TCM Clinic As

25/03/2025

Alpha-lipoic acid contains an asymmetric carbon atom and exists as two optical isomers:
• R-Lipoic Acid (R-ALA): Naturally occurring, biologically active.
• S-Lipoic Acid (S-ALA): A synthetic, non-natural byproduct.

Commercially available alpha-lipoic acid supplements are typically a 50/50 mixture of R-ALA and S-ALA.
S-ALA: Low absorption efficiency and may interfere with the function of R-ALA. Prone to polymerization in gastric acid, with poor stability, resulting in low bioavailability.

Bio-Enhanced® Na-RALA
• Introduced: 2006.
• Composition: Made solely from natural R-lipoic acid sodium salt.
• Advantages:
1. High Absorption:Pharmacokinetic data show its absorption rate is 40 times higher than that of regular R-lipoic acid.

2. Strong Stability:Manufactured using a unique process, remaining stable even at temperatures exceeding 45°C.

3. Optimized for Gastrointestinal Absorption: Reaches peak plasma concentration 10-20 minutes after oral administration.

Dosage：300-1800 mg/day.

24/03/2025

In Evidence-Based Medicine (EBM), the hierarchy of evidence is ranked based on the scientific rigor and reliability of study designs. Below is a common ranking of evidence levels, from highest to lowest:
1 Level Ia: Systematic Review or Meta-Analysis based on multiple Randomized Controlled Trials (RCTs).
◦ This is the highest level of evidence because it synthesizes results from multiple high-quality studies, reducing bias from individual studies.

2 Level Ib: A single high-quality Randomized Controlled Trial (RCT).
◦ RCTs, with their randomization and control design, effectively minimize the impact of confounding factors.

3 Level IIa: Controlled Study without Randomization.
◦ For example, a prospective cohort study that includes a control group but lacks randomization.

4 Level IIb: Other types of high-quality observational studies.
◦ Such as Case-Control Studies or Prospective Cohort Studies.

5 Level III: Descriptive studies or lower-quality observational studies.
◦ For instance, Retrospective Studies or Case Series.

6 Level IV: Expert Opinion, clinical experience, or basic research.
◦ This is the lowest level of evidence, primarily based on personal experience or laboratory studies, lacking systematic validation.

Whenever I try to explain the principles of a disease and the patient doesn’t fully understand, they often say, “I trust you!”

I always respond, “You shouldn’t blindly trust anyone—trust logic and objective evidence instead.”

Because the “expert opinion” you firmly believe in (including mine) is merely the lowest level of evidence.

23/03/2025

Lipoic acid is a sulfur-containing fatty acid present in every cell of the human body. It is soluble in both fat and water and is known as the “universal antioxidant.”

Physiological Functions:
• Supports mitochondrial oxidation, converting glucose into energy.
• Regenerates other antioxidants (e.g., vitamins C and E), enhancing the oxidative defense system.
• Penetrates all parts of nerve cells, protecting nerves from damage.
Evidence-Based Research (High-Level Evidence):

Diabetic Neuropathy:
• Intravenous Lipoic Acid: ALADIN Study (1995, RCT, Lancet): 328 patients with diabetic neuropathy received 600-1200 mg/day intravenously for 3 weeks. Symptom scores (TSS) decreased by approximately 50% (p

22/03/2025

Anti-aging: It is not only about prolonging life, but more importantly, it is about improving the quality of life.

21/03/2025

Overview of Coenzyme Q10 (CoQ10)
Coenzyme Q10 is widely present in animals, plants, and microorganisms in nature. It is a critical substance for energy production in human cells and acts as a fat-soluble antioxidant, capable of activating vitamins E and C. Found in every cell of the human body, CoQ10 is essential for maintaining health. A deficiency in CoQ10 may lead to reduced physical stamina and endurance.

CoQ10 exists in two forms:
• Ubiquinone: The oxidized form, which must be converted into ubiquinol in the body, requiring additional energy.
• Ubiquinol: The reduced form, accounting for approximately 95% of CoQ10 in the blood, exerting antioxidant effects by neutralizing free radicals and preventing oxidative damage.

Introduction to Kaneka Q10®
Brand Origin: Kaneka Q10® is a CoQ10 raw material brand produced by Kaneka Corporation of Japan, established in 1949.

Production Process: In 1977, Kaneka pioneered the world’s first yeast fermentation method to produce CoQ10, resulting in a structure identical to the CoQ10 naturally produced by the human body.

Certifications and Applications: Approved by the U.S. FDA and compliant with GRAS (Generally Recognized as Safe) standards, it is the preferred raw material for NIH-funded clinical trials and most global studies, regarded as the gold standard in the CoQ10 industry.

