Flashback Friday: Preventing Brain Loss with B Vitamins?

Flashback Friday: Preventing Brain Loss with B Vitamins?
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One week on a plant-based diet can significantly drop blood levels of homocysteine, a toxin associated with cognitive decline and Alzheimer’s disease. Without vitamin B12 supplementation, though, a long-term plant-based diet could make things worse.

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By our seventies, 1 in 5 of us will suffer from cognitive impairment, and within five years, half will progress to dementia, in a progression from cognitive impairment without dementia, to dementia, and death. The earlier we can slow or stop this process, the better.

Although an effective treatment for Alzheimer’s disease is unavailable, even interventions just to control risk factors could prevent millions of cases. So, an immense effort has been spent on identifying risk factors for Alzheimer’s, and developing treatments to reduce them.

In 1990, a small study of 22 Alzheimer’s patients reported they had high concentrations of something called homocysteine in their blood. The homocysteine story goes back to 1969, when a Harvard pathologist reported two cases of children, one dating back to 1933, whose brains had turned to mush. They both suffered from extremely rare genetic mutations that led to abnormally high levels of homocysteine in their bodies. So, “Is it possible?” he asked, that homocysteine could cause brain damage even in people without genetic defects?

Well, now here we are in the 21st century, and homocysteine is considered a strong, independent risk factor for the development of dementia and Alzheimer’s disease. Having a blood level over 14 may double our risk. In the Framingham Study, they estimated that as many as 1 in 6 Alzheimer’s cases may be attributable to elevated homocysteine in the blood–now thought to play a role in brain damage, and cognitive and memory decline. Our body can detoxify homocysteine, though, using three vitamins–folate, vitamin B12, and vitamin B6. So, why don’t we put them to the test?

No matter how many studies find an association between high homocysteine and cognitive decline, dementia, or Alzheimer’s disease, a causal role–a cause-and-effect role–can be confirmed only by interventional studies.

Initially, the results were disappointing—vitamin supplementation did not seem to work. But the studies were tracking neuropsychological assessments, which are more subjective compared to structural neuroimaging–actually seeing what’s happening to the brain.

And a double-blind randomized controlled trial found that homocysteine-lowering by B vitamins can slow the rate of accelerated brain atrophy in people with mild cognitive impairment. As we age, our brain slowly atrophies, but the shrinking is much accelerated in patients suffering from Alzheimer’s disease. An intermittent rate of shrinkage is found in people with mild cognitive impairment. The thinking is that maybe if we could slow the rate of brain loss, we could slow the conversion to Alzheimer’s disease. So, they tried giving people B vitamins for two years and they found it markedly slowed the rate of brain shrinkage. The rate of atrophy in those with high homocysteine levels was cut in half. A simple, safe treatment can slow the accelerated rate of brain loss.

A follow-up study went further by demonstrating that B vitamin treatment reduces, by as much as sevenfold, the brain atrophy in the regions specifically vulnerable to the Alzheimer’s disease process. Here’s the amount of brain atrophy over two years in the placebo group; here’s the amount of loss in the B vitamin group. Less brain loss.

Now the beneficial effect of B vitamins was confined to those with high homocysteine, indicating a relative deficiency in one of those three vitamins. So, wouldn’t it be better to not get deficient in the first place? Most people get enough B12 and B6, but the reason these folks were stuck up at a homocysteine of 11 is that they probably weren’t getting enough folate, which is found predominantly in beans and greens. 96% of Americans don’t even make the minimum recommended amount of dark green leafy vegetables, the same pitiful number who don’t eat the minimum recommendation for beans.

In fact, if you put people on a healthy diet, a plant-based diet, you can drop their homocysteine levels 20% in just one week–up from around 11 down to 9. The fact that they showed significant homocysteine lowering without any pills, without supplements–even at one week–suggests that multiple mechanisms may have been at work. They suggest it may be because of the fiber. Every gram of daily fiber consumption may increase folate levels in the blood nearly 2%, perhaps by boosting vitamin production in our colon by our friendly gut bacteria. It also could be from the decreased methionine intake; that’s where homocysteine comes from. Homocysteine is a breakdown product of methionine, which comes mostly from animal protein. And so, if you give someone bacon and eggs for breakfast, then a steak for dinner, you can get these spikes of homocysteine levels in the blood. Thus, decreased methionine intake on a plant-based diet may be another factor contributing to lower, safer homocysteine levels.

The irony is that those who eat plant-based diets long-term, not just at a health spa for a week, have terrible homocysteine levels. Meat eaters up at 11, but vegetarians at nearly 14, and vegans at 16. Why? They’re getting more fiber and folate, but they’re not getting enough vitamin B12. Most vegans can be classified as being likely to suffer from hyperhomocysteinaemia–too much homocysteine in the blood–because most vegans in this study were not supplementing with vitamin B12, or eating vitamin B12-fortified foods, which is critical for anyone eating a plant-based diet. But if you take vegans and give them B12, their homocysteine can drop down below 5. Why not just down to 11? The reason the meat-eaters were stuck up at 11 is probably because they weren’t getting enough folate. But once vegans got enough B12, they could finally fully exploit the benefits of their plant-based diets and come out with the lowest levels of all.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to WikiImages via Pixabay.

By our seventies, 1 in 5 of us will suffer from cognitive impairment, and within five years, half will progress to dementia, in a progression from cognitive impairment without dementia, to dementia, and death. The earlier we can slow or stop this process, the better.

Although an effective treatment for Alzheimer’s disease is unavailable, even interventions just to control risk factors could prevent millions of cases. So, an immense effort has been spent on identifying risk factors for Alzheimer’s, and developing treatments to reduce them.

In 1990, a small study of 22 Alzheimer’s patients reported they had high concentrations of something called homocysteine in their blood. The homocysteine story goes back to 1969, when a Harvard pathologist reported two cases of children, one dating back to 1933, whose brains had turned to mush. They both suffered from extremely rare genetic mutations that led to abnormally high levels of homocysteine in their bodies. So, “Is it possible?” he asked, that homocysteine could cause brain damage even in people without genetic defects?

Well, now here we are in the 21st century, and homocysteine is considered a strong, independent risk factor for the development of dementia and Alzheimer’s disease. Having a blood level over 14 may double our risk. In the Framingham Study, they estimated that as many as 1 in 6 Alzheimer’s cases may be attributable to elevated homocysteine in the blood–now thought to play a role in brain damage, and cognitive and memory decline. Our body can detoxify homocysteine, though, using three vitamins–folate, vitamin B12, and vitamin B6. So, why don’t we put them to the test?

No matter how many studies find an association between high homocysteine and cognitive decline, dementia, or Alzheimer’s disease, a causal role–a cause-and-effect role–can be confirmed only by interventional studies.

Initially, the results were disappointing—vitamin supplementation did not seem to work. But the studies were tracking neuropsychological assessments, which are more subjective compared to structural neuroimaging–actually seeing what’s happening to the brain.

And a double-blind randomized controlled trial found that homocysteine-lowering by B vitamins can slow the rate of accelerated brain atrophy in people with mild cognitive impairment. As we age, our brain slowly atrophies, but the shrinking is much accelerated in patients suffering from Alzheimer’s disease. An intermittent rate of shrinkage is found in people with mild cognitive impairment. The thinking is that maybe if we could slow the rate of brain loss, we could slow the conversion to Alzheimer’s disease. So, they tried giving people B vitamins for two years and they found it markedly slowed the rate of brain shrinkage. The rate of atrophy in those with high homocysteine levels was cut in half. A simple, safe treatment can slow the accelerated rate of brain loss.

A follow-up study went further by demonstrating that B vitamin treatment reduces, by as much as sevenfold, the brain atrophy in the regions specifically vulnerable to the Alzheimer’s disease process. Here’s the amount of brain atrophy over two years in the placebo group; here’s the amount of loss in the B vitamin group. Less brain loss.

Now the beneficial effect of B vitamins was confined to those with high homocysteine, indicating a relative deficiency in one of those three vitamins. So, wouldn’t it be better to not get deficient in the first place? Most people get enough B12 and B6, but the reason these folks were stuck up at a homocysteine of 11 is that they probably weren’t getting enough folate, which is found predominantly in beans and greens. 96% of Americans don’t even make the minimum recommended amount of dark green leafy vegetables, the same pitiful number who don’t eat the minimum recommendation for beans.

In fact, if you put people on a healthy diet, a plant-based diet, you can drop their homocysteine levels 20% in just one week–up from around 11 down to 9. The fact that they showed significant homocysteine lowering without any pills, without supplements–even at one week–suggests that multiple mechanisms may have been at work. They suggest it may be because of the fiber. Every gram of daily fiber consumption may increase folate levels in the blood nearly 2%, perhaps by boosting vitamin production in our colon by our friendly gut bacteria. It also could be from the decreased methionine intake; that’s where homocysteine comes from. Homocysteine is a breakdown product of methionine, which comes mostly from animal protein. And so, if you give someone bacon and eggs for breakfast, then a steak for dinner, you can get these spikes of homocysteine levels in the blood. Thus, decreased methionine intake on a plant-based diet may be another factor contributing to lower, safer homocysteine levels.

The irony is that those who eat plant-based diets long-term, not just at a health spa for a week, have terrible homocysteine levels. Meat eaters up at 11, but vegetarians at nearly 14, and vegans at 16. Why? They’re getting more fiber and folate, but they’re not getting enough vitamin B12. Most vegans can be classified as being likely to suffer from hyperhomocysteinaemia–too much homocysteine in the blood–because most vegans in this study were not supplementing with vitamin B12, or eating vitamin B12-fortified foods, which is critical for anyone eating a plant-based diet. But if you take vegans and give them B12, their homocysteine can drop down below 5. Why not just down to 11? The reason the meat-eaters were stuck up at 11 is probably because they weren’t getting enough folate. But once vegans got enough B12, they could finally fully exploit the benefits of their plant-based diets and come out with the lowest levels of all.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to WikiImages via Pixabay.

