The Safety of Glucosamine

We’ve all heard about the benefits of using Glucosamine (especially in conjunction with Chondroitin and MSM) to help treat sore and painful joints. We also think of Glucosamine as generally safe, it’s been rated a toxicity level 5 (on a scale of 0-100) by the Task Force of the European League against Rheumatism. In addition, recent OARSI (OsteoArthritis Research Society International) guidelines for hip and knee osteoarthritis also confirm its excellent safety profile, but have you ever heard much about the glucosamine side effects in humans? There are a few possible adverse affects you should be aware of when taking Glucosamine, most commonly are some mild reactions such as an upset stomach, constipation, diarrhea, and heart burn. Some rare reactions include headache, loss of appetite, rash (or other skin reactions) and drowsiness.

According to there is a possibility that taking Glucosamine Sulfate may increase your risk of bleeding. If you are someone with a bleeding disorder, or taking medications to control bleeding, take extra precautions and discuss with your doctor before taking a Glucosamine product. Another possible glucosamine side effect in humans discussed on is abnormally high levels of protein in a person’s urine, although “the clinical meaning of this is unclear.”

The Safety of Glucosamine

There is lots of discussion on the glucosamine side effects in humans who have an allergy to shellfish. Since most forms of Glucosamine are derived from shellfish (you can sometimes find it derived from corn) it would seem obvious that someone allergic to shellfish shouldn’t take it. However, Glucosamine is derived from the shells of the shellfish and most allergies are to the meat of the shellfish, based on this, according to the National Institute of Health “There are no reports of allergic reactions to glucosamine in people who are allergic to shellfish.” Nevertheless, caution should always be taken when dealing with your health, so always talk with your doctor before starting any medication or supplementation.

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Vitamin A: Moderation Is Key

We are what we eat, but for most of us the nutrients and vitamins we take in daily are poorly understood and frequently taken for granted. So in an effort to gain appreciation for these important nutrients, I have decided to study and write about a few in particular starting with Vitamin A.

What is vitamin A?
The term “vitamin” refers to any nutrient required by a living organism that can’t be self synthesized and must be obtained from your diet. In the case of Vitamin A, the name actually refers to several different compounds that have similar biochemical functions. These compounds include Retinol, Retinal, and four carotenoids including beta carotene. Vitamin A is most commonly known for its role in vision, but also plays an important role in gene transcription, immune function, bone growth, reproduction, Iron transport, and blood cell formation.

What are the recommended daily allowances and upper levels of intake?

Adult RDA or RDI for Vitamin A
Males(18+): 900 mcg/day RAE (3000 International Units)
Females (18+): 700 mcg/d RAE (2300 International Units)


  • Pregnancy 750-770 mcg/day RAE (2500-2600 International Units)
  • Lactation 1200-1300 mcg/day RAE (4000-4300 International Units)

Upper Limit of intake (UL)

Adults: 3000 mcg/day RAE (10,000 International Units)

Pregnancy: 2800 mcg/day RAE (9200 International Units)
Lactation: 3000 mcg/day RAE (10,000 International Units)

Pediatric RDA

1-3 years old: 300 mcg/day RAE (1000 International Units)
4-8 years old: 400 mcg/day RAE (1333 International Units)
9-13 years old: 600 mcg/day RAE (2000 International Units)
14-18 years old: 900 mcg/day RAE (3000 International Units)

Pediatric Upper Limits of normal intake

0-3 years old: 600/day mcg RAE (2000 International Units)
4-8 years old: 900/day mcg RAE (3000 International Units)
9-13 years old: 1700 mcg/day RAE (5700 International Units)
14-18 years old: 2800 mcg/day RAE (9200 International Units)

Vitamin A: Moderation Is Key

What happens when you are Vitamin A deficient?

