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Dr. J. Frederic Templeman FREQUENTLY ASKED QUESTIONSMost Frequenty Asked Questions About Mangosteen JuiceHow many servings should be taken and when by patients with serious illnesses? Almost all serious illnesses for which the mangosteen can be consumed are 'chronic' (of long duration) conditions. The majority of these chronic conditions are also lifestyle diseases arising from life style habits such as physical inactivity, excessive or unwise dietary habits leading to obesity and smoking or excessive alcohol consumption. By definition, these disease states have evolved slowly and often silently over years. By the time physical symptoms or signs become evident, serious and often irreparable tissue and organ damage has occurred. Only rarely will immediate or short-term benefits be noticed in such chronic conditions when mangosteen is added as a dietary supplement. This being said, symptom relief can occur in only a matter of days when the major disease mechanism is inflammation. This would be the case in most types of arthritis, myalgia (muscle pains) or stomach complaints. One serving of mangosteen is considered to be one ounce (30ml). For prevention, one serving before a meal (to assure adequate absorption) is sufficient but when a medical problem is already present and the mangosteen is being taken for that reason, one or more servings before each meal is recommended. While there is no upper limit to the amount which can be consumed, normally three 1 -2 oz servings per day is sufficient when medical problems are present. In chronic illnesses, up to 2-3 months of treatment may be necessary before significant change is noticed. However, the majority of consumers will experience benefit in 2-3 weeks. Is mangosteen safe for pregnant or breastfeeding mothers? We have many consumers who have used the juice while pregnant or while breast-feeding with nothing but beneficial effects. I find it helpful to think about drinking the mangosteen juice in pregnancy and during lactation just as you would think about any other fruit juice because, when all is said and done, the preparation most of you will use contains nothing but fruit juices. While the effects of the mangosteen qualify it as a functional food meaning that it is consumed for more than simply its pleasant taste, it still is only a food without known toxic effects. When complications exist in pregnancy such as gestational diabetes or blood pressure problems, please discuss the use of the mangosteen with your physician, just as you would discuss other dietary changes, pointing out to him/her the reasons for which you wish to supplement with the juice. Normally a single one ounce (30 ml.) serving before a meal is recommended. ALTERNATIVE CANCER TREATMENT THIS INFORMATION COULD SAVE YOUR LIFE ... HOW OVER 2,000 PEOPLE HAVE SUCCESSFULLY USED THE ALTERNATIVE CANCER TREATMENTS! What benefits can patients with diabetes expect from using the mangosteen? Diabetes mellitus is a relatively common disease in North America and other developed areas of the world. While we currently classify the disease into only three categories (type one or insulin dependent, type II or adult onset and gestational diabetes), it is my belief that we will soon discover that several other clinically distinct forms of the disease exist, undefined, within the current classifications. Once that happens, we will be better able to predict the effects of the supplement in the existing category of type II diabetes which is currently too broad to be considered as a single disease entity. Type I diabetes, as an entity, is more homogeneous and patient experience, hence, more predictable. In type I diabetes all the beta cells (insulin-producing cells) in the pancreas have been destroyed and patients must take exogenous (from outside the body) insulin to survive. In these patients, blood sugar control is often very problematic with levels fluctuating widely. Low blood sugar is acutely dangerous and can cause loss of consciousness, for example. High blood sugar levels causer fewer acute problems in type I diabetes but they do contribute to such serious complications as: • Increased speed and amount of arteriosclerotic plaque accumulation in the arteries (increased risk of heart attacks, stroke and the amputation of lower limbs) • Blindness • Kidney Failure • Increased susceptibility to infection with the use of mangosteen as a supplement, we have noted the following beneficial effects in type I patients: • Improved glycemic (blood sugar) control as the amplitude of blood sugar fluctuations are significantly reduced. • Perceptible decreases in the frequency of infection. While the protection from diabetic complications cannot be easily seen in the short-term, there is good reason to believe, based on laboratory observations and accepted disease theory, that end-organ (heart, eyes, nerves and kidneys) damage can be substantially mitigated in all types of diabetes mellitus. Type II Diabetes is primarily linked to obesity. It also has