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EP-NO Research

Product Objective:

To develop a natural supplement to help maintain ferritin and hemoglobin levels without the side effects of constipation.
 
Possibly stabilize hematocrit level as an in-direct effect.
 
Why:
 
Athletes, especially endurance athletes and very specifically female endurance athletes are prone to a decrease in red blood cells, ferritin, and hemoglobin levels due to training, bad dietary choices and monthly cycles.
 
Ingredients:
 
Vitamin C as ascorbic acid
Iron as ferrous picolinate and derived from dessicated liver and red beet root extract.
Vitamin B6 as pyridoxine HCL
Vitamin B12 as methylcyanocobalamin
Folic acid as folate
Zinc as zinc picolinate
Biotin
Dessicated Liver
Red Beet Root extract as beta vulgarious
 
Referrences:
 
Effect of physical exercise and vitamin C on absorption of ferric sodium citrate.

 

Medicine & Science in Sports & Exercise. 28(12):1470-1473, December 1996.
SCHMID, ANDREAS; JAKOB, ERNST; BERG, ALOYS; RUMANN, THOMAS [latin sharp s]; KONIG, DANIEL; IRMER, MANFRED; KEUL, JOSEPH

Abstract:
The effect of physical exercise and vitamin C on iron absorption after oral iron administration was investigated. Eight healthy male subjects without iron deficiency were studied after administration of 100 mg ferric sodium citrate complex, 100 mg ferric sodium citrate complex with 200 mg ascorbic acid, and without iron intake, both under resting conditions and after a 1-h bicycle ergometer test at moderate exercise. Serum concentrations for iron, transferrin, and ferritin were measured before and 30 min, and 1, 2, and 4 h after each administration.

Under resting conditions administration of 100 mg ferric sodium citrate led to a significant increase in serum iron concentrations. When ferric sodium citrate was administered with vitamin C, iron values increased significantly further. Ingestion of iron together with physical exercise resulted in a higher serum iron concentration than under resting conditions. The maximum increase, reached after 4 h, was 48.2% with exercise and 8.3% without. In combination with exercise, the addition of 200 mg vitamin C did not further increase serum iron concentration. In conclusion, 1 h of moderate exercise enhanced the rate of iron absorption. Under resting conditions the combination of ferric sodium citrate with vitamin C led to significantly increased postabsorption serum iron concentrations compared with iron administration without vitamin C.
 
Enhancers of iron absorption: ascorbic acid and other organic acids.

Nutrition Division, Institute of Food Research, Norwich NR4 7UA, UK. birgit.teucher@bbsrc.ac.uk

Ascorbic acid (AA), with its reducing and chelating properties, is the most efficient enhancer of non-heme iron absorption when its stability in the food vehicle is ensured. The number of studies investigating the effect of AA on ferrous sulfate absorption far outweighs that of other iron fortificants. The promotion of iron absorption in the presence of AA is more pronounced in meals containing inhibitors of iron absorption. Meals containing low to medium levels of inhibitors require the addition of AA at a molar ratio of 2:1 (e.g., 20 mg AA: 3 mg iron). To promote absorption in the presence of high levels of inhibitors, AA needs to be added at a molar ratio in excess of 4:1, which may be impractical. The effectiveness of AA in promoting absorption from less soluble compounds, such as ferrous fumarate and elemental iron, requires further investigation. The instability of AA during food processing, storage, and cooking, and the possibility of unwanted sensory changes limits the number of suitable food vehicles for AA, whether used as vitamin fortificant or as an iron enhancer. Suitable vehicles include dry-blended foods, such as complementary, precooked cereal-based infant foods, powdered milk, and other dry beverage products made for reconstitution that are packaged, stored, and prepared in a way that maximizes retention of this vitamin. The consumption of natural sources of Vitamin C (fruits and vegetables) with iron-fortified dry blended foods is also recommended. Encapsulation can mitigate some of the AA losses during processing and storage, but these interventions will also add cost. In addition, the bioavailability of encapsulated iron in the presence/absence of AA will need careful assessment in human clinical trials. The long-term effect of high AA intake on iron status may be less than predicted from single meal studies. The hypothesis that an overall increase of dietary AA intake, or fortification of some foods commonly consumed with the main meal with AA alone, may be as effective as the fortification of the same food vehicle with AA and iron, merits further investigation. This must involve the consideration of practicalities of implementation. To date, programs based on iron and AA fortification of infant formulas and cow's milk provide the strongest evidence for the efficacy of AA fortification. Present results suggest that the effect of organic acids, as measured by in vitro and in vivo methods, is dependent on the source of iron, the type and concentration of organic acid, pH, processing methods, and the food matrix. The iron absorption-enhancing effect of AA is more potent than that of other organic acids due to its ability to reduce ferric to ferrous iron. Based on the limited data available, other organic acids may only be effective at ratios of acid to iron in excess of 100 molar. This would translate into the minimum presence/addition of 1 g citric acid to a meal containing 3 mg iron. Further characterization of the effectiveness of various organic acids in promoting iron absorption is required, in particular with respect to the optimal molar ratio of organic acid to iron, and associated feasibility for food application purposes. The suggested amount of any organic acid required to produce a nutritional benefit will result in unwanted organoleptic changes in most foods, thus limiting its application to a small number of food vehicles (e.g., condiments, beverages). However, fermented foods that already contain high levels of organic acid may be suitable iron fortification vehicles.

