NutriGest - R X Vitamins

USES:
TECHNICAL REPORT
for USE by VETERINARIANS ONLY
Robert J. Silver DVM, MS, CVA
Rx Vitamins for Pets Formulator and Chief Medical Officer
NutriGest
As a dietary supplement to aid in the treatment of:
Acute and chronic diarrhea
Chronic intestinal infections/Intestinal Dysbiosis
Inflammatory Bowel disease(s)
Chemotherapy-associated gastrointestinal side-effects
With antibiotic administration to promote bowel recolonization
THERAPEUTIC STRATEGY:
1) Provide nutritional support for repair of damaged intestinal mucosa
2) Provide substantial counts of colony forming units of beneficial bacteria to reinoculate
bowel microflora
3) Support normal function of bowel
4) Gently eliminate pathogenic micro-organisms from bowel microfloral ecology
5) Provide nutritional co-factors to improve digestive function
6) Provide botanical and nutraceutical support to reduce heightened
inflammatory response in the bowel
INGREDIENT LIST (2 capsules or ½ teaspoon of powder provides):
1. Probiotic Cultures: (L-Acidophilus (85%); L-Thermophilus (1.7%); L-Plantarum (1.7%)
Bifidobacterium Bifidum (5%); Bifidobacterium Longum (5%); B-Coagulans
(1.7%)……………………………………………………500 million viable cells
2. L- Glutamine (free form amino acid)..........................................……...200 mg.
3. Cats Claw (Uncaria tomentosa) (standardized to 3% oxindole
alkaloids)...........................................…………………………150 mg.
4. N-acetyl D glucosamine..........................................................………....150 mg.
5. Calcium pantothenate…..........................................................…………100 mg.
6. Ginger root extract(standardized Zingiber officinale supplying 4% volatile
oils)....................................................…………….....…………50 mg.
7. Fructooligosaccharide..............................................................………….50 mg.
8. Oregon Grape Root (Mahonia repens)...........................................…......50 mg.
9. Garlic (Allium sativum) (standardized to 1% total allicin potential)...…..25 mg.
10. Psyllium Seed (Plantago ovata)....................................…...............….....25 mg.
11. Aloe Extract (emoden free)........................................................…….......25 mg.
12. DGL (deglycerrhized licorice)......................................................……....25 mg.
13. Folic Acid.............................................................................…………...50 mcg.
14. Vitamin A (retinol)..........................………………….............…………100 IU.
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INGREDIENT RATIONALE:
Probiotic cultures: Intestinal microflora play a significant role in the maintenance
and health of the gastrointestinal tract (Shahani, 1980). Studies
demonstrate that certain strains of intestinal microflora beneficially
influence the host immune response. (Perdigon, 1988) Probiotic cultures
are an exogenous source of these beneficial bacteria which can recolonize
the bowel and improve intestinal microfloral ecology. Other studies have
demonstrated that beneficial bacteria also exert an “antibiotic” effect upon
pathogenic intestinal microflora such as Pseudomonas spp., E. coli, and
the agents causing “traveler’s diarrhea” in humans. (Price, 1970)
(Clements, 1981) (Warram, 1978)
Lactobacillus acidophilus has been shown to inhibit the following bacteria
(Murray, 1996):
Bacillus subtilis
B. cereus
B. stearothermophilus Candida albicans
Escherichia coli
Clostridum perfringens
L. bulgaricus Klebsiella pneumonia
Lactobacillus helveticus
L. fermenti
L. leichmannii L. lactis
Proteus vulgaris
L. plantarum
Pseudomonas aeruginosa P. fluorescens
Salmonella typhosa
S. schottmuelleri
Shigella dysenteriae
S. paradysenteriae
Sarcina lutea
Serratia marcescens
Stapholococcus aureus
Streptococcus faecalis
S. lactis Vibrio comma
Reinoculation of the bowel with active cultures of beneficial intestinal
microflora will help to restore healthy digestion if administered both
during and after a course of antibiotic therapy. Oral administration of l.
