Thyroid Investigator

Vitamin B12 Deficiency

Jan 272017

What do all of these diseases have in common?

Alzheimer’s, dementia, cognitive decline and memory loss (collectively referred to as “aging”)
Multiple sclerosis (MS) and other neurological disorders
Mental illness (depression, anxiety, bipolar disorder, psychosis)
Cardiovascular disease
Learning or developmental disorders in kids
Autism spectrum disorder
Autoimmune disease and immune dysregulation
Cancer
Male and female infertility

Answer: they can all mimic the signs and symptoms of vitamin B12 deficiency.

B12 deficiency: an invisible epidemic

B12 deficiency isn’t a bizarre, mysterious disease. It’s written about in every medical textbook and its causes and effects are well-established in the scientific literature.

However, B12 deficiency is far more common than most health care practitioners and the general public realize. Data suggests that 40 percent of people between the ages of 26 and 83 have plasma B12 levels in the low normal range – a range at which many experience neurological symptoms. 9 percent had outright deficiency, and 16 percent exhibited “near deficiency”. Most surprising to the researchers was the fact that low B12 levels were as common in younger people as they were in the elderly.

That said, B12 deficiency has been estimated to affect about 40% of people over 60 years of age. It’s entirely possible that at least some of the symptoms we attribute to “normal” aging – such as memory loss, cognitive decline, decreased mobility, etc. – are at least in part caused by B12 deficiency.

Why is B12 deficiency so under-diagnosed?

B12 deficiency is often missed for two reasons. First, it’s not routinely tested by most physicians. Second, the low end of the laboratory reference range is too low. This is why most studies underestimate true levels of deficiency. Many B12 deficient people have so-called “normal” levels of B12.

Yet it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL – levels considered “normal” – have clear B12 deficiency symptoms. Experts who specialize in the diagnosis and treatment of B12 deficiency, suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL. They also recommend treating patients with normal B12, but elevated urinary methylmalonic acid (MMA), homocysteine and/or holotranscobalamin (other markers of B12 deficiency).

In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss. Some experts have speculated that the acceptance of higher levels as normal in Japan and the willingness to treat levels considered “normal” in the U.S. explain the low rates of Alzheimer’s and dementia in that country.

What is vitamin B12 and why do you need it?

Vitamin B12 works together with folate in the synthesis of DNA and red blood cells. It’s also involved in the production of the myelin sheath around the nerves, and the conduction of nerve impulses. You can think of the brain and the nervous system as a big tangle of wires. Myelin is the insulation that protects those wires and helps them to conduct messages.

Severe B12 deficiency in conditions like pernicious anemia (an autoimmune condition where the body destroys intrinsic factor, a protein necessary for the absorption of B12) used to be fatal until scientists figured out death could be prevented by feeding patients raw liver (which contains high amounts of B12). But anemia is the final stage of B12 deficiency. Long before anemia sets in, B12 deficiency causes several other problems, including fatigue, lethargy, weakness, memory loss and neurological and psychiatric problems.

B12 deficiency occurs in four stages, beginning with declining blood levels of the vitamin (stage I), progressing to low cellular concentrations of the vitamin (stage II), an increased blood level of homocysteine and a decreased rate of DNA synthesis (stage III), and finally, macrocytic anemia (stage IV).

Why is B12 deficiency so common?

The absorption of B12 is complex and involves several steps – each of which can go wrong. Causes of B12 malabsorption include:

intestinal dysbiosis
leaky gut and/or gut inflammation
atrophic gastrits or hypochlorhydria (low stomach acid)
pernicious anemia (autoimmune condition)
medications (especially PPIs and other acid-suppressing drugs)
alcohol
exposure to nitrous oxide (during surgery or recreational use)

This explains why B12 deficiency can occur even in people eating large amounts of B12-containing animal products. In fact, many patients that are B12 deficient are following a Paleo diet where they eat meat 2-3 times a day.

Experience in Melbourne Australia sees Afghan refugees, whose diet is heavily centered around lamb, needing B12 injections, as do Indians who have a primarily vegetarian diet.