Ferrous - Picolinate, Succinate and Amino Acid Chelate:

The absorption and metabolism of iron amino acid chelate

Albion Laboratories, Inc., Clearfield, Utah, USA.

This paper summarizes several studies which describe significant increases in the intestinal absorption of iron from iron amino acid chelate compared to inorganic iron salts. While these increased uptakes of iron from the amino acid chelate into mucosal tissue are highly significant, this paper also demonstrates that there is a mechanism in the mucosal tissue which controls the quantity of iron from the amino acid chelate that is transferred to the plasma. For example, the higher the hemoglobin value, the less iron transferred. When considered together these studies demonstrate that iron amino acid chelate is both a safe and effective source of iron for treatment of iron deficiencies.

Toxicology and safety of Ferrochel and other iron amino acid chelates. Albion Laboratories, Inc., Clearfield, Utah, USA.

Iron is estimated to be deficient in the diets of one fifth of the world's population. Iron is commonly provided as a supplemental nutrient in industrialized countries for uses of choice. In other countries of the world, it may be required as an overt addition to the diet to prevent iron deficiency. This may be accomplished through fortification of a common food. As a micronutrient, iron has a relatively narrow range of safety--whether given as a supplement or fortificant, it must be in a high enough dose to be appreciably absorbed, but low enough to avoid toxicity. This concern can be ameliorated by careful choice of the form of iron administered. A source of iron which has proven to be highly bioavailable, yet regulated by dietary need, is iron chelated with amino acids. The structural integrity and longevity of these compounds have been proven by valid chemical and instrumental tests. Proofs of safety of iron amino acid chelate in the dietary administration of iron to swine in both multigenerational and longevity studies are reported. Formal tests of toxicity utilizing ferrous bisglycinate chelate (Ferrochel) carried out in accordance to US-FDA guidelines are also summarized. Ferrochel has been demonstrated to have a No Observable Adverse Effect Level (NOAEL) of at least 500 mg per kg rat body weight, the highest dose tested. This and other results of the detailed toxicity test, as well as other tests of safety and efficacy, have resulted in the US-FDA acknowledging that this product is Generally Recognized As Safe (GRAS) under its approved conditions of use as a source of iron for food enrichment and fortification purposes.

Iron absorption after oral application of a combination of Fe2+-succinate and multivitamins

The rate of iron absorption of Fe2+-succinate orally applied with multivitamins, was measured by means of whole-body counter in 45 subjects. The dosage was 330 mg ferrous succinate (115 mg Fe2+). Absorption was generally 4.5% (5.2 mg) in normal subjects, 8.6% (9.9 mg) in subjects with latent iron deficiency, and 29.6% (34 mg) in subjects with manifest iron deficiency. 

Effect of physical exercise and vitamin C on absorption of ferric sodium citrate.

 

Medicine & Science in Sports & Exercise. 28(12):1470-1473, December 1996.
SCHMID, ANDREAS; JAKOB, ERNST; BERG, ALOYS; RUMANN, THOMAS [latin sharp s]; KONIG, DANIEL; IRMER, MANFRED; KEUL, JOSEPH

Abstract:
The effect of physical exercise and vitamin C on iron absorption after oral iron administration was investigated. Eight healthy male subjects without iron deficiency were studied after administration of 100 mg ferric sodium citrate complex, 100 mg ferric sodium citrate complex with 200 mg ascorbic acid, and without iron intake, both under resting conditions and after a 1-h bicycle ergometer test at moderate exercise. Serum concentrations for iron, transferrin, and ferritin were measured before and 30 min, and 1, 2, and 4 h after each administration.

