TAKING JUST A FEW vitamins CAN optimize the function of ALL your body’s systems. It’s true. But you have to know what to take and you have to know why these supplements work …
That’s why, in this week’s blog, I am going to discuss one of the most important biochemical processes for long-term health and how you can keep it running at its very best with supplements and other measures.
Unfortunately, many people suffer from one or more of the 8 factors that negatively impact this biochemical process, so problems in this area are widespread though many don’t realize they are suffering.
The good news is that there are MANY things that you can do right now to optimize this critical biochemical process that may have a dramatic impact on your health. In today’s blog I will review the 8 factors that can lead to problems in this area, and outline 12 tips that will help you optimize this essential part of your biology.
But first, I’d like to tell you about two of my patients with seemingly unrelated health problems that were actually caused by a breakdown in this biochemical process. And I want to share a study done on Chinese babies who had a birth defect known as spina bifida.
You’ll be amazed at how all three — my two patients and these Chinese babies — were affected by the exact same thing …
Interestingly, these Chinese babies, Mr. Roberts, and Mr. McNally all have something very important in common. They all have inadequate levels of specific vitamins, either acquired or genetic, …
What an Elderly Golfer, a College Professor, and Chinese Babies have in Common
One of my patients, Mr. Roberts, was an 88-year-old businessman who didn’t let his age slow him down. He still golfed three times a week, worked two days a week, flew around the world in his private jet, and was “romantic” once a week with a wife 30 years his junior. He also loved his 6 ounces of Grey Goose vodka every night.
Of course, he did have some health problems. Mr. Roberts had been treated well for mild heart disease. His doctor even recommended 800 mcg of folic acid and 250 mcg of vitamin B12 — megadoses by any standard.
Mr. Roberts also had a check-up at the Mayo Clinic and was told that he was healthy, despite having mild anemia and large red blood cells. Yet he still complained of mild fatigue and trouble with his short-term memory. Plus, I noticed a slightly wide gait common in someone with poor balance.
Then there was Mr. McNally, a Boston college professor who was 50 years old, fit, and lean but wore a worried look as he walked into my office.
He recounted the sad tale of his 7 brothers. Four had died of a heart attack and three others had had bypass operations at a young age. Concerned about his own fate, he ate a low-fat diet, exercised regularly, didn’t smoke, had normal blood pressure and cholesterol levels, and took antioxidants and a multivitamin. Perhaps his only vice was the multiple Starbuck’s grande lattes he downed each day. Living under a constant state of impending doom, Mr. McNally came to me asking for a stress test to see how his heart was doing.
Strange as it may seem, these two men reminded me of my time in China. When I lived in Beijing, a study was done on a group of women in Harbin, the northern most industrial city in the Gobi desert, just north of Beijing. It seemed that there was an unusually high rate of birth defects in the area, specifically spina bifida.
The Chinese have a tradition of holding weddings during the Chinese New Year in February. In Harbin, many of the babies born 9 months later had birth defects. This study sought to determine what the link was and found that the major factor was the lack of fresh greens or vegetables in the Gobi desert in the middle of winter.
Interestingly, these Chinese babies, Mr. Roberts, and Mr. McNally all have something very important in common. They all have inadequate levels of specific vitamins, either acquired or genetic, and their methylation systems are not working properly as a result. I’ll explain more about what “methylation” is in a second. First let’s analyze the similarities in these cases.
Take Mr. Roberts. Our romantically active 88-year-old took high doses of B vitamins. But he still had very high levels of homocysteine and methylmalonic acid — indicators of folic acid and B12 deficiency.
Mr. McNally had similar problems. Our college professor had a genetically sluggish metabolism of homocysteine which caused extremely high levels of this toxic amino acid to build up in his blood. This was the likely cause of all the heart disease in his family.
Again we see a similar set of problems in those Chinese babies. Their mothers were conceiving in the middle of winter — when their folate intake was low from the absence of fruits and vegetables. This is what triggered such a high rate of birth defects.
The common link in all three of these cases is a problem with methylation. Let me tell you more about that that actually means.
Methylation is a key biochemical process that is essential for the proper function of almost all of your body’s systems. It occurs billions of times every second; it helps repair your DNA on a daily basis; it controls homocysteine (an unhealthy compound that can damage blood vessels); it helps recycle molecules needed for detoxification; and it helps maintain mood and keep inflammation in check.