Those at risk for vitamin A deficiency include vegans, recent immigrants, alcoholics, preschool children living below the poverty line, patients suffering from fat mal-absorption, Inflammatory bowel disease, cystic fibrosis, sprue, pancreatic insufficiency, and persons who have undergone small-bowel bypass surgery.
One of the first signs of Vitamin A deficiency is poor vision,particularly night blindness. There is also increased interest in subclinical vitamin A deficiency where low storage levels of vitamin A lead to an increased risk of respiratory and diarrheal infections, poor bone development, decreased growth rate, and decreased ability to survive serious illness.
According to the National Institute of Health(NIH)“Vitamin A deficiency is common in developing countries but rarely seen in the United States. Approximately 250,000 to 500,000 malnourished children in the developing world become blind each year from a deficiency of vitamin A. In the United States, vitamin A deficiency is most often associated with strict dietary restrictions and excess alcohol intake.”

What happens when you get too much Vitamin A?

Vitamin A can be derived from two different sources, animal or a plant.Animal source Vitamin A is called preformed vitamin A. It is absorbed in the form of retinol. Retinol is one of the most bioavailable forms of vitamin A. Vitamin A that is found in fruits and vegetables is called provitamin-A carotenoid. These can be made into retinol in the body. As a preformed vitamin is fat soluble, it is more difficult for your body to get rid of excess levels. This makes animal source or preformed vitamin A more dangerous in terms of toxicity because storage levels continue to increase over time. Beta-carotene is a safe source of vitamin A because the conversion of beta-carotene to vitamin A is regulated in the body.

The four main negative effects of toxic levels of vitamin A storage (Hypervitaminosis A) are: birth defects, liver abnormalities, reduced bone mineral density, and central nervous system disorders.
Toxic symptoms can also arise after consuming very large amounts of preformed vitamin A over a short period of time. Signs of acute toxicity include nausea and vomiting, headache, dizziness, blurred vision, and muscular incoordination. Although hypervitaminosis A can occur when large amounts of liver are regularly consumed, most cases result from taking excess amounts of the nutrient in supplements.

Pregnancy Vitamins

During pregnancy Vitamin A plays several important roles including, neural development and development of heart, ears, eyes, limbs, and lungs. Pregnant mothers need to be careful as excess vitamin A is teratogenic, (a term for anything harmful to the normal physiological development of the baby) The UL(upper limit) during pregnancy is 9200 IU, 800IU lower than that recommended for an adult female as excess Vitamin A may cause cardiovascular, craniofacial, thymus, and nervous system malformations. The following is a warning from the national institute of health;“Over the past 15 years, syntheticretinoids have been prescribed for acne, psoriasis, and other skin disorders. Isotretinoin (Roaccutane® or Accutane®) is considered an effective anti-acne therapy. At very high doses, however, it can be toxic, which is why this medication is usually saved for the most severe forms of acne. The most serious consequence of this medication is birth defects. It is extremely important for sexually active females who may become pregnant and who take these medications to use an effective method of birth control. Women of childbearing age who take these medications are advised to undergo monthly pregnancy tests to make sure they are not pregnant.”

Sources of vitamin A

So after all of this discussion about what vitamin A is and what it does, the next question is what are the vitamin A levels in common foods we eat? The following is a chart provided by the NIH**.

Table 1: Selected animal sources of vitamin A
Food Vitamin A (IU)* %DV**
Liver, beef, cooked, 3 ounces



Liver, chicken, cooked, 3 ounces



Milk, fortified skim, 1 cup



Cheese, cheddar, 1 ounce



Milk, whole (3.25% fat), 1 cup



Egg substitute, ¼ cup




Table 2: Selected plant sources of vitamin A (from beta-carotene)
Food Vitamin A (IU)* %DV**
Carrot juice, canned, ½ cup



Carrots, boiled, ½ cup slices



Spinach, frozen, boiled, ½ cup



Kale, frozen, boiled, ½ cup



Carrots, 1 raw (7½ inches)



