The following are notes taken from Dr. Low Dog’s book, Fortify Your Life. It is an excellent read, and I happened upon it by our Megafood rep who gave me a copy. Dr. Low Dog has worked with Megafood, a whole-food supplement company out of New Hampshire, and she has transformed their products better than ever. It’s quite a lengthy read, but I hope you will enjoy snippets out of a book, rather than dedicating to an entire book. I also hope that it will change the way you think about whole-food supplementation. We will see how not all supplements are created equal, especially considering each individual’s medications and overall health. The following post will cover vitamins A-B, and next week we will continue on with C-K, followed by minerals, and nutraceuticals. We will also look at how to interpret labels, health information, and databases that contain reliable research.
Bioavailability means that a nutrient or ingredient is absorbed in a form that is usable and able to reach the right target.
Synthetic vs Natural: does your body know the difference?
It depends. A, D, and E should be derived from natural sources whenever possible. Synthetic vitamin E is only as biologically active as the natural form. Look for d-alpha tocopherol on the label, which indicates the natural form. There are eight forms of Vitamin E (four tocopherols and four tocotrienols), each with a unique function in the body. Using a mixture might be the optimal way to supplement with Vitamin E.
If your supplement contains more than 100 mg of vitamin C, chances are high you’re getting at least some synthetic vitamin C. However, natural and synthetic ascorbic acid are chemically identical, and there are no known differences in their biological activities or bioavailability. Your body will be happy with either one and will use it effectively to perform all the tasks natural vitamin C would perform: boosting immunity, contributing to healthy gums, and so on.
Stomach acids play a key role in helping the body use and absorb calcium, magnesium, iron, and B12. As we get older, we make less stomach acid, which is why people over the age of 50 should take a B12 supplement and/or eat foods fortified with B12. It’s also why calcium citrate is recommended over carbonate, as it does not require stomach acid. Drugs that shut down stomach acid, such as PPIs, increase the risk for deficiencies of these nutrients.
After leaving the stomach, food enters the small intestine, where enzymes secreted by the pancreas further the digestion of proteins, carbohydrates, and particularly fats. Some people, such as those with cystic fibrosis, do not make enough pancreatic enzymes to digest and absorb the fat-soluble vitamins A, D, E, and K.
Large amounts of calcium (250 mg or more) can impair the absorption of iron, while vitamin C increases it. If you take iron, take it with vitamin C, and not with large doses of calcium. Taking large doses of calcium or magnesium (250 mg or more) can compete with the absorption of other minerals, including each other, for absorption. Dr Low Dog recommends taking magnesium at bedtime to help with sleep and relaxation. Take your multivitamin-mineral supplement at least two hours apart from your calcium or magnesium. It is better to take fat-soluble vitamins (A, D, E, K) and fish oil with a meal containing fat. One study found that taking vitamin D with dinner instead of breakfast increased blood levels of vitamin D by about 50 percent.
Most multivitamin-mineral supplements are best taken with food to aid their dissolution and absorption. Multivitamin-mineral supplements and vitamins C, E, and B-complex can all be taken together at the same meal. Take larger amounts of calcium or magnesium several hours apart from other minerals. Calcium carbonate must be taken with food, whereas calcium citrate does not need to be. Dr Low Dog recommends the latter.
Herbal bitters are often taken 20 minutes before a meal to “prime” the digestive tract, revving up the production of stomach acid and alerting the pancreas that food is coming. SAMe, a supplement used for mood problems, osteoarthritis, and fibromyalgia, is also recommended 20 to 30 minutes before a meal. As a general rule: Take your supplements two hours apart from any medicine.
Vitamins are critically important to your health. You need sufficient amounts not only to stave off disease but more importantly, to promote vitality and well-being. You might find that there are key vitamins that you might be deficient in due to age, medication use, or a specific health issue. If you think you might be lacking, you may want to consider getting some laboratory tests done that can provide your actual levels, or keep a two-day food diary to determine whether you are getting enough key nutrients.
Animal derived vitamin A is referred to as retinol, or preformed vitamin A, and is the most biologically active form. Some forms of plant-derived vitamin A, especially the colorful carotenoids in fruits and vegetables, can be converted, when needed, to the active, or retinol form of vitamin A. Thus, these carotenoids are referred to as provitamin A. It plays a key role in the formation of rhodopsin, the visual pigment in the retina that is essential for the eyes to adapt to the dark. Vitamin A maintains the health of the cells that line our nose, throat, and respiratory, digestive, and urinary tracts. This barrier serves as our body’s first line of defense against infection. In the bones, retinol is needed to produce red blood cells and integrate iron into hemoglobin so the blood can carry oxygen to all the tissues in our body. Avoid using topical retinol, they accelerate the growth of skin cancers upon exposure to sun. Apply only at night when you won’t be exposed to the sun. Only a few of the dietary carotenoids- beta-carotene and beta-cryptoxanthin- can be readily converted into retinol. Lycopene, lutein, and zeaxanthin are also carotenoids but have no vitamin A activity. Natural preformed vitamin A is usually listed on the label as retinyl acetate, retinol acetate, or vitamin A acetate.
