Shoppig Cart
Checkout
0
0

After an angioplasty or stenting, is the job done?

images
09 Aug 2020 Heart & Vascular Health

After a stent is placed in a blocked artery, the journey only just begins to prevent occlusion 

 
 Click Here   

 

  Find Practitioners
Click Here 

 

 
 

                                                                          

Key Points
Are stenting, angioplasties and by-passes saving lives? Absolutely! Does this mean that all is well with interventionist Cardiology and that the situation could not be better? Well absolutely NO! 

> Stenting and by-passes can be life-saving for severe Left Anterior Descending (LAD) coronary artery blockages, unstable coronary artery syndromes, critical blockages in a failing heart. But these make up a minority of people that require such procedures. 

> Erectile Dysfunction (ED) is often the first sign of vascular disease long before angina occurs: The penile artery is a small artery and so is the 'Canary in the mineshaft'. Men that have difficulties with achieving an erection is a warning sign that your blood vessels are not doing too well. Those with vascular disease often suffer from ED. Click on 'Learn More' in the supplement panel to see how L-Citrulline can provide significant help for those with ED and how L-Citrulline can help provide your body with Nitric Oxide (NO) a powerful blood vessel dilator to increase blood supply to tissues and organs.   

> People think that after an angioplasty or stent/s that they have been "cured":  25 - 40 percent of angioplasties fail25,26.  A scientific paper in Australia showed that a staggering 42% believed that their heart disease was cured after a procedure26. Whose fault is this? After any procedure, the risk factors are still hanging in there. These risk factors add to the build-up of existing plaque or previously treated plaque. An artificial tube in an artery in the most damaged and blocked area of a blood vessel will NOT miraculously fix a long-term, diet-related and body-wide metabolic problem that is vascular and heart disease. This is true folly and wishful thinking. A stent in one location cannot fix a damaged artery above or below the stent where the arterial lining is also diseased and is subject to plaque build-up and rupture. Without a rigorous preventative approach, this strategy of surgical or interventionist Cardiology will fail! Scroll down to view the animation of blockage risk above or below the stent. 

> Insulin Resistance (IR) and a deadly link to cardiovascular risk:

Insulin Resistance, a prediabetic state, adds hugely to cardiovascular risk. Countless millions in the COVID-19 pandemic were put in the sights of this virus. They were sitting ducks because of this prediabetic state which is for all intents and purposes, diabetes wrapped up in a benign-sounding "pre" diabetes designation and is a condition that if often ignored. With 4 million Australians suffering from this prediabetic state, it is no wonder this problem is not addressed as this will mean 4 million extra people (thus expense), on the Medicare "books". Around 89 million Americans have this problem. A large waist circumference is an excellent guide that you may have IR. A waist circumference of 94 cm in men and 80 cm in women of European descent, is a significant marker for insulin resistance being present in that individual. However, you may look thin on the outside but fat on the inside, and these people are called TOFI's as they accumulate deep visceral fat. A DEXA body composition scan can reveal toxic fat deep visceral fat in your body. Glaringly obvious signs of insulin resistance include a high isolated triglyceride level, a raised CRP level (a marker of inflammation), a raised Uric Acid (UA) that can lead to gout, high blood pressure, a fatty liver and obstructive sleep apnoea (OSA) are all associated with insulin resistance. Have your doctor check for IR if this hasn't been done. 

> Coronary Artery Calcification (CAC): A stent or blocked artery procedure does not mean that the rest of the blood vessels in the body are not damaged. This is highly unlikely and indeed rare. A CT-Scan of the heart can reveal calcium deposited in the coronary arterial walls, and this indicates damage has occurred to the lining of blood vessels. Calcification can also occur in the heart valves for this reason. Calcification of blood vessels and heart valves can occur due to the myriad number of risk factors discussed above with insulin resistance. These risk factors may not have been looked for in the first instance effectively and or not treated aggressively. However, one greatly missed dietary aspect of this blood vessel calcium accumulation is the lack of Vitamin-K2 which acts like a 'calcium cop' guiding calcium away from soft tissues like arteries and cardiac valves to bone where it is needed. To create Vitamin-K2, you need Vitamin-K1 which is then converted to the K2 version by the gut microbiome. The problem is that you get Vitamin-K1 from dark green leafy vegetables and in study after study, 95% of the Australian population does not get anywhere near the recommended intake of vegetables or fruit. 

