Poor Senses and Nutrient Deficiencies

Poor Senses and Nutrient Deficiencies

We are sentient beings and our senses are hugely involved in how we perceive and understand the environment around us; Our senses are integral to how we experience the world as human beings. We use our senses in a multitude of ways; essentially our senses help us to ‘make sense of’ and interpret each other and the world we inhabit.

Although we have the capability to sense in other ways (for example it is possible to sense danger; and we all have, to varying degrees, a sense of balance) there are the basic (though hugely complex) five well known or ‘traditional’ senses that we use countless times daily to navigate our way through life. These are taste, sight, touch, smell, and hearing.

Although our senses are separate, very rarely do they work alone; they are fundamentally linked. We often use a combination of the senses; often all five senses will be used at the same time; which all send individual signals to our brain, which are interpreted and ultimately manifest as how we ‘feel’ or ‘react’ or take action’ about something. Our amazing five senses communicate with our brain by sending messages via receptor cells, which is all made possible via our very clever nervous system. The nervous system has a particular organ or complex sensory structure, committed to each of the five senses.

Taste

The tongue, one of the strongest muscles in the human body, has thousands of taste receptors, called papillae, that send messages via the nervous system to the brain. These taste receptors are sensitive to bitter, sweet, salty and sour tastes. These receptor cells are commonly known as taste buds and help us to distinguish between the four different types of taste. On our tongue, the taste receptors at the very back are sensitive to bitter tastes; sour and salt are detected by taste buds in the middle of the tongue, and sweet tastes are detected on the tip of the tongue.1

Our sense of taste is a vital tool; no more so than in our hunter-gatherer days when we relied on our sense of taste when foraging for food. Poisonous, inedible food is more often than not accompanied by a sour or bitter taste so our taste buds have helped us to navigate our way through food sources in order to thrive and survive.2 Our taste buds help us to decide if we like a particular food or not. They also help us to decide if food is still fresh and fit to eat; if our sense of smell has not already made this decision of course!

Our sense of taste is closely linked to and in many ways inseparable to our sense of smell. When the taste of food is combined with the smell of food we then detect the flavour of that food. The flavour is produced through a combination of both senses. This is wonderfully highlighted when we are suffering from a common cold; with a stuffy, blocked up nose our sense of smell is impaired and when eating, the flavour, and therefore our enjoyment, of food is significantly altered too due to our impaired sense of smell. Our sense of taste alone is not sufficient to produce the ‘usual’ or ‘recognised’ taste/flavour of the food being consumed. In fact, over 75% of what we experience as the ‘taste’ of food is actually produced from our sense of smell, not our sense of taste.3 Taste and smell are both senses which are crucial to stimulating a desire to eat food, so are essentially precursors to the body’s nutritional and energy needs being met via diet.

As with all the senses, our sense of taste is closely linked to our emotions. A particular taste can make us feel nauseous. In the same way a particular taste can make us feel good and makes all the difference to our enjoyment of a meal. Our sense of taste can be very individual and is closely linked to texture and temperature which are also detected on the tongue.4

Smell


Our sense of smell occurs in the nose. There are around 20 million special receptor cells called neurons located inside our nose in the area that detects smell. And within this vast number of neurons there are about 450 different types of nasal receptor cells each detecting a different type of molecule and working together to form our overall sense of smell. When we detect a smell, what we are actually smelling is molecules.

Smell, as with our other senses, is linked firmly to emotion and is a strong emotional trigger. For example, a newborn baby identifies his/her mother largely by using the sense of smell. A mother’s smell is immediately soothing to a baby. Smells are strongly linked to ‘associations’ and smell is one of the most evocative of all the senses when it comes to memory. Smell is also strongly linked to sexual attraction. Interestingly, some specific neurones in the nose function solely to detect pheromones. The inability to smell is called anosmia.

Sight

Our sense of sight is, of course, located in the eyes and is crucial to helping us navigate our way physically. We also use our sense of sight in a whole multitude of other ways, to help us interpret and make sense of the world and each other. For instance, our sense of sight is strongly linked to our emotions and connected, for example, to feelings of attraction we experience for others. Likewise, we can be repulsed, angered, or saddened by something we see; such as a distressing scene on the TV. Our sense of sight is used when we communicate with each other; along with our sense of hearing, it helps us to fully interpret and understand conversations.