a strong genetic component which increases the risk of contracting the disease. Type II diabetes (previously called adult-onset) is now commonly seen in obese children and teenagers. In fact, our North American epidemic of obesity has also caused type II diabetes to reach epidemic proportions. This ominous fact should concern us all as the complications of diabetes are deadly (ie. a fourfold increase in death from heart disease). In newly diagnosed (early-stage) diabetics, particularly the obese, the mangosteen appears to have a beneficial effect in reducing carbohydrate cravings and thereby facilitating weight loss which is critical in controlling the severity of the disease. Additionally, type II diabetics experience significant decreases in blood sugar levels. Sometimes these decreases come quickly after starting supplementation although the normal pattern is a gradual drop over days to weeks. Careful fingerprick monitoring at least twice daily is recommended until adjustments to diabetic medication levels can be made under a physician's guidance. However, because of the, as yet undefined, diversity of conditions grouped under the label 'type II diabetes", some patients cannot use several servings of the mangosteen daily when they first get started with the supplement. Multiple servings tend to raise blood sugar initially in this small number of patients who may have to begin with as little as 1/2 ounce or 15ml of the juice and then increase, in small increments, the amount consumed over several weeks. This rare phenomenon has been observed more often in people of Asian descent who are not obese. In long-term diabetics who may be using insulin injections, blood sugar levels are also significantly improved but their benefit tends to come on more slowly than in newly diagnosed patients. Insulin doses should be reduced, when appropriate, only under a physician's supervision! A word of caution ... diabetic patients too often take mangosteen's favorable effects on blood sugar to mean that they can relax their vigilance regarding dietary restrictions or just outright 'cheat' with forbidden calories. Such action will nullify the beneficial effects of this marvelous food supplement. What effect will the mangosteen have on Blood Pressure? This is not a simple question to answer because blood pressure is virtually never the same from minute to minute throughout the day. Not only is blood pressure affected by circadian rhythm (it is always higher during the early morning hours) but a multitude of factors both intrinsic to the body (ie. pressure sensors in artery walls) as well as extrinsic to it (ie. circumstances leading to emotional distress) affect blood pressure. Dietary content is also important (ie. salt intake). Blood pressure regulation problems can exist as solitary entities (either high or low pressure) but are more commonly seen as one element in a medical syndrome (ie. in the dysmetabolic syndrome: elevated blood pressure, elevated blood sugar, elevated cholesterol). The diagnosis of blood pressure problems, particularly hypertension or high blood pressure, generally require at least three BP readings spread out over time of which the average will be taken. Since, in developed societies like ours, blood pressure tends to rise with age, the ability to monitor your own BP with a reliable measuring device is a skill within the capability of most of us and one which we should acquire. BP, in adults, should be measured regularly, ideally by the same observer. In diagnosed disease, it should be monitored even more closely since single readings are often misleading but significant changes are important. So what about mangosteen and blood pressure? The research is not much help here as we have insufficient data to reach any justified conclusions. It is our intention to proceed with two studies which will address the question of food-drug interaction. These studies will bear indirectly upon the issue of hypertension in individuals taking medication for the problem. In clinical experience with my own patients, the mangosteen's effects were BP neutral or, in other words, no effects at all were noted. I have received information from consumers, however, who report what they interpret as movements in BP in both directions... down and up. The overwhelming majority of reported effects involved reductions in BP. However, all of these reports are difficult to verify for the reasons previously stated. In conclusion, I favor my own observations that the mangosteen supplement is blood pressure neutral. I continue however to monitor case reports of blood pressure changes and should any significant evidence come to light either through further research or from consumer experience, I will be reporting such information as soon as confidence levels are strong enough to justify any conclusions. Wisdom dictates that all adults should regularly have their blood pressure checked and, if a medical condition exists, this monitoring should include self-monitoring and be frequent. If consumers of the mangosteen follow