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Vitamins, Minerals, and Herbs for Chronic Fatigue

© Susan M. Lark M.D. (Excerpted from The Menopause Self Help Book)



Nutritional supplements can play an important role in your chronic fatigue recovery program. They help stimulate your immune system, glands, and digestive tract, and they can help stabilize and relax your mood. They also promote good circulation of blood and oxygen to the entire body, a necessity for high energy and vitality. When adequate nutritional support is lacking, I have found it very difficult to entirely relieve fatigue. In fact, poor or inadequate nutrition may play a major role in causing fatigue. Thus, the use of essential nutrients is an important facet of a good chronic fatigue treatment program. Numerous research studies done at university centers and hospitals support the importance of nutrition in relieving fatigue; a bibliography is included at the end of this chapter for those wanting more technical information.
Most women have difficulty getting their nutrient intake up to the levels needed for optimal healing using diet alone. The use of supplements can help make up this deficiency so you can heal as rapidly and completely as possible. I do want to emphasize the importance of a good diet along with the use of supplements. Supplements should never be used as an excuse to continue poor dietary habits. I have found that my patients heal most effec-tively when they combine a nutrient rich diet with the right mix of supplements.

This chapter is divided into four sections. The first discusses the role of vitamins and minerals; the second section explains the beneficial effects of fatty acids. The third section tells which herbs help relieve chronic fatigue. I end the chapter with specific recom-mendations on how to make and use your own supplements, along with a series of charts that list major food sources for each essential nutrient.

Vitamins and Minerals for Chronic Fatigue
Many vitamins and minerals are useful in the treatment and pre-vention of fatigue. While a high nutrient diet plays an important role in combating fatigue, you may get the best therapeutic results by adding supplements to boost the level of these nutrients. However, I must caution you to use supplements very carefully. This chapter includes formulas with specific dosage recommendations for supplements, but I suggest that you start slowly. You may want to begin with as little as one-fourth of the listed dose, to see how you tolerate the supplements. You can then increase your dose gradually until you find the level that works best for you. Very rarely, women experience nausea or diarrhea when begin-ning a supplement program. If this happens, your body is having difficulty tolerating a particular supplement. In this case, stop all supplements. After a week you may want to begin your supple-ment intake again. Start with one supplement at a time until you discover which one gives you trouble. You should probably eliminate that supplement from your program. Before taking any supplements, consult your physician or a nutritionist with specific questions about their use or possible side effects.

Vitamin A
This nutrient helps protect the body against invasion by pathogens such as viruses (which might trigger chronic fatigue syndrome) and by bacteria, fungi, and allergies. It does this in several ways. Vitamin A supports the production and maintenance of healthy skin, as well as the mucous membranes that line the mouth, lungs, digestive tract, bladder, and cervix. When these tissues are healthy, invaders have difficulty penetrating the mem-branes, the body´s first line of defense. Vitamin A also enhances the immune system by increasing T-cell activity (these are impor-tant cells that help to fight infectious disease). Vitamin A also contributes to the health of the thymus, a gland located in the chest that plays an important role in maintaining healthy immune function.

Because Vitamin A is needed for normal production of red blood cells, it helps prevent fatigue caused by anemia. It also helps control the tiredness caused by anemia that occurs with heavy menstrual bleeding.

Vitamin A should be used carefully. It is a fat-soluble vitamin that is stored in the body. You should not take more than 20,000 I.U. (international units) per day without being monitored by a physician. An overdose of vitamin A can cause headaches and stress the liver.

Beta carotene, called provitamin A, is a precursor of vitamin A found in fruits and vegetables. Beta carotene is water soluble and, unlike vitamin A, does not accumulate in the body. As a result, it can be used safely in high doses. Certain foods, such as sweet potatoes and carrots, contain large amounts of beta carotene. A single sweet potato or a cup of fresh carrot juice contains 25,000 I.U. of beta carotene.

Provitamin A also enhances immune function. It stimulates immune cells called macrophages and helps trigger increased immune activity against certain bacteria as well as candida. Beta carotene is also a powerful antioxidant that helps to protect the body from damage by free radicals. Free radicals are chemicals that occur as by-products of oxygen use in the body, exposure to ultraviolet light, and other natural processes; they can damage the cell membranes as well as other parts of the cell. Antioxidants like beta carotene neutralize free radicals.

Vitamin B Complex
This complex consists of 11 vitamin B factors. The whole complex works together to perform important metabolic functions, including glucose metabolism, stabilization of brain chemistry, and inactivation of estrogen. These processes regulate the body´s level of energy and vitality. Because B vitamins are water soluble and are not stored in the body, they are easily lost when a woman is under stress or is eating unhealthy food, including coffee, cola drinks, and other caffeine containing beverages. Fatigue and depression can result from the depletion of B vitamins.

Many women with anemia are deficient in three B-complex vitamins: folic acid, pyridoxine (vitamin B6), and vitamin B12. All three are needed for normal growth and maturation of red blood cells. Their deficiency leads to anemia and fatigue. Supplemental vitamin B12 is necessary for women on a vegetarian diet. It is usually given by injection.

Vitamin B6 is extremely important in relieving and preventing fatigue. In women who are prone to fatigue caused by bacteria, viruses, candida, or allergies, B6 supports a healthy immune response. Vitamin B6 is needed for both the production of antibodies by white blood cells and the production of T-cell lymphocytes by the thymus. This vitamin also appears to help enhance the activity of the T-cells, making them more effective in destroying infectious agents.

