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Ask Dr. Mike: B12 & Folate Levels, Safety of Unpasteurized Milk, Nicatinomide vs. NAD+

Here you'll find the answers to a wealth of health and wellness questions posed by Healthy Talk fans.

Listen in because what you know helps ensure healthy choices you can live with. Today on Healthy Talk, you wanted to know:

I've been taking NAD+ for longevity, however I recently began taking Nicotinamide to decrease my chances of getting skin cancer. Do I need to take the NAD+ or will the Nicatinomide cover both health concerns?

In a short answer, you should still be taking both. The Nicatinomide is a precursor to NAD+. Nicatinomide will have have to go through a conversion in order to become NAD+ and will boost these levels. Nicatinomide also has other benefits besides protecting against skin cancer.

I did a Life Extension nutrient panel blood test. My vitamin B12 and folate levels are very high. Is that going to be a problem for me?

No, there is no harm in having high levels of B12 and foliate. The reason is because these nutrients are very transient and fluctuate.

I have been taking magnesium with calcium. I wonder if magnesium citrate is better? How much do I need to take per day? I also take vitamin K2; is there also a ratio to calcium for this?

Magnesium citrate does absorb better than any other kind of magnesium. The problem is, anytime you have citrate added to the mineral, it becomes a huge molecule that you can't (and shouldn't) mix with any other mineral. Dr. Mike doesn't suggest switching to magnesium citrate and to just continue to do what you're doing.

As far as the ratio, most people do a 1:2 ratio of calcium, but there's not ratio of vitamin K2 and calcium.

What's your opinion on drinking unpasteurized milk?

Dr. Mike thinks that if it's stored properly and consumed within a couple of days of milking the cow, it's fine.

If you have a health question or concern, Dr. Mike encourages you to write him at This email address is being protected from spambots. You need JavaScript enabled to view it. or call in, toll-free, to the LIVE radio show (1.844.305.7800) so he can provide you with support and helpful advice.

RadioMD Presents:Healthy Talk | Original Air Date: June 17, 2015
Host: Michael Smith, MD

You're listening to RadioMD. It's time to ask Dr. Mike on Healthy Talk. Call or email to ask your questions now. Email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 877-711-5211. The lines are open.

DR MIKE: The next listener question is asking, "Can someone get hooked on Adderall?" Have you heard of Adderall before? It's a stimulatory type drug that's used pretty commonly now to treat ADHD or Attention Deficit Disorder. There are some concerns about it becoming habit forming, and that's what people mean by getting hooked on it. Is it habit forming?

Well, first of all, let's just talk about what is Adderall. Adderall is a combination of amphetamine and dextroamphetamine, so it is a combination of two speed-based chemicals. Right there, I can tell you the answer to this is very simple. I don't care what the manufacturer says about its habit-forming potential. It's speed, and it's two forms of speed. Yes, you can get hooked on it. Amphetamine and dextroamphetamine are central nervous system stimulants that affect chemicals in the brain, nerves, it contributes to – it has an effect – these speed-based compounds have an effect on hyperactivity and impulse control and we're not really sure how these drugs work ultimately. So, here you have somebody with an attention problem, even a hyperactivity attention problem, and we give them speed amphetamine? It does seem to help bring people who really need it into focus.

This is what is really interesting about it: talk to people who are addicted to crystal meth--crystal methamphetamine on the street, speed on the street; they'll tell you – talk to people in treatment programs – that one of the best things about it is that for a couple days (because it will keep you up for a couple days), they're focused; they're able to actually do some things for a while: organize, get some cleaning done. It actually gives you some focus on things. Of course, as you continue to abuse it, that becomes less and less. There's this interesting side effect to speed as it does help organize thought a little bit.

Adderall is used to treat narcolepsy (which is where you fall asleep) and Attention Deficit Hyperactivity Disorder. Bottom line here: amphetamine and dextroamphetamine absolutely have the potential for being habit forming. Then, you combine them in one drug called Adderall. Yes. This is speed.

So, I don't want to just leave it there, though. The listener that asked this question, I don't want to just leave it there. So, what are some of the alternatives?

