Cornerstone DPC

Amino acids are defined as “the building blocks of proteins”, they are also the result from the digestion of proteins. There are 22 amino acids that are required by the human body to create human proteins, and these aminos must be placed in a particular pattern. Fourteen of these are considered non-essential (as the body can manufacture them); eight are referred to as “essential”, meaning that they must be obtained from food and/or supplements.

One such non-essential amino acid is L-carnitine. It is found mainly in the heart and skeletal muscle, and more specifically in the mitochondria (“the powerhouse of the cell”) where it is utilized in employment of fats called beta-oxidation.

Essential fats cannot pe*****te the inner membrane of a mitochondria without a transporter - this is where l-carnitine comes in. L-carnitine utilizes at least three different enzymes in the process, and the success of the aforementioned beta-oxidation process is then determined by not only the transport system itself, but how much carnitine is available for use. Obviously, higher levels of l-carnitine will increase the beta-oxidation while lower levels slow it down.

Regarding weight loss, you want your body to switch from utilizing carbohydrates for energy to using stored fat. For this to occur, you will need a steady and adequate supply of l-carnitine to transport the stored fat into the mitochondria. Now, if you are overweight, your body does not create as much of this amino acid; therefore, you will need to supplement. (Note: exercise is a MUST when adding in l-carnitine for weight loss.). New studies are being done to show that in women diagnosed with PCOS, a deficiency of l-carnitine has been noted.

Another benefit of this amino acid is that it has the backing of multiple studies to show its effectiveness in reducing fat accumulation in the blood and tissues, a major symptom of cardiovascular disease. (This in no way is to be a substitute for a healthy, cardiometabolic diet and exercise program, but rather as a supplement.) Studies showing that a minimum dose of 2000 mg daily helped to reduce the amount of heart attacks in persons with CVD, and at a dose of 3000 mg, it helped these patients to improve their exercise performance. Another groundbreaking study even reported that in patients who were taking anti-arrythmic drugs, supplementing with l-carnitine improved the efficacy of these drugs.

If you have hypothyroidism, be wary of l-carnitine as it can prevent thyroid hormone from getting into the cells; on the other hand, this mechanism of action may help to diminish symptoms of hyperthyroidism. If you are taking anticoagulants or blood pressure medication, please check with your functional medicine provider prior to taking l-carnitine.

There is some proof that l-carnitine may protect against the toxic effects of doxorubicin (a chemotherapy agent) without lessening the efficacy of the drug.

Also, please remember that dietary supplements are there to help supplement the diet (hence the name!) There is absolutely nothing that can take the place of a healthy diet, daily exercise and proper sleep.

Kelly Sieberg, Integrative Health Practitioner and Functional Medicine Certfiied Health Coach

Standard disclaimer: These statements have not been evaluated by the Food and Drug Administration. The information provided here, although backed by research, is not intended to diagnose, treat, cure, or prevent any disease.

References (some abstracts noted):
Benvenga S, Ruggieri RM, Russo A, Lapa D, Campenni A, Trimarchi F. Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind placebo-controlled clinical trial. J Clin Endocrinol Metab. 2001;86(8):3579-3594.
Fatih Celik, Mesut Kose, Mehmet Yilmazer, Gülengül N. Köken, Dagistan Tolga Arioz & Mine Kanat Pektas (2017) Plasma L-carnitine levels of obese and non-obese polycystic o***y syndrome patients, Journal of Obstetrics and Gynaecology, 37:4, 476-479, DOI: 10.1080/01443615.2016.1264375
Fugh-Berman A. Herbs and dietary supplements in the prevention and treatment of cardiovascular disease. Prev Cardiology. 2000;3:24-32.
Longo N, Frigeni M, Pasquali M. Carnitine transport and fatty acid oxidation. Biochim Biophys Acta. 2016 Oct;1863(10):2422-35. doi: 10.1016/j.bbamcr.2016.01.023. Epub 2016 Jan 29. PMID: 26828774; PMCID: PMC4967041
DiNicolantonio, J, Lavie C, Farres H, Menezes A, O’Keefe, J. L-carnitine in the secondary prevention of cardiovascular disease: Systematic review and meta-analysis. Mayo Clinic Proceedings 2013 April 17. 88; 6, 544-551. doi.org/10.1016/j.mayocp.2013.02.007
Talenezhad N, Mohammadi M, Ramezani-Jolfaie N, Mozaffari-Khosravi H, Salehi-Abargouei A. Effects of l-carnitine supplementation on weight loss and body composition: A systematic review and meta-analysis of 37 randomized controlled clinical trials with dose-response analysis. Clin Nutr ESPEN. 2020 Jun;37:9-23. doi: 10.1016/j.clnesp.2020.03.008. Epub 2020 Apr 18.
Wang ZY, Liu YY, Liu GH, Lu HB, Mao CY. l-Carnitine and heart disease. Life Sci. 2018 Feb 1;194:88-97. doi: 10.1016/j.lfs.2017.12.015. Epub 2017 Dec 11. PMID: 29241711.
Xiapoing, L, Reichetzer B, Trines J, Benson L, Lehotay D. L-carnitine attenuates doxorubicin-induced lipid peroxidation in rats. 1999 Free Radical Biology and Medicine; 26(9-10). 1158-1165

