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Is Ortho-Core the best overall Multivitamin?

multivitamin aor ortho core

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#1 SillyRabbit

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Posted 06 June 2014 - 05:37 AM


Been using Ortho-Core for a couple of years now and I just wanted to check in and make sure that it's still the best Multivitamin on the market.

 

I am a male, mid-twenties, and would like a Multivitamin that provides proper doses of the most bioavailable forms of all the essential Vitamins and Minerals, along with extra goodies that help with anti-aging and overall health.

 

As I prefer to air on the side of "less is more," I usually take 4 capsules a day opposed to the recommended 6.

 

My diet doesn't consist of too many fruits and vegetables, so adequate supplementation including bioflavanoids and phytochemicals are essential.

 

Anyway, is Ortho-Core still the best bet for my goals? Or is there something else that would be better? I'd prefer to stick with Ortho-Core unless there is something substantially more suited to my goals.

 

Edit: After doing some searches, i've seen people also recommend AOR's Multi-Basics 3, LEF Two-Per-Day, and LEF Mix. What are people's thoughts on how these stack up against Ortho-Core?


Edited by SillyRabbit, 06 June 2014 - 05:43 AM.


#2 pbandy1

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Posted 06 June 2014 - 06:42 AM

I prefer Designs for Health Complete Multi (iron-free), or ThorneFX Multi AM/PM



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#3 timar

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Posted 06 June 2014 - 10:36 AM

I am a male, mid-twenties, and would like a Multivitamin that provides proper doses of the most bioavailable forms of all the essential Vitamins and Minerals, along with extra goodies that help with anti-aging and overall health.

 

That's at least what the marketing of companies like LEF, ORM, Thorne & co wants you to believe. In fact, the extent to which all those multivitamins and most other "extra goodies" "help with anti-aging and overall health" is highly uncertain. In fact it is debatable whether even the most "goodie-ladden" multivitamins do anything at all for longevity (I think they do, albeit not very much compared to other lifestyle measures - e.g. eating a healthy diet, exercising and not smoking).

 

My diet doesn't consist of too many fruits and vegetables, so adequate supplementation including bioflavanoids and phytochemicals are essential.

 

That's exactly the wrong approach - and the very reason why multivitamins may do more harm than good for some poeple. A multivitamin may help to fill some gaps in the diet, but you can't compensate for an suboptimal diet with supplements. A healthy diet is much more than the sum of its known chemical constituents. If there is a common theme in nutritional research, it is that epidemiological studies provide conclusive evidence for the health benefits of dietary pattern rich in whole foods, fish, fruits and vegetables and micronutrient biomarkers related to such a diet. In the next step, via in-vitro and animal studies, a certain compound in the diet is identified which is thought to be mechanistically responsible for some of the observed health benefits. Then this promising compound is supplemented in randomized controlled trails - and usually fails to show the preventive effects it was thought to excert. In most cases, we're left non the wiser and the only thing we know for sure is that fruits and vegetables are good for you...

 

Seriously: if you diet doesn't contain enoguh fruits and vegetables you have to change your diet. It's not that hard, really.

 

Anyway, is Ortho-Core still the best bet for my goals? Or is there something else that would be better? I'd prefer to stick with Ortho-Core unless there is something substantially more suited to my goals.

 

Edit: After doing some searches, i've seen people also recommend AOR's Multi-Basics 3, LEF Two-Per-Day, and LEF Mix. What are people's thoughts on how these stack up against Ortho-Core?

 

As I've said, if your goal is to compensate for a unhealthy diet, it is an illusionary goal and no multivitamin or supplement will bring you there. If you just want a nutritional insurance with the added benefits of supra-RDA amounts of certain micronutrients, however, you don't need to take a whole lot of pills or spend a lot of money. One pill for a dime a day will do. That's why I recommend taking one of LEF's "Two-per-Day". It is reasonably inexpensive and the formula avoids the possible downsides of most cheap multivitamins (cheap folic acid and inorganic selenium, copper and iron) while in my opinion providing (at half dose) a good balance between the potential benefits of therapeutic doses of some nutrients on the one hand and a conservative approach to what can be considered a safe dose on the other hand.


Edited by timar, 06 June 2014 - 10:51 AM.