Before I go into these alternatives, let me go back and say something, though, about Adderall. It does have some benefit. There are some people with extreme cases, in my opinion, with ADD or ADHD that do benefit from it. Please understand that if you're someone who's taking Adderall and it's the only thing that's worked and you actually are doing a little bit better, that's fine. There are situations where these speed-based, amphetamine-based drugs do work and they do need to be used and they can make a major impact on people's lives.

I have concern about giving these kinds of drugs to kids. We have no idea what's happening with these speed-based drugs in a developing brain. We just don't. There is a situation where these drugs are important and can help you but what are some natural alternatives to Adderall that may not be so habit forming or not even habit forming at all?

The first thing really is about diet. I think if you have ADHD or ADD, whether adult or kid, diet really is key—very, very important. No artificial anything in your diet. Nothing. No artificial colors, especially. It's the artificial colors that really are starting to pan out in the research to have a link to attention deficit. Things like Quinoline Yellow. Have you ever heard of that? It's an actual color we use in food. The number is E104. That's my opinion--that research shows pretty clearly that that has a link to ADHD. Another one is called Sunset Yellow. E110. Allura Red. E125. You've got to avoid those things. No artificial colors. No artificial sweeteners. You've got to be eating fresh, organic food. That's number one.

Number two. You know when it comes to supplements, it's a little tougher. There's not a lot of research using supplements in ADHD. There are some out there. We've written about it at Life Extension. We even have an ADHD protocol. So, fish oil--the Omega 3 oils--2-4 grams a day. One called Phosphatidylserine; PS is how it is abbreviated. PS caps. About 100 milligrams a day. Anything that's choline based: phosphatidylcholine products. Choline is important to the production of acetylcholine, which could play a role here. Carnitine might play a role in ADHD. Magnesium. There's some interesting research linking a lot of these types of attention problems to gut issues, digestive issues, so maybe some probiotics thrown in the mix. Ginseng has shown some benefit in ADHD. And, of course, everything I just said – fish oil, PS caps, choline, carnitine, magnesium, probiotics, ginseng – obviously, these are not habit forming. They might be some alternatives for you. Give them a try. If they don't work, trust me, your doctor will always be fine writing a prescription for Adderall. Again, there are some people out there – I may even have some listeners – who take Adderall and it's the best thing they've ever done. I get that. But you're a one percenter if that's the case. Most people don't get that kind of benefit from Adderall. It is habit forming and I think there's other things that we can do.

Alright, great question.

Question number two. "What's better to take for aches and pains: Tylenol or Advil?" Tylenol is acetaminophen. Advil is ibuprofen. So, it's the nonsteroidal anti-inflammatory drug ibuprofen versus the acetaminophen Tylenol. Most people probably are familiar with both of these. It's hard to answer this question because it's very variable. The effect of nonsteroidal drugs like ibuprofen and acetaminophen in people is all over the place.

I can give you my own personal experience. I mean, I don't use these drugs a lot. I do a lot of good supplements. I like tart cherry for aches and pains; that always does well for me. But, obviously, I've been around for a while; I've used both Tylenol and ibuprofen. From my own personal experience, Tylenol never does anything for me; even some higher doses of Tylenol. Fevers, aches, I don't ever get any effect out of Tylenol. Ibuprofen, on the other hand, works really well. There you go. So, I think it's just kind of a trial-error approach.

I think they key thing to remember though with both of these drugs is dose. These types of aches and pain drugs have very narrow dose ranges, and it's important not to go over those because they can be dangerous. If you do too much Tylenol, liver damage. Too much ibuprofen, kidney damage and bleeding in your gut can happen. Tylenol dose: the max dose is 4000 milligrams a day. That's the max 24-hour dose. 4000 milligrams. You cannot go over that. The problem with Tylenol is, it's mixed with all kinds of other drugs now. You might be doing a Tylenol product plus another pain reliever that has some Tylenol in it and you don't even know it. So, you've got to look at labels. Do not do more than 4000 milligrams of Tylenol a day. For Advil or ibuprofen, the max in a 24-hour period is 1600 milligrams. If you go over that, you could have kidney issues, ulcer issues, bleeding issues. So, you've got to be careful with that.

So it's trial and error. For me, ibuprofen works better. Watch those max doses. 4000 for Tylenol. 1600 in a day for ibuprofen.

This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.