadequate levels (either too much or too little) are linked to the development of relevant diseases.

Vitamin D binds to its specific receptors to develop its functions. These receptions are not found just in the classic tissues such as bones, bowels, or kidneys. But many different tissues also have these receptions, allowing for activated vitamin to develop their roles in hormonal secretion (not just in the Protohormone or PTH, but it also affects other hormones such as insulin), in immune response, cell proliferation and cancer, mainly.

Dr. Débora Nuevo Ejeda – Neolife Medical Team

Vitamin D3 Production

Only a small part of the production of vitamin D3 comes from food. The main source of vitamin D derives from sunlight exposure.

Vitamin D3 is produced on the skin through the 7-dehydrocholesterol pathway, when the B ring of the skeleton is broken by the effects of UVR radiation giving way to Previtamin D3 (PreD3). This production is quite quick, reaching its highest peak in just a couple of hours. However, extended exposure to UVR rays, turns it into two biologically inactive molecules: lumisterol and tachysterol. This conversion is reversible, which is why a prolonged exposure to solar radiation does not trigger a toxic production of vitamin D3. Excess production turns into lumisterol and tachysterol; and if the levels of PreD3 drop, these 2 inactive molecules will become PreD3 once again.

Intensity of solar rays varies depending on the season of the year and the latitude. The further people are from the Equator, the lower their solar exposure will be. Furthermore, clothing and sunscreen decrease the production of vitamin D in the covered areas.

Activation of vitamin D3 and mechanism of action

For vitamin D3 to become activated it must be transformed into Vit D 25OH. Several enzymes of cytochrome P450 are responsible for this activation, although the most studied enzyme is CYP27A1. These enzymes are found mainly in the liver, although they are also found in other tissues. In any case, to be completely active, Vit D 25OH must be transformed into 1,25OH VitD2 by CYP27B1. This process takes place mainly on the proximal renal tubule, although this enzyme is also found in multiple extra-renal locations such as bones, parathyroids, immune cell system, and other tissues.

The regulation of the CYP27B1 enzyme in the kidneys is controlled by PTH (which stimulates its activation) and the fibroblast growth factor (FGF-23) that inhibits it.

Additionally, the 1,25 (OH) vitamin D controls its own levels inducing CYP42, which promotes the catabolism of both 25OH Vit D and 1,25OH VitD2.

Outside of the kidneys, macrophages express a non-functional CYP24 that reduces the catabolism of Vit D. Keratinocytes also have CYP27B1 but with a normal CYP24 function which is the same that Vit D2 1,25OH regulates its own levels in the epidermis.

The vitamin D receptor is part of a super-family of nuclear receptors acting as a heterodimer interaction with specific DNA sequences and inducing activation or the repression of transcription. The control of this process requires co-regulators that are different in each tissue, and make vitamin D response specific, depending on the location.

Non-classic functions of vitamin D

Typically, non-classic actions of vitamin D are grouped in 3 different types, that allow for simplification, although it’s fairly artificial:

1. Regulation of hormonal secretion.
2. Regulation of immune response.
3. Regulation of cell proliferation and differentiation.

1. Regulation of hormonal secretion:

The ability of 1.25 OH Vit D to regulate hormonal secretion plays an essential role in the maintenance of bone mineral density. Not only does it regulate PTH secretion, but it also stimulates insulin secretion. Pancreatic B cells express Vit D receptors (VDR) and calbindin-D28k, which also modulated intracellular calcium that can stimulate the liberation of insulin and protect β-cells from cytokine-mediated destruction. All of the above, makes it possible to link vitamin D deficit with metabolic syndrome , DM II or gestational diabetes. It has also been related to certain polymorphisms of the vitamin D-receptor gene to DM I.

On the other hand, 1.25 OH Vit D also stimulates secretion of FGF23 (fibroblast growth factor) which is mainly produced in the bones. Moreover, increase of FGF23 inhibits the production of 1,Oh Vit D in the kidney, which can lead to hypophosphatemia, vitamin D deficit and osteomalacia.

2. Regulation of immune response:

Inflammatory cells have vitamin D receptors, thus explaining the immunomodulatory role of this vitamin. It can inhibit T-cell proliferation in macrophages can also generate Vitamin D, which highlights its involvement in both acquired and innate immunity.

• Acquired immunity: This type of immunity involves the ability of T and B lymphocytes to produce cytokines and immunoglobulins, respectively, in response to the presentation of surface antigens by macrophages and dendritic cells. The 1,25 Oh Vit D suppresses the production of immunoglobulins and delays the differentiation of B-lymphocytes. It also inhibits the proliferation of T-lymphocytes (especially T-Helpers able to produce IFN-γ and IL-2) and the activation of macrophages. All of this slows down increased antigen presentation and the recruitment of new T-lymphocytes. However, it boosts the production of IL-4, IL-5 and IL-10, which tips the balance towards Th2 lymphocytes.

The involvement of 1.25OH vitamin D in the function and development of Th17 lymphocytes has been discovered very recently, and it is also related to several autoimmune diseases. This is why vitamin D may have a beneficial effect against the development of certain autoimmune diseases such as inflammatory bowel disease, rheumatoid arthritis, autoimmune diabetes, and even multiple sclerosis.  Certain studies have used the administration of vitamin D to prevent or to treat these diseases with very promising results.

Furthermore, considering the situation of chronic inflammation underlying pathologies such as obesity or cardiovascular diseases, it seems that there is an inverse relationship between vitamin D levels and the development of cardiovascular disease.

• Innate immunity: Innate maturity involves the activation of toll-type receptors (TLRs) on polymorphonuclears, monocytes, and neutrophils, which are also present in a multitude of cells (of the epidermis, gingiva, gall bladder, vagina, bowels, and lungs). TLRs are transmembrane receptors that recognize specific patterns deleted by infectious agents. Their activation produces antimicrobial peptides and reactive oxygen species killing these infectious microorganisms. 1.25OH Vit D 2 induces the expression of these peptides. We shouldn’t forget either, that this Vitamin D is also produces in macrophages and epithelial cells.

3. Regulation of cell proliferation and differentiation:

The epidermis can produce vitamin D and it’s also capable of transforming it into 1.25 (OH) 2 Vit D. And this vitamin D can suppress the immune response, which contributes partly to the development of psoriasis, for example.

It also influences the hair follicle cycle, where vitamin D seems to play an essential role through the activation of its receptors in the prevention of some types of autoimmune alopecia.

The antiproliferative action of vitamin D in many cellular tissues and the list of tumor tissues expressed by the vitamin D receptor, highlight its potential anti-cancer effect.

In keratinocytes, 1.25 (OH) 2Vit D has shown to promote repair UVR-induced damage, reducing cell apoptosis and increasing survival after exposure. Although a reduction has been seen in many types of tumors, the tumors in which the beneficial effect of vitamin D has been extensively studied has been in breast, colon, and prostate cancer. Certain studies have shown a reduction in colon and breast cancer of up to 77% in women taking 1100 UI of Vit D and 1400-1500 mg of calcium.

What are the recommended levels of vitamin D?

Despite de basis for everything explained in this article, the effects that we have named as “non-classical” effect of vitamin D in relation to different diseases are not conclusive from the point of view of scientific literature to be able to establish a causal relationship. This is partly due to discrepancies in the assessment of vitamin D levels.