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#4 SillyRabbit

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Posted 06 June 2014 - 10:54 AM

That's exactly the wrong approach - and the very reason why multivitamins may do more harm than good for some poeple. A multivitamin may help to fill some gaps in the diet, but you can't compensate for an suboptimal diet with supplements. A healthy diet is much more than the sum of its known chemical constituents. If there is a common theme in nutritional research, it is that epidemiological studies provide conclusive evidence for the health benefits of dietary pattern rich in whole foods, fruits and vegetables. In the next step, via in-vitro and animal studies, a certain compound in the diet is identified which is thought to be mechanistically responsible for some of the observed health benefits. Then this promising compound is supplemented in randomized controlled trails - and usually fails to show the preventive effects it was thought to excert. In most cases, we're left non the wiser and the only thing we know for sure is that fruits and vegetables are good for you...

 
If you read my post, I already stated that I don't even take the full recommended serving of Ortho-Core, which has been determined to be dosed at an adequate level, not over dosed like your typical drug store multivitamin.
 
Secondly, no where in my post did I say that I had an unhealthy diet, I simply said I do not eat as much fruits and vegetables as an optimal diet would require. I still eat them, but usually just 1-3 servings per day.

 

Seriously: if you diet doesn't contain enoguh fruits and vegetables you have to change your diet. It's not that hard, really.

 

As I've said, if your goal is to compensate for a unhealthy diet, it is an illusionary goal and no multivitamin or supplement will bring you there. If you just want a nutritional insurance with the added benefits of supra-RDA amounts of certain micronutrients, however, you don't need to take a whole lot of pills or spend a lot of money. One pill for a dime a day will do. That's why I recommend taking one "Two-per-Day". It is reasonably inexpensive and the formula avoids the possible downsides of most cheap multivitamins (cheap folic acid, copper and iron) while in my opinion providing (at half dose) a good balance between the potential benefits of therapeutic doses of some micronutrients on the one hand and a conservative approach to what can be considered a safe dose on the other hand.

 

My goal is not to compensate for an unhealthy diet. It is to supplement my diet with Vitamins, Minerals, and other goodies that I am most likely not getting from my diet. (Do you get optimal amounts of Vitamin K2 or Vitamin D from your diet?)

 

I see that you have recommended LEF Two-Per-Day. However this doesn't seem to be superior to Ortho-Core, especially when you look at the Vitamin E Complex. Since Vitamin E is a potent Antioxidant, it ranks quite high on my priority list.

 

Do you have any other arguments for taking LEF Two-Per-Day other than the fact that it suits your minimalistic approach to supplements? 

 

Furthermore, can you explain what the "downside" of a 60% dosage of Ortho-Core would be? There doesn't seem to be any "cheap fillers" that would "cause more harm than good."


Edited by SillyRabbit, 06 June 2014 - 10:58 AM.


#5 timar

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Posted 06 June 2014 - 09:07 PM

 

That's exactly the wrong approach - and the very reason why multivitamins may do more harm than good for some poeple. A multivitamin may help to fill some gaps in the diet, but you can't compensate for an suboptimal diet with supplements. A healthy diet is much more than the sum of its known chemical constituents. If there is a common theme in nutritional research, it is that epidemiological studies provide conclusive evidence for the health benefits of dietary pattern rich in whole foods, fruits and vegetables. In the next step, via in-vitro and animal studies, a certain compound in the diet is identified which is thought to be mechanistically responsible for some of the observed health benefits. Then this promising compound is supplemented in randomized controlled trails - and usually fails to show the preventive effects it was thought to excert. In most cases, we're left non the wiser and the only thing we know for sure is that fruits and vegetables are good for you...

 
If you read my post, I already stated that I don't even take the full recommended serving of Ortho-Core, which has been determined to be dosed at an adequate level, not over dosed like your typical drug store multivitamin.

 

I read your post, but your response isn't related at all to what I wrote above. Anyway, what do you consider an overdose? Most drug store multivitamins contain most vitamins and minerals at 100% DV, which is OK for some of some but very low for others (like vitamin C and D). The problem with drug store multis is that they often contain iron and copper and cheap, unfavorable forms of certain micronutrients (I'm repeating myself here).

 

Secondly, no where in my post did I say that I had an unhealthy diet, I simply said I do not eat as much fruits and vegetables as an optimal diet would require. I still eat them, but usually just 1-3 servings per day.