In general, the following groups are at greatest risk for B12 deficiency:

vegetarians and vegans
people aged 60 or over
people who regularly use PPIs or acid suppressing drugs
people on diabetes drugs like metformin
people with Crohn’s disease, ulcerative colitis, celiac or IBS
women with a history of infertility and miscarriage

Note to vegetarians and vegans: B12 is found ONLY in animal products

B12 is the only vitamin that contains a trace element (cobalt), which is why it’s called cobalamin. Cobalamin is produced in the gut of animals. It’s the only vitamin we can’t obtain from plants or sunlight. Plants don’t need B12 so they don’t store it.

A common myth amongst vegetarians and vegans is that it’s possible to get B12 from plant sources like seaweed, fermented soy, spirulina and brewers yeast. But plant foods said to contain B12 actually contain B12 analogs called cobamides that block intake of and increase the need for true B12.

This explains why studies consistently demonstrate that up to 50% of long-term vegetarians and 80% of vegans are deficient in B12.

The effects of B12 deficiency on kids are especially alarming. Studies have shown that kids raised until age 6 on a vegan diet are still B12 deficient even years after they start eating at least some animal products. In one study, the researchers found:

…a significant association between cobalamin [b12] status and performance on tests measuring fluid intelligence, spatial ability and short-term memory” with formerly vegan kids scoring lower than omnivorous kids in each case.

The deficit in fluid intelligence is particularly troubling, the researchers said, because:

…it involves reasoning, the capacity to solve complex problems, abstract thinking ability and the ability to learn. Any defect in this area may have far-reaching consequences for individual functioning.

It’s absolutely crucial for those that abstain from animal products to understand that there are no plant sources of B12 and that all vegans and most vegetarians should supplement with B12. This is especially important for vegetarian or vegan children or pregnant women, whose need for B12 is even greater than adults.

Treatment of B12 deficiency

One of the greatest tragedies of the B12 epidemic is that diagnosis and treatment is relatively easy and cheap – especially when compared to treatment of the diseases B12 deficiency can cause. A B12 test can be performed by any laboratory.

As always, adequate treatment depends on the underlying mechanism causing the problem. People with pernicious anemia or inflammatory gut disorders like Crohn’s disease are likely to have impaired absorption for their entire lives, and will likely require B12 injections indefinitely. This may also be true for those with severe B12 deficiency causing neurological symptoms.

Some recent studies have suggested that high dose oral or nasal administration may be as effective as injections for those with B12 malabsorption problems. However, most B12 experts still recommend injections for people with pernicious anemia and advanced B12 deficiency involving neurological symptoms.

Cyanaocobalamin is the most frequently used form of B12 supplementation but recent evidence suggests that hydroxycobalamin (frequently used in Europe) is superior to cyanocobalamin, and methylcobalamin may be superior to both – especially for neurological disease.

Japanese studies indicate that methylcobalamin is even more effective in treating the neurological sequelae of B12 deficiency, and that it may be better absorbed because it bypasses several potential problems in the B12 absorption cycle. On top of that, methylcobalamin provides the body with methyl groups that play an role in various biological processes important to overall health.

If you suspect you have B12 deficiency, the first step is to get tested. You need an accurate baseline to work from. If you are B12 deficient, the next step is to identify the mechanism causing the deficiency. This is something you’ll probably need help with from a medical practitioner. Once the mechanism is identified, the appropriate form (injection, oral, sublingual or nasal) of supplementation, the dose and the length of treatment can be selected.

So, next time you or someone you know is “having a senior moment”, remember: it might not be “just aging”. It could be B12 deficiency.

Iodine optimisation

Jan 272017

Why optimizing your iodine intake is so crucial, and why both too little and too much iodine can be harmful.

Iodine deficiency is the most common cause of hypothyroidism worldwide. Once researchers realized this, health authorities around the world began adding iodine to table salt.

This strategy was effective in correcting iodine deficiency. But it had an unanticipated—and undesired—effect. In countries where iodine has been added to table salt, the rates of autoimmune thyroid disease have risen.

Why does this happen? Because increased iodine intake, especially in supplement form, can increase the autoimmune attack on the thyroid. Iodine reduces the activity of an enzyme called thyroid peroxidase (TPO). TPO is required for proper thyroid hormone production.

On the other hand, restricting intake of iodine can reverse hypothyroidism. In one study, 78% of patients with Hashimoto’s regained normal thyroid function with iodine restriction alone.

