Posts Tagged ‘Vitamins’

The Hangover: Make it go away!

by Joshua Goldman, MD, MBA

the-hangover-wallpaperIt’s 9am and you’re cuddling your fire truck-esk alarm as you wake up to realize that you’re already an hour late for work.  You sit up and immediately notice the pounding sensation in your head, reminding you of your alcoholic escapades from the night before.  It’s official, you’re hungover.  The question is “What do you do now?”  We’re here to offer a few suggestions to help mitigate hangovers with some preventive steps before and during drinking, and some hangover-relieving tricks for the morning after.

Rather than accepting a hangover as the unfortunate side effect of a night out, there are a few tricks to help reduce the likelihood of ever becoming hungover.  Here’s our recommendations:

  • Drink slowly (obviously).  Frank the Tank is well on his way to a hangover after beer bong number 3.

  • Eat a full meal before drinking.  One study showed that glucose (which your body gets from food) effectively inhibits the metabolic disturbances induced by ethanol (i.e. a hangover).  The glucose in the meal also helps build up a store of energy so you won’t feel as weak the next day.

  • Drink in moderation. For those of you who aren’t sure what this means, The National Institute on Alcohol Abuse and Alcoholism recommends that women have no more than 1 drink per day and men no more than 2 drinks per day (one drink = a 12-ounce bottle of beer, a 4-ounce glass of wine, or a 1 1/2-ounce shot of liquor).  WaterAlso, the average individual can process one of these alcoholic beverages per hour.  Two drinks in one hour makes you one drink drunk.  Five drinks in two hours make you three drinks drunk.  You follow?

  • Drink a glass of water in between alcoholic drinks. This will help you drink less alcohol while simultaneously hydrating you (remember that a large part of your hangover is dehydration).

We realize that these tips are not ideal for those of you looking to get a little wild during your night out on the town.  As such, here are some additional tips to help mitigate the pounding in your head that you will experience the next morning once the hangover has set in:

  • Replace all the fluids and electrolytes you lost. If you remember, alcohol is Rehydrating with Electrolyte Drinkdehydrating and, unfortunately, you lose a lot of electrolytes along with the fluid (mainly sodium, potassium, and magnessium).  There are a number of great electrolyte drinks (pedialyte, Gatorade Performance, Powerade, Smart Water, etc.) that can replace both water and electrolytes simultaneously.  If you prefer a more natural approach, water plus bananas and a salty snack can help replenish your fluids as well as the missing sodium and potassium.  You can also take a multivitamin to rapidly (and thoroughly) get all your needed minerals back on board.

  • Replenish your energy stores. Consume foods and drinks that contain fructose (such as fruit juice or honey). There is some evidence that fructose will help your body break down and eliminate the alcohol faster.  Also, remember that alcohol inhibits your body’s production of glucose (your body’s form of gasoline).  When you wake up the next morning, your body is in desperate need of glucose replenishment.  A healthy carbohydrate-rich meal will quickly replenish these glucose stores.  Add some protein (think eggs) to breakfast and you can simultaneously boost your body’s cysteine level which will help counteract the brutal effects of alcohol’s metabolites.

  • Stock up on Vitamin C. Vitamin C has been shown to increase your body’s level of glutathione, the chemical needed to breakdown alcohol that becomes depleted in hangovers (1).  Vitamin C also neutralizes free radicals (which are formed at an increasing rate during drinking) that can cause damage to your body in the aftermath of a night out.  Oranges or those tasty chewable Vitamin C tablet will both do the trick.

  • Get your liver back on track. In addition to Vitamin C, milk thistle is an excellent way to replace your liver’s glutathione stores (which you need to process all the alcohol you consumed).  You can also find glutathione in asparagus and spinach.  Eggs are rich in cysteine which is a building block of glutathione.  Vitamin B6, riboflavin, and selenium are required in the manufacture of glutathione (they can be found in most multivitamins) and are essential to getting your body back to normal.

  • Upset StomachBe gentle on your stomach. You spent a good portion of last night dumping the equivalent of battery acid into your digestive track.  It’s understandable that it’s not feeling so hot the next morning.  The alcohol you consume irritates the lining of your digestive track much like the way it is irritated with very spicy foods.  This irritation causes you to feel nauseous and makes it hard to eat.  To help your stomach heal, eat bland foods the next day and save the spicy peppers and chili sauce for another day.  If your upset stomach is sucking your will to live, try Pepto-Bismol (it acts as a temporary stomach lining protecting your irritated gut from its natural acid while it heals…yes, the picture on the pink bottle is true).

