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Thinking of adding Padma basic to my regimen. Any thoughts on whether it is likely to interact with:

Circumin
Fish oil
Evening primrose oil
Walnuts
Vit D3, E, B12
R-Alpha lipoic acid
Inosine
Copaxone

Thanks,

Jim

Thanks..to..much..

jim just a question - have I already asked you what form of vit E you are using? also depending on the size of that d3 dose you may want to consider measuring/testing your serum magnesium level (i'd suggest serum zinc too, but I know you have that result coming in today anyway!)

Zinc was 80 (don't have units in front of me). UA was 4. Don't know what form of vitamin E. taking 400 IU per 3 grams of PUFAs.

Good cholesterol was obscenely low (20). Doc suggested adding niacin. Creatinine also low.

80! that's rough. aim for 120 if you can. when supplementing with zinc, do be sure to balance with copper. solaray has a decent zinc copper product, zn:cu 50:2. fyi in this rat study zinc deficiency lowered hdl ('good') and raised ldl cholesterol.
Effect of dietary zinc deficiency on hematological and biochemical parameters and concentrations of zinc, copper, and iron in growing rats
http://www.ncbi.nlm.nih.gov/pubmed/11567779

UA 4 - that looks roughly like an MS remission sort of value. is that a baseline number? or after some inosine?

with vit e be aware that alpha tocopherol on its own can be trouble. some are synthetic. the SELECT study demonstrated that driving the natural ratio out of balance with supplements using a single fraction (ie synthetic alpha tocopherol) at the expense of another (gamma tocopherol) can lead to increased cancer risk.

http://www.thisisms.com/forum/regimens- ... c2489.html
"vitamin E - choose a natural source natural ratio E8 complex, with 4 tocopherols and 4 tocotrienols. note: you don't want just alpha tocopherol, or 'mixed tocopherols'. "

4 is the "before" number. Started the inosine the day after I gave the sample. Thanks for the tip on the vitamin E, probably the bad one as it was cheap. You'll recall that you and I agreed to disagree on zinc supplementation. I don't want another round of papers cited. It suffices to say that I think zinc poses more risk than benefit to MS patients. I'll leave low-normal alone for now.

oh yea, what was the name of that book again?

ah I found it - here's the link for any interested readers. the zinc details are on p. 94.
http://books.google.ca/books?id=g9fuxaV ... nc&f=false

the murine EAE study referenced dosed the mice with the equivalent of 450mg zinc daily to induce harmful effects. do be careful never to take that much!

the book linked above limits its recommendation to 10-15mg per day (see top of p. 94).
standard recommendations for ms patients are on the order of 25-50mg per day. (eg 'best bet' recommendations)

missing from the book: at present the upper limit recommendation for healthy men and women is 40mg/d
http://www.hc-sc.gc.ca/fn-an/nutrition/ ... bl-eng.php

so much for practice. meanwhile in research, the upper limit is actually 50mg/d
http://jn.nutrition.org/content/130/5/1344S.full.pdf (2000)
"Currently this is commonly considered to be a total of 50 mg elemental zinc per day for adults"

again, I would emphasize healthy adults.. my doc prescribed 100mg/d in the short term (1 month) to address deficiency.

anyway j, you are welcome re the vit E

re the uric acid you only have to get to 5 - but as you know I think your low-ish ua level is an indicator of your low zinc status so 'nough said.

going back to the magnesium - any plans there, given the intake of supplemental vit d3?

I played frisbee today for an hour without falling once - thanks padma! Started on Saturdsy. Niacin is also at full dose now, so hard to say for sure it was the padma, but definitely seemed the first noticeable improvement in a while.

hi jim, question: when did you start adding niacin to the above, what have been the incremental doses, and is it straight niacin? are you doing it primarily for the flush reaction? or..?

I went 100 for two nights, then 200, up to 500 (mg). Yes, it is straight niacin. My doctor put me on it to raise my good cholesterol. I was looking into it anyways because of its neuroprotective properties / benefits to brain injury patients. Adding benfotiamine (oil soluble b1) for similar reasons.

