Think you take a complete multivitamin? Well, maybe not. Typical multivitamins simply do not provide enough nutrients for optimal health. Or for that matter, the proper forms and carriers of nutrients to do the job right—the all important task of providing you with essential nutrients for health. Not so easy these days? Well, Hank & Brian’s Mighty Multi-Vite! can help—a lot!
MIGHTY MULTI-VITE! DEFINES A COMPLETE MULTIVITAMIN
The task of providing you with a complete set of nutrients—as easily absorbed forms—is where Hank & Brian’s Mighty Multi-Vite! shines brightly in the world of #multivitamins. Quite simply, Dr. Hank Liers carefully formulated Mighty Multi-Vite! as the most advanced, complete multivitamin available. It uniquely includes a wide range of vitamins, minerals, cofactors, herbs, antioxidants, and Nrf2 activators (nutrients that allow your body to make its own antioxidants). This wide range of nutrients alone puts Mighty Multi-Vite! in a class by itself.
Calling HPDI’s Mighty Multi-Vite! “complete” is an understatement. While other multivitamins may contain more ingredients, Dr. Hank’s goal is not to “stuff” as many ingredients (or amounts) into Mighty Multi-Vite! as possible. That is a “shotgun” approach—Dr. Hank avoids it—that often results in too large capsules, huge tablets (“horse pills”), or eight-per-day dosages that are hard to consume—and even harder to stick with over time. You get the idea.
Instead, Dr. Hank carefully designed Mighty Multi-Vite! to include both a broad range of essential nutrients and abundant amounts of the most important nutrients for health in easily to assimilate forms using multiple carriers that give the body choices. For example, the body requires far smaller amounts of coenzyme B vitamins (which are the natural forms best utilized by cells) than conventional forms of B vitamins. This allows for more efficient dosing and does not “waste” space in the capsule allowing more room for other nutrients, like antioxidants and Nrf2 activators. In a nutshell, few multivitamins are so well balanced and designed carefully to give the body what it needs for optimal health. You get it all in just four (4) regular size capsules, daily. How easy is that?
As I mentioned, Mighty Multi-Vite! includes highly absorbable forms of nutrients. These include mineral carriers like Krebs Cycle bionutrients—carriers that feed the energy producing system in the body—including malates, ascorbates, aspartates, sebacates, citrates, and glycinates. Thus, we use magnesium malate, and calcium ascorbate and citrate. The whole point is that the body immediately recognizes and utilizes these forms.
In practice, Dr. Hank’s inclusion of the most absorbable forms and carriers means you actually absorb and assimilate more of the ingredients—whether vitamins, minerals, cofactors, antioxidants, herbs, or Nrf2 activators—than you would from the same old conventional forms and carriers (oxides, for example) found in many multivitamins, especially “off-the-shelf” or “one-a-day” type formulas. Many so-called “boutique” formulas use conventional forms and carriers. Who knew!?
To top it off, many advanced ingredients in Mighty Multi-Vite! (like Nrf2 activators) are nowhere to be found in the vast majority of multivitamins. You might not even know to look for them!
However, the biggest benefit of the science behind Mighty Multi-Vite! is how you feel when taking it. I really feel the difference. Your multivitamin should work for you and support your best health. If your multivitamin is not giving you what you need—or you can’t feel the difference it makes in your life—then why take it? Maybe it is better than nothing, but why settle for less when better options are available?
The single biggest reason I am a huge fan of Mighty Multi-Vite! is because I have taken it for more than 20 years. I have gained all the benefits it offers—for thousands of days—year after year. I am more than confident in its superior benefits not just for me, but because I have seen many other people gain benefits, and heard countless positive testimonies from happy customers. I know you can gain major benefits from it, too.
But wait, there’s more! Read the overview (below) for some nitty, gritty details distinguishing Dr. Hank’s design of Mighty Multi-Vite!. These not-so-little details can make all the difference for your good health.
MIGHTY MULTI-VITE! OVERVIEW
COMPLETE, BALANCED ESSENTIAL NUTRITION – Provides a full spectrum of nutrients exceptionally well balanced for creating and maintaining optimal heatlh. Mighty Multi-Vite! offers all of the most important vitamins along with minerals, cofactors, antioxidants, herbs, and Nrf2 activators.
RAPID, EASY ASSIMILATION – Incorporates the most bioavailable vitamin and mineral carriers most easily recognized and rapidly assimilated by your body. In addition, the formula uses multiple forms of mineral carriers to ensure assimilation. In addition, the capsule form (compared to tablets) speeds uptake because it does not require time for the body to break it down.
ENERGIZING – Includes coenzyme form vitamins and Krebs Cycle bionutrients that work with your body to create super high energy levels. Provides significantly higher levels of B vitamins than most multivitamins (especially coenzyme B vitamins). These vitamins are known for boosting energy, supporting the body during times of stress, and supporting nerve, heart, brain and immune system function.
FEATURES & BENEFITS OF MIGHTY MULTI-VITE! MULTIVITAMIN
• A full-spectrum of B-complex vitamins, most in coenzyme forms, as well as more conventional forms. Includes Vitamin B1 as thiamin HCl, Vitamin B2 as riboflavin and riboflavin-5’-phosphate, Vitamin B3 as niacinamide and niacin, Vitamin B5 as pantothenic acid, Vitamin B6 as pyridoxine HCl and pyridoxal-5’-phosphate, folate as L-5-methyltetrahydrofolate calcium (L-5-MTHF), Vitamin B12 as methylcobalamin, and biotin
• All of the most absorbable and usable forms of the fat-soluble vitamin group, including Vitamin A (as alpha & beta-carotene), Vitamin E (as d-alpha tocopherol succinate), Vitamin D3 (as cholecalciferol), and Vitamin K (as phytonadione (K1) and MK-7 (menaquinone-7) (K2))
• A complete and balanced supply of the most abundant carotenoids found in the body, including beta-carotene, alpha-carotene, lycopene and lutein
• A variety of the best-known herbal preparations, including whole grape extract (seeds, pulp, skin), turmeric (95% curcuminoids), broccoli sprouts powder, and octacosanol (from rice bran)
• All of the known essential minerals in forms readily absorbed and recognized by the body including calcium, magnesium, potassium, zinc, manganese, boron, copper, chromium, molybdenum, vanadium, and selenium
• Mineral carriers such as ascorbates, Krebs cycle bionutrients, and amino acids providing the body with important metabolic substrates and vitamins, including citrate, succinate, malate, glycinate, aspartate, sebacate, and Vitamin C
• Contains a wide range of antioxidants and Nrf2 activators including Buffered Vitamin C, Vitamin A, Vitamin E, Carotenoids, NAC, whole grape extract, curcuminoids, and broccoli sprouts
• Includes N-Acetyl-L-Cysteine (NAC), an important sulfur-containing amino acid supporting the body’s antioxidant and detoxification systems, and betaine HCl to support digestive processes
• Includes Choline and inositol which play a crucial role in all the cell membranes of the body, in brain function, and in liver function
• Includes Nrf2 transcription factor activators (i.e., Nrf2 activators), which are nutrients that direct cells to produce their own antioxidants, making your body an antioxidant production machine. Most multivitamins contain few, if any Nrf2 activators. Mighty Multi-Vite! is one of the few multivitamins whose design intentionally provides Nrf2 activators.
• Exclusion of the prooxidant minerals of iron and iodine which can lead to excessive free-radical production and PABA that sometimes adversely affects brain function in some individuals. (Note: we sell iodine formulas separately.)
• Capsule form ensures maximum absorption of ingredients
• Four-per-day full dosage allows for partial dosing for children, seniors, and pets
• Vegetarian formula (including capsule) suitable for vegetarians and vegans
• Exclusion of ingredients such as wheat, dairy, corn, soy, gluten, and egg having well-known antigenic properties and that may be associated with allergy or delayed hypersensitivity reactions
• A minimum of excipients, fillers, lubricants, etc. having deleterious effects in some individuals
• NON-GMO (no genetically modified organisms)
CONSIDER MIGHTY MULTI-VITE!
Most people don’t think too hard about their multivitamins. They focus on taking the supplement de jour (whatever supplements make headlines) or continue taking the same one-a-day multivitamin.
That is too bad because a multivitamin truly is the single most important nutritional supplement. We at HPDI place the multivitamin first—above all other supplements—in importance. Our Foundational Supplements system starts with a multivitamin because it is the only formula designed to provide the basic nutrients essential for health. That is, you can add other essential nutrients (like vitamin C or essential fats) to complete your regimen. But the multivitamin remains king (or queen) because it establishes your baseline nutrient intake. That is something is to consider when selecting the multivitamin you will take daily for the rest of your life.
Ask yourself: Is my multivitamin complete, providing all the most important nutrients I need for health? Is it easily absorbed using multiple, readily assimilated forms and usable carriers of those nutrients? Is it proven to work? Is it easy to take? Do I notice the effects?
If you answer “no” to any of these questions, or if you simply never think about it, then consider Hank & Brian’s Mighty Multi-Vite!. You should love your multivitamin because of how it supports your health. We think you will love Mighty Multi-Vite!.
