Why we need B12, B6, Active Folate and TMG

Written by Brenton Wight – LeanMachine, Health Researcher
Updated 2nd December 2019, Copyright © 1999-2019 Brenton Wight and BJ & HJ Wight trading as Lean Machine abn 55293601285

Vitamin B12

Vitamin B12, or Cobalamin, is part of the B group of vitamins, but is different in three respects:

  • The B12 molecule is the largest and most complex vitamin known.
  • B12, like the rest of the B-group vitamins, is water-soluble, but B12 is the ONLY water-soluble vitamin which can be stored in the liver for months, or even years
  • B12 is generally formed in the high-acid stomach, but those with low acid levels cannot form B12.

Benefits of B12

  • Protects brain cells, improves nerve growth and conduction, increasing speed of messages to and from the brain
  • Protects the myelin sheath surrounding nerve cells.
  • Protects against Alzheimer’s and other brain-degenerative diseases
  • Mental clarity, concentration, memory, nervous system
  • Circulation
  • Aids in turning food carbohydrates into glucose for energy
  • Fat metabolism, digestion
  • Helps produce DNA and RNA, the genetic material in our cells
  • Increases iron utilisation to build red blood cells, preventing anemia
  • With B9 (folate), helps the manufacture of S-adenosylmethionine to reduce depression and boost the immune system
  • With B9 (folate) and B6, B-12 inhibits homocysteine production, an amino acid linked to heart disease.
  • Adrenal hormone function
  • Energy – physical, emotional, mental

B12 is only found in animal products, apart from mushrooms, which are the only vegetable (actually a fungus) containing B12, but the B12 exists only in the skin of the mushroom which is often peeled off and discarded, and in any case, this is a poor food source of B12.
This is why vegetarians, and especially vegans should take additional B12 supplements.
The elderly are also at risk for B12 deficiency, because as we age, the level of stomach acid tends to drop, and once it drops below a certain point, this ends the conversion process that generates the B12 that can be absorbed.
Many diets recommend that we limit protein from animal products, but this is very wrong. LeanMachine has been a vegetarian for over 40 years, but regularly eats eggs and fish for B12 intake. Even so, B12 levels were low the first time they were checked at around age 64. Since then, daily B12 supplements have built B12 levels to around five times the normal amount. We cannot overdose on B12, unlike Folate and other vitamins.
Unfortunately many doctors never test for B12, and if we are deficient in B12, doctors typically misdiagnose this deficiency, resulting in prescribing drugs that do not help the condition, but may even create side effects that only make us feel worse!
Some PPI (Proton Pump Inhibitor) medications such as Nexium, prescribed for reflux, heartburn and other digestive issues, deliberately lower stomach acid, and there are many off-the-shelf antacids which do the same, and all result in knocking out our Vitamin B12. Note also that microwaving food also knocks out all B12.

Symptoms of B12 deficiency

  • Anaemia
  • Macrocytosis (larger than normal red blood cells)
  • Hypersegmented neutrophils (Nuetrophil blood cells with more lobes than normal)
  • Fatigue, lack of energy
  • Weak legs
  • Forgetfulness, mental fogginess
  • Mood swings, lack of motivation
  • Depression, paranoia, delusions
  • Yellow colour
  • Feelings of apathy
  • Loss of appetite
  • Hair loss
  • Rapid heart rate (Tachycardia)
  • Shallow breathing, short of breath
  • Unintended weight loss
  • Bleeding or bruising more than normal
  • Persistent constipation or diarrhea
  • Dizziness
  • Incontinence
  • Loss of taste and smell
  • Sore tongue or mouth
  • Bones which easily break, even if a DEXA scan says they are dense
  • Tingling in fingers or toes
  • Strange nerve sensations
  • Muscle Tenderness

Untreated, a severe B12 deficiency may lead to permanent nerve damage.
Not everyone with low B12 will have all symptoms, but having a few of these suggests testing for B12 and Folate.

Who is at Risk?