The eyeball is made up of the cornea which functions like a lense, located at the front of the eye, primarily working to focus light and images onto the retina located at the back of the eye. The retina has two types of receptor cells, called rods and cones, which are sensitive to light. The cones receive colour and the rods enable us to focus at night and to use our peripheral vision. Signals are sent from these receptor cells via the optic nerve to the visual cortex, the part of the brain that controls our sense of sight. The brain receives these images upside down so it turns the images around so what we see is the right way up. All very amazing when you consider how quickly this process must take place. Our brain also interprets the signals sent via the rods and cones to enable us to see the world around us in 3D; which essentially means we can sense depth.5

Touch

Our sense of touch is something that takes place across the entire body and is made possible by receptor cells or nerve endings on our skin and other parts of the human body. Our skin contains the most nerve endings and is the largest organ in our body. Some parts of the skin have more receptor cells than others, such as our fingertips, so are more sensitive to touch. These nerve endings send signals to the brain and are able to perceive the sensation of heat, cold, pain and contact. These signals are interpreted by the brain which then dictates our ‘reaction’ to the sensation of touch. For example, if something we touch is too hot, such as a saucepan handle left on the hob, our sense of touch, via nerve endings in our fingertips and hands, sends this information to the brain which then results in the action of stopping contact with the hot object; all in a matter of seconds. So our sense of touch can help to keep us safe as well as helping us to make sense of our world and how we feel about our surroundings. A soft blanket can be comforting to touch, for example, helping us to experience feelings of cosiness; and a gentle touch or embrace can bring about feelings of well-being, actually causing the production of Oxytocin, a neurochemical that can help us build trusting relationships and feel a sense of emotional warmth.6

Hearing

Our sense of hearing occurs in our ears. Hearing is a complex process that happens when different parts of the ear work together to convert sound waves into information that the brain understands and then interprets as different sounds. Our ears have approximately 24,000 sensory receptor cells and consist of three parts. The outer ear, the part that we can see, collects sound waves which then travel into the middle ear, where the sounds vibrate, and into the inner ear where the vibrations are changed into signals which are carried to our brain via the auditory nerve, where the sounds are interpreted.7 Our sense of hearing, as with all of the senses, is inexplicably linked with our emotions and how we perceive and experience the world around us. A sudden, loud bang, for example, can make us feel scared; and a certain song can bring about feelings of euphoria or nostalgia. Our sense of hearing enables us to communicate with each other.

Some Causes of Poor Senses

Age

With the ageing process comes the natural deterioration of our senses. The way our sense of hearing, sight, taste, smell and touch work changes with age. Ageing can change all of the senses, but usually, hearing and sight are most commonly affected. Ageing can cause the structures in both the ears and eyes to change, which affects our ability to use our sense of hearing and vision as effectively. Loss of vision and hearing is a common symptom of old age as these senses become less sharp and less able to function properly. In addition to the loss of sight and hearing; when we age our sense of taste is also affected. The nutrients that have an influence on and affect our sense of taste, namely vitamins A, B6, B12 and B1, folate, zinc and copper, are often found to be deficient in the elderly. This leads to the problem of potential loss of taste and in turn loss of appetite for food which leads to one becoming further deficient in the nutrients required to activate our sense of taste. And here lies the loop. Further to this, these nutrients that influence taste are also some of the essential nutrients the body requires to survive.8

Cancer Treatments: Impairment of the Senses

Treatments used for cancer such as radiation therapy, surgical oncology and chemotherapy can affect the senses, in particular, our sense of taste and smell. These treatments can cause damage to the taste buds, affecting our sense of taste, as well as changing how things smell; so altering our ‘normal’ sense of smell. This can cause a loss of appetite since our sense of taste and smell are so bound up in how we experience the ‘flavour’ of food and ultimately whether we enjoy and feel like eating. Loss of appetite can potentially lead to weight loss and nutritional deficiencies. Changes in our sense of smell and taste can inevitably cause distress and anxiety; with the potential to vastly affect quality of life.9

Nutrient deficiencies

Vitamin deficiencies have been linked to a reduced ability to taste food, impairing our sense of taste and smell. Research has shown a link between deficiencies in Vitamin B12, thiamin, folate, iron and riboflavin and a loss of the sense of taste.10 Other research has also indicated a link between Vitamin E and our sense of taste, concluding that “vitamin E may play a role in growth and development of stem cells in taste buds.”11 Yet further research has found a correlation between deficiencies in Vitamin A, Vitamin B6, Zinc, Nickel and Copper and a reduced sense of taste due to an impairment of the taste receptors, and/or an impairment of the sense of smell, as a result of these specific deficiencies.12


