Contents

Preface 9

Introduction 13

CHAPTER 1: Life Fortified 23

CHAPTER 2: Inside the Bottle and Behind the Label 33

CHAPTER 3: Vitamins 73

CHAPTER 4: Minerals 145

CHAPTER 5: Nutraceuticals 199

CHAPTER 6: Supplements for Common Ailments 249

CHAPTER 7: Making Sense of Health Information 259

APPENDIX 1: Your Food Journal 279

APPENDIX 2: Your Personalized Supplements Chart 281

APPENDIX 3: Laboratory Tests 285

APPENDIX 4: Drug-Nutrient Depletions and Interactions 297

Glossary 322

Acknowledgments 325

Index 327

Chapter 1

Life Fortified

It was in the deep winter of 1535–36 in what is now Quebec

City, Canada, that the crew of the French explorer Jacques

Cartier developed scurvy. Dom Agaya, son of the Iroquois

chief Donnacona, showed Cartier how to prepare a tea from the

branches of the cedar tree that could treat the disease. The tea was

so effective that Cartier proclaimed it a miracle that so many of his

men survived. Is it any surprise then that the northern white cedar

became known as the “tree of life”? Cedar needles were not part

of the typical diet, but they were consumed during the long winters

by indigenous peoples. In 1932, scientists finally determined that

a lack of vitamin C is what causes scurvy. And guess what? Cedar

needles contain vitamin C.

Many cultures around the world looked to nature for substances

that could enhance their health during different seasons of the

year as well as during different stages of their lives. In Traditional

Chinese Medicine, physicians recommended medicinal plants

to fortify the mind and body. Reishi, a nonculinary mushroom,

was dried and consumed as tea to encourage vigor and long life.

Scientists have found that reishi is a powerhouse antioxidant,

Fortify Your Life ~ 24

helping protect the body from environmental toxins as well as

shutting down excessive inflammation, which we know drives

many chronic diseases. In Ayurveda, the traditional medicine

of India, one category of plants, the rasayanas, were believed to

promote health, protect the mind and memory, and support the

body’s ability to defend itself against infection and many of the

degenerative processes that can happen as we age. Researchers are

now finding that some of these rasayanas, such as bacopa, ashwa-

gandha, and shatavari, have incredible promise for their ability to

squelch inflammation and oxidative stress, as well as to support

immune and brain health. So, when I hear the argument that peo-

ple haven’t traditionally “supplemented” their diet, I beg to differ.

The concept of enhancing our health through supplementation is

quite ancient. In my opinion, with all the stressors of modern life,

we may need to fortify our lives more than ever before.

HOW OUR LIVES HAVE CHANGEDModern advances in sanitation, public health initiatives, immu-

nizations, and medicine have led to a dramatic decline in many

acute and infectious diseases. My grandmother’s brother died at

age 13 in southwestern Kansas from a ruptured appendix because

there were no local surgeons or hospitals. This was not uncom-

mon just a few generations ago but is thankfully a rarity in the

U.S. today. Early detection has allowed us to identify potentially

life-threatening diseases early enough to successfully intervene

in the disease process. There is so much to be thankful for when

it comes to modern medicine. Yet, even with all these incredible

advances, and there have been many, Americans are still faced

with a staggering burden of chronic disease.

Life Fortified ~ 25

Almost one in ten people have diabetes and that number is

rapidly growing. A disease once only seen in the elder population,

type 2 diabetes now affects children as young as four years of

age. Heart disease continues to be the number one cause of death

for both men and women, with more than 70 percent of elderly

Americans taking medications to treat it in 2012. Dementia, or

what was once called senility, is now diagnosed every 67 seconds

in the U.S. And while researchers and clinicians work tirelessly

to find the most effective ways to treat cancer, this devastating

disease is on the rise in the young and old around the globe. Some

experts believe that today’s children will be the first generation

in history to not live as long as their parents.

What is driving the rise in chronic disease? The answer is com-

plex, as there are many factors at play. Diet, obesity, lack of physical

activity, poor management of stress, inadequate rest and sleep, and

exposure to environmental toxins are among the primary drivers

of many of the chronic diseases plaguing 21st-century America.

Our lives have changed dramatically over the past 100 years.