The main source of vitamin D comes from sun exposure and only a small part from intake. In Spain and in Europe, supplements contain de cholecalciferol or vitamin D3, whereas in the USA they are mainly made up of ergocalciferol, vitamin D2. Therefore, the methods used should be able to measure both forms. Additionally, the measurement of 25 (OH)D is difficult due to the hydrophobic natural of the molecule, its high affinity for its transport protein, its low concentration in samples, and because both of these structural forms are very similar. For this reason, it is important to individualize vitamin D levels and consider special situations that must be considered as risky if having a vitamin D deficiency.

Especially:

• Osteoporosis.
• Hyperparathyroidism.
• Chronic hepatic and renal disease.
• Obesity.
• Pregnancy and Lactation.
• The Elderly.
• Sarcoidosis, tuberculosis, histoplasmosis, and other granulomatous diseases.
• Lymphomas.
• Certain treatments such as anti-seizure drugs, anti-fungal medication, retroviral drugs, and corticoids.

In general, the recommendation for the general population under 70 years old, is of approximately 600UI per day of vitamin D and 800 UI in people over that age. In the abovementioned situations, which involve a higher risk of deficiency, it is advised to increase intake by 50%, and during pregnancy and lactation by up to 150%.

As regards to sun exposure, at least 3 hours of indirect exposure, avoiding the middle of the day and wearing clothes. This may be enough to obtain appropriate levels of vitamin D without increasing the risk of skin cancer.

BIBLIOGRAPHY

(1) Bikle D. Nonclassic actions of vitamin D. J Clin Endocrinol Metab. 2009;94:26-34.

(2) Prosser DE, Jones G Enzymes involved in the activation and inactivation of vitamin D. Trends Biochem Sci 29:664–673

(3) Calle Pascual AL, Torrejón María J. La vitamina D y sus efectos “no clásicos”. Rev. Esp. Salud Pública [Online journal]. 2012, Oct [quoted 2 November 2015]; 86(5): 453-459.

(4) Sutton AL, MacDonald PN. Vitamin D: more than a bone-a-fide hormone. Mol Endocrinol. 2003;17:777-791.

(5) Holick MF 2007 Vitamin D deficiency. N Engl J Med 357:266–28

La entrada Vitamin D, beyond the bone se publicó primero en Neolife.

In humans, coronaviruses usually cause mild respiratory infections, such as the common cold. However, in some patients it goes beyond these symptoms and leads to what is called acute lung injury and ARDS (acute respiratory distress syndrome), which may seriously affect the patient’s respiratory capacity and lead to death.

Our best defense, at this time when we don’t have a vaccine or fully tested drugs to cure the infection, is to maintain an optimized immune system. We won’t be able to avoid catching the virus if we’re exposed to it, but it’s possible to keep the viral load to a minimum. To do this, at Neolife we optimize your metabolism with the right nutritional supplements (vitamins, minerals, specific natural compounds, and probiotics) and hormone replacement therapy, using high doses of melatonin and DHEA.

Neolife Medical Team

We are dealing with a new virus to which we have no natural immunity, because we have never been exposed to it before.

In the context of this health emergency due to the coronavirus COVID-19, here at Neolife we wish to provide information to the population. Knowledge is power and knowing our “enemy” in this fight, our defense systems, and how to strengthen them certainly seems to be paramount.

In this article, we will describe our immune system and its components, show how COVID-19 behaves once it has infected a body, and how it is able to affect the invaded organism, and also review what scientific evidence tells us about what we can do at the supplement level and at the hormonal level.

Additionally, you will find a complete article on nutrition and diet written by our team of nutritional experts in the blog post titled “COVID-19: How Nutrition Affects Our Immune System“, to boost our immunity in case of the viral attack.

OUR IMMUNE SYSTEM

Let’s begin by a very summarized description of what our immune system looks like.

An immune system (IS) is the set of structures and mechanisms in an organism that allows it to maintain a balance against external attacks (pathogens, contaminants, radiation, etc.) and internal ones (cancer cells).

It is composed of a number of cells found in our fluids and tissues, which are generated in the bone marrow.

There are 2 types of immune system, the innate or nonspecific and the acquired or adaptive.

The innate system is present in almost all living beings, however simple they may be. Among the mechanisms it uses are the production of antimicrobial peptides, phagocytosis, carried out by neutrophils and macrophages, the complement system, etc. The innate IS detects signals in cells that distinguish the healthy ones from those that have been damaged by burns, radiation, viruses, bacteria, parasites, etc. The cells involved in the the innate IS are macrophages, neutrophils, dendritic cells, mast cells, eosinophils, basophils, and NK cells. These cells identify and eliminate pathogens. Innate cells are also important mediators in the activation of the adaptive IS.

The adaptive IS allows for a greater immune response, as well as the establishment of an immune memory. The adaptive immune response is specific to antibodies and requires recognition of antigens that are not its own through a process called “antigen presentation”. Adaptive IS cells are a special type of leukocytes called lymphocytes. B and T cells are the main classes of lymphocytes (1,2). There are 2 types of T cells:

• Cytotoxic T cells, which kill infected or sick cells when their receptor binds to their specific antigen in the other cell’s membrane.
• Collaborating T cells, which regulate both the innate and adaptive response.

B lymphocytes, on the other hand, generate specific antibodies after being activated by a collaborating T cell.

THE INFECTIVITY OF COVID-19

Well, now that we know our immune system a little better, let’s get back to the COVID-19.

We are dealing with a new virus to which we have no natural immunity, because we have never been exposed to it before. It is a virus with a high degree of infectivity, with a mortality rate that, according to the current figures is 2-3%, but which will likely be lower once we obtain more data on the number of actual infected people (i.e., the number of deaths will remain the same, but as the number of infected increases with more testing, the mortality rate decreases).

Its high infectivity rate is due to several phenomena:

• A person may be an asymptomatic carrier during the incubation period of the disease, which may vary from 2 to 14 days.
• It can survive up to 9 days in fomites, that is, inanimate objects that can be contaminated by viruses, such as subway bars, shopping cart handles, door knobs, etc.
• It is very easily transmitted through the tiny drops we expel when we cough, sneeze, or just talk.

HOW COVID-19 ACTS IN OUR BODY

It seems that once it has entered, especially through an airway, it binds to the receptors in lung tissue. From there, it does what viruses usually do, which is to infect the cells and modify them to create more copies of itself, leading to the death of the host cell, which can also die as a result of the immune reaction that has started. When many of an organ’s cells die, their function is obviously altered.

In humans, coronaviruses usually cause mild respiratory infections, such as the common cold. However, in some patients it goes beyond these symptoms and leads to what is called acute lung injury and ARDS (acute respiratory distress syndrome), which may seriously affect the patient’s respiratory capacity and lead to death. According to the Chinese Disease Control Center, 81% of cases are mild, 14% severe, and 5% critical, of which half die.

There are essentially two roads that lead to death:

• Some people are young, with strong immune systems. For them, the problem is that the virus overstimulates their immune system, triggering a cytokine storm, which causes the person’s own immune system to attack the lungs, leading to a large release of fluids into them (ARDS). This eventually leads that person to “drown” in his or her own lung fluids.
• The second group tends to be elderly, with weakened immune systems and lungs that are already compromised by disease (COPD, emphysema, etc.). For them, the virus may further weaken the immune system, to the point of developing pneumonia, which in many cases can be severe or even fatal, if they develop ARDS, heart failure, or sepsis.