 

Don't fool yourself. A diet that provides only 1-3 servings of fruits and vegetables is an unhealthy diet. At least it is far from being an optimum diet. You said that your motivation for taking a multivitamin is the fact that your diet "doesn't consist of too many fruits and vegetables". That motivation is clearly misguided, as I have explained in my response.

 

 

My goal is not to compensate for an unhealthy diet. It is to supplement my diet with Vitamins, Minerals, and other goodies that I am most likely not getting from my diet. (Do you get optimal amounts of Vitamin K2 or Vitamin D from your diet?)

 

Again: don't fool yourself. Vitamin D and K2 are exceptional vitamins that are often missing from even the most healthy dietary patterns (hence they are missing from most multivitamins too). Vitamin D should be supplemented independent from a multivitamin according to one's blood level. Vitamin K2 has become somewhat overhyped and is not nearly as essential as vitamin D. You don't get significant amounts of K2 from the diet unless you eat natto (cheese and other animal products contain only small amounts) but you do produce your own K2 from K1, which is abundant in leafy greens. If there are any other micronutrients except vitamin D and K2 (and perhaps zinc and B12) that your diet is deficient in, you should improve your diet, which in your case obviously means to eat more fruits and vegetables. As I have explained: you won't get the majority of the health benefits of fruits and vegetables by supplementing the micronutrients or even polyphenols they contain. At least most of the evidence we have clearly suggests so.

 

I see that you have recommended LEF Two-Per-Day. However this doesn't seem to be superior to Ortho-Core, especially when you look at the Vitamin E Complex. Since Vitamin E is a potent Antioxidant, it ranks quite high on my priority list.

 

Do you have any other arguments for taking LEF Two-Per-Day other than the fact that it suits your minimalistic approach to supplements? 

 

Furthermore, can you explain what the "downside" of a 60% dosage of Ortho-Core would be? There doesn't seem to be any "cheap fillers" that would "cause more harm than good."

 

I didn't say that they are "superior" by any standards, which are all more or less arbitrary and up to your personal bias btw. I said that I recommend them for the reasons I have given. In my opinion it is a waste of money to spend more then a dime or two a day on any multivitamin.

 

Moreover, I have never implied that Ortho-Core has any particular downsides - it hasn't, except for the price and the number of pills you have to take (but that applies to most other "premium" multis like LEF's Mix as well), which in my opinion gives them an unreasonable cost-benefit ratio. I think it is far more reasonable to spend that money on buying fresh, organic fruits and vegetables, which will very likely provide much greater health benefits (not to mention their culinary benefits!).


Edited by timar, 06 June 2014 - 09:28 PM.


#6 Bghead8che

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Posted 08 June 2014 - 08:14 PM

Is Ortho-Core the best overall Multivitamin?

 

No.  IMO, the level of B vitamins is way overdone and potentially dangerous long term.  800mcg of Folic Acid and 100mg of Vitamin B6?  No thanks.  I would not want to be ingesting over 200 mcg (max) and 2mg (max) per day.  Not to mention the other Bs are very high as well.  I just would not feel safe taking this supplement.  There's just no excuse for that level of B vitamins.

 

<<I prefer Designs for Health or ThorneFX>>

 

300ius of Vitamin E.  750mc of Copper.  50 - 75mgs of B vitamins.  I'd pass. 

 

-Brian

 


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#7 pbandy1

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Posted 08 June 2014 - 08:26 PM

Is Ortho-Core the best overall Multivitamin?

 

No.  IMO, the level of B vitamins is way overdone and potentially dangerous long term.  800mcg of Folic Acid and 100mg of Vitamin B6?  No thanks.  I would not want to be ingesting over 200 mcg (max) and 2mg (max) per day.  Not to mention the other Bs are very high as well.  I just would not feel safe taking this supplement.  There's just no excuse for that level of B vitamins.

 

<<I prefer Designs for Health or ThorneFX>>

 

300ius of Vitamin E.  750mc of Copper.  50 - 75mgs of B vitamins.  I'd pass. 

 

-Brian

 

What's wrong with 50 - 75 mg of B vitamins, in the correct form? Link please, I'm curious.