To keep methylation running smoothly you need optimal levels of B vitamins. Without enough B vitamins methylation breaks down, and the results can be catastrophic. In these cases we see more birth defects like spina bifida (as with the Chinese babies), more cases of Down’s syndrome, and more miscarriage.
A breakdown in methylation also puts you at higher risk for conditions like osteoporosis, diabetes, cervical dysplasia and cancer, colon cancer, lung cancer, depression, pediatric cognitive dysfunction ( mood and other behavioral disorders), dementia, and stroke. And like Mr. Roberts and Mr. McNally, you may be at higher risk for cardiovascular disease.
To avoid all of these problems, the key is to maximize methylation. That means avoiding the things that cause your methylation to break down, testing to find out how well your methylation is working, and including the things that support proper methylation. Let’s look at how to do that.
8 Factors that Affect Your Methylation Process
8 major factors negatively impact methylation. They are:
1. Genetics.
- Like an estimated 20 percent of us, you could be genetically predisposed to high homocysteine.
2. Poor diet.
- The word “folate” comes from “foliage.” You need to eat plenty of leafy greens, beans, fruit, and whole grains to get adequate levels of vitamins B6 and B12, betaine, and folate. Egg yolks, meat, liver, and oily fish are the main dietary sources of vitamin B12 — so long-term vegan diets can be a problem. Plus, certain compounds can raise levels of homocysteine and deplete the B vitamins. These include excess animal protein, sugar, saturated fat, coffee, and alcohol. Irradiation of food depletes nutrients, so foods treated this way may be lower in B vitamins, too.
3. Smoking.
- The carbon monoxide from cigarette smoke inactivates vitamin B6.
4. Malabsorption.
- Conditions like digestive diseases, food allergies, and even aging can reduce absorption of nutrients.
5. Decreased stomach acid.
- Aging and other conditions can reduce stomach acid — and therefore absorption of vitamin B12.
6. Medications.
- Drugs like acid blockers, methotrexate (for cancer and arthritis and other autoimmune diseases), oral contraceptives, HCTZ (for high blood pressure), and Dilantin (for seizures) can all affect levels of B vitamins.
7. Other conditions.
- These include hypothyroidism, kidney failure or having only one kidney, cancer, and pregnancy.
8. Toxic exposures.
- Some toxins can interfere with vitamin production.
Watch out for these factors and you will go a long way toward protecting your methylation.
Measuring Your Own Methylation Process
To find out if your methylation process is optimal, ask your doctor for the following tests:
1. Complete blood count.
- Like our friend Mr. Roberts, large red blood cells or anemia can be a sign of poor methylation. Red blood cells with a mean corpuscular volume (MCV) greater than 95 can signal a methylation problem.
2. Homocysteine.
- This is one of the most important tests you can ask for. The normal level is less than 13, but the ideal level is likely between 6 and 8.
3. Serum or urinary methylmalonic acid.
- This is a more specific test for vitamin B12 insufficiency. Your levels may be elevated even if you have a normal serum vitamin B12 or homocysteine level.
4. Specific urinary amino acids.
- These can be used to look for unusual metabolism disorders involving vitamins B6 or B12 or folate, which may not show up just by checking methylmalonic acid or homocysteine.
12 Tips to Optimize Your Methylation Process
Just as there are many causes of poor methylation, there are lots of things that support its proper functioning. Here’s how to maximize methylation — and prevent conditions like heart disease, cancer, dementia, depression, and more.
1. Eat more dark, leafy greens.
- You want to eat l cup a day of vegetables like bok choy, escarole, Swiss chard, kale, watercress, spinach, or dandelion, mustard, collard, or beet greens. These are among the most abundant sources of the nutrients needed for optimal methylation.
2. Get more Bs in your diet.
- Good food sources include sunflower seeds and wheat germ (vitamin B6); fish and eggs (vitamin B6 and B12); cheese (B12); beans and walnuts (vitamin B6 and folate); leafy dark green vegetables; asparagus, almonds, and whole grains (folate); and liver (all three).
3. Minimize animal protein, sugar, and saturated fat.
- Animal protein directly increases homocysteine. Sugar and saturated fat deplete your body’s vitamin stores.
4. Avoid processed foods and canned foods.
- These are depleted in vitamins.
5. Avoid caffeine.
- Excess amounts can deplete your B vitamin levels.