As the year draws to a close, it is a good time to reflect on the past year, as well as to look forward to the New Year with respect to one’s health goals. This includes assessing your nutritional supplement regimen. There is more confusion about nutritional supplements than ever. With this in mind, we present “Megavitamin Myth-Busting” from Andrew W. Saul, PhD and Helen Saul Case from the Orthomolecular Medicine News Service to clear confusion about vitamins and other nutritional supplements, and set the record straight. Enjoy! ~
Commentary by Andrew W. Saul and Helen Saul Case
(Orthomolecular Medicine News Service, Dec 23, 2019)
People are so confused about endless internet vitamin legends. Now it’s time to be blunt and set the record straight.
The media says that taking vitamins will kill me. Is that so? NO.
It’s been said that the FDA does not regulate nutritional supplements. Is that true? NO. “FDA regulates both finished dietary supplement products and dietary ingredients.” [U.S. Food and Drug Administration, http://www.fda.gov/Food/DietarySupplements/ ]
Do I need special vitamin preparations for my body to absorb them? NO. With vitamins, there is usually no absorption issue. All animals need and absorb nutrients, including vitamins. If they didn’t, they’d be long extinct. The surface area of your small intestine, if all the nooks and crannies were flatted out, would be half the size of a regulation basketball court. There is ample opportunity for nutrient absorption.
Some persons have a genetic trait that makes it more difficult for them to convert dietary carotene into active vitamin A. Does this mean they must take preformed oil retinol A? NO. Even a poor converter can still make sufficient vitamin A from carotene if they eat lots of fruits and vegetables . . . which we should all be doing anyway.
Is niacin clinically incompatible for people with methylation issues? NO. Theoretically, perhaps. But Dr. Abram Hoffer, the world’s most experienced niacin physician, has said it is not clinically significant.
Aren’t B-vitamins so poorly absorbed that they need to be methylated? NO. Comparing their molecular weights with the simplest of all sugars, we find:
•Glucose (C6H12O6) weighs 180 grams/mole • Niacin (C6H5NO2) weighs 123 g/mol • Pyridoxine 169 g/mol • Pantothenic acid 219 g/mol • Biotin 244 g/mol • Thiamin 265 g/mol • Riboflavin 376 g/mol • Folic acid or folate 441 [Methylated may be better. However: 1) See: Bailey LB. Dietary reference intakes for folate: the debut of dietary folate equivalents. Nutr Rev. 1998;56(10):294-299. And 2) The Linus Pauling Institute says: “Unmetabolized folic acid concentrations returned to baseline levels at the end of the study, suggesting that adaptive mechanisms eventually converted folic acid to reduced forms of folate.” • Cobalamin 1,355 g/mol [methylated is probably better in this case]
Do I need to consume vitamin K-2 because K-1 in foods is ineffective? NO. Your body will make the conversion for you. John Cannell, MD, writes that the conversion “occurs through an intermediary molecule, vitamin K3, which is made in the intestine from vitamin K1. [Hirota Y, et al. J Biol Chem. 2013 Sep 30.] “[M]odern humans are deficient in K2 because they do not eat large quantities of vitamin K1 containing foods. If we look at Paleolithic humans, they probably got high amount of vitamin K2 from eating large quantities of kale and spinach-like foods, very high in K1, which then supplied their tissues with all the vitamin K2 they needed. [A]s far as getting enough vitamin K2, the best thing to do is eat your greens.”
I drink milk, and I spend time in the sunshine. Don’t I get plenty of vitamin D? NO. If your shadow is longer than you are, you are not making vitamin D from sunlight, says William Grant, PhD. Thus, little vitamin D is made by your body in the six colder months of the year. This is also true in the summer months if only exposed to sun mornings and afternoons. http://www.orthomolecular.org/resources/omns/v07n07.shtml
(Andrew W. Saul, OMNS founder and Editor-in-Chief, has coauthored four books with Abram Hoffer, MD, and is editor of the textbook The Orthomolecular Treatment of Chronic Disease. OMNS Assistant Editor Helen Saul Case is the author of The Vitamin Cure for Women’s Health Problems, Vitamins & Pregnancy: The Real Story, and Orthomolecular Nutrition for Everyone.)
Nutritional Medicine is Orthomolecular Medicine
Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org
The peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource.
Comments and media contact: email@example.com OMNS welcomes but is unable to respond to individual reader emails. Reader comments become the property of OMNS and may or may not be used for publication.
I previously wrote METHYLATION CYCLE, GENETICS, B VITAMINS in which I considered in-depth how the Methylation Cycle functions, how genetics affect metabolic pathways, and how B vitamins (including vitamin B12, folate, vitamin B6, and vitamin B2) are used in Methylation Cycle pathways. In today’s article, I take an in-depth view of what you need to know about vitamin B12, including the effects of not having sufficient amounts of Vitamin B12 in the body.
Vitamin B12 is one of eight B vitamins. It is the largest and most structurally complicated vitamin. It consists of a class of chemically related compounds (vitamers), all of which show physiological activity. It contains the biochemically rare element cobalt positioned in the center of a chemical ring structure.
Vitamin B12 (also called cobalamin) is a water-soluble vitamin that is involved in the metabolism of every cell of the human body. It is a cofactor in DNA synthesis, and in both fatty acid and amino acid metabolism. It is particularly important in the normal functioning of the nervous system via its role in the synthesis of myelin and in the maturation of developing red blood cells in the bone marrow.
Vitamin B12 contains the biochemically rare element cobalt positioned in the center of a chemical ring structure.
YOUR NEED FOR VITAMIN B12
Vitamin B12 deficiency is thought to be one of the leading nutritional deficiencies in the world. An extensive 2004 study showed that deficiency is a major health concern in many parts of the world, including the North America, Central and South America, India, and certain areas in Africa. It is estimated that 40 percent of people may have low levels of vitamin B12.
Vitamin B12 affects your mood, energy level, memory, nervous system, heart, skin, hair, digestion and more. It is a key nutrient regarding adrenal fatigue and multiple metabolic functions including enzyme production, DNA synthesis, and hormonal balance.
Because of vitamin B12’s extensive roles within the body, a vitamin deficiency can show up in many different symptoms, such as chronic fatigue, mood disorders such as depression, chronic stress, and low energy.
SOURCES OF VITAMIN B12
The only organisms to produce vitamin B12 are certain bacteria and archaea. Some of these bacteria are found in the soil around the grasses that ruminants eat. They are taken into the animal, proliferate, form part of their gut flora, and continue to produce vitamin B12.
Products of animal origin such as beef (especially liver), chicken, pork, eggs, dairy, clams, and fish constitute the primary food source of vitamin B12. Older individuals and vegans are advised to use vitamin B12 fortified foods and supplements to meet their needs.
Salmon is a good source of Vitamin B12
Commercially, Vitamin B12 is prepared by bacterial fermentation. Fermentation by a variety of microorganisms yields a mixture of methylcobalamin, hydroxocobalamin, and adenosylcobalamin. Since multiple species of propionibacterium produce no exotoxins or endotoxins and have been granted GRAS status (generally regarded as safe) by the United States Food and Drug Administration, they are the preferred bacterial fermentation organisms for vitamin B12 production.
Methylcobalamin and 5-deoxyadenosylcobalamin are the forms of vitamin B12 used in the human body (called coenzyme forms). The form of cobalamin used in many some nutritional supplements and fortified foods, cyanocobalamin, is readily converted to 5-deoxyadenosylcobalamin and methylcobalamin in the body.
Hydroxocobalamin is the direct precursor of methylcobalamin and 5-deoxyadenosylcobalamin. In mammals, cobalamin is a cofactor for only two enzymes, methionine synthase (MS) and L-methylmalonyl-coenzyme A mutase (MUT).
Unlike most other vitamins, B12 is stored in substantial amounts, mainly in the liver, until it is needed by the body. If a person stops consuming the vitamin, the body’s stores of this vitamin usually take about 3 to 5 years to exhaust. Vitamin B12 is primarily stored in the liver as 5-deoxyadenosylcobalamin, but is easily converted to methylcobalamin.
ABSORPTION OF VITAMIN B12
Vitamin B12, bound to protein in food, is released by the activity of hydrochloric acid and gastric protease in the stomach. Intestinal absorption of vitamin B12 requires successively three different protein molecules: Haptocorrin, Intrinsic Factor and Transcobalamin II. If there are deficiencies in any of these factors absorption of Vitamin B12 can be seriously decreased.
When vitamin B12 is added to fortified foods and dietary supplements, it is already in free form and, thus, does not require the separation from food protein step. Free vitamin B12 then combines with intrinsic factor, a glycoprotein secreted by the stomach’s parietal cells, and the resulting complex undergoes absorption within the distal ileum by receptor-mediated endocytosis.
Approximately 56% of a 1 mcg oral dose of vitamin B12 is absorbed, but absorption decreases drastically when the capacity of intrinsic factor is exceeded (at 1–2 mcg of vitamin B12).