 

Same goes for 300 iu of mixed tocopherals, what's wrong with it. It is NOT d-alpha tocopherol.

 

And copper glycinate-chelate. There's nearly 3 mg of copper in 3 oz of oysters, 1 mg in a cup of kale. How many of us are eating these foods on a daily basis, in the right amounts? Copper, in the right form, doesn't sound so bad, does it? 



#8 serp777

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Posted 12 June 2014 - 02:19 AM

Actually many multivitamins, have been shown to do absolutely nothing!

 

Furthermore, substances such as selenium can contribute to some male cancers.


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#9 mustardseed41

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Posted 12 June 2014 - 04:48 AM

There never has been a best multi...and never will be.



#10 pamojja

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Posted 12 June 2014 - 05:17 AM

There never has been a best multi...and never will be.

 

Well compared to the worst.. there will always be better.. and best - and which of course might be a different one for any other. With a serious health condition caused by a huge part by decades of bad dieting (vegetarian and in developing countries..) - and seeing how much improvement could be gained by only a few years on high dose orthomolecular supplementation and my medical condition (where I was told whatever lifestyle-wise I would do, a certain 30% of dying in 5 years would remain) - I can't but only strongly oppose such notions as:
 

 

A multivitamin may help to fill some gaps in the diet, but you can't compensate for an suboptimal diet with supplements.

 

After the damage done and trying to improve my diet I went to extremes in using those foods which provide the most in certain nutrients, but some were still lacking compared to the RDA meant for healthy subjects, not for diseased as myself.

 

Therefore I'm a bid bland now in stating that I probably could have saved myself a lot of suffering if I supplemented even the worst of Multies in those ignorant years. And with the extent of deficiencies accumulated I'm glad now for being able to improve my medical condition with the additional aid of high dose Multies.

 

With the caveat, of course, that one has to educate oneself about possible complications with pharmacological doses of nutrients, and get whatever lab-tests to monitor possible excess or deficiencies. In case of illness cron-o-meter, RDAish levels, and amounts of healthy foods I simply have a too small a stomach for, wont suffice. You might differ.


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#11 ironfistx

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Posted 15 September 2014 - 12:55 AM

Is Ortho-Core the best overall Multivitamin?
 
No.  IMO, the level of B vitamins is way overdone and potentially dangerous long term.  800mcg of Folic Acid and 100mg of Vitamin B6?  No thanks.  I would not want to be ingesting over 200 mcg (max) and 2mg (max) per day.  Not to mention the other Bs are very high as well.  I just would not feel safe taking this supplement.  There's just no excuse for that level of B vitamins.
 
<<I prefer Designs for Health or ThorneFX>>
 
300ius of Vitamin E.  750mc of Copper.  50 - 75mgs of B vitamins.  I'd pass. 
 
-Brian


2mg max of B6? Most of the versions i've seen have much more.

#12 timar

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Posted 15 September 2014 - 10:28 AM

Is Ortho-Core the best overall Multivitamin?
 
No.  IMO, the level of B vitamins is way overdone and potentially dangerous long term.  800mcg of Folic Acid and 100mg of Vitamin B6?  No thanks.  I would not want to be ingesting over 200 mcg (max) and 2mg (max) per day.  Not to mention the other Bs are very high as well.  I just would not feel safe taking this supplement.  There's just no excuse for that level of B vitamins.

 

Those levels are at the upper end of, but not above, the well-established safe intake ranges. While I wouldn't feel quite comfortable taking such a high amount of folic acid and B6 too, there is certainly some rationale for taking even those amounts, such as individual genetic polymorphisms (extensively reviewed here by Ames et al.) and health conditions potentially hindering the absorption or increasing the metabolic demand for B vitamins (potential anti-gylcation benefits of megadoses of P5P would be another reason, but they have to be weighted against the risk of neurotoxicity).

 

Of course, from the non-toxicity and absence of an UL for many B vitamins doesn't follow that it is a good idea to megadose them. For many polymorphisms mentioned in the Ames paper, doses one order of magnitude above the RDA are actually sufficient to compensate for the decreased coenzyme binding affinity. Given that most B complex supplements generally provide 50 mg of B1, B2, B6, niacin(amide) and panthothenate, and are available for at least 50 years and taken by millions of people worldwide, 50 mg can be taken as a resonably conservative, pragmatic UL, particularly with regard to B6 and its potential for neurotoxicity.