Under resting conditions administration of 100 mg ferric sodium citrate led to a significant increase in serum iron concentrations. When ferric sodium citrate was administered with vitamin C, iron values increased significantly further. Ingestion of iron together with physical exercise resulted in a higher serum iron concentration than under resting conditions. The maximum increase, reached after 4 h, was 48.2% with exercise and 8.3% without. In combination with exercise, the addition of 200 mg vitamin C did not further increase serum iron concentration. In conclusion, 1 h of moderate exercise enhanced the rate of iron absorption. Under resting conditions the combination of ferric sodium citrate with vitamin C led to significantly increased postabsorption serum iron concentrations compared with iron administration without vitamin C.
 
Vitamin B6:
 

Vitamin B6 metabolism in human red cells. I. Variations in normal subjects.

Physiologic and pharmacologic factors affecting intracellular red cell vitamin B6 metabolism in normal human subjects were studied using a new assay for pyridoxine kinase (PnK) together with saturated and total aspartate aminotransferase (AST) activities as indirect indices of intracellular pyridoxal 5-phosphate (PLP) availability. The presence of reduced PnK activity in Blacks was confirmed but this could not be explained on the basis of increased enzyme inactivation during red cell aging in vivo. Racial differences were also noted in the metabolism of AST and, in Caucasians, net dissociation of PLP from the apoprotein was demonstrated to occur in vivo. Despite the wide variation in Pn5 activity, AST levels were maintained within relatively narrow limits. However, when pharmacologic doses of pyridoxine were administered, PnK and AST activities increased proportionately. These findings suggest that when the supply of B6 vitamers is not limiting, PnK may play a role in regulating red cell PLP levels.

Regulation of vitamin B6 metabolism in human red cells.

The effects of pyridoxine and pyridoxal 5-phosphate (PLP) administration on pyridoxine kinase (PnK) and asparate aminotransferase (EGOT), a PLP-dependent enzyme, were studied in human red cells separated into young and old populations by density centrifugation. After a delay of 48 hr, both pyridoxine and PLP increase EGOT activity in mature red cells by activating preformed GOT apoenzyme. In addition, in young erythroid cells, pyridoxine therapy induces synthesis of PnK, while both pyridoxine and PLP induce synthesis of GOT apoprotein. Thus, PLP stimulates EGOT induction without a change in PnK activity, suggesting that PLP enters erythroid precursor cells without prior dephosphorylation. However, with both pyridoxine and PLP, the full induction of enzyme activities reflect the gradual replacement of circulating red cells by newly formed cells with higher enzyme levels. Therefore, the use of EGOT as a measure of vitamin B6 nutritional status requires recognition of the complexities of intracellular enzyme regulation.

Red cell aspartate aminotransferase saturation with oral pyridoxine intake.

Hematology Division, Instituto Adolfo Lutz, Av. Dr. Arnaldo 355, São Paulo, Brazil CEP 01246-000. maoshiro@ial.sp.gov.br

CONTEXT AND OBJECTIVE: The coenzyme of aspartate aminotransferase is pyridoxal phosphate, generated from fresh vegetables containing pyridoxine. Vitamin B6-responsive sideroblastic anemia, myelofibrosis and Peyronies syndrome respond to high pyridoxine doses. The objective was to investigate the oral pyridoxine oral dose that would lead to maximized pyridoxal phosphate saturation of red cell aspartate aminotransferase. DESIGN AND SETTING: Controlled trial, in Hematology Division of Instituto Adolfo Lutz. METHODS: Red cell aspartate aminotransferase activity was assayed (before and after) in normal volunteers who were given oral pyridoxine for 15-18 days (30 mg, 100 mg and 200 mg daily). In vitro study of blood from seven normal volunteers was also performed, with before and after assaying of aspartate aminotransferase activity. RESULTS: The in vivo study showed increasing aspartate aminotransferase saturation with increasing pyridoxine doses. 83% saturation was reached with 30 mg daily, 88% with 100 mg, and 93% with 200 mg after 20 days of oral supplementation. The in vitro study did not reach 100% saturation. CONCLUSIONS: Neither in vivo nor in vitro study demonstrated thorough aspartate aminotransferase saturation with its coenzyme pyridoxal phosphate in red cells, from increasing pyridoxine supplementation. However, the 200-mg dose could be employed safely in vitamin B6-responsive sideroblastic anemia, myelofibrosis and Peyronies syndrome treatment. Although maximum saturation in circulating red cells is not achieved, erythroblasts and other nucleated and cytoplasmic organelles containing cells certainly will reach thorough saturation, which possibly explains the results obtained in these diseases.

 
Vitamin B12:
 

Carmel, R., "Subtle and Atypical Cobalamin Deficiency States," Am J Hematol 34.2 (1990) : 108-14.

Ellis, F.R., and Nasser, S., "A Pilot Study of Vitamin B12 in the Treatment of Tiredness," Br J Nutr 30.2 (1973) : 277-83.