In 2007, Kaneka introduced Kaneka Ubiquinol™, the world’s only commercially available ubiquinol raw material, now used in over 200 brands.

Advantages of Kaneka Q10®
• Clinical Research Support: Over 2,000 clinical studies worldwide have utilized Kaneka Q10, covering areas such as heart health, fatigue, and statin-related side effects.
• Natural Yeast Fermentation: Free of synthetic impurities, with a structure identical to the body’s natural CoQ10.
• Safety: Non-GMO, allergen-free, with safety validated over more than 40 years.
Highlights of Clinical Research
1. Heart Health
• Heart Failure: 300 mg daily (100 mg × 3 times) for 2 years significantly reduced the risk of cardiovascular adverse events by nearly 50% and improved quality of life (Mortensen, 2014).
• Hypertension: Reduced systolic blood pressure by 17 mmHg and diastolic blood pressure by 10 mmHg, with no significant side effects (Rosenfeldt, 2007).

2. Statin-Related Side Effects
• Muscle Pain: 100 mg daily (50 mg × 2 times) reduced muscle pain by 33.1% within 30 days and improved daily activities by 40.3% (Skarlovnik, 2014).
• Meta-Analysis: CoQ10 supplementation alleviates statin-related muscle symptoms (Qu, 2018).

3. Fatigue and Muscle Pain
• Fibromyalgia: 300 mg daily (100 mg × 3 times) for 40 days improved pain, depression, and anxiety (Alcocer-Gómez, 2017).
• Chronic Fatigue: Effectively reduced fatigue symptoms (Tsai, 2022).

4. Mental Health and Neuroprotection
• Migraine: 300 mg daily reduced attack frequency (Sandor, 2005).
• Tinnitus: Effective in patients with low CoQ10 levels (Khan, 2007).
• Neuroprotection: Increased mitochondrial concentration in the brain, protecting brain cells (Matthews, 1998).

5. Fertility
• Male: Improved s***m density, motility, and pregnancy rates (Safarinejad, 2009).
• Female: Enhanced oocyte quality and pregnancy rates, particularly in older women (Ben Meir, 2015).

Dosage Recommendations
• Clinical Research Dosage: 200–300 mg/day.
• Maximum Safe Dosage: 1,200 mg/day.

References：
1. LAMBRECHTS P et al. COENZYME Q10 AND UBIQUINOL AS ADJUNCTIVE THERAPY FOR HEART FAILURE. Agro Food Industry Hi Tech. 2012 Mar;24(2):60-62
2. Mortensen SA et al. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014 Dec;2(6):641-9.
3. Rosenfeldt FL et al. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum Hypertens. 2007 Apr;21(4):297-306.
4. Skarlovnik A et al. Coenzyme Q10 supplementation decreases statin-related mild-to-moderate muscle symptoms: a randomized clinical study. Med Sci Monit. 2014 Nov 6;20:2183-8.
5. Qu H et al. The effect of statin treatment on circulating coenzyme Q10 concentrations: an updated meta-analysis of randomized controlled trials. Eur J Med Res. 2018 Nov 10;23(1):57.
6. Qu H et al. Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2018 Oct 2;7(19):e009835.
7. Cordero MD et al. Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement. PLoS One. 2012;7(4):e35677.
8. Castro-Marrero J et al. Does oral coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in chronic fatigue syndrome? Antioxid Redox Signal. 2015 Mar 10;22(8):679-85.
9. Alcocer-Gómez E et al. Effect of Coenzyme Q10 on Psychopathological Symptoms in Fibromyalgia Patients. CNS Neurosci Ther. 2017 Feb;23(2):188-189.
10. Tsai IC et al. Effectiveness of Coenzyme Q10 Supplementation for Reducing Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Pharmacol. 2022 Aug 24;13:883251.
11. Kawaharada Y et al. Usefulness of regular intake of the reduced form of CoQ10 for stress management for workers. Japanese Pharmacology and Therapeutics 2013 Jan; 41(12):1229-1237
12. Söderberg M et al. Lipid Compositions of Different Regions of the Human Brain During Aging. Journal of Neurochemistry 1990 Feb.

13/03/2025

12/03/2025

For most people, even if you know the benefits of nutritional supplements, the reason they have little effect after taking them is: the product quality is poor. Not only does it fail to work, but it may even waste more of the body’s energy to process it.

As shown in the figure: FenuMat™ technology from Akay Bioactives, an Indian company. The vitamin C in this technology is encapsulated in lipid spheres extracted from sunflowers, which are then further enveloped in a hydrogel made of fenugreek fiber. Experiments have proven that its bioavailability is 7.17 times higher than that of ordinary vitamin C.