Vegetable soup, canned, chunky, ready-to-serve, 1 cup



Cantaloupe, 1 cup cubes



Spinach, raw, 1 cup



Apricots with skin, juice pack, ½ cup



Apricot nectar, canned, ½ cup



Papaya, 1 cup cubes



Mango, 1 cup sliced



Oatmeal, instant, fortified, plain, prepared with water, 1 cup



Peas, frozen, boiled, ½ cup



Tomato juice, canned, 6 ounces



Peaches, canned, juice pack, ½ cup halves or slices



Peach, 1 medium



Pepper, sweet, red, raw, 1 ring (3 inches diameter by ¼ inch thick)



As you can see one portion of liver on the animal side and carrots on the vegetable provide 400-550% each of the daily value requirement of vitamin A. Many other sources provider lesser amounts but certainly add up to make vitamin A deficiency unlikely in the typical American diet.
In conclusion, vitamin A plays many important roles in the human body but should be respected in terms of toxicity and may have some implications amongst certain populations for deficiency. Pregnant women need to be most careful with intake and beta carotene is a safer form of vitamin A to use during this time. Finally, a well-balanced diet should provide most people with all of the vitamin A they need.
To Your Health,

Dave Rigby MS, PA-C, member ASN
*definitions of medical terms:

The Hidden Value of Vitamin D

Is it just me or has Vitamin D been getting a lot of attention lately? I’m wondering if it’s because we’re headed into the time of year when people generally spend less time outside and that’s how lots of people get additional Vitamin D (from the sun.) Anyway, I decided to do a little research on our friend, Vitamin D, and here are a few things I learned:

1.) According to fat in our body acts as a Vitamin D “battery” and will store Vitamin D and save it for times when we aren’t receiving enough.

2.) Also on they say that 6 days of modest exposure to the sun can make up for 49 days without any sun exposure (as far as replenishing out Vitamin D levels!)

3.) For all babies who are exclusively breastfed the American Academy of Pediatrics recommends 400IU daily of Vitamin D until the time they are drinking enough milk to receive the necessary amount of Vitamin D.

The Hidden Value of Vitamin D

4.) An easy way to prevent Vitamin D deficiencies, according to is through sun exposure. They say that even just 10 minutes a day can be enough to make a difference.

5.) Check out this study which shows that Vitamin D3 is more potent than Vitamin D2:

If you are looking for more information, or you are interested in carrying or purchasing our products, please do not hesitate to call us at 800.995.6607 or send us an e-mail at [email protected]

Who Needs Vitamin D?

I was shocked when I took my baby in for her 2 month check up and her doctor told me I should be giving her a vitamin supplement.  I went home and decided to do a little research, not that I don’t trust our doctor, I was just curious.  I was a little surprised to learn that the American Academy of Pediatrics recommends 400 IU/daily of Vitamin D for all infants who are exclusively breastfed.

They recommend starting the supplement “shortly after birth” and continuing until they are consuming enough fortified milk to receive proper amounts of Vitamin D.  I know it’s said that Vitamin D deficiency is huge right now, and this made me wonder what other groups need Vitamin D (and probably aren’t getting it).

The Office of Dietary Supplements listed these as the groups at the highest risk of being Vitamin D deficient:

-breastfed infants, since it’s likely they are not receiving adequate amounts of Vitamin D from breast milk alone.

-older adults, over time your skin loses the ability to synthesize Vitamin D.
-people with limited exposure to the sun, a lot of times our diets alone do not provide enough Vitamin D so some sun exposure is necessary.  Those who do not get much exposure to the sun may need additional supplementation.

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-people with dark skin, dark skin comes from having a larger amount of pigment melanin in the epidermal layer, which has been shown to inhibit the skin’s ability to produce Vitamin D from sunlight.

– people with fat malabsorption, people with conditions such as cystic fibrosis, Crohn’s disease and some forms of liver disease, have a harder time absorbing dietary fat.  Some dietary fat in the body is necessary in the absorption of Vitamin D, a fat-soluble vitamin.