Vitamin B12 deficiency can be difficult to detect, especially since the symptoms of a vitamin B12 deficiency can be similar to many common symptoms, such as feeling tired or unfocused, experienced by people for a variety of reasons.
Vitamin B12 deficiency is commonly associated with chronic stomach inflammation, which may contribute to an autoimmune vitamin B12 malabsorption syndrome called pernicious anemia and to a food-bound vitamin B12 malabsorption syndrome. Poor absorption of vitamin B may be related to coeliac disease. Impairment of vitamin B12 absorption can cause megaloblastic anemia and neurologic disorders in deficient subjects. In some cases, permanent damage can be caused to the body when B12 amounts are deficient.
It is noteworthy that normal function of the digestive system required for food-bound vitamin B12 absorption is commonly impaired in individuals over 60 years of age, placing them at risk for vitamin B12 deficiency.
A diagnosis of vitamin B12 deficiency is typically based on the measurement of serum vitamin B12 levels within the blood. However, studies show that about 50 percent of patients with diseases related to vitamin B12 deficiency have normal B12 levels when tested. This can cause individuals to ignore taking in adequate levels of vitamin B12 with potential serious consequences.
FUNCTIONS AND ISSUES ASSOCIATED WITH VITAMIN B12 STATUS IN THE BODY
Vitamin B12 or cobalamin plays essential roles in folate metabolism and in the synthesis of the citric acid cycle intermediate, succinyl-CoA.
Vitamin B12 deficiency is commonly associated with chronic stomach inflammation, which may contribute to an autoimmune vitamin B12 malabsorption syndrome called pernicious anemia and to a food-bound vitamin B12 malabsorption syndrome. Impairment of vitamin B12 absorption can cause megaloblastic anemia and neurologic disorders in deficient subjects.
Normal function of the digestive system required for food-bound vitamin B12 absorption is commonly impaired in individuals over 60 years of age, placing them at risk for vitamin B12 deficiency.
Vitamin B12 and folate are important for homocysteine metabolism. Elevated homocysteine levels in blood are a risk factor for cardiovascular disease (CVD). B vitamin supplementation has been proven effective to control homocysteine levels.
The preservation of DNA integrity is dependent on folate and vitamin B12 availability. Poor vitamin B12 status has been linked to increased risk of breast cancer in some, but not all, observational studies.
Low maternal vitamin B12 status has been associated with an increased risk of neural tube defects (NTD), but it is not known whether vitamin B12 supplementation could help reduce the risk of NTD.
Vitamin B12 is essential for the preservation of the myelin sheath around neurons and for the synthesis of neurotransmitters. A severe vitamin B12 deficiency may damage nerves, causing tingling or loss of sensation in the hands and feet, muscle weakness, loss of reflexes, difficulty walking, confusion, and dementia.
While hyperhomocysteinemia may increase the risk of cognitive impairment, it is not clear whether vitamin B12 deficiency contributes to the risk of dementia in the elderly. Although B-vitamin supplementation lowers homocysteine levels in older subjects, the long-term benefit is not yet known.
Both depression and osteoporosis have been linked to diminished vitamin B12 status and high homocysteine levels.
The long-term use of certain medications, such as inhibitors of stomach acid secretion, can adversely affect vitamin B12 absorption.
Vitamin B12 is required for proper red blood cell formation, neurological function, and DNA synthesis.
MORE DETAILS ASSOCIATED WITH VITAMIN B12 STATUS IN THE BODY
1. Vitamin B12 is required for proper red blood cell formation, neurological function, and DNA synthesis. Vitamin B12 as methylcobalamin functions as a cofactor for methionine synthase. Methionine synthase (MS) catalyzes the conversion of homocysteine to methionine. Methionine along with ATP is required for the formation of S-adenosylmethionine (SAMe), a universal methyl donor for almost 100 different substrates, including DNA, RNA, hormones, proteins, and lipids.
2. Vitamin B12 as 5-deoxyadenosylcobalamin functions as a cofactor along with L-methylmalonyl-CoA mutase (MUT) to convert L-methylmalonyl-CoA to succinyl-CoA in the degradation of propionate, an essential biochemical reaction in fat and protein metabolism. Succinyl-CoA is also required for hemoglobin synthesis.
3. Vitamin B12, bound to protein in food, is released by the activity of hydrochloric acid and gastric protease in the stomach. When synthetic vitamin B12 is added to fortified foods and dietary supplements, it is already in free form and, thus, does not require this separation step. Free vitamin B12 then combines with intrinsic factor, a glycoprotein secreted by the stomach’s parietal cells, and the resulting complex undergoes absorption within the distal ileum by receptor-mediated endocytosis. Approximately 56% of a 1 mcg oral dose of vitamin B12 is absorbed, but absorption decreases drastically when the capacity of intrinsic factor is exceeded (at 1–2 mcg of vitamin B12).
4. Pernicious anemia is an autoimmune disease that affects the gastric mucosa and results in gastric atrophy. This leads to the destruction of parietal cells, achlorhydria, and failure to produce intrinsic factor, resulting in vitamin B12 malabsorption. If pernicious anemia is left untreated, it causes vitamin B12 deficiency, leading to megaloblastic anemia and neurological disorders, even in the presence of adequate dietary intake of vitamin B12.
5. Vitamin B12 status is typically assessed via serum or plasma vitamin B12 levels. Values below approximately 170–250 pg/mL (120–180 picomol/L) for adults indicate a vitamin B12 deficiency. However, evidence suggests that serum vitamin B12 concentrations might not accurately reflect intracellular concentrations. An elevated serum homocysteine level (values >13 micromol/L) might also suggest a vitamin B12 deficiency. However, this indicator has poor specificity because it is influenced by other factors, such as low vitamin B6 or folate levels. Elevated methylmalonic acid levels (values >0.4 micromol/L) might be a more reliable indicator of vitamin B12 status because they indicate a metabolic change that is highly specific to vitamin B12 deficiency.
6. Vitamin B12 deficiency is characterized by megaloblastic anemia, fatigue, weakness, constipation, loss of appetite, and weight loss. Neurological changes, such as numbness and tingling in the hands and feet, can also occur . Additional symptoms of vitamin B12 deficiency include difficulty maintaining balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue. The neurological symptoms of vitamin B12 deficiency can occur without anemia, so early diagnosis and intervention is important to avoid irreversible damage. During infancy, signs of a vitamin B12 deficiency include failure to thrive, movement disorders, developmental delays, and megaloblastic anemia. Many of these symptoms are general and can result from a variety of medical conditions other than vitamin B12 deficiency.
7. Typically, vitamin B12 deficiency is treated with vitamin B12 injections, since this method bypasses potential barriers to absorption. However, high doses of oral vitamin B12 can also be effective. The authors of a review of randomized controlled trials comparing oral with intramuscular vitamin B12 concluded that 2,000 mcg (I like 5,000 mcg) of oral vitamin B12 daily, followed by a decreased daily dose of 1,000 mcg and then 1,000 mcg weekly and finally, monthly might be as effective as intramuscular administration. Overall, an individual patient’s ability to absorb vitamin B12 is the most important factor in determining whether vitamin B12 should be administered orally or via injection. In most countries, the practice of using intramuscular vitamin B12 to treat vitamin B12 deficiency has remained unchanged.
8. Large amounts of folate can mask the damaging effects of vitamin B12 deficiency by correcting the megaloblastic anemia caused by vitamin B12 deficiency without correcting the neurological damage that also occurs. Moreover, preliminary evidence suggests that high serum folate levels might not only mask vitamin B12 deficiency, but could also exacerbate the anemia and worsen the cognitive symptoms associated with vitamin B12 deficiency. Permanent nerve damage can occur if vitamin B12 deficiency is not treated. For these reasons, folate intake from fortified food and supplements should not exceed 1,000 mcg daily in healthy adults.
Groups at Risk of Vitamin B12 Deficiency
The main causes of vitamin B12 deficiency include vitamin B12 malabsorption from food, pernicious anemia, postsurgical malabsorption, and dietary deficiency. However, in many cases, the cause of vitamin B12 deficiency is unknown. The following groups are among those most likely to be vitamin B12 deficient.
Older adults: Atrophic gastritis, a condition affecting 10%–30% of older adults, decreases secretion of hydrochloric acid in the stomach, resulting in decreased absorption of vitamin B12. Decreased hydrochloric acid levels might also increase the growth of normal intestinal bacteria that use vitamin B12, further reducing the amount of vitamin B12 available to the bodY.
Individuals with atrophic gastritis are unable to absorb the vitamin B12 that is naturally present in food. Most, however, can absorb the synthetic vitamin B12 added to fortified foods and dietary supplements. As a result, the IOM recommends that adults older than 50 years obtain most of their vitamin B12 from vitamin supplements or fortified foods. However, some elderly patients with atrophic gastritis require doses much higher than the RDA to avoid subclinical deficiency.