their blood pressure in this manner, any definitive trend should become more readily apparent. Will mangosteen help with weight loss? Consumers who experience initial weight loss which doesn't usually persist unless behavior is changed to prevent regaining the weight. That being said, I have also received far more reports of very significant weight loss (up to 40 Ibs) that has maintained without special precautions besides using die supplement. There is no scientific data to support a mechanism which would allow us either to reliably predict weight loss or to explain those losses which do occur. I have not received reports of weight gain by consumers. Will the mangosteen's effect on the immune system make it unsafe to use for organ transplant patients or patients suffering from auto-immune disorders such as lupus or rheumatoid arthritis? First, we need to comment on organ recipients and their need to continue a lifelong regimen of immuno-suppressant drugs intended to thwart the body's rejection response directed at any tissue that is not perceived by the immune system as self. These immune suppressant drugs are double-edged swords because, while they protect the donated organs, they also lower the body's protection against infection and cancer, for example. By definition, such side-effects are serious considerations. The fear is that, if the immune system were stimulated by the mangosteen across the full range of its various functions, the immune rejection activity would also be raised and the transplanted organ's survival adversely affected. The same logic applies when auto-immune diseases (diseases resulting from the misdirected attacks of the immune system against the body's own tissue as if it were foreign tissue) are considered. If the fears were factual, it could be predicted that lupus, for example, could be worsened. Clinically, this doesn't seem to occur. In fact, quite the opposite effect is seen as disease symptoms in autoimmune conditions diminish with the use of the mangosteen. The laboratory studies on the xanthones in the mangosteen showed that white blood cell function was improved when mangosteen xanthones were incubated with the body's WBCs and bacteria. This specific WBC response should not, in my opinion, be used as the basis for concluding that mangosteen produces a wholesale stimulation of immune function. Evidence from favorable patient response in autoimmune disease, in fact, seems to indicate that immune system modulation rather that simply stimulation is occurring. In other words, when necessary, the immune system's activity can be either raised or lowered by the mangosteen's effects. No other conclusion appears to be justified by patient results to date. The immune system is arguably the most diverse and complex of the body systems. It would be a simplistic mistake, in my view, to treat it as uni-dimensional. We do not yet understand it well enough to even explain how viral infections, for example, can subvert the system's activity to the point where autoimmune disorders result from some viral infections but not from others. Caution, however, is merited in the case of transplant patients who seem to benefit enormously (ie. fatigue and vulnerability to infections) from a single one ounce (30ml.) serving a day. I do not recommend more. In autoimmune disorders, three servings of one ounce or more daily seem to produce the best results. Will the mangosteen help with neurodegenera-tive disorders such as Alzheimer/s, multiple sclerosis and Parkinson's disease? Laboratory evidence substantiates the potent anti-inflammatory effects of some of the mangosteen's xanthones. Clinical experience in patients with neurodegenerative disorders reinforces that laboratory evidence. Inflammation in the central nervous system is a basic disease process in all neurodegenerative disorders. Presumptively, the mangosteen's powerful anti-inflammatory properties account for the majority of the improvements we see in consumers. In fact, the effects of the mangosteen plus additional new developments with other experimental central nervous system anti-inflammatories, justifies our questioning of certain basic presumptions about the nature of the actual disease process which causes neurological dysfunction. We have believed, up until now, that when the particular CNS (central nervous system—the brain and the spinal cord) function disappeared (ie. loss of sight or bladder problems in MS) that the nerves regulating the function had been irreparably damaged (neuronal die back). This presumption may be inaccurate. Alzheimer's patient reports, for example, indicate that some functions which were lost can indeed be regained. The same is true in MS patients and to a lesser degree in Parkinson's patients. This wouldn't be possible if nerve function had permanently ceased when the functions were lost. It is exciting to realize that the results we see with the mangosteen could become the basis upon which a challenge to a long accepted medical disease model might be issued. Is the mangosteen safe to use