Vitamin B6 helps reduce PMS related mood swings, fatigue, food cravings, and fluid retention through its effect on glucose metabolism and its participation in prostaglandin synthesis. Prostaglandins hormones that regulate many important physiological functions are formed in the body from certain essential vegetable and fish oils. The essential fats can only be converted to prostaglandins in the presence of B6 and other essential nutrients. Prostaglandin deficiency adversely affects brain chemistry and mood and can worsen fatigue.

Women using birth control pills and menopausal women on hormonal replacement therapy can be prone to fatigue because the use of hormones causes vitamin B6 deficiency. Finally, B6 deficiency has been found in fatigued women who suffer from depression. Vitamin B6 can be taken safely by most women in doses up to 250 milligrams. Doses above this level should be avoided because B6 can cause toxic symptoms in the nervous system in susceptible women.

The B-complex vitamins are usually found together in beans and whole grains. These foods should be part of the diet of women with chronic fatigue, who would also probably benefit from the use of supplemental vitamin B.

Vitamin C
This an extremely important nutrient for fatigue. In one research study done on 411 dentists and their spouses, scientists found a clear relationship between the presence of fatigue and lack of vitamin C. By supporting the immune func-tion, vitamin C helps prevent fatigue caused by infections. It stimulates the production of interferon, a chemical found to prevent the spread of viruses in the body. Necessary for healthy white blood cells and their antibody production, vitamin C also helps the body fight bacterial and fungal infections. Women with low vitamin-C intake tend to have elevated levels of histamine, a chemical that triggers allergy symptoms. Vitamin C is an important antistress vitamin, needed for the production of sufficient adrenal gland hormones. Healthy adrenal function helps prevent fatigue and exhaustion in women who are under physical or emotional stress.

In women with iron deficiency anemia, vitamin C increases the absorption of iron from the digestive tract. Vitamin C has also been tested, along with bioflavonoids, as a treatment for anemia caused by heavy menstrual bleeding a common cause of fatigue in teenagers and premenopausal women in their forties. Vitamin C reduces bleeding by helping to strengthen capillaries and prevent capillary fragility. One clinical study of vitamin C showed a reduction in bleeding in 87 percent of women taking supplemental amounts of this essential nutrient. The best sources of vitamin C in nature are fruits and vegeta-bles. It is a water soluble vitamin, so it is not stored in the body. Thus, women with chronic fatigue should replenish their vitamin C supply daily through a healthy diet and the use of supplements.

Bioflavonoids
These nutrients are found abundantly in flowers and in fruits, particularly oranges, grapefruits, cherries, huckleberries, blackberries, and grape skins. Besides giving pigmentation to plants, they have a number of beneficial physiological effects that can help decrease fatigue symptoms. Bioflavonoids are powerful antioxidants that help protect cells against damage by free radicals. They help protect us from fatigue caused by allergic reac-tions, because their anti-inflammatory properties help prevent the production and release of compounds such as histamine and leukotrienes that promote inflammation. Bioflavonoids such as quercetin have powerful antiviral properties that protect us from infections. Quercetin also inhibits the release of allergic compounds from mast cells the cells in the digestive and respiratory tract that release histamine.

Bioflavonoids are among the most important nutrients for mid-life women suffering from menopausal symptoms. Bioflavonoids produce chemical activity similar to estrogen and can be used as an estrogen substitute. Clinical studies have shown that bioflavonoids can help control hot flashes and the psychological symptoms of menopause, including fatigue, irritability, and mood swings. Interestingly, bioflavonoids contain a very low potency of estrogen, much lower than that used in hormonal replacement therapy. As a result, no harmful side effects have been noted with bioflavonoid therapy.

Because of their ability to strengthen capillary walls, bioflavonoids have also shown dramatic results in reducing the anemia caused by heavy menstrual bleeding. They have been used in women with bleeding caused by hormonal imbalance and have even been tested in women who have lost multiple pregnancies because of bleeding. They were used in conjunction with vitamin C In these studies. Bioflavonoids are often found with vitamin C in fruits and vegetables.

Vitamin E
This vitamin can enhance immune antibody response at high levels and has a significant immune stimulation effect. Vitamin E has antihistamine properties and should be used by women who suffer from allergies. One group of volunteers who were injected with histamine showed far less allergic swelling around the injection site when they were pretreated with vitamin E.

Like vitamin C and beta carotene, vitamin E is an important antioxidant. It protects the cells from the destructive effects of environmental pollutants that can react with the cell membrane. Because it has been found to increase red blood cell survival, it is an important nutrient for the prevention of anemia.

Vitamin E can act as an estrogen substitute. Like bioflavonoids, it has been studied as a treatment for hot flashes and for the psychological symptoms of menopause, including depression and fatigue. It can even relieve vaginal dryness in those women who either can´t take or can´t tolerate estrogen. According to one study, vitamin E helped skew the progesterone/estrogen ratio in the body toward progesterone. This could be very helpful for women who have heavy menstrual bleeding caused by excess estrogen. Vitamin E is also needed for healthy thyroid function.

Vitamin E occurs in abundance in wheat germ, nuts, seeds, and some fruits and vegetables.

Iron
An essential component of red blood cells, iron combines with protein and copper to make hemoglobin, the pigment of the red blood cells. Studies have shown that women with iron deficiency have decreased physical stamina and endurance. Iron deficiency, the main cause of anemia, is common during all phases of a woman´s life, because of both poor nutritional habits and regular blood loss through menstruation. Iron deficiency frequently causes fatigue and low energy states.