> Vitamin-D, Magnesium, Vitamin-K2: May all help decrease the risk of insulin resistance and cardiovascular disease. It is vital to have optimal levels of these critical micronutrients. See below. 

> You can decide your fate. Weight loss, stopping smoking, increasing exercise, checking all your metabolic risk factors, and of critical importance, eating well will decide your destiny.
The specialist Activ8Health Dietitians can provide precision nutrition principles to target areas of concern for optimal management. 

> Inflammation: We can measure Omega-6 and  Omega-3's that could be driving inflammation in your body. This is too important to guess.  An Omega-3 and Omega-6 imbalance s a terrible circumstance and a consequence of poor Western diets that can drive many chronic diseases and cancers. So why the concern about Omega-6's? The reason is that a high level of Omega-6 fatty acids in the cell membranes produce inflammatory chemicals called eicosanoids. LTB4 is one powerful driver of inflammation that is a result of Omega-6 metabolism. The Omega-6 fatty acids are in direct competition for the very same enzymes used to convert Omega-3's into anti-inflammatory eicosanoids. Thus high levels of Omega-6's in cell membranes will prime all your cells for a heightened inflammatory response for example with a virus such as COVID-19 or seasonal Influenza or any number of other threats to the body. The biggest contributors to your Omega-6 intake are 1) Animal meats 2) Cereals and cereal products 3) Vegetable oils and products derived from them. 

> Dietary Analysis and Personalised Dietary Foundation: Health will be difficult to obtain without a solid dietary foundation. The one-size-fits-all approach is dead-in-the-water as both nutrition and medicine are moving rapidly to a personalised approach as each person has an entirely different genetic makeup and microbiome to anyone else on the planet. Thus generalized approaches are now becoming rapidly redundant when billions of dollars have been spent on moving personalised medicine forward. At the very least, getting a Dietary Analysis by one of our highly specialised Activ8Health Dietitians will allow us to see what it is that you are putting in your mouth. If you are very truthful with your dietary inputs then we should get a great idea of your strengths and importantly your weaknesses in nutrient intake. Discuss this with a member of our team. Scroll up to see the link to 'Find Practitioners' 

 

Learn More Button: Click on the 'Learn More' button under the 'Supplement Panel' and discover what you can do to switch off inflammation by maximising Omega-3 intake. Omega-6's and Omega-3's are at the heart of inflammatory processes and this process is an undeniable scientific fact with Nobel Prizes awarded for understanding this metabolic cascade. It is wise to get a full Omega-6, Omega-3 analysis as this can help us target management (discuss this with an Activ8Health practitioner). A large number of ignored yet powerful anti-inflammatory compounds also exist like N-Acetyl Cysteine (NAC) used in Accident & Emergency departments to reverse paracetamol poisoning. A full complement of essential fatty acids can help significantly to optimise cell membranes, with a higher intake of DHA and Choline which are great nutrient allies in the fight against inflammation. Ensuring you have all the essential micronutrients to 'fill in the gaps' of your diet will give your body the best chance to overcome disease processes by functioning optimally in a biochemical, immune and molecular sense.


Medicine can be so much more if fundamental researched-based understandings of molecular micronutrient action can be used at the coalface of medicine as adjunctive treatment for common clinical conditions.  

 

A stent in one location cannot fix a damaged artery above or below a stent

A blockage above or below a stent can easily result in a heart attack or stroke. Fixing up one area of an artery will NOT fix damaged blood vessels above or below that stent. 