  • Those aged over 50
  • Vegans, vegetarians
  • Those taking antacids
  • Those on PPI (Proton Pump Inhibotor) medications, e.g. Nexium
  • Diabetics taking Metformin (Diabex)
  • Those having surgery where part of the stomach is removed
  • Those with Ceoliac Disease
  • Those with bacterial overgrowth, stomach and intestines
  • Alcoholics
  • Those taking some anti-seizure medications
  • Those drinking too much water

Research suggests that in the over-50 age group, more than 20% of the population are low in B12, and a fifth of those are seriously deficient.

Recommended Daily Allowance for B12

Official recommended dietary amounts (RDAs) are:

  • Infants 0-6 months, 0.4 mcg
  • Infants 7-12 months, 0.5 mcg
  • Children 1-3 years, 0.9 mcg
  • Children 4-8 years, 1.2 mcg
  • Children 9-13 years, 1.8 mcg
  • Adults: 2.4 mcg daily for ages 14 years and older
  • Pregnant Females: 2.6 mcg daily
  • Breastfeeding Females: 2.8 mcg daily
  • Adults over 50 years old: 20 mcg daily

However, LeanMachine has the opinion that these amounts are way too low. If anyone has any symptoms of deficiency, testing and subsequent supplementation may be required, but beware of cheap supplements containing cyanocobalamin (an artificial chemical made from cyanide) and only use methylcobalamin which is the active form of Vitamin B12. Even though the cyanide in cheap B12 is fairly harmless, and easily excreted into urine, the methyl version can be used directly by the body without conversion, and contributes to the important methylation process, which occurs over a billion times per second in the body.
LeanMachine recommends Active B12 1500mcg 60 vcaps

Testing Vitamin B12

It is important to test Folate at the same time as B12, because a deficiency in one can mask a deficiency in the other.
Blood Test for B12 deficiency:
For a long time, the reference range in Australia has been 135 to 650 pmol/L (pica moles per litre) but this is way too low.
In the 1980’s, Japan lifted their low end of the range to 500, and for those people with the defective MTHFR gene (up to 40% of the population), even this can be too low.
LeanMachine recommends 750 to 1500 as a more desirable range. LeanMachine uses B12 supplements, and tests at the top end of this range.
However, a high B12 reading does not always mean a satisfactory level.
When B12 is low, two enzyme substrates will increase: tHcy (total homocysteine) and MMA (methylmalonic acid). If deficiency symptoms do not go away, these should also be tested.

Treating Low Vitamin B12

Memory loss is a significant symptom, and if diet and/or supplementation is improved within one to two years, full memory can often be restored, but after two years, permanent memory damage may have occurred.
Ideally, we should look at the diet first, and if this does not improve B12, then B12 supplements are essential. If deficiency symptoms are severe, immediate supplementation or a B12 injection is advised.
Because B12 can be stored in the body, B12 injections are only required every 3 months to maintain healthy levels.
Here are some food sources of vitamin B12, arranged from highest to lowest:

Type of Food mcg of B12/serving % of RDA
Shellfish (Clams) 85g/3oz 84 1400
Liver, beef 85g/3oz 70.0 1178
Shellfish (Oysters) 85g/3oz 84 408
Crab, raw, 85g/3oz 9.8 163
Trout, rainbow, wild, cooked, 85g/3oz 5.4 90
Salmon, sockeye, cooked, 85g/3oz 4.9 80
Red Meat (Beef) 85g/3oz 5.1 85
Yogurt, plain, 1 cup 1.4 25
Haddock, cooked, 85g/3oz 1.2 20
Egg (chicken), one extra-large 0.5 20

Chicken is missing from the table above, because one egg has as much B12 as nearly half a chicken. Another case for the egg coming before the chicken!

Who should NOT take Vitamin B12
In those with Leber’s Disease (Leber Hereditary Optic Neuropathy, or LHON, a rare eye disease affecting less than 1 in 50,000) B12 can seriously damage the optic nerve, so B12 should never be taken.