Women who suffer from heavy menstrual bleeding are more likely to be iron deficient than woman with normal menstrual flow. In fact, some medical studies have found that inadequate iron intake may be a cause of excessive bleeding as well as an effect of the problem. Women who suffer from heavy menstrual bleeding should have their red blood count checked to see if supplemental iron and a high iron diet are necessary.

Good sources of iron include liver, blackstrap molasses, beans and peas, seeds and nuts, and certain fruits and vegetables. The body absorbs and assimilates the heme iron from meat sources, such as liver, much better than the nonheme iron from vegetarian sources. To absorb non-heme iron properly, you must take it with at least 75 milligrams of vitamin C.

Zinc
Zinc plays an important role in combating fatigue. Supplementation with zinc improves muscle strength and endurance. It reduces fatigue by enhancing immune function, acting as an immune stimulant and triggering the reproduction of lymphocytes when incubated with these cells in a test tube. Zinc is a constituent of many enzymes involved in both metabolism and digestion. It is needed for the proper growth and development of female reproductive organs and for the normal functioning of the male prostate gland. Good food sources of zinc include wheat germ, pumpkin seeds, whole grain wheat bran, and high protein foods.

Magnesium and Malic Acid
Combinations of these two supplements are very important for the maintenance of energy and vitality. Magnesium is required for the production of ATP, the end product of the conversion of food to usable energy by the body´s cells. ATP is the universal energy currency that the body uses to run hundreds of thousands of chemical reactions. Malic acid is extracted from apples and is also an important component in the production of ATP. Another form of magnesium has been researched for the treatment of fatigue called magnesium aspartate, formed by combining magnesium with aspartic acid. Aspartic acid also plays an important role in the production of energy in the body and helps transport magnesium and potassium into the cells. Magnesium aspartate, along with potassium aspartate, has been tested in a number of clinical studies and has been shown to dramatically improve energy levels after five to six weeks of constant use. Many volunteers began to feel better even within ten days. This beneficial effect was seen in 90 percent of the people tested, a very high success rate.

Magnesium is an important nutrient for women with chronic candida infections. A magnesium deficiency can develop from the diarrhea, vomiting, and other digestive problems associated with intestinal candida infections. Magnesium deficiency can worsen fatigue, weakness, confusion, and muscle tremor in women with candida infections. Women with these symptoms must replace the magnesium through appropriate supplementation. Magnesium deficiency has also been seen in women suffering from PMS; medical studies have found a reduction in red blood cell magnesium during the second half of the menstrual cycle in affected women. Magnesium, like vitamin B6, is needed for the production of the beneficial prostaglandin hormones as well as for glucose metabolism. Magnesium supplements can also benefit women with severe emotional stress, anxiety, and insomnia. When taken before bedtime, magnesium helps to calm the mood and induce restful sleep. Good food sources of magnesium include green leafy vegetables, beans and peas, raw nuts and seeds, tofu, avocado, raisins, dried figs, millet and other grains.

Potassium
Like magnesium, potassium has a powerful enhancing effect on energy and vitality. Potassium deficiency has been associated with fatigue and muscular weakness. One study showed that older people who were deficient in potassium had weaker grip strength. Potassium aspartate has been used with magnesium aspartate in a number of studies on chronic fatigue; this combination significantly restored energy levels.

Potassium has many important roles in the body. It regulates the transfer of nutrients into the cells and works with sodium to maintain the body´s water balance. Its role in water balance is important in preventing PMS bloating symptoms. Potassium aids proper muscle contraction and transmission of electrochemical impulses. It helps maintain nervous system function and a healthy heart rate. Potassium is found in abundance in fruits, vegetables, beans and peas, seeds and nuts, starches, and whole grains.

Calcium
This mineral helps combat stress, nervous tension, and anxiety. An upset emotional state can dramatically worsen fatigue in susceptible women. A calcium deficiency worsens not only emotional irritability but also muscular irritability and cramps. Calcium can be taken at night along with magnesium to calm the mood and induce a restful sleep. Women with menopause related anxiety, mood swings, and fatigue may also find calcium supplementation useful. It has the added benefit of helping prevent bone loss, or osteoporosis, because calcium is a major structural component of bone.

Like magnesium and potassium, calcium is essential in the maintenance of regular heartbeat and the healthy transmission of impulses through the nerves. It may also help reduce blood pressure and regulate cholesterol levels; it is essential for blood clotting. Good sources of calcium include green leafy vegetables, salmon (with bones), nuts and seeds, tofu, and blackstrap molasses.

Iodine
This mineral is necessary to prevent fatigue caused by low thyroid function. Iodine, along with the amino acid tyrosine, is necessary for the production of the thyroid hormone thyroxin. Without adequate thyroid hormone women may suffer from excessive fatigue, excess weight, constipation, and other symptoms of a slowed metabolism. Iodine deficiency has also been linked to breast disease. Only trace amounts of iodine are needed to maintain its important metabolic effects. Good food sources include fish and shellfish, sea vegetables such as kelp and dulse, and garlic.

Tyrosine
This amino acid combines with iodine within the thyroid gland to form the thyroid hormone thyroxine. Thyroxine has many important functions in the body, including control of metabolic rate, promotion of growth (particularly crucial in children), and carbohydrate and fat metabolism.