What’s this about the cytokine storm we mentioned?

A cytokine storm is triggered when the body perceives that the virus that is attacking it is stronger than it can handle with a normal response. This can happen in different ways (5):

• The virus can be so virulent that it triggers the storm directly. This overreaction will damage the lungs and other organs such as the heart, liver, or kidneys.
• The virus can be so new (as in the case at hand) that our body does not recognize it and cannot send to the best-trained defenses, the B and T cells. Instead, it sends macrophages and dendritic cells, which are powerful but aggressive, and their attack is not very targeted, which causes collateral damage. This is the path that leads healthy young people to critical stages of the disease.
• A virus, by itself, may not be strong enough to trigger a cytokine storm, but it may be strong enough to cause a secondary infection (usually pneumonia), which when combined with the initial infection is strong enough to cause the cytokine storm. Any respiratory virus, such as the flu, respiratory syncytial virus, or now COVID-19, can lead to pneumonia. That’s how the flu kills 600,000 people a year in the world. They don’t die of the flu, but from the cytokine storm triggered by a secondary infection. The elderly with weak immune systems are particularly vulnerable to this when they are infected by COVID-19, and this is how most deaths have occurred.

Therefore, our best defense, at this time when we don’t have a vaccine or fully tested drugs to cure the infection, is to maintain an optimized immune system. We can’t avoid catching it if we are exposed to the virus (as we said, until now no one has ever been exposed to it and no one has antibodies against this new virus), but the viral load may be kept to a minimum, so that it does not progress to a cytokine storm, pneumonia, or ARDS.

WHAT CAN WE DO TO BOOST OUR IMMUNITY?

A proper nutritional and hormonal balance will keep our immune system functioning properly, but also keep in mind that getting enough sleep also helps, while stress has the opposite effect.

We can boost our immune system with supplements and natural products derived from traditional medicines, hormone replacement therapy, a good diet, and good habits. In this article, we’ll tell you more about the first two, supplements and hormone replacement therapy.

1. Vitamins and minerals

Immune support through micronutrients is historically based on vitamin C deficiency and its supplementation to prevent scurvy. Since then, it has been established that the complex and integrated immune system needs multiple specific micronutrients, including vitamins A, D, C, E, B6, and B12, as well as folate, zinc, iron, copper, and selenium, which play a vital, often synergistic role in each stage of the immune response. Obtaining adequate amounts of these vitamins, minerals, and trace metals is essential to ensure the proper functioning of the physical barriers against infections and the immune cells; however, the daily intake of these micronutrients needed to support immune function may be higher than the recommended daily allowance (RDA). Certain populations have inadequate intakes of these nutrients, and there are situations such as the infection itself and stress, which may cause their levels to drop further, and thus modify the amount that needs to be received. Several micronutrients may be in deficit, and even values in the low range of normality may affect immunity. Although there is conflicting data, the available evidence indicates that multi-micronutrient supplementation with immune support functions is able to modulate immune system function and reduce the risk of infection. The micronutrients with the strongest evidence for immune system support are vitamins C and D and zinc (1).

2. Specific supplements that help boost your defenses

There are also natural products that Western medicine has learned from Asian medicine, which it has researched and standardized. Thus, for example, plants, like the echinacea, have immunostimulant properties: they boost the production and activity of lymphocytes and macrophages, increase the production of interferon, which improves the response to viral infections, reduce the symptoms of respiratory infections, etc.(3).

Mushrooms like Reishi, Shiitake, or Maitake also produce effects on the immune system (4). Reishii is known for its immunostimulant and immunomodulatory properties. Shiitake activates macrophages, T cells, and NK cells, and Maitake has been shown to stimulate the innate and adaptive IS, even in cancer patients.

3. Probiotics and their various benefits to the immune system

The use of probiotics deserves its own section, as they promote a healthy immune system and lower the incidence of colds, allergies, and eczema by boosting the immune system. The latest studies show that these beneficial bacteria account for 80-90% of our immune function. They have multiple functions: they are not only a barrier to prevent the entry of microorganisms, but they also kill pathogens such as bacteria, viruses, fungi, and parasites, and act as immunomodulators, producing substances such as lactoferrin and B vitamins. Scientific studies have shown that supplementing with probiotics prevents recurrent pharyngitis and tonsillitis. Another study in children from age 3 to 5 showed that the incidence of fevers was reduced by 53%, as well as cases of cough by 41% and cases of catarrhal rhinitis by 28%. Also, the use of antibiotics in these children fell by 84%.

Do we only have healthy flora in our gut? No, it’s also in the mouth, nose, skin, urinary tract, vagina, and lungs; which brings us back to the COVID-19 again. Obviously the bacterial strains we find in the lungs are very different from those found in the intestine, but we know that the signals from the gut bacteria reach the lung while maintaining this first line of defense against pathogens. When mice with a healthy gut flora were inoculated with the influenza virus, 80% survived, compared to 33% who did so by having an antibiotic-altered flora (6,7).

Therefore, if you want to have a strong immune system, you need a good probiotic supplement and be careful with antibiotics.

4. Melatonin at high doses and its protective effect

Melatonin is a molecule with multiple and important functions. Numerous clinical trials have examined its usefulness in different fields of medicine. Its effectiveness has been shown to prevent cell damage in acute states (sepsis and asphyxiation in newborns) and chronic states (metabolic and neurodegenerative diseases, cancer, inflammation and aging).

The beneficial effects of melatonin can be explained by its powerful antioxidant properties, and because it is an antioxidant enzyme inducer, apoptosis regulator or cell death, and immune system stimulator. These effects support its use in viral infections that are often associated with inflammation-induced injury and increased oxidative stress. The following table shows some of the many studies examining its usefulness in protecting us against viral infections (8,9).

Various studies have been conducted in humans to show these properties. Its virtual absence of toxicity has allowed its use to be considered in combination with conventional therapies.

Gitto et al. used melatonin to treat newborns with severe sepsis with very significant improvement in mortality. Another study for the treatment of herpes simplex improved the cure rate to 7 days compared to the usual treatment with aciclovir.

Moreover, its beneficial effects have been shown in combination with common drugs improving the results obtained with its use alone.

Earlier this week, when faced with this contingency of the coronavirus pandemic, Dr. Darío Acuña, Europe’s leading expert on melatonin, has informed us that an emergency trial with high injectable doses of melatonin will be conducted to combat COVID-19, and he recommends increasing oral doses of this hormone throughout this period as an endogenous protective mechanism for all of those who are already taking melatonin.

6. DHEA

Another hormone that we manage daily in consultation with our patients and which has fascinating properties is dehydroepiandrosterone (DHEA). We use it in several cases and for its important cardiovascular effects (it improves all manifestations of metabolic syndrome, including central obesity, atherogenic dyslipemia, high blood pressure, insulin resistance, and prothrombotic state), aid in bone health (it increases bone density), brain health (it modulates response to stress, helps memory, controls sleep, and improves mood and anxiety states), sexual health (it improves erectile dysfunction, satisfaction during intercourse, sexual desire, and orgasmic function), autoimmune diseases (it has shown beneficial effects in the management of ulcerative colitis and Crohn’s disease), etc.

As for immune function, the issue that concerns us most today, studies show that whether it is directly or via conversion to other metabolites, it evokes important responses from many components of the immune system. It has powerful effects on cytokine production, lymphocyte proliferation, it increases T and NK cells… It has even been shown to have an adjuvant effect on vaccination, improving the production of protective antibodies (10).