 

Given the lingering doubts about cancer-promoting effects of high-dose folic acid and the considerable genetic variation in the dihydrofolate reductase enzyme activity, which can lead to build-up unmetabolized folic acid in the plasma in some poeple, it would seem reasonable to limit folic acid to 400 mcg, or reduced folate (which is actually less bioavailable) to 800 mcg.

 

When it comes to B12, megadoses are generally a good idea because active absorption is strictly limited by the notoriously unreliable intrinsic factor and absorption by passive diffusion is in the range of 0.5-2% of given dose. Given that 500 mcg are commonly taken long-term by vegans or poeple lacking intrinsic factor, this amount again can be taken as a pragmatic UL.

 

With biotin there is a similar wide range in supplemental doses as with B12 but it is a much less critical nutrient. Although it seems completely non-toxic and some supplements contain high milligram doses, there is a rather dubious epidemiologic association between increased biotin intake and DNA instability (as mentioned here by Krillin) in one study that should provide enough reason to avoid such megadoses. On the other hand, there is some recent evidence from a study with transgenic mice that chronic alcohol consumption may lead to functional biotin (and possibly panthothenate) deficiency by significantly downregulating the expression of the "multivitamin" (biotin, pantothenate and lipoate, that is) transport protein SMVT. Given this study and that the RDA for pantothenate is much higher than for B1/2/6, I'd set the pragmatic UL to 100 mg, a level often found in B complex supplement. For biotin, the DV of 300 mcg contained in many multivitamins is actually 10 times the current RDA and this amount can be taken as the pragmatic UL.

 

Using the common approach in toxicology to divide the no observed adverse effect level (NOAEL) by two in order to provide an additional safety margin, I would devise the "ideal" B-vitamin supplement as follows:
 

Vitamin B1 (thiamin): 25 mg
Vitamin B2 (riboflavin): 25 mg
Vitamin B3 (niacin or niacinamide): 25 mg
Vitamin B6 (pyridoxine or P5P*): 25 mg

Folate (MTHF or natural folate): 400 mcg

Vitamin B12 (cyano- or methylcobalamin**): 250 mcg

Biotin: 150 mcg

Pantothenic acid: 50 mg

 

Optionally:

Lipoic acid: 50 mg or R-lipoic acid: 25 mg

CoQ10: 50 mg

 

*preferentially P5P or a mixture of both forms.

**preferentially methylcobalamin

 

 


Edited by timar, 15 September 2014 - 10:39 AM.

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#13 stan08

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Posted 15 September 2014 - 12:28 PM

Personally, I like Thorne Basic Nutrients 2/Day:

 

 

Two Capsules Contain: Amount Per Serving %DV Vitamin A (3,000 IU from Mixed Carotenes and 2,000 IU as Palmitate) 5,000 IU 100% Vitamin C (as Ascorbic Acid) 250 mg 417% Vitamin D (as Vitamin D3) 2,000 IU 500% Vitamin E (as d-Alpha Tocopheryl Acid Succinate) 20 IU 67% Vitamin K (200 mcg as Vitamin K1 and 200 mcg as Vitamin K2) 400 mcg 500% Thiamin (as Thiamin HCI) 50 mg 3,333% Riboflavin (as Riboflavin 5'-Phosphate Sodium) 12 mg 706% Niacin (as Niacinamide) 80 mg 400% Vitamin B6 (as Pyridoxal 5' Phopsphate) 20 mg 1,000% Folate (as L-5 Methltetrahydrofolate† from L-5 Methyltetrahydrofolic acid, Glucosamine Salt) 400 mcg 100% Vitamin B12 (as Methylcobalamin) 600 mcg 10,000% Biotin 500 mcg 167% Pantothenic Acid (as Calcium Pantothenate) 45 mg 450%

Calcium (as Calcium Bisglycinate Chelate)