Women whose protein intake is low (which can be a problem for vegans who get their protein exclusively from plant sources) and women who can´t absorb and assimilate protein due to severe digestive problems, may lack sufficient tyrosine in their diets and require manufactured thyroxine. These women may have border-line low thyroid levels which can be remedied by increasing their intake of thyroid hormone precursor nutrients. Besides increasing protein, tyrosine may be taken as a dietary supplement. Generally, 500 to 1500 milligrams of pure tyrosine per day may be used. It is best to take tyrosine with a meal high in carbohydrates.

Tyrosine has been reported to help relieve depression, another cause of chronic fatigue. It has also been shown to relieve some symptoms in patients with Parkinson´s disease. Women using monoamine oxidase (MAO) inhibitor drugs for the treatment of depression should avoid taking tyrosine as should those diagnosed with melanoma. Otherwise, tyrosine is safe for use by most people.

Phenylalanine
Tyrosine, the amino acid needed by the body to produce the thyroid hormone thyroxine, is actually manufactured from another amino acid called phenylalanine. This essential amino acid must be acquired through diet since the body cannot make phenylalanine from other amino acids. Good food sources of phenylalanine include fish, poultry, red meat, soybeans, almonds, lentils, lima beans, chickpeas, and sesame seeds. It can also be taken in purified form as a dietary supplement. Five hundred to 2,000 milligrams per day is the usual theraputic dosage. Be sure to start at the lower end of the range, increasing gradually.

Phenylalanine is a natural antidepressant and pain killer, but can also cause jitteriness and nervousness when used in too high a dose. As with tyrosine, it should be avoided by women using monoamine oxidase inhibitor drugs for depression. Patients on phenylalanine may notice a greater alertness, an increased sense of well-being, and an enhancement of sexual interest.

Essential Fatty Acids for Chronic Fatigue
Essential fatty acids are very important nutrients for women with fatigue and play an important role in maintaining optimal health. Essential fatty acids consist of two types of special fats or oils, called linoleic acid (Omega-6 family) and linolenic acid (Omega-3 family). Because your body cannot make these fats, you must sup-ply them daily via foods or supplements. Though these essential fatty acids supply stored energy in the form of calories, they also perform many other important functions in the body.

Essential fatty acids are important components of the membrane structure of all the body´s cells. They are also required for normal development and function of the brain, eyes, inner ear, adrenal glands, and reproductive tract. The essential oils are also necessary for the synthesis of prostaglandins type I and III, which are hormonelike chemicals that help decrease the risk of heart disease by regulating blood pressure and platelet stickiness. Prostaglandins type I and II help reduce fatigue through their role in preventing a number of healthcare problems: they decrease inflammation, boost immune function, decrease menstrual cramps, and help to reduce PMS symptoms. One essential fat evening primrose oil has been tested in the United States and England for its beneficial effects on PMS and menstrual cramps.

Essential oils are particularly important to menopausal women because deficiency of these oils is responsible in part for the drying of skin, hair, vaginal tissues, and other mucous membranes that occurs with menopause. Along with vitamin E, which also benefits the skin and vaginal tissues, I have used essential oils extensively in my nutritional program for women. Essential fatty acids are important in treating immune problems such as candida infections, allergies, and CFS, which worsen fatigue in millions of women.

The best sources of linoleic and linolenic acids are flax seeds and pumpkin seeds. Both the seeds and their pressed oils should be used absolutely fresh and unspoiled. Because these oils become rancid very easily when exposed to light and air (oxygen), they need to be packed in special opaque containers and kept in the refrigerator. Essential oils should never be heated or used in cooking because heat affects their special chemical properties. Instead, add these oils as a flavoring to foods that are already cooked. Fresh flax seed oil is my special favorite. Good quality flax seed oil is available in health food stores. Flax seed oil is golden, rich, and delicious. It is extremely high in linoleic and linolenic acids, which comprise approximately 80 percent of its total content. Pumpkin seed oil has a deep green color and spicy flavor. It is probably more difficult to find than flax seed oil. Fresh raw pumpkin seeds are a good source of this oil. They can be purchased from many health food stores. Both flax seed oil and pumpkin seed oil can also be taken in capsule form.

Linolenic acid (Omega-3 family) is also found in abundance in fish oils. The best sources are cold water, high fat fish such as salmon, tuna, rainbow trout, mackerel, and eel. Linoleic acid (Omega-6 family) is found in seeds and seed oils. Good sources include safflower oil, sunflower oil, corn oil, sesame seed oil, and wheat germ oil. Many women prefer to use raw fresh sesame seeds, sunflower seeds, and wheat germ to obtain the oils. The average healthy adult requires only four teaspoons per day of essential oils. However, women with chronic fatigue, who may have a real deficiency of these oils, need up to two or three tablespoons per day until their symptoms improve. Occasionally, these oils may cause diarrhea; if this occurs, use only one teaspoon per day. Women with acne and very oily skin should use them cautiously. For optimal results, be sure to use these oils along with vitamin E.

Herbs for Chronic Fatigue
Many herbs can help relieve the symptoms and treat the causes of chronic fatigue. I have used fatigue relieving herbs in my practice for many years and many women have found them to be effective remedies. I use them as a form of extended nutrition. They can balance and expand the diet while optimizing nutritional intake. Some herbs provide an additional source of essential nutrients that help relax tension and ease anxiety. Other herbs have mild anti-infective and hormonal properties in addition to their nutritional content; these help to combat fatigue causing viruses and fungi, as well as provide support for the endocrine system with a minimum of side effects. In this section, I describe many specific herbs useful for relief of chronic fatigue and related problems.