-people who are obese, those who have a higher percentage of body fat are found to be Vitamin D deficient because “greater amounts of subcutaneous fat sequester more of the vitamin and alter its release into the circulation”

-those who have undergone gastric bypass surgery, after a gastric bypass surgery, “part of the upper small intestine where vitamin D is absorbed is bypassed and vitamin D mobilized into the serum from fat stores may not compensate over time.”

If you are looking for more information, or you are interested in carrying or purchasing our products, please do not hesitate to call us at 800.995.6607 or send us an e-mail at [email protected]

5 Simple Steps for a Healthy New Year

With a new year upon us many people are working on their resolution to live a healthier lifestyle.   As a medical practitioner and nutritionist I see a wide variety of scientifically unsound or unsustainable diet and fitness plans that lead to more frustration than good.   So for this coming year may I suggest a simple plan with 5 easy to follow steps that are sustainable and practical.

1.    CHOOSE AN EVENT – First, select a specific event with a date.  This could be anything from a 5k or triathlon, to a high school reunion or wedding.  The key to this is a defined goal and a set deadline.  By creating a time frame with a purpose, what once seemed like a never ending journey becomes an attainable and enjoyable goal.   Have fun with this goal and advertise to yourself.  You can even make a poster collage of this event with pictures that inspire or remind you of what you hope to accomplish or simply promise yourself a reward.   As you prepare for this event the sacrifice, effort, and pain can be associated with the higher purpose or goal and this will increase the likelihood of success.  As you succeed with this first event make sure and choose another and you’ll find yourself in a life full of success and accomplishment.

2.    FITNESS PLAN – Second, commit to a specific fitness plan that will help you achieve the desired goal.  For most of us it is too hard at the end of a long day to go out and exercise when we don’t have a plan.  By choosing and committing to a plan we are likely to be more mentally prepared and will often push ourselves more than if we do just what we feel like doing that day.  This plan can be a video series, a plan from a book or website, training from a coach, or even a handheld phone application.   Whatever plan you choose make sure that it is specific enough to write out your daily tasks for the month.  This will help avoid hesitation or excuse making.   If a workout is in the plan and you committed, just get it done.  Of course be responsible and allow yourself proper time for rest and make sure your plan isn’t so far beyond your present fitness level that it can lead to injury or burnout.

3.    PEER SUPPORT – Third, enlist a friend.  The buddy system and accountability work.  Choose someone to take this challenge with.  Share your goals and if possible a similar event and goal to work towards.  Have some type of documenting system to track your success and push and motivate each other.  You can use a written journal or online website.   One of my favorite websites, allows people from all across the world to log their workouts and see workouts their friends have accomplished.  We are able to comment on each other’s workouts and cheer success, commiserate with setbacks, and share in adventure.  Other similar sites include and   Each of these allows accountability and support in a fun way that exponentially increases our ability to continue forward with a plan.

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4.    NUTRITION PLAN – Fourth, develop a nutrition plan that is sustainable. Notice I did not use the word diet.  I believe improving what we eat is much simpler than the torture that many endure under the various diets that are popular for a season.  I believe as people become conscious of what goes into their body they will naturally choose those things that help them feel energetic if they are available.  To improve nutrition I recommend a person to do a 7 day food journal and observe the calories associated with the foods in their normal diet.  There are many programs online and for phone applications that will help you do this.  (My favorite app is my fitness pal.)

Then, and this is the key, I recommend choosing 10 items which are either low in nutrients and high in calories or foods that simply make you feel sluggish or ill and place them on your “Black list”.  This is a written list that you may choose to keep with you to help you consciously avoid foods that don’t contribute to your sense of energy and well-being.   Foods such as soda, excess alcohol or coffee, overeating, donuts, candy, or fast food can be placed on this list with a short written reminder of why we have chosen not to eat them.   Then get any food on the black list out of your house.