What is functional medicine? In a nutshell, functional medicine is what patient care SHOULD be. Chronic illnesses and autoimmune diseases, etc. have risen exponentially. Unfortunately, the traditional method is to simply write a prescription for the latest medicine that may help to “control” the symptoms, albeit with multiple side effects. Often, the side effects will result in the prescribing of yet another medication, and sadly the root cause of the illness is never addressed. As a result, nothing is fixed. Nothing changes. The patient continues to suffer.

Functional medicine physicians will spend time listening to their patients, taking time to gather together a complete medical history. Doing so allows for a timeline in which triggers, mediators and antecedents may be identified as potential causes for the illness. Many times, genetics combined with poor nutrition, stress and environmental assaults are the problem. Scientists are discovering more and more about the gut microbiome and its association with immune, cardiovascular and neurological health, with inflammation being a major driver in many conditions.

Once a root cause (or multiple root causes) is found, then and only then can the condition be properly addressed. Nutrition is always the first step – personalizing a food plan. There is no one-size-fits-all food plan that will help everyone. The second step will then be to add in proper supplements; these are only added in to supplement the diet (hence the name!) They are not to be relied upon as a sole cure for any condition. Third, exercise, sleep, stress management – all of these will be taken into account as well, and once again, an individualized plan will be created for the patient.

The end goal here is recovery – but the one thing that we stress to our patients more than anything is that is a complete lifestyle change! Things didn’t happen overnight and recovery won’t be overnight, but please know that the journey and end result will be completely worth it.

Dr. Sieberg is a family practice physician with 25 years of experience and is certified as an IFMCP by the Institute for Functional Medicine.

For more information, you can visit our website or simply call Dr. Sieberg at 217-809-0771.

Prices for a functional medicine appointment $250/hour; $75 for each 30 minutes following.

Functional Medicine – Cornerstone DPC Functional Medicine What is functional medicine and how can it work for you? The functional medicine model is an individualized, patient-centered, science-based approach that empowers patients and practitioners to work together to address the underlying causes of disease and promote optimal wellness...

Reposting this fantastic piece of information on vitamin C. Folks, if you are considering getting intravenous vitamin C, please read the following:

Most aesthetic salons that are practicing this for the aesthetics are not considering the health factors that are required prior to dosing intravenous Vitamin C. The practitioner must also pay complete attention to the patient, constantly checking in to see how he/she is feeling. Follow-ups are also very important, to make sure the patient has tolerated the procedure.

For example, someone considering high dose intravenous/oral vitamin C should be given a thorough history and be informed of the risks and benefits of this kind of therapy. Some basic lab work should be done before the IVs, such as checking the kidney and liver functions, the iron level, and a genetic test (G-6-PD) to make sure the patient’s red blood cells would not be affected by the treatments. This is a practice not routinely done by aesthetic salons, nor is the vitamin C compounded locally, but instead a bag of pre-made solution is used; one that has been ordered from an out-of-state company and then shipped during times of extreme heat or extreme cold, thereby affecting the volatility and purity of the mix.

If you are considering high dose vitamin C, please call us here at Cornerstone DPC, 217-809-0771.

(Edit to add: we also do addition intravenous formulas, all individualized for the patient and the condition, as there is no one-size-fits-all formula)

Let's talk about vitamin C. Everyone knows that this vitamin is something we should consume every day and that extra C can even help with colds, but the value of vitamin C goes far beyond that. In today’s post I will describe the its history and the role that this very important vitamin plays in our health.

First, a little background:

Vitamin C is a compound that is used in a variety of processes in the body, including its antioxidant effects, healing of injured tissues, and maintaining the immune system’s effectiveness. Although almost every animal is able to manufacture their own vitamin C, neither humans, primates, fruit bats or guinea pigs do not have this ability, so we have to try to obtain it from the foods we eat (or utilize it from a supplement). All other animals have an enzyme called L-gulonolactone oxidase (GLO) that converts glucose into vitamin C; strangely enough, although humans have the genetic instructions for making the GLO enzyme, that part of our genetic code is not “turned on”. Predictably, researchers are trying to figure out how to activate this genetic code.

That being said, it is likely that a VERY small number of humans have a genetic alteration that has allowed the GLO enzyme to be activated. This possibly could explain why there are some people who drank excessive amounts of alcohol every day or smoked three packs of ci******es daily and still lived to be 99 years old. If they had GLO activity, then their body was better able to repair the damage created by poor lifestyle decisions.