Individuals with pernicious anemia: Pernicious anemia, a condition that affects 1%–2% of older adults, is characterized by a lack of intrinsic factor. Individuals with pernicious anemia cannot properly absorb vitamin B12 in the gastrointestinal tract. Pernicious anemia is usually treated with intramuscular vitamin B12. However, approximately 1% of oral vitamin B12 can be absorbed passively in the absence of intrinsic factor, suggesting that high oral doses of vitamin B12 might also be an effective treatment.
Individuals with gastrointestinal disorders: Individuals with stomach and small intestine disorders, such as celiac disease and Crohn’s disease, may be unable to absorb enough vitamin B12 from food to maintain healthy body stores. Subtly reduced cognitive function resulting from early vitamin B12 deficiency might be the only initial symptom of these intestinal disorders, followed by megaloblastic anemia and dementia.
Individuals who have had gastrointestinal surgery: Surgical procedures in the gastrointestinal tract, such as weight loss surgery or surgery to remove all or part of the stomach, often result in a loss of cells that secrete hydrochloric acid and intrinsic factor. This reduces the amount of vitamin B12, particularly food-bound vitamin B12, that the body releases and absorbs. Surgical removal of the distal ileum also can result in the inability to absorb vitamin B12. Individuals undergoing these surgical procedures should be monitored preoperatively and postoperatively for several nutrient deficiencies, including vitamin B12 deficiency.
Vegetarians: Strict vegetarians and vegans are at greater risk than lacto-ovo vegetarians and non-vegetarians of developing vitamin B12 deficiency because natural food sources of vitamin B12 are limited to animal foods. Fortified breakfast cereals and fortified nutritional yeasts are some of the only sources of vitamin B12 from plants and can be used as dietary sources of vitamin B12 for strict vegetarians and vegans. Fortified foods vary in formulation, so it is important to read the Nutrition Facts labels on food products to determine the types and amounts of added nutrients they contain.
Pregnant and lactating women who follow strict vegetarian diets and their infants: Vitamin B12 crosses the placenta during pregnancy and is present in breast milk. Exclusively breastfed infants of women who consume no animal products may have very limited reserves of vitamin B12 and can develop vitamin B12 deficiency within months of birth. Undetected and untreated vitamin B12 deficiency in infants can result in severe and permanent neurological damage.
The American Dietetic Association recommends supplemental vitamin B12 for vegans and lacto-ovo vegetarians during both pregnancy and lactation to ensure that enough vitamin B12 is transferred to the fetus and infant. Pregnant and lactating women who follow strict vegetarian or vegan diets should consult with a pediatrician regarding vitamin B12 supplements for their infants and children.
Health Risks from Excessive Vitamin B12
The IOM did not establish a UL for vitamin B12 because of its low potential for toxicity. In Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline, the IOM states that “no adverse effects have been associated with excess vitamin B12 intake from food and supplements in healthy individuals”.
Findings from intervention trials support these conclusions. In the NORVIT and HOPE 2 trials, vitamin B12 supplementation (in combination with folic acid and vitamin B6) did not cause any serious adverse events when administered at doses of 0.4 mg for 40 months (NORVIT trial) and 1.0 mg for 5 years (HOPE 2 trial).
Interactions with Medications
Vitamin B12 has the potential to interact with certain medications. In addition, several types of medications might adversely affect vitamin B12 levels. A few examples are provided below. Individuals taking these and other medications on a regular basis should discuss their vitamin B12 status with their healthcare providers.
Chloramphenicol: Chloramphenicol (Chloromycetin®) is a bacteriostatic antibiotic. Limited evidence from case reports indicates that chloramphenicol can interfere with the red blood cell response to supplemental vitamin B12 in some patients.
Proton pump inhibitors: Proton pump inhibitors, such as omeprazole (Prilosec®) and lansoprazole (Prevacid®), are used to treat gastroesophageal reflux disease and peptic ulcer disease. These drugs can interfere with vitamin B12 absorption from food by slowing the release of gastric acid into the stomach. However, the evidence is conflicting on whether proton pump inhibitor use affects vitamin B12 status. As a precaution, healthcare providers should monitor vitamin B12 status in patients taking proton pump inhibitors for prolonged periods.
H2 receptor antagonists: Histamine H2 receptor antagonists, used to treat peptic ulcer disease, include cimetidine (Tagamet®), famotidine (Pepcid®), and ranitidine (Zantac®). These medications can interfere with the absorption of vitamin B12 from food by slowing the release of hydrochloric acid into the stomach. Although H2 receptor antagonists have the potential to cause vitamin B12 deficiency, no evidence indicates that they promote vitamin B12 deficiency, even after long-term use. Clinically significant effects may be more likely in patients with inadequate vitamin B12 stores, especially those using H2 receptor antagonists continuously for more than 2 years.
Metformin: Metformin, a hypoglycemic agent used to treat diabetes, might reduce the absorption of vitamin B12, possibly through alterations in intestinal mobility, increased bacterial overgrowth, or alterations in the calcium-dependent uptake by ileal cells of the vitamin B12-intrinsic factor complex. Small studies and case reports suggest that 10%–30% of patients who take metformin have reduced vitamin B12 absorption. In a randomized, placebo controlled trial in patients with type 2 diabetes, metformin treatment for 4.3 years significantly decreased vitamin B12 levels by 19% and raised the risk of vitamin B12 deficiency by 7.2% compared with placebo. Some studies suggest that supplemental calcium might help improve the vitamin B12 malabsorption caused by metformin, but not all researchers agree.
Background: Low vitamin B-12 status is prevalent among the elderly, but few studies have examined the association between vitamin B-12 status and intake.Objective: We hypothesized that vitamin B-12 concentrations vary according to intake source.Design: Plasma concentrations and dietary intakes were assessed cross-sectionally for 2999 subjects in the Framingham Offspring Study. The prevalence of vitamin B-12 concentrations <148, 185, and 258 pmol/L was examined by age group (26–49, 50–64, and 65–83 y), supplement use, and the following food intake sources: fortified breakfast cereal, dairy products, and meat.Results: Thirty-nine percent of subjects had plasma vitamin B-12 concentrations <258 pmol/L, 17% had concentrations <185 pmol/L, and 9% had concentrations <148 pmol/L, with little difference between age groups. Supplement users were significantly less likely than non-supplement-users to have concentrations <185 pmol/L (8% compared with 20%, respectively). Among non-supplement-users, there were significant differences between those who consumed fortified cereal >4 times/wk (12%) and those who consumed no fortified cereal (23%) and between those in the highest and those in the lowest tertile of dairy intake (13% compared with 24%, respectively), but no significant differences by meat tertile. Regression of plasma vitamin B-12 on log of intake, by source, yielded significant slopes for each contributor adjusted for the others. For the total group, b = 40.6 for vitamin B-12 from vitamin supplements. Among non-supplement-users, b = 56.4 for dairy products, 35.2 for cereal, and 16.7 for meat. Only the meat slope differed significantly from the others.Conclusions: In contrast with previous reports, plasma vitamin B-12 concentrations were associated with vitamin B-12 intake. Use of supplements, fortified cereal, and milk appears to protect against lower concentrations. Further research is needed to investigate possible differences in bioavailability.
Almost daily articles, reports, or studies appear claiming nutritional supplements are not effective. The claims vary, but the verdict is always there is little or no scientific evidence proving supplements (or the nutrients in supplements) work. Others assert that people who take supplements have the world’s most expensive urine. This is nonsense! The scientific evidence is clear, available, and it has been for a long time.
Among the many problems with these reports is bashing supplements based on studies using low dose or non-therapeutic levels of nutrients. There is frequently failure to consider the importance of synergy among nutrients. Often there is data manipulation via statistical methods (often in meta-analyses).
Well beyond the question of whether supplements support health are the factors in modern life that create a greater needs for supplementing with important vitamins, minerals, cofactors, and other nutrients.
This month we present “Seven Arguments for Nutritional Supplements.” As the title implies, there are at least seven solid arguments for nutritional supplementation. There are actually a lot more.
To preview these arguments in favor of taking supplements, they are: 1) reduced food quality, 2) nutrient density varies by location, 3) modern lifestyles and stress, 4) environmental pollution, 5) too low RDAs, and 6) promotion of health and delaying of aging, and 7) the human right to correct information.
Essential Fatty Acids (EFA) are one type of essential nutrient required for health.
We at HPDI re-publish articles from the Orthomolecular News Service (OMNS) because the authors provide much needed truth. Truth the form of correcting the false assumptions of anti-supplement propagandists to clarify the benefits of nutritional supplements. This information can help people be healthier easily and at relatively low cost.
HPDI offers a full line of foundational nutritional supplements, including multivitamins, vitamin C and antioxidant formulas, essential fats, and high-RNA Rejuvenate! superfoods. We also offer nearly 100 other nutritional supplements from single nutrients to condition specific formulas. See our full product overview.
Enjoy this article from the Orthomolecular News Service (OMNS). ~
Seven Arguments for Taking Nutritional Supplements
by Dag Viljen Poleszynski, PhD
(OMNS Sept 12 2018)
One of the most vitamin-restrictive countries in the world is Norway. There, authorities limit potencies to only slightly higher than RDA (Recommended Dietary Allowance) levels for dietary supplements sold outside of pharmacies. The traditional reasoning is that most people receive the nutrients they need from a “balanced diet.” 