Chronic Fatigue and Depression
For women with fatigue and depression, herbs such as oat straw, ginger, ginkgo biloba, licorice root, dandelion root, and Siberian ginseng (eleutherococcus) may have a stimulatory effect, improving energy and vitality. Women who use these herbs may note an increased ability to handle stress, as well as improved physical and mental capabilities.

Some of the salutary effects may be due to the high levels of essential nutrients captured in herbs. For example, dandelion root contains magnesium, potassium, and vitamin E, while ginkgo contains high levels of bioflavonoids. These essential nutrients help relieve fatigue, depression, PMS, and hot flashes, and they increase resistance to infections.

Siberian ginseng, ginger, and licorice root have been important traditional medicines in China and other countries for thousands of years. They have been reputed to increase longevity and decrease fatigue and weakness. These herbs have been found to boost immunity and to strengthen the cardiovascular system. The bioflavonoids contained in ginkgo are extremely powerful antioxidants and help to combat fatigue by improving circulation to the brain. They also appear to have a strong affinity for the adrenal and thyroid gland and may help to boost function in these essential glands. Oat straw has been used to relieve fatigue and weakness, especially when there is an emotional component. One note of caution: Licorice root should be used carefully and only in small amounts because, over time, it can cause potassium loss.

In modern China, Japan, and other countries, there has been much interest in the pharmacological effects of these traditional herbs. Scientific studies are corroborating the medicinal effects of these plants.

Anxiety, Irritability, and Insomnia
Women suffering from anxiety, irritability and insomnia often have a worsening of their fatigue symptoms because of emotional stress and sleep deprivation. Luckily, a number of herbal remedies relieve such symptoms. Herbs such as passionflower (passiflora) and valerian root have a calming and restful effect on the central nervous system.

Passionflower has been found to elevate levels of the neurotransmitter serotonin. Serotonin is synthesized from tryptophan, an essential amino acid that has been found in numerous medical studies to initiate sleep and decrease awakening. Valerian root has been used extensively in traditional herbology as a sleep inducer. It is used widely in Europe as an effective treatment for insomnia. Research studies have confirmed both the sedative effect of valerian root and its effectiveness as a treatment for insomnia. For women with insomnia, valerian root can be a real blessing. I have used it with patients for the past 18 years and noted much symptom relief. Other effective herbal treatments include chamomile, hops, catnip, and peppermint teas. I have used them all in my practice and many pleased patients have commented on their effectiveness.

Chronic Fatigue Syndrome, Candida Infections, and Allergies
Women with fatigue symptoms caused by severe immune dysfunction may initially have difficulty using any herbs at all because their bodies are too weak. In cases of severe fatigue, I often start the patient on aloe Vera and peppermint. Most women can tolerate these two supportive and soothing herbs. You can take aloe Vera internally as a juice. Buy the cold pressed, nonpasteurized brands. You can take peppermint as a tea or, even better, as an oil in capsules or an herbal tincture in water.

Once you are stronger and less fatigued, you may be able to tolerate herbs that can boost your energy and vitality (see information earlier in this section), as well as herbs that help suppress infections from viruses, candida, and other pathogens. One of the best herbs for this purpose is garlic. Garlic contains a chemical called allicin that is a powerful broad spectrum antibiotic. Studies have shown garlic to be effective against fungi such as candida, as well as the fungus that causes athlete´s foot and the dangerous fungus that causes serious cryptococcal meningitis. Garlic also kills bacteria and viruses. In addition, garlic protects the cells through its powerful antioxidant effects.

Two other herbs have strong anti-infective properties and can be used to treat pathogens that cause fatigue. The first is echinacea, a powerful immune stimulant herb. Echinacea helps fight infections by promoting interferon production, as well as activa-tion of the T-lymphocytes (natural killer cells) and neutrophils (the cells that kill bacteria). Native Americans traditionally used this plant as a medicinal agent. I have used echinacea often with patients and have been pleased with its powerful anti-infective properties. The second herb, goldenseal, is also an excellent immune stimulant. Goldenseal contains a high level of chemical called berberine. Berberine activates macrophages (cells that engulf and destroy bacteria, fungi, and viruses). When used in combination with garlic and echinacea, goldenseal is an effective tool for suppressing infections.

Menopause, PMS, and Hypothyroidism
Many plants are good sources of estrogen, the hormone that helps control hot flashes in menopausal women. Blueberries, blackberries, huckleberries, and citrus fruit contain bioflavonoids. Bioflavonoids have weak estrogenic activity (1/50,000 the strength of estrogen), but are very effective in controlling such common menopausal symptoms as hot flashes, anxiety, irritability, and fatigue. Plants containing bioflavonoids may be particularly useful for women who cannot take normal supplements because of their concern about the possible strong side effects of the prescription hormones (increased risk of stroke, cancer, etc.). Other plant sources of estrogen and progesterone used in traditional herbology include Dong Quai, black cohosh, blue cohosh, unicorn root, false unicorn root, fennel, anise, sarsaparilla, and wild yam root. The hormonal activities of these plants have been validated in a number of interesting research studies.

Women with PMS also benefit from herbs that relieve mood swings and anxiety, such as valerian root or passionflower, and those that directly reduce fatigue and depression, such as ginger root, ginkgo biloba, and dandelion. Ginger also helps relieve the bloating and fluid retention symptoms of PMS, as do dandelion and burdock root, which act as mild diuretics. Iodine containing plants, including dulse and kelp, help correct low thyroid function. These sea vegetables are also high in trace minerals, so are excellent for general health and well being. Iodine is used for the production of thyroxin, the thyroid hormone that helps boost metabolism and maintain energy level.

