After touching upon B vitamin deficiencies in Episode 1, Abigail and Killeen are back to dig deeper on the importance of B vitamins. Learn why B6 is key for energy, what “methylation” means, all about an important B vitamin “cousin,” and more. In this episode, you’ll hear from health experts Erin Stokes, ND and Tieraona Low Dog, MD.
Announcer: [00:01] The statements in this podcast have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
[00:09] Welcome to episode two of "That Supplement Show." Today, Abigail and Killeen are here to talk about the B vitamin family. Learn why B6 is so key for energy. What methylation means? Why I was texting my wife in the middle of this recording to tell her all about choline here.
Killeen: [00:24] Hey, it's Killeen.
Abigail: [00:26] And Abigail.
Killeen: [00:27] In our first ever episode of That Supplement Show, Abigail and I talked about nutritional poverty. We talked about the prevalence of nutrient deficiencies in the country. Abigail quizzed me on some of the stats.
[00:40] It got us talking. We ended up even calling our friend, the doctor, about vitamin B6. One of the statistics we talked about which I found completely staggering was that 30 million people are deficient in vitamin B6. Dr. Erin Stokes gave us some awesome information about the important role that B vitamins play in the body.
[00:59] We wanted to know more. Today, we're here to talk about...
Abigail: [01:03] B vitamins!
Killeen: [01:05] Abigail, I got to say, I feel like B vitamins are the unsung heroes of the letter vitamin lineup. We always give C a big spotlight for immune support. Honestly, who can make it through a lazy summer beach day without somebody saying, "Oh, at least I'm getting my vitamin D in today."
[01:22] No one talks about the Bs. I honestly find that surprising. I only started learning about supplements in the last few years. I've come to understand that Bs are key in supporting our energy levels. Energy is something everybody is after. Who doesn't want more of it?
[01:40] As a runner and a mom and someone who's prone to the stress of balancing the whole work and family equation I know that there are plenty of people out there who, like me, are super interested in finding a supplement that can fuel their day naturally.
[01:54] Abigail, I thought we should start from the beginning, since you know so much about this topic. Can you get a little bit into exactly what B vitamins are?
Abigail: [02:02] B vitamins, they're a family of water soluble vitamins. That's means our body breaks them down in water. They all have similar functions. Like a family, they all work together and...
Killeen: [02:13] Well, it depends on which family you're talking about. My family doesn't always work together well.
Abigail: [02:18] Like an ideal family.
Killeen: [02:20] OK, so us on a good day.
Abigail: [02:22] Yes. They all work together, have similar functions. They help each other get their jobs done. As a broad group, they support the metabolism of foods. They're supporting brain function, the production of neurotransmitters, mood, energy, and so much more.
[02:38] Even heart health can fall under the category of B vitamins. There's eight nutrients that are currently categorized as B vitamins. You have B1, B2, B3, B5, B...
Killeen: [02:54] Wait, wait. What about B4? Can't you count, Abigail?
Abigail: [02:53] [laughs] It's funny you should ask about that. We skipped from B3 to B5. We've got B6, 7, we're skipping 8 again. We've got B9 and then, B12. When they were first identifying vitamins, thiamine, or vitamin B1, was the first in this family to be categorized, discovered in 1910.
[03:12] Next up was B2, but interestingly enough, B12 was identified before vitamin B3, but we didn't know that it functioned like a B vitamin until much later, hence the larger number there.
[03:24] Things like B4 were compounds that were originally thought to be part of this family, something like choline which we'll talk about a little bit later a relative of, but still different from the B vitamin family, so it lost its categorization. We've got some holes in there.
Killeen: [03:41] That's interesting, because choline, I had never thought of it as being grouped in with B vitamins. It sounds like it is, but isn't?
Abigail: [03:50] Yeah, spoilers. [laughs]
Killeen: [03:53] To go back to the B vitamins then, since choline is not exactly one. They have a lot of functions in common, but what do they specialize in? I've heard, especially B12, when it comes to pregnancy. Can we talk a little bit more about their specialties?
Abigail: [04:08] Yeah, where do you want to start? Pick one.
Killeen: [04:10] Let's start with B6, since right in the beginning, I was saying that 30 million Americans are deficient in B6, and that's how this whole topic of ours started today. Let's go there.