Here at Neolife, we know that your immune system is very important for your current and future health. Therefore, we optimize your metabolism and hormonal axes, and help with supplements, nutrition, and habits to ensure your immune system’s optimal functioning.

BIBLIOGRAPHY

(1) Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020;12(1):236. Published 2020 Jan 16. doi:10.3390/nu12010236

(2) Janeway CA Jr, Travers P, alport M, et al. Immunobiology: The Immune System in Health and Disease. 5th edition. New York: Garland Science; 2001. The components of the immune system.

(3) Isbaniah F, Wiyono WH, Yunus F, Setiawati A, Totzke U, Verbruggen MA. Echinacea purpurea along with zinc, selenium and vitamin C to alleviate exacerbations of chronic obstructive pulmonary disease: results from a randomized controlled trial. J Clin Pharm Ther. 2011 Oct;36(5):568-76.

(4) Lee, Kuo-Hsiung et al. “Recent progress of research on medicinal mushrooms, foods, and other herbal products used in traditional Chinese medicine.” Journal of traditional and complementary medicine vol. 2,2 (2012): 84-95.

(5) Tisoncik JR, Korth MJ, Simmons CP, Farrar J, Martin TR, Katze MG. Into the eye of the cytokine storm. Microbiol Mol Biol Rev. 2012;76(1):16–32. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294426/

(6) Gregory J. Leyer, Shuguang Li, Mohamed E. Mubasher, Cheryl Reifer, Arthur C. Ouwehand, “Probiotic Effects on Cold and Influenza-Like Symptom Incidence and Duration in Children.” Pediatrics  124  No. 2  August 1, 2009 pp. e172 -e179. https://pediatrics.aappublications.org/content/124/2/e172.full.pdf+html

(7) Bradley KC, Finsterbusch K, Schnepf D, et al. Microbiota-Driven Tonic Interferon Signals in Lung Stromal Cells Protect from Influenza Virus Infection. Cell Rep. 2019;28(1):245–256.e4. https://dx.doi.org/10.1016/j.celrep.2019.05.105

(8) Boga JA, Coto-Montes A, Rosales-Corral SA, Tan DX, Reiter RJ. Beneficial actions of melatonin in the management of viral infections: a new use for this”molecular handyman”? Rev Med Virol. 2012 Sep;22(5):323-38.

(9) Sánchez-Barceló EJ, Mediavilla MD, TanDX, Reiter RJ. Clinical uses of melatonin:evaluation of human trials.Current Medicinal Chemistry2010;17: 2070–2095..

(10) Prall, S. P., & Muehlenbein, M. P. (2018). DHEA Modulates Immune Function: A Review of Evidence. Vitamins and Hormones, 125–144.

La entrada COVID-19: The Immune System, Supplements, and Bioidentical Hormone Replacement Therapy se publicó primero en Neolife.

The Neolife team wishes, through this article and direct communication with you, to give you all the support, information, and assistance you may need to stay perfectly healthy during this current situation.

In this post, we’ll address various recommendations for dealing with COVID-19: what you can do to protect yourself from the coronavirus, who is most likely to present serious symptoms, what you should do if you or someone you know has symptoms that are consistent with COVID-19, how self-isolation helps, and finally, Neolife’s recommendations for boosting your immune system.

Neolife Medical Team and Nutrition Department

Coronaviruses (CoVs) are a large family of viruses that can cause a variety of conditions, from the common cold to more serious respiratory diseases (1). They usually affect only animals, although sometimes they can be passed on to humans. The novel SARS-CoV-2 coronavirus is a new type of coronavirus that was first detected in December 2019, which affects humans and causes the COVID-19 illness (2).

Experts have confirmed that the virus is transmitted from person to person, through the tiny drops that are released when someone coughs or sneezes. The most common signs and symptoms are fever, cough, shortness of breath, loss of smell and/or taste, and even diarrhea.

What can I do to protect myself from the coronavirus?

Is the use of masks an effective way to prevent it?

• The general healthy population does NOT need to wear masks.
• Masks help prevent transmission of the virus if worn by those who are sick.
• Healthcare professionals will indicate the use of masks in situations where they deem they are necessary.

Who is most likely to experience serious symptoms?

According to the series published by the Chinese CDC, the highest mortality rate is for the age group of adults over 80 at 14.8%. For patients with no comorbidity, the mortality rate was 0.9%, compared to those with comorbidity, who had much higher rates: 10.5% for those with cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for high blood pressure, and 5.6% for cancer. Modelling has estimated a mortality rate of 14% among those hospitalized and in the general population rates of 0.1 to 0.3%.

Therefore, the most at risk groups are the most vulnerable:

• Adults over 60.
• Patients with cardiovascular disease and high blood pressure.
• Patients with diabetes.
• Patients with chronic lung disease.
• Patients with cancer.
• Immunocompromised patients.
• Pregnant women.

What should I do if I have symptoms of COVID-19?

Helplines for each of Spain’s aunonomous communities:

What should I do if I know someone with COVID-19 symptoms? What is self-isolation good for?

There’s been a lot of talk about “flattening the curve.” As we discussed in the article about our immune system in relation to COVID-19, none of us have defenses against this new virus, because no one has ever been exposed to it before. Our immune system does not recognize it, but also its capacity for contagion is enormous, which is say to say that PRACTICALLY ALL of us will catch it at some point. The aim of limiting social contact is precisely to prevent everyone from catching it all at once. You’ve probably already heard that, on an individual level, its behavior is not as malignant; over 80% of the infected exhibit mild or moderate symptoms, and 14% develop a serious clinical condition.

We want our health system to be able to take on the number of hospitalizations due to infection and to have enough resources to provide ventilators, medical treatment, etc., to patients who become critically ill.

Recommendations for home self-isolation

Neolife’s recommendations for boosting your immune system

As we discussed in this and other articles, having a healthy immune system is critical to overcoming the inevitable COVID-19 infection: both an excessive immune response against the virus and an insufficient one may lead to a serious clinical condition. Available scientific evidence recommends:

1. EATING THE PROPER DIET

Our article titled “COVID-19: How Nutrition Affects Our Immune System” explains how to eat an adequate, balanced, and healthy diet that favors a better immune response.

• It is important to eat a balanced diet, that includes a variety of foods, starting with fresh foods that are rich in vitamins and minerals. Fruits, vegetables, and legumes are foods that contain a high nutritional density and are rich in antioxidants and vitamins, such as C, E, and A, which boost immune response. The Mediterranean diet has shown great health benefits.
• We recommend including bluefish, nuts, extra virgin olive oil, and avocado, to ensure a balanced contribution of different fats that are essential for immune health.
• Regular consumption of fermented dairy such as yogurt or kefir helps increase your immune defenses. Several studies show that those who eat these foods on a regular basis have a healthier immune system thanks to vitamin D. Moreover, probiotics are living microorganisms present in these foods, which have proven to have beneficial actions on the immune system.
• Iron deficiency (common in women and older adults) decreases immune response. Iron is present in the liver, meats, fish, egg yolk and, to a lesser extent, in legumes, so it is wise to include these protein-rich food groups in our diet.
• Vitamin B12 is only present in animal-based food sources, in seafood, meat, fish, eggs, and dairy products. Immune system alterations associated with a deficit in this vitamin have been reported because it decreases antibody production.
• An excessive calorie intake can affect the immune system‘s ability to fight infections, so overweight and obesity are linked to a higher incidence of infectious diseases. Therefore, it is important to control calorie intake during this time of less activity.