164 responses to “Flashback Friday: Preventing Brain Loss with B Vitamins?

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  1. Some common conditions associated with high homocysteine are:

    osteoporosis, or bone thinning
    atherosclerosis, or a buildup of fats and other substances in the arterial walls
    thrombosis, a blood vessel blood clot
    venous thrombosis, a blood clot in the veins
    heart attack
    coronary artery disease
    stroke
    dementia
    Alzheimer’s disease

    -healthline.com

    1. Vitamin B12 is not made by ANY animal nor ANY plant. Only bacteria can produce it. That is why it is important to consume fermented food: there is no need for eating meat or swallowing supplements.

          1. Navy Corpsman, you ask”Where do you think ALL HERBIVORES get THEIR B12?” Since bacteria in animal guts make B12, which is then excreted, I thought it was because they ate poop! Insect poop and other poop, everywhere, all over their food. And drank untreated water (full of bacteria excreting B12) (which is where we used to get our vitamin B12: untreated water).

            Also, fermenters simply grow bacteria, which excrete B12, which can be purified and put into supplements. Not too different from fermenting food, such as cheese and sourdough bread.

            1. When bacteria in animal guts make B12, its host absorbs it then and there.

              In the past there was no shortage of fermenting food; besides pickling, fermentation was the only way to preserve non-dry foodstuff.

      1. Hi Navy Corpsman, you are right about B12 is made by bacteria in the guts of animals. As Dr Greger explains why don’t the bacteria in our colon make B12? They do, actually. It’s just too far downstream to be absorbed.

        In a study of Centenarians in Korea they found that they got their B12 from Kimchi which is made of salted Chinese cabbage, red pepper, garlic, fermented fish sauce or/and fermented small fish, green onion, ginger, starch, and some other optional vegetables and generally fermented for a few days, but sometimes for a few months in low temperature. It has been reported that the vitamin B12 content of Kimchi would be derived from the fermented fish sauce, one of the ingredients of Kimchi [45]. So I also think that how the fermented food was prepared is a factor if that fermented food is a good source of B12 or not.

        Discovery of Novel Sources of Vitamin B12 in Traditional Korean Foods from Nutritional Surveys of Centenarians

        1. If B12 did not derive from the fermentation of plant fiber by bacteria, there would be no animal life on Earth. Bacteria are the dominant life form, not Human Beans.

          1. This does not mean that you can rely on fermented products to get enough. Read the url I included in another reply to you.

          1. spring03, from the link you posted:

            “Most of Koreans consume Kimchi, a vegetable-fermented food, at almost every meal. There are a multitude of varieties of Kimchi in Korea, but Cabbage Kimchi is the most popular.”
            – – – –

            Wow, at almost every meal! I wonder where Dr. G. got his intel that Koreans’ high rate (?) of stomach cancer can be attributed to the Kimchi eating. I once heard him say this as he was sweatin’ away on his treadmill.

            1. ‘Salt or salted food
              The average daily salt intake in the Korean population was 13.4 g in 2005,(23) whereas the daily intake recommended by the World Health Organization is less than 5 g.(24) Ingestion of salt directly damages the stomach lining, enhancing the carcinogenic effects of gastric carcinogens, increasing nitroso compound formation, and facilitating H. pylori infection.(25) An ecological study on the association between sodium intake evaluated by 24-hour urine collection and gastric cancer mortality and incidence in four areas of Korea suggested a positive correlation between sodium intake and gastric cancer incidence and mortality.(26) A salt preference showed a 1.1-fold increased risk for gastric cancer in a cohort study of 2,248,129 subjects.(27)

              Kimchi, which is allegedly believed to have anti-carcinogenic properties, accounts for approximately 20% of sodium intake.(23) Case-control studies on the intake level of kimchi and gastric cancer risk generally showed an increased risk among subjects with high or frequent intakes of kimchi.(28-30) In addition, a high intake of soybean paste (28) or frequent intake of soybean paste stew (31) increased the risk of gastric cancer.’
              https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204471/

              1. Mr.Fumblefingers– Thank you for the links, and a summary of research on the negative effects of excessive sodium intake. Kimchi (and other salted/fermented items) may contribute beneficial compounds, but the balance of results seems very negative.

                We should supplement with B12, to be sure of having enough, especially since there is still some variation among authorities on the minimum we absolutely must have. Would that we could demonstrate a simple, dose-related effect for B12 in reducing homocysteine and cancer risk.

                1. Thanks. Yes. it is al very complicated.

                  I think there is some evidence that B12 does bring down homocysteine levels but I understand that lowering homocysteine levels in and of itself does not necessarily reduce the risk of adverse events.
                  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548176/
                  https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006612.pub4/epdf/full

                  Also. I believe that some studies suggest that there may even be an increased risk of cancer wih long term use of B12 but the jury is still out on this
                  http://cebp.aacrjournals.org/content/early/2018/10/19/1055-9965.EPI-17-1198#

                  1. Tom, I read that B-12 one before, but thank you for posting the link. When I just re-read the opening sentences, they gave a mechanism for how it might cause Cancer for me to try to look up.

                    I am iced in after a snow and ice storm right now so it gives me something to ponder.

                    B-12 and folate might cause cancer by disrupting one carbon metabolism whatever that means.

                    It sounds like.a Bob Marley song.

                    My dog can’t go outside. He tried but slipped without getting down the first step and turned around and came back in and christened the area rugs I bought when he got sick as his potty patches. He walked slowly across all of them.

                    He is not getting any food today.

                  2. Okay, I need help from the scientifically minded members.

                    I looked up one carbon metabolism and they talked about three things being involved in methylation. Folatr, B12 and SAM, I think was the list.

                    So does that mean having extra Methyl groups is what is causing the cancer?

                    Does it mean to not take the Merhyl forms or does it mean we need the Methyl forms or am I understanding so little of it that I am totally off track?

                    1. I just listened to something on methylation and cancer. There was hyper methylation and hypo methylation involved in cancer so that didn’t help. I did learn that niacin is a Methyl sponge.

                      Other than that I didn’t learn anything except that hypo and hyper methylation probably matters quite a bit.

                    2. Okay, Dr Greger, I appeal to you for a B-12 and cancer risk video.

                      Does it change dosage or is homocysteine the standard?

                      Is there a way to not mess up one-carbon metabolism? Or to fix it?

                      Does that notion affect which B-12 to take or which one to avoid?

                      It seems like it would be a reason to understand our supplements.

                      A lot of people are doing Methyl folate and Methyl B-12 and SAMe, is that an oops, I might get cancer faster? Do the people need to take niacin with their overmethylators? The dance of the over-supplemented?

                      How do we know when the methyl groups are in balance? Are there physical symptoms for either?

                      I feel like I want to warn the confused people to not read my ramblings, but I need the science geeks to tell me should I pair methyl with cyano or some stupid thing like that?

                      Either way the expensive pee maybe just messed up my one-carbon metabolism and I don’t know what that is.

                    3. Trying to understand the one-carbon cycle.

                      I understand the supplementing for folate versus eating foods. I got up to the folate trap if you don’t have proper B-12 levels and noted that the whole MTHFR thing comes before the B-12 Homocysteine to Methionine to SAM step.

                      Okay, I understand what to do with the folate issue. Eat plant based. Don’t do both plant food and supplements, because the synthetic stuff might compete with the natural sources and I emphasize might, because they don’t know for sure.

                      Supplementing with ‘FA differs from natural folates in that (i) it contains a single glutamate residue and (ii) it is an oxidized and inactive form of the coenzyme. To become an active coenzyme, FA must be reduced twice: first to dihydrofolate and then to tetrahydrofolate (Fig. 1). Dihydrofolate reductase (DHFR) is the enzyme responsible for catalyzing both steps; however, it is a relatively slow enzyme in humans and appears incapable of completely converting large amount of FA to tetrahydrofolate (8). In contrast to natural folates, which are unstable and can readily degrade in food preparation and storage, FA is a stable compound (9). FA, being only a monoglutamate, also has excellent bioavailability (10). It should be noted that the combination of fortified foods and multivitamin supplements can result in a substantial accumulation of unmetabolized FA in cells (8). Moreover, this accumulation may be highly variable in individuals since up to five-fold differences in DHFR activity have been reported in humans (8). The accumulation of intracellular FA is likely driven by increased levels of unmetabolized FA in blood, a phenomenon observed in numerous studies assessing the effects of FA intake. Whether increased circulating FA is a risk factor for certain pathologies or whether it might have a beneficial effect is not clear at present.”

                      “There is a consensus view that folic acid supplementation has numerous health benefits, many of which are significant in their impact. However, emerging evidence suggests that increased population exposure to folic acid may also have a negative impact with respect to certain developmental and degenerative disorders. As examples, presently much attention is focused on the role of folic acid fortification augmenting colon cancer risk, whereas earlier in the life cycle, the vitamin may additionally influence insulin resistance. Without question, conditions that are influenced by folic acid are both diverse and many – from concerns relating to cognitive decline, breast cancer and vascular disease through to preconceptional issues where maternal folate levels might conceivably alter the phenotype of offspring via epimutations.”

                      Exemplifying this concern, there is a clinically important relationship between folate and vitamin B12 deficiency. Vitamin B12 (cobalamin) is a cofactor of methionine synthase, the enzyme catalyzing the regeneration of methionine from homocysteine and 5-methyltetrahydrofolate (5-MTHF). In instances of B12 deficiency, this enzyme is inactive leading to elevated homocysteine levels and the symptoms of megaloblastic anemia. Since this is the only reaction utilizing 5-MTHF in the cell, the absence of B12 causes the accumulation of 5-MTHF at the expense of other forms of folate. Direct experimental evidence for this phenomenon, commonly known as the “methylfolate trap,” has been obtained in a mouse model where disruption of the methionine synthase reductase gene (essential for methionine synthase activity) led to decreased plasma methionine and increased plasma homocysteine and tissue 5-MTHF (20). FA supplementation can correct the megaloblastic anemia caused by B12 deficiency, and this fact has raised the concern that folate may “mask” this easily detectable symptom and thus exacerbate the more toxic neurological sequelae of vitamin B12 deficiency, such as sub-acute degeneration of the spinal cord (1).”

