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Dr.Weil on Healthy Aging Supplements

Some years ago, I went to my 25th high school reunion; I hadn't seen most of my classmates since our graduation. A few were just as I remembered them, hardly changed at all. Others looked so aged that I could barely find points of similarity with the pictures of them I had in my head.

Why are some individuals so outwardly altered by time and others not? Or, in other words, why is there often a discrepancy between chronological age and biological age? I believe that the answer has to do with complex interactions of genetics and environment. I also believe, based on evidence I have reviewed, that we have control over some of those factors.

Your body grows and develops according to the genetic instructions acquired from your parents. But research also consistently reminds us of the profound influence of environment on genes and their expression. It is always nature and nurture, never just one or the other. Nature has dealt you a certain hand of genetic cards; it is up to you how to play them.

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Wherever you are on the continuum of aging, you can live in ways that maximize health and happiness. This means eating an anti-inflammatory diet (see "Healthy From the Inside Out," on the importance of preventing chronic, systemic inflammation), getting regular physical activity and adequate rest, and practicing methods of stress reduction. But it also includes the incorporation of supplements into your daily routine. Dietary supplements are not substitutes for the whole foods that contain those nutrients, but they can provide insurance against gaps in your diet.

I've identified by category certain supplements to consider as part of a program for healthy aging: those that help provide important nutrients, prevent inflammation, bolster your immune system, support your liver, and increase your energy levels. To age gracefully requires learning and practicing what we have to do to keep our bodies and minds in good working order. Lending support with these key nutrients is a great way to start.

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Multivitamins
Start with a daily multivitamin/multi-mineral supplement. Because I recommend taking a product that meets certain specifications (see "Multivitamin Checklist" below), you'll probably need to take more than one pill or capsule. Always do so with a full stomach to avoid indigestion. Note, too, that carotenoids as well as certain vitamins like D and E need fat to be absorbed, so don't take them with a low-fat breakfast.

Multivitamin Checklist
As you scan the vitamin aisle for a daily formula, keep in mind that your choice should:

-not contain preformed vitamin A, often indicated as retinol.

-give you a mixture of carotenoids (lutein, lycopene, as well as other members of this family of antioxidant pigments) not just beta-carotene.

-provide vitamin E as mixed, natural tocopherols (or mixed tocotrienols), not just as d-alpha-tocopherol or, worse, synthetic dl-alpha-tocopherol.

-provide 50 mg each of most B vitamins, except folic acid (at least 400 mcg) and vitamin B12 (at least 50 mcg).

-not contain much more than 200 mg of vitamin C, which is all the human body can use in a day.

-provide at least 400 IU of vitamin D (but you'll need to take additional vitamin
D to get to my recommended daily intake of 1,000 IU).

-not contain iron, unless you are menstruating, pregnant, or have documented iron-deficiency anemia.

-contain no more than 200 mcg of selenium, a key antioxidant mineral.

-provide some calcium, preferably as calcium citrate (although most women and some men need to take additional calcium to maintain bone health).

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Antioxidants
In addition to the antioxidants you get from food (such as fruits, vegetables, tea, and olive oil) and from your multivitamin, consider a few well-researched natural products that provide additional antioxidant support.

Coenzyme Q10 (CoQ10, or Ubiquinone)
Coenzyme Q10 increases oxygen use at the cellular level, improves the function of heart-muscle cells, and boosts the capacity for aerobic exercise. The main problem with it is its bioavailability -- how much gets into your system and used. New softgel and emulsified forms are much better than other forms in this respect but still need to be taken with a fat-containing meal. I recommend 60 mg a day of CoQ10.

Grape-Seed Extract
Grape-seed extract helps prevent and treat age-related diseases, including cardiovascular disease, cataracts, and macular degeneration. If you're generally healthy, I suggest 100 mg a day.

Alpha-Lipoic Acid
Alpha-lipoic acid (with or without acetyl-l-carnitine)decreases insulin resistance while augmenting the body's antioxidant defenses. If you have any degree of metabolic syndrome (low HDL cholesterol, high serum triglycerides, a tendency to gain weight in the abdomen, a tendency toward high blood pressure) or have a personal or family history of obesity or type 2 diabetes, consider taking ALA. Start with 100 mg a day; take up to 400 mg a day.

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Anti-Inflammatory Support
Abnormal inflammation is a common root of many chronic diseases, including autoimmune conditions such as type 1 diabetes and rheumatoid arthritis. It can be a component of other diseases like multiple sclerosis and inflammatory bowel disease. Besides eating an anti-inflammatory diet, you might want to give your body additional support with a few key anti-inflammatory herbs and over-the-counter drugs.