Our modern diet looks very different than that of our ancestors.

People lived on wild game or meat—including organ meats and

eggs sourced from their own livestock, as well as vegetables and

fruits that were often grown in their own garden, along with

legumes, nuts, and seeds. Depending upon where people lived,

cheese, butter, and whole grains were also consumed. But nowhere

on the planet were people eating Pop-Tarts for breakfast or pro-

cessed salty snack chips and soda pop for lunch. Processed foods

are almost always lower in important nutrients than foods closer

to their natural, whole form, and they often contain substances

such as high-fructose corn syrup and artificial flavorings/colorings

that are foreign to our body. In the span of just 100 years, we’ve

gone from roughly 8 pounds of added sugar per person per year

to more than 100 pounds! More than one-third of this sugar

Fortify Your Life ~ 26

comes from soda or energy and sports drinks, none of which were

present in your great-grandmother’s kitchen.

Plant-based foods are incredibly important for our health,

and we require an abundance of them in our diet. With all the

stresses of modern life, we need the antioxidants (substances that

maintain cellular integrity and prevent damage to DNA) and phy-

tonutrients (plant nutrients) found in fruits, vegetables, nuts, and

seeds. However, in spite of public health messages encouraging

us to eat 4 to 5 cups of vegetables and fruits every day, the aver-

age American falls far short. And when you read the latest news

report touting an increase in vegetable intake, check the fine print.

Two-thirds of this increase is generally attributed to potatoes,

potato chips, and French fries—hardly the rich, rainbow-colored

produce those who care about public health were hoping for!

And even if you are eating your fruits and veggies, their

nutritional value has also changed. While modern agricultural

advances have allowed farmers to grow larger varieties and quan-

tities of produce, enabling us to feed the growing populations of

the world, that bountiful harvest, unfortunately, has come at a

cost. Breeding plants for size, quick growth, long-distance trans-

port, and weeks-long storage has made our veggies and fruits

less nutritious. A landmark study published by Donald Davis et

al., in the Journal of the American College of Nutrition in 2004,

compared USDA nutrient data for 43 garden crops from 1950

to 1999. It found a statistically reliable decline in six important

nutrients: a 6 percent decline in protein and a 15 to 38 percent

decline in calcium, iron, riboflavin, phosphorous, and vitamin C.

And reduced nutrition in produce is not just a U.S. problem.

A 2005 report from the United Kingdom noted that the average

concentrations of copper, magnesium, and sodium in vegetables

and copper, iron, and potassium in fruits decreased significantly

between the 1930s and the 1980s. Another study of 20 commonly

Life Fortified ~ 27

eaten vegetables published in the British Food Journal found that

the average calcium content had declined 19 percent, iron by 22

percent, and potassium by 14 percent. With so many people in the

world deficient in important vitamins and minerals, the declining

concentration of almost half of all the essential nutrients in our

produce is concerning.

It’s not just the change in nutritional value that is alarming, but

also the reality that the use of pesticides and herbicides is now

common practice in farming. I recognize that there have been ben-

efits associated with their use, but we can’t ignore the damaging

effects they can have on our health, particularly during pregnancy

and childhood, when chemical exposures are most dangerous.

Studies published in highly prestigious scientific/medical journals

show that pesticide exposure, in utero and during childhood,

may increase the risk of childhood leukemia and other child-

hood cancers, early female puberty, irregularities in menstrual

and ovarian function, and attention-deficit-hyperactive disorder

(ADHD). Long-term exposure, small “doses” over decades, can

have a cumulative effect that may make us more vulnerable to

prostate cancer, early menopause, breast cancer, and neurological

harm. Certain toxic chemicals, such as PCBs, DDT, and dioxins,

are classified as persistent organic pollutants because they persist

in the environment for a very long time. Although they have been

banned, these chemicals that are known to adversely affect human

health continue to show up in our bones and bloodstream.