6. Limit alcohol to 3 drinks a week.
- More than this can deplete your B vitamin levels.
7. Don’t smoke.
- As noted above, smoking inactivates vitamin B6.
8. Avoid medications that interfere with methylation.
- See notes on this above.
9. Keep the bacteria in your gut healthy.
- Take probiotic supplements and use other measures to make sure the bacteria in your gut are healthy so you can properly absorb the vitamins you do get.
10. Improve stomach acid.
- Use herbal digestives (bitters) or taking supplemental HCl.
11. Take supplements that prevent damage from homocysteine.
- Antioxidants protect you from homocysteine damage. Also make sure you support methylation with supplements like
- .
12. Supplement to help support proper homocysteine metabolism.
- Talk to your doctor to determine the best doses and forms for you. Here are a few suggestions:
- Folate (folic acid): Amounts can vary based on individual needs from 200 mcg to 1 mg. Some people may also need to take preformed folate (folinic acid or 5 formylTHF) to bypass some of the steps in activating folic acid.
- Vitamin B6: Take 2 to 5 mg a day. Some people may need up to 250 mg or even special “active” B6 (pyridoxyl-5-phosphate) to achieve the greatest effect. Doses higher than 500 mg may cause nerve injury.
- Vitamin B12: Doses of 500 mcg may be needed to protect against heart disease. Oral vitamin B12 isn’t well absorbed; you may need up to 1 or 2 mg daily. Ask your doctor about B12 shots.
- Betaine: This amino acid derivative is needed in doses from 500 to 3,000 mg a day, depending on the person.
By working to optimize your methylation you can protect yourself from virtually all the so called “diseases of aging.” When you do, you will be well on the road to lifelong vibrant health.
Now I’d like to hear from you …
Do you have symptoms of poor methylation?
What are you doing to optimize this process?
Do you take B-vitamin supplements? Have you noticed any results?
Please share your thoughts by adding a comment below.
To your good health,
Mark Hyman, M.D.
Please give any info for muscle pain over whole body.
Thank you, JoAnne, for your message and your interest in Dr. Hyman’s work. Your question and constellation of symptoms represents a complex medical condition. Questions regarding conditions like these cannot be answered in a responsible manner via the Internet.
If you would like information on becoming a patient at The UltraWellness Center please see “How to Become a Patient” at http://www.ultrawellnesscenter.com. That site is designed to give prospective patients a comprehensive source of information about The UltraWellness Center. You may also feel free to call The UltraWellness Center at (413) 637 9991.
Regardless of becoming a patient at The UltraWellness Center, it sounds like you need to consult with a doctor. Please seek medical attention for the issues that you outlined in your message.
Wishing You the Best of Health!
For many years, I took B vitamins and sometimes received a B vitamin shot from my doctor. Never noticed a difference. I think I took for mood issues and the shot for weight loss. Never worked. After taking, I could always taste them on belching. Once I took them on an empty stomach and they made me very sick. I vomited so hard that I gave myself two black eyes (literally)! After that, never took them again as I could determine no benefit. But now that I am aging (55) I am trying to minimize the effects of aging and to recapture my past good health (I have rheumatoid arthritis and high BP). I know that the medical community usually only addresses symptoms by throwing toxic, side-effect laden costly pharmaceuticals — again, the important distinction — they only address SYMPTOMS not the cause. So I have researched and come up with a list of dietary supplements (I already take D, Co-10, Omega-3s & probiotics). I have recently added a few more to address BP issues and my inflammation issues. I’m wondering if perhaps now I might try B again. I think I’ll try my new regimen for 3 months (I’m very optimistic about results) and continue to eat healthy (leafy greens, other vegetables and whole grains) & see if that doesn’t suffice my foliate needs. If not, perhaps I’ll try adding. I’m trying to keep my vitamin consumption to a minimum but it is not easy.
Thank you for your wonderful articles. I take all the supplements that you have suggested, including a good multi, lots of fish oils, along with CoQ 10. do not eat meat, eat mostly organic vegetables, fresh wild fish, avoid alcohol, etc etc… and homocysteine was recently 5.5. I feel great and feel that I am reversing family history of heart disease. I am so very grateful for your information and the information and supplements and fresh food that are available to us now.