                      “Other health concerns about folate supplementation have been raised in the literature. For example, some studies have suggested that high intake of FA may lead to cognitive dysfunction (21, 22). Also, a link between autism and folate has been suggested based upon the temporal correlation of the rise in autism diagnoses and FA fortification (23). While these potential negative effects are questionable, it would still be prudent to account for the possibility that FA supplementation may have no clear positive effect on diseases other than NTDs. For instance, recent meta-analyses failed to find a link between folate supplementation and the incidence of cardiovascular disease (24, 25). It is also important to consider that folate supplementation alone may not be a panacea for NTDs, and it is possible that the ability of folate to reduce the development of NTDs may be limited to certain genetic sub-populations (26). Moreover, a recent study in mice has demonstrated that depending on the genetic background, FA supplementation may even increase the incidence of NTDs (27).”

                      The effect of folate on cancer initiation and progression is an extremely important public health issue because the mandatory fortification of grain food with FA has resulted in increased folate intake, raising the concern that it may increase the incidence of malignancies and cancer-related death (41). End-point effects of the vitamin could depend on its ingested form, synthetic FA versus natural (reduced) folate. For example, a recent randomized clinical trial indicated that supplementation with FA doubled the risk of prostate cancer while baseline dietary (natural) folate revealed a protective effect (42). Another example of this trend is the inverse correlation between the risk of pancreatic as well as colon cancer and the dietary (natural) folate intake while no effect was demonstrated for the FA supplemented diet (43). The dose of ingested folate clearly matters as well. Of note, in the above study on prostate cancer FA was given at the dose of 1 mg per day (44), which was 2.5-fold higher than the normally recommended daily allowance of 0.4 mg and was given on top of folate obtained from natural and fortified foods. The tumorigenic response to dietary folate may also depend on the cells/organs of origin and cancer type, but results on this matter are inconsistent (3, 45). Thus, while epidemiological studies of head and neck cancer, liver cancer and neuroblastomas mostly reported protective effects of folate (46–49), results of studies on colorectal, breast, prostate and lung cancers are far less conclusive (50–53). This inconsistency prompted the idea that effects of folate in tumorigenesis depend on the timing and duration of folate administration (18, 19, 54). These effects could be further modified by other factors such as age and the status of vitamins B6 and B12 (4). Finally, it is likely that the relationship between the folate intake and cancer risk also depends on individual genotypic features including polymorphisms in folate enzymes (55–57).

                      “Theoretically, increased blood levels of FA may interfere with cellular folate transport and metabolism, or regulatory functions of the coenzyme through competitive inhibition of binding of natural folates to enzymes and/or carrier proteins (30). High intake of FA may exert an antagonistic effect towards natural folates due to accumulation of dihydrofolate, which is known to inhibit thymidylate synthase (TS) and methylenetetrahydrofolate reductase (MTHFR), leading to decreased levels of thymidylate and 5-MTHF (30, 31). Importantly, the shortage of thymidylate impairs DNA integrity and cellular division while the shortage of 5-MTHF decreases methionine biosynthesis thus affecting protein production and DNA methylation. As well, high doses of FA may simply saturate DHFR and potentially inhibit the entire folate metabolism (8). Thus, paradoxically, high doses of FA may induce effects similar to those produced by deficiency of the bioactive forms of folate.”

                    4. Being low in B-12 might make the Folic Acid situation worse? Right?

                      But being high in B-12 might be linked to cancer?

                      Okay, I understand the potential mechanisms of Folic Acid causing problems, but why B-12?

              2. Okay, yes, I heard Dr Greger talk about salted soy, too and I read that study and that data was the data which got me to stop eating Miso. Then I watched the Miso video and soy is high in potassium so you can eat Miso and not have it harm your endothelials. Which made me also ponder soy sauce with a question mark.

                So back to salted soy. Scapegoat? Or is the whole potassium balancing logic hog wash?

                1. So fermented foods double the risk of stomach cancers

                  Kimchi and sauerkraut

                  Possibly because of the sodium

                  Possibly because of the lactobacillus (which one PubMed person gives as part of the nutrition to cancer patients.

                  Boy, I hate the competing logic, too, but I know different studies focus on different things.

                  1. I bought a chili paste which was fermented which is going into the garbage.

                    The PubMed entry saying lactobacillus was one of the things which helps for cancer is where it genuinely gets frustrating when some of us are trying to heal our loved ones.

                    1. Okay, I rewatchdd the danger of probiotics video and twice as many people died of pancreatitis on probiotics than those who didn’t take them.

                      I have to read that study and look for lactobacillus.

                    2. 24 people died in the probiotic group versus 9 in the control group. The probiotic group had slightly more infections and had more bowel ischemia if I am spelling that right.

                      My friends daughter has been sick for a year and they are big probiotics people. Lots of antibiotics, too. Grain free lots of chicken if I remember right. She had to delay college, but just can’t get well.

        1. hi Brian, Spring03 answered another commenter below about the use of nutritional yeast. B12 is added to the yeast, and would require 2 tsp 3x day to get enough B 12. It’s much cheaper/easier to simply buy the b12 supplement itself.

    2. Jimbo, thanks for the list. Also, don’t think it was mentioned, but some diabetics on Metformin, have high homocysteine beacause Metformin can block absorption of B12. Most doctors don’t tell patients this when handing out the prescription.
      Diabetics on this drug should supplement.

      1. Metformin is also contraindicated for people with kidney disease. I was on metformin for a few years as a diabetic and my GFR sank to 17, two points away from transplant country. At the time I was vegetarian and eating lots of processed food, but still got my GFR back to the low 40s. Then, since WFPB, I’m up to 60. So that’s one nasty drug!

        1. Thanks for the heads up.

          I am trying to get my brother to not need his kidney removed, but if I don’t succeed at that, I can still succeed at keeping him off Metformin!

      2. https://www.selfhacked.com/blog/23-longevity-boosting-supplements-drugs-increase-lifespan/

        Metformin belongs to a family of drugs called biguanides that have been shown to increase lifespan. For example, Metformin extended the lifespan of worms by 40% (median) and significantly increased the lifespan of mice [R].

        Like many other life-extending drugs, metformin induces many of the benefits of calorie restriction, such as improved physical performance, increased insulin sensitivity, and reduced LDL and cholesterol levels without actual calorie restriction [R].

        Metformin might extend lifespan by behaving as a metabolic stressor that activates an oxidative stress and detoxification response (involving AMPK) [R, R, R].

        In animal models, deactivation of IGF-1 genes increases lifespan. Metformin decreases IGF-1 [R].

        As already mentioned, blood sugar regulation is an important factor in aging. Metformin lowers blood sugar by increasing insulin sensitivity in liver and muscles. It might also work by suppressing glucose production in the liver [R].

        Metformin mitigates the high risk of diabetics getting cardiovascular disease and brain issues.

        Diabetics who take metformin are at decreased risk of developing a range of cancers. It is unclear whether these cancer prevention properties would apply to non-diabetics [R, R].

        Metformin changes the microbiome in a way that promotes health and longevity, possibly by altering microbial Folate and Methionine Metabolism [R, R].

        Metformin promotes mobility in old age, decreases the fat build up, and increases stress resilience in response to oxygen deprivation [R].

        Metformin is a prescription drug, so speak with your doctor before you take it.

    1. Barb, I’ve got to wonder if part of the reason for this is that they used synthetic vitamins.
      Folic acid is not the same as the folate in foods. In fact, folic acid can be counter productive particularly in people with certain genetic SNP’s.
      The closest form of folate to that in food is L-methylfolate, preferred form of B6 is Pyridoxal-5-Phosphate. And some people only respond to sub-lingual B12. Also, just supplementing with B6,9, and 12, added to a poor diet may not help much. B vitamins work together, and thiamine and riboflavin to just name two, are important also.

      1. I wasn’t sure what the problem was Marilyn and I’m thankful for your reply. I remember buying the homocysteine formulas but wincing at the folic acid. In fact, it seems that folic acid is added to a many food products these days. So, if we are eating our greens then for the folate, and tak8ng b12, we’re good? Also, The vitamins, as I understand it, did lower homocysteine, but did not reduce cardiac events (like a change in diet and lifestyle would). My doc suggested it could be a marker rather than cause. Thanks again!

  2. I am wondering as to the validity of the comment I will paste below from this site in 2012. My question is what is the healthiest and or safest form of b-12 one can consume being on a strict plant based diet with no processed foods.

    Thanks, if anyone can answer this for me.
    Mike Stilinovich

    Stephen says:
    APRIL 24TH, 2016 AT 4:18 PM
    Thank you for bringing this up!

    Methylcobalamin vs cyanocobalamin

    Cyanocobalamin exists only as a cheap chemical synthesized in laboratories. It doesn’t occur naturally in any living organism and also has a cyanide group, and it is an inactive form of Vitamin B12 that requires a number of metabolic processes to gain any benefit

    Cyanocobalamin isn’t something nature ever intended your body to deal with. Your body has no use for the cyano- compound itself, and has to convert any cyanocobalamin you take into methylcobalamin.

    A small amount of cyanide is released during the conversion process that must then be removed from your body by your liver.

    By taking synthetic cyanobalamin, you’re actually stealing methyl groups from your body, using up substances such as glutathione and making it do more work at the biochemical level.

    Cyanocobalamin, in summary, is a low-grade, low-quality and slightly toxic (cyanide) form of vitamin B-12 that’s used by all the cheap vitamin manufacturers. You get what you pay for.