2. SUPPLEMENTATION AND ITS BENEFITS TO THE IMMUNE SYSTEM

The blog post titled “COVID-19: The Immune System, Supplements, and Bioidentical Hormone Replacement Therapy” mentions the scientific and medical endorsement of supplements that can help us strengthen our defenses. We’ll summarize it for you here:

• Vitamin and mineral supplements. Vitamins A, D, C, E, B6, B12, and folic acid, as well as the minerals zinc, iron, copper, and selenium play a vital role at every stage of the immune response.
• Natural supplements. Plants such as echinacea, Reishii mushroom, and Shiitake and Maitake mushrooms have immunostimulant and immunomodulatory properties.
• Probiotics. Probiotics promote a healthy immune system and lower the incidence of colds, allergies, and eczema by boosting the immune system. The latest studies show that these beneficial bacteria account for 80-90% of our immune function.

3. HORMONE REPLACEMENT THERAPY. HORMONES THAT STIMULATE THE IMMUNE SYSTEM

You can also find more detailed information about this in the blog post titled “COVID-19: The Immune System, Supplements, and Bioidentical Hormone Replacement Therapy“. We’ll summarize it for you here:

Two of the bioidentical hormones we manage daily with our patients have shown very important effects on the immune system:

• Studies conducted with dehydroepiandrosterone (DHEA) indicate that when given directly or via conversion to other metabolites, it evokes powerful responses from many components of the immune system. It has even been shown to have an adjuvant effect on vaccination, improving the production of protective antibodies.
• Melatonin, on the other hand, is a fascinating molecule with multiple and important functions. It possesses antioxidant properties, regulates cell death, and stimulates the immune system, which supports its use in viral infections that are often associated with injury due to inflammation and increased oxidative stress. Moreover, it has been proven to have a synergistic effect with antiviral drugs. People who take it are advised to increase their doses to 50 mg or even 100 mg to reinforce the endogenous response in this situation.

4. EXERCISE AND REST

Staying active is very important. This situation involves a very significant decrease in our usual activity and our caloric consumption, with the risk of losing muscle mass, increasing body fat, and weakening the immune system. Exercise will take up our time, help improve our mood, maintain our muscle mass and, consequently, also our metabolic rate.

Here at Neolife, we are recommending the use of exercise tables and apps at an individual level that include a series of exercises adapted to the equipment you have access to and your current physical condition.

All our patients have made a great effort so far within their program, and we don’t want them to lose their gains.

On the other hand, you should get enough rest. A good number of hours of restful sleep helps our defense system to stay in top shape.

5. STAY POSITIVE AND AVOID STRESS AS MUCH AS POSSIBLE

Maintaining a positive attitude, managing stress, keeping the mind busy, meditating, practicing mindfulness or yoga are all things that scientific evidence has shown improve our overall health, slow down the aging process, and help the correct functioning of our immune system.

Our recommendation here at Neolife: do some intellectual work, exercise, do pleasurable activities (cooking, reading a book or enjoying your favorite TV series), and keep in touch with family and friends, talking to them whenever you can.

The Neolife team wishes, through this article and direct communication with you, to give you all the support, information, and assistance you may need to stay perfectly healthy during this current situation.

BIBLIOGRAPHY

(1) BVS Spain Regional Portal. (2020). “Enfermedad por coronavirus (COVID-19)” [Coronavirus disease (COVID-19)]. URL: https://bvsalud.org/vitrinas/es/post_vitrines/nuevo_coronavirus/

(2) Government of Spain. (2020). “Enfermedad por nuevo coronavirus, COVID-19: información para la ciudadanía” [Novel coronavirus disease, COVID-19: citizens’ information]. Ministry of Health.

URL: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/ciudadania.htm (3) (2020). “Brote de enfermedad por coronavirus (COVID-19)” [Coronavirus disease (COVID-19) Pandemic]. URL: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

La entrada Coronavirus Recommendations from Neolife se publicó primero en Neolife.

To achieve a perfect balance between the different vital functions certain substances called vitamins are necessary. Here, we’ll tell you more about vitamin K. There are two main forms of this vitamin (vitamin K1 and vitamin K2), each found in a different source and with also different biological functions.

Vitamin K1 is Phylloquinone. It plays an important role in blood coagulation because it is an essential cofactor in the activation of certain key proteins. Phytonadione is the synthetic form of vitamin K1. Vitamin K2, also called Menaquinone, is distributed in different forms from MK-4 (menatetrenone) to MK-13.

Dr. Celia Gonzalo Gleyzes – Neolife Medical Team

The Sources, Metabolism, and Recommended Daily Intake of Vitamin K

Vitamin K1 is commonly found in the human diet because it’s synthesized by specific green plants and vegetables. Among these we have kale, spinach, broccoli, and some fruits and herbs. Some oils, like soybean and canola oil, contain large quantities.

The sources of vitamin K2 are: some types of cheese, eggs, meat, and natto (food made with fermented soybeans that is very common in Japan, which gets first place with a content of 775 mcg/100 g). Some menaquinones are synthesized by the gut microbiota.

Vitamin K1 can be converted into vitamin K2 (MK4), and this in turn can be accumulated in extrahepatic tissues. The most common forms of vitamin K2 have 60% of vitamin K1 activity.

The bioavailability of all forms of vitamin K varies greatly depending on the intraluminal nutrient content (in the digestive tract).

In order to properly absorb vitamin K, it’s necessary to have healthy, functioning pancreas and liver, as well as mechanisms of fat absorption. The vitamin K obtained from food sources is linked to proteins; it is released from them with the help of pancreatic enzymes in the small intestine. It then undergoes a solubilization in micelles through the action of bile salts, so that it can be absorbed by the intestinal cells.

A 90 mcg intake is recommended in women, 120 mcg in men, and in children, the amount ranges from 2 to 75 mcg daily.

The different functions of vitamin K

• Coagulation: Vitamin K is essential for the activity of various carboxylase enzymes, which is why it’s necessary for the activation of coagulation factors VII, IX, X, and prothrombin.
• Activation of C and S proteins: these anticoagulant proteins also require vitamin K.

• Reverse anticoagulation: it may decrease or reverse the anticoagulant effect of dicoumarol (Acenocumarol).

• Bone metabolism: vitamin K is a cofactor of some proteins involved in mineralization, including osteocalcin and the matrix Gla protein (MGP). Vitamin K is responsible for the carboxylation of osteocalcin. This promotes the transition from osteoblast (immature bone cell) to osteocyte (mature bone cell) and also limits osteoclastogenesis (osteoclasts are cells that reabsorb and reshape bones). One study established a positive association between osteoporotic fractures in men and long-term treatment with vitamin K antagonists (anticoagulants). In women of all ages, a low vitamin K intake is associated with bone deterioration which suggests a beneficial effect of vitamin K on bone health. More studies (larger sample sizes, including Caucasian populations, distinguishing between doses and vitamin K types, etc.) are required to recommend vitamin supplements, taking into account possible synergies between different nutrients.
• Coronary calcification: the hypothesis is that vitamin K deficiency may increase it due to poor MGP activity. More studies are needed to confirm this theory.