The authorities are also obsessively concerned that some vitamins and minerals are harmful in high doses. And, since an intake of water-soluble vitamins in excess of needs is excreted in the urine, Norwegian “experts” advise that taking supplements is a waste of money.
Accordingly, the argument goes, the public should be protected not only from possible harm, but also from wasting money on unnecessary nutrients. The official policies on nutritional supplements vary within OECD (Organization for Economic Cooperation and Development) countries. Some are more liberal, while others are even more restrictive.
The official view on the connection between nutrient intake and possible toxicity is illustrated by the Norwegian Food Authority in a graph. 
Perceived risk from intake of nutrients. (Source: Expert Group on Vitamins and Minerals. Safe upper limits for Vitamins and Minerals. May 2003: Food Standards Agency, UK.)
The graph illustrates the official view on nutrients, assuming that nutrients function in the same way as pharmaceuticals, which they do not. Supplements of most vitamins, but also minerals and other nutrients, do not have very serious side effects even when taken at very high levels – in contrast with most drugs. [3,4] The fact that most of the chemotherapeutic drugs used against cancer have none or even just marginal effects against most cancers , while at the same time cause a lot of serious side effects, is rarely up for discussion.
The idea that nutritional supplements are not safe has a legal underpinning in Norwegian Food Law, which in section 16 prohibits sale of any food which is not safe: “Any food shall be considered not to be safe if it is seen as detrimental to health or not fit for consumption.” 
However, the Norwegian authorities do admit that vitamin D supplements are needed during part of the year.  Only part of the year? One third of Norway is within the Arctic Circle. Norway has far too little sunshine (especially during winter months) to get adequate levels of vitamin D from UVB radiation on the skin.
The authorities also recommend that pregnant women take folic acid to prevent birth defects, and omega-3-fatty acids may be advisable for those who do not eat fish regularly. Norwegians have a long tradition of giving children cod liver oil, which in a daily tablespoon provides enough vitamin A and D and essential fatty acids to cover basic needs.
Essential and conditionally essential nutrients
There are thousands of dietary supplements on the market, including 40+ essential nutrients alone and in various combinations, i.e. vitamins, minerals, trace elements and fatty acids. However, a number of other nutrients are “conditionally essential”, meaning that the body normally can make these molecules, but some people do not make optimal amounts. Examples are L-carnitine, alpha-lipoic acid, the methyl donor betaine,  chondroitin sulfate, coenzyme Q10, choline, amino acids such as tyrosine or arginine, and “essential” sugars normally formed in the body. 
Healthy young people normally make sufficient amounts of conditionally essential molecules in the body, although the levels are not always optimal. With inadequate levels of minerals or vitamins, key enzymes in biochemical pathways may not function optimally.
Due to genetic mutations, some enzymes may have increased needs for certain cofactors (vitamins), which can prevent them from functioning optimally. Some enzymes only function normally when supplied with cofactors in greater amounts than normally required.
If supplements of essential nutrients prove insufficient for optimal enzyme function, “conditionally essential” nutrients may be added as part of a comprehensive, therapeutic program.
Parents are advised to become familiar with the literature on essential nutrients, for instance by consulting the Orthomolecular News Service. Children should be given supplements in appropriate doses and in a suitable form. Pills should not be given before children can control the swallowing reflex. Multivitamin powder can be given dissolved in water or juice. Parents should not dose vitamin C so high that a child comes to school or kindergarten with loose bowels or diarrhea.
In high doses, niacin may cause unpleasant side effects such as flushing and itching lasting up to several hours.  Although this is not dangerous, it may cause a child to feel unwell and anxious. Starting niacin supplementation with a low dose and gradually increasing it will allow the body to adapt and avoid the niacin flush.
A multivitamin supplement containing moderate amounts of niacin is often adequate until a child is 8-10 years old. For younger children, the dosage should start with only a few tens of milligrams, and not increased to more than 50-100 mg/day. Adults may gradually get used to taking 1,000-1,500 mg/d divided into 3 doses per day.
When it comes to omega-3 fatty acids (omega = ω) such as EPA and DHA, children may be given cod liver oil and served fish and/or other seafood 2-3 times a week. It is important to check the dose of vitamin A supplied, as it can be toxic in high doses, especially for children. One problem with cod liver oil today is that vitamin D has been removed during processing, thus changing the natural ratio of the two vitamins so that we ingest relatively too much of vitamin A. 
Higher dosages may be given after having consulted a therapist who has measured the ratio of omega-6 to omega-3 fatty acids in relevant cell membranes (red blood cells). In most industrialized countries, many people get too much of the omega-6 fatty acids, and would therefore benefit from eating more seafood or taking supplements with omega-3 fatty acids derived from organisms low in the food chain (algae, krill).
Flax seeds contain a high level of the essential omega-3 fatty acid alpha-linolenic acid, and freshly ground flaxseed meal or flax oil can be mixed with breakfast cereals or smoothies. Note that it may be advisable to limit eating farmed fish to once per week, since their fodder contains less omega-3 fatty acids than the food eaten by wild fish, and possibly also contains more contaminants.  Some researchers even warn against letting children eat too much fish because of the content of environmental toxins. [13,14]
Reasons for high-dose supplements of micronutrients
I have identified a number of arguments in favor of supplementing the modern diet with essential nutrients, here summarized with seven headlines. Most people should consider taking a multivitamin supplement containing vitamins and minerals even if they eat a nutritionally balanced diet.
Additional nutrients may contribute to better health and, in some cases, can be of vital importance in our modern world. The arguments are presented in random order, i.e. the order does not reflect priority.
1. The agricultural revolution has reduced food quality
The transition from an existence as hunter and gatherers to urban agriculture around 10,000 years ago began an epoch when foods were mass-produced but had lower nutritional density, compared with the previous food eaten by our ancestors. The nutritional density in many foods has fallen significantly since human societies transformed from hunter-gatherers into resident farmers. This is especially true in the last 60-70 years after agriculture was changed from small, versatile ecologically driven family farms to large, chemical-based, industrial agriculture. 
The reduction of nutritional content in modern crops, compared with older varieties, is well documented.  It is a consequence of soil erosion, loss of essential minerals from continual heavy use, combined with breeding of new varieties, which has increased the size and growth rate of plants by increasing the content of sugar and water and decreasing their mineral content compared to ancient species. At the same time, the relative content of other macronutrients (fat, protein/amino acids) and antioxidants may have been reduced.
Reduced nutritional density in many foods, combined with the use of refined “foods” like sugar, white flour and refined oils, places a greater priority on eating the most nutritious foods.
Farm produce grown organically generally has higher levels of essential nutrients such as trace minerals because the soil contains higher levels of trace minerals and the produce grows slower and thus has more time to absorb nutrients from the soil. Examples of nutrient dense foods are sardines, wild salmon, shellfish, eggs, liver, kale, collards and spinach, sea plants (seaweed), garlic, blueberries, and dark chocolate. 
2. Nutritional content of food varies with geographical location
Nutritional density varies considerably geographically between different regions, even with the same agricultural methods. This was documented in the United States in 1948 by a researcher at Rutgers University in the so-called Firman Bear report.  At that time agriculture was little mechanized, and artificial fertilizers and pesticides were hardly used.
The analysis found large differences in the content of minerals in the same food. The largest variations were found for potassium, sodium, boron and iron in spinach, while the greatest differences in calcium, magnesium and copper content were found in tomatoes.
The soil in areas with relatively low rainfall may in some cases contain an extremely high concentration of minerals, which is reflected in the plants growing there. This was well documented 70 years ago in the book Tomorrow’s Food.  The dentist George W. Heard found that the soil in Hereford, Texas, was exceptionally rich in minerals.
Hereford became known as the “town without a toothache” after a newspaper article from January 29, 1942, reported that Hereford had the lowest incidence of tooth decay of any city in the United States.  Dr. Heard found that people in Hereford had exceptionally few dental cavities and also that the soil locally was especially rich in minerals. He emphasized that the population in the county ate unprocessed food and was drinking raw milk. 
Recent research shows that differences in the content of the selenium in the soil can cause major differences in the concentration of selenium in meat.  For instance, since the soil in Finland is poor in selenium, the authorities decided in the early 1980s to add selenate to commercial fertilizers. A survey of selenium status among 108 healthy young people showed an increase in the blood selenium level of about 50 percent after four years. 
A similar problem with the level of minerals in the soil exists for the content of magnesium. Often when the soil gets depleted of magnesium from heavy use, this essential mineral is not included in soil amendment with fertilizers. Produce grown in soil with an adequate level of magnesium will contain more magnesium than produce grown in soil deficient in magnesium.
Perhaps as many as 70-80% of the US population is magnesium-deficient, which causes many health problems.  Magnesium supplements (chloride, malate or citrate) can provide an adequate level when vegetables grown in soil with adequate magnesium are not available.