Natural Compounds & Their Effects 

Designed to target inflammation in many ways 

  • LTB4 is a powerful leukotriene. There are natural 5-Lipoxygenase inhibitors that can decrease LTB4 production. LTB4 is a "potent mediator" of vascular inflammation31. Boswellia Serrata is a compound researched for its activity against LTB4. Inflammation drives most chronic diseases including cardiovascular disease. 
  • Boron. The full 3 mg suggested as an effective dose29. The effect of boron on inflammation has been underestimated. It lowers CRP and can block the effect of 5-Lipoxygenase (5-LOX) that produces LTB4 from Arachidonic Acid a powerful inflammatory compound. In combination with Boswellia Serrata, it provides additive action against 5-LOX. 
  • Blocking Estrogen not only is a risk for breast cancer and prostate cancer but there is mounting evidence that estrogen may produce adverse cardiovascular effects especially after damage has occurred in blood vessels and with possible decreasing estrogen receptors in blood vessels with advancing age. There are many natural compounds that can block the effect of estrogen such as lignans. 
  • DIM and Broccoli Sprout Powder (Sulforaphane) Have effects on Phase-I and Phase-II biotransformation pathways in the liver to convert strong estrogens to weaker and less dangerous ones 
  • Calcium-D Glucarate has been shown to prevent gut microbiome organisms that produce beta glucuronidase from splitting bound dangerous estrogen destined for excretion through the bowel, back to a free-form hormone that can be reabsorbed and recirculated 
  • Resveratrol, Quercetin and Grape Seed Extract have been shown in research studies to inhibit aromatase, the enzyme discussed that has significant activity in abdominal fat that can convert testosterone to estrogen that affects both breast and prostate. 
  • Mixed Carotenoids. A range of mixed carotenoids (Alpha-Carotene; Beta-Carotene; Gamma-Carotene; Lycopene) that all have protective roles in many tissues including effects against skin cancer30 and the vasular system.
Magnesium Threonate (MgT): 

 

  • Magnesium Threonate (MgT) 

     

  • Vital for insulin receptor function32 
  • Essential to help dampen inflammation in the body
  • Inflammation can drive many cancers and cause them to spread42. Inflammation also drives heart and vascular disease, Endometriosis, Asthma and other lung diseases and is a part of Insulin Resistance (IR) and diabetes.
  • Inflammation also increases the risk for Alzheimer's Disease. It is known that magnesium has an inverse relationship with the highly researched inflammatory markers, hsCRP and IL-6 as shown in a large and very long 20-year study in young American adults43. In other words the higher the magnesium levels, the lower the levels of these inflammatory markers and a lower diabetes incidence. 
  • Inflammation is associated with spread of malignant cancers42.
  • Magnesium deficiency is common in the diets of many countries including Australia, where over 70% may be deficient in magnesium dependent on age65. 
  • Insulin resistance is widespread in society, and hyperinsulinaemia (high blood insulin levels) can lead to many cancers through various mechanisms41. 
  • A vicious cycle may develop between low magnesium levels and magnesium excretion in the kidneys32. In other words, if magnesium levels are low, the effect is to lower it even further through kidney magnesium excretion. A dangerous self-perpetuating effect in the body.
  • May assist in the treatment of hypertension (high blood pressure) 
  • May assist with decreasing calcification of the arteries as shown in the huge, decades-long Framingham Study where it was shown that those with the highest intake of magnesium, had the lowest rates of arterial calcification, strokes and fatal heart attacks33. 
  • Magnesium Threonate is a Massachusetts Institute of Technology (MIT) researched form of magnesium that can cross the Blood-Brain-Barrier (BBB) to help with brain health34,35. 

L-Citrulline & Nitric Oxide (NO) Generation

 

 

 