Partner nutrients: zinc and iron. Zinc transports the A stored in your liver to where it needs to go, such as your eyes. A helps move iron into hemoglobin. Taking vitamin A and iron, along with vitamin C, is often the best way to correct iron deficiency anemia.
The reason there are gaps between the numbers is because these slots were originally taken up by substances thought to be vitamins that later turned out not to be, so they were removed from the list. Because the B vitamins have similar functions, they work synergistically together. They are often referred to as “stress vitamins” for good reason. They not only play important roles in the metabolism of carbs, fats, and proteins, and in the production of fuel and energy, but they are crucial for the production of brain chemicals that help to regulate our mood, sleep, and feeling of pleasure.
Thiamine plays a vital role in your body’s production of energy. It is a coenzyme, or helper nutrient- for enzymes that are responsible for converting food to energy, particularly the metabolism of carbs, glucose, and alcohol. It is vital for the healthy function of our brain, as well as our nervous and cardiovascular systems. Beriberi is a disease caused by thiamine deficiency. Because we consume so many sugar-laden, nutrient-devoid carbs, we require a constant supply of thiamine. Research suggests this vitamin plays a vital role in helping our body deal with stress and preserving our memory as we age. Wernicke-Korsakoff psychosis happens when the parts of the brain involved with memory are permanently damaged. People are unable to form new memories and often suffer the loss of old memories as well. It is most often seen in alcoholics and those who are severely malnourished. Those who drink 2 or more alcoholic drinks and high amounts of coffee and tea need thiamine as well.
Riboflavin serves as a helper, or co-factor, in many enzyme reactions that are involved in the body’s production of energy. It maintains the health of our nervous system and eyes, helps us break down and use dietary proteins and fats, and converts vitamins B6 and B9 (folate) to their active forms in the body. Riboflavin plays an important role in the maintenance of our 24-hour circadian rhythm by activating blue light-sensitive cells in the retina, inhibiting the production of melatonin. Riboflavin has been studied for the prevention of migraine headaches. A current theory is that migraines are caused by mitochondrial dysfunction in brain cells. Riboflavin helps maintain normal energy production in brain mitochondria.
Riboflavin, with the help of vitamin C, increases the level of glutathione, one of our body’s most potent antioxidants. Vitamin B2 is crucial for the absorption and use of iron in the body. Recently, a five-year study of more than 1,200 people in China found a strong correlation between low riboflavin and iron and concluded that “correcting inadequate riboflavin intake may be a priority in the prevention of anemia.”
Vitamin B3 (Niacin)
Niacin is a major player in converting carbs, proteins, and fats into fuel. It promotes cellular health and protects our DNA from damage. A study of airline pilots, who are subject to high exposures of radiation, found that niacin, but not other antioxidants, reduced DNA damage. Before we had statins, niacin was the drug of choice (in high doses) for treating cholesterol problems. Two recent large studies found that while niacin improved lipid profiles, it did not reduce heart attacks or save lives. Statin medications were shown to do both.
During the first 40 years of the 20th century, a strange but deadly disease killed many poor people in the U.S., known as pellagra. Remember pellagra by the three Ds: dermatitis, diarrhea, and dementia. Thanks to food fortification programs, significant niacin deficiency may be more prevalent than we realize, especially in alcoholics, those with absorption problems, the homeless or malnourished, and people with cancer.
Vitamin B5 (Pantothenic Acid)
Vitamin B5 takes its name from the Greek pantothen, which means “on all sides” [Think Pantheon!] because small quantities of this vitamin are found in nearly every food, making deficiency in humans exceedingly rare. It is a primary component of coenzyme A (CoA), a helper or cofactor for more than 70 different enzymatic pathways in the body, including the production of acetylcholine, a neurotransmitter involved in memory, learning, attention, and the contraction of skeletal muscles. CoA is also involved in the production of melatonin, antibodies, adrenal hormones, and heme, the protein in hemoglobin that carries oxygen throughout the body.