11/03/2025

I. Overview of Vitamin C
Properties: A water-soluble antioxidant that humans must obtain from food. Functions: Promotes the synthesis of collagen, carnitine, and neurotransmitters, enhances iron absorption, and boosts antioxidant capacity.

II. Evidence-Based Benefits
Common Cold:
• Evidence: Multiple trials show that 1000 mg/day can shorten the duration of colds or prevent them (especially in individuals with weakened immunity) [Cochrane Review, 2013].

Preeclampsia Prevention:
• Evidence: Double-blind studies indicate that 1000 mg of vitamin C combined with 400 IU of vitamin E reduces the risk in pregnant women [Roberts et al., NEJM, 2010].

Urinary Tract Infection:
• Evidence: 4000 mg/day increases urine acidity, inhibiting E. coli; 100-200 mg/day in pregnant women reduces infection by 56% [Ochoa-Brust et al., 2007].

Iron Absorption:
• Evidence: 200 mg of vitamin C significantly improves iron absorption rates [Hallberg et al., 1989].

Type 2 Diabetes:
• Evidence: 500 mg twice daily reduces urinary protein levels; combined with vitamin E, it lowers glycated hemoglobin [Afkhami-Ardekani et al., 2007].

Bruising:
• Evidence: Double-blind studies confirm a reduction in bruising [Schultz et al., 1996].

Gout:
• Evidence: Lowers uric acid levels and prevents attacks [Huang et al., Arthritis Rheum, 2005].

Lead Poisoning:
• Evidence: Supplementation with vitamin C reduces blood lead levels [Simon & Hudes, JAMA, 1999].

III. Dosage
General: 1000 mg/day
Specific Conditions: Follow medical advice

IV. Food Sources
Common: Broccoli, red bell peppers, citrus fruits, strawberries. Naturally High Content: Rose hips, camu camu, acerola cherries (tens of times higher than citrus fruits).

V. Deficiency Symptoms
Symptoms: Bleeding gums, fatigue, bruising. At-Risk Groups: Smokers, alcohol consumers, pregnant women.

VI. Precautions
Contraindications: Avoid in cases of hemochromatosis, kidney stones, or during chemotherapy. Side Effects: High doses may cause diarrhea or increased urinary oxalate. Drug Interactions: Aspirin and oral contraceptives may lower vitamin C levels.

VII. Types
Standard Form: Fast absorption, high acidity. Sustained-Release Form: Low acidity, suitable for those with sensitive stomachs.
Esterified Form: Longer retention time. Liposomal Form: High absorption rate, suitable for chronic conditions.

08/03/2025

Berberine Overview
Properties: Yellow needle-like crystals, a bitter quaternary alkaloid, traditionally extracted from plants such as Coptis (huanglian) and European barberry (Berberis vulgaris), now synthetically produced as berberine hydrochloride or sulfate.

Alias: “Plant antibiotic,” due to its broad-spectrum antibacterial effects.

Pharmacokinetics: Primarily remains in the gut after oral administration, with limited systemic absorption and fewer side effects.

Mechanisms and Evidence-Based Findings：
1. Broad-Spectrum Antibacterial
•Mechanism: Inhibits bacterial DNA replication, RNA transcription, and protein synthesis, effective against both Gram-positive and Gram-negative bacteria.
•Evidence:
◦A systematic review (2021, PMC) demonstrates significant inhibition of Shigella dysenteriae, Mycobacterium tuberculosis, and Staphylococcus aureus, with the strongest effect against Shigella, commonly used for acute gastroenteritis and diarrhea.
◦An RCT (1987, J Infect Dis) confirms berberine sulfate’s efficacy in treating diarrhea caused by enterotoxigenic Escherichia coli and Vibrio cholerae.
•Limitation: High risk of resistance, particularly with Shigella and S. aureus.

2. Antifungal and Antiviral
•Mechanism: Disrupts fungal cell membrane function and inhibits viral replication.
•Evidence:
◦Cutting-edge research (2024, Frontiers) suggests moderate inhibition of influenza viruses, Entamoeba histolytica, and certain skin fungi, though clinical data remain limited.
◦More high-quality RCTs are needed for validation.

3. Lipid-Lowering
•Mechanism: Upregulates hepatic LDL receptor expression, inhibits PCSK9, and reduces cholesterol synthesis.
•Evidence:
◦A meta-analysis (2021, Oxid Med Cell Longev) of 27 RCTs shows that 1000 mg/day of berberine for 3 months reduces total cholesterol (TC) by 25-35%, significantly lowers low-density lipoprotein (LDL-C), and slightly increases high-density lipoprotein (HDL-C).
◦An RCT (2023, Eur Rev Med Pharmacol Sci) validates that berberine phytosome improves lipid profiles in overweight individuals with good safety.
•Consistency: High-level evidence supports superiority over placebo, though slightly less effective than statins.