 
  • "Most experts agree that NO is by and large a potent and effective agent of cardioprotection40"
  • Nitric Oxide (NO) causes vasodilation (enlargement of blood vessel diamater), prevents clotting and is anti-inflammatory40.
  • The importance of Nitric Oxide (NO) in cardiovascular health cannot be challenged as this is a well recognised medical fact!
  • It is important in both men and women to protect their heart and vascular system
  • In men it has an advantage in that it helps provide L-Arginine the building-block of Nitric Oxide (NO) and this helps Cialis® or Viagra® function as intended to trigger an erection in men with erectile dysfunction (ED)
  • What can also not be challenged is that Nitric Oxide is derived from L-Arginine mainly and through nitrates from food. 
  • The problem with using L-Arginine orally is the high first-pass metabolism in the liver to Urea and Ornithine making only a small percentage of the L-Arginine consumed available for Nitric Oxide (NO) production. 
  • A clever way of increasing L-Arginine in the body is to consume L-Citrulline which gets around the first-pass liver metabolism by going through the kidneys to create L-Arginine that is directly shunted into the circulation making far more L-Arginine available for Nitric Oxide production. Click here
  • By not providing L-Citrulline to men with Erectile Dysfunction (ED) to be taken along with either Cialis® or Viagra® , is a missed opportunity for a highly synergistic action of the two. 
  • Many practitioners do not realise that Nitric Oxide is critical for these medications to work. The usual response to failure by these medications is to increase the dose or change the medication rather than being clever about this and using a product like L-Citrulline which converts to L-Arginine and then Nitric Oxide  (NO) which can provide that all important kick-start that Cialis® or Viagra®  needs to function optimally. Without Nitric Oxide activating sCG these PDE5 inhibitors just don't work very well. Click here

 

Fibre Supplements  

 

  • Very safe fibre combination supplement taken with food47, 48, 49, 50 can help decrease the dangerous glucose spikes after eating.
  • A combination of soluble fibres have been assessed in various Universities including Sydney University for the effect on glycaemic (glucose) impacts after eating51. These fibres have been shown to lower the glucose impacts on the body and decrease the damage to the lining of blood vessels (the endothelium) caused by after eating glucose elevations. 
  • This soluble fibre combination has also been shown to decrease the amount of visceral fat i.e. the deep abdominal fat that can cause metabolic changes in teh body. 
  • Due to restrictions, this product cannot be viewed unless you register. Find an Activ8Health practitioner to guide you but registration will enable you to view this valuable product. 
  • A high carb diet esp. with high Glycaemic Index (High GI) carbs increases the risk of your blood glucose jumping sky high after eating. High glucose after meals means risk to cells, blood vessels, tissues and organs like the heart and brain. This fibre supplement has been shown to decrease the Glycaemic Index (GI) of a meal, i.e. helping to decrease the blood glucose levels after a meal. This is important for anyone with insulin resistance, the Metabolic Syndrome or Diabetes as these glucose spikes cause incremental damage to tissues and organs and premature ageing. 
  • Fibre can help reduce appetite and as such is helpful in individuals wanting to lose weight. This is well established in multiple research studies on the critical nature of a high fibre intake. 
  • Any fibre supplement or an increase in dietary fibre can cause bloating and thus it is prudent to start off slowly with the dose schedule as recommended. This is not a bad thing. It is showing that your gut microbiome is responding favourably to a higher fibre intake keeping in mind that fiber is used as food for the gut microorganisms. They are happily using the fibre as food and in the process producing gas as a by-product. 
  • Adding fibre and a diversity of fibre helps optimise the gut microbiome and as a result, the immune system is primed to function optimally. 

 

Magnesium (Mg) deficiency in plants. An urgent problem

The heading above was a title of a paper published in 201636. It states that magnesium levels in wheat grain have declined by a massive 19.6% and wheat being the most common grain consumed on the planet. With the top grains providing 50% of the energy requirements and 50% of the protein requirements for people on Earth37, magnesium deficiency then is a very  big deal. It is stated that in many regions in this world, 75% of magnesium intake is from cereals36,37. Magnesium deficiency is common in Australia with both young and older people alike. The Western diet does not help with highly processed grains lacking Mg and where over 95% do not get anywhere near their daily needs for vegetables and fruit where vegetables are rich in Magnesium. 

If you have insulin resistance and this should be assessed in everyone who has had a stent, angioplasty or by-pass grafting done and a fasting insulin and better still a Glucose Tolerance Test with Insulin at Every Stage (GTT+Insulin at all stages) is vital. 

For those with low magnesium levels, a vicious cycle occurs. Magnesium is critical for the insulin receptor to function and with low magnesium levels there is increased insulin resistance. With increased insulin resistance there is also increased Magnesium excretion from the kidneys lowering the magnesium even further32.  Such highly researched nutritional science totally ignored in a medical setting and such a waste of knowledge if this is not provided to a patient with vascular disease many of which will have insulin resistance as a driver of that disease. 

