By Cassie I. Story, RDN
What is vitamin B12? Vitamin B12 is a water-soluble vitamin that plays an important role in neurological and hematological functions.1 The majority of bodily cells require vitamin B12, especially ones that undergo rapid turnover like red blood cells (RBC).2 Vitamin B12 is also involved in DNA synthesis and methylation of RNA, as well as Phase I detoxification.1,3 Perhaps one of its most important roles is in relationship to the nervous system and its need for the formation of the myelin sheath, which is found around nerve cells.2 In fact, long-term vitamin B12 deficiency-induced neuropathy can damage nerve cells to the point of irreversible neurologic damage.2 What food sources are rich in vitamin B12?Foods rich in vitamin B12 are primarily from animal sources including liver, oysters, poultry, fish, eggs.2 Some fermented foods like miso and tempeh also contain vitamin B12. However, plant sources of vitamin B12 are likely unavailable for absorption by humans—so special care should be taken by people who avoid or do not consume animal products.2 Absorption considerations In order for food-based vitamin B12 to be absorbed, it must first interact with hydrochloric acid (HCl) and gastric protease in the stomach. These substrates allow vitamin B12 to be released from the protein it is bound to and then to be combined with intrinsic factor (IF), which is secreted by the parietal cells in the stomach. The combined vitamin B12-IF complex travels through the gastrointestinal (GI) tract for absorption in the distal ileum. It is well-established that HCl and IF production decline with age, and certain medications (proton pump inhibitors, metformin) have been found to reduce vitamin B12 absorption in the gut.2,4 Supplementation with vitamin B12 in its free form, or combined with IF, may be more beneficial in preventing or treating a deficiency.2 Bodily storage As vitamin B12 is stored in the liver in high amounts, with estimates being 3-5 milligrams, the majority of individuals are not at high risk for a deficiency.2 Situations in which individuals have difficulty absorbing vitamin B12, such as malabsorptive disorders, lack or decline in the production of HCl or IF, low levels of hepatic storage, or dietary insufficiency, particularly for those who follow a strict vegan diet, are at higher risk of deficiency.1 Typically, there are three causes for a potential vitamin B12 deficiency. These include:1
What happens with a vitamin B12 deficiency? Nutritional deficiency is the main cause for low hemoglobin and red blood cells (RBCs).2 A reduction of hemoglobin in the blood can eventually lead to anemia, a condition that can affect day-to-day living by impacting energy levels.2 Macrocytic anemia can result from low levels of vitamin B12 and presents with typical signs of anemia like pallor and fatigue.1 Jaundice can also be present as a result of impaired RBC formation.1 Certain medications can negatively impact vitamin B12 status, including contraceptive pills. Oral contraception can impact B12 status, without typically producing the above symptoms or neurological damage.3 Some medications have been shown to deplete vitamin B12 including antibiotics, anticonvulsants, metformin, and proton pump inhibitors.2 Diagnosing deficiency Serum vitamin B12 is a standard marker used to evaluate deficiency; however, this may miss 30-50% of vitamin B12 deficiencies in certain people, including those with a history of GI or bariatric surgery.5 For this reason, serum methylmalonic acid (MMA) is the preferred method for assessment and also helps to distinguish between vitamin B12 and folate deficiencies.2,5 Additional markers can include intrinsic factor antibodies (IFAB) and parietal cell antibodies. Differential diagnosis of vitamin B12 and folate deficiencies lie in the measurement of MMA. If both MMA and homocysteine are elevated and vitamin B12 is depressed, this indicates a vitamin B12 deficiency. Alternatively, if homocysteine is elevated but MMA is within normal limits, this may indicate a folate deficiency.1 Physical signs and symptoms of deficiencyIt is estimated that 75-90% of individuals who present with a vitamin B12 deficiency experience neurologic disorders.2 Neurological symptoms present in vitamin B12 deficiency may include peripheral neuropathy, decreased reflexes, ataxia, vibratory sense loss, dementia, psychosis, and altered mood.1,6 Paradoxically, while vitamin B12 deficiency can cause fatigue, it also may induce insomnia.2 Other chief complaints may include glossitis, diarrhea, and headaches.1 In a 24-month randomized and double-blind intervention study that included 168 elderly individuals with mild cognitive impairment, oral supplementation of vitamin B12, folic acid, and vitamin B6 slowed the progression of brain atrophy and the reduction of cognitive performance by 53%.7 How much vitamin B12 is recommended?The common dosage range for treating vitamin B12 deficiency with supplements is 500-2,000 mcg per day and is available as cyanocobalamin or methylcobalamin, which is the active form. Methylcobalamin may be preferred especially for individuals with certain genetic polymorphisms, increased oxidative stress, or digestive conditions of any kind.2 Common repletion recommendations:2,5