30 mg 3% Iodine (as Potassium Iodide) 75 mcg 50% Magnesium (as Magnesium Bisglycinate Chelate) 20 mg 5% Zinc (as Zinc Bisglycinate Chelate) 15 mg 100% Selenium (as Selenomethionine) 200 mcg 286% Copper (as Copper (II) Bisglycinate Chelate) 750 mcg 38% Manganese (as Manganese (II) Bisglycinate Chelate) 3 mg 150% Chromium (as Chromium Nicotinate Glycinate Chelate) 400 mcg 333% Molybdenum (as Molybdenum (II) Glycinate Chelate) 100 mcg 133% d-Gamma Tocopherol (from Mixed Tocopherols) 24 mg * Boron (as Boroganic Glycine) 2 mg *

 



#14 krillin

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Posted 16 September 2014 - 03:54 AM

Given the lingering doubts about cancer-promoting effects of high-dose folic acid and the considerable genetic variation in the dihydrofolate reductase enzyme activity, which can lead to build-up unmetabolized folic acid in the plasma in some poeple, it would seem reasonable to limit folic acid to 400 mcg, or reduced folate (which is actually less bioavailable) to 800 mcg.

 

Using the common approach in toxicology to divide the no observed adverse effect level (NOAEL) by two in order to provide an additional safety margin, I would devise the "ideal" B-vitamin supplement as follows:

 

Vitamin B1 (thiamin): 25 mg
Vitamin B2 (riboflavin): 25 mg
Vitamin B3 (niacin or niacinamide): 25 mg
Vitamin B6 (pyridoxine or P5P*): 25 mg

Folate (MTHF or natural folate): 400 mcg

Vitamin B12 (cyano- or methylcobalamin**): 250 mcg

Biotin: 150 mcg

Pantothenic acid: 50 mg

 

Optionally:

Lipoic acid: 50 mg or R-lipoic acid: 25 mg

CoQ10: 50 mg

 

*preferentially P5P or a mixture of both forms.

**preferentially methylcobalamin

 

 

According to the DRI book, folic acid supplements are absorbed 100% alone or 85% with food, and food folate is absorbed 50%. 5-methyl THF is absorbed as well as folic acid, so it must be the polyglutamyls and not the oxidation state that limits food folate absorption. Does anyone know if they leave the polyglutamyls on in the lemon peel extracts?
 

B1 could be 10 mg because that's about all you can absorb. B12 should be 500 mcg for people without intrinsic factor because 2.4 mcg RDA divided by 0.005 passive diffusion absorption rate = 480 mcg.

 

What is the lipoic acid supposed to accomplish? Supplements aren't added to the body's lipoic acid pool and it takes 50 microM from ~435 mg Na-RALA to get the Nrf2 effect.



#15 timar

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Posted 16 September 2014 - 09:22 AM

According to the DRI book, folic acid supplements are absorbed 100% alone or 85% with food, and food folate is absorbed 50%. 5-methyl THF is absorbed as well as folic acid, so it must be the polyglutamyls and not the oxidation state that limits food folate absorption. Does anyone know if they leave the polyglutamyls on in the lemon peel extracts?

 

Interesting - I always thought reduced forms to be less bioavailable than folic acid but of course it is the conjugation to the polyglutamyl chains which limits the bioavailability of natural folate. Thanks for clearing that up!

 

I have no idea regarding the lemon peel extract. I was puzzled by that too and tried to get more information but I haven't even found a patent application giving any details as to the exact process they use to isolate folate from lemon peel.

 

B1 could be 10 mg because that's about all you can absorb. B12 should be 500 mcg for people without intrinsic factor because 2.4 mcg RDA divided by 0.005 passive diffusion absorption rate = 480 mcg.

 

That's a flawed calculation because the RDA of course takes absorption into account. The actual metabolic requirement has been estimated to be 1 mcg and the absorption to be 50%, hence the EAR of 2 mcg or RDA of 2.4 (adding two standard deviations). So even using the most pessimistic estimation for passive diffusion of 0.5% (most studies have shown it to be around 1%), 200 mcg should be sufficient to meet the metabolic requirement of ~1 mcg.

 

What is the lipoic acid supposed to accomplish? Supplements aren't added to the body's lipoic acid pool and it takes 50 microM from ~435 mg Na-RALA to get the Nrf2 effect.