Magnesium is involved in around 300 enzyme reactions including the production of the most abundant antioxidant, Glutathione and without Magnesium the enzyme ATPase won't work and this enzyme is central to energy production in the form of ATP. You will have to ask yourself why this incredibly important information is not provide by medical practitioners?

Vitamin-K2 and Artery Disease 

In bone, Vitamin-K2 activates a protein called Osteocalcin that increases bone density (making bones strong). In contrast, in arteries Vitamin-K2 activates a protein called Matrix GLA protein (MGP) and by stimulating MGP it inhibits the deposition of calcium in arterial walls. Coronary artery calcification is an indicator of heart attack risk. The higher the amount of calcium deposited in the arterial walls, the greater the risk.

A special Coronary CT-Scan of of the heart can provide an Agatston Score which indicates the level of coronary artery calcification. 

Due to food processing Vitamin-K2 levels have dropped in food38 and to add this worry is that around 95% of the population do not get anywhere near the intake of vegetables needed on a daily basis. Vitamin-K2 is formed through the conversion of Vitamin-K1 found in dark green leafy vegetables by the gut microbiome. Supplementation beyond RDA has been recommended to enable adequate tissue levels of Vitamin-K2 which can drop with age 40 years and above39. 

Many people use calcium supplements that can increase their risk for arterial calcification and cardiovascular disease38 and the most likely explanation is that a lot of calcium is not being directed and processed optimally because of the lack of Vitamin-K2. 

Having enough magnesium can help decrease the risk of arterial calcification as well. The huge Framingham Study which began decades ago in 1948, showed an inverse relationship with magnesium intake and coronary artery calcification33. In other words, the higher the intake of magnesium, the lower the risk of coronary artery calcification and in turn this most likely adds to magnesium's protective role against stroke and fatal coronary heart disease33. (see Magnesium Threonate above). 

This fundamental research shows how dietary measures and supplementation may offer profound benefits and this knowledge can and should be incorporated in the medical care of those with cardiovascular risk.

Targeting estrogen the driver of many diseases in women and men

Estrogen is a driver of Endometriosis, so it is not surprising that this should be a target for both medical and diet-related ways of decreasing the impact of estrogen on metastatic endometrial tissue. We can look at the following mechanisms to minimise the effect of powerful estrogens on endometrosis tissue: 

The Estrobolome

The body gets rid of excess hormones by biotransformation. Often the hormone or toxic compound is bound to another molecule which makes it easier to excrete in the bile, through the kidneys or bowel.

However, we have organisms called the Estrobolome which are gut microorganisms that produce an enzyme called Beta-Glucuronidase that can zip apart that bound estrogen in the bowel lumen to release back into your body once again what your body has worked hard to excrete. Reabsorbing estrogen designed for excretion won't help your cause. 

Calcium-D-Glucarate can inhibit Beta-Glucuronidase and can be found in the comprehensive supplement recommended. 

Lignans and Competitive Inhibition of Estrogen

Certain compounds called lignans can be converted by the gut microbiome to weak estrogenic compounds. This fact may seem counterproductive when Endometriosis is driven by estrogen but, paradoxically, these weak estrogens compete for the more powerful forms of estrogen at the receptor level thus blocking their effects. 

Increasing lignans can be achieved through dietary and supplementary means. Our highly qualified Activ8Health Dietitians can guide you towards the consumption of a high-lignan diet and also have a look at the comprehensive supplement recommended below that has a powerful lignan compound. 

Converting Stronger Estrogens to Weaker Ones 

The body is constantly trying to balance or eliminate harmful compounds, and it does this through various mechanisms one being biotransformation which occurs mainly in the liver the so-called Phase-1 (CYP450) and Phase-2 (Conjugation) pathways. This is where the body uses biochemical processes in the liver to make toxic compounds into neutral and non-toxic compounds to excrete via the liver in the bile or through the gastrointestinal tract or excreted through the kidneys. 