Anemia and Heavy, Irregular Menstrual Bleeding
Plants that contain bioflavonoids help strengthen capillaries and prevent heavy, irregular menstrual bleeding (menorrhagia), a common bleeding pattern in women approaching menopause. Besides controlling hot flashes, bioflavonoids also help to reduce heavy bleeding. Bioflavonoids are found in many fruits and flowers; excellent sources are citrus fruits, cherries, grapes, and hawthorn berries.

According to research studies, they have also been found in red clover and in some clover strains in Australia. Many medical studies have demonstrated the usefulness of citrus bioflavonoids in treating a variety of bleeding problems in addition to those related to menopause, including habitual spontaneous abortion and tuberculosis. Herbs such as yellow dock and pan d´arco are useful for anemia because of their high iron content.

How to Use Optimal Nutritional Formulas for Chronic Fatigue
Good dietary habits are crucial for relief of chronic fatigue, but many women must also use nutritional supplements to achieve high levels of certain essential nutrients. I have included both vitamin and mineral formulas and herbal formulas so that you will have the widest range of supplements to choose from.

I recommend that women with chronic fatigue take all supple-ments cautiously. Start with one-quarter of the daily dose listed in the following formulas. Do not go to a higher dose level unless you are sure you can tolerate the dose you´re already using. If you have specific questions, be sure to consult your physician.



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Nutritional System for Chronic Fatigue Syndrome, Candida Infections, Allergies, and Depression

Vitamins and Minerals Maximum Daily Dose
Malic acid/Magnesium hydroxide 1,800-6,000 mg (take in 6 small doses)
Beta carotene (provitamin A) 10,000 I.U.
Vitamin B complex
B1 (thiamine) 50 mg
B2 (riboflavin) 75 mg
B3 (niacinamide) 200 mg
B5 (pantothenic acid) 200 mg
B6 (pyridoxine) 75 mg
B12 (cyanocobalamin) 100 mcg
Folic acid 400 mcg
Biotin 400 mcg
Choline 700 mg
Inositol 500 mg
PABA (para-aminobenzoic acid) 50 mg
Vitamin C 2000 mg
Vitamin D 200 I.U.
Vitamin E 400 I.U.
Calcium aspartate 1200 mg
Magnesium aspartate 600 mg
Potassium aspartate 200 mg
Iron 18 mg
Chromium 150 mcg
Manganese 20 mg
Selenium 50 mcg
Zinc 15 mg
Copper 2 mg
Iodine 150 mcg

Dosage: Take one-quarter to full amount of the above nutrients on a daily basis. Begin this formula with the lowest dose of each nutrient and increase the dose slowly and gradually to the recommended maximum depending on how you are feeling.
Herbal Tinctures Maximum Daily Dose
Ginkgo biloba 2 droppersful
Ginger root 2 droppersful
Burdock root 2 droppersful
Dandelion root 2 droppersful
Licorice root 1/2 dropperful

Dosage: Take one-quarter to full amount of the above nutrients on a daily basis. Begin this formula with the lowest dose of each nutrient and increase the dose slowly and gradually to the recommended maximum depending on how you are feeling.



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Optimal Nutritional Supplementation for PMS and Hypothyroidism

Vitamins and Minerals Maximum Daily Dose
Beta carotene (provitamin A) 15,000 I.U.
Vitamin B complex
B1 (thiamine) 50 mg
B2 (riboflavin) 50 mg
B3 (niacinamide) 50 mg
B5 (pantothenic acid) 50 mg
B6 (pyridoxine HCl) 300 mcg
B12 (cyanocobalamin) 50 mcg
Folic acid 200 mcg
Biotin 30 mcg
Choline bitartrate 500 mg
Inositol 500 mg
PABA (para-aminobenzoic acid) 50 mg
Vitamin C 1000 mg
Vitamin D (cholecalciferol) 100 I.U.
Vitamin E 600 I.U.
Calcium (amino acid chelate) 150 mg
Magnesium 300 mg
Iodine 150-300 mcg
Iron (amino acid chelate) 15 mg
Copper 0.5 mg
Zinc 25 mg
Manganese 10 mg
Potassium 100 mg
Selenium 25 mcg
Chromium 100 mcg

Dosage: Take one-quarter to full amount of the above nutrients on a daily basis. Begin this formula with the lowest dose of each nutrient and increase the dose slowly and gradually to the recommended maximum, depending on how you are feeling.
Amino Acids for hypothyroidism
(as capsules) Maximum Daily Dose
Phenylalanine 500 mg-2000 mg
Tyrosine 500 mg-1500 mg
Herbs (as capsules) Maximum Daily Dose
Burdock 210 mg
Sarsaparilla 210 mg
Ginger 70 mg

Dosage: Take one to two capsules per day.



