Living Low Carb (62 page)

The recommended dose for chromium is 200 micrograms, 3 times a day, though it is frequently used in dosages up to 1,000 micrograms with no negative effects.

High-Dose Biotin

Biotin is associated in the public’s mind with shiny hair, clear skin, and healthy nails, but when used in megadoses (100 or more times the amount found in your typical B complex), it can be very effective for lowering blood sugar. It enhances insulin sensitivity and increases the activity of an enzyme called glucokinase, which is responsible for helping the liver use sugar.
⁴⁵
One study that used 9 milligrams a day of biotin produced significant decreases in fasting blood-sugar levels in type 2 diabetics,
⁴⁶
and another did the same by using 8 to 16 grams a day.
⁴⁷
Dr. David Leonardi treats a large number of diabetics at the Leonardi Medical Institute for Vitality and Longevity in Denver, and frequently sees excellent results in those patients taking 15 milligrams a day. And it was recently suggested that high-dose biotin taken with chromium may be a viable treatment for insulin resistance.
⁴⁸

Carnitine

Carnitine, also known (and referred to interchangeably) as L-carnitine, is a very interesting nutrient with a fascinating pedigree. I frequently recommend it for weight-loss clients in the dosage of 1 to 2 grams a day. However, you’re unlikely to get the full weight-loss benefits from it unless you use it in the form and dosages described at the end of this section and in conjunction with a low-carb, reduced-calorie diet. And there are many other terrific things that carnitine does for the overweight patient that you should know about while we’re at it.

Carnitine is a spectacular nutrient because of its demonstrably positive therapeutic value for the heart,
⁴⁹
because it increases energy and combats fatigue, and because it has been shown repeatedly to lower triglycerides as well as lipoprotein(a), a serious risk factor for heart disease.
⁵⁰
In one trial, people with diabetes were given carnitine, and both their cholesterol and their triglycerides dropped 25% to 39% in just 10 days.
⁵¹
From the basic raw material of carnitine, the body naturally makes acetyl-L-carnitine, a particular form of carnitine that is enormously protective for the brain. Relative to our concerns here, carnitine improves insulin sensitivity in insulin-resistant diabetics and helps with glucose uptake in nondiabetic patients.
⁵²

But although this amino acid–like nutrient has a reputation as a weightloss aid, until recently study after disappointing study failed to show an effect on weight loss or body composition. There were some studies that indicated otherwise,
⁵³
but they were few and far between. Many clinicians believe that while carnitine is amazing for a number of applications, its use as a weight-loss supplement is questionable.

Many others, however, do not agree. Some of the greatest clinicians in America routinely use it, have seen terrific results with it, and sing its praises from the rooftops. Their experience with it can’t be ignored. Atkins routinely recommended from 2 to 5 grams (sometimes more) for patients at his clinic. Patrick Quillin, PhD, R.D., called carnitine a “‘wonder nutrient’ that could make weight reduction just a bit easier.”
⁵⁴
And one of the country’s most revered nutritionists and educators, Robert Crayhon of the Crayhon Research Institute, calls it “the best nutrient there is for promoting weight loss.” He even wrote a book about it called
The Carnitine Miracle
.

So what’s the deal? It is well established that carnitine is
absolutely necessary
for “fat-burning.” There’s no disagreement about what it does in the body—carnitine is the “escort” for fat on its journey into the little “furnaces” of the cell (the mitochondria), where it is burned for fuel. The only question is whether carnitine supplementation actually increases the amount of fat “burned.”

It’s beginning to look like it does. An extremely impressive study with normal subjects demonstrated that supplemental carnitine actually
increased
fat-burning, even in subjects
without
carnitine deficiencies.
⁵⁵
Some recent animal studies showed that supplemental carnitine significantly increased weight loss
⁵⁶
and reduced fat gain.
⁵⁷

Here’s what you should keep in mind about carnitine.