Pennypacker, L.C., et al., "High Prevalence of Cobalamin Deficiency in Elderly Outpatients" (see comments), J Am Geriatr Soc 40.12 (1992) : 1197-204.

Markle, H.V., "Cobalamin," Crit Rev Clin Lab Sci 33.4 (1996) : 247-356.

Factors affecting the response to erythropoiesis-stimulating agents

Service de nephrologie et de transplantation renale, hopital Sud, CHU d'Amiens, avenue Rene-Laennec, 80054 Amiens 01, France.

Recombinant human erythropoietin (rHuEPO) has transformed the management chronic renal failure (CKD) and considerably improved the outcome of patients on regular chronic dialysis. However, a significant number of patients fail to respond to high of Erythropoiesis-stimulating agents (ESAs) and several causes of inadequate response to epoetin therapy have been identified. Some factors, such as gender, age, length of time on dialysis, type of dialysis and co-morbidities such as hemoglobinopathy, are not susceptible to clinical intervention. However, many other factors can be adjusted. Iron deficiency, whether functional or absolute, is the most common factor that limits the response to rHuEPO. Monitoring of iron parameters and a large use of iron supplementation result in an efficient epoetin response. Infection and inflammation have been shown to reduce responsiveness to ESAs by disrupting iron metabolism and increasing the release of pro-inflammatory cytokines that inhibit erythropoiesis. Increase dialysis dose is associated with improvements in anemia correction and reduced requirements for ESAs. Severe hyperparathyroidism and aluminum overload lead to a reduced number of responsive erythroid progenitor cells. Finally, a number of nutritional factors, such as deficiencies of carnitine, vitamin B12, folic acid, and vitamin C, are susceptible to alter erythropoiesis. Optimizing patient response to ESAs therefore requires consideration of many of well-established factors and is important for both patient outcomes and cost of treatment. 

Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortifification.

 

Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA.

BACKGROUND: Historic reports on the treatment of pernicious anemia with folic acid suggest that high-level folic acid fortification delays the diagnosis of or exacerbates the effects of vitamin B-12 deficiency, which affects many seniors. This idea is controversial, however, because observational data are few and inconclusive. Furthermore, experimental investigation is unethical. OBJECTIVE: We examined the relations between serum folate and vitamin B-12 status relative to anemia, macrocytosis, and cognitive impairment (ie, Digit Symbol-Coding score < 34) in senior participants in the 1999-2002 US National Health and Nutrition Examination Survey. DESIGN: The subjects had normal serum creatinine concentrations and reported no history of stroke, alcoholism, recent anemia therapy, or diseases of the liver, thyroid, or coronary arteries (n = 1459). We defined low vitamin B-12 status as a serum vitamin B-12 concentration < 148 pmol/L or a serum methylmalonic acid concentration > 210 nmol/L-the maximum of the reference range for serum vitamin B-12-replete participants with normal creatinine. RESULTS: After control for demographic characteristics, cancer, smoking, alcohol intake, serum ferritin, and serum creatinine, low versus normal vitamin B-12 status was associated with anemia [odds ratio (OR): 2.7; 95% CI: 1.7, 4.2], macrocytosis (OR: 1.8; 95% CI: 1.01, 3.3), and cognitive impairment (OR: 2.5; 95% CI: 1.6, 3.8). In the group with a low vitamin B-12 status, serum folate > 59 nmol/L (80th percentile), as opposed to < or = 59 nmol/L, was associated with anemia (OR: 3.1; 95% CI: 1.5, 6.6) and cognitive impairment (OR: 2.6; 95% CI: 1.1, 6.1). In the normal vitamin B-12 group, ORs relating high versus normal serum folate to these outcomes were < 1.0 (P(interaction) < 0.05), but significantly < 1.0 only for cognitive impairment (0.4; 95% CI: 0.2, 0.9). CONCLUSION: In seniors with low vitamin B-12 status, high serum folate was associated with anemia and cognitive impairment. When vitamin B-12 status was normal, however, high serum folate was associated with protection against cognitive impairment

Influence of training volume and acute physical exercise on the homocysteine levels in endurance-trained men: interactions with plasma folate and vitamin B12.

Department of Prevention, Rehabilitation, and Sports Medicine, Center of Internal Medicine, University of Freiburg, Germany.

