REFERENCE FOR DOCTORS

Designed for your quick reference.Fully independent evidence based with references.

The landmark Age-Related Eye Disease Study 2 (AREDS2) trial specified a specific concoction of lutein, zeaxanthin, copper, zinc, vitamin A and vitamin E. When used for patients suffering from intermediate dry ARMD or worse, it is demonstrated to reduce disease progression. AREDS2’s formula is different from the initial AREDS trial as it replaces beta cartone with lutein and zeaxanthin. Beta-carotene has been associated with a higher incidence of lung cancer in former smokers, and its removal from the AREDS2 formula did not result in significant change in effectiveness.

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3 studies (2 cohort, 1 double blind) on allergic rhinitis demonstrated improvements in allergic symptoms with the usage of Nigella Sativa in the oil form and seed powder form.

1 cohort study of asthmatics showed improvement in symptoms and reduction in anti-asthmatic medication usage.

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6 double blind studies investigating Kava vs placebo showed significant improvement of non-psychotic anxiety symptoms over placebo. 1 double blind study did not demonstrate any difference between kava and placebo but both groups had improvements of symptoms. A meta-analysis of kava confirmed the former, where Kava is more effective than placebo at reducing anxiety.

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There are various components to the supplements we offer that are beneficial to cognition. Generally, they improve cognition of young and elderly by reducing fatigue.

Amongst all, rhodiola has the most notable anti-fatigue effects, which resulted in an improvement of performance and mood.

Reference for rhodiola

Gingko has been widely touted by many as a supplement for brain health as you would have experienced. But when is it actually effective? The most notable effects were specifically for people already suffering from cognitive decline and the effects were comparable to donepezil.

Reference for gingko biloba

Panax ginseng (Korean Ginseng) has less notable effects for cognition. It possesses an anti-fatigue function which is associated with better cognition.

Reference for panax ginseng

Bacopa Monierri has notable effects in improving memory (not increasing rate of learning), possibly by reducing rate of forgetting. This has to be used for long term (6 months or more) to have noticable effects as shorter trials did not demonstrate any significant difference.

Reference for bacopa monierri

Till date, there have been no treatment for mild upper respiratory tract infections caused by viruses like rhinovirus, adenovirus, or the non-novel coronavirus. In the primary care setting, we have always been asked for treatment and very often have to explain that antibioitics are useless and does more harm than good for viral infections.

We have traditionally been preaching that we cannot treat viral infections and have to let it run it’s course. While there are still no available antivirals for mild colds, it will be worth considering these evidence for preventing future mild infections and hastening recovery of current infections.

A multitude of studies have been conducted on Vitamin C and cold. There is still mixed evidence that vitamin may reduce the duration of infection by less than a day if taken prior to the infection setting in. Once the infection has occurred, there is evidence that vitamin C does not aid in recovery. Thus, vitamin C may be considered to be used as a prophylaxis.

Reference for Vitamin C

Vitamin E have been demonstrated to enhance immunity in older persons. There does not seem to be any effect on younger people possible due to age-related immune suppression.

Reference for Vitamin E

Stronger data exists for echinacae in its effectiveness in reducing the length of the common cold. A meta-analysis in 2007 showed there is a reduction of common cold symptoms by 1.4 days and decreased odds of developing the cold by 58%.

Reference for Echinacae

Mixed evidence presents zinc as a possible candidate for reducing the duration of common cold. If it works, effects are minor too. Zinc lozenges have similar mixed efficacy in reduction of sore throat symptoms. We must be careful to avoid zinc nasal sprays as permanent anosmia may result.

Reference for Zinc

Light but positive evidence for andrographis demonstrated efficacy. A double-blinded placebo study of 158 participants showed andrographis significantly alleviated symptoms of the common cold when taken on the onset of infective symptoms. Do note that this is not suitable for pregnancy nor breastfeeding.

Reference for Andrographis

There are plenty of suggestions that psychotherapy should be first line treatment in depression as it harbours no medication side effect and has similar efficacy to antidepressants. If medications still has to be used, saffron appears to have comparable effects to some antidepressants (fluoxetine and imipramine) in managing major depressive disorder.

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Melatonin is a hormone that is naturally produced at night by a part of our brain called the pineal gland. It synchronises circadian rhythms, and improve the onset, duration and quality of sleep. Melatonin offers an alternative treatment to the currently available pharmaceutical therapies for sleep disorders with significantly less side effects.

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There is no question in modern medicine that breastmilk is best for the newborn. A double-blind study of fenugreek, control and placebo showed the fenugreek group doubled the average milk production.

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For triglyceride reduction, very strong evidence suggests that fish oil, in both the form of DHA and EPA, can bring about 15-30% reduction. If your patient has a higher baseline triglyceride level, there is evidence that suggestion that the reduction after using fish oil is higher. Interestingly, there isn’t much efficacy of fish oil on HDL-c and LDL-c.

Reference for fish oil

To solve the issue of HDL-c and LDL-c, garlic has been definitively proven to increase HDL-c and reduce LDL-c levels with meta-analysis. The amounts of garlic used in the studies are significantly higher than our average daily consumption from food.

Reference for garlic

Specifically for osteoarthritis pain, glucosamine has been very thoroughly researched. Various meta-analyses demonstrated consistency in better efficacy than placebo, and comparable with paracetamol (acetaminophen). Do consider this for patients who are at a risk of side effects from medications used to manage osteoarthritis pain. Alternatively, curcumin appears to be effective in managing osteoarthritis pain too.

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Higher doses of curcumin has been shown to be effective in pain reduction for patients suffering from general pain symptoms, arthritic pain, and post-operative pain. Comparing the side effect profiles of prescription analgesia, curcumin is worth considering. It is important to note that curcumin absorption is not high when ingested, so different curcumin products will have different levels of efficacy.

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Overwhelming studies and placebo controlled trials demonstrated strong efficacy of vitex in managing the symptoms of PMS.

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