Abigail: [04:22] All right, awesome. B6, we know, is so important for energy production. That was what Dr. Erin Stokes focused on during our last episode when we called the doctor. It's tricky to get in the diet. I think I quizzed you a little bit about that last week, too.
Killeen: [04:37] You sure did. I did awesome.
Abigail: [04:41] I may have a quiz later for you, so be prepared.
Killeen: [04:43] OK. Oh, shoot.
Abigail: [04:46] [laughs] B6, it's involved in the metabolism of proteins in the body. It's found in the production of the heme in our hemoglobin, so it's important for healthy blood formation. Deficiency in it can lead to a lot of different concerns, including depression, was one that Dr. Erin Stokes mentioned last week.
[05:04] We're talking about low energy, diminished mood. All of these things are impacted by that one nutrient, and we only need one and a half milligrams of it a day. It packs a big punch for that little amount that we need in our daily diet.
Killeen: [05:18] That's actually an easy vitamin to supplement?
Abigail: [05:21] Totally. Even your daily multivitamin should have enough B6 to get you through and fill in those gaps, and if not, a great balanced B complex formulation is going to help smooth those gaps over as well.
Killeen: [05:33] That gives me a good idea about B6. Which other ones have you excited?
Abigail: [05:38] I wanted to talk about two of them today. I wanted to talk about vitamin B12 and then I also wanted to talk about folate, which is also known as vitamin B9.
Killeen: [05:45] I didn't know that. I actually wondered why B12 and folate were always lumped together. Folate's actually B9.
Abigail: [05:52] Yes.
Killeen: [05:53] I wonder why we don't just say B9.
Abigail: [05:55] Some of them, B12, we don't tend to call methylcobalamin, but that's what it is. Folate or folic acid has just caught on more than referring to it as vitamin B9, I suppose, but it is. It's in that number list.
Killeen: [06:08] Yeah. No, that makes sense. Folate's less of a mouthful than whatever else you just said. Methylco...
Abigail: [06:13] [laughs] Methylcobalamin. That's B12. Let's start with B12. I think that's a good place to start. These two nutrients, they have something else in common in addition to being members of the same B vitamin family. We'll get to that in a minute.
[06:26] I think it's a good opportunity maybe to call the doctor again to get some information. B12 is important for nervous system health and for energy production.
[06:35] This is one that if you're following a plant based diet, if you're vegan or vegetarian, you have to supplement with it. You can't get it in any plant based products. It's only found in meats and animal products. If you're following that plant based diet, you want to take a supplement of B12. Form is important.
[06:51] That's similar with folate. Folate, or B9, we think of as a pregnancy nutrient. It's important for healthy fetal development. We still need it as adults to help manage a lot of different things in the body, including homocysteine levels. Are you familiar with homocysteine, Killeen?
Killeen: [07:11] No. I'm totally not, Abigail. Enlighten me.
Abigail: [07:16] Homocysteine is amino acid found in our blood and elevated levels in our blood are linked to precursors of cardiovascular risk, heart disease and those sorts of concerns.
[07:26] You want to make sure you're having a lower or moderate level of homocysteine in the blood. Folate is, along with vitamin B12 and B6, is key in making sure that those homocysteine levels stay in check and that we're protecting the heart and our cardiovascular system.
[07:41] Important for pregnancy, certainly, but folate or B9 is still important for adults to get an adequate amounts as well. The challenge around adequate B12 and folate amounts in the diet is a concern around methylation, which is something I know that we've been talking about before and I'm sure you've heard of.
Killeen: [07:59] I definitely have and I'd like to go deeper there in a second. To bring it back to the amounts that we need in our diet, you mentioned that B6 was a very small amount and it was easy to supplement with. Are B12 and folate in the same type of situation, or do we need a little bit more than we do for B6?
Abigail: [08:18] They're all measured a little bit differently. For folate, if you're just a regular adult not looking to start a family and you're not currently pregnant, then 400 micrograms. B6 was 1.5 milligrams. We're talking micrograms with folate and that's 400. If you are pregnant, you want to shoot for around 800 micrograms a day.
Killeen: [08:37] It's funny to think how, when I was pregnant, I immediately went on to a multivitamin, but like many other people, when I was done with nursing, I gave up the multi. Now here I'm seeing that as a vegetarian, gee, maybe I shouldn't have done that so quickly. Thankfully, I am back on a multi now and loving it.