The interrelation between physical exercise and plasma levels of homocysteine (Hcy), vitamin B(12), and folic acid has not been examined. Therefore, we investigated the influence of extensive endurance training and acute intense exercise on plasma concentrations of total Hcy, vitamin B(12), and folic acid in 42 well-trained male triathletes. Examinations and blood sampling took place before and after a 30-day endurance training period as well as before and 1 and 24 h after a competitive exercise (sprint triathlon). Following the training period, no significant change in Hcy levels could be detected for the whole group. Subgroup analysis in quartiles of training volume revealed that - as compared with the lowest quartile (low-training group: 9.1 h training/week) - athletes in the highest training quartile (high-training group: 14.9 h training/week) exhibited a significant decrease in Hcy levels (from 12.7 +/- 2.3 to 11.7 +/- 2.4 micromol/l as compared with levels of 12.5 +/- 1.5 and 12.86 +/- 1.5 micromol/l in the low-training group; p < 0.05). The plasma folate levels were significantly higher in the high-training group at all points of examination (p < 0.05). 1 h and 24 h after competition, the Hcy concentration increased in all athletes independent of the previous training volume (24 h: 12.3 +/- 1.8 vs. 13.5 +/- 2.6 micromol/l; p < 0.001), although the increase was decisively stronger in the low-training group. 1 h after competition, the plasma folate concentration increased (7.03 +/- 2.1 vs. 8.33 +/- 2.1 ng/ml; p < 0.05) in all athletes. Multivariate analysis showed that the exercise-induced increase in the Hcy levels was dependent on baselines levels of folate and training volume, but not on the vitamin B(12) levels. In conclusion, although intense exercise acutely increased the Hcy levels, chronic endurance exercise was not associated with higher Hcy concentrations. Moreover, athletes with the highest training volume, exhibiting also the highest plasma folate levels, showed a decrease in Hcy levels following the training period as well as a much lower increase of the Hcy concentration after acute intense exercise. The combined effect of training and higher plasma folate levels to reduce Hcy should be investigated in future studies.

The effect of two different doses comprising the simultaneous administration of intravenous B-complex vitamins and oral folic acid on serum homocysteine levels in hemodialysis patients.

Renal Unit, Greece.

Background: Several regimens using different doses of folic acid (FA) alone or supplemented with B-complex vitamins (BCVs) have been tested for their ability to reduce total homocysteine (tHcy) serum levels in hemodialysis (HD) patients. In the present study, we assessed the effect of two different doses comprising the simultaneous administration of intravenous (IV) BCVs and an oral FA supplementation on serum tHCy levels in HD patients. Patients-methods: In a cohort of 49 patients (31 male, 18 female) undergoing chronic HD treatment for a mean of 40.0+/-40.7 months, serum concentrations of tHcy, folate and vitamin-B12 (vB12) were determined at the end of three sequential periods as follows: 20 weeks without any BCV and/or FA supplementation (period A), 20 weeks with a dose comprising the simultaneous administration of IV BCVs and an oral supplementation of 5 mg of FA once a week (period B), and 20 weeks with a dose comprising the simultaneous administration of IV BCVs and an oral supplementation of 5 mg of FA thrice a week (period C). An IV dose of BCVs consisting of a 5 mL solution containing vitamin B(1) (250 mg), vitamin B(6) (250 mg) and vitamin B(12) (1.5 mg) was administered at the end of hemodialysis. Results: Mean serum tHcy levels were significantly higher at the end of period A relative to levels at the end of periods B and C (35.8+/-23 mumol/L vs. 22.0+/-17.6 and 15.0+/-4.5 mumol/L, respectively; p < 0.000001). Mean serum folate levels and mean serum vB12 levels were significantly lower at the end of period A relative to levels at the end of periods B and C (p < 0.000001). Mean serum tHcy levels were lowest at the end of period C (p < 0.000001 in comparison to periods A and B), and 26 of the 49 HD patients (67.3%) possessed tHcy levels below 16 mumol/L. Conclusions: In HD patients, high doses consisting of the simultaneous administration of IV BCVs and an oral FA supplementation resulted in the efficient reduction of serum tHcy levels.

 
Folic acid:
 

 

Trends in serum folate, RBC folate, and circulating total homocysteine concentrations in the United States: analysis of data from National Health and Nutrition Examination Surveys, 1988-1994, 1999-2000, and 2001-2002.