)Was diagnosed with high Homocysteine in 1998 . [Reading 93}. after 26 blood clots and DVT’s. Have been taking high doses of B Vitamins and 5mg of Folic Acid daily. Have had 4 more superficial clots in legs since, and have severe osteoporosis. I had the first DVT at 21, if only the blood test had been available then, it could have prevented so many years so many years of weeks in hospital and subsequent severe damage to my spine. My children have been tested and they are OK, my grandchildren are also going to be tested. I am 73 next month so hope for a continuing clot free lifr.
Thanks for taking time of you busy schedule to write such great information. I enjoy and learn so much from reading your articules . Wish you have you office here in Houston, Texas.
Thanks again!
Leticia
Thank you, Leticia, for your message and your interest in Dr. Hyman’s work. To locate a practitioner of functional medicine in your area see the “Find a Functional Medicine Practitioner” link at the Institute of Functional Medicine’s website. Here you will find a place to enter your zip code and look for practitioner’s in your area that have completed the institute’s five-day training course in functional medicine. Understand that not all of the doctors listed here will fit your particular needs. Many different medical professionals complete this training, and you will have to do additional research on your own regarding a particular practitioner’s approach and whether or not it fits your specific medical requirements. This may include calling the practioner’s office, visiting his or her website, and/or scheduling a consultation.
Wishing You the Best of Health!
Thank you, I am thinking of showing my sister this and I hope she appreciates it! I would send it to my dad but I think he wants to focus on his weight then again… I’ll just make this public on my facebook today! Thank you!
Hello Dr. Mark.
My son’s B6 is >100 (LabCorp scale 5.3-46.7) and his B12 is >1999 (scale 211-946). Could he have a methylation issue? DO you recommend folate to help with detox? If not, are there other things you would suggest? His symptoms include extreme anxiety and I have read that excess B levels can lead to that. Any ideas? Thank you so much for any comments!
Thank you for your message and your interest in Dr. Hyman’s work. Your question and constellation of symptoms represents a complex medical condition. Questions regarding conditions like these cannot be answered in a responsible manner via the Internet.
If you would like information on becoming a patient at The UltraWellness Center please see “How to Become a Patient” at http://www.ultrawellnesscenter.com. That site is designed to give prospective patients a comprehensive source of information about The UltraWellness Center. You may also feel free to call The UltraWellness Center at (413) 637 9991.
Regardless of becoming a patient at The UltraWellness Center, it sounds like you need to consult with a doctor. Please seek medical attention for the issues that you outlined in your message.
Wishing You the Best of Health!
Do you recommend nutrigenomic testing?
Hi,
I appreciate Dr. Hyman’s article on Methylation. Methylation is out of balance on a 3 out of 10 level for me.A recent “Nutra Eval showed 9 out of 10 need for detoxification and a high level of ethanolamine and Methylhistidine and low levels of several other AA. It’s scary because it indicates that I have a 9 out of 10 risk for Cardiac Disease. I’ve always been very health conscious and used to be an avid hiker. Now I’m achy and tired after short walk. Would love any information that might be available.
Thanks,
Elaine
Thank you, Dr. Hyman, for this article on Methylation. I now have somewhat of a clue as to what my last several labs (past 10 years) have revealed and what my current and past doctors have been unable to answer. My labs have consistently shown high MCV levels as well as high homeocysteine levels. I have a whole food diet, take supplements including Omega-3 fish oil, extra b vitamins and eat lots of veggies (greens) and nuts. I also exercise 5 days a week. I am stumped as to why these high levels are plaguing me. They actually got worse after my low B-12 levels went up too high following sublingual B-12 supplementation. I also have been diagnosed with a Protein C deficiency so I am particularly concerned with these abnormal readings. Any feedback would be greatly appreciated.
Thank you, Carmen, for your message and your interest in Dr. Hyman’s work. Your question and constellation of symptoms represents a complex medical condition. Questions regarding conditions like these cannot be answered in a responsible manner via the Internet.
If you would like information on becoming a patient at The UltraWellness Center please see “How to Become a Patient” at http://www.ultrawellnesscenter.com. That site is designed to give prospective patients a comprehensive source of information about The UltraWellness Center. You may also feel free to call The UltraWellness Center at (413) 637 9991.
Regardless of becoming a patient at The UltraWellness Center, it sounds like you need to consult with a doctor. Please seek medical attention for the issues that you outlined in your message.
Wishing You the Best of Health!