We then move to the “Green list” which is a list of lower calorie options or foods that consistently help you feel energetic and well.   Write down your top 10 favorite and fill your refrigerator and pantry with these options.  As you simply trade one for the other you will notice a difference in the way you feel and very likely a significant reduction in the mindless calories you take in.

5.    Supplement support- Fifth and finally research and implement one of the various supplements available to enhance your energy levels and athletic performance.  An old fable talks of a man who took 5hours to chop down some trees with a dull axe and another who took 2hours to sharpen his axe and 1 hour to cut down the trees.  There are natural supplements out there that can significantly improve our efforts and keep our bodies healthy and intact while we push for our goal.   With the scientific understanding available to the public today each of us can enjoy the advanced nutritional benefits of supplementation once enjoyed only by elite athletes and the ultra-wealthy.  I recommend talking with someone you trust or a sports nutritionist and your medical doctor to discuss the various options available and give yourself an edge on success.

By following these simple and practical techniques I know you can make the upcoming year one of your most energetic and accomplished yet.

To your health,

David Rigby MS, PA-C, Member of American Society of Nutrition

Immune Balance 365: What’s So Great About It?

Immune Balance 365 is a daily use supplement that supports and shields the areas vital to immune health. Much more than a simple vitamin c tablet, Immune Balance 365 is a sophisticated synergistic multisystem supplement in a highly absorbable liquid form. It provides cutting edge support to the 6 main areas of immune health. Nutrient absorption, Antioxidants, Stress/cortisol balance, Immunomodulation, Adaptogens, and Intestinal Health.

1.) Stress and Cortisol – Stress is a major factor in nearly all forms of significant illness from heart disease to compromised immune health. There is truth to the statement “stress kills”. Some studies indicate chronic stress as a more harmful factor than cigarette smoking in terms of overall wellbeing. Cortisol, a helpful hormone when occasionally released in times of stress, can become harmful after states of prolonged or chronic stress. Higher levels of cortisol have been correlated to weakened immune response, increased belly fat, fatigue, and longer recovery times for illness. Studies of Sensoril, (a standardized extract of ashwagandha), contained within Immune balance 365 demonstrated a 69% reduction in perceived stress and 24% Reduction in serum cortisol.

2.) Advanced Immunomodulators – The immune system is often misunderstood and oversimplified with claims being made that a product will “boost” this complex system. The problem with “boosting” is there are elements of the immune system, such as the innate system, that pushed out of balance may lead to inflammation, pain, and allergic itching. With the science and technology available today a more appropriate tactic is to “balance” the immune defenses by using natural phytonutrients to give the body an abundance of the nutritional components it needs to maintain healthy barriers and a ready to go immune response.

Immune Balance 365: What's So Great About It

Our primary immunomodulator is maitake gold 404, a standardized extract of maitake mushroom guaranteed by the producer to be immune-active. It has been clinically shown to increase phagocytosis, cytokine, interleukin, and natural killer activity. Each of these being beneficial components of the innate and adaptive immune response. Immune balance 365 also contains the powerful Black elderberry, which has demonstrated prominent immunomodulating benefits and significant reduction in time to recovery from illness.

3.) Intestinal Health/Digestive Support. Get better not Diarrhea. – When considering immune response many people don’t factor in the importance of intestinal health. Antibiotics are often inappropriately prescribed for viral illness, which can lead to antibiotic resistance and destruction of the normal flora or healthy bacteria that colonize the intestinal tract. With the healthy bacteria gone, nutrient absorption decreases and other harmful bacteria can colonize the intestines leading to further illness, particularly diarrhea. In contrast to antibiotics Immune balance 365 contains Nutraflora ScFos, a “prebiotic” or food for the desirable or “good” intestinal bacteria. This natural prebiotic is then able to feed and fortify rather than destroy the beneficial bacteria in your intestines, thus maintaining a strong barrier against opportunistic disease and diarrhea.