I believe that now more than ever, our cells need protection from

the damaging effects of environmental pollutants. Studies show

that vitamins A, C, and E, and melatonin (a hormone produced

in the pineal gland) protect our body from organophosphate pes-

ticides, dioxins, and PCBs. Yet, according to the Office of Dietary

Supplements, most Americans don’t meet the RDA for vitamin E

from their diet alone—and melatonin, which plays a vital role in

Fortify Your Life ~ 28

regulating our 24-hour circadian clock, is routinely suppressed

by the constant exposure to blue light from computer screens,

televisions, and house lights. Vitamins C and E also protect us

against cigarette smoke, air pollution, and ultraviolet radiation.

Yet 16 million Americans are severely deficient in vitamin C. Iron

helps protect against lead toxicity, which is incredibly dangerous

to the brain and nervous system of infants and young children.

Yet 7 percent of American children between the ages of one

and five have iron deficiency anemia, and that number doubles

among Hispanic children. The point is this: We are exposed to

an increasing number and amount of chemicals in our food and

environment, and the typical American diet is not sufficient to

protect our DNA and health from these toxins.

Our work lives have also changed: Many of us no longer spend

much of our time outdoors as people did in centuries past. We live,

work, and even play indoors. However, getting adequate exposure

to sunlight is critical for maintaining a normal sleep-wake cycle,

fostering healthy mood, and synthesizing vitamin D. And when

we do go outside, we wear sunscreen. Most women, and many

men, put on skin moisturizer every morning that contains an SPF

of 15 or higher.

I’m not recommending that you get rid of your sunscreen. It’s

important to protect your skin from sun damage and reduce your

risk for skin cancer. However, since sunscreen limits sun absorp-

tion, it also significantly limits the subsequent manufacture of

vitamin D. It’s very hard to get adequate amounts of vitamin D

in the diet; the body was designed to produce it in the skin after

exposure to sunlight. Vitamin D is not only vitally important for

healthy bones; research shows that it also plays a significant role

in immune and cardiovascular health. Vitamin D deficiency/insuf-

ficiency among Americans is a big problem, particularly for those

who are dark-skinned, spend most of their time indoors, regularly

Life Fortified ~ 29

use sunscreen, live in northern latitudes, and/or are overweight

or obese. According to the Centers for Disease Control (CDC),

at least 66 million Americans have low levels of vitamin D. Are

you one of them?

Another change: our consumption of salt, as I mentioned earlier.

In the early 20th century, goiter, a swelling of the thyroid gland,

was common in areas around the Great Lakes and in the Pacific

Northwest. When it was found that iodine could both treat and

prevent goiter (iodine is critical for maintaining thyroid function),

the Morton Salt Company began selling iodized salt in 1924. Salt

was a perfect delivery system, as iodine didn’t alter its taste, and

both rich and poor consumed it regularly. Goiter was all but erad-

icated. Today, public health messages warn that excessive salt can

increase blood pressure and harm the kidneys and cardiovascular

system, so we’ve cut back, especially at home. And when we do use

table salt, an increasing number of us are choosing from a variety

of options now available in the marketplace: Himalayan, kosher,

and sea salt. Unless they specifically say they are iodized, these

salts are naturally very low in iodine. Fast foods and processed

foods may be high in sodium, but they don’t contain iodized salt.

What’s more, the chemical perchlorate, which is both natu-

rally occurring and man-made, blocks the uptake of iodine by

the thyroid gland. The Department of Defense and the National

Aeronautics and Space Administration (NASA) use significant

amounts of manufactured perchlorate in the production of rock-

ets, munitions (grenades, flares, fuses), and missiles. The perchlo-

rate can then contaminate groundwater and soil, making its way

into our food and drinking water. Having lived in New Mexico

much of my life, I’m very aware of this situation, given that two

of our large military bases in southern New Mexico—Holloman

Air Force Base and White Sands Missile Range—have been found

to have, and continue to have, very high levels of perchlorate

Fortify Your Life ~ 30

in both surface and ground water. Having adequate amounts

of iodine in the diet is extremely important as it competes with

perchlorate for binding sites on the thyroid, reducing some of the

chemical’s adverse effects.

Although the United States has been considered “iodine suffi-

cient” for decades, the most recent large government nutrition

study found that reproductive age women in this country are now

borderline iodine insufficient. Canada reported similar findings.