I also take my inosine (down to 500 mg from 2g) with it. Inosine bath for brain is theoretically good and niacin crosses blood brain barrier.

ah so as a statin alternative. are they doing liver function tests too?

when I first took niacin (intentionally), it was for the flush reaction ie heightened delivery of oxygen and nutrients to cells. the very first time I had a niacin flush reaction it was accidental and I called telehealth to try to find out what was happening to me LOL! it must have been after that, that I stumbled on the klenner protocol for ms, of which niacin flushing is a component.

did you have to go to 500 in order to get a sufficient flush? if so, lack of essential fatty acids and/or zinc can impair the flush reaction response. looks like you already have the fatty acids under control. I actually didn't expect to find this next piece, and sorry for harping about zinc again! but here's an interaction I just learned of:

http://www.nlm.nih.gov/medlineplus/drug ... l/924.html
"The body can make niacin. People who are malnourished and have niacin deficiency, such as chronic alcoholics, make extra niacin if they take zinc. There might be an increased risk of niacin-related side effects such as flushing and itching if niacin and zinc are taken together."

just as a side note i think i would have figured out how to rephrase that so that it's clear the zinc would be low or deficient too for this approach to work (it would for alcoholics or anyone else with poor zinc status from imbalanced intakes of gluten, phytates, dairy, sugar, etc). i don't know if there's a situation where someone would be niacin deficient without zinc deficiency. if there is, then in that case zinc is probably not the issue.

i was just thinking, it's known that zinc can alter the lipid profile - wonder if it partly due to its effect on niacin biosynthesis.. very interesting!

sorry for this one, I ran across this searching for something else altogether. I couldn't resist relaying to you b/c of the title:

The Essential Toxin: Impact of Zinc on Human Health (2010)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872358/
"Compared to several other metal ions with similar chemical properties, zinc is relatively harmless. Only exposure to high doses has toxic effects, making acute zinc intoxication a rare event. In addition to acute intoxication, long-term, high-dose zinc supplementation interferes with the uptake of copper. Hence, many of its toxic effects are in fact due to copper deficiency. While systemic homeostasis and efficient regulatory mechanisms on the cellular level generally prevent the uptake of cytotoxic doses of exogenous zinc, endogenous zinc plays a significant role in cytotoxic events in single cells. Here, zinc influences apoptosis by acting on several molecular regulators of programmed cell death, including caspases and proteins from the Bcl and Bax families. One organ where zinc is prominently involved in cell death is the brain, and cytotoxicity in consequence of ischemia or trauma involves the accumulation of free zinc. Rather than being a toxic metal ion, zinc is an essential trace element. Whereas intoxication by excessive exposure is rare, zinc deficiency is widespread and has a detrimental impact on growth, neuronal development, and immunity, and in severe cases its consequences are lethal. Zinc deficiency caused by malnutrition and foods with low bioavailability, aging, certain diseases, or deregulated homeostasis is a far more common risk to human health than intoxication."

Liver functions are low (good). Zinc is mid-range. I may have been concerned if it was hugging the bottom limit of normal, but it is in the middle 50% of the normal range.

Low good cholesterol most likely due to laziness (desk job, no exercise). I have added 20 minutes daily stationary bike in addition to niacin.

Sometimes I get flushing, other times I don't. That is a side effect (not the purpose) of my niacin intake.

good news re liver tests even if they're not the most reliable indicators in the world. still it's known that niacin can be hepatotoxic so best to monitor using what's available.

as for zinc, sounds like the range is off at your lab. it's a pretty common issue. to clarify, the WHO 'normal' range (which includes both sick and healthy people) is 11.5-18.5 umol/L (75-121 ug/dL). meanwhile at an infectious disease clinic I've dealt with, where you'd expect all the data points to be from pretty unhealthy individuals, the 'normal' range for serum zinc is 9-14 umol/L (59-92 ug/dL).

your zinc test came back 80, so according to the infectious disease clinic's range, you're smack in the middle of 'normal'. but as far as the WHO is concerned, you're at the bottom of the barrel. to match healthy controls you'd need to match more like 120.

optimizing zinc has good potential to help with the lipid profile, but adding the exercise is definitely a win!

while the flush may be a side effect of your cholesterol treatment, it is nonetheless an indicator. if you're not getting a flush reaction at 500mg intakes, i'd take that as a sign that there's something that needs work in the biochem department.

I already posted the zinc link, here's something on the fatty acid aspect:
Membrane fatty acids, niacin flushing and clinical parameters
http://www.sciencedirect.com/science/ar ... 7896901398
The results of this study of niacin flushing confirm that the absence of flushing is significantly associated with low levels of arachidonic acid and DHA.