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Optimal Nutritional Supplementation for Fatigue Related to Menopause

Vitamins and Mineral Maximum Daily Dose
Beta carotene 5000 I.U.
Vitamin A 5000 I.U.
Vitamin D 400 I.U.
Vitamin E (d-alpha tocopheryl acetate) 800-2000 I.U.
Vitamin C 1000-2000 mg
Bioflavonoids 800-2000 mg
Rutin 200 mg
Vitamin B1 50 mg
Vitamin B2 50 mg
Niacin (as niacinamide) 50 mg
Vitamin B6 30 mg
Vitamin B12 50 mcg
Folic acid 400 mcg
Biotin 200 mcg
Pantothenic acid 50 mg
Choline 50 mg
Inositol 50 mg
PABA (para-aminobenzoic acid) 50 mg
Calcium (calcium citrate) 1200 mg
Magnesium 320 mg
Iodine 150 mcg
Iron (ferrous fumarate) 27 mg
Copper 2 mg
Zinc 15 mg
Manganese 10 mg
Potassium (potassium aspartate) 100 mg
Selenium 25 mcg
Chromium 100 mcg
Bromelain 100 mg
Papain 65 mg
Boron 3 mg


Dosage: Women with mild to moderate menopause symptoms can use the formula at half strength. Women with severe symptoms should use the full strength.
Herbs (as capsules) Maximum Daily Dose
Fennel 100-250 mg
Anise 100-250 mg
Blessed thistle 100-250 mg
False unicorn root 100-250 mg
Blue cohosh 100-250 mg

Dosage: Take one to two capsules per day.



--------------------------------------------------------------------------------
Optimal Nutritional Supplementation for Anemia

Vitamins and Minerals Maximum Daily Dose
Iron 27 mg
Vitamin C 250 mg
Vitamin E (natural d-alpha) 30 I.U.
Vitamin B1(thiamine) 7.5 mg
Vitamin B2 (riboflavin) 7.5 mg
Vitamin B3 (niacinamide) 10 mg
Vitamin B5 (pantothenic acid) 50 mg
Vitamin B6 (pyridoxine) 30 mg
Vitamin B12 (cyanocobalamin) 250 mcg
Folic acid 400 mcg
Biotin 100 mcg
Choline bitartrate 5 mg
Inositol 5 mg
PABA (para-aminobenzoic acid) 5 mg
Zinc 1.5 mg
Copper 250 mcg
Betaine HCL 10 mg
Herbs Maximum Daily Dose
Chlorophyll 2 droppersful
Yellow dock 2 droppersful
Pau d´arco 2 droppersful
Licorice root 1/2 dropperful
Red clover 1 dropperful

Dosage: Take one-quarter to full amount of the above nutrients on a daily basis. Begin this formula with the lowest dose of each nutrient and increase the dose slowly and gradually to the recommended maximum, depending on how you are feeling.


--------------------------------------------------------------------------------
Food Sources of Vitamin A

Vegetables
Carrots
Carrot juice
Collard greens
Dandelion greens
Green onion
Kale
Parsley
Spinach
Sweet potatoes
Turnip greens
Winter squash
Fruit
Apricots
Avocado
Cantaloupe
Mangoes
Papaya
Peaches
Persimmons
Meat, Poultry, Seafood
Crab
Halibut
Liver-all types
Mackerel
Salmon
Swordfish

--------------------------------------------------------------------------------
Food Sources of Vitamin B Complex (including folic acid)

Vegetables and Legumes
Alfalfa
Artichokes
Asparagus
Beets
Broccoli
Brussels sprouts
Cabbage
Cauliflower
Corn
Garbanzo beans
Green beans
Green peas
Kale
Leeks
Lentils
Lima beans
Onions
Pinto beans
Romaine lettuce
Soybeans


Meat, Poultry, Seafood
Egg yolks *
Liver *
Grains
Barley
Bran
Brown rice
Corn
Millet
Rice bran
Wheat
Wheat germ
Sweetners
Black-strap molasses
* Eggs and meat should be from organic range-fed stock fed on pesticides free food.


--------------------------------------------------------------------------------
Food Sources of Vitamin B6

Grains
Brown rice
Buckwheat flour
Rice bran
Rice polishings
Rye flour
Wheat germ
Whole wheat flour
Vegetables
Asparagus
Beet greens
Broccoli
Brussels sprouts
Cauliflower
Green peas
Leeks
Sweet potatoes
Meat, Poultry, Seafood
Chicken
Salmon
Shrimp
Tuna
Nuts and seeds
Sunflower seeds

--------------------------------------------------------------------------------
Food sources of Vitamin B12

Fish
Eggs*
Liver*
* Eggs and meat should be from organic range-fed stock fed on pesticides-free food.


--------------------------------------------------------------------------------
Food Sources of Vitamin C

Fruits
Blackberries
Black Currents
Cantaloupe
Elderberries
Grapefruit
Grapefruit juice
Guavas
Kiwi fruit
Mangoes
Oranges
Orange juice
Pineapple
Raspberries
Strawberries
Tangerines
Vegetables
Asparagus
Black-eyed peas
Broccoli
Brussels sprouts
Cabbage
Cauliflower
Collards
Green onions
Green peas
Kale
Kohlrabi
Parsley
Potatoes
Rutabaga
Sweet pepper
Sweet potatoes
Tomatoes
Turnips


Meat, Poultry, Seafood
Liver-all types
Pheasant
Quail
Salmon

--------------------------------------------------------------------------------
Food Sources of Iron (listed from best to good)