Conditions at risk of vitamin K deficiency

Because it is a fat-soluble vitamin, the following conditions suggest a greater vigilance or even direct treatment: cystic fibrosis, primary biliary cholangitis, primary sclerosing cholangitis, biliary atresia, familial intrahepatic cholestasis, celiac disease, short bowel syndrome, liver failure, high doses of vitamin E, antibiotics, and toxic doses of vitamin A.

The elderly population, who suffer from obesity or diabetes are also at risk (due to a lower peripheral conversion rate from VK1 to VK2 or/and due to reduced microbiota activity) (1,2).

BIBLIOGRAPHY

(1) UpToDate: Overview of vitamin K

(2) Vitamin K and osteoporosis: Myth or reality? Palermo, Andrea et al. Metabolism – Clinical and Experimental, Volume 70, 57 – 71. https://www.metabolismjournal.com/article/S0026-0495(17)30045-8/fulltext

La entrada Vitamin K and Its Different Functions se publicó primero en Neolife.

For stressful situations, improving one’s intellectual performance is always a good thing because, during these moments, it is harder for us to memorize and focus, we lose the ability to assimilate information that comes our way and we find that our mind is a little more clumsy.

NeoMemory from Neoactives contains Acetyl L-Carnitine, L-Theanine, Phosphatidylserine, Phosphatidylcholine, Rhodiola, Gingko, Lutein, Zeaxanthin and Vitamin B5. All of these compounds come together in a single supplement aimed at improving cognitive performance and mitigating the effects of mental fatigue in our daily lives.

Dr. Francisco Martínez Peñalver – Neolife Medical Team

NeoMemory from Neoactives improves mental performance in stressful situations.

We detail below the importance of each of the components of this supplement, which help delay brain aging and benefit memory and neuropsychological processes.

In the case of the Acetyl L-Carnitine, there is extensive literature on its beneficial effects in terms of cognitive impairment. In patients with Alzheimer’s disease (1), it delays the accelerated cognitive impairment that occurs. With regard to age-related degenerative cognitive processes, Acetyl-L-Carnitine improved the emotional sphere, making patients less prone to depression, and memory, delaying the onset of dementia (2). In young patients, the addition of this compound seems to improve reflexes and motor coordination.

L-Theanine is essentially an amino acid found mainly in the green tea plant that has beneficial properties when it comes to stress and behavior (3). A wide range of studies measuring stress markers such as cortisol or salivary amylase have shown a reduction among patients who incorporate L-Theanine in their diet (4). This reduction in the adrenergic system has even been observed in patients with high blood pressure due to emotional causes.

Phosphatidylserine is a classic complement to supplementation intended for the improvement of neurocognitive functions. There is clinical evidence about its effects on the elderly and on patients with neurodegenerative diseases by delaying the progression of symptoms (5). It has also been proven to be useful in children with attention deficit hyperactivity disorder by improving short-term memory, inattention periods, and the impulsivity that appears in these cases (6).

Phosphatidylcholine is another classic supplement used to help slow down cognitive decline. It has been shown that having high levels of this compound decreases the chance of contracting neurodegenerative disease with the onset of dementia by up to 47% (7).

Rhodiola is a root whose active metabolite is SHR-5. It has traditionally been used in problems related to stress and generalized anxiety with proven effectiveness against placebo in cases of severe fatigue after periods of acute stress (8).  It has also proven to be somewhat effective in subjects in athletic training by improving their endurance. In addition, the cardioprotective effects of Rhodiola have been studied, revealing a lower secretion of catecholamines in response to stress, with higher levels of AMPc in the myocardium, in patients receiving Rhodiola supplementation (9).

Ginkgo biloba and its active metabolite EGb-761 improve the processing speed of brain orders. It has traditionally been associated with a vasculoprotective effect on the central nervous system and, therefore, on cognitive functions of the body such as memory (10). Ginkgo biloba is presented as a safe and proven therapeutic option for patients who are both entering old age and those in the early stages of cognitive decline.

Zeaxanthin is a carotenoid traditionally associated with the high cognitive abilities, which we find in high concentrations in the eye’s macula. Low levels of Zeaxanthins are related to the onset of disorders associated with cognitive decline (11).

BIBLIOGRAPHY

(1) Pettegrew et al. Clinical and neurochemical effects of acetyl-L-Carnitine in Alzheimer´s disease. Neurobiol Aging. 1995 Jan-Feb;16(1):1-4

(2) Salvioli G et al. L-acetylcarnitine treatment of mental decline in the elderly. Drugs Exp Clin Res. 1994;20(4):169-76.

(3) White DJ et al. Anti-stress, behavioural and magnetoencephalography effects of an L-Theanine-based nutrient drink: A randomized, double-blind, placebo-controlled, crossover trial. Nutrients. 2016 Jan 19;8(1)

(4) Unno K et al. Anti-stress effect of theanine on students during pharmacy practice: positive correlation among salivary alpha-amylase activity, trait anxiety and subjective stress. Pharmacol Biochem Behav. 2013 Oct;111:128-35.

(5) More MI et al. Positive effects of soy-lecithin-derived phospatidylserine plus phosphatidic acid on memory, cognition, daily functioning, and mood in elderly patients with Alzheimer´s disease and dementia. Adv Ther. 2014 Dec;31(12):1247-62.

(6) Hirayama S et al. The effect of phosphatidylserine administration on memory and symptoms of attention-deficit hyperactivity disorder: a randomized, double-blind, placebo-controlled clinical trial. Hum Nutr Diet. 2014 Apr;27 Suppl 2:284-91.

(7) Schaeffer EJ et al. Plasma phosphatidylcholine docosahexaenoic acid content and risk of dementia and Alzheimer disease: The Framingham Heart Study. Arch Neurol. 2006 Nov;63(11):1545-50.

(8) Olsson EM et al. A randomised, double-blind, placebo-controlled, parallel-group study of the standarised extract SHR-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Med. 2009 Feb;75(2):105-112.

(9) Maslova LV et al. The cardioprotective and antiadrenergic activity of an extract of Rhodiola rosea in stress. Eksp Klin Farmakol. 1994 Nov-Dec;57(6):61-3.

(10) Rai GS et al. A double-blind, placebo controlled study of Ginkgo biloba extract (“tanakan”) in elderly outpatients with mild to moderate memory impairment. Curr Med Res Opin. 1991;12(6):350-5.

(11) Feeney J et al. Low macular pigment optical density is associated with lower cognitive performance in a large, population-based sample of older adults. Neurobiol Aging. 2013 Nov;34(11):2449-56.

La entrada Boost your mental capacity se publicó primero en Neolife.

The fast pace of life these days, together with our bad habits that include a more sedentary lifestyle, unbalanced nutrition and even sleep disruption due to numerous factors, have made chronic tiredness one of the most common symptoms reported at the doctor’s office.

NeoVital Boost from Neoactives is composed of elements aimed at alleviating this annoying symptom that is so prevalent among our patients. These molecules have been used for thousands of years to improve the overall condition of patients, but only in recent years have they passed through the filter of medicine based on evidence with positive results in published studies.

Dr. Francisco Martínez Peñalver – Neolife Medical Team

NeoVital Boost is a formula specially developed for active individuals who want to maintain the best version of themselves in their daily lives.

As a rule, adopting certain healthy habits should — in the medium term — mitigate the feeling of tiredness, but sometimes this is not the case. The modification of, for example, sleep patterns is often difficult (in toddlers, due to work schedules, etc.) or even impossible.