However—and this is a big “however”— it appears that iodine may only pose a problem for people with Hashimoto’s and other autoimmune thyroid diseases in the presence of concurrent selenium deficiency. In the study above where rats developed goiter while receiving excess iodine, when they were given adequate selenium they did not develop the goiter.

Other studies have shown that selenium protects against the effects of iodine toxicity and prevents the triggering and flaring of autoimmune disease that excess iodine without selenium can cause.

Always test for both iodine deficiency and Hashimoto’s when a patient presents with hypothyroid symptoms. If they are iodine deficient, start them on a trial of iodine and selenium together. In most cases, patients see a significant improvement. In a minority of cases, they cannot tolerate supplemental iodine even with adequate selenium intake.

Unfortunately, the blood test for iodine that your doctor might run is not very accurate. The best way to determine iodine status is with a 24-hour urine loading test. This involves taking a large dose of iodine and collecting your urine for 24 hours afterward. If you are iodine deficient, you’ll retain more of the ingested iodine than you should and the level of iodine excreted in the urine will be lower than expected.

If your doctor or health care practitioner won’t order these tests, you can simply begin an iodine protocol. This involves starting with a low dose of iodine ( start with kelp tablets that contain 325 mcg of iodine per tablet) and increasing very slowly over time. It’s crucial that you also take 200 mcg of selenium per day during this protocol to protect against the potentially adverse effects of iodine supplementation, especially if you have autoimmune thyroid disease.

Physicians that specialize in treating hypothyroidism with iodine suggest doses as high as 50 mg per day may be necessary to restore iodine levels in those that are deficient. It’s imperative that patients build up to such high doses very slowly, and I don’t recommend doing it without the supervision of a clinician experienced with iodine treatment. Be aware that high doses of iodine can lead to a transient increase in TSH levels, which can be mistakenly interpreted as a sign of hypothyroidism.

Finally, it’s important to keep in mind that a minority of patients with Hashimoto’s confirmed by biopsy (the gold standard) never test positive for thyroid antibodies. This is probably because their immune systems are so depressed they can no longer produce antibodies. If you have a combination of hyper- and hypothyroid symptoms, I would still suspect Hashimoto’s even if your thyroid antibody tests are normal. It’s wise to be cautious with iodine if you have any signs of autoimmune thyroid disease, even without a confirmed diagnosis.

How much Iodine per day

Life Stage	Recommended Amount
Birth to 6 months	110 mcg
Infants 7–12 months	130 mcg
Children 1–8 years	90 mcg
Children 9–13 years	120 mcg
Teens 14–18 years	150 mcg
Adults	150 mcg
Pregnant teens and women	220 mcg
Breastfeeding teens and women	290 mcg

How much is too much

Life Stage	Upper Limit
Birth to 12 months:	Not established
Children 1–3 years:	200 mcg
Children 4–8 years:	300 mcg
Children 9–13 years:	600 mcg
Teens 14–18 years:	900 mcg
Adults:	1,100 mcg

https://ods.od.nih.gov/factsheets/Iodine-Consumer/

Bioavailabilty of Nutrients

Jan 272017

The importance of bioavailability
It’s not just the amount of nutrients that a food contains that is important, it’s how bioavailable those nutrients are to the body.
Bioavailability refers to the portion of a nutrient that is absorbed by the body.
The amount of nutrients we absorb from a food is invariably lower than the absolute amount of nutrients the food contains.
The nutrients in some foods are more bioavailable to humans than others. For example, the grass on your front lawn is loaded with vitamins and minerals, but they’re largely inaccessible to humans. Grass contains large amounts of a plant fibre called cellulose, which humans cannot break down. Since we can’t break down the cellulose, we can’t absorb the nutrients grass contains.
On the other hand, nutrients in animal products like fish, meat, poultry, dairy, and eggs are highly bioavailable. This means we can absorb them easily.
The key to nourishing your body, then, is to maximize your intake of bioavailable nutrients. This will ensure that your body has everything it needs to function optimally.

The nutrient density and bioavailability of foods
The table below ranks foods according to their nutrient density and bioavailability.