•  Carnitine works best with a lower-carb diet (insulin blunts its action).

•  Carnitine needs to be taken in the tartrate form.

•  The amount of carnitine
usually
included in commercial “fatburning” formulas is completely meaningless and ineffective; if you’re going to give carnitine a fair trial, you need to use meaningful doses (see below).

•  The main source of carnitine is animal foods. If you’re a vegetarian, it’s a virtual certainty that you should be supplementing with carnitine, especially if you’re trying to lose weight. If your main source of protein is soy, be aware that unless it’s fortified, it’s lacking in methionine, one of the two amino acids from which the body makes its own carnitine.

•  Carnitine lowers cortisol levels (and can therefore be helpful for adrenal health),
⁵⁸
and adrenal activity affects weight gain and loss.

Carnitine
alone
cannot promote weight loss. But in combination with diet, it can and will decrease body fat and body weight, probably more than diet alone would. Carnitine in conjunction with a low-carb diet and an exercise program makes a winning combination. If you are a vegetarian, there’s no question that you should use it, and if your plan calls for ketosis, you should definitely use it as well, since when carnitine is deficient, conversion of fat to ketones is impaired.
⁵⁹

Plan to use no less than 1 gram, preferably 2 grams or more, and remember to get the tartrate form. A great time to take it is on an empty stomach before working out. The best carnitine is the tartrate form marketed by both Designs for Health and Crayhon Research. The powder makes higher doses very easy and palatable (it tastes like lemony Tang). One teaspoon equals 2,800 milligrams (2.8 grams). Be aware that it’s expensive.

CoQ10 (Coenzyme Q10)

CoQ10 is not a weight-loss supplement per se, but is vitally important in the production of energy, and if you are low or deficient in it, it may keep you from losing weight.
⁶⁰
CoQ10 is short for coenzyme Q10. Technically, it’s not a vitamin (because it’s synthesized in the cells), but it acts like a vitamin in the body because it is involved in so many metabolic functions. It is found in high concentrations in the heart (also in the kidneys, liver, and pancreas) and is considered a very important nutrient for heart health, largely because of its importance in the creation of molecules of energy (known as ATP), which are required in large amounts by the heart.
⁶¹
It can also decrease blood sugar in diabetics. CoQ10 is frequently depleted by medications, especially statin drugs. (If you’re on a statin, you should definitely be on CoQ10.)

If energy and fatigue are an issue for you, I often recommend the “energy cocktail” of carnitine, CoQ10, and ginseng. Remember, however, that lack of energy is often due to lifestyle—not enough high-quality sleep, the wrong diet, and adrenal burnout. You need to address those issues and not take the “cocktail” as a substitute for doing something about them.

Green Tea (EGCG)

Dr. Shari Lieberman, author of
The Real Vitamin and Mineral Book
, considers the active compound in green tea to be one of the best weight-loss supplements available, and I agree.

Compounds in green tea can raise your metabolism. The particular compound responsible for the increase in fat-burning ability is called EGCG (epigallocatechin gallate), and it works by increasing the production of noradrenaline, which turns up your metabolism.
⁶²
EGCG also stimulates brown-fat metabolism, thus increasing thermogenesis.
⁶³
Green-tea extracts have been shown to increase fat-burning as well as metabolic rate (the amount of calories you burn) for up to 24 hours.
⁶⁴
In animal studies, they have been shown to have a mild antiobesity effect;
⁶⁵
and if that were not enough, the EGCG in green tea has recently been shown to enhance insulin activity.
⁶⁶

You’d need to drink five or more cups of the tea a day to get the amount of EGCG required to produce an effect, so high-quality supplements are probably the way to go.

Ginseng

Ginseng is what is known as an adaptagen, which means it can help you restore equilibrium to something that is out of balance. In that sense, it’s like the thermostat on your central air-conditioning/heating unit—if the room is too hot, the thermostat tells the unit to cool things off, but if the room’s too cold, the thermostat signals the unit to warm things up.