  • Get plenty of rest. Alcohol inhibits your ability to reach your most deep and restful phase of sleep.  As such, you will be tired regardless of the number of hours you spent in bed.  Try to take a midday nap to allow your body time to catch up on some much needed deep sleep.

  • Take an aspirin. Aspirin (as well as ibuprofen and naproxen) has been proven to be effective in minimizing the pain in many types of headaches including a hangover headache.  Avoid taking any medications for your hangover that contain acetaminophen (such as Tylenol), because it may cause liver damage when combined with alcohol.  Your liver is already angry; no need to push it over the edge with Tylenol.

House Call, MD’s Hypothetical Hangover Remedy:

In simplified terms, this is our best (scientifically supported) guess at what can get you back on track:

  1. A carbohydrate-rich breakfast with eggs on the side (but remember to keep it bland)

  2. Electrolyte-enhanced fluids…lots of them

  3. A multivitamin (make sure it has Vit B6, B12, riboflavin, and selenium)

  4. Vitamin C – Consume any way you’d like (OJ or oranges will kill two birds with one stone)

  5. Aspirin – One dose in the AM is probably all you need

  6. Rest – Try an afternoon nap…you look like you need it.

1. Johnston CJ, Meyer CG, Srilakshmi JC. Vitamin C elevates red blood cell glutathione in healthy adults. Am J Clin Nutr 58:103-5, 1993
2. Kera Y, Ohbora Y, Komura S (1989). “Buthionine sulfoximine inhibition of glutathione biosynthesis enhances hepatic lipid peroxidation in rats during acute ethanol intoxication”. Alcohol Alcohol. 24 (6): 519–24.


10 2009

Cholesterol-Lowering Essentials: The future of Cholesterol Management in a Simple Vitamin

by Leah Frankel, MS, RD

Fish with NiacinHypercholesterolemia (high cholesterol) affects 37.7 million Americans and is a major cause of cardiovascular disease (American Heart Association, 2005). Numerous methods are used to lower cholesterol including change in diet, exercise or use of medications (usually a type of drug called a statin.  You’ve seen them plaguing your primetime TV commercials). However, research suggests that a simple vitamin may actually help improve cholesterol levels.

Niacin, previously referred to as Vitamin B3, is important in the function of the digestive system, skin, nerves as well as metabolism. The RDI (Recommended Daily Intake) for niacin ranges from 14 mg/day (females 19-70) to 16 mg/day (males 19-70). Food sources of the B vitamin include: dairy, produce, fish, eggs, lean meats, nuts, legumes and enriched breads and cereals.

There are two forms of niacin: nicotinic acid and nicotinamide (no need to memorize these names…they will not be on the test at the end of the article). Both of these forms have the same function when taken in milligram doses. However, when nicotinic acid is taken in gram doses, it works as a cholesterol lowering drug.  The effect of nicotinic acid as a cholesterol-lowering agent was first seen in the middle of the 20th century when Rudolf Altschul noticed that giving rabbits nicotinic acid caused their cholesterol levels to lower (1). At this time he also discovered that nicotinamide had no effect on lowering cholesterol.

Cholesterol & ArteriesSo how does it work? At approximately the same time that nicotinic acid was discovered to lower cholesterol levels, free fatty acids were observed to be precursors of LDL (free fatty acids are converted into LDL and remember that LDL is the bad form of cholesterol.  We outline the different types of cholesterol below). Nicotinic acid was found to lower concentrations of free fatty acids in a matter of minutes, with an increase in free fatty acid levels back to normal levels in approximately an hour. Studies done in rats explained this observation, because nicotinic acid was shown to prevent the release of free fatty acids that were stored as fat (2). Therefore, nicotinic acid is believed to lower cholesterol by preventing fat from being turned into LDL.

The two types of cholesterol we are most familiar with are HDL (high density lipoprotein) and LDL (low density lipoprotein); HDL is commonly known as the “good” cholesterol and LDL as “bad” cholesterol. LDLs are produced by the liver and carry cholesterol and other lipids (fats) from the liver to different areas of the body, like muscles, tissues, organs, and the heart. HDL is produced by the liver to carry cholesterol and other lipids (fats) from tissues and organs back to the liver for recycling or degradation. Once it was determined that high HDL levels would lower the incidence of cardiovascular disease the early findings that nicotinic acid would raise HDL became of some importance. Nicotinic acid has the unique property of modifying each type of cholesterol in a way that is beneficial in reducing the risks of vascular disease. It not only lowers LDL, it raises the concentration of HDL which is unique to nicotinic acid, and very effective in changing your cholesterol mix for the better.