[08:56] Back to methylation, let's go there for a minute, because that is a hot topic. I feel like anybody who's maybe started to delve into supplements even just a little bit has probably fallen across the concept of not being able to methylate certain B vitamins. Let's go there.
Abigail: [09:15] Methylation, this concern is something that impacts up to 40 percent of the population.
Killeen: [09:20] 40 percent?
Abigail: [09:21] 40 percent.
Killeen: [09:22] That's a hefty percentage.
Abigail: [09:24] It is. It's a substantial amount of the population, and basically it means that we can convert these B12 and folate into the active forms that we need. I think to go a little bit deeper on this, we should call the doctor and see what Dr. Erin Stokes has to say on the topic. What do you think?
Killeen: [09:40] I think it's a great idea. Let's call the doctor.
[09:42] [phone rings]
Dr. Erin Stokes: [09:45] Hello? Hi, this is Dr. Erin Stokes.
Killeen: [09:48] Hi, Erin, this is Killeen and Abigail calling.
Dr. Erin: [09:51] Hi Killeen and Abby, how are you?
Killeen: [09:53] We're doing great, thank you. We are on the topic of B vitamins. I was asking Abby to tell me a little bit more about methylation and what the whole story was behind that, and she thought it would be a good idea to call you.
Dr. Erin: [10:08] So glad you called. Let's talk methylation.
Killeen: [10:09] Let's do it.
Dr. Erin: [10:10] Methylation, people don't have a sense of what that is.
[10:16] I like to refer to it as, really, activation. Methylation is essentially a way that we activate our vitamins, specifically two B vitamins that are very important, Killeen, folate and vitamin B12.
[10:33] You might be going, "OK, reactivate these B vitamins." The thing is that there's a certain percentage of people, just because of their unique genetic makeup, that are unable to activate and metabolize these very important vitamins.
[10:53] We're learning more and more about this. We want people to be able to have methylated forms because these are the forms that your body can actually utilize.
[11:04] We'll use folate as an example. A lot of people are familiar with folic acid, with folate. It's important, particularly, during pregnancy. It's very important for the healthy growth and development of the baby.
[11:21] In general, we need folate to have healthy red blood cells and to maintain healthy levels of a compound called homocysteine that many people know of.
[11:31] The active form of folate is the methylated forms. We go back to methylation of why methylation matters. This is a form, again, that your body can utilize.
[11:44] It's officially referred to 5 MTHF. You don't have to say the whole word, 5 methyl tetrahydrofolate. It's a fun tongue twister.
[11:54] That's the form that when you give that to your body, in a supplement, then you're able to utilize it. It's ready to go and you can use that form to do all the great things that folate does. That's basically it. Did you have any questions?
Killeen: [12:14] No, I don't think I have any additional questions, Erin. Thank you so much. That does help me get a grip on what methylation is. Thanks so much.
Dr. Erin: [12:23] You're welcome. People may be wondering now, "Am I one of those people that's not able to methylate or not? Where do I fall on this spectrum?"
[12:36] There are genetic tests that are available to determine if you're one of those people. We often turn to "Fortify Your Life" by Dr. Tieraona Low Dog as a reference guide.
[12:50] What she suggests in the book, and I think makes a lot of sense, is if you're unsure whether or not you're able to methylate, that it just makes sense to go with a supplement that contains these methylated forms.
[13:06] That's an important thing to add if people are left wondering what they should do. When in doubt, it just makes sense to go with the methylated forms in your multivitamin or your other supplements. That just makes a ton of sense.
Killeen: [13:21] Erin, that was so enlightening. Thank you so much.
Dr. Erin: [13:24] Thank you.
Killeen: [13:26] You have a great day.
Dr. Erin: [13:27] You too. Bye.
Killeen: [13:28] Let's pause here for just a moment to have a quick word from our sponsor.
[13:32] [sound effect]
Announcer: [13:33] This episode was brought to you by MegaFood's balance B complex, formulated to contain a balanced ratio of B vitamins delivered in a variety of nourishing whole foods. Balance B complex promotes energy and supports the health of the nervous system.