Biotransformation pathways can be supported by ensuring you have all the vitamins, minerals and trace elements needed to support the enzyme systems involved and to have an optimal intake of cruciferous based vegetables or extracts such as Sulforaphane that helps the Phase-2 pathway function more efficiently. 

The Liver Biotransformation Pathways 

 

The Gut Microbiome and the GI360 Test: Finding out your Beta-Glucuronidase Activity

The GI360 test is a comprehensive analysis of your gut microbiome. This includes the assessment of the level of Beta-Glucuronidase activity that frees up estrogen destined for excretion being reabsorbed to worsen your Endometriosis condition. If this enzyme level is high, a far more targeted approach can be taken.

This Beta-Glucuronidase activity may be undermining your ability to control the Endometriosis process. 

Find a highly specialised Activ8Health Dietitian to help you organise an analysis of your gut microbiome.

 

Cardiovascular Disease (CVD) is driven by inflammation: How inflamed is your body? 

A big driver of inflammation in people is caused by a combination of the following: 

  • A big difference in the amount of Omega-6 fatty acids consumed relative to Omega-3's. This will prime all cell membranes for inflammatory responses.
  • High saturated and trans fat diets can powerfully alter the gut microbiome to allow Endotoxin (Lipopolysaccharide or LPS) to drive high levels of inflammation in the body
  • High-fat diets can also increase blood triglyceride levels after eating and these have been described as producing a 'soaring' inflammatory response in the body23.
  • A high protein diet that can markedly stimulate the mTOR cell synthesis pathway increasing cell multiplication and body fat stores as protein can easily be converted to fat in the body including highly inflammatory visceral fat and this protein to fat conversion is easy as stated by this highly respected biochemistry text22. Your protein intake needs to be calculated based on many variables, and a highly qualified Activ8Health Dietitian can do this for you. Adequate protein is critical to weight management, and this is known as 'Protein Leverage'24. With weight management concerns, a complete amino acid blend can be used instead of whole protein that can add excess calories to your diet. 
  • High starchy carbohydrate diets can lead to postprandial (after-eating) inflammatory surges in blood glucose that can also produce glycation to proteins damaging them to create Advanced Glycation Endproducts (AGEs), and these damaged proteins can lead to inflammation. 
References
  1. Grindler, N.M., Vanderlinden, L., Karthikraj, R., Kannan, K., Teal, S., Polotsky, A.J., Powell, T.L., Yang, I.V. and Jansson, T., 2018. Exposure to phthalate, an endocrine disrupting chemical, alters the first trimester placental methylome and transcriptome in women. Scientific reports, 8(1), p.6086.
  2. Signorile, P.G. and Baldi, A., 2010. Endometriosis: new concepts in the pathogenesis. The international journal of biochemistry & cell biology, 42(6), pp.778-780.
  3. Louis, G.M.B., Peterson, C.M., Chen, Z., Hediger, M.L., Croughan, M.S., Sundaram, R., Stanford, J.B., Fujimoto, V.Y., Varner, M.W., Giudice, L.C. and Kennedy, A., 2012. Perfluorochemicals and Endometriosis The ENDO Study. Epidemiology (Cambridge, Mass.), 23(6), p.799.
  4. Kwa, M., Plottel, C.S., Blaser, M.J. and Adams, S., 2016. The intestinal microbiome and estrogen receptor–positive female breast cancer. JNCI: Journal of the National Cancer Institute, 108(8).
  5. Walaszek, Z., 1990. Potential use of D-glucaric acid derivatives in cancer prevention. Cancer letters, 54(1-2), pp.1-8.