Vitamin C deficiency

Scurvy is the condition that results from inadequate intake of vitamin C. It is a horrible disease as it causes debilitating pain, fatigue, spontaneous bleeding, and eventual death. This condition was noted to affect sailors and finally figured out in the 1700s by Dr. James Lind. In 1753, Dr. Lind wrote “A Treatise of the Scurvy”, in which he treated 12 sailors with various foods in an attempt to learn what would reverse this condition. Two of the men were given two oranges and one lemon daily for six days. They promptly recovered, whereas the others continued to be ill. With Dr. Lind’s observations, the cause of scurvy was established, and ships started carrying plenty of citrus in the form of juice (cool fact: this is why British sailors are called “Limeys”).

Our cells are able to pack away vitamin C (intracellular storage), as plenty is needed for energy production. As the level of vitamin C in the blood falls and approaches zero, the intracellular vitamin C levels will deplete, and symptoms of scurvy will become evident over the course of a few months. Untreated, scurvy will be fatal in every affected person.

Vitamin C recommendations

The government has established recommendations for daily vitamin C intake. For adults, men should consume 90mg and women should consume 75mg of vitamin C every day. The highest consumption is in women who are nursing, as they should take 120mg a day. Smokers need to take more than the recommended amounts, as vitamin C helps to repair the damage done by smoking.

How did the government arrive at these recommendations? They figured out the minimum amount of vitamin C to keep a person from developing scurvy. Doctors see no reason to take more than the above amounts, but please note that there is a difference between optimal doses and taking just enough to prevent scurvy. These doses are simply the RECOMMENDED levels.

I have utilized vitamin C intravenously in former patients for specific conditions, so I am well-versed in its many benefits; however, new information has come to light regarding many more conditions/diseases that have been successfully treated with high-dose vitamin C. So in my next post, I will describe just how this amazing vitamin was employed for the treatment of these illnesses, as well as the dosage and preferred route of supplementation.

-Dr. Sieberg

When the cold weather hits, it is common to want to stay indoors and out of the cold. For many, this can be detrimental as then the risk of viral exposure from others becomes greater. Besides making sure that your vitamin D levels are adequate (more on that later), it is vital that you have proper nutrients on hand; preferably, n-acetylcysteine, or NAC for short.
I had stated in a previous post to not overdo it on the immune supplements, and this still holds true; however, NAC is a more stable form of a (non-essential) amino acid called L-cysteine. NAC is a sulfur-containing amino that acts as a stabilizer for protein structures, but it is more notable as the precursor to the formation of glutathione. Glutathione is the body’s largest and most protective antioxidant, providing detoxification and intracellular defense against oxidative damage.
NAC became widely known as a frontline treatment for the virus of 2020, thanks to its ability to prevent the virus from replicating and forming spike proteins. With influenza and RSV, it has the ability to do the same, and can breakup proteins found in lung mucus – reducing their chain lengths and thereby thinning out the mucus – resulting in better lung function.
There are multiple studies stemming as far back as 2003 showing the benefits of NAC against both RSV and influenza. More recently, scientists have reported that …”NAC has ben shown to inhibit influenza virus replication and to reduce the secretion of inflammatory and apoptotic mediators during virus infection.” The conclusion of this 2022 groundbreaking study showed support for “the use of NAC to exert antimucin synthesis, anti-inflammatory, antioxidant, and antiviral effects on airway epithelium during RSV infection” (Chi, Cui 2022).
Other studies show that “NAC restores the normal functions of the epithelium, inhibiting ICAM1 expression” and “subsequent RSV infection” (Mata, Sarrion, Armengot, et al 2012).
In 2011, scientists reported that use of NAC significantly inhibits inflammatory cytokines, such as MUC5AC, IL8, IL6 and TNF-alpha – all of which can contribute to and result in severe viral infection. This same study also demonstrated that NAC inhibits viral replication of Influenzas A and B, and RSV (Mata, Morcillo, Gimeno and Cortijo 2011.)
Yet another study shows that NAC inhibits virus replication and expression of these same pro-inflammatory molecules in cells that have become infected with influenza A (Geiler, Michaelis, Naczk et al. 2010).
There are dozens more of these types of peer-reviewed studies available that show the benefits of taking NAC daily, and not just for the current influenza and RSV situation that is cycling. Many more studies have been reported that also show its ability to lower oxidative stress and inflammation associated with COPD, diabetes, hypertension and hyperlipidemia. NAC taken with selenium and vitamin E has also shown to be beneficial for women suffering with PCOS, and there are studies that demonstrate it may help with anxiety and depression, as well.
Dosing for NAC should stay around 600 – 1800 milligrams a day; if you are going to take 1800, it is best to take the 600 mg capsule three times a day. It may be taken any time day or night.

REMEMBER: please check with your functional medicine physician or practitioner prior to starting or adding in any supplements to your daily routine. This post is for informational purposes only; no claims to treat or cure any disease or illness. The picture is of NOW Foods brand of NAC; we are not endorsing any one product.
Citations available in comments.

- Kelly Sieberg, FMCHC, IHP