A Closer Look at Supplements and Your HealthSeptember 18, 2013 Craig Peterson, N.D. MSA LAc. Naturopathic Resident Cancer Treatment Centers of America

1. A Closer Look at Supplements
and Your Health
September 18, 2013
Craig Peterson, N.D. MSA LAc.
Naturopathic Resident
Cancer Treatment Centers of America®

2. Disclaimer
• All material provided today is for informational
and educational purposes only, and is not
intended to provide you with medical advice.
• This presentation is not a substitute for medical
care nor is it a substitute for consultation with a
healthcare professional. Please discuss all
medical and nutrition questions with your health
care provider.
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3. Principles of Naturopathic Medicine
• The Healing Power of Nature
• Identify and Treat the Cause(s)
• First Do No Harm
• Doctor as Teacher
• Treat the Whole Person
• Prevention
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4. What is a Naturopathic Physician?
• Licensed naturopathic physician (ND)
― 4 year, doctoral-level Naturopathic Medical school; federally
accredited
― Same 2 year basic sciences as an MD with additional training in
Clinical Nutrition, Homeopathic Medicine, Botanical
Medicine, Psychology, and Counseling
― Trained to use prescription drugs
― Perform minor surgeries – removing cysts, stitching up superficial
wounds. Do not practice major surgery.
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5. Naturopathic Medicine - Licensure
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http://www.aanmc.org/images/LicensureMapBig_Up
dateJune2013.jpg

6. Main Topics
• Supplements 101
• Vitamin B12
o What is it?
o What are the benefits?
o When is it indicated?
• Managing Side Effects
o How to utilize supplements to ease side effects?
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7. Supplements - Overview
• Definition
• Purpose
• Categories
– Vitamins
– Minerals
– Herbs
• Cautions
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8. Supplements - Definition
Dietary Supplement Health and Education Act (DSHEA)
Dietary supplement:
– Intended to supplement the diet
– Contains one or more dietary ingredients (including
vitamins, minerals, herbs or other botanicals, amino
acids, and certain other substances) or their
constituents
– Intended to be taken by mouth, in forms such as
tablet, capsule, powder, softgel, gelcap, or liquid
– Labeled as being a dietary supplement
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9. Federal Regulation
• The regulations for dietary supplements are not the
same as those for prescription or over-the-counter drugs.
• Manufacturers of dietary supplements are responsible
for ensuring that their products are safe and that the
label information is truthful and not misleading.
• However, a manufacturer of a dietary supplement
does not have to provide the FDA with data that
demonstrate the safety of the product before it is
marketed.
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10. Purpose of Dietary Supplements
• Added to the diet to boost overall health & energy
• Provide immune system support and reduce the risks
of illness and age-related conditions
• Improve performance in athletic and mental activities
• Support the healing process during illness and
disease
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11. Categories of Dietary Supplements
• Vitamins
• Minerals
• Herbal/ Botanical
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12. Vitamins
• Vitamins are micronutrients – substances the
body uses in small amounts
• The body requires vitamins to support its basic
biochemical functions
• Deficiencies over time can lead to illness and
disease
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13. Water & Fat Soluble Vitamins
• Water-soluble vitamins dissolve in water and pass
through the body quickly, meaning that the body needs
them on a regular basis.
• Fat-soluble vitamins are stored in the body's fatty
tissue, meaning that they remain in the body longer.
• Water-soluble vitamins include the B-complex and
vitamin C.
• Fat-soluble vitamins include vitamins A, D, E, and K.
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14. What happened to the alphabet?
Where is F-J?
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Vitamin A
Vitamin B1
Vitamin B2
Vitamin B3
Vitamin B5
Vitamin B6
Vitamin B7
Vitamin B9
Vitamin B12
Vitamin C
Vitamin D
Vitamin E
Vitamin K