    Methylcobalamin is a biologically active form of B12 that exists in nature. Because is pre-methylated, your biochemistry can use it immediately without any metabolic steps to make it body friendly.

    Methylcobalamin research has shown that it remains in the body for a longer period of time, with increased absorption, better retention in tissues, and at higher levels than cyanocobalamin, and of course, no cyanide!

    Pills are an inferior method of taking B12 as studies have shown that up to 99% is wasted.
    The best methods to take B-12 is injections, sublingual absorption and skin absorption.
    Because injection must be done by trained professionals, sublingual absorption and skin absorption is the most practical for most people.

    But beware that many sublingual formulas are cyanocobalamin. This is changing but you must check the label to ensure that you are getting the vastly superior methylcobalamin.

    Skin patches are available that deliver methylcobalamin released over a 1-2 day period. Again, be sure that it is methylcobalamin if you care about this difference.

    The sublingual spray form that I just discovered a few months ago is extracted from Saccharomyces cerevisiae according to the label, and is a species of yeast according to my research. (Mykind-Garden of Life). I’m sure there are others.
    I am biased as any supplements I use must be made with and from organic foods and natural sources, as well as my food as well must be organic. This is just my personal requirements and to each his own.

    1. This topic has been addressed by Dr. Greger and discussed many times on this forum. Dr. Greger recommends cyanocobalamin. See his videos or vitamin recommendations.

      I don’t think anyone can say which is “the healthiest”. But cyanocobalamin is safe, cheap, shelf stable, and the form generally used by physicians to treat b12 deficiency.

      Sublingual forms, although fine, are not better absorbed than pills.

      I don’t think whoever wrote those comments knows what they are talking about.

      1. gengo, actually in people with certain forms of IBD, Crohn’s, Celiac, etc. sublingual types are the only forms that work.
        I also think they work better in people taking PPI’s.

        1. Thanks for pointing out those special cases. My comment was assuming normal digestion, and was based on the results of https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884303/?tool=pmcentrez

          “Aims

          To compare the efficacy of sublingual and oral administration of 500 µg of cobalamin in subjects with cobalamin deficiency.
          Materials and results

          Thirty subjects with low serum concentrations of cobalamin participated in the study. Subjects were randomly allocated to receive one tablet daily of 500 µg cobalamin sublingually or orally, or two tablets daily of a vitamin B complex. Serum cobalamin concentrations before treatment were 94 ± 30 pmol l−1, 108 ± 17 pmol l−1 and 98 ± 14 pmol l−1 in the sublingual B12, oral B12 and oral B-complex groups, respectively. After 4 weeks, concentrations rose to 288 ± 74 pmol l−1, 286 ± 87 pmol l−1 and 293 ± 78 pmol l−1, respectively. The increase in each group across time was statistically significant (*P* = 0.0001, differences [95% confidence intervals] 194.2 (114.5, 273.9), 178.3 (104.2, 252.4), and 195.1 (135.0, 255.2) pmol l−1, respectively). There was no significant difference in concentrations between the treatment groups.
          Conclusion

          A dose of 500 µg of cobalamin given either sublingually or orally is effective in correcting cobalamin deficiency.”

      2. Gengo the previous comment is easily researched as fact, yours is a bias to Greger. I love Greger but he isn’t God and over the years he has admitted to being wrong on things and has changed his view. The comments we correct cyanocobalamin is not natural, it it’s not whole and DOES indeed take from your body to work. It also is NOT safe for anyone with any kind of liver condition or damaged liver as it will increase risk.

        We should be willing to change our view and not just hold strictly to one person as though they are God

        1. Randall,
          You seem to be implying that I always agree with Dr. Greger, which is untrue.

          You have not presented any evidence i.e. scientific studies published in reputable medical journals, supporting your view. Please do so, so I can read them. I am certainly willing to change my opinions but would hardly do so based on your unsupported claims.

          Regarding liver disease, I admit that I have never looked into that, but as is typical with general recommendations like Dr. Greger’s on cyanocobalamin, it is assumed to apply to otherwise healthy individuals. Of course, “ceteris is not always paribus”, so I would not be surprised if cyanocobalamin is counter-indicated in some circumstances such as liver, kidney or other diseases.

    2. Michael,

      Methyl form is less shelf stable and a few of us have had it not work.

      I ended up with tiny lesions and leg spasms and skin issues and getting brain problems back and when I looked up the symptoms it ended up being B-12 insufficiency. I switched off of Methyl B-12 and got better.

      Someone else on the site had blood blisters in their mouth and the were taking Methyl B-12 and still tested insufficient.

      Studies showed that Cyano was the most effective.

      Also, Methyl wasn’t a complete form. If you take Methyl B-12, you also need Adenosyl. (Both have different functions.) So you either take cyano or take Methyl, plus Adenosyl or Methyl, plus cyano or Methyl, plus Hydroxy. Either way, I ended up insufficient even taking Methyl and it might have been the shelf life or whatever, I just know that I can’t trust Methyl and that Cyano tested better in studies. Cyano tested better than Methyl and Hydroxy B-12.

      As far as the cyanide goes, there is about 5000 times more cyanide in flaxseed and nobody ends up in the ER from either of those. Apricot Kernels and B-17, people do get enough cyanide to end up in the ER, but there is an antidote. Hydroxy B-12 is the antidote.

      Easy enough to have a bottle of that on hand if you are afraid, but someone on PubMed analyzed that the Methyl group is removed also from Methyl B-12 and has to be put back on and also, people go way overboard on Methyl groups in vitamins and too many Methyl groups can harm you. The dirty gene guy never did his own research and might be a little bit of a con artist who found a niche is another thing I remember. There is a skeptical person who analyzed it online. Trying to remember the other things.

      1. I will gather the PubMed links for you after work.

        Cyano is more effective. That is why doctors use it. Merhyl is less shelf stable. It becomes less effective with light, heat and time. Plus it isn’t complete without Adenosyl. Plus, you need to take more of it and high doses of B-12 may be more linked to lung cancer. I think it was lung cancer.

        Both have the prefix removed and a methyl group is put on at the end so a PubMed article said that it is not likely to be superior.

        People freak out about cyanide, which happens to be in everything and as long as you have enough….. Glutamate….. I think it was, your body handles it well.

        People are afraid of cyano B-12, then take apricot seeds or high doses of B-17 for cancer when that really does have enough cyanide to begin to cause problems.

        Toddlers die from too many apricot seeds. If you are a little person, you might need to be more careful with flaxseed, but nobody has ever ended up in the ER from it and they keep track of things like that.

      2. I ended up finding a newer comparison and that study was looking to replace cyano and what they recommended was if you don’t want to take cyano to do trial and error and/or take multiple of the types of B-12 (Methyl wasn’t enough for me. Adenosyl/Hydroxy combo seem to be enough. I tried that next, but Cyano was also enough. Not getting enough gives me serious brain problems and other problems):

        “Based on the considerations discussed in the current article, it is possible that individuals with particular SNPs affecting B12 assimilation might raise their B12 status more efficiently with 1 or more particular forms of vitamin B12. However, because those types of SNPs are not currently reported in commercial tests, individuals may require either a trial-and-error approach by supplementing with one particular form of B12 at a time, or they might simply use a supplement with a combination of all 3 naturally occurring forms of B12 that are commercially available for a better chance of achieving faster clinical results. That approach may or may not offset genetic polymorphisms involving B12 metabolism and related pathways.”

        1. Here is the other forms are not likely to be superior

          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692085/

          Methylcobalamin (MeCbl) and adenosylcobalamin (AdoCbl) are coenzymes for methionine synthase and methylmalonyl-CoA mutase, respectively. Hydroxylcobalamin (HOCbl) and cyanocobalamin (CNCbl) are frequently used for supplementation. MeCbl and AdoCbl have recently emerged as alternative forms in supplements. In the light of metabolic transformation of Cbl into its cofactor forms, this review discusses current evidence on efficacy and utility of different Cbl forms in preventing or treating Cbl deficiency. Cbl-transporting proteins bind and mediate the uptake of all aforementioned forms of Cbl. After internalization and lysosomal release, Cbl binds to the cytosolic chaperon MMACHC that is responsible for (i) flavin-dependent decyanation of [CN-Co(3+) Cbl to [Co(2+)]Cbl; (ii) glutathione-dependent dealkylation of MeCbl and AdoCbl to [Co(2+/1+)]Cbl; and (iii) glutathione-dependent decyanation of CNCbl or reduction of HOCbl under anaerobic conditions. MMACHC shows a broad specificity for Cbl forms and supplies the Cbl(2+) intermediate for synthesis of MeCbl and AdoCbl. Cobalamin chemistry, physiology, and biochemistry suggest that MeCbl and AdoCbl follow the same route of intracellular processing as CNCbl does. We conclude that supplementing MeCbl or AdoCbl is unlikely to be advantageous compared to CNCbl. On the other hand, there are obvious advantages of high parenteral doses (1-2 mg) of HOCbl in treating inborn errors of Cbl metabolism.

          Here is an argument about whether to give Methyl. The jury is still out as of this one.

          https://www.ncbi.nlm.nih.gov/pubmed/25117994

          “Vitamin B12 (cyancobalamin, Cbl) has two active co-enzyme forms, methylcobalamin (MeCbl) and adenosylcobalamin (AdCbl). There has been a paradigm shift in the treatment of vitamin B12 deficiency such that MeCbl is being extensively used and promoted. This is despite the fact that both MeCbl and AdCbl are essential and have distinct metabolic fates and functions. MeCbl is primarily involved along with folate in hematopiesis and development of the brain during childhood. Whereas deficiency of AdCbl disturbs the carbohydrate, fat and amino-acid metabolism, and hence interferes with the formation of myelin. Thereby, it is important to treat vitamin B12 deficiency with a combination of MeCbl and AdCbl or hydroxocobalamin or Cbl. Regarding the route, it has been proved that the oral route is comparable to the intramuscular route for rectifying vitamin B12 deficiency.”

