The Impact of Vitamins and Supplements
March 13, 2013
Presented by
Georgia Tetlow, MD
The Impact of Vitamins and Supplements
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Disclosure/Disclaimer
Disclaimer
• Information is intended for educational purposes only,
not as medical or psychological advice or treatment
Nothing that isn’t disclosed
– I have an online store that benefits educational
programs
– Monthly educational webinars
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Agenda
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Integrative Medicine
Key research pearls
Vitamin D
Omega 3’s
Dairy
Soy
• Lifestyle choices
– Smoking
– Weight
– Alcohol
– Green tea
– Emotional/spiritual
health, social
connection, mindfulness
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Integrative Medicine
• Combines best of conventional medicine
– Cancer fighting drugs, therapies, surgery
• With additional safe, effective approaches, treatments
• Evidence-based = standard for medicine
• JUST GOOD MEDICINE
– Need provider who is open to all the evidence and
who is trained
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Integrative Medicine continued…
• Biological interventions
– Vitamins and Supplements
– Whole Food diet
• Mind-Body Medicine
• Alternative Medical Systems
– Traditional Chinese Medicine, Ayurveda, Homeopathy
• Energy Medicine
– Acupuncture
• Hands-On medicine
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Integrative Medicine
“Integrative medicine honors the innate ability of the body to
heal, values the relationship between patient and physician, and
integrates complementary and alternative medicine to support
the organism and facilitate healing.”
---Victoria Maizes, MD, Executive Director
University of Arizona Center for Integrative Medicine
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Why Integrative Medicine?
• Patient at the center
• Addresses the full range of physical, emotional, mental, social,
spiritual and environmental influences
• Personalized strategy that considers the patient’s unique conditions,
needs and circumstances
• Health as “a state of complete physical, mental and social wellbeing
and not merely the absence of disease or infirmity.”*
*Constitution of the World Health Organization — Basic Documents, Forty-fifth edition, Supplement,
October 2006.
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
About Georgia Tetlow, MD
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Graduate Fellow, University of Arizona Center for
Integrative Medicine
CEO, Founder of Philadelphia Integrative Medicine
Clinical Assistant Professor of Rehabilitation Medicine
Thomas Jefferson Medical College
Yoga Teacher for 20 years
Mindfulness teacher
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Your Plate
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Your Plate
• No one food ingredient
– Eat from the rainbow
– Broccoli/cabbage family
• Indole-3-carbinol
– Supports immune system, reduces cellular damage
balances hormones
– Collards, mustard greens, turnips, cabbage, broccoli,
kale, cabbage, cauliflower and Brussels sprouts
• Food choices for healthy weight
• 5 or more servings of vegetables and fruit daily
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Antioxidants
• Reduce inflammatory and toxic cell mediators
– NFkB, Il-6, Il-8
• Donate electrons to electron-deficient free radicals
– Neutralize them!
– Cells and DNA protected, help prevent cancer
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Why Supplements, Anyway?
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Strengthen the immune system
Reduce inflammation
Reduce free radicals
Reduce DNA damage that leads to cancer
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Pearl 1
• Whole foods and healthy diets should be the primary
approach in designing studies to test nutrition-cancer
associations
• Experts believe components in many foods, especially
fruits and vegetables, act synergistically to reduce
cancer risk
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Pearl 2
• Seek products that most closely mimic the forms that
nutrients naturally take in food, such as vitamin E in the
form of mixed tocopherols and tocotrienols or vitamin A
in the form of mixed carotenoids (vs. β-carotene alone or
vitamin A palmitate)
• Dosage, duration and quality matter
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Pearl 3
• The greatest benefit from taking supplements of any kind
seems to be for those who are deficient in a particular
nutrient
"Diet, anthropometric measures and prostate cancer risk: a review of prospective cohort and intervention
studies." Dagnelie PC, et al. BJU international 93(8):1139-50 May, 2004
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Pearl 4
• Genetic differences contribute to individual variation in response to
foods and nutrients
• Genetics influence the rates of absorption, metabolism and sites of
action of individual constituents
• Unmeasured, uncharacterized gene variation likely explains
inconsistent findings across studies and across different populations
Milner, JA. "Incorporating basic nutrition science into health interventions for cancer prevention.” The Journal
of nutrition 133(11 Suppl 1):3820S-3826S Nov, 2003
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Vitamin D3 (Cholecalciferol)
• Hormone
• Controls phosphorus, calcium and bone metabolism and
neuromuscular function
• The only vitamin the body can manufacture from sunlight
• More and more people deficient due to indoor living,
heliophobia and sunscreen use
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Vitamin D3 (Cholecalciferol) continued…
• Approx. 1 billion* may be Vitamin D3 deficient
• Dark skin, obesity, heredity may hinder production
• Elderly may need more D3 (decreased skin, renal
synthesis)
• Test: 25 (OH) Vitamin D
– <30 ng/mL insufficient
– 45 ng/mL adequate
– 60-80 ng/mL more optimal
*world wide
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Vitamin D3 continued…
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Fats, Omega 3’s
• Cook with Olive Oil
• FISH OIL (Omega 3’s fatty acids)
– modulate estrogen metabolism, estrogen
receptors
– Must be triglyceride
– 1-3 grams daily, with food, discuss with
doctor
– mercury/toxin free
– many benefits
– thins the blood
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Fish Oil Slows Tumor Growth
Hardman, J. Nutr. 132:3508S-3512S, 2002
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Dairy
• Over 36 case-control plus 10 prospective cohort studies
showed inconsistent findings
• Recent pooled analysis of American and European
cohort studies found no association with dairy and
postmenopausal breast cancer
Moorman PG, et al. "Consumption of dairy products and the risk of breast cancer: a review of the literature."