NeoVital Boost from Neoactives is composed of different elements aimed at alleviating this annoying symptom that is so prevalent among our patients. These molecules have been used for thousands of years to improve the overall condition of patients, but only in recent years have they passed through the filter of medicine based on evidence with positive results in published studies.

The first component we’re going to talk about is Korean ginseng. Controlled studies have shown improvements in physical capacity, muscle strength, heart rate, cellular energy use, responsiveness, and even cognitive and psychomotor improvements (1). One of the proven uses of Korean ginseng is in patients with fibromyalgia, where it has been shown that, in comparison to other treatments such as amitriptyline, it is more effective for treating the main symptoms of the disease (pain, anxiety, sleep disruption, etc.) (2). Korean ginseng has been shown to enhance effectiveness when administered alongside other substances such as caffeine (which we will talk about below) or poly-vitamins by up to 50% (3).

The next component we want to mention is caffeine. It occurs naturally in coffee seeds, cocoa seeds, guarana, and tea leaves such as yerba mate. Its consumption in moderation is considered absolutely safe (regulating its use in children and pregnant women especially), and it has recently been identified as a mediator for weight loss, so it can be useful secondarily in patients with metabolic syndrome. An earlier reference in a publication on amateur athletes showed that the positive effects of caffeine were enhanced when applied together with Korean ginseng (4 and 5).

Another component of NeoVital Boost from Neoactives is Siberian ginseng. For hundreds of years this compound has been used for health problems associated with the appearance of a chronic fatigue. Studies show that this treatment especially reduces the intensity and duration of tiredness when compared to a placebo in a way that is totally safe and free of side effects (6).

Another component of this formula is the ubiquinol or coenzyme Q10. Its use in diseases associated with chronic tiredness, such as fibromyalgia or chronic fatigue syndrome, give it a well-deserved place in this nutritional supplement. In these patients, there is a demonstrated reduction in amount of CoQ10 in their cell cytoplasm or misuse of it by the mitochondria (7). Many situations in our daily lives can, in turn, decrease levels of this enzyme; for example the consumption of statins or extreme exercise.

Thanks to its antioxidant effects recognized by the EFSA, vitamin C also has a place in this compound, as optimizing energy use at the mitochondrial level contributes to delaying exhaustion and thus better use of energy.

Likewise, according to the EFSA, supplementation of vitamin B5 is useful when tiredness is due to vitamin and nutritional deficiencies, especially of this vitamin.

In short, NeoVital Boost is a compendium of natural supplements intended to curb metabolic imbalances responsible for the onset of chronic tiredness and, in turn, improve symptoms in a short period of time to improve patients’ quality of life.

BIBLIOGRAPHY

(1) Bucci LR et al. Selected herbals and human exercise performance. Am J Clin Nutr. 2000 Aug;72(2Suppl):624S-36S

(2) Braz AS et al. Effects of Panax ginseng extract in patients with fibromyalgia: a 12 week, randomized, double-blind, placebo-controlled trial. Braz J Psychiatry. 2013 Mar;35(1):21-8.

(3) Caso Marasco A et al. Duble-blind study of a multivitamin complex supplemented with ginseng extract. Drugs Exp Clin Res. 1996;22(6):323-9.

(4) Bandyopadhyay A et al. Effects of acute supplementation of caffeine and Panax ginseng on endurance running performance in a hot and humid environment. J Hum Ergol (Tokyo). 2011 Dec;40(1-2):63-72.

(5) Heckman MA et al. Caffeine (1, 3, 7-trimethylxanthine) in foods: a comprehensive review on consumption, functionality, safety, and regulatory matters. J Food Sci. 2010 Apr;75(3):R77-87

(6) Hartz AJ et al. Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychol Med. 2004 Jan;34(1):51-61.

(7) Cordero MD et al. Oxidative stress correlates with headache symptoms in fybromialgia: coenzyme Q10 effect on clinical improvement. PLoS One. 2012;7(4):e35677.

La entrada Be the best version of yourself in your daily life se publicó primero en Neolife.

The human body has two prominent organs that “cleanse” it of all the waste products ingested or generated by the body itself. We’re talking, of course, about the kidneys and the liver.

Neoactives’ new supplement, NeoDetox, is a combination of natural substances that optimize the cleaning function of the liver and ultra-filtering function of the kidneys Its composition includes milk thistle, turmeric, artichoke leaf, dandelion, alpha-lipoic acid, inositol, betaine, glutathione and taurine.

Dr. Francisco Martínez Peñalver – Neolife Medical Team

NeoDetox helps improve normal lipid metabolism and maintain normal liver function.

The human body has two prominent organs that “cleanse” it of all the waste products ingested or generated by the body itself. We’re talking, of course, about the kidneys and the liver. Broadly speaking, the liver has the essential task of “disabling’ proteins that, due to their size or substances, or their composition, can be toxic if they accumulate in the blood (ammonium radicals, hormones, drugs, etc.). In addition, the kidneys act as an ultra-filtering system to clean the blood plasma of any molecules that may jeopardize its osmotic, oncotic or mineral balance.

The new supplement, NeoDetox by Neoactives, is a combination of natural substances that optimize the cleaning function of the liver and ultra-filtering function of the kidneys.

Among these substances, we should first mention milk thistle. “Silybum marianum” or milk thistle is a medicinal plant belonging to the bioflavonoids group that has been used for centuries as a hepatic protector. This protective function is performed in numerous ways, mainly through its antioxidant and anti-inflammatory effects, but also by helping to stabilize the cell membrane of the hepatocyte, a regenerator of hepatocytes, and by avoiding collagen fiber deposits (which eventually causes cirrhosis) (1). However, recent studies show that milk thistle also has protective effects for the kidneys and the cardiovascular system and helps prevent the onset of certain neurodegenerative diseases, such as Parkinson’s or Alzheimer’s. Also, studies have been done in recent years demonstrating the ability of this plant to cause cell apoptosis in cells with damaged DNA. This ability is interesting because milk thistle has been suggested as a possible treatment in some cancer cases (2). Finally, there is a well-designed clinical trial on the effects of milk thistle on chronic hepatitis caused by the hepatitis C virus. In this study of 62 patients, the quality of life of patients treated at high doses and the biomarkers measured in the specific analysis (3) improved.

Another one of the compounds we’ll talk about is turmeric. Administering it in a preventive way has shown to be effective in patients who would later be exposed to situations or drugs (such as Methotrexate) that were likely to cause severe liver damage. Hepatotoxic effects were mitigated in these patients due to its anti-inflammatory properties (4). A decrease in liver enzyme activity was observed, improving the use of glutathione at the intracellular level and reducing lipid peroxidase levels, thus decreasing the entire inflammatory cascade in the liver (5).

Another substance included in this supplement is artichoke leaf (Cynara scolimus), which has been used for hundreds of years to solve difficult-to-treat gastrointestinal issues, such as functional dyspepsia (6). Another pathology characterized by uncertain treatment where artichoke leaf has proven effective is nonalcoholic fatty liver disease, which is also the most common cause of chronic liver disease worldwide. These beneficial effects have been demonstrated through imaging, ultrasound, and by improvement in biomarkers related to hepatic homeostasis as well as total bilirubin and transaminases levels (7). Finally, artichoke leaf extract has also been shown to be an effective treatment against the toxicity of certain heavy metals associated with contamination such as cadmium (8).