When to take and what to take it with? Taking vitamin B12 early in the day with the presence of other B vitamins including folate and possibly calcium is recommended. Avoid taking with alcohol and antibiotics.3 ConclusionAwareness and treatment of vitamin B12 deficiency are important to ensure that individuals are not impacted by its potentially permanent damaging effects to neurological health, as well as to ensure overall health and wellbeing and expected energy levels for daily living. Check with your healthcare practitioner to see if you should be tested for deficiency and how much you should be supplementing with daily. References: 1. Ankar A et al. Vitamin B12 Deficiency. StatPearls. Treasure Island, FL: StatPearls Publishing, 2021. 2. Mahan L, Escott-Stump S. Krause’s Food, Nutrition, and Diet Therapy 10th edition. Philadelphia, PA: W.B. Saunders Company, 2000. 3. Mortimore D. Nutritional Healing. Boston, MA. Element Books Limited, 1999. 4. Miller JW. Adv Nutr. 2018;9(4):511S-518S. 5. Parrott J et al. SOARD. 2016;12:955-959. 6. Shils M et al. Modern Nutrition in Health and Disease. Vol 10th edition. Baltimore, MD: Lippincott Williams and Wilkins, 2006. 7. Gröber U et al. Nutrients. 2013;12:5031-5045.
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 Add These Detoxifying Foods to Your Shopping List
Detox is a hot topic nowadays. Many detox programs promise to cleanse your body harmful compounds, and others tout weight loss and additional health benefits. Unfortunately, many of these detox methods involve a major dietary overhaul or giving up solid foods altogether, which may actually be harmful to your body.1 Because your body is in constant detox mode, you can encourage this process, correctly and effectively, by simply eating the right foods. Scientific research has found that the nutrients, enzymes, and antioxidants found in certain whole foods can help support the liver’s detoxification pathways, prevent the buildup of toxins, and support overall health.2-4 Chemicals and toxins are everywhere, but your body is built to fight back. Here are six of your top nutritional allies: 1. Cruciferous vegetables & leafy greens Spinach, broccoli, and Brussels sprouts are among the folate- and chlorophyll-richgreens that support the body’s detoxification process by helping to detoxifythe blood and cleanse the intestines.2,4-7 All the more reason to go green! Broccoli deserves some special attention for its high concentrations of glucoraphanin, which is converted in the body to sulforaphane—an active compound associated with many positive health benefits, including its role in inducing phase II detoxification enzymes and support for overall liver health.8-10 2. Turmeric Used in many anti-inflammatory and detoxifying recipes, turmeric contains a powerful substance called curcumin, a polyphenol with anti-inflammatory and antibacterial properties. Science has found curcumin to play a role in modulating cellular response to oxidative stress—demonstrating hepaprotective and therapeutic effects on liver health.11,12 3. Sesame Commonly used in bread products, oils, and dressings, sesame is flowering plant that maybe beneficial for detox. Sulfur-containing amino acids methionine and cysteine—both of which are found at high levels in sesame—are precursors to the production ofglutathione, a key antioxidant in the detoxification process.4 4. Beets These pretty-colored veggies contain betanin, which can help repair liver cells and help support detoxification processes in the liver.13,14 It’s also great for digestion. Tell toxic chemicals to “beet” it! 5. Guacamole No party spread is complete without it! Avocado has high concentrations of the antioxidant glutathione, which has been found to neutralize free radicals to support and protect the liver—i.e., your detoxification powerhouse.4,15,16 Why guacamole? Avocado in this form often uses other healthful ingredients, like cilantro. Also known as coriander, cilantro contains oils with antibacterial, antifungal, and antioxidative properties.17 Pass the guac, please. 6. Garlic Alongside its knack for warding off vampires, garlic may be beneficial for clearing out toxins. The sulfur-containing compound allicin, which gives garlic its unique and strong-smelling aroma, may enhance antioxidation and detoxification capabilities18,19 and has also demonstrated hepatoprotective effects against heavy metals in the liver.20 Incorporating more of these foods into your diet can help support detox processes. Add them to your shopping list today! References:
Submitted by the Metagenics Marketing Team  By Molly Knudsen, MS, RDN
There’s no doubt that antioxidants are good for health. Antioxidants have been in the public spotlight since the 1990s and have only gained attention over the years, basically reaching celebrity status. And that status has not wavered, especially as their role in immune health becomes increasingly known. Antioxidants and antioxidant-rich foods continue to trend and make headlines, most recently in the forms of matcha/green tea drinks, acai bowls, golden milk, or just good ol’ fashioned fresh fruits and vegetables. Antioxidants are here to stay not only because they’re found in delicious foods, but they also play a vital role in health by protecting the body against oxidative stress.1 What is oxidative stress? Everyone’s heard of oxidative stress, but what exactly does that refer to? Oxidative stress occurs from damage caused by free radicals. Free radicals are unstable molecules that have lost an electron from either normal body processes like metabolism, reactions due to exercise, or from external sources like cigarette smoke, pollutants, or radiation.1 Now electrons don’t like to be alone. They like to be in pairs. So do free radicals suck it up and leave one of their electrons unpaired? Nope. They steal an electron from another healthy molecule, turning that molecule into another free radical and, if excessive, wreak havoc in the body and its defense system. Immune cells are particularly vulnerable to oxidative stress because of the type of fat (polyunsaturated) that they have in their membrane.2 So high amounts of oxidative stress over time can be especially detrimental to immune system. What are antioxidants? Antioxidants are the heroes that can break this cycle. And there’s not just one antioxidant. Antioxidants refer to a whole class of molecules (including certain vitamins, minerals, compounds found in plants, and some compounds formed in the body) that share the same goal of protecting the body and the immune system against oxidative stress.2 But different foods contain different antioxidants, and each antioxidant has its own unique way of supporting that goal. 6 antioxidants for oxidative stress protection + immune health 1. Vitamin C Vitamin C is a powerful antioxidant that also contributes to immunity. It works by readily giving up one of its electrons to free radicals, thereby protecting important molecules like proteins, fats, and carbohydrates from damage.3 Vitamin C is a water-soluble vitamin, which means storage in the body is limited, and consistent intake of this nutrient is vital. Research shows that not getting enough vitamin C can impact immunity by weakening the body’s defense system.3 Vitamin C is found in many fruits and vegetables, including strawberries, bell peppers, citrus, kiwi, and broccoli. The benefits of vitamin C’s antioxidant capabilities are more than just internal. Benefits are also seen when a concentrated source of this antioxidant is applied to the skin. For example, topical vitamin C serums are often recommended by dermatologists and estheticians to help protect the skin from sunlight and address hyperpigmentation.4 2. Epigallocatechin 3-gallate (EGCG) Green tea is easily, and unofficially, considered one of the world’s healthiest foods, and the presence of EGCG is one reason for this drink’s reputation. EGCG is the most abundant, potent, and researched polyphenolic antioxidant found in green tea leaves.5 It has been shown to protect against damage caused by free radicals.5 Drinking green tea is a great way to reap the benefits of EGCG and other nutrients found in tea leaves, or it’s also available as an extract in nutritional supplements. If you choose to drink green tea, it’s important to remember that water preparation matters. Using hot water to steep green tea not only preserves, but it also encourages more antioxidant activity compared to using cold water, as hot water may be better at extracting polyphenols from the leaves.5 3. Glutathione Glutathione is a powerful antioxidant that the body actually makes internally from three amino acids (AKA building blocks of protein): cysteine, glutamate, and glycine.6 Not only does this antioxidant protect the body against oxidative stress, it also supports healthy liver detoxification processes.7 Glutathione levels naturally decrease with age, and lower glutathione levels in the body are associated with poorer health.8 Since it takes all three of those amino acids to form glutathione, ensuring that the body has adequate levels of all three is vital. Cysteine is the difficult one. It’s considered the “rate-limiting” step in this equation, since it’s usually the one in short supply, and glutathione can’t be formed without it.6 Cysteine contains sulfur, so foods like unprocessed