Vitamin B6 (Pyridoxine)
Vitamin B6 plays an important role in the production of fuel and energy, and is critical for the optimal function of our brain and our nervous and immune systems. In spite of how important vitamin B6 is to health, research shows that more than 30 million Americans are deficient in this nutrient. Most of the vitamin B6 we ingest travels to the liver, where it is converted to pyridoxal 5′-phosphate (PLP), the biologically active form. PLP then travels via the bloodstream to cells throughout the body. What is not readily used is stored in our muscles. A deficiency of vitamin B6 can lead to anemia. B6, along with niacin, zinc, and magnesium, is necessary for the conversion of plant omega-3 (ALA) to the long-chain omega-3 fatty acid DHA, which is crucial for brain, eye, and cardiovascular health throughout our lives. Vitamin B6 is also needed to convert tryptophan to niacin.
Vitamin B6 is necessary for the brain to develop and function properly. It is also involved in the production of the neurotransmitters GABA, serotonin, norepinephrine, and dopamine, all of which positively affect mood. Low levels of B6 increase the risk for depression and impair cognition, attention, and memory. Vitamin B6 is important for the manufacture of melatonin; a deficiency in B6 can make it harder to fall and stay asleep. The Framingham Heart Study revealed that those with the highest levels of inflammation had the lowest levels of vitamin B6 [Think of type-2 diabetes, heart disease, R.A., IBS, coronary artery disease, stroke].
Vitamin B7 (Biotin)
Several small studies suggest biotin can improve thin, brittle nails when taken at doses of 2.5 mg per day for at least six months. Unfortunately, there is virtually no evidence that biotin can help improve thinning hair, a condition for which it is commonly promoted. Biotin is necessary for the synthesis of fatty acids and for making glucose from sources other than carbs. Two randomized, placebo-controlled trials are currently under way to see if biotin might be beneficial for those living with MS.
Vitamin B9 (Folate)
Vitamin B9 comes in two primary forms: Folate occurs naturally in food, whereas folic acid is synthetic. Folate is vital for growth and development and for maintaining healthy brain function, protecting us from certain cancers, and preventing a rise in homocysteine. Folate is vitally important in pregnancy. Without adequate folic acid, DNA synthesis and cell division are hindered, increasing the risk for miscarriage and neural tube defects (NTD), such as spina bifida and anencephaly, which are caused by the incomplete closing of the spine and skull. The end of the neural tube that becomes the baby’s head closes 23 to 26 days after conception, which is why physicians recommend that folic acid be started at least one month before a woman gets pregnant.
One area that is relatively new in the medical scene is the realization that not everyone has the right genetic machinery to metabolize and activate certain nutrients. This appears to be particularly true when it comes to converting supplemental folic acid to its active form L-methylfolate. Since it is unclear when and who to test, it makes sense to choose a supplement that contains the active form of folic acid. The active form of folic acid is usually listed on the label as L-methylfolate or 5-methyltetrahydrofolate (5-MTHF).
Vitamin B12 (Cobalamin)
Vitamin B12, among its many roles, is necessary for the production of healthy red blood cells and prolonged deficiency leaves the body without enough red blood cells to carry oxygen to all our tissues. If not corrected, this lack of red blood cells damages the heart, nerves, brain, and other organs, eventually leading to death. Of the 13 essential vitamins, it is the only one that contains the trace mineral cobalt, which is why vitamin B12 is also referred to as cobalamin. We need vitamin B12 for physical and mental energy, as well as emotional well-being. Vitamin B12, along with B6 and folate, plays an important role in the production of the neurotransmitters serotonin, dopamine and norepinephrine, chemicals in the brain that are responsible for mood and pleasure. Low levels of vitamin B12 can lead to depression, confusion, and possibly even dementia.
Just like folate, vitamin B12 is needed during pregnancy to ensure the healthy development of the baby. Even marginally low levels may increase a woman’s risk for postpartum depression. Vitamin B12 is found almost exclusively in animal foods and requires three steps for absorption. Once the food enters the stomach, hydrochloric acid and the digestive enzyme pepsin act upon the food to separate the B12 from the protein that it is attached to. This free vitamin B12 is then joined to a protein called gastric intrinsic factor (IF), made by the parietal cells in the stomach. The B12-IF then travels to the very end of the small intestine where, if calcium supplies are adequate, it is absorbed. No matter what you might read, you cannot get vitamin B12 by eating nonfortified foods, nutritional yeast, algae, or seaweed. If you suddenly stop consuming all animal products, you’ll be fine for a few years because you can use the vitamin B12 stored in your liver.
We need stomach acid to help with the absorption of vitamin B12, but as we get older, we produce less stomach acid. One of the primary reasons many people have insufficient stomach acid is the widespread use of PPIs (Nexium, Prilosec, Prevacid) and H2 blockers. Short term use of these drugs (two to six months) is not likely to cause problems, but many people take them for years.
Cyanocobalamin is a synthetic form of vitamin B12. Your body wants and needs methylcobalamin (methyl B12)
Bottom line: Taking a daily multivitamin will help ensure that you are getting adequate levels of these vitamins.