4. Anti-Heart Failure and Anti-Arrhythmia
•Mechanism: Anti-inflammatory and antioxidant effects, regulates ion channels, and improves myocardial metabolism.
•Evidence:
◦An RCT (2022, Circ Arrhythm Electrophysiol) shows berberine prevents postoperative atrial fibrillation and reduces inflammatory markers (e.g., IL-6).
◦A review (2024, Frontiers) suggests potential benefits for heart failure, but larger trials are needed.

5. Diabetes and Obesity
•Mechanism: Activates the AMPK pathway, enhances insulin sensitivity, inhibits hepatic gluconeogenesis, and promotes fat breakdown.
•Evidence:
◦A meta-analysis (2021, PMC) of 46 RCTs shows significant improvement in insulin resistance (HOMA-IR reduced by 1.25, 95% CI: 0.25-2.24) and fasting plasma glucose (FPG) by ~0.65 mmol/L.
◦An RCT (2021, Nat Commun) testing berberine ursodeoxycholate reports a 4.8% reduction in liver fat content and improved HbA1c after 18 weeks.
◦A systematic review (2020, Biomed Pharmacother) notes greater weight loss effects in individuals with metabolic disorders, with insufficient data in healthy populations.

Dosage and Administration
•Recommended Dosage:
◦Lipid-lowering/Blood sugar control: 500-1500 mg/day, taken in 2-3 divided doses, with effects optimal after 3+ months (meta-analysis, 2021).
◦Antibacterial: 300-500 mg/day, short-term use (7-14 days).
•Note: Adjust dosage based on product instructions and medical advice.

Drug Interactions
•Hypoglycemia: May enhance effects of antidiabetic drugs (e.g., metformin), requiring monitoring for hypoglycemia risk (RCT, 2008, J Clin Endocrinol Metab).
•Hypotension: May potentiate antihypertensive drugs, caution advised in hypertensive patients (2024, Frontiers).
•Drug Metabolism: Inhibits CYP3A4, potentially affecting levels of drugs like cyclosporine A (2005, Eur J Clin Pharmacol).
•Contraindications: Prohibited in jaundice or severe liver disease due to potential exacerbation of liver damage.

Safety Considerations
•Safety: Well-tolerated at recommended doses (meta-analysis, 2019, Am J Chin Med).
•Side Effects: Gastrointestinal discomfort (nausea, constipation) in

01/03/2025

27/02/2025

Fat loss and weight loss are two different concepts.
�Weight loss mainly refers to an overall decrease in body weight, meaning the number on the scale gets smaller. This can be achieved by losing fat, muscle, water, or even bone mass. For example, dieting, dehydration, or excessive exercise might lead to weight loss, but it’s not necessarily healthy.
�Fat loss, on the other hand, is about reducing the body’s fat content while trying to preserve muscle and essential weight components. The goal is to make the body firmer and more defined, rather than just chasing a lower number on the scale. This usually involves a balanced diet, such as high protein and low carbs, combined with exercise.
�In summary:�Weight loss is a change in “quantity”—a drop in overall weight.�Fat loss is an improvement in “quality”—a smaller waistline with increased muscle content.

26/02/2025

Hyabest® Hyaluronic Acid

Produced by Japan’s Kewpie Group using patented biofermentation technology, Hyabest® is vegan and non-GMO. It features medium to low molecular weight, high purity, easy absorption, and safety certified by U.S. and Canadian standards. After oral intake, it is broken down in the large intestine by gut bacteria into oligo-hyaluronic acid (Oligo HA), which is then transferred via the bloodstream to the skin, activating collagen metabolism and fibroblasts to promote HA synthesis.

Clinical Studies:
1 Improvement of Dry Skin:�Study 1: 61 participants, 120 mg/day (MW 300K/800K), after 6 weeks, skin moisture significantly increased, with the 300K group showing more sustained effects.
2 Wrinkle Reduction:�Study 2: 60 participants, 120 mg/day (MW 200K/300K), after 12 weeks, wrinkle volume decreased; the 300K group showed results by week 8, with improved skin gloss and softness.
3 Skin Enhancement:�Study 3: 40 participants, 120 mg/day, after 12 weeks, notable improvements in wrinkles, hydration, and elasticity were observed.
4 Absorption Mechanism:�Study 4: Rat experiments showed HA is not degraded by gastric or intestinal fluids but is broken down into oligosaccharides in the large intestine, absorbed, and distributed to the skin.
5 Joint Function:�Hyabest®(S) improves knee joint function.
6 Anti-Inflammatory:�Hyabest®(A) (MW