Dietary changes and Supplements to improve Taste and Smell

Zinc

Zinc (Zn) is a trace element, that’s found in almost every cell in the human body and is a vital cofactor component of many enzymes. Zinc is essential, meaning it’s only found in the body due to its consumption in foods; we are unable to make it. Studies have shown a strong link between a deficiency in zinc and the loss or impairment of taste and smell. Zinc is found in foods such as organ meats, oysters, beef, crab, yeast, whole grains and eggs; so increasing dietary intake of these foods is wise if deficient in zinc and wanting to improve the sensory functions of taste and smell.

Zinc is required to produce an enzyme called carbonic anhydrase (CA) VI, which is essential to taste and smell activity. The loss of our sense of smell is more often than not indicative of acute zinc deficiency. Zinc is thought to affect our sense of taste and how this functions in a number of ways. Zinc has been shown to have a part to play in how the taste buds function; assists the nerves in the process of communicating information about taste, and finally on how the brain interprets the messages it receives.13

A deficiency of zinc can cause changes in taste and appetite. Several studies have shown a link between a zinc deficiency and taste dysfunction and these studies revealed that treating patients who had a zinc deficiency with a zinc supplement predominantly improved their sense of taste.14

Zinc is known to contribute to the health of the immune system and is highly effective in combating cold and flu symptoms, which can affect our sense of taste. Additionally, Zinc is an antioxidant that protects DNA, protein and lipid structure and is thought to be effective in helping to fight infections; also an antiviral, particularly useful in preventing lower respiratory infections.15

B Vitamin Complex

Essentially B Vitamins are crucial nutrients needed by the body for growth, development, and a range of other important functions. Studies have shown that some of the B vitamins are particularly effective in assisting our sense of taste and smell. A deficiency in Vitamin B12 has been linked to symptoms of a decline in taste, smell, vision, and sensory/motor function. In addition to this, a deficiency of Vitamin B1 Thiamin, a B-vitamin abundant in whole grains or enriched grain products and present in nerve cells, can impair normal sense of taste.16

Folate
Folic Acid or folate is an essential B vitamin which works to help form new cells within the body and helps to break down macronutrients that are crucial in helping the organs in the body work properly. The body is unable to produce or store large amounts of Folate easily, hence, why it’s readily available and recommended as a supplement. There are natural sources of Folic acid, these include, dark green leafy vegetables (kale and spinach),soya beans, kidney beans, broccoli, cabbage, avocado, cereals and barley. A folate deficiency can result in loss of taste. 


The Vitamin B complex formulation provided by Oxford Vitality contains Vitamin B1, B2, B3, B5, B6, B12, D-Biotin, Folic Acid and Inositol. Eating foods rich in vitamin B such as broccoli, bananas and tomato juice in addition to taking the B vitamin complex can assist with the overall effects.


Alpha lipoic acid

Alpha Lipoic Acid(ALA) can also be referred to as “α-lipoic acid” and “Thioctic acid.” ALA is an organic vitamin-like compound found in every cell of the human body. Its role within the body is to take part in aerobic metabolism, it does so by acting as a coenzyme to B vitamins. By promoting enzymatic work in the mitochondria it aids the citric acid cycle which makes the universal form of energy within the body. In addition, it indirectly benefits the antioxidant ability of the body by helping to regenerate potent antioxidants, such as Vitamin C and E.

Alpha Lipoic acid is classified as both an essential fatty acid and an antioxidant that can be found in a variety of foods in very low levels. Alpha lipoic acid is typically found in foods such as organ meats (Liver and Kidney), brewer's yeast, vegetables including broccoli, spinach, peas and sprouts.17

Alpha Lipoic acid has been linked to an improved sense of taste. Studies have shown that Alpha Lipoic acid may help to restore normal nerve function, assisting our sense of both taste and smell. A study investigating the effect of Alpha Lipoic Acid on taste impairment was conducted involving 44 patients with an average age of 43. The patients were given 200 mg of lipoic acid three times a day (600 mg/day total) for 60 days. At the end of the study, 46% of the group who took the lipoic acid had completely regained their sense of taste, while 27% reported “decided improvement”; in all, 91% reported at least some improvement with lipoic acid.18