  6. Upson, K., Sathyanarayana, S., De Roos, A.J., Thompson, M.L., Scholes, D., Dills, R. and Holt, V.L., 2013. Phthalates and risk of endometriosis. Environmental research, 126, pp.91-97.
  7. Hapangama, D.K., Kamal, A.M. and Bulmer, J.N., 2014. Estrogen receptor β: the guardian of the endometrium. Human reproduction update, 21(2), pp.174-193.
  8. McCarty, M.F., 2006. Isoflavones made simple–genistein’s agonist activity for the beta-type estrogen receptor mediates their health benefits. Medical hypotheses, 66(6), pp.1093-1114.
  9. Corrales, J., Kristofco, L.A., Steele, W.B., Yates, B.S., Breed, C.S., Williams, E.S. and Brooks, B.W., 2015. Global assessment of bisphenol A in the environment: review and analysis of its occurrence and bioaccumulation. Dose-Response, 13(3), p.1559325815598308.
  10. Parazzini, F., Viganò, P., Candiani, M. and Fedele, L., 2013. Diet and endometriosis risk: a literature review. Reproductive Biomedicine Online, 26(4), pp.323-336.
  11. Missmer, S.A., Chavarro, J.E., Malspeis, S., Bertone-Johnson, E.R., Hornstein, M.D., Spiegelman, D., Barbieri, R.L., Willett, W.C. and Hankinson, S.E., 2010. A prospective study of dietary fat consumption and endometriosis risk. Human Reproduction, 25(6), pp.1528-1535.
  12. Zeisel, S.H. and Da Costa, K.A., 2009. Choline: an essential nutrient for public health. Nutrition reviews, 67(11), pp.615-623.
  13. Brand-Miller, J.C., Atkinson, F.S., Gahler, R.J., Kacinik, V., Lyon, M.R. and Wood, S., 2010. Effects of PGX, a novel functional fibre, on acute and delayed postprandial glycaemia. European journal of clinical nutrition, 64(12), p.1488.
  14. Porpora, M.G., Brunelli, R., Costa, G., Imperiale, L., Krasnowska, E.K., Lundeberg, T., Nofroni, I., Piccioni, M.G., Pittaluga, E., Ticino, A. and Parasassi, T., 2013. A promise in the treatment of endometriosis: an observational cohort study on ovarian endometrioma reduction by N-acetylcysteine. Evidence-based Complementary and Alternative Medicine, 2013.
  15. Dull, A.M., Moga, M.A., Dimienescu, O.G., Sechel, G., Burtea, V. and Anastasiu, C.V., 2019. Therapeutic Approaches of Resveratrol on Endometriosis via Anti-Inflammatory and Anti-Angiogenic Pathways. Molecules, 24(4), p.667.
  16.  Boocock DJ, Faust GE, Patel KR, et al. Phase I dose escalation pharmacokinetic study in healthy volunteers of resveratrol, a potential cancer chemopreventive agent. Cancer Epidemiol Biomarkers Prev. 2007;16(6):1246-1252
  17. Bulun, S.E., Fang, Z., Imir, G., Gurates, B., Tamura, M., Yilmaz, B., Langoi, D., Amin, S., Yang, S. and Deb, S., 2004, January. Aromatase and endometriosis. In Seminars in reproductive medicine (Vol. 22, No. 01, pp. 45-50). Copyright© 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
  18. Lin, Y.H., Chen, Y.H., Chang, H.Y., Au, H.K., Tzeng, C.R. and Huang, Y.H., 2018. Chronic niche inflammation in endometriosis-associated infertility: current understanding and future therapeutic strategies. International journal of molecular sciences, 19(8), p.2385.
  19. Zhao, Y., Gong, P., Chen, Y., Nwachukwu, J.C., Srinivasan, S., Ko, C., Bagchi, M.K., Taylor, R.N., Korach, K.S., Nettles, K.W. and Katzenellenbogen, J.A., 2015. Dual suppression of estrogenic and inflammatory activities for targeting of endometriosis. Science translational medicine, 7(271), pp.271ra9-271ra9.
  20. Ross, R. G., et al. (2013). "Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk." American Journal of Psychiatry 170(3): 290-298.
  21. Zeisel, S. H. (2004). "Nutritional importance of choline for brain development." Journal of the American College of Nutrition 23(suppl 6): 621S-626S.