[13:45] With the inclusion of kale from Fox Organic, it offers trace minerals and nutrients to optimize utilization of these key vitamins. Learn more about balance B complex and other MegaFood products at megafood.com.
[13:55] [sound effect]
Killeen: [13:57] Now we've got the full on scoop on methylation. It makes a lot of sense that if you're not sure to just go ahead and place it safe and take a methylated form, right?
Abigail: [14:09] Absolutely. It can be tricky to get tested and verify your status unless you're working with a healthcare practitioner, or, like Erin said, you do some of that at home genetic testing which can be expensive.
[14:21] We don't all have the resources just like "Nutritional Poverty" talking about last week. We don't have the resources to do that. Smart money says just take the methylated forms, and you have all your bases covered.
[14:31] In fact, you've just saved your body a step because you don't have to convert it.
Killeen: [14:34] Sounds like a nice, easy way to make sure you get those Bs. When you are in the supplement aisle, is it clearly listed on the bottle, which supplements will have the methylated form?
Abigail: [14:45] For B12, you want to look for methylcobalamin, which is what we mentioned earlier. The other form out there is cyanocobalamin, and that's what our body has to convert. If you see methyl in the name there, you're safe. For folate, you look for the form, 5 MTHF.
Killeen: [15:00] Got it. Easy enough.
Abigail: [15:02] If it says folic acid, then it's probably not methylated. [laughs]
Killeen: [15:07] That's another important distinction, folate versus folic acid.
Abigail: [15:11] In the industry, folate's become the catchall for the naturally occurring amounts of folate. Probably the methylated folates as folic acid tends to refer to like food fortification in isolated nutrient forms.
Killeen: [15:23] I see. Again, playing it safe, look for the folate. Awesome. That's all pretty interesting. Is there anything else that we should talk about in regards to B vitamins?
Abigail: [15:32] Yes, absolutely. We said that the B vitamins, they're a family of nutrients, right?
Killeen: [15:37] Yeah, eight of them.
Abigail: [15:39] They have an extended family, and I mentioned choline earlier. Choline was originally identified and thought to be part of the family, given one of the numbers. It's more of a relative. Think of a cousin that lives in another town.
[15:52] Similar functions, comes to the family events, but isn't very close knit with [laughs] the core family. Choline is something that's getting more and more prominent over the last couple of years.
[16:03] It's hard to get in the diet, and it's also difficult to find in most multivitamins and supplements that are on the market.
[16:11] Quiz time for you, Killeen.
[16:12] [background music]
Killeen: [16:16] I knew this was coming.
Abigail: [16:17] Just one question today. What is the number one dietary source of choline?
Killeen: [16:25] Clearly, I'm not aware. Fish.
[16:28] [buzzer sound]
Abigail: [16:29] It's actually eggs, and specifically egg yolks. This is interesting to me because eggs have gone through this roller coaster ride over the last couple of decades.
[16:39] They're good for us, they're bad for us. Just the whites, avoid the yolks. Everyone has their egg white omelets in the morning.
[16:46] The most nutrition is found in those yolks, and that's where you're going to get your dietary choline. It's dramatically higher in egg yolks than any other food that contains choline.
[16:56] We're just not eating a lot of eggs. I think you have chickens at home. You're probably getting....
Killeen: [17:00] I do.
Abigail: [17:00] plenty of great choline every day, you and your family. It's hard to get in the diet, especially if eggs aren't part of your daily diet.
[17:07] It's incredibly important for production of our neurotransmitters. Acetylcholine is one of our neurotransmitters, and we need choline to create that neurotransmitter which is so important for cognitive function and mood.
[17:18] It's also important, and I would say just as important, during pregnancy as folate. It's important for fetal brain development and cognitive function in the developing baby.
[17:27] We want to make sure women going through pregnancy or thinking they may become pregnant are getting adequate amounts of choline in their diet.
Killeen: [17:36] That's great to know as well. Just as we said, we're always hearing about folate with pregnancy. I don't think anybody ever talked to me about choline.
Abigail: [17:44] It's becoming more and more part of the conversation as the years go on. A couple of years ago, I never even heard of choline.
[17:52] Working with Dr. Tieraona Low Dog, this is something she feels really, really passionately about, making sure especially during pregnancy that women are getting adequate amounts.