This is very troubling given that low iodine during pregnancy

reduces IQ and increases the risk for impaired cognitive develop-

ment in babies. A Mount Sinai study published in the Journal of

Women’s Health in 2014 found that 38.9 percent of the pregnant

women attending prenatal clinics in New York City who were not

taking iodine supplements were at risk for mild to severe iodine

deficiency according to World Health Organization guidelines.

The RDA for iodine is 150 to 290 micrograms (mcg) for adults,

and the American Thyroid Association now recommends that all

pregnant and nursing women take a daily vitamin that provides

150 mcg of iodine as potassium iodide. This is one example of

how dangerous it can be to dismiss supplements out of hand.

Another factor to consider: We take lots of prescription drugs.

In fact, the U.S. population takes more medications than any

other country on the planet. In 2011, Americans spent $263

billion on prescription drugs, accounting for almost 10 percent

of all national health expenditures. According to the CDC report

Health: United States 2013, about 50 percent of Americans take

at least one prescription drug per day and 10 percent take five or

more. You may need to take a pharmaceutical drug for months

or years, but do you know the effects of that drug on your body’s

ability to absorb and use key nutrients in your diet?

Proton pump inhibitors, or PPIs (drugs that inhibit the proton,

or acid-producing, pumps in the stomach), are one of the most

Life Fortified ~ 31

widely prescribed classes of drugs in the U.S. Sold under such brand

names as Nexium, Prilosec, and Protonix, they are used to treat

acid reflux—and are, in my opinion, overprescribed. Stomach acid

is vitally important for your ability to absorb and/or utilize many

key nutrients, including iron, calcium, magnesium, and vitamin

B12. PPIs carry an FDA black box warning that they can increase

your risk for bone fracture and cause your magnesium levels to

drop dangerously low, increasing the risk for seizures and serious

heart arrhythmias. Most physicians are not aware of, nor do they

monitor for, these potentially severe nutritional depletions. And

there are many such nutrient-depleting medications. Metformin,

a frequently prescribed drug for diabetes, causes B12 deficiency,

especially if you take it for more than four years. ACE inhibitors and

thiazide diuretics used to treat high blood pressure deplete zinc. The

list goes on and on. Many patients taking these drugs have never

been checked for specific nutrient deficiencies, and no clinician has

told them to either increase their dietary intake of foods rich in

these vitamins/minerals, take a supplement, or both.

If you look closely at the multitude of ways that our lives, diets,

foods, and medication use have changed over the past 100 years,

it becomes clear that there may be gaps in your nutrition, as well

as higher needs for certain nutrients based upon your age, gender,

personal health history, use of medications, and level of exposure

to environmental toxins and other stressors.

WHY SUPPLEMENTS MATTERI hope you are beginning to see that your diet may not be enough

to ensure that you are getting all the key nutrients necessary for

life in the 21st century. Fortunately, we can draw upon a large

body of research on nutrition and nutritional supplements to help

Fortify Your Life ~ 32

us in our pursuit of better health. A quick search of the National

Library of Medicine’s online resource PubMed yields more than

307,000 citations on nutrition, 535,000 on micronutrients,

33,000 for the combination of calcium and health, 44,000 for

vitamin D and health, and 23,000 articles just on iron deficiency.

However, with the rate of medical knowledge doubling every

three years, and expected to double every 73 days by the year

2020, clearly, it’s impossible for any clinician to keep up with

all the data. This is why it is important that you learn how to

take charge of your own health, so that you can make informed

decisions for you and your family.

It can be hard to sort through the noise. If you have a particular

illness or disease, you’ve probably already started researching

what nutritional support may be beneficial for you. But even if

you’re generally healthy, it’s still important to be aware that low

levels of key nutrients can significantly stress your body. That is

why I want to help you recognize your risks for being deficient in

certain nutrients, figure out what nutritional supplements might

help you address those deficiencies, and know what to look for

when purchasing nutritional supplements for yourself and your

loved ones.

You want to make sure you fasten your seat belt when it comes

to nutrition and, when appropriate, take the supplements that

offer the most protection. If you have a chronic health problem,

you might be surprised by how much better you feel when you

choose the correct nutritional and supplement regimen. You

might even be able to slow the progression of your disease. You

can feel confident that you are supporting your health by opti-

mizing your nutrition—without wasting money or taking dozens

of capsules or tablets each day.