The next component we should look at is dandelion (Taraxacum officinale), a perennial medicinal plant originating in the Northern Hemisphere, which has yielded promising results in studies where it has been used to prevent or treat the effects of accumulation of heavy metals such as lead, especially in relation to redox metabolism and liver poisoning (9).

Another component is alpha-lipoic acid, a molecule that has been well-known for years for its protective properties against liver cytotoxicity, which is caused by contaminants such as heavy metals present in environmental pollution, by optimizing the use of glutathione, one of the cell’s energy sources (10).

The other components, inositol, betaine, glutathione and taurine, target the alleviation of inflammation and the harmful effects on the oxidative stress of toxins in general, but of heavy metals and hepatotoxic substances in particular. These components are important for homeostasis, the normal function of the mitochondria, the true “energy factory” at the cellular level and the main target of the toxins mentioned.

BIBLIOGRAPHY

(1) Bahmani M et al. Silybum marianum: Beyond Hepatoprotection. J Evid Based Complementary Altern Med. 2015 Oct;20(4):292-301.

(2) Miljic N et al. New therapeutic potentials of milk thistle (Silybum marianum). Nat Prod Commun. 2013 Dec;8(12): 1801-1810.

(3) Fathalah WF et al. High Dose of Sylimarin in patients with decompensated liver disease: A randomized controlled trial. J Interferon Cytokine Res. 2017 Nov;37(11):480-487.

(4) Moghadam AR et al. Pre-administration of turmeric prevents methotrexate-induced liver toxicity and oxidative stress. BMC Complement Altern Med. 2015;15:246.

(5) Lee Hy et al. Turmeric extract and its active compound, curcumin, protect against chronic CCI4-induced liver damage by enhancing oxidation. BMC Complement Altern Med. 2016 Aug;16(1):316.

(6) Holtman G et al. Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six-week placebo-controlled, double blind, multicenter trial. Aliment Pharmacol Ther. 2003 Dec;18(11-12):1099-1105.

(7) Panahi Y et al. Efficacy of artichoke leaf extract in non-alcoholic fatty liver disease: A pilot double-blind randomized controlled trial. Phytother Res. 2018 Jul;32(7):1382-1387.

(8) El-Boshy M et al. Studies on the protective effect of the artichoke (Cynara scolymus) leaf extract against cadmium toxicity-induced oxidative stress, hepatorenal damage, and immunosuppressive and hematological disorders in rats. Environ Sci Pollut Res Int. 2017 May;24(13):12372-12383.

(9) Gargouri M et al. Dandelion-enriched diet of mothers alleviates lead-induced damages in liver of newborn rats. Cell Mol Biol (Noisy-le-grand). 2017 Feb 28;63(2):67-75.

(10) Shi C et al. Alpha-Lipoic acid protects against the cytotoxicity and oxidative stress induced by cadmium in HepG2 cells through regeneration of glutathione by glutathione reductase via Nrf2/ARE signaling pathway. Environ Toxicol Pharmacol. 2016 Jul;45:274-281.

La entrada Extra help cleaning your body se publicó primero en Neolife.

The body’s purifying processes primarily involve the kidneys and the liver, purifying organs that help maintain homeostasis or the “inner well-being” of our body.

NeoDren from Neoactives is a mixture of all the elements that help the kidney perform its excretory function to remove residues that are harmful to the body and help prevent improper fluid retention. It is made up of horsetail, orthosiphon, dandelion, nettle and birch, as we will see below.

Dr. Francisco Martínez Peñalver – Neolife Medical Team

Sometimes we accumulate more fluid than necessary, a problem that occurs most during the summer and affects women especially.

NeoDren from Neoactives is a formula made from a selection of 5 of the most widely recognized and commonly used plants in drainage type diets, together with abundant intake of fluids. All of these plants are incorporated in the form of concentrated and standardized extracts to guarantee relevant quantities of each one.

These plants share many components, and combining them helps to strengthen their properties and synergies significantly.

Horsetail extract (Equisetum arvense) has been used in medicine since Ancient Greece for its healing properties. It is currently used to help the body drain excess liquids, but its excess silicon makes it an interesting complement for use in bone problems, hair loss or nail health. However it performs its best-known function as a diuretic thanks to its potassium and flavonoid content, which allows it to increase the amount of excreted urine, in some cases up to 25-30%. There are studies that show its diuretic function is equal to that of thiazides at low doses, without producing the electrolyte output associated with the latter (1).

Another element of this diuretic formula is orthosiphon. Orthosiphon stamineus is a natural diuretic that has been used for centuries to treat circulatory and fluid retention problems. The increased volume of urine is based on an increase in potassium excretion. Orthosiphon treatment also slightly elevates BUN and creatinine, probably through mild dehydration, which means we should use this herb with some caution (2). However, its effects are milder than those of other diuretics used much more frequently such as thiazides and loop diuretics such as furosemide (3).

Dandelion extract (Taraxacum officinale) has been used as a diuretic for over 2,000 years in Traditional Chinese Medicine and other types of therapy such as Ayurvedic Medicine. In studies across the board this extract has been shown to increase the volume of excreted urine with a good safety profile and no side effects when taking the recommended dose (4).

Nettle extract, Urtica dioica, is used as a diuretic, but for its natriuretic properties, i.e. sodium excretion. It can be a very useful weapon in patients with high blood pressure indicators as it can help control it. However, an excess dose, precisely because of these mentioned beneficial effects, can be toxic and cause extreme hypotension (5).

Birch extract (Betula pubescens) is part of a group of natural elements classically used to combat urinary tract infections as they alter the adhesion of the endothelial walls so pathogens cannot attach themselves to them (6). In some animal studies this extract has been shown to raise levels of Prostaglandins E2, hormones that regulate inflammatory events (7).

BIBLIOGRAPHY

(1) Carneiro DM et al. Randomized, double-blind clinical trial to assess the acute direct effect of Equisetum arvense (Field Horsetail) in healthy volunteers. Evid Based Complement Alternat Med. 2014;2014:760683.

(2) Adam Y et al. Diuretic properties of Orthosiphon stamineus Benth. J Ethnopharmacol. 2009 Jul 6;124(1):154-8.

(3) Ameer OZ et al. Orthosiphon stamineus: traditional uses, phytoche mistry, pharmacology, and toxicology. J Med Food. 2012 Aug;15(8):678-90.

(4) Bevin A et al. The diuretic effect in human subjects of an extract of Taracaxum officinale Folium over a single day. J Alternat and Comp Med. 2009;15(8):929-34.

(5) Tahri A et al. Acute diuretic, natriuretic and hypotensive effects of a continuous perfusion of aqueous extract of Urtica dioica in the rat. J Ethnopharmacol. 2000 Nov;73(1-2):95-100

(6) Rafsanjani N et al. Antiadhesion as a functional concept for protection against uropathogenic Escherichia coli: in vitro studies with traditionally used plants with antiadhesive activity against uropathogenic Escherichia coli. J Ethnopharmacol. 2013 Jan 30;145(2):591-7.

(7) Masteikova R et al. An orientational examination of the effects of extracts from mixtures of herbal drugs on selected renal functions. Ceska Slov Farm. 2007 Apr;56(2):85-9.

La entrada Avoid fluid retention during the summer se publicó primero en Neolife.