Ginseng is traditionally used for energy, especially during times of stress or fatigue, but recent evidence has shown that it is amazing for helping to regulate blood sugar, and may possibly be of value in weight loss as well. In one study, it elevated mood and reduced fasting blood sugar.
⁶⁷
In two animal studies, it improved glucose tolerance while the animals lost weight,
⁶⁸
and in another it produced a significant amount of weight loss, an increase in calories expended, and a reduction in the amount of calories consumed. It also decreased cholesterol!
⁶⁹

This may be why Asian ginseng is commonly used in traditional Chinese medicine to treat diabetes. In animal research, it has been shown to increase the number of insulin receptors,
⁷⁰
and recent studies showed that even nondiabetics taking American ginseng before eating had less-elevated blood-sugar readings after they ate.
⁷¹

Siberian ginseng might be worth a try if you’re fatigued, or try American ginseng if you’re concerned about your blood sugar. Alternatively, you can get the more stimulating Panax type, also known as Chinese or Korean ginseng.

5-HTP

This supplement (a metabolite of the amino acid tryptophan) has been found to have an effect on weight loss in several impressive studies, even sometimes without dietary changes.
⁷²
5-HTP (5-hydroxytryptophan) is the immediate precursor to serotonin and has been found very useful as an antidepressant. It’s thought to exert its influence over eating behavior by affecting serotonin. Studies have shown that 5-HTP decreases food intake (predominantly carbohydrates) and promotes weight loss.
⁷³
If you’re currently taking antidepressants, make sure to check with your doctor before adding 5-HTP to your supplement regimen. I recommend always including B6 along with your 5-HTP, since B6 is needed for the conversion to serotonin.

Bitter Orange

Bitter orange (
Citrus aurantium
) is the ingredient found in most of the new “ephedra-free” diet pills. It’s an herb that contains the active ingredient
synephrine
. Synephrine is chemically very similar to ephedrine and pseudoephedrine and has similar effects in terms of providing an energy boost, suppressing the appetite, and increasing metabolic rate and caloric expenditure. By stimulating specific adrenergic receptors, synephrine is thought to stimulate fat metabolism without the negative cardiovascular side effects experienced by some people with ephedra, also called “ma huang.”

Bitter orange usually contains about 1% to 6% synephrine, but some manufacturers boost the content to as much as 30%.
⁷⁴
It does have a thermogenic (fat-burning) effect
⁷⁵
; in animal studies, synephrine caused weight loss but also increased the risk of cardiovascular problems.
⁷⁶

Bitter orange can also increase the side effects of many medications, including (but not limited to) Xanax, Zocor, Sudafed, Buspar, Celexa, Zoloft, Allegra, prednisone, Meridia, Viagra, and a number of blood-pressure medications.
⁷⁷
Do
not
take bitter orange if you have high blood pressure or are pregnant.

The bottom line is this: bitter orange is a stimulant, and the same cautions about other stimulants (like ephedra) apply.

Glutamine

Glutamine is your secret weapon against carbohydrate cravings. I use it all the time with my clients—I have them combine a couple of grams of the powder with a little heavy cream and xylitol for sweetener. This has a remarkable ability to curb the urge for something sweet.

Glutamine’s usefulness as a cravings-buster was first discovered when it was shown that about 12 grams of glutamine curbed alcohol cravings.
⁷⁸
Its effect on sugar cravings was acknowledged by a research director at the National Institutes of Health as far back as 1986.
⁷⁹
Atkins routinely used it with his patients to combat the compulsion to eat sugar.
⁸⁰
Dr. Ron Rosedale explains that glutamine acts as a brain fuel, so it can help eliminate carbohydrate cravings while you are in that “transition” period.
⁸¹
Glutamine (also known as L-glutamine) comes in capsules or powders, but I prefer the powder for its versatility and fast-acting ability.