  22. Salway, J. (2006). Medical biochemistry at a glance, Wiley-Blackwell.
  23. Margioris, A. N. (2009). "Fatty acids and postprandial inflammation." Current Opinion in Clinical Nutrition & Metabolic Care 12(2): 129.
  24. Raubenheimer, D. and Simpson, S., 2020. Eat Like the Animals: What Nature Teaches Us about the Science of Healthy Eating. Houghton Mifflin.
  25. Ozner, M., 2010. The great American heart hoax. Lifesaving Advice Your Doctors Should Tell.
  26. Torrance, C. and Campbell, M., 2005. Coronary angioplasty: impact on risk factors and patients' understanding of the severity of their condition. Australian Journal of Advanced Nursing, The, 22(4), p.26.
  27. Devi, S., 2011. US physicians urge end to unnecessary stent operations. The Lancet, 378(9792), pp.651-652.
  28. Chan, P.S., Patel, M.R., Klein, L.W., Krone, R.J., Dehmer, G.J., Kennedy, K., Nallamothu, B.K., Weaver, W.D., Masoudi, F.A., Rumsfeld, J.S. and Brindis, R.G., 2011. Appropriateness of percutaneous coronary intervention. Jama, 306(1), pp.53-61.
  29. Boden, W.E., O'Rourke, R.A., Teo, K.K., Hartigan, P.M., Maron, D.J., Kostuk, W.J., Knudtson, M., Dada, M., Casperson, P., Harris, C.L. and Chaitman, B.R., 2007. Optimal medical therapy with or without PCI for stable coronary disease. New England Journal of Medicine, 356(15), pp.1503-1516.
  30. Guo, W., Nazim, H., Liang, Z. and Yang, D., 2016. Magnesium deficiency in plants: An urgent problem. The Crop Journal, 4(2), pp.83-91.
  31. Cordain, L., 1999. Cereal grains: humanity's double-edged sword. World review of nutrition and dietetics, 84, pp.19-19.
  32. Gommers, L.M., Hoenderop, J.G., Bindels, R.J. and de Baaij, J.H., 2016. Hypomagnesemia in type 2 diabetes: a vicious circle?. Diabetes, 65(1), pp.
  33. Slutsky, I., et al. (2010). "Enhancement of learning and memory by elevating brain magnesium." Neuron 65(2): 165-177.
  34. Liu, G., Weinger, J.G., Lu, Z.L., Xue, F. and Sadeghpour, S., 2016. Efficacy and safety of MMFS-01, a synapse density enhancer, for treating cognitive impairment in older adults: a randomized, double-blind, placebo-controlled trial. Journal of Alzheimer's Disease, 49(4), pp.971-990.
  35. Osher, E., Weisinger, G., Limor, R., Tordjman, K. and Stern, N., 2006. The 5 lipoxygenase system in the vasculature: emerging role in health and disease. Molecular and cellular endocrinology, 252(1-2), pp.201-206.
  36. Gouva, L. and Tsatsoulis, A., 2004. The role of estrogens in cardiovascular disease in the aftermath of clinical trials. HORMONES-ATHENS-, 3, pp.171-183.
  37. Maresz, K., 2015. Proper calcium use: vitamin K2 as a promoter of bone and cardiovascular health. Integrative Medicine: A Clinician's Journal, 14(1), p.34.
  38. Theuwissen, E., Magdeleyns, E.J., Braam, L.A.J.L.M., Teunissen, K.J., Knapen, M.H., Binnekamp, I.A.G., van Summeren, M.J.H. and Vermeer, C., 2014. Vitamin K status in healthy volunteers. Food & function, 5(2), pp.229-234.
  39. Hruby, A., O'Donnell, C.J., Jacques, P.F., Meigs, J.B., Hoffmann, U. and McKeown, N.M., 2014. Magnesium intake is inversely associated with coronary artery calcification: the Framingham Heart Study. JACC: Cardiovascular Imaging, 7(1), pp.59-69.
  40. Pizzorno, L., 2015. Nothing boring about boron. Integrative Medicine: A Clinician's Journal, 14(4), p.35.
  41. Kim, J., et al. (2019). "Association of Vitamin A Intake With Cutaneous Squamous Cell Carcinoma Risk in the United States." JAMA dermatology.
  42. Fox, C., Ramsoomair, D. and Carter, C., 2001. Magnesium: its proven and potential clinical significance. Southern medical journal, 94(12), pp.1195-1202.
Our Activ8Health team is here to support you  
 
Highlighted Product References