acidophilus concurrent with antibiotic therapy has been demonstrated to
help maintain normal levels of beneficial intestinal bacteria. (Zoppi, 1982)
An L. acidophilus strain fed to experimental animals helped to reduce the
development of antibiotic resistant strains of pathogenic bacteria. (Gotz,
1979)
With a long history of usage as a dietary supplement for both humans and
livestock, probiotics have been observed and reported to provide health
benefits for cancer victims, and other patients who have immune systems
weakened by viruses, medications or environmental toxins.
l-Glutamine
This free form amino acid has been used with a high degree of success in
human medicine in the treatment of severe trauma and burns, drug and
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alcohol withdrawal, and restoring intestinal mucosal integrity. Glutamine
has been found to promote intercellular hydration, which in turn triggers
anabolic (tissue building-healing and repairing) activity. (Pasquale, 1998).
Glutamine is known to benefit a number of tissues, including: GI mucosal
cells, hepatocytes, monocytes (macrophage), T and B lymphocytes,
pancreatic exocrine cells, kidney tubular cells, fibrocytes, and myocytes. L
glutamine is of benefit for the anabolic metabolism in any living cell.
Glutamine is considered to be a conditionally essential amino acid
(Grimble, 1993). Glutamine is a conditional nutrient when its
supplementation in a diet resolves symptoms associated with a dietary
deficiency l glutamine. This conditional status occurs when the body’s
production of glutamine is at an insufficient rate to keep up with the tissue
demands.
A variety of conditions and circumstances can increase the tissue demands
for l glutamine. Glutamine is necessary for maintenance of the structural
and functional integrity of the mucosal lining of the small intestine.
(Nappert, 1999) Other studies have demonstrated that dietary
supplementation with glutamine promotes the repair of damaged and
“leaky” intestinal mucosal lining. (Fox, 1988) These studies, in
combination with the observed clinical benefits of glutamine
supplementation support the use of enteral glutamine supplementation in
patients with intestinal dysbiosis as well as inflammatory bowel disease.
Clinical applications of high dose glutamine therapy for chemotherapy
patients has provided substantial benefits for patients undergoing
potentially enterotoxic cancer therapies. Fewer gastrointestinal side
effects, improved activity levels and improved appetance were noted in
these patients. (Silver, 1998)
Cat’s Claw (Uncaria tomentosa)
This botanical compound is derived from the bark of the root of a large
woody vine that grows in the South American rainforest. It contains over
50 active constituents, including five oxindole alkaloids. In traditional
use, Cat’s Claw is prescribed for a variety of conditions characterized by
inflammation, immune system defects. or infection, such as: Skin
problems, poor hair growth, rheumatism, female contraceptive, gastric
ulcers, dysentery, pediatric gastroenteritis, diabetes, fevers, abscesses,
chemotherapy side-effects, hemorrhage, and urinary tract infections.
(Jones, 1995)
In a study of the effects of Cat’s Claw published by Humberto Ruiz,
Professor Emeritus of Veterinary Medicine at the University Mayor de San
Marcos, Lima, Peru, studies performed on 135 dogs and 53 cats carried out
over the course of four years, found Cat’s Claw to be effective in the
treatment of arthritis, hip dysplasia, feline immunodeficiency viral
infections, and intervertebral disc disease (Ruiz, 1995) In this study,
patients were given capsules of pulverized bark, containing 250-300 mg
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per capsule. The dosage used by Ruiz was 250 mg/10 kg of body weight
divided BID.
Dr. Ruiz reports that cat’s claw is effective as an adjunctive therapy in the
treatment of parvovirus enteritis and inflammatory conditions of the
stomach, as well improve immune system function when faced with feline
immuno-deficiency virus (Jones, 1995) and feline leukemia virus
infections. Cat’s claw repeatedly demonstrated an ability to improve
immune system function with out any sign of toxicity or adverse sideeffects.
N-acetyl D-glucosamine is necessary in the manufacture of mucin, the
glycoprotein that lines the intestinal tract. One study demonstrated the
increased uptake of N-acetyl D glucosamine by the intestinal mucosa in
patients with inflammatory bowel disease. (Burton, 1983) Some human
patients with Crohn’s disease and ulcerative colitis are “slow acetylators”
and are unable to convert endogenous glucosamine sulfate to N acetyl D
glucosamine, and therefore must have this nutrient supplied in their diet.