Dietary changes and Supplements to improve Sight

 Bilberry Tablets

Bilberry contains a variety of phenolic compounds that act as potent anti-oxidising agents. The benefits of these are extensive particularly for eye health. Bilberry is a rich source of Anthocyanins which are thought to be particularly beneficial for promoting the health of the eye by protecting the microvascular systems.19 Studies have shown a direct link between the activity of anthocyanins and anthocyanin-rich extracts in eye function. Studies have shown that anthocyanins could help lessen the risk of cataracts and macular degeneration and help maintain the health of the cornea and blood vessels in various parts of the eye. Other potential eye benefits of anthocyanins include the potential to help reduce inflammatory eye disease and diabetic retinopathy.20


Ginkgo Biloba Tablets

Ginkgo Biloba has been linked with beneficial effects to the eyes and ears, particularly for the elderly generation. Ginkgo Biloba is a rich source of the flavonol Kaempferol. The active compounds of the Biloba seeds are called Ginkgolides and Bilobalides. These compounds provide a beneficial list of therapeutic actions, namely their effects on cognitive function. This ample source of kaempferol is thought to help maintain mental well-being and memory function, while helping to protect against cognitive decline, typically associated with the ageing process, including functions linked to our sense of sight.

Vitamin C

Vitamin C is also known by the names, Ascorbate and Ascorbic acid. It’s a water-soluble vitamin, which means that compared to a fat soluble vitamin it must be consumed in much greater quantities because of poor storage capacity. Vitamin C is a powerful antioxidant that can help protect the health of the eyes by assisting the body to build and maintain connective tissue, specifically collagen which is found in the cornea of the eye. Research has also indicated that long-term consumption of Vitamin C could also reduce the risk of developing cataracts and loss of vision as a result of macular degeneration.21

Vitamin C is found in many plant-based foods including kale, mango, strawberries, carrots, cabbage and raspberries. A normal dietary intake per day is 75-125mg, however, supplements provide between 250 and 2000mg. Increasing intake of vitamin c via food sources and a dietary supplement will significantly help to ensure levels of this essential vitamin are maintained.

Lutein Tablets

Lutein is one of 600 Vitamin A derived carotenoids found in nature. Lutein used by Oxford Vitality is extracted from Marigold Flowers. Carotenoids are the plant based form of Vitamin A. These are then converted to retinal and retinol, which aids the maintenance of normal vision.22

Vitamin A Tablets

Vitamin A is a fat-soluble vitamin predominantly stored in the liver, with powerful antioxidant capabilities. It’s well researched that Vitamin A can help protect the health of the eyes and is essential for normal vision.

There are different structures of vitamin A found in nature. Firstly, there is the pre-formed Vitamin A known as Retinol, which is only found in animal sources. Or Carotenoids, which are only found in plant sources. Once the Carotenoids have entered the body they are converted to all-trans-retinol where it is active for use in the body. Food sources of pre-formed retinol are butter, cod liver oils, oily fish, egg yolks, and whole milk. Whereas sources of Carotenoids include dark leafy green vegetables, peppers, sweet potato, broccoli, kale, parsley and carrots. The recommended intakes for Vitamin A are 0.7mg for men and 0.6mg for women.23

A deficiency in Vitamin A is serious where the sense of sight is concerned and can lead to a thickening of the cornea which can lead to complete loss of sight.24

Grape Seed Extract


The active ingredients are called Grape Antioxidant Dietary Fibre (GADF) and Oligomeric Proanthocyanidins (OPCs). This is a potent antioxidant known for its ability to scavenge radicals and protect tissue and vascular health. The powerful activity of the antioxidants present in grape seeds has been shown to help protect the retinal cells and reduce risk of premature deterioration caused by oxidative stress.25

Astaxanthin Tablets

Astaxanthin is a molecule rich in carotenoids, a yellow/orange pigment and a derivative of the lipid soluble Vitamin A. Astaxanthin can be sourced naturally and also synthetically produced.

Astaxanthin carries out a similarly protective role within the human body; shielding cells from oxidative stress as well as carrying out a range of other beneficial activity. Amazingly it can travel throughout the entire body and protect cells in all our organs, muscles and tissues. The human body cannot produce Astaxanthin so we have to consume it through diet. Astaxanthin has been shown to benefit eye, brain and central nervous system health.26 Try pairing Astaxanthin with Coenzyme Q10 to provide maximised and far-reaching anti-oxidant protection.