Moorman PG, et al. The American journal of clinical nutrition 80(1):5-14 Jul, 2004
Missmer SA, et al. "Meat and dairy food consumption and breast cancer: a pooled analysis of cohort studies."
International journal of epidemiology 31(1):78-85 Feb, 2002
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Dairy continued…
• Dietary calcium and low-fat dairy products associated
with a moderately lower risk of postmenopausal breast
cancer compared with women with lowest intake levels
• Supplemental calcium or higher levels of total calcium
(diet plus supplements) were not related to overall breast
cancer risk
Moorman PG, et al. "Consumption of dairy products and the risk of breast cancer: a review of the literature."
Moorman PG, et al. The American journal of clinical nutrition 80(1):5-14 Jul, 2004
Missmer SA, et al. "Meat and dairy food consumption and breast cancer: a pooled analysis of cohort studies."
International journal of epidemiology 31(1):78-85 Feb, 2002
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Soy
• Soy beans and fermented soy bean products such as tofu,
tempeh and soymilk
• Case-control studies support a protective effect of soy in the
breast
– case-control study among Korean women stratified by
menopausal and hormone receptor status of the tumors
• significant 64% reduction in breast cancer risk (95% CI
0.20, 0.64) with higher soy consumption
Cho YA, et al. "Effect of dietary soy intake on breast cancer risk according to menopause and hormone
receptor status." European journal of clinical nutrition 64(9):924-32 Sep, 2010
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Soy continued…
• This association may not only result from higher intake of
soy but also in utero and early exposure and prepubertal and adolescent exposure during mammary
gland development
• In addition, soy intake among Asian women is strongly
correlated with increased consumption of fruit and
vegetables
Butler LM, et al. "A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal
Singapore Chinese women." The American journal of clinical nutrition 91(4):1013-9 Apr, 2010
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Soy Conclusions
• Moderate amounts in diet are safe and likely protective
• Half serving a day servings per day
• May not be advisable in advanced stage breast cancer
as early evidence from cell culture studies suggest
possible proliferative effect in the setting of metastatic
carcinoma
Messina M, et al. Can clinicians now assure their breast cancer patients that soy foods are safe? Women's
health (London, England) 6(3):335-8 May, 2010
Martínez-Montemayor, et al. "Individual and combined soy isoflavones exert differential effects on metastatic
cancer progression." Clinical & experimental metastasis 27(7):465-80 Oct, 2010
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Cancer: Factors Within Your Control
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Smoking
Weight control/Exercise
Diet
– Alcohol
– (Fruits/vegetables, best fats, certain cancers: hormones in beef and milk)
– Green tea
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Omega 3 Fatty Acids
• Vitamin D—get tested!
Healthy immune system—emotional and spiritual health, social connection
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Breast cancer prevention: 1 drink daily or less
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Mind-Body Interventions -Mindfulness
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Mindfulness Literature
• Witek-Janusek, et al (2008). Effect of mindfulness based
stress reduction on immune function, quality of life and coping
in women newly diagnosed with early stage breast cancer.
Brain, Behavior, and Immunity, 22(6), 969-981.
• Carlson, et al (2007). One year pre-post intervention follow-up
of psychological, immune, endocrine and blood pressure
outcomes of mindfulness-based stress reduction (MBSR) in
breast and prostate cancer outpatients. Brain, Behavior, and
Immunity, 21(8), 1038-1049.
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
“Integrative medicine addresses the
root causes of illness and
suffering. These root causes
involve many aspects of a
person’s life, including the
physical, but also the
psychosocial, emotional, and
spiritual dimensions as well.”
--Dean Ornish, MD Founder and
Director of the Preventive
Medicine Research Center
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Return to Art of Medicine
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Mind, Body and Spirit
Fight cancer, but focus is on health and returning to
health
• Power of life style choices!
– Understand root causes
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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The Impact of Vitamins and Supplements
Mission
Philadelphia Integrative Medicine offers a comprehensive
approach to health and healing which recognizes the
whole person, and champions self-care for health, illness
recovery and prevention through education, inspiration
and empowerment.
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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4wholeness.com
An online community and
resource for women with
breast cancer who want
information about how to
integrate natural and holistic
therapies with allopathic
cancer treatment.
If the HPERLINK above doesn’t work, copy and paste this link into your Internet browser:
http://vimeo.com/28516754
The Impact of Vitamins and Supplements
Upcoming Webinar
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• Friday, April 5, 2013 (12-1pm)
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• Learn how the elimination diet profoundly detoxifies and
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Thank you!
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
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