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From: B. Harris)
Subject: Re: Acetyl-L-Carnitine Improves Alzheimer's Symptoms
Date: Tue, 19 Aug 1997

In <> Joan
Livingston <> writes:

>On Mon, 18 Aug 1997, Tom Matthews wrote:
>> jwwright wrote:
>> >  so, is it your opinion that we should take carnitine to prevent
>> > alzhemer's?
>> ALC has been clearly shown to have brain enhancing (smart drug) effects
>> and to be generally beneficial to brain health. Therefore it make sense
>> to take it continuously from middle age on as a hedge against the
>> natural deterioration of your brain with aging.
>> > how do we know when to start?
>> If you want the "smart drug" effects start any time, otherwise start
>> when you are 40-50.
>> --Tom
>> Tom Matthews
>	But Tom, isn't Dr. Steve Harris, "noted geriatiric specialist,"
>on your staff or editorial board or something and he admitted he takes
>NO supplements and he is 40.

    No hormone supplements.  Unless you count melatonin used
occasionally on a rather pharmacologic basis to get me to sleep.  I do
take lots of vitamin and mineral and antioxidant supplements, as a
matter of fact.  The evidence for some of these is better than others,
of course, and I do not recommend to the public everything I try
myself.  And my recommendations for patients are more conservative yet,
since the patient-doctor relationship is somewhat more formal (as a
whole) and requires a little more conservative approach to knowledge
and advice.  For all of that, I've already noted that I recommend
hormone replacement to most (not all) women, and why.  As a
gerontologist I see women every single day suffering horribly with
fracture immobility, dementia, incontinence, congestive heart failure--
all greatly modifiable with early hormone therapy.  Breast cancer
related suffering and death is way, way, down the line in terms of the
horrors of aging, even through it is also a geriatric disease
(incidence of breast cancer in women over 85 is highest of all age

> Why isn't he trying to take this "proven" smart drug? He seems to
>prefer taking a "watchful waiting" approach to his own
>aging health and body. Why is that?

   Oh, I've tried most of the "smart drugs" at one time or another,
including ALC.  I find the effects generally transient or unimpressive,
with only a few mild exceptions for me (gingko, caffeine, ginseng).
I'm happy that my brain seems to work efficiently at present.  As I
age, I don't expect this to remain true indefinately, of course. As to
whether any of these drugs actually prevent brain aging, there isn't
nearly the evidence for any of them which exists for estrogen's effect
on the brain-aging of women.  And even that is far from iron-clad.

                                           Steve Harris, M.D.

From: B. Harris)
Subject: Re: Why Aren't Nutritional Supplements Given with Drugs
Date: 3 Jul 1998 05:57:49 GMT

<> (//ryb) writes:

>If it is already proven than antibiotics reduce intestinal flora and
>some AIDS medications cause vitamin and mineral deficiencies, why
>don't doctors give supplements to their patients?
>I have watched one person with AIDS devour drugs.  The drugs get
>switched and changed as time goes on.  He has his problems, but at no
>time has ANY of the many doctors he has seen recommended any
>nutritional support.
>He gets 'filled up' taking medications. He doesn't always have a good
>appetite, so his doctors give him megace.
>Giving nutritional supplements seems logical to me to someone on harsh
>drugs.  Why isn't it done?


   Because nutritionists once upon a time spent a long time figuring
out just what vitamins and minerals were in what foods, and just how to
plan diets accordingly.  Supplements took a lot of that away (in their
perception), making all those years of training obsolete, and therefore
they (nutritionists and dieticians) came out against supplements (while
taking them, themselves, of course, more than half the time).

   Doctors got taught by nutritionists, and still do.  They get told
that eating a good planned diet in good amounts would give you all the
nutrients you needed, without supplements being necessary.  And that
only sick people might need supplements (this not emphasized, and in a

   Than what happened?  Doctors went out into practice, and practically
all they SAW was sick people.  And none of them eating all of some
perfectly planned diets, either.   And guess what?  The doctors only
remembered what they'd been told about supplements in the "well person"
lecture.  Because they really didn't get taught about supplements in
the sick person lectures, because that part was left out (and there
weren't any specialties that really had responsibility for it).
Surgeons and ICU specialists (intensivists), to their credit, did learn
a little about nourishing *very* ill people.  And so did the hospital
nutrition support teams.  Outpatients who were very ill, however, were
out of luck if what they had wasn't fixable by Ensure, and they could
drink Ensure, and liked Ensure.  Internists and their subspecialists
like cardiologists and ID experts (who were later to inherit the AIDS
care) learned very little about nutrition as THERAPY.  And that's where
it stands.  The damned naturopaths know far more about it, and they
learned some of it from pretty good scientific sources.  It's a

   Things are changing now, but very slowly.  One help is the influx of
women into the ranks of attending physicians.  Women are
psychologically attuned to nutrition.  I think there's some special
wiring for it in their brains.  We can use this.

   Comes the revolution, and nutrition will start every case of medical
evaluation.  And the nutritionists and dieticians will realize that
even subtracting the vitamin and mineral knowledge, they still have
PLENTY to do to insure good intakes of a lot of good things in fruits
and vegetables (some known, some unknown) which are good for people.
Let them get to work on phase II, then, and quit stalling on the
vitamin/mineral therapy.  Let every patient in every hospital have
expensive urine, this I pray.  The expense is tiny compared with all
the rest.

   As a recent editorial in the New England Journal put it (in
connection with folate): "Eat right and take your vitamin TOO."

                                    Steve Harris, M.D.

From: B. Harris)
Subject: Re: Why Aren't Nutritional Supplements Given with Drugs
Date: 4 Jul 1998 02:28:23 GMT

In <6nk1jd$> (M. Compton) writes:

>Doctor Harris,
>You put it in a nutshell. I know a couple doctors, and it is quite
>distressing the lack of nutritional information they have. I actually
>lectured a gastroenterologist one time about fiber content from natural
>foods. All he ever prescribed for his patients was Metamucil. In my
>opinion, it should be called the "Sickness" industry, rather than the
>"Health Care" industry, because calling it the "Health Care" industry
>denotes preventative care, and frankly, most doctors are only trained how
>to take care of problems rather than preventing them. Even GI doctors are
>not given that much nutritional education. Shame!

    The other side of the coin is that nobody's willing to pay us to,
and we all have to make a living.

     People go to doctors to get absolution from their dietary sins.
They're not terribly interested in paying $100 an hour to hear somebody
preach repentance.

                                      Steve Harris, M.D.

From: B. Harris)
Subject: Re: supplements and nutrient absorption
Date: 31 Aug 1998 08:57:27 GMT

In <> barbara <> writes:

>Some say that taking dietary supplements causes the body to loose its
>ability to absorb nutrients from foods.
>Any ideas on this?

   I know of no data, but it does sound like the kinds of things the
body does.  It's a lazy son of a gun.

    To minimize the possibility, I suggest taking no nutrient for
strictly preventive purposes, oftener than once a day.  That gives you
just one spike in the gut lasting an hour or two each day (10% of the
time?) and several more meals each day where the body has to fend for
itself.   None of this time release stuff is necessary.  The body
stores vitamins, even water soluble ones, quite well enough not to show
even early deficiency signs for weeks, and generally at least a month,
after being repleted.

   These rules would not apply to nutrients being taken as
pharmacologics to treat disease states (antioxidants for neuropathy,
say).  There, getting the job done might outweigh the problems of
adaptation that can occur.  It's the same with pain meds or any other

                                         Steve Harris, M.D.

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