 

To be clear, there is not much evidence for benefits of low-dose lipoic acid. This is why I added it as optional, primarily to complete the list of coenzyme "vitamins". However, I think that to undiscriminatingly apply the standard approach of pharmacokinetics to nutrients and physiological compounds like lipoic acid is fundamentally flawed. Most pharmaceutical compounds are  non-physiological substances, acting on proteins as they simply pass through the organism, and their uptake and catabolism can thus easily be traced. There is nothing like, for example, a "statin deficiency" where deficient tissues hold on to the exogenous statin. However, such mechanismns of course exist for vitamins and I see no reason why a similar mechanism shouldn't theoretically exist for lipoate as well. All studies done so far regarding the pharmacokinetics of lipoic acid I am aware of have been done with healthy subjects, which probably were lipoate replete. What about subjects suffering from metabolic disturbances causing a functional lack of lipoate in specific tissues? I don't think this question has been answered yet. However, there is good clinical evidence that diabetics may benefit from a dose of 200 mg all-rac lipoic acid administered three times daily, which is 100 mg R-lipoic acid per dose and way below the Nrf2 inducing threshold you came up with (btw., could you reference the study where you got that figure from?)
 


Edited by timar, 16 September 2014 - 09:26 AM.


#16 krillin

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Posted 17 September 2014 - 03:18 AM


B1 could be 10 mg because that's about all you can absorb. B12 should be 500 mcg for people without intrinsic factor because 2.4 mcg RDA divided by 0.005 passive diffusion absorption rate = 480 mcg.

 

That's a flawed calculation because the RDA of course takes absorption into account. The actual metabolic requirement has been estimated to be 1 mcg and the absorption to be 50%, hence the EAR of 2 mcg or RDA of 2.4 (adding two standard deviations). So even using the most pessimistic estimation for passive diffusion of 0.5% (most studies have shown it to be around 1%), 200 mcg should be sufficient to meet the metabolic requirement of ~1 mcg.

 

What is the lipoic acid supposed to accomplish? Supplements aren't added to the body's lipoic acid pool and it takes 50 microM from ~435 mg Na-RALA to get the Nrf2 effect.

 

To be clear, there is not much evidence for benefits of low-dose lipoic acid. This is why I added it as optional, primarily to complete the list of coenzyme "vitamins". However, I think that to undiscriminatingly apply the standard approach of pharmacokinetics to nutrients and physiological compounds like lipoic acid is fundamentally flawed. Most pharmaceutical compounds are  non-physiological substances, acting on proteins as they simply pass through the organism, and their uptake and catabolism can thus easily be traced. There is nothing like, for example, a "statin deficiency" where deficient tissues hold on to the exogenous statin. However, such mechanismns of course exist for vitamins and I see no reason why a similar mechanism shouldn't theoretically exist for lipoate as well. All studies done so far regarding the pharmacokinetics of lipoic acid I am aware of have been done with healthy subjects, which probably were lipoate replete. What about subjects suffering from metabolic disturbances causing a functional lack of lipoate in specific tissues? I don't think this question has been answered yet. However, there is good clinical evidence that diabetics may benefit from a dose of 200 mg all-rac lipoic acid administered three times daily, which is 100 mg R-lipoic acid per dose and way below the Nrf2 inducing threshold you came up with (btw., could you reference the study where you got that figure from?)
 

 

 

If I had read the B12 chapter more carefully I would have known that... I've always thought absorption was 100% up to ~6 mcg due to a Steve Harris post years ago. Thanks for the correction.

 

Pubmed went down last night so I couldn't link to the NaRALA references. Here they are: 600 mg NaRALA yields 14.2 mcg/ml = 69 microM. 50 microM lipoic acid worked for elevating GSH but 25 microM did not. Table 1 makes it sound like they believe 50 microM is also the highest non-toxic concentration. I got 435 mg by doing linear interpolation.

 

Do you have any examples of lipoic acid being used TID for diabetes? I thought it was a daily spike-dose for that too.



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#17 timar

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Posted 12 October 2014 - 07:38 PM

Do you have any examples of lipoic acid being used TID for diabetes? I thought it was a daily spike-dose for that too.

 

Sorry, forgot about your question. 200 mg t.i.d. is still common medical practise in Germany (most lipoic acid prescribed to diabetic patients is 200 mg per tablet). There are probably many older European studies using a daily dose of 600 mg, which is in fact 200 mg t.i.d. without mentioning it explicitly the methods. Here is an example of an - although non placebo controlled - study where 200 mg t.i.d. is explicity stated, showing improved muscular ATP production.


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