Due to the role of nicotinic acid as an HDL-raising drug, it is now being considered as a complementary drug to be used with statins or other LDL lowering drugs. Nicotinic acid treatment was shown to increase HDL levels by 21% (3). In an earlier trial, when nicotinic acid was given with statins, it was seen that there was an increase in HDL by almost 30%, and a lowering of LDL cholesterol by 25-40%…pretty good if you ask us.  Other studies using nicotinic acid in combination with statins have found that there is a significant clinical benefit because there is a reduction in both coronary artery disease events (i.e. heart attacks) and mortality (i.e. you die). This is thought to be due to the rise in HDL, which is only seen with nicotinic acid.

The biggest problem with the use of nicotinic acid in lowering cholesterol is the side effects. There are two major side effects seen in patients taking nicotinic acid:

  1. Flushing (You feel warm and get red in the face.  Imagine passing gas in the middle of a first date – that feeling)

  2. Increased uric acid in the blood

A prolonged-release formula of nicotinic acid, also known as extended-release or ER, has been created to help minimize the side effects.

NiacinSo should we be consuming greater amounts of niacin in our diet to help manage our cholesterol?  The answer for now, is probably not. The tolerable upper limit (what is considered a “safe upper limit”) for niacin is 35 mg/day and as noted above niacin only has a lipid lowering effect when taken in gram doses (10-fold higher than what is safe today).  While consuming extra niacin will probably not lead to healthier cholesterol levels in its current formulation the research between the effects of nicotinic acid and cholesterol levels are promising as pharmaceutical companies are currently creating new forms of nicotinic acid, which will hopefully have less side effects allowing for more extensive use.


10 2009

Urine: Nectar of the Gods?

GladiatorIt has been fabled since the days of Gladiators in Rome that drinking one’s own urine while training for battle  provided special nutritional value to the fighters in training. Fighters such as Lyoto Machida, who claims to swill his pee every morning, is one example.  These individuals profess that their urine is full of nutrients that their body could not absorb on the first pass. But is there any medical validity to this ancient practice?

Dr. Johnny Benjamin, sports columnist and renowned orthopedic surgeon shared the truth behind this myth with us, “Urine is 95 percent water, 2.5 percent urea, and a 2.5 percent mixture of minerals, salts, hormones, enzymes and non-toxic waste products.

“The practice of drinking urine is certainly not new or limited to a few modern practitioners of combat sports such as world champions Lyoto Machida in MMA and Juan Manuel Marquez in boxing. China, India, the Middle East and Rome all have ancient and modern writings that discuss the willful consumption of urine.

“I recently viewed an HBO 24/7 episode with Mr. Marquez sipping a steaming glass of his golden nectar in preparation for an upcoming fight with Floyd Mayweather Jr. I have the utmost respect for Marquez as a champion, but apparently the thought of a potential ass whipping will drive a man to consider a great many things.

“Although the potential benefits and healing capacities of drinking urine have been encouraged for centuries by many cultures, there is no credible medical literature or studies that support these beliefs.

Urine and Straw“Urine has been consumed to combat dehydration in extreme survival situations for its 95-percent water content. Also, water is reclaimed from urine, purified and filtered for consumption on the International Space Station.

“Drinking your own urine may reclaim a small bit of water, but if the body didn’t want the other five percent (waste products and the like) during the first time, why would it want it the second time around?  Wouldn’t it be easier (and probably considerably tastier) to just sip a tall refreshing glass of H20 and take a multivitamin?”

In addition, proteins are not present in a healthy individual’s urine.  Loss of proteins in urine is a sign of kidney problems and necessitates further medical investigation.  If you’re looking for extra protein in your diet, we recommend a hearty chicken breast or protein shake after your workout.

As Juan Manuel Marquez says in his HBO clip, he drinks his urine because “that’s where a lot of proteins and vitamins are, part of your vitamin intake, and why not drink them again instead of wasting them?”  That’s an interesting question, Dr. Marquez.  Our thoughts are that 1) it’s pretty disgusting, and 2) you can consume infinitely superior “proteins and vitamins” from any number of other non-urine-based sources.  Are we supposed to believe that hot urine contains super-nutrients that you can’t find at the GNC, and the body is flushing them out of your system?  No disrespect to our beloved light-heavyweight champion, but is it possible that the athletes who swear by urine-drinking just enjoy drinking pee?  Maybe it simply serves as means of intimidation to the opponent.  After all, we wouldn’t fight him.


09 2009

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