Grains
Bran cereal (All-Bran)
Millet, dry
Wheat germ
Pasta, whole wheat
Bran muffin
Pumpernickel bread
Oat flakes
Shredded wheat
Whole wheat bread
Rye bread
Wheat bran
Pearl barley
White rice
Fruits
Prune juice
Figs
Raisins
Prunes, dried
Avocado
Apple juice
Dates, dried
Blackberries
Pineapple
Grape juice
Apricots, fresh
Cantaloupe
Strawberries
Cherries
Legumes
Black beans
Pinto beans
Garbanzo beans
Soybeans
Kidney beans
Lima beans
Lentils
Split peas
Black-eyed peas
Tofu
Meat, Poultry, Seafood
Calf liver
Beef liver
Chicken liver
Oysters
Trout
Clams
Scallops
Sardines
Shrimp
Chicken
Haddock
Cod
Salmon
Vegetables
Brussels sprouts
Spinach
Broccoli
Sweet potatoes
Dandelion greens
Green beans
Corn
Leeks
Kale
Swiss chard
Beets
Beet greens
Mushrooms
Green peas
Parsnips
Carrots
Mustard greens
Green pepper
Lettuce
Turnips
Asparagus
Collards
Cauliflower
Zucchini
Winter squash
Red cabbage
Nuts and Seeds
Sesame seeds
Sunflower seeds
Pistachios
Pecans
Sesame butter
Almonds
Hazelnuts (filberts)
Walnuts

--------------------------------------------------------------------------------
Food Sources of Zinc

Grains
Barley
Brown rice
Buckwheat
Corn
Cornmeal
Millet
Oatmeal
Rice bran
Rye bread
Wheat bran
Wheat germ
Wheat berries
Whole wheat bread
Whole wheat flour
Vegetables and Legumes
Black-eyed peas
Cabbage
Carrots
Garbanzo beans
Green peas
Lentils
Lettuce
Lima beans
Onions
Soy flour
Soy meal
Soy protein
Fruits
Apples
Peaches
Meat, Poultry, Seafood
Chicken
Oysters


--------------------------------------------------------------------------------
Food Sources of Calcium

Vegetables and Legumes
Artichoke
Black beans
Black-eyed peas
Beet greens
Broccoli
Brussels sprouts
Cabbage
Collards
Eggplant
Garbanzo beans
Green beans
Green onions
Kale
Kidney beans
Leeks
Lentils
Parsley
Parsnips
Pinto beans
Rutabaga
Soybeans
Spinach
Turnips
Watercress
Meat, Poultry, Seafood
Abalone
Beef
Bluefish
Carp
Crab
Haddock
Herring
Lamb
Lobster
Oysters
Perch
Salmon
Shrimp
Venison
Fruits
Blackberries
Black currants
Boysenberries
Oranges
Pineapple juice
Prunes
Raisins
Rhubarb
Tangerine juice
Grains
Bran
Brown rice
Bulgar wheat
Millet


--------------------------------------------------------------------------------
Food Sources of Magnesium

Vegetables and Legumes
Artichokes
Black-eyed peas
Carrot juice
Corn
Green peas
Leeks
Lima beans
Okra
Parsnips
Potatoes
Soybean sprouts
Spinach
Squash
Yams
Grains
Brown rice
Millet
Wild rice
Nuts and Seeds
Almonds
Brazil nuts
Hazelnuts
Peanuts
Pistachios
Pumpkin seeds
Sesame seeds
Walnuts
Fruits
Avocado
Bananas
Grapefruit juice
Papayas
Pineapple juice
Prunes
Raisins


--------------------------------------------------------------------------------
Suggested Reading
Castleman, M. The Healing Herbs. Emmaus, PA: Rodale Press, 1991.

Crook, W., M.D. Chronic Fatigue Syndrome and the Yeast Connection. Jackson, TN: Professional Books, 1992.

Crook, W., M.D. The Yeast Connection. Jackson, TN: Professional Books, 1983.

Erasmus, U. Fats and Oils. Burnaby, BC, Canada: Alive Books, 1986.

Gittleman, A. L. Supernutrition for Women. New York: Bantam Books, 1991.

Hasslering, B., S. Greenwood, M.D., and M. Castleman. The Medical Self-Care Book of Women´s Health. New York: Doubleday, 1987.

Hogladaroom, G., R. McCorkle, and N. Woods. The Complete Book of Women´s Health. Englewood Cliffs, NJ: Prentice-Hall, 1982.

Kirschmann, J., and L. Dunne. Nutrition Almanac. New York: McGraw- Hill, 1984.

Kutsky, R. Vitamins and Hormones. New York: Van Nostrand Reinhold, 1973.

Lambert-Lagace, L. The Nutrition Challenge for Women. Palo Alto, CA: Bull Publishing, 1990.

Lark, S., M.D. Heavy Menstrual Flow & Anemia Self Help Book. Berkeley, CA: Celestial Arts, 1995.

Lark, S., M.D. Menopause Self Help Book. Berkeley, CA: Celestial Arts, 1990.

Lark, S., M.D. Menstrual Cramps Self Help Book. Berkeley, CA: Celestial Arts, 1995.

Lark, S., M.D. Premenstrual Syndrome Self Help Book. Berkeley, CA: Celes-tial Arts, 1984.

Mowrey, D., Ph.D. The Scientific Validation of Herbal Medicine. New Canaan, CT: Keats Publishing, 1986.

Murray, M., N.D. The 21st Century Herbal. Bellevue, WA: Vita-Line, Inc., 1992.

Padus, E. The Woman´s Encyclopedia of Health and Natural Healing. Emmaus, PA: Rodale Press, 1981.

Reuben, C., and J. Priestly, M.D. Essential Supplements for Women. New York: Perigree Books, 1988.

Trowbridge, J., M.D., and M. Walker, D.M.P. The Yeast Syndrome. New York: Bantam Books, 1988.

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