[18:01] Another way to play it safe, have an egg a couple times a week. Enjoy that yolk.
Killeen: [18:06] That's the best part anyway.
Abigail: [18:08] Actually, I think Dr. Low Dog was recently talking to Dr. Erin Stokes about choline, especially in pregnancy. Let's take a listen.
[18:14] [sound effect]
Dr. Tieraona Low Dog: [18:15] It's a nutrient that many people may not actually be aware of, it's called choline. It's related to the B vitamins, so think of it as a member of the B family. You find it in calves liver, you find it in egg yolks.
[18:32] You can find it in some meat and fish, but the big places you get choline in the diet are principally in American diet are from egg yolks. You need 450 milligrams a day, or 550 milligrams if you're breastfeeding. We don't get anywhere near this amount.
[18:50] Why does it matter? Why do you care? Well, choline during pregnancy has a very specific job. At the level of placenta, it modulates the mother's stress hormones, protecting the baby from these stress responses that the mom is having.
[19:14] We believe, if the data bears out that we think it is that when mom has adequate choline on board during pregnancy and when she's breastfeeding, it may offer that child lifelong protection against exaggerated stress response.
[19:32] This choline is powerful, and what I would say to you is, is there a correlation at all? I mean, Erin, I'm fascinated. We quit eating calves liver, which is the most abundant source of choline, and then we told everybody to eat egg whites.
Dr. Erin: [19:51] Egg whites.
Dr. Tieraona: [19:51] Seriously. This started like in the '60s and '70s.
Dr. Erin: [19:54] The egg white omelet and all that, yes.
Dr. Tieraona: [19:57] Those were the primary sources of choline. What we know is that pregnant women are not getting enough choline. I'm outraged that prenatal vitamins, the vast majority do not provide this very important nutrient. We need it at all stages of our life, but not just pregnant women.
[20:20] Now you're hopefully going to choose to breastfeed, and you cannot give what you do not have.
Dr. Erin: [20:26] That's true.
Dr. Tieraona: [20:27] You cannot give your baby what you do not have, and if you don't have adequate choline, you can't give it to the baby. You need 450 milligrams a day when you're pregnant, but you need 550 milligrams a day when you're breastfeeding. That is hard to get in the American diet. It is hard to get.
[20:46] If you're giving your baby infant formula, they're getting lots of choline. If you're breastfeeding your baby, chances are they're missing out on it, and this choline is absolutely critical for this baby's brain and nerve development.
[21:01] That's a big one that has changed. I didn't know all about that in the 1980s, especially when I was doing a lot more baby catching, I didn't know about that.
[21:13] I was with a woman from India recently. She's a physician and she said, "Isn't it interesting? My grandmother told me, in India, everyday one glass of milk and one whole egg." She said, "Do you think she knew something about choline?"
[21:28] I said, "I wouldn't second guess grandmas ever." They seem to know a little bit about everything.
[21:33] [sound effect]
Abigail: [21:33] Isn't that so fascinating? I'm so glad we were able to hear from Dr. Low Dog talking about choline.
Killeen: [21:38] Yeah, and actually it shows her passion for talking about prenatal health. I think we could go deeper on that at some point with her.
Abigail: [21:47] Maybe one day we will.
Killeen: [21:47] Yeah, I think so. To recap for today, you taught me about vitamin B6, B9 or folate, B12. We talked about methylation and the methylated forms of B vitamins, then we wrapped it up with choline.
[22:03] Thanks, Abigail. I did learn a lot today.
Abigail: [22:05] I'm so glad.
Killeen: [22:07] While we're on the topic of B vitamins and energy, which is why I'm suddenly so intrigued about them, maybe next time we can go into other ways to keep those energy levels up.
[22:18] We can talk more about B vitamins and maybe other supplements that help with energy, but I'd love to shoot things back and forth with you on what you do to optimize energy in your life, and maybe I can share some things with you too.
Abigail: [22:30] Yeah, absolutely. There's so many great ways that we can manage our energy levels even without supplements. We can talk about meditation and other great practices like that. I'm looking forward to it.
Killeen: [22:40] Sounds good. I'm going to get out of here and I'm going to go take some B vitamins, so I'll see you later.
Abigail: [22:46] All right, sounds good. Bye, Killeen.
Killeen: [22:47] Bye.
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