Homocysteine – an inflammatory marker

Homocysteine levels in the blood are a marker of inflammation and cardiovascular disease, and low levels of Vitamin B12 and Folate can raise Homocysteine levels.
High homocysteine levels usually lead to cognitive decline in advancing years, cardiovascular disease, Alzheimer’s disease and many other ageing-related diseases.
Homocysteine is produced in the body as a result of demethylation of methionine utilisation of fats and proteins.
In Australia, doctors seldom order a Homocysteine blood test unless we ask for it. This test can also check for a rare inherited disorder called homocystinurina. The risk for homocystinurina is low, but it is best to rule it out.
If there is a family history of high homocysteine, children should be tested from birth.
The main purpose of the Homocysteine test is to determine if you have increased risk for heart attack or stroke, and a deficiency in B12 and Folate, and all should be tested at the same time.

What is Homocysteine?

Homocysteine is an amino acid, one of the building blocks of proteins. We can not get homocysteine from the diet.
Homocysteine can only be made from methionine, another amino acid that is found in meat, fish, and dairy products, and this reaction can only happen with enough Vitamin B6 (pyridoxine), Vitamin B12 and folate.
Foods containing methionine are transformed into homocysteine in the blood, and then Vitamin B6 helps convert homocysteine to cysteine. Vitamin B12 related enzymes can also recycle homocysteine back into methionine.
Cysteine is a very important protein, involved in how proteins in cells are folded, maintain their shape, and link to each other, and cysteine is a source of sulfide, taking part in metabolism of iron, zinc, copper and other important minerals. Cysteine also acts as an anti-oxidant. If homocysteine cannot be converted into cysteine or returned to the methionine form, levels of homocysteine in the body increase. Elevated homocysteine levels have been associated with heart attack, stroke, blood clot formation, and perhaps the development of Alzheimer’s disease.

Homocysteine Test

Laboratories generally say that normal homocysteine serum levels are between 4 and 15 micromoles per litre, with anything above 15 considered high.
However, the OPTIMAL level of homocysteine is less than 10 or 12 in good labs, but many doctors will ignore readings unless they are flagged on the report (above 15).

CRP  (c-Reactive Protein)

C-Reactive Protein is another important marker for inflammation and risk for strokes, and should be tested if homocysteine results are inconclusive.
Healthy people should ask for the High-Sensitivity test, hs-CRP.
Those in poor health should ask for the regular CRP test, which is not as sensitive, but has a much wider range of values.

Folate, Folic Acid, Folinic Acid, Active Folate

These all sound similar, but most forms have to be converted in the body to the active form that the body can use: MTHF or (6S)-5-MethylTetraHydroFolate, commonly calles Active Folate.
Up to 40% of the population have a MTHFR gene polymorphism. The MTHFR gene helps make  methylenetetrahydrofolate reductase, an enzyme involved in processing amino acids, the building blocks of proteins.
Unfortunately, consumption of Folic Acid can aggravate this MTHFR gene polymorphism, making the problem worse, blocking the real folate, increasing cancer risk and causing other health problems.

Treating High Homocysteine

Because homocysteine is missing CH3 (the methyl group), the best way to lower homocysteine is to add a methyl donor, which will aid the breakdown of homocysteine into methionine.
The following are all methyl donors:

Studies

In a 2-year study of people aged over 70 with elevated Homocysteine levels over 11.3 micromoles/litre, patients were given either a placebo or Folic Acid 800mcg, Vitamin B12 500mcg, and Vitamin B6 20mg daily.
Most of those on the placebo showed distinct cognitive decline. Those on the supplements showed no decline or much more moderate decline.

  • A 2-year study of people aged 60 to 74 with symptoms of depression using smaller doses and only Folic Acid 400mcg and Vitamin B12 100mcg taken twice daily, showed small but significant improvements in short-term and long-term memory
  • An 8-year study of several hundred people in their seventies showed that those having the lowest levels of B12 in their blood (under 257 pmol/l), 40% of the group, had the highest rates of cognitive decline. Formerly, the official danger point for B12 was set at 148 pmol/l (picomoles per litre), but this study confirms that this level is too low, and that most people aged 50 or over should either consume foods fortified with B12 or take supplements
  • A 2-year study showed that B12 and Folic Acid supplements significantly reduced the risk of Alzheimer’s Disease
  • A study found that although bone density remained the same in the B12 and Folate group as well as the placebo group, the number of bone fractures was 80% less in the supplement group.
    It appears that high homocysteine levels interfere with the way collagen works to strengthen bone