          “However, the clinical evidence for the use of MeCbl in deficiency states in the form of controlled trials is scanty. It has also been argued that use of MeCbl in Vitamin B12 deficiency will not reverse the neurological deficit.[1] MeCbl and 5’-deoxyadenosylcobalamin (AdoCbl) are the active coenzyme forms of Vitamin B12 formed intracellularly. It has been suggested that these coenzymes are necessary for normalization of the hematological and neurological manifestations of B12 deficiency, respectively. AdoCbl-dependent methylmalonyl CoA mutase reaction, a step in propionate metabolism, is proposed to be responsible for myelin synthesis.[1] Hence, it is suggested that AdoCbl cannot be substituted by MeCbl and thereby patients receiving MeCbl would not experience the full therapeutic benefits unless AdoCbl was also added or CNCbl/OHCbl were administered which subsequently get converted intracellularly to both the active forms. However, the assertion that AdoCbl deficiency is responsible for the neurological impairment has been challenged. It has been suggested that deficiency of methionine synthase (requires MeCbl) and the block of the conversion of methionine to S-adenosylmethionine is responsible for the neuropathy in B12 deficiency states.[2] In this context, it is also important to consider the role of methylmalonic aciduria and homocystinuria type C protein, a cytosolic chaperon.[2] This protein removes the ligands attached to the cobalamin molecule (cyano, hydroxyl, methyl, or adenosyl groups by decyanation or dealkylation) for further synthesis of the necessary coenzyme forms.”

          1. There is some evidence that combinations work better than just one form.

            But, again, you just probably don’t want to go to high in doses.

              1. Yes, people invent conditions to manipulate people into buying supplements.

                Don’t take scary cyanocobalamin because it has a trace amount of cyanide. Plus, you might have dirty genes, so you need to buy my supplements, not their cheap stuff.

                Not saying it never happens. Just saying that Methyl is in fashion right now and there is fear-mongering about cyano even though cyano works better and is cheaper and you don’t have to take as much of it and nobody has ended up with health problems from it – but people have ended up in serious health problems, even dying and rotting their spinal cords and Alzheimer’s from not having enough B-12, so either take the cyano or buy the expensive stuff, but if you aren’t doing cyano, you probably need more than one.

                If your cholesterol goes up or you get Charley horses or cracks on the side of your mouth or tiny lesions or blood blisters in your mouth, consider adding another B-12 into your regime.

              2. Re:article in Forbes, while the writer has some valid points, it also shows a lot of ignorance.
                Best example is that the writer clearly doesn’t understand that folic acid and the folate in food is not the same.
                For that reason I personally won’t eat foods supplemented with folic acid as mandated by the US government.
                Ezekiel muffins, for instance, do not have added ‘vitamins’.

                I do not like synthetic vitamins, and most multi-vitamin formulas have too high doses. The human body isn’t made to absorb that much at once. Also, taking a lot of one vitamin can block absorption of others as they can use the same liver pathways. If you feel you absolutely need vitamin supplements, take those derived from foods. They are more expensive, yes, but safer.
                Better yet, eat your greens and beans!

                1. Marilyn,

                  Yes, supplements regularly get proven less than safe.

                  I do B12, D3/K2 with iodine, Omega 3 and zinc.

                  I bought Epsom salts to soak my feet to increase Magnesium on occasion, but mostly food.

                    1. Thanks Marilyn!

                      I love that my dog is alive, but, boy, I want my brother to get healed of kidney cancer, too.

                      I am so attached to my dog that I had no concept how much more having my brother have cancer was going to affect me.

                      This is so much more emotional.

                      I think it is more so because my dog had no choice but to try the things I wanted him to try. He might have rebelled against some of the foods when he was genuinely sick, but he fasted when I wanted him to fast and didn’t stop until I fed him. It was hard, but not nearly as hard as feeling like you have an answer and being helpless to convince the person. He finally did a 48 hour fast and that might be enough, I am not sure. It should be enough to lower the Heme Oxygenase-1, but it is like Groundhog’s day and I am waiting to see if his immune system saw the cancer.

                2. This is just a hit piece on Dr. Lynch, And a bad one at that. The information I got from genetic testing gave me a quality of life when no other practitioner could help me, traditional or alternative. I was sick as a dog. Dr. Lynch’s information is based on sound science and physician are flocking to his courses for just that reason. Granted many people want to find a simple genetic reason for their illnesses rather than do the hard work of changing their diets and toxic environments. But for many of us we did all that and still could not get anywhere, with continuing deteriorating health and quality of life. Most of the people, myself included, usually have a combination of snps in critical areas that together are causing us a miriad of problems and illnesses. not just a single snp. I do take supplements to help support blocked pathways, but not Dr. Lynch’s brand, and regardless of what this article implies. In addition, there is a lot of misinformation in this artlcle, Such as the following: “Many of the supplements may not even be safe. There is worrisome evidence that taking too much folic acid and related forms may promote the development of cancer and increase the chances of dying from it. But this should not be interpreted to undermine the well-documented benefits of taking a recommended daily dose of 400 mcg of folic acid before getting pregnant and during early pregnancy.” There is indeed evidence that taking too much synthetic folic acid may promote the development of cancer, but this does not translate to the natural related forms. And Dr. Lynch himself is very careful to warn against taking too much of any one supplement as well as warning that getting the nutrition from diet first is key. Only when combined polymorphism are clearly leading to clinical problems, does supplementation come in. Dr. Lynch has done his homework and frankly I do consider him one of the leading experts in the MTHFR gene and the methylation pathway.

    3. Hello Michael,

      Dr. Greger generally favors cyanocobalamin because it’s the cheapest, easiest to obtain, and has the most research behind it. You are correct that there is a small amount of cyanide produced in its metabolism, but as of now I am not aware of any risks associated with such a small amount. The reason Dr. Greger isn’t as much of a fan of methylcobalamin is because it is not shelf stable and by the time you take the supplement there may not be much left, so it’s very important to speak with your doctor about getting blood tests to ensure you’re receiving B12 from your supplements. Injections are certainly a quick way to get a huge dose, but sublinguals are also great to bypass most of the metabolism. If you are taking capsules of cyanocobalamin, stick to 250mcg/day or 2500mcg/week.

      I hope this helps,

      Matt, Health Support

  3. My wife and brother have both died from stroke complications. Both had carotid surgery to prevent further strokes, but the arteries clogged up again, they had more strokes, and died. Neither had high cholesterol. Being a little anxious, I had my arteries scanned and the results were less than 15% blockage, even though my cholesterol varies from 250 to 325 (depending on whether I put whipped cream and butter on my bacon and eggs for breakfast). The surgeon (who is a close friend) threw me out of his office saying I was bad for business. I asked him why do I not have a problem. He asked if my wife and brother were smokers. They were. He asked if I was. I am not.

    He told me that the CARBON MONOXIDE in the cigarette smoke causes a very high level of homocysteine in the blood, causing the plaque to become sticky. I asked him why do you NOT hear about the danger of carbon monoxide in cigarette smoke. He had no answer. Perhaps it’s because carbon monoxide is not as headline grabbing as CANCER.

    So, my wife and brother died of carbon monoxide poisoning. Smoking = carbon monoxide = homocysteine = sticky plaque = death.

    P.S. Even on your plant based diet for six months, my cholesterol is only down to 236. But my arteries are still less than 15%.

    1. Kim,
      I am so sorry for the losses that you experienced. What I wonder is did they continue to smoke after the carotid artery surgery and is that what caused subsequent strokes?

        1. Kim, I have relatives like that. Lighting up while on oxygen.

          Painful to watch.

          No amount of Health warnings changes it.

          There are pills which take away cravings and I have seen those help.

          Sorry for your loss.

    1. Wanda,

      Well, that is a complicated question. Partly because I don’t know if you are asking “Should I take a multi” or if you are asking what brand.

      Don’t do the multi. Eat your leafy greens for folate.

      B-12, Dr. Greger recommends Cyano. The discussion above is that it isn’t the natural form. It is however the one which tested best. Though you can take more than one of the other types together and combinations bested cyano alone at reversing deficiency. (They didn’t pair cyano up. They tested it and tested Methyl plus Adenosyl together competing with Cyano and the two worked better than the one. I noticed that they didn’t pair up Cyano with Hydroxy, which would have pummeled the Methyl /Adenosyl combo. They didn’t do that combination on purpose because there it is fashionable to be against Cyano right now, but it has been used effectively for a long time and there haven’t been known health problems from it. But high doses of B-12 now is being implicated in cancer and I don’t know what that means because you don’t need as high of a dose of cyano, so I can’t analyze that data to know if there is a difference. The main thing is to take some, but not too much. B-12 deficiency is also linked to cancers and brain problems because of homocysteine.

      I was taking Garden of Life because it had enzymes and probiotics, but I am not sure that is a good idea and I say it because of the probiotics warning video.

      Then, I moved to Pure brand and that got good recommendations and good reviews.

  4. Everyone in my family has the MTHFR genetic polymorphism. We are “homozygous for C677T of MTHFR = 10-20% efficiency in processing folic acid = high homocysteine, low B12 and folate levels”

    8.8% of the European-decended population has this polymorphism.

    Although the McCully study cited in the video specifically mentions the genetic mutation, Dr. Greger himself does not list this as a possible risk factor for hyperhomocysteinemia.

    Why this general neglect of common genetic polymorphisms as they relate to nutritional medicine in Dr. G’s otherwise excellent vids?

    1. My husband also has the MTHFR gene mutation…..only found after the seizures and the heart attack. I think the misunderstanding is that most people don’t know that you’re not able to convert the B’s from the food into a usable form. My husband now has to inject himself monthly with the already converted form of B that his body can utilize plus a daily Rx of Folic Acid (originally placed on Rx Cerefolin) just for having this mutation. Also, his homocysteine did go down even with a poor S.A.D. diet.