HIGH	MEDIUM	LOW
Organ meat	Whole grains*	Refined grains (i.e.bread, pasta, crackers, etc.)
Meat,wild game and poultry	Legumes*	Sugar
Fish and shellfish	Plant fats and oils**	Industrial seed oils
Eggs	Animal fats and oils**	Processed food and snacks
Fruits	Dairy products	Sugar-sweetened beverages
Vegetables		Artificial ingredients
Nuts and seeds*		Alcohol
Herbs and spices		Natural sweeteners

* Whole grains, legumes, and nuts and seeds contain substances called “nutrient inhibitors” that impair the absorption of some of the nutrients they contain.
** Plant and animal fats are relatively low in nutrients, but they play other crucial roles, including helping us to absorb the nutrients in other foods.

Looking at the table you might notice several interesting things.

Firstly, all of the most nutrient-dense foods are real, whole foods, and all of the least nutrient-dense foods are processed and refined foods.

Processed and refined foods are destroying our health because they promote overeating and inflammation, and inflammation is at the root of all modern disease. Here we see yet another problem with these foods: they are at the bottom of the scale in terms of nutrient density.

Secondly, you might be surprised to see that organ meats, meat, fish and shellfish are in the highest category of nutrient density. In fact, when the major nutrients required for human function are considered, these foods are even more nutrient-dense than fruits and vegetables.

One serving of beef (about 3.5 ounces) typically contains more B12, niacin (B3), vitamin D, retinol (vitamin A), zinc, iron, potassium, phosphorus, and EPA and DHA than the same amount of blueberries or kale, which are two of the most nutrient dense plant foods. In addition, the nutrients in meat are highly bioavailable when compared to foods like cereal grains, nuts and seeds, and legumes. The bioavailability of zinc, for example, is four times higher in meat than it is in grains.

Thirdly, while neither animal nor plant fats are especially nutrient dense, they do play other important roles in the diet. Perhaps most importantly, they help us to absorb the nutrients that are present in other foods.

Finally, look at where whole grains and legumes are on the table; they’re not the nutritional powerhouses you may have been led to believe they are. Not only do they lack important nutrients, but they also contain substances called “nutrient inhibitors” that make it more difficult for us to absorb some of the nutrients they do contain.

Cultures who ate a lot of grains and legumes went to great lengths to break down these nutrient inhibitors so they could better absorb the nutrients in these foods.
Methods included soaking, sprouting, fermenting, and leavening.
If you have the time and energy to prepare grains and legumes in these ways, and you tolerate them well, there’s no reason they can’t be part of a diet that emphasizes other more nutrient dense foods like meat, fish, eggs, and fruits and vegetables.

Likewise, if you eat nuts and seeds, you should soak and then dehydrate or roast them first in order to increase the bioavailability of the nutrients they contain.

Vitamin E

Jan 272017

Food

Numerous foods provide vitamin E. Nuts, seeds, and vegetable oils are among the best sources of alpha-tocopherol, and significant amounts are available in green leafy vegetables and fortified cereals. Most vitamin E in American diets is in the form of gamma-tocopherol from soybean, canola, corn, and other vegetable oils and food products

Selected Food Sources of Vitamin E (Alpha-Tocopherol)
Food	Milligrams (mg) per serving	Percent DV*
Wheat germ oil, 1 tablespoon	20.3	100
Sunflower seeds, dry roasted, 1 ounce	7.4	37
Almonds, dry roasted, 1 ounce	6.8	34
Sunflower oil, 1 tablespoon	5.6	28
Safflower oil, 1 tablespoon	4.6	25
Hazelnuts, dry roasted, 1 ounce	4.3	22
Peanut butter, 2 tablespoons	2.9	15
Peanuts, dry roasted, 1 ounce	2.2	11
Corn oil, 1 tablespoon	1.9	10
Spinach, boiled, ½ cup	1.9	10
Broccoli, chopped, boiled, ½ cup	1.2	6
Soybean oil, 1 tablespoon	1.1	6
Kiwifruit, 1 medium	1.1	6
Mango, sliced, ½ cup	0.7	4
Tomato, raw, 1 medium	0.7	4
Spinach, raw, 1 cup	0.6	3

