The Vitamin Professor Newsletter

Gene Bruno, MS, MHS, RH(AHG)

Chief Scientific Officer at Nutraland USA

Published Nov 26, 2024

Gene Bruno, MS, MHS, RH(AHG) is a 45-year veteran of the dietary supplement industry, and for 20 of those years he served as Professor of Nutraceutical Science at Huntington University of Health Sciences. He now serves as Chief Scientific Officer for Nutraland USA. As “The Vitamin Professor”, Gene will share the most recent research on nutraceuticals in this free bimonthly newsletter. Make sure to subscribe.

This issue of The Vitamin Professor will focus on recent research showing low GI side effects with iron supplementation during pregnancy; vitamin D supplementation improved quality of life during chemotherapy in colorectal cancer patients; and creatine HCl and creatine monohydrate performed the same on muscular strength, hypertrophy, and hormonal responses in resistance training.

Low GI side effects with iron supplementation during pregnancy

Many pregnant women are reluctant to follow the recommendation concerning oral iron prophylaxis due to concerns about gastrointestinal (GI) side effects. To assess the frequency of GI complaints during low-dose oral iron prophylaxis and compare three iron formulas in equipotent doses, the results from two randomized, double-blind studies in healthy women with an uncomplicated single pregnancy were reported in this analysis[1]. The Gentofte study comprising 404 women allocated into four groups taking 20, 40, 60, and 80 mg of elemental iron as ferrous fumarate/day and the Naestved study comprising 78 women allocated into two groups: 25 mg of elemental iron as ferrous bisglycinate/day and 50 mg of elemental iron as ferrous sulphate/day between meals. GI complaints (nausea, vomiting, epigastric pain/pyrosis, belching, meteorism, borborygmi, intestinal colic, flatulence, loose stools, constipation, and use of laxatives), as well as black stools, were recorded by interview at the time of inclusion and at regular intervals during gestation. Results were that, at inclusion, the frequency of total combined GI complaints in all women (n = 482) was 21%. In the groups taking 20-60 mg iron/day as fumarate, there was no association between the iron dose and the frequency of GI side effects. An iron dose of 80 mg as fumarate was associated with significantly higher frequencies of constipation and the use of laxatives. Comparing the three equipotent doses of iron formulas, which can prevent iron deficiency, ferrous bisglycinate 25 mg iron had the most favorable GI side effect profile, while ferrous fumarate 40 mg iron and ferrous sulphate 50 mg iron had higher but similar GI side effect profiles. The frequency of black stools increased with the iron dose. Ferrous bisglycinate 25 mg iron had a lower frequency of black stools (8%) than ferrous fumarate 40 mg iron (22%) and ferrous sulphate 50 mg iron (31%). In conclusion, low-dose iron supplementation appears to have no clinically significant GI side effects, as none of the included women presented with GI complaints of such severity that it necessitated either reduction of iron dose, change to an alternative iron formula, or discontinuation of iron supplement. However, ferrous bisglycinate 25 mg iron/day is associated with significantly fewer GI complaints than ferrous fumarate 40 mg iron/day and ferrous sulphate 50 mg iron/day.

Vitamin D supplementation improved quality of life during chemotherapy in colorectal cancer patients

Although chemotherapy is typically used to treat stage II-III colorectal cancer, there are side effects that decrease the patient's quality of life. A single-blinded, randomized controlled trial (RCT)[2] with consecutive sampling was conducted to assess the effect of vitamin D supplementation on the quality of life of stage II-III colorectal cancer patients undergoing chemotherapy. Data was taken from the medical record, history taking, and personal interviews. Quality of life was measured at the first, third, and sixth months after chemotherapy using the validated Indonesian version of the EORTC QLQ-C30 questionnaire. Results were that a total of 34 patients received vitamin D and 34 others received placebo. Serum vitamin D levels significantly increased (p < 0.001) in the intervention arm. Meanwhile, it decreased in the placebo arm. The patients’ quality of life improved significantly after receiving vitamin D, compared with the placebo group on the third (median of 75.0 vs 45.83) and sixth (median of 83.33 vs 33.33) months after chemotherapy. In conclusion, vitamin D consumption (10,000 IU/day) could improve the quality of life of colorectal cancer patients undergoing adjuvant chemotherapy.

Creatine HCl and creatine monohydrate performed the same on muscular strength, hypertrophy, and hormonal responses in resistance training

A randomized, placebo-controlled study[3] was conducted to determine the effects of resistance training (RT) alongside creatine-hydrochloride (Cr-HCl) or creatine monohydrate (CrM) supplementation on anabolic/catabolic hormones, strength, and body composition. Forty participants with an age range of 18-25 years were randomly divided into four groups (n=10): RT+Cr-HCl (0.03 g.kg-1 of body mass), RT+CrM-loading phase (CrM-LP) (0.3 g.kg-1 of body mass for five days (loading) and 0.03 g.kg-1 body mass for 51 days (maintenance)), RT+CrM-without loading phase (CrM-WLP) (0.03 g.kg-1 body mass), and RT+placebo (PL). The participants consumed supplements and performed RT with an intensity of 70-85 % 1RM for eight weeks. Results were that in the supplementation groups, strength, arm and thigh muscular cross-sectional area, and skeletal muscle mass significantly increased, and percent body fat significantly decreased (P</=0.05); this change was significant compared to the placebo group (P</=0.05). Additional results showed a significant increase in growth hormone (GH), insulin-like growth factor-1 (IGF-1), levels, the ratio of follistatin/myostatin, testosterone/cortisol (P</=0.05), and a significant decrease in cortisol and adrenocorticotropic hormone (ACTH) levels (P</=0.05) in the supplementation groups. Hormonal changes in GH, IGF-1, testosterone/cortisol, cortisol, and ACTH levels in the supplementation groups were significant compared to the PL group (P</=0.05). The results showed that CrM and Cr-HCl significantly enhanced the beneficial effects of RT on strength, hypertrophy, and hormonal responses, with Cr-HCl showing no benefit over CrM.