Food Sources of B Vitamins

All B-group vitamins come primarily in meat and eggs, the only exception being mushrooms as the only “vegetable” with B-group vitamins).
ALL vegetarians and especially vegans should supplement with Active B12 and Active Folate.
Almost all seniors need B12 because of reduced stomach acid as we age, and anyone taking statin drugs (e.g. Simvastatin, Lipitor, etc for Cholesterol) or heartburn medication (Nexium) (or off-the-shelf remedies) MUST supplement with B12 because stomach acid will not be strong enough for the body to produce any B12 at all.

As we age, we also lose our ability to absorb B12, B6 and Folate from foods, so most people over 50 should supplement.
Many younger people are also deficient in B-group vitamins due to diet, health, lifestyle, genetic makeup or illness, so annual blood tests are recommended for everyone.

Around 20% of the population suffer from Folate deficiency, but too much Folate (over 1000mcg or 1mg daily) can be toxic to the liver.
However, we cannot overdose on B6 or B12. No side-effects have ever been observed at extremely high doses.

TMG – TriMethylGlycine

The TMG molecule consists of three methyl groups (CH3) and one glycine group (C2H5NO2).

The advantage of TMG is that it can donate all three methyl groups, leaving pure glycine.

Glycine is very important for body functions, including:

  • Build lean muscle mass
  • Preventing sarcopenia (muscle loss, muscle wasting)
  • Producing human growth hormone
  • Improving memory and mental performance
  • Reducing risk of strokes and seizures
  • Protecting skin from aging and cell mutations
  • Increasing collagen in joints, reducing joint pain
  • Improving flexibility and range of motion
  • Lowering blood glucose, reducing risk of type 2 diabetes
  • Improving sleep quality
  • Reducing inflammation and free radical damage
  • Increasing glutathione production
  • Reducing risk for some cancers
  • Building gastrointestinal tract lining
  • Producing bile salts and digestive enzymes
  • Reducing allergic and autoimmune reactions
  • Increasing energy levels, fighting fatigue
  • Increasing red blood cell production
  • Reducing stress,  anxiety
  • Controlling symptoms: seizures, schizophrenia, mental disorders

The following are my recommended supplements:

LeanMachine Supplements

Disclaimer

LeanMachine is not a doctor, and everyone should consult with their own health professional before taking any product to ensure there is no conflict with existing prescription medication.
LeanMachine has been studying nutrition and health since 2011 and has completed many relevant studies including:
Open2Study, Australia – Food, Nutrition and Your Health
RMIT University, Australia – Foundations of Psychology
Swinburne University of Technology, Australia – Chemistry – Building Blocks of the World
University of Washington, USA – Energy, Diet and Weight
Johns Hopkins Bloomberg School of Public Health, USA – Health Issues for Aging Populations
Johns Hopkins Bloomberg School of Public Health, USA – International Nutrition
Johns Hopkins Bloomberg School of Public Health, USA – Methods in Biostatistics I
Johns Hopkins Bloomberg School of Public Health, USA – Methods in Biostatistics II
Johns Hopkins Bloomberg School of Public Health, USA – Principles of Human Nutrition
TUFTS University, USA – Nutrition and Medicine
TUFTS University, USA – Lipids/Cardiovascular Disease I and Lipids/Cardiovascular Disease II
Technical Learning College, USA – Western Herbology, Identification, Formulas
Bath University, England – Inside Cancer
WebMD Education – The Link Between Stroke and Atrial Fibrillation
WebMD Education – High Potassium: Causes and Reasons to Treat
Leiden University Medical Center, Netherlands – Anatomy of the Abdomen and Pelvis
MIT (Massachusetts Institute of Technology) – A Clinical Approach to the Human Brain

LeanMachine has now examined thousands of studies, journals and reports related to health and nutrition and this research is ongoing.

Updated 2nd December 2019, Copyright © 1999-2019 Brenton Wight and BJ & HJ Wight trading as Lean Machine abn 55293601285