I have read recently, that studies showed that reducing homocysteine levels via B-vitamin supplementation had no effect on outcome of cardiovascular disease. What does Dr Hyman hold as an opinion on this research?
Hello Ryan, thank you for your interest in Dr. Hyman’s website and for your comment. The following article may answer you question:
http://drhyman.com/blog/conditions/why-cholesterol-may-not-be-the-cause-of-heart-disease/.
Wishing You the Best of Health!
Dr. Hyman,
I make $22,000 a year working with adults with developmental disabilities and I live in San Francisco! I cannot afford your Essential Vitamin package for women. To keep the cost down, what are the bare minimum vitamins I need that you recommend, buying them from you or someone else.
Thank-you,
Pam
Hi Pam, thank you for comment and your interest in Dr. Hyman’s website. Please refer to: http://drhyman.com/blog/conditions/how-dietary-supplements-reduce-health-care-costs/ for answers to your question.
Wishing You the Best of Health!
I have Diabetes 2 and Kidneyfailure stage 4 , 2 weeks ago my DFS(?) was 14
my Doctor took me off Lisinopril for 10 days and the new bloodtest the gfs was
21, I take 50.000 unit vitamin D once a month, is there anything else I can do to
inprove my Kidney function, I am 83 years old, (young) than you.
P.S I have some traveling to do, some parts of the world I have not seen yet
Hi Licetta, thank you for your message. We cannot give medical advise online. If you would like, see the “Find a Functional Medicine Practitioner” link at the Institute of Functional Medicine’s website.
Wishing You the Best of Health!
what do you mean by “awaitinf moderation”
Hi Licetta, this is a typo. Thank you for bringing it to our attention.
Wishing You the Best of Health!
Congratulations for the fantastic work you do by providing the numerous efficient health information.
One question: What do you recommend for HIV+ people to boost their IM and decrease their viral load when not on medications?
Your expertise will be greatly appreciated,
Sabol
The blog is really nice one and full of information we appreciate the kind of information you have provided in this post. The things you have discussed in this post will be very helpful for us. Healthy Weight Loss
There are now B-12 skin patches that are the methylcobaliman vs cyanocobaliman. The co making these say many cant take advantage of the cyano form of B-12, so he created these which do not take away any methyl groups to enable your body to utilize the B-12. You apply a tiny patch and keep it on for 12 hrs every so often. B-12 is critically important. recently i re-did my homocysteine test and it had crept up. I told him i have been taking b6 and folic acid religously, and he asked- “what about the B-12?” I had forgotten that B12 was a huge part of the puzzle to control homocysteine so now i am bldg the b12 back up. your body apparantly stores it a long time, so once levels get back to normal, you do not have to take it constantly. i found these patches on the raw food world
Aren’t the B vitamins that folks are concerned about lacking obtained through brewer’s yeast? Doesn’t brewer’s yeast provide enough of all aspects of the B vitamins that we need daily and the the body eliminates those that are beyond it needs? Doesn’t SAMe provide the methylation that the body needs to be nutritionally balanced?
Hi Barney,
Brewers Yeast has been helpful in supplying chromium but not all the Bs. Brewers yeast is not recommended to be taken in the same way that multis are-in fact it is more a moderate, short term deal. Great thought though!
In good health
Dr. Hyman,
This a great article! Thank you for all your work in educating the US and the world!
Dr. Hyman,
Is betaine HCl an acceptable form of betaine?
How best to determine the need for a specific form of folic acid?
Hello! I admire the intelligent mind of Dr.Hyman and his clever conclusions about health. I have read the ultramind solution book and I congratulate you for this work.
Im very interested in methylation¨,and I¨m wondering if it is necessary to take the aminoacid methionine, with folate, b6, b12, and betaine?
Thanking you in advance,
Regards,
Ana from Spain
Hello Dr Hyman! I asked you a question about methylation last week, and I don´t know why I can not see it in writing.
I would like to know if it is also convenient to take METHIONIN with vitamine b6,b12, folate and betaine for a proper methylation.
Thanking you for your marvelous work. Ana
HI Ana,
Thank you for your interest in Dr. Hyman’s work. While we do not know your full health history and caanot prescribe or diagnose via the internet, in all likelihood you would NOT take methionine. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor who practices functional medicine like Dr. Hyman, go to http://www.functionalmedicine.org and scroll down to where it says “locate a practitioner” and enter your zip. Progress accordingly from there.
In good health
Lizzy