This glycosaminoglycan is used as substrate in the formation of the
proteoglycan ground substance that holds cells together. The ground
substance is weakened by the inflammatory process. Patients with chronic
inflammatory conditions can benefit from the introduction of N acetyl D
glucosamine or glucosamine sulfate to their diets. (Murray, 1996)
Calcium pantothenate supplies both the macromineral calcium as well as the B
vitamin pantothenate (B5). Vitamin B5 is utilized in the manufacture of
coenzyme A (CoA) and acyl carrier protein (ACP).Both are compounds
that have essential roles in the utilization of fats and carbohydrates for
energy production. Pantothenate is also used in the manufacture of
adrenal hormones and the production of red blood cells. As a result of its
influence on adrenal hormone production, B5’s role has been
acknowledged as the anti-stress vitamin. (Fry, 1976) It has been known
for over 40 years that pantothenate also plays a role in improving immune
system function. (Axelrod, 1955). This vitamin in this formula addresses
patient stress and the loss of appetite associated with inflammatory bowel
disease and the side-effects of chemotherapy.
Ginger (standardized Zingiber officinale supplying 4% volatile oils) contains over
300 biologically active compounds in its volatile oil fraction. These
compounds have a variety of actions, including promotion of the secretion
of saliva and gastric juices, stimulation of bile flow, anti-microbial
activity, intestinal anti-spasmodic activity, and improving the tone of the
gastrointestinal tract as well as stimulating peristalsis of the intestines.
Ginger has also been used for inappetance, dyspepsia, and as a digestive
aid for hypochlorhydric gastritis. In folk medicine ginger has been used to
relieve flatulence, as an expectorant, and as an astringent. (Gruenwald,
1998) Clinical trials have shown ginger to be an anti-emetic equivalent in
activity to diphenhydramine (Mowrey, 1982) and a motility enhancer
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equivalent in activity to metoclopramide. (Yamahara, 1990). Ginger has
been shown to be effective in the treatment of diarrhea. (Huang, 1990)
Ginger has the unique ability to improve gastric motility at the same time
as it exerts anti-spasmodic effects upon the bowel.
Ginger has shown itself to have potent anti-inflammatory and painrelieving
activity. A number of the volatile oil fractions in ginger are
potent inhibitors of prostaglandin and leukotriene synthesis. (Kiuchi,
1992) Ginger has been shown to inhibit the release of substance P from
nocioceptive nerve endings. (Onogi, 1992) In this formula ginger is being
used both for its anti-inflammatory activity as well as for its ability to
balance digestive function for patients with inflammatory conditions of the
bowel and GI problems secondary to chemotherapy.
Fructooligosaccharides are short chain sugar compounds that are digested not by
mammals, but by the beneficial bacteria that colonize the bowel. Human
studies have shown that FOS increases colonization by Bifidobacterium
spp and Lactobacillus spp, at the same time as it reduces colonization by
pathogenic species of bacteria. Other benefits noted by researchers include
the increased production of beneficial short-chain fatty acids such as
butyrate. (Gibson, 1995) These short chain fatty acids are dietary
metabolism factors which benefit human patients with small bowel
bacterial overgrowth syndrome. (Hoverstad, 1985) The
fructooligosaccharide content of this formula is designed to assist in reestablishing
healthy bowel micro-floral ecology.
Oregon Grape Root (Mahonia repens AKA Berberis aquifolium) is a berberinecontaining
herb that has natural antibiotic properties. Berberine hcl is an
alkaloid present in a number of herbs, including goldenseal (Hydrastis
canadensis), goldenthread (Coptis chinensis), and barberry (Berberis
vulgaris). Its antibiotic spectrum of activity is directed primarily toward
the population of pathogenic bacteria that can colonize the bowel as a
result of chronic gastrointestinal disease, following anti-biotic therapy,
food poisoning and chemotherapy. (Gupte, 1975) Oregon grape root also
exerts a beneficial effect on the secretory capacity of the mucosal cells
lining the bowel, (Tai, 1981) as well as affecting the ability of pathogenic
bacteria to adhere to the intestinal mucosal cells. (Sun, 1988). In this
formula, the oregon grape root is being used to reestablish a healthy bowel
ecology.