3. Stress and the modern lifestyle increase the need for nutrients
Mental stress increases the excretion and hence the need for many nutrients. Among the most important are magnesium and vitamin C, both of which are used by the body in larger quantities during periods of physical and mental stress. [24,25] Compared with our past as hunters and gatherers, today´s stress is often of a more permanent nature. Instead of experiencing occasional situations where we had to fight or flee, many of us live with recurring stress day in and out.
Vitamin C protects the brain and nervous system from damage caused by stress because the synthesis and maintenance of chemical neurotransmitters such as adrenaline and noradrenaline requires adequate levels of vitamin C. 
Vitamin C is also needed to repair collagen which is essential for skin, blood vessels, bones and joints, and muscles. When these are damaged by physical stress, extra vitamin C is necessary.
A controlled trial of 91 adults who experienced increased anxiety and stress 2-3 months after an earthquake in New Zealand in 2011 was divided into three groups, two were given a broad spectrum supplement of micronutrients in low or higher doses.  The supplements were found to alleviate the experience of stress, with the biggest dose having the biggest effect.
Our sedate, modern lifestyle reduces the need for energy from food, which implies a lower food intake or obesity. Loren Cordain, PhD, and coworkers have estimated that hunter-gatherers had significantly higher energy needs than the typical modern office worker. 
A lower energy intake generally reduces the absolute intake of all nutrients, while the need for some nutrients is not always reduced proportionally with energy intake. Overall this suggests that more exercise along with a more nutritious diet, including supplements of essential nutrients and less carbohydrates, will help to prevent obesity and maintain health.
Processing of food reduces its nutritional content, and the finished products are often based on fractions of the original foods. One example is milling grain to make white flour,  which has a lower nutritional density than whole grain flour.
The reduction in nutritional value has accelerated since whole foods are now divided into pieces, for example, boneless chicken breast. When meat is injected with saline to increase the volume, the relative level of essential nutrients is reduced. In the United States, many supermarkets in low-income rural and inner city areas have a limited selection of nutrient-dense foods, compared with high-income areas. 
4. Environmental pollutants increase the need for nutrients
The need for efficient detoxification and excretion is greatly increased by environmental pollution from the chemical industry, herbicides and pesticides used by industrial agriculture, antibiotic treatment of animals, transport, and plastic packaging. 
In our polluted world, the increased toxic load may be compensated for by an increase in nutrients to promote detoxification. One can respond by taking large doses of supplements of essential nutrients, for example, antioxidants vitamin C and E, and an adequate dose of selenium, which help the body detoxify harmful chemicals. Also helpful is regularly taking sauna baths, fasting periodically, and eating an excellent diet that includes generous portions of dark green leafy vegetables and colorful vegetables and fruits. 
A recent study predicts that global warming may reduce the nutrient density in many foods worldwide.  Atmospheric CO2 is estimated to surpass 550 ppm in the next 30-80 years, leading to larger crops with lower content of protein, iron and zinc per energy unit.
Assuming that diets remain constant, while excluding other climate impacts on food production, the researchers estimated that elevated CO2 could cause an additional 175 million people to be zinc deficient and an additional 122 million people to be protein deficient in 2050. Anemia would increase significantly if crops lose even a small amount of iron. The highest risk regions – South and Southeast Asia, Africa, and the Middle East – are especially vulnerable, since they do not have the means and access to compensate using nutritional supplements.
5. The RDA for essential nutrients is too low
The recommended nutrient reference intake (NRI) has been defined by UK authorities and the EU Food Safety Agency as the dose that is adequate for 95 percent of the population.  These authorities have given recommendations for a total of 41 chemical substances,  including 13 vitamins, 17 minerals/trace elements, 9 amino acids and two fatty acids. The problem with such guidelines is that when using the same 0.95 fraction for just 16 of the essential nutrients, the fraction of the overall population that has their needs met with the RDA is less than half (0.9516 = 0.44).
Given the above assumption, the proportion of the population having all nutrient needs met falls below 25 percent for 30 nutrients (0.9530 = 0.21). These 25 percent will not necessarily get optimal amounts, just enough so that they probably will have no deficiencies in accordance with established standards. Each individual is different and has different biochemical needs, so we all need different doses of essential nutrients. Many vitamins and minerals can give additional benefit when taken at higher doses.
The need for several essential nutrients increases with age and sickness. This applies, for example, to vitamin C, vitamin D, magnesium, and iron. In 2017 the Norwegian Food Safety Authority proposed to revise the official maximum levels for vitamins and minerals in dietary supplements. 
Their proposal introduced four different age categories with separate maximum intakes. Initially, the agencies proposed to revise the daily doses allowed in dietary supplements for folic acid, magnesium, calcium, vitamin C and D. At the same time, maximum rates were temporarily suspended for vitamins A, E, K, thiamine (B1), riboflavin (B2), niacin (B3), pantothenate (B5), pyridoxine (B6), cobalamine (B12), biotin, and for phosphorus, iron, copper, iodine, zinc, manganese, selenium, chromium, molybdenum, sodium, potassium, fluoride, chloride, boron and silicon.
The upper limits for some nutrients may be changed in the future. Unfortunately, Norwegian nutrition “experts” will likely continue to limit allowable doses below those freely available in the US and even Sweden.
6. An optimal nutrient intake promotes health and delays aging
A spokesperson for optimal nutritional intake is the well-known biochemist Bruce Ames, who proposed the “triage theory of nutrients,” in which enzymes responsible for cell maintenance functions evolved to have lower affinity for the essential vitamin and mineral cofactors than the enzymes responsible for short-term survival, to preserve life during times of famine. 
Thus, higher levels of vitamins and minerals may delay mitochondrial aging, speed up the repair of large molecules such as DNA and collagen, and generally improve other cellular functions. This is an important rationale for taking higher doses of vitamins and minerals than recommended reference intakes.
Dietary supplements can slow the aging process, in part by reducing the harmful effects of free radicals, known to be involved in many diseases such as cardiovascular disease and cancer. 
Naturally occurring hormones and/or supplements of cofactors needed for optimal hormone production in the body can have a significant life-prolonging effect if the body produces less than optimal amounts.  This is especially relevant for those with a genetic predisposition for disease.
An optimum intake of all nutrients is difficult to achieve even for those who eat almost exclusively an excellent diet of nutrient dense foods, such as meat and innards, fish, shellfish, fowl, eggs, nuts, mushrooms, and vegetables, berries and nutritious fruits. Some nutrients such as folic acid or carotenoids in vegetables are absorbed better from processed than unprocessed foods.
Although vegetables are often considered to be a good source of vitamins, for example vitamin A from carrots, vitamin A is only found in animal products such as liver, egg yolk, fish cod and cod liver oil. Although eating raw vegetables is helpful for several reasons (vitamin C, fiber, microbiota), carotenoids (alpha/beta-carotene, lutein, lycopene) in vegetables are less well absorbed from raw than cooked food and better absorbed in the presence of added fat. [38,39].
Nutrients in vegetables are better absorbed when finely chewed, graded, or mashed , and cooking and grinding meat reduces the energy required to digest it  and increases nutrient absorption .
Orthomolecular pioneer Abram Hoffer and Orthomolecular News Service Editor Andrew W. Saul suggested this list of daily intakes of vitamins and minerals.  The Norwegian 2017 recommendations for adult men and women  are given in comparison. Individual needs may vary substantially from person to person and also with health status.
The figures for optimal intake are obtained from the Independent Vitamin Safety Review Panel of physicians, researchers and academics, who concluded:
“People are deceived in believing that they can get all the nutrients they need from a ‘balanced diet’ consisting of processed foods. To achieve an adequate intake of vitamins and minerals, a diet of unprocessed whole foods, along with intelligent use of dietary supplements is more than just a good idea: it is vital.” [44: 55]
A well-known example is vitamin C, which can effectively fight viral infections, prevent or reverse disease caused by bacteria, and help the body detoxify organic and inorganic toxins.  Vitamin C also reduces the risk for cancer, strengthens connective tissues (collagen), and counteracts stress by increasing the adrenal´s production of cortisol. The dose required is set according to the body’s need.
Nobel Price Laureate Linus Pauling suggested that an optimal daily intake of vitamin C could vary from at least 250 mg up to 20 grams per day.  Because unabsorbed vitamin C attracts water into the gut, some people may experience loose stools, gas and/or diarrhea by ingesting only 1-2 grams at a time, while others with a higher level of stress may tolerate 5-6 grams or more. The dose that causes loose stools is called the “bowel tolerance” for vitamin C.  To avoid the laxative effect of high doses, it is best to take vitamin C throughout the day in smaller divided doses.
When the body is stressed by disease, the gut will naturally absorb more vitamin C because the body needs more. To find the optimal dose, the intake should be increased until bowel tolerance is reached. Some people can tolerate more than 100,000 mg/d of vitamin C in divided doses during serious illness without having loose stool.
Liposomal vitamin C bypasses the normal bowel tolerance because it is absorbed directly through cell membranes, so higher doses can be tolerated without diarrhea.