meat, garlic, and asparagus are great choices to support cysteine levels. Like cysteine, the compound N-acetylcysteine (found in supplements and often labeled NAC) can also be used to support the body’s glutathione levels.6 4. Curcumin Curcumin is the yellow pigment and considered the active ingredient in the spice turmeric. In the culinary world, turmeric is best known for playing the leading role in curries as well as in golden milk. Studies show that curcumin has been shown to improve markers of oxidative stress, act as a free radical scavenger, and assist with other antioxidant processes in the body.9 Curcumin isn’t very bioavailable, so your body isn’t able to fully capture the benefits when consumed on its own or just as turmeric.9 But adding other spices or herbs like black pepper or fenugreek can significantly increase your body’s ability to utilize curcumin.9 5. Vitamin E Vitamin E is a fat-soluble vitamin, meaning it’s best absorbed with fat. It acts as an antioxidant by stopping the production of free radicals from forming when fat is oxidized, or burned.10 Vitamin E is found in nuts and seeds (almonds, sunflower seeds, and hazelnuts) as well as green leafy vegetables. Vitamin E also plays a role in heart, eye, and cognitive health.10 6. Quercetin Quercetin is one of the most well-studied flavonoids, or plant compounds, typically found in onions, kale, broccoli, apples, and tea. Quercetin acts as a free radical-scavenging antioxidant, helps inhibit oxidative stress, and supports a healthy immune response.11 What’s the bottom line? Antioxidants are a crucial part to any healthful diet. They help protect the body from damage caused by oxidative stress and support immune function. There are many more antioxidants that are beneficial to health than those listed here. The best way to ensure that you’re getting enough antioxidants from the diet and supporting the antioxidants the body makes on its own is to consume a diet high in plants like fruits, vegetables, nuts, seeds, and legumes. References
 By Melissa Blake, ND
When it comes to building a healthy immune system, we often hear about diet and exercise, but unfortunately less often about the importance of sleep. But, when it comes to the immune system, sleep is a crucial component. Researchers around the world continue to discover the numerous benefits of our nightly slumber. Sleep is when the body and the mind have a chance to rest and repair on a cellular level, and without enough of it, or enough quality sleep, one’s health can begin to suffer.1 Disrupted sleep is a major contributor to hormone imbalances, skin issues, weight gain, and even a weakened immune system.1-4 Whether you’re not sleeping well due to stress, your schedule, or another factor, prioritizing sleep is a key component to a healthy immune system.1 The sleep debt cost Most likely everyone can relate to the immediate impact of a sleepless night. Even getting just a little less sleep than one needs or is used to can contribute to confusion, weakness, muscle pain, and changes in appetite.2-4 The long-term consequences of neglecting sleep are even more serious. A regular lack of sleep increases the risk of cardiovascular issues, weight gain, and compromised immune function.4,5 Correlation between sleep & immune health Driven by a circadian rhythm, messengers called cytokines impact the state of the immune system and also contribute to sleep-wake patterns.1 While we are sleeping, cytokines instruct immune cells to work hard at repairing damage, clearing toxins, and defending us against illness.1 This might be one reason why we feel more tired and require more rest when we are sick. It’s during sleep that the immune system is most active and focused on recovery and developing immune memory.1 A good night’s rest is also key for improving the function of immune cells known as T cells, a type of immune cell that fights against pathogens such as viruses.6 A German study found that in people who slept adequately the night before, T cells were better able to attach to their targets, including virus-infected cells, than in the T cells of those who stayed up all night.7 The findings highlight one of many immune-supportive effects of sleep. Conclusion Habits such as a consistent routine, including regular bed and wake times, as well as exposure to natural sunlight within an hour of waking are small, simple changes people can make in order to get a better night’s sleep while improving their body’s circadian health. Even going to bed just 10 minutes earlier can have a profound effect on how you feel, so give it a try starting tonight—your immune system will thank you. This is the first in a three-part series on circadian health. For more information on sleep and other general wellness topics, please visit the Metagenics blog. References:
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