Nutritional doses, corrective doses, pharmacological doses:
The nutritional doses are intended to avoid deficits, to meet circumstantial needs (eg growth, pregnancy, sport, stress, etc.), to ensure the maintenance of the organism and therefore the prevention of acute and long-term pathologies. These are therefore daily contributions, adjustable according to needs.
Pharmacological doses, generally higher than corrective doses, are not given on the basis of a deficit, but to obtain a drug effect.
Eg the indications of magnesium as tocolytic, antiarrhythmic, anticonvulsant, in asthma attack, myocardial infarction, stroke, alcohol withdrawal, etc…. The indications of omega three against hypertriglyceridemia, viral infections or to sensitize cancer cells to chemo or radiotherapy.
Food and nutrient compatibility: liposolubility. fibers, etc.
Vitamins A, D, E, K are fat soluble, but also carotenoids and coenzyme Q10.
Carotenoids are linked to fibers. Carotene from raw carrot (like lycopene from whole tomato) is absorbed at 5%. Crushed into juice or cooked, the absorption increases to 30%. If we add fat at 70%.
Phytates (wholemeal bread, bran) slow the absorption of zinc, baking with sourdough avoids this inhibition. The absorption of polyphenols is slowed down by milk proteins (tea, chocolate), but increased by alcohol (red wine).
The rules of composition of food supplements
- No iron, no copper, no manganese, no vanadium
- Fluoride should never be given by bone, but topically
- Vitamin A should be replaced with beta-carotene
- For the elderly and in the more dosed antioxidant complexes must appear at least the three main carotenoids: beta-carotene, lycopene. lutein (with vitamin C, selenium and natural vitamin E)
- Vitamin E must be natural (D-RRR-alpha-tocopherol)
Taking large doses of polyunsaturated fatty acids (especially omega three) must be combined (except contraindications such as chemo / radiotherapy) with antioxidants to protect them
- Compatible minerals must be bioavailable (magnesium glycerophosphate, zinc citrate, etc.)
- Nutritional doses must take into account food intake, population categories, increased needs
- Pharmacological doses must be validated by pharmacokinetic studies (ex sulforaphane at least 35 mg) as well as the number of doses and their frequency. Ex: need to maintain stable plasma magnesium implies three doses per day, in case of viral infection, 125 mg of vitamin C every 2 hours or every hour
- For some nutrients, there are chronobiological data, e.g. tyrosine in the morning at least 20 minutes before breakfast to increase the synthesis of catecholamines, calcium and vitamin D in the evening to better slow down PTH
Contraindications, side effects and follow-up:
Contraindications:
- Antioxidants in pharmacological doses cannot be given during chemo or radiotherapy (especially NAC and vitamin C)
- Omega three supplements should not be given if there is a risk of bleeding, because they increase the bleeding time:
- at the end of pregnancy
- perioperatively
- in case of hemorrhagic stroke
- in case of retinal hemorrhage
- and should be taken with care
- in hemophiliacs, other carriers of coagulation disorders, in people who have heavy bleeding (eg menorrhagia, nosebleeds, UC, etc.), in people on anticoagulants
- The same restrictions apply to pharmacological doses of vitamin E which can inhibit platelet adhesion (also with turmeric, some forms of cinnamon, garlic)
- Vitamin K cannot be given to someone on VKA (a drug that should be negotiated for a change because vitamin K is vital)
- There are rare anaphylactic reactions to vitamin B12
- Iron cannot be given to a person with infection, cancer or inflammatory disease.
- Tyrosine cannot be given in case of pregnancy, psychosis, hyperthyroidism, pheochromocytoma and must be the subject of precautions for use in case of cardiac arrhythmia.
(Non-exhaustive list)
Side effects:
- Vitamin C in excess is laxative
- It can reduce sleep at the onset of fullness. Avoid giving it in the evening the first week.
- Tyrosine can make you nervous, irritable, aggressive, insomniac, give stomach acidity … the simplest measure is to allow yourself a week of magnesia repletion to avoid these side effects
- Carotene can give an orange color to the seed coat (usually more than 30 mg / day, but individual susceptibility)
- There are rare cases of polyneuritis following chronic administration of vitamin B6 at doses of around 500 mg / day, almost all of which are reversible after discontinuation of treatment; it is prudent not to administer more than 100 mg / day (and there is no reason to do it for more than a month as part of a corrective course which should combine the other B vitamins and magnesium)
- The combined administration of magnesium and other B vitamins also seems to reduce this risk.
Nicotinic acid can give hot flashes, redness, hypotension….
(Non-exhaustive list)
Followed:
Any prescription for nutritherapy must be the subject of monitoring protocols, both to realize the adherence to the treatment, its possible positive and negative effects, and to adjust the dosages according to the evolution, as well as the nutrients and synergistic measures. The prescribed amounts should be adapted to the intensity of the problems. In the event of insufficient results, there are measures gradually more intense or complete to try to exceed the limits of the first-line treatments.
Author Jean-Paul Curtay