Department of Human Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA. vganji@uic.edu

Folate intakes increased dramatically after folic acid fortification. We investigated the changes in serum folate, RBC folate, and total homocysteine (tHcy) concentrations utilizing data from National Health and Nutrition Examination Surveys (NHANES) 1988-2002. NHANES 1988-2002 were based on a stratified, multistage, probability sampling design conducted among civilian U.S. residents. The current study included 17,144, 17,213, and 11,415 measurements for serum folate, RBC folate, and tHcy, respectively. Overall, geometric mean serum folate concentrations were 149.6 and 129.8% higher in 1999-2000 and 2001-2002, respectively, than in 1988-1994 (P < 0.0001). Sex-, age-, and race-ethnicity-adjusted serum folate was significantly lower in 2001-2002 than in 1999-2000 (10.4%, P < 0.0002). The prevalence of low serum folate decreased from 18.4% in 1988-1994 to 0.8% in 1999-2000 and to 0.2% in 2001-2002 (P < 0.0001). RBC folate increased from 391 nmol/L in 1988-1994 to 618 nmol/L in 1999-2000, and to 611 nmol/L in 2001-2002. Consequently, the prevalence of low RBC folate decreased from 45.8% in 1988-1994 to 7.3% in 1999-2000 and to 7.1% in 2001-2002 (P < 0.0001). Although, RBC folate status improved after folic acid fortification in all race-ethnicities, the prevalence of low RBC folate ( approximately 20.5%) continues to be high in non-Hispanic blacks. Age-, sex-, and race-ethnicity-adjusted tHcy declined from 9.5 micromol/L in 1988-1994 to 7.6 mumol/L in 1999-2000 and to 7.9 micromol/L in 2001-2002. Although folic acid fortification contributed to significant improvement in folate status, serum folate concentrations have declined recently. This may be attributable to lower folic acid intakes.

 
Trends in blood folate and vitamin B-12 concentrations in the United States, 1988 2004.

National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA.

BACKGROUND: Monitoring the folate status of US population groups over time has been a public health priority for the past 2 decades, and the focus has been enhanced since the implementation of a folic acid fortification program in the mid-1990s. OBJECTIVE: We aimed to determine how population concentrations of serum and red blood cell (RBC) folate and serum vitamin B-12 have changed over the past 2 decades. DESIGN: Measurement of blood indicators of folate and vitamin B-12 status was conducted in approximately 23 000 participants in the prefortification third National Health and Nutrition Examination Survey (NHANES III; 1988-1994) and in approximately 8000 participants in 3 postfortification NHANES periods (together covering 1999-2004). RESULTS: Serum and RBC folate concentrations increased substantially (by 119-161% and 44-64%, respectively) in each age group in the first postfortification survey period and then declined slightly (by 5-13% and 6-9%, respectively) in most age groups between the first and third postfortification survey periods. Serum vitamin B-12 concentrations did not change appreciably. Prevalence estimates of low serum and RBC folate concentrations declined in women of childbearing age from before to after fortification (from 21% to <1% and from 38% to 5%, respectively) but remained unchanged thereafter. Prevalence estimates of high serum folate concentrations increased in children and older persons from before to after fortification (from 5% to 42% and from 7% to 38%, respectively) but decreased later after fortification. CONCLUSIONS: The decrease in folate concentrations observed longer after fortification is small compared with the increase soon after the introduction of fortification. The decrease is not at the low end of concentrations and therefore does not raise concerns about inadequate status. 

 
Zinc:
 
Effect of zinc supplementation on hematological parameters in athletes. School of Physical Education and Sports, Meram School of Medicine, Selcuk University, Konya Turkey.

The hematological effects of oral supplementation of zinc to training athletes are reported in the present study. A total of 30 subjects between 16 and 22 yr of age volunteered to participate in a 4-wk study. They were equally divided into three groups. Group 1 acted as resting controls receiving daily doses of 3 mg Zn/kg body wt. Group 2 was actively engaged in wrestling and exercised for 90-120 min, 5 d a week. Group 3 was also actively engaged in wrestling and exercised for 90-120 min, 5 d a week, but they were supplemented with 3 mg Zn/kg body wt per day. The erythrocyte, leukocyte, and thrombocyte counts and the hemoglobin values of all subjects participating in the study were measured before and after exercise at the beginning and at the end of the 4-wk study period.In all groups, there were no significant differences in the measured parameters before and after exercise. At the end of the supplementation period, the parameters of the subjects in groups 1 and 3 were significantly higher than those of group 2, both before (p<0.005) and after (p<0.05) exercise. These results suggest that zinc supplementation has a positive effect on hematological parameters in athletes.

Effects of zinc supplementation on blood rheology during exercise.

Centre d'Exploration et de Readaptation des Anomalies du Metabolisme et du Muscle (CERAMM), H pital Lapeyronie, Montpellier, France.