Vitamin B6

A study showed that Vitamin B6 can help slow down eye diseases that can cause loss of vision such as Age-related macular degeneration (AMD). Findings showed that a group of women who took 50 mg of vitamin B6 per day, along with 1,000 mcg of cyanocobalamin (vitamin B12) and 2,500 mcg of folic acid, significantly reduced their risk of developing AMD.

Dietary changes and Supplements to improve Touch

Vitamin B6 Tablets

Vitamin B6 is a water-soluble vitamin that comes in 3 forms, Pyridoxine, Pyridoxal, and Pyridoxamine. The body has the ability to swap between the 3 forms, dependent on the body’s needs. Its active form is phosphorylated and known as pyridoxal 5’-phosphate (PLP). This Vitamin is found naturally in many food sources including organ meats, egg yolks, tuna, pork, bananas, avocados, soy beans, chicken, corn and kale.

B-complex vitamins are needed for healthy skin and also help the nervous system function properly. Vitamin B6 is essential for the production of collagen, needed to build body tissue and bones; therefore Vitamin B6 can help support our sense of touch and benefit the health of the nerve endings by helping to build and maintain connective tissue.27

Dietary changes - Supplements to improve Hearing

Magnesium

Magnesium is thought to be beneficial to normal muscle and nervous system function and a clear link has been made between the role of magnesium in the health of receptor cells connected to the senses, particularly our sense of hearing. Various scientific studies have shown magnesium to be beneficial for the treatment of hearing loss and tinnitus. The role of magnesium in ear and hearing health is linked to its ability to help expand blood vessels and improve circulation; while also helping to manage the release of glutamate, one of the main factors of noise-induced hearing loss.28

Increasing dietary sources of magnesium is advisable if finding it hard to hear properly/suffering from hearing loss. A naturally rich source of magnesium is beetroot which could be sourced in supplement form by enriching a healthy and varied diet with Beetroot tablets.29 Other natural sources of magnesium include dark leafy greens, nuts, seeds, fish, beans, whole grains, avocados, yogurt, bananas, dried fruit and dark chocolate.

Ginseng

Ginseng is a native plant of Asian Countries such as China and Korea. The Asian form is known as the Panax Ginseng. The root is where the active ingredient Ginosenosides reside. The Asian form of Ginseng is one of the oldest known herbal medicines and has been used in traditional Chinese medicine for over 7000 years. In China they refer to it as the “root of heaven”, as they believed it had the ability to cure every ailment. Research has taken place to assess the benefits of ginseng as a treatment for hearing damage caused by excessive noise; general hearing loss; and tinnitus. In particular, ginseng supplementation could help prevent hearing loss due to the ageing process.30

Coenzyme Q10 (CoQ10)

Coenzyme Q10 is known as Ubiquinone and is found in most human cells. It is a fat soluble substance that is often confused for a vitamin, but is not strictly classified as a vitamin. Coenzyme Q10 is synthesised from the amino acid Tyrosine. The amino acid Tyrosine is non-essential, which means we are able to make these within the body. However, they can also be found in foods such as cheese, organ meats, mackerel, broccoli and spinach. Coenzyme Q10 is a powerful antioxidant. The role of an antioxidant is to scavenge and destroy oxidising free radicals that have been linked to a reduction in cell integrity and disease.31

Various studies have taken place to assess the effectiveness of CoQ10 as a treatment for loss of hearing and tinnitus. One such study showed that 160-600 mg of CoQ10 taken daily significantly improved hearing in people with sudden sensorineural hearing loss and presbycusis (Ahn 2010; Salami 2010; Guastini 2011). Another study found that CoQ10 reduced tinnitus in those who were deficient in CoQ10. (Khan 2007). Further research illustrated Coenzyme Q10 may slow down the onset of hearing loss associated with a mitochondrial genetic mutation (Angeli 2005).32


Folic acid

Folic Acid is an essential B vitamin which helps to break down macronutrients that are crucial in helping the organs in the body work properly. The body is unable to produce or store large amounts of Folate easily, hence, why it’s readily available and recommended as a supplement. Folic acid or folate has been found to benefit hearing loss associated with aging. There could be a link between a deficiency folate levels in the blood and the sudden loss of hearing in adults.33 There are natural sources of Folic acid, these include, dark green leafy vegetables (kale and spinach), soya beans, kidney beans, broccoli, cabbage, avocado, cereals and barley.