Ginger and Turmeric
Ginger and turmeric can, of course, be added to food but are most effective taken in supplement form. You can take a starting dose of 1 gram a day of ginger (after a meal) and 1 gram of whole extract of turmeric (rather than a preparation of curcumin, only one of the spice's active components). I know many people whose musculo-skeletal and other ailments disappeared after using ginger, while extract of turmeric may have a preventive effect against Alzheimer's disease and may also reduce the risk of cancer.

Aspirin
Aspirin offers many health benefits, including its influence on the same hormones that mediate inflammation -- an influence that offers a reduction of cancer risk as well. Aspirin can cause irritation and bleeding of the stomach and lower GI tract, but in general, the health benefits of low-dose aspirin regimens outweigh the risks. I take two baby aspirins a day, the equivalent of half an adult tablet.

Other NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
These include ibuprofen (sold as Motrin and Advil) and other products. Ibuprofen reduces the risk of Alzheimer's disease but, like aspirin, can cause GI irritation and bleeding. I recommend its daily use only for those with symptomatic inflammation (like arthritis) or a significant family history of Alzheimer's.

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Immune Support
Our immune systems weaken as we age, making us more susceptible to infections and cancer and slowing our healing responses. And our immune systems are under constant assault from toxins in the environment, both natural and man-made. It's worth experimenting with natural products that enhance immune function.

Astragalus
Astragalus has a long history in Chinese medicine, where it's used to ward off colds and flu. I often recommend it to people who "get whatever's going around," to cancer patients undergoing chemotherapy, to those people with immune deficiencies, and to everyone during flu season. Look for standardized extracts in capsules and take them as the label directs.

Immune-Enhancing Mushrooms
These include edible species like shiitake, maitake, and oyster mushrooms as well as purely medicinal ones like reishi that are too bitter and woody to be used as food. I believe it's better to take a number of these mushrooms together, because their effects are synergistic. Liquid, powder, and encapsulated forms are available, some providing extracts of seven or more species.

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Detoxification
Protection from toxins begins with minimizing your exposure to them, such as by not smoking, drinking purified water, eating lower on the food chain and eating pesticide-free food when possible, not ingesting toxic substances, and not living near hazardous sites like toxic-waste dumps. You also can help support the liver, the organ responsible for processing toxins.

Milk Thistle
Milk thistle is an herbal remedy with an excellent reputation for protecting and enhancing liver function. Anyone who drinks alcohol heavily, who takes drugs or medications that can harm the liver, who has abnormal liver function for any reason, or who works with solvents or has a history of toxic exposures should take milk thistle. Look for extracts standardized to 70 percent to 80 percent silymarin, and take two capsules twice a day or as the label directs.

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Energy Support
A common complaint among older people is waning energy. Tonic herbs and mushrooms are especially helpful in addressing this issue. Experiment with these favorites to find out which ones work best for you, trying each one daily for two months. If you like its effects, you can stay on these herbs indefinitely, perhaps giving yourself occasional breaks -- say, two or three weeks off every four months.

Asian ginseng (Panax Ginseng)
Asian ginseng is esteemed as a sexual energizer for men. American ginseng (Panax quinquefolius) is valued for its stress-protective properties. Buy products standardized for ginsenoside content, follow dosage recommendations, and don't expect to notice results until after six to eight weeks of regular use.

Eleuthero Ginseng
Formerly called Siberian ginseng, eleuthero ginseng has a long history of use by athletes, military personnel, and cosmonauts of the former Soviet Union due to its energy-enhancing properties. Buy products standardized for eleutheroside content, follow dosage recommendations, and wait six to eight weeks to evaluate the effect.

Arctic Root
Arctic root, or rhodiola, can enhance endurance, reduce harmful effects of stress, and improve mood and memory. It may increase sexual energy as well. Buy products standardized to 3 percent rosavins and 1 percent salidroside, and follow dosage recommendations.

Cordyceps
Cordyceps is a mushroom long used in China as an energizing tonic for people debilitated by age, illness, or injury. Here, you'll find extracts of cordyceps in either liquid or capsule form.

Adapted from "Healthy Aging" by Dr. Andrew Weil (Knopf; 2005). Dr. Weil's Self Healing newsletter is Body+Soul's sister publication; for subscriptions, call 800-523-3296.

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