7. A human right to receive correct information
Access to correct information about food and essential nutrients, including knowledge about the importance of food for health is a fundamental human right. Such information should not only provide a summary of the nutrient content of food, but in our opinion should also explain how dietary supplements can counteract deficiencies and prevent and reverse disease caused by nutrient deficiencies.
We should be free to purchase quality-controlled supplements of essential nutrients and to use them to counteract aging and damage from stress as part of a long-term health plan. The right to reject recommendations by doctors for symptomatic treatment with synthetic, some times life-threatening, drugs to alleviate symptoms should be included. [48,49]
I have not found any formulation of such rights from the Norwegian authorities. The role of parents and their right to receive correct health information is addressed in a book by lawyer Anne Kjersti C. Befring, a fellow at the University of Oslo since 2014. 
The use of dietary supplements is widespread. High doses of vitamins are thought to be helpful because they help the body recover from damage and maintain itself long-term. Many vitamins are not harmful in doses even 10 to 100-fold higher than officially recommended.
Some governments warn about possible negative side effects, even including increased mortality from “excessive” intake of certain supplements. However, supplements of essential nutrients have been available for more than 80 years. They are known to be safe, and the observed side effects are generally mild with few exceptions.
It is possible to ingest too much of certain vitamins and minerals (vitamin A, calcium, iron, copper, selenium) which may exacerbate an existing imbalance or lack of another mineral (magnesium, zinc). It is also important to balance intake of fatty acids in the omega-6 and omega-3 series, as most people get too much omega-6 and not enough omega-3.
Small children can be overdosed with adult doses of for example vitamin A or iron, and pills may be dangerous for babies or young children because they can get stuck in the throat. Therefore, I recommend consulting a doctor or nutritionist educated in orthomolecular medicine. Most people are likely to benefit from taking a broad-spectrum multivitamin/mineral supplement as a basic insurance against deficiencies.
Compared to pharmaceutical drugs, supplements of most essential nutrients are quite harmless. However, some supplements may have poor quality, or contain toxic metals such as lead or cadmium. Therefore, it is the duty of our authorities to ensure that potentially hazardous products or supplements of poor quality are not sold, and that consumers are offered fair prices in a free market.
An example where the Norwegian authorities do not follow up such basic duties is that pharmacies demand more than 1,600 Norwegian Kroner (about $190) per kg of vitamin C in powder form, which would cost less than $20 with free competition and no restrictions in permitted doses or outlets.
Those who want to use natural healing methods, such as the use of food and supplements of essential nutrients to prevent or reverse illness, should consult therapists who are qualified to give advice on how natural therapies can help.
I recommend that anyone interested in supplements read the references for this article as well as the archives of the Journal of Orthomolecular Medicine http://orthomolecular.org/library/jom/ and the Orthomolecular Medicine News Service http://orthomolecular.org/resources/omns/index.shtml . Both are free access online.
(Dag Viljen Poleszynski, PhD, is the editor of Helsemagasinet [Health Magazine] https://vof.no/arkiv/ . He has translated and published a large number of OMNS releases in Norwegian.)
1. National Nutrition Council. Dietary advice to promote public health and prevent chronic disease. Directorate of Health, Oslo January 2011.
22. Hintze KJ, Lardy GP, Marchello MJ, et al. Areas with high concentration of selenium in the soil and forage produce beef with enhanced concentrations of selenium. Journal of Agricultural and Food Chemistry 2001; 49: 1062-7. https://pubs.acs.org/doi/abs/10.1021/jf000699s
23. Mäkelä AL, Näntö V, Mäkela P, et al. The effect of nationwide selenium enrichment of fertilizers on selenium status of healthy Finnish medical students living in South Western Finland. Biological Trace Element Research 1993; 36: 151-7. https://link.springer.com/article/10.1007/BF02783174
24. Dean C. The Magnesium Miracle. Second Edition. New York: Ballantine Books, 2017. ISBN-13: 978-0399594441
25. Hickey S, Saul AW. Vitamin C: the real story. Laguna Beach, CA: Basic Health Publications, Inc., 2008. ISBN-13: 978-1591202233
26. Rucklidge JJ, Andridge R, Gorman B, et al. Shaken but unstirred? Effects of micronutrients on stress and trauma after an earthquake: RCT evidence comparing formulas and doses. Human Psychopharmacology and Clinical Experience 2012; 27: 440-54. https://onlinelibrary.wiley.com/doi/abs/10.1002/hup.2246
27. Cordain L, Gotshall RW, Eaton SB. Evolutionary aspects of exercise. In: Simopoulos AP, ed.: Nutrition and fitness: Evolutionary aspects. World Review of Nutrition and Diet 1997; 81: 49-60. https://www.ncbi.nlm.nih.gov/pubmed/9287503
28. Zenk SN, Powell LM, Rimkus L, et al. Relative and absolute availability of healthier food and beverage alternatives across communities in the United States. American Journal of Public Health 2014; 104: 2170-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202991/
29. Waldbott GL. Health effects of environmental pollutants. Second edition. St. Louis, MI: The C. V. Mosby Company, 1978. ISBN-13: 978-0801653308
36. Halliwell B, Gutteridge HMC. Free radicals in biology and medicine. 5th edition. Oxford, NY: Clarendon Press, 2015. ISBN-13: 978-0198717485
37. Hertoghe T. The hormone handbook. Copyright (c) 2006 Thierry Hertoghe. Surrey, UK: International Medical Publications, 2006.
38. Edwards AJ, Nguyen CH, You CS, et al. a- og ß-carotene from a commercial carrot puree are more bioavailable to humans than from boiled-mashed carrots, as determined using an extrinsic stable isotope reference method. Journal of Nutrition 2002; 132: 159-67. https://academic.oup.com/jn/article/132/2/159/4687130
39. Unlu NZ, Bohn T, Clinton SK et al. Carotenoid absorption from salad and salsa by humans is enhanced by the addition of avocado or avocado oil. The Journal of Nutrition 2005; 135: 431-6. https://www.ncbi.nlm.nih.gov/pubmed/15735074
40. Boback SM, Cox CL, Ott BD et al. Cooking and grinding reduces the cost of meat digestion. Comparative biochemistry and physiology. Part A, molecular & integrative physiology 2007; 148: 651-6. https://www.ncbi.nlm.nih.gov/pubmed/17827047
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I previously published “Homocysteine Genetics – Coenzyme B Vitamins” in which I considered in-depth how homocysteine (an intermediate chemical in the Methylation Cycle) is formed from methionine, how genetics affects the metabolic pathways, and how B vitamins are used in metabolic pathways. I also wrote “Folate Ingredients – Folinic Acid & 5-MTHF” which discussed how coenzyme folate vitamins are far superior to the synthetic folic acid form. In today’s article, I take a broader view of the topic that encompasses the Methylation Cycle, genetics, and B vitamins.
THE METHYLATION CYCLE
The Methylation Cycle is considered to be one of the most important metabolic pathways in the human body. Its most important function is to provide methyl groups via SAM (S-adenosyl methionine) to hundreds of different body substrates. Methylation is continually occurring in the body, transforming many millions of molecules throughout the body every second. Molecules receive methyl groups, then separate and recombine continuously, transforming and reforming constantly in the ongoing process of life!
As a reminder of the pathways involved in the Methylation Cycle, the following figure provides a flow chart showing the details.
Figure 1. Metabolic Pathways in Methylation Cycle
A key purpose of this cycle is to provide methyl groups (CH3) needed by a broad range of of body functions (over 200 different functions). Examples include:
Influences the genetic expression that parents give their children and helps guide the development of the embryo.
Is needed by the nervous system to produce neurotransmitters and maintain the nerves.
Mobilizes fats and cholesterol so they do not accumulate where they are harmful, such as the arteries and liver.
Regulates hormones, including, estrogen, adrenaline, and melatonin.
Detoxifies harmful chemicals and histamine a prime substance involved in inflammation.
Helps repair damaged proteins in the cells so they can function properly.
Protects the DNA in the genome (genetic code) to reduce the chances of mutation.
Creates antioxidants used in the antioxidant defense system.
DESCRIPTION OF PATHWAYS WITHIN THE METHYLATION CYCLE
The overall flow of the Methylation Cycle begins with dietary methionine (an essential amino acid) which combines with ATP (adenosine triphosphate – body energy) to form SAM (S-adenosyl methionine) – the common cosubstrate involved in methyl group transfers, transsulfuration, and aminopropylation. When SAM transfers a methyl group to a body chemical the residue from this reaction leads to the production of homocysteine.
Homocysteine can be converted in the transsulfuration pathway that requires coenzyme vitamin B6 to produce cysteine, glutathione, taurine, and sulfates. These sulfur containing substances provide important antioxidant protection and detoxification functions in the body.
Homocysteine can be converted back to methionine through the betaine (trimethyl glycine) pathway which requires zinc and magnesium. This pathway also requires dietary betaine or choline which the body can convert into betaine.
Also, homocysteine can be converted back to methionine via the remethylation pathway which requires 5-MTHF, coenzyme vitamin B2 and methylcobalamin (B12).