We previously reported a higher blood viscosity at corrected hematocrit (45%) (explained by a higher value of erythrocyte rigidity) in football players with low serum zinc (Zn) and thus presumably Zn deficiency; subjects with low serum zinc had also an impairment in performance. This interventional study was undertaken in order to assess the effects of zinc supplementation (compared to placebo) on blood rheology and performance either at rest or during exercise. Ten male healthy volunteers (age: 26+/-1.3 yr; weight 67.9+/-2.24 kg; height 177+/-3 cm) received at random order either zinc (20 mg/day) and placebo, according to a double blind cross-over procedure, during seven days. In each case on the eighth day they performed a 25 min submaximal exercise-test. At rest blood viscosity at corrected hematocrit 45% (gamma = 1000 s(-1)) was lower after Zn (3.56+/-0.14 vs. 4.13+/-0.16 mPa.s, p = 0.009), explained by a lower RBC rigidity index 'k' according to Quemada's equation (1.65+/-0.07 vs. 1.84+/-0.08, p = 0.03). Hematocrit and plasma viscosity were unchanged, but RBC aggregation was decreased (laser retrodiffusion-derived aggregation time 'Ta' 3.52+/-0.51 vs. 2.75+/-0.59, p = 0.02). The increase in blood viscosity during exercise is lower after Zn than placebo. Blood viscosity at corrected hematocrit 45% remains unchanged during exercise after Zn, yet it increases after placebo. RBC rigidity index 'k' remains lower during exercise after Zn. The rating of perceived exertion (Borg's scale) at the 20th minute of exercise is lower after zinc (5.6+/-0.4 vs. 6.6+/-0.4, p = 0.008). This study confirms that Zn improves erythrocyte deformability, decreases the exercise-induced acute increase in blood viscosity, and improves exercise tolerance. Since Zn deficiencies are not unfrequent in sportsmen, these findings may be potentially relevant to sports nutrition.

Biotin:
 
Blood Enzyme Complex: (Dessicated Liver and Red Beet Root extract)
 
Dessicated Liver:

 

Liver extracts are a decent source of iron and B vitamins that may have some use as an adjunctive treatment for iron deficiency anemia.In the Encyclopedia of Natural Medicine, Murray and Pizzorno cite one study whose hepatitic subjects saw a reduction in liver enzyme levels following liver extract supplementation. This decrease in enzyme levels, Murray and Pizzorno say, suggest that liver extract is effective in treating chronic hepatitis.Similarly, The Natural Medicines Comprehensive Database (Therapeutic Research Faculty, 2003) notes liver extract ability to stimulate liver cell proliferation in experimental animals after partial hepatectomy.Michael DiPalma, N.D., in Natures Medicine (Rodale, 1999) advocates liver extract supplementation for anemics, saying that it contains all the things that your body needs to rebuild blood.

 

The desiccated liver powder comes from fresh, hormone-free beef liver. It contains all the factors occurring in low-heat non-defatted beef liver. It is pure liver and has nothing added.

 

CLINICAL RESEARCH ON THE HEMOPOIETIC ACTION OF NUCLEOSIDES ASSOCIATED WITH LIVER EXTRACT, VITAMIN B COMPLEX AND VITAMIN B 12.

 

PHARMACOLOGICAL RESEARCH ON A NEW LIVER EXTRACT WITH CARDIOSTIMULATING ACTIVITY.
 

Fujisawa K. Therapeutic effects of liver hydrolysate preparation on chronic hepatitis: a double-blind, controlled study. Asian Med J.

 

Ohbayashi A, Akioka T, Tasaki H. A study of effects of liver hydrolysate on hepatic circulation. J Therapy.

.

Washizuka M, Hiraga Y, Furuichi H, et al. [Effect of liver hydrolysate on ethanol- and acetaldehyde- induced deficiencies].  Nippon Yakurigaku Zasshi.

 

Stability of blood cell counts, hematologic parameters and reticulocytes indexes on the Advia A120 hematologic analyzer.
J Lab Clin Med. 2005 Dec;146(6):333-40.

 

 

Beet Root:

 

Biosynthesis and radical scavenging activity of betalains during the cultivation of red beet (Beta vulgaris) hairy root cultures.

Group of Applied Microbiology and Biotechnology, Institute of Microbiology, Bulgarian Academy of Sciences, Plovdiv.

Betalains biosynthesis and antiradical scavenging activity were investigated during cultivation of four hairy root cultures of Beta vulgaris, obtained from different cultivars (Bordo, Egyptian, Detroit 2 and Detroit Dark Red). The best producer of betalains was a hairy root culture from Beta vulgaris cv. Detroit Dark Red (13.27 mg/g dry weight total pigment production). The ethanol extract, derived from roots of the same culture grown for 15 days under submerged conditions, showed a high antiradical activity (83% of inhibition of the stable DPPH.).

 

 

Biosynthesis and radical scavenging activity of betalains during the cultivation of red beet (Beta vulgaris) hairy root cultures.

Group of Applied Microbiology and Biotechnology, Institute of Microbiology, Bulgarian Academy of Sciences, Plovdiv.