      1. There also is a less serious MTHFR mutation that affects 44.2% of European decendents: 1 copy of C677T allele of MTHFR = 65% efficiency in processing folic acid. Together, the homozygous and heterozygous forms account for 50% of the population.

  5. General lack of B12 seems to be on the few shortcomings of a vegan diet.

    Vegans having homocysteine levels at 16 makes me think how important it is to properly choose a well-balanced diet, even if it plant-based.
    One misstep – and things may really get out of control.

    Dmitriy P,
    Shilajit Secret

    1. Yash,

      He talked about it in the video. It is that you need several spoonsful per day and it gets expensive to have as much as you need and people may not eat it 3 times per day, like they would need to.

  6. I am vegan but maby I need to eat meat sometimes to be sure.I have B6 diffency and other B diffency but not with B12.Maby because I have no thyroid,Had thyroidcancer.So I have to eat B vitamins by subscribtion in spite of that I eat a lot of beans and a lot of green vegetables and other vegetables.What to do?
    The longest living person ate mostly raw fruits,greens ,fish and meat once a year
    I have got ostephoros and some clocked arteries in my heart.Both my parents had heartattacks,stroke

    1. Hello Marie,

      I’m sorry to hear about your struggles. What sort of testing did you have for your B6 deficiency? If you are B6 deficient, there are many plant foods that are very high, such as whole grains and legumes. With your thyroid history it is difficult to make specific recommendations without a formal physical exam; therefore, the best course of action would be to speak with your doctor about your options in this case.

      Matt, Health Support

  7. I take B12 supplement. I’m plant based. Blood test showed excess of B12 in blood but a deficiency on cellular level.
    How is this possible?

      1. There was a study of people who had normal blood count, but who were actually deficient and they gave the reasons. Don’t know if it will help, but here it is.

        Results Out of 3045 patients, there were 415 (155 males and 260 females, aged 36 +/- 18 years) with normal blood count, but low vitamin B12 level, which was between 40-140 pmol/l ( normal 145-637). 350 patients agreed (81 males and 170 females), but complete information was obtained only from 251 patients (71.71%). Symptoms included fatigue, tingling and numbness, impaired short-term memory, insomnia and impaired concentration. Identified causes of Vitamin B12 deficiency were as follows: 65 patients (26%) had partial gastrectomy, 12 (5%) had resection of the terminal ileum, 16 (6%) had gastric atrophy, 18 (7%) had celiac disease, 36 (14%) were vegetarians, 49 (20%) were diabetic on metformin, 47 (19%) were on proton pump inhibitors, and in 8 (3%) the cause could not be identified.

        1. While taking the Methyl form, I ended up having: tiny lesions, brain problems, tingling in the limbs, muscle spasms, impaired concentration and I will add in insomnia, but I am not sure I could blame that on the B-12.

          Switching types helped.

    1. I am most probably giving you wrong information but here it says “proteins that help transport vitamin B12 between cells”

      NAME: Functional vitamin B12 deficiency
      LINK: https://www.nhsdirect.wales.nhs.uk/encyclopaedia/a/article/anaemia,vitaminb12andfolatedeficiency

      “Some people can experience problems related to a vitamin B12 deficiency, despite appearing to have normal levels of vitamin B12 in their blood.

      This can occur due to a problem known as functional vitamin B12 deficiency – where there’s a problem with the proteins that help transport vitamin B12 between cells. This results in neurological complications involving the spinal cord.”

  8. Hi Christina Thomas, thanks for your question. I wanted to say that there are two steps for the body to absorb vitamin B12 from food. First, hydrochloric acid in the stomach separates vitamin B12 from the protein to which vitamin B12 is attached in food. After this, vitamin B12 combines with a protein made by the stomach called intrinsic factor and is absorbed by the body. Some people have pernicious anemia, a condition in which they cannot make intrinsic factor. It would be a good idea to include variety of food with added B12 and supplements to see which is more agreeable to you. I hope these explanations are useful to you.

  9. Why does Dr. Greger post these videos and opens the message board, but never returns to answer questions? I actually feel stressed and more confused by all the “experts” posting statements on here and often citing medical reports that continuously contradict each other. After a while, his videos lose their impact as they often leave more questions that go unanswered. Every popular nutritionist doctor has their own book and cult following. Too much information can be dangerous to your health also. It would be nice if Dr. Greger responded in these boards at least once to clear the air.

    1. Jack. A person can only do so much volunteer work to benefit the public. Dr Greger has assistants that help him with the comment section. Did you notice that spring03 answered a few questions above. People ask all types of medical questions in this forum; how could he possibly answer them all? And there is the liability factor, someone suing for advice that they weren’t happy with. The good doctor is combing through millions of studies without pay to give you one consensus. You want too much.

      1. I wasn’t trying to be disrespectful to Dr. Greger. I was just expressing my frustration at the fact that he puts out a video and then it gets challenged and contradicted by people who say that they tried doing the “right thing” and it didn’t work for them. That person then gets challenged by someone else who lists a study that goes in a different direction. I appreciate the volunteers who help Dr. Greger but, are the answers coming from Dr. Greger, or from the health volunteer who does not have as much knowledge as the doctor? As an example, there was a recent video and discussion about supplementing with vinegar. In the discussion, some people said that vinegar is actually damaging to the body. Perhaps these people work for a doctor of nutrition also, and have first hand experience in seeing the negative consequences of using vinegar. There was a book written by another doctor titled, “Grain Brain.” (I can’t recall his name at the moment), he has his own theories about what you should eat and not eat that disagrees with Dr. Greger. I am not choosing sides here. But, I read both books and here we have two American doctor’s that both went to medical school to study anatomy and nutrition. They don’t seem to agree on much. Both claim to be experts. Both have people that have tried their methods and swear by them.

        There are all kinds of medical studies and you have to be careful of how they are calculated. Many years ago there was a study in England where it was reported that a popular birth control pill doubled the risk of a certain disease. Many women suddenly stopped taking the pill and there was then a large spike in unwanted pregnancies soon thereafter. It turns out the original chance of contracting the disease was like 1 in a million and doubled to 2 in a million when taking that pill. People didn’t understand the full numbers in the study. Dr. Greger may be 99.9% correct on all his information. I have learned many things reading his book. The problem in my opinion, is that it is difficult to ignore all the contradicting experiences from everyone on the board. Sorry for upsetting the apple cart.

        1. Jack,

          I tried to post a response to this, but it doesn’t seem to have posted.

          Take 2.

          I highly respect this comment. All of us go through this. All of us.

          Whole Food Plant Based is simple if you stay within it, but gets confusing when you are looking between Whole Food Plant Based and things like Keto or Paleo or what they call Pegan or other diets.

          I had the very same problem with Grain Brain. I started off with serious brain problems. I was a Standard American Diet and probably had Diabetes and may well have had cancer. I had symptoms of each but went straight to trying to change it with diet. The symptoms are gone for the most part. I still have some confusion now and then, but I was having night terrors and hallucinations and ridiculous processing problems and it made it so hard to figure out whether to listen to Grain Brain or Dr. Amen or Dr. Greger or Dr. McDougall or the Paleo woman or Dr. Berg from Keto or Dr. Hyman.

          In the end, Dr. Berg was telling people to eat 5% animal products and to eat 10 servings of vegetables and so was Dr. Hyman, so there were enough commonalities that I could just start there. I threw up whenever I tried to eat coconut oil and couldn’t lose weight when I was on oil or dairy so Whole Food Plant Based chose me and it has helped so much.

          When my dog got cancer, I went through the same Keto versus Whole Food Plant Based Vegan question and I found dogs who were healed just doing a vegan diet and I found Keto Pet Sanctuary and they healed a dog who had the same cancer as my dog, but they use so many things like surgery and chemo and supplements and exercise and hyperbaric oxygen, so I just knew it was easier to stick with Whole Food Plant Based, but I will tell you that it was water fasting which seems to have healed him.

          I don’t think anybody can answer your questions. The industry studies and the doctors selling supplements really have confused the issue. When I was younger, they started doing metrics versus American conversions and what I will say is that it isn’t confusing until you have to translate from one standard of measure to another. If you stick with inches and feet and miles it is so much less stressful than going back and forth.

          There is so much peace of mind and simplicity in that.

          Right now, my brother is 60% Whole Food Plant Based and in 3 weeks I got my first comment on how much healthier he looks and I agreed. He already looks like a new person and he goes out for pizza and steak now and then, but Whole Food Plant Based is powerful enough to still work at 60%.

          1. He really does look like a whole new person after 3 weeks of 60% Whole Food Plant Based meals.

            This walk isn’t about perfection.

            1. Jack,

              It gets easier. The first year of hearing the arguments going back and forth was constantly like feeling tricked and confused and it eroded all sense of trust of any medical person.

              But now I have heard the arguments from all directions and I have figured out how much they all have in common and all of the diets are so much better than the SAD that it comes down to nuances.

              I don’t know if you have bought a car or a house or chose a career or if you are married and if your mind had to figure out between qualities you liked and qualities you didn’t like and if you found contentment or if you kick the tire of your car or the dog instead of your boss. Healthy is not a pursuit of perfection almost anyplace unless you are some sort of Ninja Warrior or Olympian or something where you have the skills to aim for perfection. Learning to be happy and content is an art form.

              I am so happy being Whole Food Plant Based, even if I put a creamer in my coffee at a baby shower months ago. I watch the videos of how the animals are treated in so many farms and I feel happy not contributing to that system. Genuine happiness. My brother is happy that he gets his weekend pizza right now. I will be happier if he gets healed of his Kidney cancer, but he will be happy if it doesn’t go Stage 4. I am already so happy that he water fasted for 48 hours. I may get him to do it longer, but if not, I will get to learn if 48 hours and lowering Heme Oxygenase-1 will be enough to get someone’s immune system to see the cancer. Learning will have its own pleasure for me.

