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From the Townsend Letter for Doctors & Patients
July 2003
Nutritional Influences on Illness
by Melvyn R. Werbach, MD
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Accelerating the Healing of Injuries with Nutrients
Recovery from injuries due to outdoor activities can often be hastened with the aid of nutritional supplements. Take vitamin C and the healing of fractures as an example. Compared to controls, rats with tibial fractures given a single high dose of vitamin C went through the stages of fracture healing faster.1 Moreover, a double-blind study reported in the Lancet randomly gave 123 adults who had sustained wrist fractures either 500 mg ascorbic acid or placebo daily for 50 days. While 22% of patients in the placebo group developed reflex sympathetic dystrophy (persistent pain along with skin and other changes near the site of the injury) over the next year, it developed in only 7% of the supplemented group.2

Several nutrients can aid in the recovery from traumatic brain injuries. The worse the brain damage, the lower the serum ionized magnesium,3 and animal studies have found supplemental magnesium to improve outcome.4 In one study, half of a group of 68 victims of severe closed head injuries randomly received supplemental zinc in addition to standard treatment. Twenty-eight days later after injury, 26% of the controls had died compared to only 12% of the supplemented patients, and a measure of coma was significantly better in the supplemented group.5

Citicoline, an essential intermediate in the synthesis of the structural phospholipids of cell membranes, has been extensively studied for its neuroprotective effects. In regard to head trauma, its administration accelerated the recovery from post-traumatic coma and the recuperation of walking ability, achieved a better final functional result and reduced hospital stays, in addition to improving the cognitive and memory disturbances.6 Also, animal work has shown that creatine supplementation prior to brain7 or spinal cord8 injury is strongly neuroprotective, suggesting that the supplement could help to minimize acute and delayed neurodegenerative processes.7

Because of their free-radical-quenching, iron-chelating, and anti-inflammatory properties, flavonoids such as quercetin may reduce the effects of brain and spinal cord injuries.9 Moreover, a series of controlled trials from the 1960s found that supplementation with citrus bioflavonoids to athletes prior to injury greatly reduced recovery time as well as protected against sprains.10 Sports may cause damage to the cartilage of the kneecap (chondropathia patellae), and glucosamine sulfate 500 mg 3 times daily appears to speed the healing process.11

Finally, many studies, most of them double-blind, have demonstrated the benefits of administering hydrolytic enzymes following injuries. For example, 43 injured athletes received either a mixture of proteolytic enzymes containing trypsin and chymotrypsin or placebo. Treated patients had statistically significant benefits including less bruising, a more rapid return of function in the injured area, and a more rapid return to play.12 In another study, when players sustained blunt wounds to the soft tissue with distortion of the ankle joint, ice and tape was applied and one group received hydrolytic enzymes while the other received placebo. Based on objective measurements of swelling and joint motility as well as on subjective measurements of pain during rest and with motion, recovery was better in the enzyme-treated group. The time during which the players were unable to work or train was found to be reduced by about 50%, a statistically significant difference, by enzyme therapy.13

Doctor Werbach cautions that the nutritional treatment of illness should be supervised by physicians or practitioners whose training prepares them to recognize serious illness and to integrate nutritional interventions safely into the treatment plan.

1. Yilmaz C et al. The contribution of vitamin C to healing of experimental fractures. Arch Orthop Trauma Surg 2001 Jul;121(7):426-8
2. Zollinger PE et al. Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial. Lancet 354:2025-8, 1999
3. Memon ZI et al. Predictive value of serum ionized but not total magnesium levels in head injuries. Scand J Clin Lab Invest 55(8):671-7, 1995
4. Vink R et al. Magnesium attenuates persistent functional deficits following diffuse traumatic brain injury in rats. Neurosci Lett 2003 Jan 9;336(1):41-4
5. Young B et al. Zinc supplementation is associated with improved neurologic recovery rate and visceral protein levels of patients with severe closed head injury. J Neurotrauma 13:25-34, 1996
6. Secades JJ, Frontera G. CDP-choline: pharmacological and clinical review. Methods Find Exp Clin Pharmacol 17 Suppl B:2-54, 1995
7. Sullivan PG et al. Dietary supplement creatine protects against traumatic brain injury. Ann Neurol 2000;48(5):723-9
8. Hausmann ON et al. Protective effects of oral creatine supplementation on spinal cord injury in rats. Spinal Cord 2002 Sep;40(9):449-56
9. Juurlink BH, Paterson PG. Review of oxidative stress in brain and spinal cord injury: suggestions for pharmacological and nutritional management strategies. J Spinal Cord Med 21(4):309-34, 1998
10. Broussard MU. Evaluation of citrus bioflavonoids in contact sports. Citrus in Medicine 2(2), October, 1963
11. Böhmer D et al. Treatment of chondropathia patellae in young athletes with glucosamine sulfate, in N Bachl et al, Eds. Current Topics in Sports Medicine. Proc World Congress of Sports Med, Vienna, 1982. Urban & Schwarzenberg, 1984
12. Rathgeber WF. The use of proteolytic enzymes (Chymoral) in sporting injuries. S Afr Med J 45(7):181-3, 1971
13. Baumuller M. [Therapy of ankle joint distortions with hydrolytic enzymes: results of double-blind clinical trials.] Allegemeinmedizin 19:178-82, 1990) (in German)

In his latest book, Dr. Werbach has assembled a unique library of case reports concerning nutritional and herbal treatments for 155 different illnesses. It is available in print or on diskette from Third Line Press Inc., 4751 Viviana Drive, Tarzana, California 91356 USA; 818-996-0076; Fax: 818-774-1575; internet:; e-mail:


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