It is important to understand that each of the pathways described above are able to be executed only in the presence of enzymes (shown in blue boxes in the diagram) created by specific genes in your genetic code. For example, Betaine-Homocysteine S-Methyltransferase (BHMT) is the enzyme required in the betaine pathway, Cystathione Beta Synthase (CBS) is the enzyme required in the transsulfuration pathway, and Methylenetetrahydrofolate Reductase (MTHFR) and Methionine Synthase (MS) are enzymes required in the remethylation pathway.
Assuming that you have perfect genetics (no mutations, SNPs, free radical damage, insertions/deletions, etc.), the proper functioning of these pathways are still subjected to the fact that the required vitamins and minerals (vitamin B6, vitamin B2, Folate, vitamin B12, zinc, magnesium, and betaine) need to be provided by your diet or from supplements for the body to function correctly.
In addition, exposure to high levels of toxins from your environment and high levels of stress require that the nutritional needs will be even higher for the pathways to work properly. For example, exposure to high levels of toxins requires that the transsulfuration pathway be more active possibly reducing the amount of available methionine to support necessary methyl transfer reactions.
For these reasons alone the consensus of knowledgeable practitioners is that you should be eating an organic whole foods diet, taking appropriate nutritional supplements, avoiding and eliminating toxins from food, water, and air (living in a clean environment), and avoiding an unduly stressful life. All of these actions fall into the category of Epigenetics which you generally have control over!! Doing these things alone could significantly balance the functioning of your Methylation Cycle and improve your health.
Unfortunately, few people have perfect genetics which often causes the various pathways in the Methylation Cycle to become imbalanced and unable to correct the dysregulation imposed upon the body. For example, the enzyme MTHFR can have heterozygous (single chromosome) genetic variations in up to 50% of certain populations and homozygous genetic variations (both chromosomes) in 10% or more of certain populations.
Some disorders that researchers have associated with MTHFR genetic variations include:
Chronic fatigue syndrome
High blood pressure
Irritable bowel syndrome
Migraines with aura
Nitrous oxide toxicity
Unexplained neurologic disease
This extensive list is highly significant and tells us that it is very important to have genetic testing done for the genes/enzymes in the Methylation Cycle pathway. I prefer the BodySync genetic test which evaluates the key Methylation Cycle genes plus many other important genes in a single test.
B VITAMINS AND MINERALS
We are strong believers that everyone should start their nutritional program by eating a balanced, organic, whole foods diet. We have been doing this ourselves for the past 30 years. Unfortunately, only a small percentage of people follow this advice and in most cases this leads to poor nutritional status that does not adequately support the body’s needs. This is especially true with respect to obtaining the nutrients needed to support the Methylation Cycle.
Nine of our family members and associates have taken the BodySync genetic test which evaluates the condition of 45 different enzymes including CBS, MTHFR (2 variations), MTR (related to B12 and 5-MTHF as they relate to methionine synthase – MS), and MTRR (related to maintaining B12 levels needed by the MTR enzyme). In every case the results showed at least 2 and up to 4 enzymes had genetic variations. These results indicate that the nutritional requirements for folate as 5-MTHF, vitamin B12 as methylcobalamin, vitamin B6, vitamin B2, magnesium and zinc will likely be significantly greater than normal.
Given the above information, it seems essential for good health to take nutritional supplements that provide the important nutrients. Below I will discuss various formulas that I have developed and refined over many years that are useful especially for the Methylation Cycle.
Please note that Health Products Distributors, Inc. (HPDI) is the preferred supplier of nutritional supplements by the BodySync genetic testing company.
When looking at the total needs the body has for nutrients that the body does not produce, including fat soluble vitamins (A, D (some), E, K1 and K2), vitamin C, B vitamins (B1, B2, B3, B5, B6, folate, B12, biotin, choline, and inositol), minerals (Ca, Mg, Zn, Se, Cu, Mn, Cr, Mo, K, boron, and vanadium), and betaine it only seems wise to include as a top priority a Multivitamin that includes all of these in what I term therapeutic amounts (carefully selected after evaluating thousands of research studies carried out over many years.)
In this context, it is important to recognize that every enzymatic reaction in the body requires mineral cofactors in order to carry out its function. A good multivitamin provides many of these required minerals.
Additionally, the multivitamin should contain ingredient forms that research has confirmed to be the most absorbable and usable by the body. These include coenzyme B vitamins, Krebs cycle (citrate, alpha-ketoglutarate, succinate, fumarate, & malate) minerals, and amino acid chelates.
In the context of supporting the Methylation Cycle we are looking for specific forms and amounts of B vitamins that can adequately provide the body’s needs. The means that there should be coenzyme folate as 5-MTHF of at least 400 mcg, coenzyme vitamin B-12 as methylcobalamin of at least 200 mcg, Vitamin B6 (including significant amounts of pyridoxal 5′ phosphate) of at least 40 mg, and Vitamin B2 (including significant amounts of riboflavin 5′ phosphate) of at least 25 mg. In addition, magnesium (100 mg) and zinc (at least 20 mg) should be provided.
Please note that the body’s requirements for magnesium is generally accepted by nutritional experts to be higher than 400 mg daily (and as high as 1,000 mg daily). For this reason we generally recommend that a person take supplemental magnesium (such as HPDI’s MYO-MAG) at levels over 400 mg daily.
The two multivitamin formulas Health Products Distributors provides for adults that meet these requirements (and more) are the Hank & Brian’s Mighty Multi-Vite and Multi Two (in both capsule and tablet forms). Click on the bottles below for technical details.
In situations where significant genetic variations are present it may be wise to add a B COMPLEX supplement to the MULTIVITAMIN to provide even larger amounts of the needed B vitamins. HPDI provides a B-Complex-50 product that includes significant amounts of coenzyme forms and contains 50 mg of Vitamin B1, 50 mg of Vitamin B2, 100 mg of Vitamin B3, 50 mg of Vitamin B6, 500 mcg of coenzyme folate (both folinic acid and 5-MTHF), 100 mcg of B12 (both methylcobalamin and hydroxocobalmin), 50 mg of Vitamin B5 (pantothenic acid), 500 mg of Biotin, 50 mg of choline, and 50 mg of inositol. Click on the bottle below for technical details.
FOLATE AS 5-MTHF
In situations where an inadequate diet is present and genetic testing indicates an MTHFR variation (especially a homozygous variation) Health Products Distributors provides a 5-MTHF folate supplement that easily absorbs into the body and can be directly used in combination with Vitamin B12 to convert homocysteine to methionine. Click on the bottle below for technical details.
5-MTHF 1 mg in veggie cap
B-12 as METHYLCOBALAMIN
It is often the case for older patients and vegetarians that Vitamin B12 is deficient. In these cases it is wise to supplement with a significant amount of methylcobalamin to ensure that the Methylation Cycle has sufficient to effectively convert homocysteine into methionine. Health Products Distributors Vitamin B12 contains 5 mg of methylcobalamin in sublingual lozenge form that supports excellent absorption even if swallowed and absorbed by diffusion. Click on the bottle below for technical details.
Magnesium and zinc are two important minerals used in the betaine pathway of the Methylation Cycle in which homocysteine is converted back to methionine.
In the body magnesium is involved in more than 400 essential metabolic reactions and is required by the adenosine triphosphate (ATP)-synthesizing protein in mitochondria. ATP, the molecule that provides energy for almost all metabolic processes, exists primarily as a complex with magnesium (MgATP). Therefore, it also is involved in converting methionine to SAM.
Over 300 different enzymes depend on zinc for their ability to catalyze vital chemical reactions. Zinc-dependent enzymes can be found in all known classes of enzymes.
Health Products Distributors provides 100 mg magnesium/vcap in its MYO-MAG supplement which is especially important in increasing ATP in the Krebs Cycle. This product also contains vitamin B1, vitamin B2, and vitamin B6 with substantial amounts of coenzyme forms and manganese. Click on the bottle below for technical details.
MYO-MAG with 100 mg magnesium per serving and key B vitamins.
Health Products Distributors provides 25 mg zinc/serving in its Double Zinc Plussupplement. This formula provides zinc in the picolinate and citrate forms as well as 3 mg of P5P (coenzyme B6). Click on the bottle below for technical details.
Double Zinc Plus supplement with P5P and 25 mg zinc
The Methylation Cycle is recognized as one of the most important metabolic pathways in the human body. When not properly supported by key B vitamins and minerals, the Methylation Cycle can become severely imbalanced which can lead to a very wide range of poor health conditions. Furthermore, genetic variations in the genes that produce important enzymes allowing the Methylation Cycle to function correctly lead to even further imbalances and greater possibility for conditions of poor health.
In this article, I have provided insight into how the Methylation Cycle works and how it can be significantly supported by lifestyle changes regarding diet and environment (Epigenetics) and by specific B vitamins and mineral supplements that I have developed over many years. In addition, we have shown that knowledge gained from genetic testing can further provide a critical understanding of your specific needs so that your health can be optimized.