with medications? There is precedent for food-drug interactions and this, I believe, is why this question is asked so often. Grapefruit juice, for instance, can affect the blood levels of some drugs thereby altering the drug's effects in the body. As well, many foods contain vitamin K (the antidote for coumadin, a form of rat poison used to impair blood-clotting in certain diseases) and can affect coumadin blood levels. The body correctly identifies drugs as toxins and the liver specifically works to eliminate them from the body. A system of liver enzymes (the P450 enzymes) is involved in this detoxification process. Foods can speed up or slow down this process when they also affect the same elements of the P450 enzyme system which are involved in detoxifying drugs. To date, we have not observed or had reported any drug-food interactions with the mangosteen. We do not, however, know precisely how the plant may affect the P450 enzyme system although we are currently investigating the means to discover how it may. When we know, it will be possible to predict any interaction, however, I consider it improbable that anything significant will be found. I base my conclusion on the lack of any reported and documented food-drug interaction despite hundreds of thousands of servings having been consumed by patients using almost all the drugs commonly prescribed. While this is not definitive proof that no food-drug interactions exist, it provides a sufficient level of confidence to offer initial reassurance, in my opinion. I urge anyone using coumadin, however, to use the juice at the dose they intend to consume daily and, after 3 days of use at this level, to go into the doctors office to have a fingerprick check of the coumadin's effect. Many consumers on coumadin use the supplement safely— in fact, I have never received a documented report of coumadin problems where the supplement appeared to be the culprit. Finally, some cancer chemotherapy drugs which depend, for their mode of action, on the production of free radicals to destroy tumors could theoretically, be adversely affected by the antioxidants in the mangosteen. However, because the side-effect benefits in chemotherapy patients using mangosteen are so beneficial, it would be unwise to simply trust the oncologist's (cancer doctor) memory on the mode of action of any individual chemotherapy drug. Either ask your pharmacist to look up the mode of action of your drug or look it up yourself in the Physicians Desk Reference on the internet. My experience is that the oncologist will say: " No, don't use it..." even when the mode of action of the chemotherapy drug has nothing to do with the production of free radicals. They just frankly don't know in most cases what the mode of action is without looking it up themselves. Additionally, many oncologists mistakenly believe that antioxidants stimulate cancer cell growth. This mistaken belief probably arises from the results of a single study that indicated that a single low dose of vitamin C stimulated the growth of both normal and cancerous cells. Several subsequent studies proved that high regular doses of antioxidants actually clearly suppressed cancerous cell growth. So stand your ground in the face of possible oncologist disapproval and please ask for the proof of what they are assuming you will accept at face value. How does the mangosteen reduce or eliminate pain? The mangosteen possesses potent anti-inflammatory qualities. Inflammation, whether acute or chronic, produces tissue swelling which can compress pain fibers in the areas where the swelling exists. Inflammation also causes the release of chemicals which interact with free nerve endings to produce pain discharges that travel to the spinal cord and from there to the brain. Reducing or eliminating inflammation through the anti-inflammatory effect of the juice prevents or removes both the pressure from swelling and the stimulus to produce pain mediators which stimulate nociceptors (pain nerves). Additionally, the COX 2 enzyme (see the August 2004 issue of the MCD newsletter) is constitutive (meaning present at all times) in the Central Nervous System (CNS = brain, spinal cord, and cerebrospinal fluid). This enzyme is linked to the I of pain signals up the spinal cord to the brain. Presumptively mangosteen inhibits the pain-related action of the COX 2 in the CNS and blocks pain impulse generation. This account for the mangosteen's ability to blunt or eliminate pain such as sciatica or peripheral neuropathy. This type of pain cannot be effectively controlled in the majority of patients by die use of drugs. Chronic pain requires at least three servings of juice per day, one before each meal. The servings should be from one to four ounces each. Results can take from a few days to a couple of months to appear. Please persist with regular use.
ALTERNATIVE CANCER TREATMENT THIS INFORMATION COULD SAVE YOUR LIFE ... HOW OVER 2,000 PEOPLE HAVE SUCCESSFULLY USED THE ALTERNATIVE CANCER TREATMENTS! |
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