Betalains biosynthesis and antiradical scavenging activity were investigated during cultivation of four hairy root cultures of Beta vulgaris, obtained from different cultivars (Bordo, Egyptian, Detroit 2 and Detroit Dark Red). The best producer of betalains was a hairy root culture from Beta vulgaris cv. Detroit Dark Red (13.27 mg/g dry weight total pigment production). The ethanol extract, derived from roots of the same culture grown for 15 days under submerged conditions, showed a high antiradical activity (83% of inhibition of the stable DPPH.).

 

Plasma membrane of Beta Vulgarious shows high water channel activity regulated by cytoplasmic pH and a dual range of calcium concentrations.

 

Betalains, phase II enzyme-inducing components from red beetroot (Beta vulgaris L.) extracts. Department of Food Science, University of Wisconsin, Madison 53706, USA.

Crude aqueous and ethanolic extracts of root tissue of red (Rd) and high-pigment (HP) beet (Beta vulgaris L.) strains exhibited antioxidant and phase II enzyme-inducing activities, and these extracts were fractionated using Sephadex LH-20 chromatography. These bioactivities tended to become co-enriched in early and late eluting fractions, comprising 5-25% of the material recovered from the column. Liquid chromatography-mass spectrometry (MS) was used to resolve and identify multiple betalain components in the most potent quinone reductase (QR)-inducing fractions. Active fractions were found to contain vulgaxanthins I and II, and (iso)betanin, but other components remained unidentified. Two of the isolated active fractions were incorporated into rodent diets at 10-150 ppm over a 2-mo period to assess bioavailability and in vivo efficacy for phase II enzyme induction in various organs. No statistically significant effect of diet was obtained, and wide ranges of tissue enzyme levels among individual animals were observed. This lack of effect and diversity in response to diet may be related to the wide range in absorptive capacity of and/or insufficient level or enrichment of the active agents or to difficulties in assessing such activity in vivo. Subsequent to the animal studies, betanin was isolated in pure form, identified by MS analysis, and confirmed to be QR inducers in the bioassay
 
Case Study #1
 
Age: 31 years
Sex: Male
EP-NO low iron
Profile:Active individual, participates in road cycling competitive events
typical training week consists of 10-14 hours of endurance training with mixed anaerobic efforts.
 
Weight resistance training 2 times per week only in offseason
 
Subject started using ep-no low iron as directed and hematological reports were given prior to using ep-no, at 5 month's and 13 month's.
 
Prior complaints of having borderline levels in his blood work, feeling fatigued and often times over trained.
 
Serum Ferritin:
Prior: 39
5 month's: 42
13 month's: 89
 
Hemoglobin:
Prior: 13.8
5 month's: 14.6
13 month's: 15.2
 
Hematocrit:
Prior: 40.3
5 month's: 40.8
13 month's: 44
 
Subject reported feeling more energy within two weeks. No irritablity or digestion issues reported
 
Case Study #2
 
Age: 34 years
Sex: female
EP-NO low iron & EP-NO 31mg iron
Profile:Professional endurance athlete
typical training week consists of 12-22 hours of endurance training
Very high volume (16-28 hours) of aerobic training in offseason
During competitive season (8-16 hours) including competition
  
Complaints of fatigue, muscle soreness and easy bruising
 
Started subject with low iron
 
Serum Ferritin:
prior: 21
6 month's: 19 
Hemoglobin:
Prior: 13.1
6 month's: 12.7 
Hematocrit:
Prior: 38
6 month's: 37.5
 
Subject recieved Iron and B-complex injection after 6 month period
2 weeks after injection:
Serum Ferritin:
483 
Hemoglobin:
13.6
Hematocrit:
38
 
Subject stopped usinig EP-NO for 3 month's
Blood levels are becoming stronger and expierenced increased energy levels; however concerned they would have to recieve another injection if levels dropped again
Serum Ferritin:
327 
Hemoglobin:
14.1
Hematocrit:
39.5
 
Started subject on EP-NO 31mg iron
Serum Ferritin:
327
3 month's: 318
6 month's: 311
14 month's: 289
20 month's: 264 
Hemoglobin:
14.1
3 month's: 14.9
6 month's: 15.7
14 month's: 16
20 month's: 17.3 
Hematocrit:
39.5
3 month's: 40.9
6 month's: 42
14 month's: 45.6
20 month's: 45.4
 
Notes: Subject has not had another injection since the first and has had stabilized blood levels. Ferrous has continued to drop at a slow rate and hemoglobin and hematocrit have increased.
 
No reports of constipation or irritabiltiy.
 
Side note: Subjects liver toxicity has also dropped over this period of time, more research needed.
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