NTP Dietary Supplementation & Herbal Support 3 — Questions and Answers
Question 1: Milk thistle's active constituent silymarin primarily supports liver health through which mechanism?
- Enhancing bile production by stimulating cholecystokinin release
- Antioxidant protection and stimulation of hepatocyte protein synthesis (Correct answer)
- Inhibiting cytochrome P450 enzymes to reduce drug metabolism
- Increasing UDP-glucuronosyltransferase to accelerate Phase II detox
Correct answer: Antioxidant protection and stimulation of hepatocyte protein synthesis
Silymarin acts as an antioxidant at the hepatocyte level, inhibits lipid peroxidation, and stimulates ribosomal protein synthesis to support liver cell regeneration.
Question 2: A client with low stomach acid is unlikely to absorb which mineral adequately even when supplementing correctly?
- Calcium carbonate (Correct answer)
- Magnesium glycinate
- Selenium selenomethionine
- Potassium citrate
Correct answer: Calcium carbonate
Calcium carbonate requires an acidic gastric environment for dissolution and absorption, making it a poor choice for clients with hypochlorhydria; calcium citrate does not.
Question 3: Which omega-3 fatty acid is the direct precursor to anti-inflammatory resolvins and protectins?
- Alpha-linolenic acid (ALA)
- Eicosapentaenoic acid (EPA)
- Docosahexaenoic acid (DHA) (Correct answer)
- Docosapentaenoic acid (DPA)
Correct answer: Docosahexaenoic acid (DHA)
DHA is the direct precursor to docosanoids including D-series resolvins and protectins, which actively resolve inflammation rather than merely suppressing it.
Question 4: Dong quai (Angelica sinensis) is traditionally used for menstrual irregularities. What is its key safety concern in NTP practice?
- Nephrotoxicity at doses above 500 mg/day
- Photosensitization and anticoagulant activity (Correct answer)
- Thyroid suppression in women with hypothyroidism
- Heavy metal contamination unique to this herb
Correct answer: Photosensitization and anticoagulant activity
Dong quai contains furanocoumarins that cause photosensitivity and has coumarin constituents with anticoagulant properties, making it a concern with blood thinners or prior to surgery.
Question 5: In the NTP model, which supplement is most appropriate to address a 'foundations first' approach to blood sugar dysregulation before adding targeted botanicals?
- Alpha-lipoic acid
- Chromium picolinate
- Zinc and magnesium repletion (Correct answer)
- Gymnema sylvestre extract
Correct answer: Zinc and magnesium repletion
The NTP foundations model prioritizes correcting mineral deficiencies; zinc and magnesium are critical cofactors for insulin signaling and glucose metabolism and should be addressed before targeted botanicals.
Question 6: Which form of B12 is preferred for clients with MTHFR polymorphisms or impaired methylation capacity?
- Cyanocobalamin
- Hydroxocobalamin
- Methylcobalamin (Correct answer)
- Adenosylcobalamin
Correct answer: Methylcobalamin
Methylcobalamin is the pre-methylated, active form of B12 that does not require methylation by the body, making it ideal for those with impaired methylation due to MTHFR variants.
Question 7: Licorice root (Glycyrrhiza glabra) is contraindicated in clients with hypertension primarily because of which constituent?
- Glycyrrhizin inhibiting cortisol breakdown and raising aldosterone-like effects (Correct answer)
- Flavonoids causing direct vasoconstriction in renal arteries
- Saponins stimulating the renin-angiotensin system
- Chalcones blocking potassium channels in vascular smooth muscle
Correct answer: Glycyrrhizin inhibiting cortisol breakdown and raising aldosterone-like effects
Glycyrrhizin inhibits 11-beta-hydroxysteroid dehydrogenase, allowing cortisol to act on mineralocorticoid receptors, causing sodium retention, potassium loss, and elevated blood pressure.
NTP Dietary Supplementation & Herbal Support 3
Milk thistle's active constituent silymarin primarily supports liver health through which mechanism?