    2. Jack,

      His moderators identify themselves.

      From what I have seen, he was here much more often when he wasn’t in the middle of writing his new book.

      He still though takes requests.

      What topic are you confused about? He asks people to leave topics in the comments and he eventually touches on them.

      Often though it is that new people missed the other times he responded through videos or Q&A or a blog entry.

      Chances are the information you are looking for has already been covered.

      But if it wasn’t, give him a topic and see what happens.

      1. Jack, The basics of what Dr. Gregor teaches are simple. Do you know about his daily dozen?
        Basically just eat whole plant foods, no processed stuff. Add some vitamin D if you don’t get enough sunshine, and B12.

      2. Marilyn, spring03 mentioned Kimchi up yonder somewhere. Dr. G. believes it can cause stomach cancer.

        So, in this case, he and a moderator do not appear to see eye to eye, do they?

        1. I was on the WFPB for 4 months. I looked awful and felt worse. I looked like I was on a hunger strike. I am 54 year old male and I exercise 4-5 days a week and meditate. I avoid sugar and unhealthy snacks. No soda, coffee, or alcohol with exception of a glass of wine now and then. I eat fish, chicken, and red meat once a week. I don’t take any prescription meds. Blood work is fine. I am simply trying to listen to what others on the board are saying who maybe 10-20 years older than I am and have experienced new health issues with age. But as I stated, it is difficult to choose a path as everyone here is different. The confusion starts when some people swear by a technique and then someone else cites a medical study that contradicts it with another medical study. The range of experiences here varies wildly and so do the results. The 7th Day Adventist Group (is that correct?) eat eggs and fish and have the longest life spans and seem to enjoy good health. Dr. Greger says that eating eggs, especially if you are male, will almost certainly cause you cancer. I stopped eating eggs years ago after reading his book. I occasionally eat some cheese and have a little bit of Irish butter on rye toast several times a week. Am I doing the right thing? I don’t know. It is hard to select a diet path due to all the conflicting info here. I appreciate people commenting and trying to help each other, and Dr. Greger, but it still leaves me with a lot of questions. Apparently, according to some, I am asking too much. I thought this site was supposed to be the go to site for proper nutrition. I just don’t think diet and nutrition should be so cut and dried. Different people have different blood types for a reason. Maybe blood types should dictate what diet you should be on? Is that correct? I don’t know. If you site the answer to that question, is someone else gong to then give a site contradicting that citation? If humans were meant to eat WFPB, wouldn’t our teeth be shaped exactly like a rabbits set of teeth? Thanks.

          1. In the 7th Day Adventist mortality study, ‘vegan’ males had the lowest relative mortality risk. Among women though, ‘pescatarians’ had the lowest relative mortality risk.
            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191896/

            The blood type diet hypthesis sold a lot of books but the evidence suggests that the basic idea is wrong (but avoiding highly processed and other junk foods benfits everybody’s health):
            ‘CONCLUSIONS:
            ABO genotype does not modify any association between blood-type diets and biomarkers of cardiometabolic disease in overweight adults, suggesting that the theory behind this diet is not valid This study was based on the data of a trial that was registered at http://www.clinicaltrials.gov as NCT00516620.’
            https://www.ncbi.nlm.nih.gov/pubmed/29659952

            As for the rabbit’s teeth idea, have you seen the teeth of gorillas? Or camels? They don’t eat meat but their teeth don’t look like those of rabbits either

          2. Jack said, “Dr. Greger says that eating eggs, especially if you are male, will almost certainly cause you cancer. I stopped eating eggs years ago after reading his book.”
            – – – – –

            Yeah, Dr. G. can scare the bejeebies outta us. :-) (If we let him.)

          3. Jack, you are correct about the inherent frustration that accompanies sorting out information; but there are numerous pathways to good health, and each of us has experience with some of these paths. Our paths diverge but our goals are similar. There is something to learn from everyone whose goal is similar to yours, regardless of their path.

            Folks who are new to this lifestyle usually want definitive instructions, and maybe they are in a hurry because they are already sick, but it takes time and experimentation to find what works. Part of what we learn is how to continue without comprehensive information. I’ve been studying and experimenting with my diet and lifestyle for over 40 years, and I think allowing everyone to share helps to remind us to stop judging other pathways to success, because we will never agree on the details.

            The information we seek is a lifelong learning endeavor. New research tends to turn what we know upside-down. Ultimately, we can move forward toward our goals through trial and error or we can continue as usual.

            My husband’s approach to health is to eat as usual with lots of physical activity. We fought over our food differences for 30 years, but fighting to uphold tradition is the way he expresses his opinion. Recently, however, his food attitude is testing my patience, so I’ll share a personal anecdote about it:

            I’m trying to sort out our dog’s allergy by eliminating one food for several weeks to see if it relieves his symptoms, but everyday my husband undermines my efforts by feeding the dog whatever is on his plate, even if it’s the food I am temporarily eliminating from the dog’s diet. Furthermore, for convenience he wants to feed the dog processed food but refuses to read the list of ingredients. He refuses to cook for the dog and scolds me when I cook for the dog. He says “you’re not going to cook for the dog because you never cook for me”. He concludes his rant when I offer to cook his steak! He says I wouldn’t know how!

            I am not surprised by his lack of cooperation, due to my 30 years of experience with his fiercely unchangeable SAD diet.

            Our culture inspires the desire for instant gratification, but how many more times must we pay the Veterinarian before my husband complies with what the Vet tells us to do every time we visit?

            Personal anecdote aside, this community agrees that we can control our health with our diet. No doubt we disagree on many details, but the community remains strong as long as we are willing to to keep the conversation going.

            1. Nicely written, Bette. :-)

              “……but everyday my husband undermines my efforts by feeding the dog whatever is on his plate, even if it’s the food I am temporarily eliminating from the dog’s diet.”
              – – – –

              Ah yes, husbands….they can drive you bonkers the longer you live with them, can’t they!

              Most cat people know their little darlings should not be given milk, but just to get on the good graces of our younger one, my hub would warm up a bowl of milk for her every evening. What did HE care, I was the one who had to scoop up the messy diarrhea later on! (I’ve posted about this before.) I hear there are easier-to-clean litter boxes in the market nowadays. (Despite the milk lapping, she lived to be in her early 20s.)

            2. Bette, you are not alone! We have a dog and my husband was feeding it too much. Everytime I turned around, he was feeding the dog some snack thereby adding to his slightly overweight issues; add to this, he also has allergies. I took the snacks and put them in a new place–still “around” but not in their usual place. As for his own diet, my husband says, “Milk and meat can’t be beat.” However, he has dementia now and I’ve become a caregiver….

              1. Liisa, you are not alone! My father had Alzheimer’s and I was his caregiver for the last 6 years of his life.

                It required finding solutions to the most challenging situations and realizing that no one can possibly understand unless they’ve done the job. The medical community is useless and self-serving non-profit Alzheimer’s organizations only support the industry supplying expensive caregivers.

                What helped me the most was understanding that if the patient is not happy, then no one in the house will be happy. Therefore, reality did not exist in conversation with my father. Here are a few examples:

                When Dad wanted to drive, I lied and told him I left the keys in the car. He would happily get in the car and fiddle around with every button on the dashboard for 15 minutes, then get sleepy and happily came inside to nap.

                Everyone else was hopelessly based in telling the truth, and refused to lie to keep my Father happy. On nearly a daily basis, I would physically stand between my parents and distract my father from listening to my mother tell him that something was wrong with his brain, and he didn’t need to go to work because he was retired, which made him angry because he knew it wasn’t true. Meanwhile, I would lie and tell him that his office called early that morning and said that his work was ahead of schedule and he could take the day off, which made him happy even if he didn’t believe it.

                Many times I stopped preparing their meal in order to drive my father to work when I was unable to convince him that he could take the day off. He would get sleepy after a 15 minute drive and suggest we turn around and go home. It was an advantageous way to waste 30 minutes, because he was happy and tired.

                Unfortunately, nowadays I’m not likely to express sympathy because when I was in the midst of the most grueling part of the job, I remember feeling like being nice to sympathetic folks was a waste of time when there was no time to waste.

                1. Bette, at my last Alzheimer’s support group meeting, it was stated that “There is a special place in heaven for those who lie to people who have Alzheimer’s.” I see you also knew how to distract–and also how to “go with the flow” of someone with Alzheimer’s. I’m finally learning some of these things, but there’s always something new to learn with this malady: how to get someone to change their clothes, take a bath, not to spit on the floor, and on and on and on…. Caregiving for someone is really a huge life lesson.

                  1. Liisa, it is a huge learning experience for the caregiver, but I don’t think the patient is capable of learning anything. Even if I could get Dad to do something, it would be the same scenario the next time …no memory of how to do it. The caregiver will eventually be doing absolutely everything for the patient. In case it might help, here’s more:

                    The bad new is that you will be forced to deal with unpleasant behavior; however, the good news is that by the time you reach your breaking point when you think you cannot continue, that horrible behavior will stop, only to be replaced with a different kind of unpleasant behavior.

                    It felt like I was finally being given a reprieve from prison, but then had to go directly into brainstorming about how to handle the newest form of bad behavior. The behavior changes and fluctuates in intensity. If you’re ready to give-up, but if you stick with it, the load will lighten. Of course it will get heavy again, then it will lighten-up, over and over.

                    In the beginning, I tried many ways to keep the past alive in my father’s mind, but it was a futile effort. An Alzheimer’s patient has only bits and pieces of memory, with no possibility of making connections. There’s no benefit to the patient even though you might want to stroll down memory lane, but don’t expect a response.

                    I was related to a patient whose daughters told the professional caregivers to take her out in public everyday because she had enjoyed a busy life with lots of activities. The patient had repetitious communication, asking the same question over and over again. Someone in her church exercise class told the patient she was crazy. For several months, all the patient would say was “I’m crazy”, over and over again. Even though Dad did not have repetitious communication, I doubted there would be any benefit for him to interact with the public.