Garlic (Allium sativum) (standardized to 1% total allicin potential) has a long
history of well-documented effects, including anti-microbial, anthelmintic,
anti-fungal, anti-viral, and anti-inflammatory. (Hughes, 1991) All of these
health benefits of garlic are advantageous to its use in this formulation.
Psyllium Seed (Plantago ovata) is a hydrophilic demulcent herb that supplies
soluble and insoluble fiber to the bowel, thus supporting the growth of the
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eneficial bacteria. Its demulcent and hydrophilic actions help to control
the symptoms of diarrhea.
Aloe Extract (emoden free) provides anti-inflammatory and wound healing
activity in this formula. The removal of the anthraquinones from the
whole aloe leaf in this emoden-free aloe vera extract have eliminated the
cathartic properties of aloe without disturbing this plant’s ability to reduce
inflammation and promote the healing of disturbed tissues. Aloe has been
shown to stimulate fibroblast and connective tissue formation.
(Davis,1987) Aloe has demonstrated benefit to gastrointestinal function in
a human study. (Bland, 1985) Aloe vera has been shown to improve both
cancer patient and HIV clinical outcomes (Harris, 1991), (Singer, 1993).
Aloe’s ability to soothe irritated tissues is its primary function in this
formulation.
DGL (deglycyrrhized licorice) is a special extract of licorice root (Glycyrrhiza
glabra) that is used in the treatment of peptic and oral ulcers in humans. It
is manufactured by removing the glycyrrhizinic acid fraction of the whole
plant extract. The active components of DGL are primarily flavonoids.
Animal studies have demonstrated the substantial protection this
compound provides following chemically induced ulcer formation.
(Yamamoto, 1992) In a placebo-controlled study, DGL was compared to
Tagamet for their relative ulcer healing properties as measured by
reduction in ulcer size. Both DGL and Tagamet were equivalent in their
ulcer healing activity. (Morgan, 1985)
Folic acid functions together with vitamin B12 in many bodily processes. Folic
acid is critical for DNA synthesis. Folic acid is found in copious amounts
in fresh green leafy vegetables and whole grains. Rapidly dividing cells in
a variety of tissues need adequate folic acid for maintenance of healthy
tissue function. The cells of the gastrointestinal tract are especially
sensitive to reductions in folic acid. In small bowel bacterial overgrowth
syndrome, folic acid and vitamin B12 are not being created by the healthy
bacteria species, and folic acid deficiency is one mechanism of this
pathology. (Bailey, 1995)
Vitamin A (retinol) plays a necessary role in the synthesis of a substantial number
of glycoproteins, which provide the ground substance that holds cells
together. Vitamin A deficiency adversely affects tissues with high cellular
turnover rates, such as the intestinal mucosal epithelium. Inadequate
Vitamin A results in hyperkeratotic tissues and reduces the semipermeable
intestinal mucosal barrier. (Murray, 1996)
CLINICAL APPLICATIONS:
NUTRIGEST for Dogs and Cats has been designed as a supportive clinical
tool to be used as an adjunctive therapy:
In the treatment of acute and chronic diarrhea
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To improve patient response in cases of chronic intestinal
parasitiasis, including giardiasis
To help recolonize the bowel following antibiotic therapy
For the remediation of intestinal dysbiosis,
To help improve patient response to therapies for the
inflammatory bowel diseases
To provide support for patients experiencing gastrointestinal
side-effects from chemotherapy.
RECOMMENDED DOSAGES:
DOG:
½ - 1 capsules BID or 0.5-1 scoop* powder daily for 5-25 lbs.
1 - 2 capsules BID or 1-1.5 scoops powder daily for 25-50 lbs.
2 - 3 capsules BID or 1.5 -2 scoops powder daily for 50 – 100 lbs.
CAT:
½ - 1 capsule BID or 0.5-1 scoop powder daily.
* 1 scoop equals ½ teaspoon
NOTE:
Dosing at up to three times the high range of values will increase
tissue levels and improve patient response times. There is no
toxicity associated with this higher dosage.
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202.
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Clements, M. L., Levine, M. M. et al. (1981). “Lactobacillus prophylaxis for diarrhea due to
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Fox, A. D., Kripke S. A, et al. (1988). “Effect of a glutamine-supplemented enteral diet on
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