Tolerable Upper Intake Levels (ULs) for Vitamin E
Age	Male	Female	Pregnancy	Lactation
1–3 years	200 mg (300 IU)	200 mg (300 IU)
4–8 years	300 mg (450 IU)	300 mg (450 IU)
9–13 years	600 mg (900 IU)	600 mg (900 IU)
14–18 years	800 mg (1,200 IU)	800 mg (1,200 IU)	800 mg (1,200 IU)	800 mg (1,200 IU)
19+ years	1,000 mg (1,500 IU)	1,000 mg (1,500 IU)	1,000 mg (1,500 IU)	1,000 mg (1,500 IU)

https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/

How a high-fruit diet can reverse cancer (The NORI Protocol)

Jan 272017

Video on Fruit Diet

http://www.noriprotocol.com

38 min

Cycling Methionine foods on and off for 7 – 21 days at a time.
ie cut back on grains, beans, seeds, nuts etc for 7 days below specific level per day
Causes stress in cancer cells and weakens them. puts them to sleep.

Raw food only.
Fruit has low levels of Methionine (5mg / 100g) and some protein so is good for this period
Vegetables have more Methionine than fruit
Dark green vegetables have higher levels.
No animal products during this time- stay vegetarian / vegan

Then eat them again for 4-5 days
Pushes cell so they basically self destruct
Soy, sessame and brazil nuts highest Methionine content

Fruit can be a problem if on a high fat diet. Keep to 5-10% fat max if eating lots of fruit.

Carry on cycle

Fasting also creates the same Methionine restriction. eg 72 hr water diet.

Fasting before and after chemo- fasting weakens cancer cells

Iodine supplement
Vitamin B12 1000mg once a week
Vitamin D sun or supplement
Selenium reduce risk of cancer / kill cancer cells in treatment program

selenised yeast 200ug per day
sodium selenite- as treatment often with vitamin K3 (or high does vitamin C)

Tumor tissue natural takes in selenium – stresses cells, causes them to die.

Taking anti oxidants can actually help cancer cells grow, so don’t take anti oxidants at same time (even Vit C at low dose & Selenium at low dose are anti oxidants, but at high dose they are oxidants)

detox to get rid of dead tumor material

blood test after 6 weeks

Free Radicals

Jan 272017

When aluminum is bound to excitotoxins glutamate and/or aspartate, it’s entry into your brain is significantly elevated. Once in the brain, aluminum increases iron-‐induced free radical activity!

7 Signs Your Thyroid Isn’t Working Properly

Jan 272017

Video on problem thyroid symptoms

6.5 min

Cold Hands
Cold Feet
Headache first thing in morning that goes away during the day
Depression
Elevated Cholesterol
Thin hair
Wide spaced teeth
Constipation
Can’t lose weight
Low body temperature first thing in the morning combined with symptoms above

TSH around 2 elevated indicates low thyroid
T4 around 8 less than 8 may need iodine and althyrisine – see GP
T3 around 130

Normal T4 with low T3 can indicate Stress

avoid soy – contains oestrogen
avoid gluten – gut inflammation

Finger Nail signs

Jan 272017

Video on Finger Nail signs

3 min

White lines
nail splitting

Excitotoxins

Jan 272017

Excitotoxins are neurotransmitters which can cause cell death when their actions
are prolonged.

Excitotoxins are compounds such as:

glutamate (monosodium glutamate or MSG) and lots of MSG is used in restaurant food,
aspartate or aspartame (i.e., NutraSweet) and
homocysteine.

Excitotoxins cause premature cell death by initiating the P53 gene.
Increased glutamate levels can stimulate the microglia (a CNS immune cell) to produce more cytokines than normal and to release
stored glutamate and quinolinic acid, both of which are excitotoxins.

The microglia can also convert tryptophan to the excitotoxin, quinolinic acid.
Therefore, tryptophan supplements should not be taken by patients with any chronic condition.

Microglial cells activated by Beta-‐amyloid can release protein kinase C,
and thus prolong inflammation.

Microglial cells can also release large amounts of glutamate and
stimulate the release of inflammatory arachidonic acid.

This degenerative process can feed upon itself, destroying massive amounts
of neuronal tissue.
Additionally, the amount of Amyloid-‐beta peptides are increased,
hydrogen peroxide levels are increased
and as a result, excitotoxicity is increased.

When aluminium (eg from deoderants) is bound to excitotoxins glutamate and/or aspartate, it’s entry into your brain is significantly elevated. Once in the brain, aluminium increases iron-‐induced free radical activity!