Tag Archives: Dr. Cathy Rosenbaum

Probiotic Dietary Supplement Safety & Efficacy Is in Question

Probiotic dietary supplements have become quite popular in recent years, touted for such conditions as general health (prevention), immune health (prevention), leaky gut, diabetes mellitus, and dysbiosis from antibiotic overuse, among others.

Probiotics are generally safe for a heathy person (Generally Recognized as Safe [GRAS] per the FDA classification).  However, some live  probiotic strains may negatively play on a weakened immune system in at-risk persons,  allowing unwanted organisms to enter the body and cause pneumonia, endocarditis, or sepsis.  Probiotic supplements are not for everyone!

Activia yogurt, kefir, kimchi, sauerkraut, tempeh, miso, and kombucha are examples of food sourced-probiotics. Culturelle and Align are popular probiotic dietary supplements. Florastor is a prescription medication.  Examples of probiotic strains include, but are not limited to, bacteria (e.g. Lactobacillus, Lactococcus, Leuconostoc, Pediococcus, Bifidobacterium, Bacillus) and yeast (e.g., Saccharomyces).

It’s important to choose the right probiotic product for your health needs with the help of your pharmacist, who can thoroughly evaluate the product  before recommending it to you.  Product criteria:

  • strain identification by genome sequencing
  • transmissible antibiotic resistant gene profile
  • toxicology in vitro and in vivo studies
  • clinical studies on efficacy (how well does the product work)
  • target population (healthy  vs sick)
  • product formulation and labeling (product purity, contaminants)

If probiotic manufacturers claim to treat/prevent disease, their probiotics should be studied and marketed as drugs, rather than as  supplements, upholding FDA regulation.  Probiotics are not drugs, not magic bullets, nor are they universally safe and effective.

The appropriate probiotic strain and formulation should be recommended by your healthcare professional based on your individual health needs.

For more information or to schedule a wellness consultation with Dr. Cathy Rosenbaum,  holistic clinical pharmacist and certified health coach in Blue Ash OH,  please visit www.rxintegrativesolutions.com.

–Dr. Cathy Rosenbaum

 

 

 

Kothari.  Probiotic supplements might not be universally-effective and safe: A review.  Biomed Pharmacother 2019;111:537-547.

The Sunshine Vitamin for Bone Health

By Cathy Rosenbaum PharmD MBA RPh
www.rxintegrativesolutions.com
July 12, 2014

Vitamin D’s Purpose

Vitamin D is found naturally in our body. It maintains normal blood concentrations of calcium and phosphorus, and helps our bones stay strong. Interestingly, the body manufactures vitamin D from cholesterol, through a process triggered in the skin by UVB rays from sunlight. Vitamin D is called ‘the sunshine vitamin.’ 

Per the Institute of Medicine, “despite the many claims of benefit surrounding vitamin D, the evidence does not support a basis for a causal relationship between vitamin D and many of the health outcomes purported to be affected by vitamin D intake.” Some of these claims yet to be proven in well designed human clinical studies include antioxidant, anti-inflammatory, and anti-cancer indications.

Reasons for Low 25-(OH)-Vitamin D Blood Levels

We require a certain level of 25-(OH)-vitamin D in the blood for health. That level can be measured by a simple blood test you can request from your doctor. If you have not yet had your blood tested or it has been awhile since your last blood level drawn, you may wish to ask your doctor to order a 25-(OH)-vitamin D level. The test will determine if you might benefit from supplementation or nutritional changes in your diet to increase vitamin D if your blood level is low (visit http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional for more information).

Since we’re talking about bone health, it is important to monitor for osteopenia or osteoporosis by way of a DEXA scan. Talk with your doctor about ordering a DEXA scan to measure bone density if you have not had one for several years (visit the National Bone Health Alliance @ www.nbha.org for more information).

25-(OH)-vitamin D blood levels may be low due to reduced exposure to sunlight (e.g., less than 20 minutes of exposure a few times a week), reduced gastrointestinal absorption or nutritional intake, Crohn’s Disease, reduced kidney conversion to the active vitamin form, or from medication interactions such as statins for cholesterol lowering (visit http://www.livestrong.com/article/282052-vitamin-d-deficiency-caused-by-prescription-medication ).

Don’t just start taking vitamin D because you think you need it. You might already be getting enough from sunlight exposure as well as your diet. The Institute of Medicine recommends 600 IU – 800 IU vitamin D3 daily from food or supplements unless otherwise directed by your doctor.

Sources of Vitamin D

Vitamin D can be found in sardines, wild salmon, herring, mushrooms exposed to UV light, fortified milk, yogurt, and breakfast cereals, egg yolks, beef liver, canned tuna, cod liver oil, and cheese.

Vitamin D2, or ergocalciferol, is the form found in prescription strength capsules.
Vitamin D3, or cholecalciferol, is the form found in most over-the-counter vitamin D products.

Vitamin D3 is also available in a variety of dietary supplements. Since there are so many different supplement doses on the market, you may wonder why some people are taking larger doses. Talk to your doctor about your individual needs. Mega doses of vitamin D can cause hypervitaminosis long term if blood levels are found to be excessive.

Side Effects

Fat soluble vitamins like vitamin D can accumulate in the body over time. Symptoms of vitamin D toxicity include headache, diarrhea, nausea, increased blood pressure, anorexia, weight loss, increased thirst, weakness, nervousness, and with long term extreme doses, abnormal heart rhythms. Many of these might not be attributed to vitamin overuse, but confused with other medical conditions. For more information on long term vitamin D safety, visit www.healthlettermayoclinic.com (Sept 2009).

Importance of Exercise for Bone Health

Finally, because bone density decreases after the age of 30 years, bone stressing exercise is important at any age and helps to preserve bone strength. The areas of risk for bone density loss include the wrists, hips, and spine. Talk with your doctor about an exercise program that is right for your individual needs.

“The light of the eyes rejoices the heart, and good news refreshes the bones.” Proverbs 15:30