4.) Bioavailable Antioxidants- The National Cancer Institute gives the following definition for antioxidants: “Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals. Free radical damage may lead to cancer. Antioxidants interact with and stabilize free radicals and may prevent some of the damage free radicals might otherwise cause. Examples of antioxidants include beta-carotene, lycopene, vitamins C, E, and A, and other substances.” Immune balance contains vitamins C and E in levels sufficient to provide powerful antioxidant ability and support to circulatory health. To further ensure bioavailability Immune Balance 365 also includes ACTIValoe which has been shown to increase bioavailability of vitamin C and E by 204% and 269% respectively!

5.) Adaptogens – Who wouldn’t like to be more resilient and capable when it comes to fighting off disease. Immune Balance 365 contains the adaptogens Rhodiola and Eleuthero. Adaptogens are substances that enhance the bodies resistance to outside stressors including fatigue, mental stress, germs, and trauma. Studies have shown both Eleuthero and Rhodiola as supports to the bodies natural ability to reduce stress, combat fatigue and improve resistance to disease.

6.) Safe For Daily use- People get sick 365 days a year not just in times of winter. So to provide this year round protection it’s important to take a supplement that is safe for daily use. Unlike antibiotics or Echinacea which are taken after an illness and are only safe for a short period of time, the vitamins and phytonutrients found in Immune balance 365 are safe for daily use. Furthermore by providing essential nutrients and vitamins such as C, D, and E, protective barriers such as skin, oral, and lung surfaces can be better fortified by healthy tissue and protective enzymes.

So this winter and spring, and summer, and fall… Be proactive, be balanced, wash your hands, and avoid unnecessary illness.

To Your health!
Dave Rigby PA-C, MS, Member of American Society of Nutrition

Back to School Nutrition

As school draws near, many parents wonder what they can do to help equip their child with all they need to succeed academically. There is no question that nutrition plays an important role in a child’s overall health, so what is the best way to ensure a child receives the nutrition they need to have adequate energy for a successful school day. The key is balance.
Some people may not be aware that in 2011 the food guide pyramid used for the past 20 years by the USDA to promote a balanced diet was replaced by the Food Guide Plate(1).

The somewhat cryptic pyramid was found to be less than helpful because the majority of the population found it too complicated to remember or too difficult to determine what portion sizes were. The new simplified graphic creates a visual that shows Fruits and Vegetables as 50% of the recommended plate with grains and protein making up the other 50%. A small circle outside the plate represents an 8oz. side of dairy. On the fruit and vegetable side, vegetables take up nearly 60% of the plate. So this visual recommendation is healthy in theory but the million dollar question; “How would your child respond to a plate that looks like this?” While it is important to teach your children to eat a variety of foods, many parents have experienced the particular difficulty that comes from convincing a child to eat vegetables.

Back to School Nutrition

A recent study in the July 2011 American Journal of clinical nutrition may hold the key to success. They demonstrated a 50%-73% increase in vegetable intake with simultaneous caloric reduction of 15-25% by simply pureeing vegetables and integrating them into the main entrée. (2) The beauty of this was that the children still ate their normal vegetables that were included in the meal without knowing they were receiving an additional dose.
So this school year, help your child feed to succeed by following the new simplified USDA Food Guide plate recommendations and for those who find it difficult to get their child to eat vegetables, use of non-confrontational techniques and nontraditional routes of delivery such as pureed or liquid forms of nutrition can create peace in the home and a healthy, well nourished, and happy child.

To Your Success,

David Rigby Nutritionist, MS (Member of American Society of Nutrition)


1. Food Guide Plate –

2. Am J ClinNutr. 2011 Jul 20. Hiding vegetables to reduce energy density: an effective strategy to increase children’s vegetable intake and reduce energy intake.Spill MK, Birch LL, Roe LS, Rolls BJ. Source Departments of Nutritional Sciences and the Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA.