Five Acid-Lowering Supplements

From [Drop Acid] by David Perlmutter, MD

Quercetin:

Quercetin is a significant dietary polyphenol and part of the flavonoid micronutrients group, known for their strong antioxidant, anti-inflammatory, and anti-pathogenic properties. It acts as a pigment that colors many plants and serves as an immune system regulator, potentially slowing the progress of degenerative diseases. Commonly present in various foods, especially in fruits and vegetables like apples, berries, red onions, cherry tomatoes, broccoli, and other green leafy vegetables, quercetin also aids in regulating mitochondrial processes.

New research shows that quercetin supplementation may have beneficial effects on neurodegenerative diseases, particularly in laboratory mouse models engineered to mimic signs of Alzheimer’s disease, by reducing the buildup of plaque proteins associated with the disease. It also inhibits the formation of AGEs in the body (AGEs, short for ‘advanced glycation end products,’ are harmful compounds formed as a result of detrimental chemical reactions). Quercetin is valuable for lowering uric acid because it inhibits xanthine oxidase, essential for the body’s production of uric acid. Inhibiting this enzyme reduces uric acid production, which is how drugs like allopurinol work. A 2016 study found that a month of daily quercetin supplementation (500 mg per dose) significantly reduced uric acid levels, especially in individuals with higher levels. The authors suggested that quercetin could be promising for lowering uric acid levels in individuals with higher-than-optimal levels, for those at high risk, and for patients recovering from therapy. Additionally, quercetin has been shown to lower blood pressure and LDL cholesterol levels in high-risk individuals. A daily dose of 500 mg of quercetin is recommended.

槲皮素是一种重要的饮食性多酚，也是具有强大抗氧化、抗炎和抗病原特性的类黄酮微量营养素的一部分。它作为一种色素为许多植物提供颜色，并且作为免疫系统调节器，有可能减缓退行性疾病的进程。槲皮素普遍存在于多种食物中，特别是在水果和蔬菜如苹果、浆果、红洋葱、樱桃番茄、西兰花以及其他绿叶蔬菜中。除了其抗氧化和抗炎特性外，槲皮素还有助于调节线粒体过程。

新研究表明，槲皮素补充可能对神经退行性疾病有益，尤其是在被设计来模仿阿尔茨海默症状的实验室小鼠模型中，它可以减少疾病相关的斑块蛋白的积累。它还能抑制体内高级糖基化终产品（简称AGEs）的形成，这些有害化合物是由不良化学反应产生的。槲皮素之所以珍贵，在于它能抑制一种名为黄嘌呤氧化酶的酶，这是尿酸生成过程中必需的。抑制这种酶可以减少尿酸的产生，这也是像别嘌呤醇这类降尿酸药物的作用机制。2016年的一项研究发现，健康成年人每天服用500毫克槲皮素一个月，能显著降低尿酸水平，尤其是在尿酸水平高于正常范围的个体中。研究作者认为，槲皮素可能是降低尿酸水平的有前途的方法，适用于尿酸水平高于理想水平的高风险人群和康复中的患者。此外，槲皮素还被发现能降低高风险人群的血压和血中LDL胆固醇水平。建议每日摄入500毫克的槲皮素。

Luteolin:

Luteolin, similar to quercetin, possesses the ability to inhibit xanthine oxidase, lending it the power to lower uric acid levels. Remarkably, luteolin’s effectiveness in reducing uric acid is comparable to that of allopurinol, a standard treatment for high uric acid levels. It’s also been observed to protect pancreatic beta cells, which are crucial for insulin production. A study in Japan in 2017 revealed that subjects with mild hyperuricemia who took luteolin supplements experienced significant reductions in uric acid levels compared to a control group.

Found in extracts like chrysanthemum flowers, luteolin is also naturally present in various fruits and vegetables, including green peppers, celery, and broccoli, and in herbs such as thyme and rosemary. It is celebrated for its anti-inflammatory and antioxidant effects and is being researched for potential cardiovascular, neuroprotective, and anti-cancer benefits.

A daily intake of 100 mg of luteolin is typically recommended.

路得因（Luteolin）和槲皮素一样，通过抑制黄嘌呤氧化酶来发挥降低尿酸的效果。值得注意的是，路得因降尿酸的能力与别嘌呤醇相当。它还能预防胰腺β细胞的功能障碍，由于尿酸过高可能直接对胰腺造成损害，这是一个重要的发现。在2017年日本的一项双盲安慰剂对照研究中，轻度高尿酸血症的参与者在服用路得因补充剂后，与对照组相比，尿酸水平显著降低。

路得因不仅存在于菊花提取物中，还天然集中在许多水果和蔬菜中，尤其是青椒、芹菜、柑橘类水果和西兰花，以及百里香、薄荷、迷迭香和牛至等香草中。作为大多数类黄酮的一员，路得因具有强大的抗炎和抗氧化特性，并且在动物研究中显示出有助于心脏保护和神经保护的潜力。目前也在研究路得因的抗癌能力。

通常建议每日摄入100毫克路得因。

DHA：

DHA: Perhaps no other molecule has received as much attention in field as DHA, or docosahexaenoic acid, an omega-3 fatty acid. DHA an important building block for the membranes surrounding brain cells, particularly the synapses, which lie at the heart of efficient bran function. It helps reduce inflammation in the brain and throughout the body and appears to increase brain-derived neurotrophic factor (BDNF he brain’s preferred “fertilizer” for new neurons. DHA also fights inflammation in the gut caused by a poor diet. And it can block the damaging effects of a diet high in sugar, especially fructose, and help prevent metabolic dysfunction.

The DHA-fructose relationship is particularly intriguing and relevant to the control of uric acid. In chapter4, I mentioned a 2017 study conducted by UCLA scientists about fructose’s damaging effects in the brain through the lens of uric acid participation. This team of researchers also found that DHA can help offset those negative effects, calling DH+ the ultimate fructose-fighting fatty acid. What they did in their nifty experiment was first to train rats to escape from a maze. Next, the divided the rats into three distinct groups: one was given water mixed with fructose; another received the same water-and-fructose mixture but also a diet rich in DHA; and the third drank plain water without fructose or DHA. Six weeks later, the researchers put the rodents to the test, watching them try to escape from the same maze. Which group struggled? The rats that had consumed water mixed with fructose got through the maze at about half the speed of the rats that drank only water, showing that the fructose had affected their memory. But the rats that were served a water-fructose mixture in combination with a diet rich in DHA finished the maze at the same speed as the group that received only water. This was clear evidence that the DHA protected against the negative effects of the fructose.

DHA also plays in important role in regulating the way vascular endothelial cells function. Recall that excess uric acid compromises nitric oxide production and function, leading to reduced vascular health and a reduction in the ability of blood vessels to properly dilate (and sup- port optimal insulin signaling within the vessels). DHA’s significant positive effects on vascular endothelial cells make it a potent counterbalance to the adverse effects of elevated uric acid.

In 2016, the American Journal of Clinical Nutrition reported that DHA beat out another popular omega-3 fatty acid, eicosapentaenoic acid(EPA), in terms of its anti-inflammatory properties.’ (Though it’s okay to b DHA that is combined with EPA.) Our bodies can manufacture all amounts of DHA, and we are able to synthesize it from a common dietary omega-3 fat, alpha-linolenic acid. But it’s hard to get all the DHA need from the food we eat, and we can’t rely on the body’s natural production of it. either. We need at least 200 to 300 mg daily as a mini- um, but most Americans consume less than 25 percent of this target and would do well to go beyond this bare minimum. Opt for a fish oil supplement or choose DHA derived from marine algae. I recommend a dose of 1,000 mg per day.

DHA，或称为二十二碳六烯酸，是一种ω-3脂肪酸，在领域内受到极大关注。DHA是构建大脑细胞，尤其是关键的突触部分膜的重要组成部分。它有助于减轻大脑和全身的炎症，并似乎能增加脑源性神经营养因子（BDNF），这是大脑新神经元的首选“肥料”。DHA还可以对抗因不良饮食引起的肠道炎症。此外，它能阻断高糖饮食，特别是果糖，对身体的损害效应，有助于预防代谢功能障碍。

DHA与果糖之间的关系在控制尿酸方面尤为引人关注。在第四章中，我提到了2017年加州大学洛杉矶分校科学家们关于果糖对大脑的损害效应以及尿酸参与作用的研究。这个研究团队还发现，DHA可以抵消这些负面效应，称DHA为最终的果糖对抗脂肪酸。他们的实验首先训练老鼠从迷宫中逃脱。然后，将老鼠分为三组：一组给予含果糖的水；另一组除了相同的含果糖水外，还提供富含DHA的饮食；第三组仅饮用不含果糖或DHA的普通水。六周后，研究人员观察老鼠在同一迷宫中的逃脱表现。结果显示，摄入含果糖水的老鼠通过迷宫的速度大约是只喝普通水老鼠的一半，说明果糖影响了它们的记忆。但同时摄入果糖水和DHA饮食的老鼠与仅饮用普通水的组别完成迷宫的速度相同，这明显证明了DHA对抗果糖的负面效应。

DHA在调节血管内皮细胞功能方面也扮演着重要角色。回想一下，过量的尿酸会影响一氧化氮的产生和功能，导致血管健康降低，血管扩张能力减弱（以及在血管内最佳胰岛素信号的支持减少）。DHA对血管内皮细胞的显著积极影响使其成为对抗高尿酸不良影响的有力对策。

2016年，美国临床营养学杂志报告称，DHA在抗炎特性上优于另一种受欢迎的ω-3脂肪酸，二十碳五烯酸（EPA）。尽管与EPA结合使用的DHA也是可以的。我们的身体可以自行制造DHA，也能从常见的饮食ω-3脂肪酸——亚麻酸中合成它。但通过饮食获得所需的所有DHA并不容易，我们也不能完全依赖身体自然产生的DHA。每天至少需要200到300毫克的DHA，但大多数美国人的摄入量不足这一目标的25%，应该尽量超过这一最低标准。可以选择鱼油补充剂或来源于海藻的DHA。我推荐的剂量是每天1000毫克。

Chlorella:

You may not have heard of chlorella before, but single-celled freshwater medicinal alga. There are many species, but one most studied for lowering uric acid is C. vulgaris, which is easy to find in supplement form. Chlorella is commonly used to help ameliorate features of metabolic syndrome because it’s well known to help lower blood sugar and C-reactive protein. It’s also known to lower triglycerides, boost insulin sensitivity, and improve liver enzymes. It’s a great detoxifier, too, binding to pesticides and heavy metals in the bloodstream to help eliminate them from the body.

In a 2017 study that used chlorella to treat patients with nonalcoholic fatty liver disease, researchers found remarkable differences between people taking chlorella versus those on a placebo after eight weeks.” In addition to recording drops in fasting glucose, inflammatory markers, and uric acid, and in addition to signs of improved liver function in the patients who received the chlorella (as opposed to the patients on the placebo), the chlorella group experienced meaningful weight loss. Remember, NAFLD patients are at risk for weight gain because they have insulin resistance and actively produce fat as a result of their condition(90 percent of patients with NAFLD have at least one of the features of metabolic syndrome). If a supplement can do all that in people with NAFLD, imagine what it can do in someone without the condition. Chlorella is a biological supercharger.

Chlorella has other applications as well, thanks to its anti- inflammatory effects. Studies, for example, are currently making a case for its use in treating depression, which is increasingly being viewed as an inflammatory disorder. In a six-week pilot study of patients with major depressive disorder, researchers documented significant improvements in those taking chlorella in addition to standard antidepressant therapy.4 Their physical and cognitive symptoms of depression as well as anxiety symptoms eased.

I recommend a dose of 1,200 mg of C. vulgaris per day.

你可能还没有听说过绿藻（chlorella），但它是一种单细胞的淡水药用藻类。有许多种类，但其中最常被研究用于降低尿酸的是粗壮绿藻（C. vulgaris），这种绿藻作为补充剂很容易找到。绿藻通常用于改善代谢综合征的特征，因为它能有效降低血糖和C反应蛋白。它还被认为可以降低甘油三酯、增强胰岛素敏感性，并改善肝脏酶指标。绿藻也是一个很好的排毒剂，能结合血液中的农药和重金属，帮助从体内排除这些物质。

在2017年的一项研究中，研究人员使用绿藻治疗非酒精性脂肪肝病患者。他们发现，在八周后，服用绿藻的人群与服用安慰剂的人群之间有显著差异。除了记录到空腹血糖、炎症标志物和尿酸的下降，以及患者肝功能的改善迹象外（与安慰剂组患者相反），服用绿藻的组别还经历了显著的减重。值得注意的是，非酒精性脂肪肝病患者因胰岛素抵抗和病情导致的积极脂肪生成而有增重风险（90%的非酒精性脂肪肝病患者至少有代谢综合征的一个特征）。如果一种补充剂能在非酒精性脂肪肝病患者身上产生这样的效果，想象一下它在没有这种病状的人身上能做些什么。绿藻是一种生物超级充电器。

绿藻因其抗炎效果而在其他领域也有应用。例如，当前的研究正在为其用于治疗抑郁症提出案例，抑郁症越来越被视为一种炎症性疾病。在一项为期六周的重性抑郁障碍患者试验研究中，研究人员记录了服用绿藻以及标准抗抑郁疗法的患者显著的改善。这些患者的身体和认知抑郁症状以及焦虑症状得到了缓解。

Vitamin C:

You know vitamin C for its long-documented benefits in supporting immunity. Vitamin C, also called ascorbic acid, must be obtained from food because we cannot manufacture this vital nutrient ourselves. It’s necessary for the growth, development, and repair of all tissues — from blood vessels and cartilage to muscles, bones, teeth, and collagen. Vitamin C is also key to many bodily processes, including wound healing, the absorption of iron, and the proper functioning of the immune system.

In the treatment and management of gout, vitamin C is frequently hailed as a hero.! And for good reason: a number of studies show that vitamin C’s uric acid-lowering powers are enough to help protect even people susceptible to gout flares. In a study of almost 47,000 men over a twenty-year period published in the Archives of Internal Medicine, researchers from the University of British Columbia found that those taking a vitamin C supplement had a 44 percent reduced gout risk.” And in a rigorous meta-analysis conducted by scientists at Johns Hopkins University that synthesized the findings from randomized controlled trials published in more than two thousand publications, the results were unanimous: “Vitamin C supplementation significantly lowered SUA[serum uric acid].”

Why might vitamin C be effective? According to the Johns Hopkins study, vitamin C increases the urinary excretion of uric acid, may decrease uric acid reabsorption in the kidney, and, interestingly, because vitamin C is a powerful antioxidant, may reduce damage to tissues that would have led to more uric acid production. Part of the reason so many vitamin C-rich citrus fruits are beneficial for lowering uric acid surely involves this micronutrient’s role.
I recommend a dose of 500 mg per day.

维生素C因其在支持免疫系统方面的长期记录的益处而闻名。维生素C，也称为抗坏血酸，必须通过食物获取，因为我们无法自行合成这种重要的营养素。它对所有组织的生长、发展和修复都是必需的——从血管和软骨到肌肉、骨骼、牙齿和胶原蛋白。维生素C也是许多身体过程的关键，包括伤口愈合、铁的吸收，以及免疫系统的正常功能。

在痛风的治疗和管理中，维生素C经常被誉为英雄。这种评价有充分的理由：许多研究表明，维生素C降低尿酸的能力足以帮助甚至是易患痛风的人。在《内科学档案》杂志上发表的一项研究中，研究人员追踪了近47000名男性长达二十年的时间。这项研究来自不列颠哥伦比亚大学，研究人员发现那些服用维生素C补充剂的人痛风风险降低了44%。在约翰霍普金斯大学的科学家们进行的一项严谨的元分析中，他们综合了发表在2000多个出版物中的随机对照试验的发现，结果是一致的：“维生素C补充显著降低了血清尿酸(SUA)。”

维生素C为何有效？根据约翰霍普金斯大学的研究，维生素C能增加尿酸的尿液排泄量，可能降低肾脏对尿酸的重吸收，并且有趣的是，由于维生素C是一种强大的抗氧化剂，它可能减少导致尿酸产生增多的组织损伤。许多富含维生素C的柑橘类水果有助于降低尿酸的原因部分涉及到这种微量营养素的作用。

我建议每天服用500毫克的剂量。

供稿：加拿大通用营养集团

Contributed by General Nutrition Group