Alpha lipoic acid

As we have seen alpha lipoic acid or ALA is an organic vitamin-like compound found in every cell of the human body and has significant potential to aid our sense of taste and smell. Research has also taken place into the role of alpha lipoic acid and our sense of hearing.

In various studies alpha lipoic acid has been found to reduce age-related hearing loss. A clinical study involving 46 elderly people diagnosed with hearing loss, over a period of 8 weeks of treatment with lipoic acid (60 mg/day) combined with two other free radical scavengers (vitamin C [600 mg/day] and rebamipide [300 mg/day]) showed significantly improved hearing at all frequencies tested (Takumida 2009).34

Ginkgo Biloba Tablets

Ginkgo Biloba has been linked with beneficial effects to the eyes and ears, particularly for the elderly generation and it could specifically assist with our sense of hearing. Research shows that Ginkgo Biloba could help protect against hearing loss and also act as an effective treatment for tinnitus. A study involving humans with tinnitus who took a daily dose of 160 mg of Ginkgo Biloba over a period of 12 weeks showed it was effective at reducing symptoms. (Morgenstern 2002).35

Senses linked to essential nutrients

It’s clear there is a definite and far-reaching link between certain vitamins and nutrients and the effective functioning of the five senses and that a deficiency in any one essential nutrients can upset the complex balance of the senses we so heavily rely on to navigate and perceive the world around us. Our senses are closely tied into our emotions and assist us to form meaningful relationships with each other. How we ‘sense’ the external world around us and how we ‘feel’ about it are interconnected. An impairment or loss of any one of these five crucial senses can hugely change how we experience life. Extensive and varied research has clearly shown that maintaining sufficient levels of essential nutrients via our diet and a combination of appropriate dietary supplements can greatly improve processes connected with each of the senses and could help lessen the risk of any of our five crucial senses being compromised. It’s clear that as we age the way our senses function changes. It’s perhaps worth combating this natural aging process by enhancing a balanced and varied diet with an effective range of health supplements that will provide all-round beneficial coverage to the functioning of the senses; So we can experience the sensory splendour of life to the full and continue to make the most out of the world around us and out of our own human bodies, as we move gracefully and healthily (with all senses intact) into old age.

 

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References

1 How does our sense of taste work? https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072592/

2 Bitter taste identifies poisons in foods. Monell Chemical Sense Center. Public Release:18-Sep-2006. https://www.eurekalert.org/pub_releases/2006-09/mcsc-bti091206.php

3 Flavour:Just how much of what we taste derives from the sense of smell? Charles Spence. Published: 2 November 2015. https://flavourjournal.biomedcentral.com/articles/10.1186/s13411-015-0040-2

4 How does our sense of taste work? U.S.National Library of Medicine: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072592/

8 Blanck HM, et al. Am J Clin Nutr. 2002 Aug;76(2):430-5. Retrieved from: http://www.cpmedical.net/newsletter/subclinical-signs-of-nutrient-deficiencies

10 Chauhan J, et al. J Am Diet Assoc. 1987 Nov;87(11):1543-50. Retrieved from: http://www.cpmedical.net/newsletter/subclinical-signs-of-nutrient-deficiencies

11 Study published in Nutrition in 2003. Retrieved from: http://www.cpmedical.net/newsletter/subclinical-signs-of-nutrient-deficiencies

13 Carbonic Anhydrases: Their Roles in Taste and Smell Function: http://www.tasteandsmell.com/mar2012.htm

14 Zinc in taste function:A critical review.Henkin RI https://www.ncbi.nlm.nih.gov/pubmed/24264025

18 Femiano F, Scully C, Gombos F. Idiopathic dysgeusia; an open trial of alpha lipoic acid (ALA) therapy. Int J Oral Maxillofac Surg 2002;31:625-8.

20 Anthocyanins and anthocyanin-rich extracts: role in diabetes and eye function. Asia Pacific Journal of Clinical Nutrition. June 2007.

21 Nutritional antioxidants and age related cataract and maculopathy. Experimental Eye Research. February 2007.Retrieved from http://www.allaboutvision.com/nutrition/vitamin_c.htm

28 Nutrient-enhanced diet reduces noise-induced damage to the inner ear and hearing loss. Le Prell 2011 https://www.ncbi.nlm.nih.gov/pubmed/21708355

34 Retrieved from: Hearing Loss and Tinnitus: Targeted Nutritional Therapies. http://www.lifeextension.com/Protocols/Eye-Ear/Tinnitus/Page-07

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