15. Minerals
• Minerals are micronutrients and are essential for
the proper functioning of the body.
• Cells in the body require minerals as part of their
basic make-up and chemical balance.
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16. Bulk & Trace Minerals
• Minerals can either be bulk minerals, used by the body in
larger quantities, or trace minerals, used by the body in
minute or trace amounts.
• Bulk minerals include
sodium, potassium, calcium, magnesium, and
phosphorus.
• Trace minerals include
iron, zinc, selenium, iodine, chromium, copper, mangane
se, and others.
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17. How Much Vitamin and Mineral is
Needed?
• The U.S. government has published recommended
dietary allowances (RDAs) for each vitamin and mineral
for the general population.
– These figures can be used as guidelines
– Individuals may have different needs depending on
gender, age, and health conditions.
• http://ods.od.nih.gov/factsheets/list-VitaminsMinerals/
• http://fnic.nal.usda.gov/
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18. Herbs - Botanical
• Herbal supplements are added to the diet for both nutritional and
medicinal purposes.
• Herbs can supplement the diet to aid in overall health or to stimulate
healing for specific conditions.
• The medicinal effects of herbs are gaining scientific validation; some
pharmaceuticals have been derived directly from plant sources
– Aspirin (found in willow bark),
– Codeine (from poppy seeds),
– Paclitaxel -Taxol (from the Pacific Yew tree)
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19. Importance of Supplement Safety
• What to look for?
– Authenticity
– Purity
– Potency
• Supplement Certification Groups
– USP (U.S. Pharmacopeial)
– NSF (National Science Foundation)
– NNFA GMP (National Nutritional Foods Association
Good Manufacturing Practices)
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20. Key Points
• To use dietary supplements safely, read and follow the
label instructions, and recognize that “natural” does not
always mean “safe.”
• Some dietary supplements may interact with medications
or pose risks if you have medical problems or are going
to have surgery.
• Most dietary supplements have not been tested in
pregnant women, nursing mothers, or children.
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21. Vitamin B12
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22. Vitamin B12 – What is it?
• Water soluble vitamin
• Contains the mineral cobalt
– “Cobalamins”
– Methylcobalamin and 5-deoxyadenosylcobalamin
• Foods that contain B12
– commonly found in fish, shellfish, meat, eggs, and
dairy products.
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23. Vitamin B12 - What are the benefits?
• Required for proper red blood cell formation and
hemoglobin synthesis
• Required for neurological function
• DNA synthesis
• Acts as a cofactor Fat and Protein metabolism
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24. Vitamin B12 - When is it indicated?
• Pernicious anemia
• Gastrointestinal – Celiac and Crohn’s disease
• Vegetarians
• Cardiovascular disease – Hyperhomocysteinemia
• Dementia and cognitive function
• Fatigue
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25. Dietary B12 Supplements
• Cyanocobalamin  converted to Methylcobalamin +
5-deoxyadenosylcobalamin in the body.
• Supplemental types:
― Oral
― Sublingual
― Injection (intramuscular)
― Intranasal gel (prescription)
• Absorption is largely limited by intrinsic factor.
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26. Vitamin B12 - Cautions
• Upper Limit has not been established
• Interactions with medications:
– Chloramphenicol (Chloromycetin)
– Proton Pump Inhibitors (PPI)
• Omeprazole (Prilosec)
• lansoprazole (Prevacid)
– H2 receptor antagonist
• Cimetidine (Tagamet)
• famotidine (Pepcid)
• ranitidine (Zantac)
– Metformin
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27. How do I utilize nutrients and
supplements to help manage side
effects?
– Fatigue
• B Complex
• Astragalus
• Ginseng
– Infection
• Vitamin C
• Elderberry Syrup
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This content is for informational and educational purposes only, and is not intended to provide medical advice or to be a substitute for medical care or consultation with a
healthcare professional. Please discuss all medical and nutrition questions with your health care provider.

28. Managing Side Effects continued…
– Neuropathy
• Vitamin B6
• L-Glutamine
• Alpha lipoic acid
• Acetyl L carnitine
– Cardiovascular wellness
• Essential Fatty Acids
• Coenzyme Q10
• L-Carnitine
• Hawthorne (Crataegus)
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This content is for informational and educational purposes only, and is not intended to provide medical advice or to be a substitute for medical care or consultation with a
healthcare professional. Please discuss all medical and nutrition questions with your health care provider.

29. Managing Side Effects continued…
– Digestive
• Probiotics
• L-Glutamine
• Slippery elm
– Musculoskeletal
• Bromelain
• Curcumin
• Magnesium
• Calcium
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This content is for informational and educational purposes only, and is not intended to provide medical advice or to be a substitute for medical care or consultation with a
healthcare professional. Please discuss all medical and nutrition questions with your health care provider.

30. Anti-Cancer Properties
– Curcumin
– Green Tea Extract (EGCG)
– Vitamin D3
– Resveratrol
– Sulforaphanes
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This content is for informational and educational purposes only, and is not intended to provide medical advice or to be a substitute for medical care or consultation with a
healthcare professional. Please discuss all medical and nutrition questions with your health care provider.

31. Avoid in Hematologic Malignancies
• Immune stimulating
– Melatonin
– Medicinal Mushroom Extract
• Reishi,
• Turkey Tail
• Shitake
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This content is for informational and educational purposes only, and is not intended to provide medical advice or to be a substitute for medical care or consultation with a
healthcare professional. Please discuss all medical and nutrition questions with your health care provider.

32. • QUESTIONS?
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33. THANK YOU!
• Wisconsin Naturopathic Physician Association
• WNPA
• www.wisconsin-nd.org
• Oncology Association of Naturopathic Physician
• OncANP
• www.oncanp.org
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34. References
• PubMed
• Uptodate
• Natural Medicine Comprehensive Database
• Natural Standard
• http://ods.od.nih.gov/factsheets/list-VitaminsMinerals/
• http://fnic.nal.usda.gov/
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