                    When he started wearing diapers, I needed a video baby monitor with me when I was in another room.

                    Dad would fall down, but he was easy to pick up. I’d turn his body around until I could put his toes up against a wall so that his legs wouldn’t splay out from under him, then stand behind him and bend my knees, bear hug him around his chest holding onto my wrists/forearms so as not to drop him, and then lift him up ….although I’d have to hold onto him until he could balance himself.

                    Eventually, he forgot how to walk and how to get out of bed, so I needed a lift. It made moving him to another room easy to accomplish.

                    You’re lucky to have a support group. They will probably give you good tips about easy ways to change his diapers.

                    There will never be enough help or information, but you can do this job.

                    1. Bette, Lisa,

                      Hugs to both of you! Been there, done it.

                      Bought a lift and I ended up buying a hospital bed with a rotation mattress. That helped so much. It moved position every 20 minutes or something so I didn’t need to keep moving my relative and it helped so much with changing. I also bought the biggest whole body transfer sheets with handles and I would put two down so that I could just remove one at changing and put a new one in. There are a lot of things which helped. Slow flow straws to avoid choking. By the end, I was using a children’s medicine dropper to feed her. I could give a tiny amount at a time and she would end up drinking 40 ounces of egg nog or a milkshake a quarter millimeter at a time. It actually went faster than the straw because she just had to open her mouth. For the few times when she had bed sores, I bought clear coverings as big as a butt cheek, which was perfect for keeping urine and feces away from the wounds.

                      I know that there are so many challenges, but I found so many good solutions online. The visiting nurses hadn’t even thought of any of them. I had a Simple Human step-on trash can and a no-touch thermometer and an audible pulse ox.

                      I pray for both of you. My suggestion is to look on Amazon and on the nursing sites and on the caregiver sites. The caregivers figure things out like how to wash hair with real shampoo in bed where the professionals use the way they were given. Gadgets are out there.

                      God bless you both!

                    2. Liisa,

                      They have a variety of lifts to help you lift up patients.

                      They are so helpful if there is a fall or for transferring someone from a bed to a wheel chair or into a car.

                      If you look at YouTube videos, you can see various kinds.

                      In America, you can buy them, rent them, or get them via prescription from a doctor.

                      There are some which you can use when the people need help standing up and others for when they can’t help.

                      If you get one, having one which reaches to the floor and which transfers into a vehicle are both helpful. The smaller, portable ones are easier if you don’t have a lot of storage.

                    3. Bette and Deb, thank you for all the information. I hope I don’t have to know all this!!! (but being forewarned is being forearmed….)

                    4. They have different slings, for instance for toileting someone, for instance.

                      There are Youtube videos for everything under the sun.

                      The full body transport sheets with handles were so helpful.

                      Ordering the highest capacity diapers was a must. Online had higher capacity than the medical supply stores.

                      I bought about 10 pillows for positioning to put under all the pressure points and I had special different colored wash cloths only for the bottom.

                      They don’t tell you, but if a person is bed bound moving the joints and massaging the pressure points really helps avoid problems.

                      I found the doctors and visiting nurses all waited until after there are problems to deal with things versus being proactive.

                      Things like hands begin to get deformed if you don’t move them.

                      I learned 100% of things online and told the visiting nurses and they didn’t offer any information except nodding after I figured it out. Plus, they had stupid supplies which you could get for free, but their supplies were harder to use than the ones I bought and their wound covering things ripped her skin where the online ones didn’t.

                      Honestly, they have free stuff, but with both my uncle and my grandmother I ended up not using it because it was not the newest and best stuff.

                    5. I had one helpful ER doc. He showed me how to use the audible pulse ox reader and taught me that you get false readings if the people’s hands are cold or if they have arthritis in a finger or if they are dehydrated. That saved me so many ER visits. From then on, I put a warm pad near my grandmothers hand if the visiting nurses were trying to send her to the ER for pulse ox. That was crucial because they count the number of ER visits to determine whether it is worth keeping them alive and we had a string of pulse ox reading ER visits and I couldn’t figure it out because minutes after she was there her readings were fine, but we still had to hang around for 6 hours. Those stupid visits are why they wanted to kill her.

                    6. Having a really good air purifier helped at cold and flu season because a lot of the nurses and aides would come sick.

                      I got a medical grade one and every person got sick except my grandmother and I.

                      So many people were sick for about a month.

                      I ended up getting the HealthMate and the Rabbit IQ. That one was ridiculously expensive, but some of us were seriously worried.

                    7. Sorry to pick on the visiting nurses.

                      It just is that they don’t tell you anything at all until after a doctor tells them to and the doctor doesn’t tell them to until after there is a problem.

                      Plus, they don’t do things like PT, unless there is an order for it.

                      The moving the joints was something I asked for and it took them 6 weeks to send someone and my grandmother’s hands started clenching and the person who came got upset that I ordered a therapy device online, but they said that the joint problems were common with bed bound people and her hands got better, but I could have bought some kids squooshies and put them in her hand the first week and not had her go through it.

            3. It seems like common sense that feeding a dog human table scraps would be highly detrimental to a dog. Does your husband have any emotional attachment to your pet? Seems like he does not want to spend money on a good quality dog food and is feeding the dog table scraps to save money. Doesn’t the dog have bowel issues from eating scraps? Sorry to hear your husband is being so difficult. He must cause you a lot of stress.

              1. Jack, my husband fiercely believes SAD foods = love, and he loves his dog. And yes the dog suffers because my husband believes all food is good for you, except the foods I eat.

                I’ve had nearly 40 years experience with my husband, and his huge support system of friends and family hold his same beliefs, so I’m the “odd man out”. But I’m comforted by the fact that I’m right and they are wrong!

                To be fair, he is intelligent in ways I am not, and on rare occasions we can be a formidable team. He is more fun to be around than anyone I’ve ever met. But one of his faults is that he refuses to value beliefs different than his, and that can be stressful.

                Here are the ways I handle stress, Transcendental meditation, tai chi, walking, biking, yoga, Tulsi tea, maca and a whole plant food vegan diet. .

                1. Maybe the Vet needs to tell him directly that he is slowly killing the dog. As for your husband, he may not realize it now, but by not eating correctly he is unnecessarily going to make you his caregiver when his health fails. You may resent him for that later on. My father drank and smoked and insisted on eating meat and potatoes almost every night. Never did a step of exercise. It was a full-time job having to take care of him and quite a burden on my mother. Over 5 years he went down hill and then died at 67. I still have the anger at what his bad habits and attitude did to the whole family. Very selfish. I hope you don’t wind up in the same position.

                  1. Jack, some folks never drank nor smoked, got plenty of exercise, and yet their health deteriorated several years before they died and they were a huge burden on their family. Some folks drank, smoked and never exercised and were never a burden to their family.

                    Whole plant food eaters believe humans have control over their destiny, but some folks believe in predestination.

                    I was brought up to not judge others, but I did.

                    Every negative quality I judged in others, I see in myself now.

                    I was never going to be like my parents. But every negative quality I judged in them, I see now in myself.

                    Just saying …later on, you might become what you despise.

                    Let the past go.

          4. Nobody said it was easy. Transitioning can a challenge. It involves many long term adaptations (psychological, physiological, etc). Initially (a couple years) it probably feels worse to some. The sooner the adaptation the easiest. It also has to with age requirements. For example, coq10 drops because of age (not diet). If you exercise 4-5 days a week it is something to keep an eye on.

          5. The only thing that is conflicting are the testimonials which is not evidence by any stretch of the imagination. There is no conflict in the objective data. Populations that eat foods containing cholesterol have much higher premature death rates than WFPB eaters.

            Dr. Ben

          6. Hello Jack,

            I thank you for your comment and looking towards Nutritionfacts.org for health information. There is a lot to unpack in your message, so I will try my best to go through it point by point in hopes of helping you understand.

            You started by saying you tried WFPB for 4 months and looked like you were on a “hunger strike.” One thing about whole plant foods that is very important to note is that they are generally low in calories. This means you have to eat much more food to maintain (or gain) weight. This can be a struggle when first starting out so it’s important to focus on more calorie dense options, such as starchy vegetables, whole grains, legumes, and nuts/seeds. You have trained your stomach your whole life to only stretch so far by eating dense foods/oils, so it may take time to get used to the added volume. Of course if you are feeling ill and losing weight as an already fairly small person, it is important to consult with your doctor in such a case.

            I commend your efforts to eliminate most processed foods and alcohol from your diet and limiting animal products to about once/week. That’s a great step! It’s also great that you’re on top of your health and have checked your bloodwork to ensure your body is functioning properly.

            You seem to have a lot of concerns about conflicting research and where to look for your nutrition advice, understandably. There is an incredible amount of conflicting data being passed around the internet and that is why Nutritionfacts.org exists. The goal here is to focus on what the overall balance of evidence states and avoid commercial biases that are littering a lot of the nutritional science. For example, you can actually find some research on the potential benefits of smoking, yet we know that the overall balance of evidence overwhelmingly suggests that it causes lung and other cancers, heart disease, and so on. There is such a vast amount of scientific literature out there that you’re bound to find something supporting almost any angle, but we try our best to find the truth.

            You’re absolutely correct that the 7th Day Adventists of Loma Linda, California are the longest living population; however, while some do eat eggs and fish, the longest living male group is actually vegan and the vegans overall had a 15% reduction in death, period, when compared to omnivores. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191896/

            Feel free to correct me if I’m wrong, but I’m not aware of anywhere that Dr. Greger has said that if you eat eggs you will most certainly get cancer. The truth is that most people won’t; however, you increase your risk of prostate and breast cancer amongst other things. It’s very similar to the fact that most people who smoke do not get lung cancer, but they have an increased risk. https://nutritionfacts.org/video/eggs-and-breast-cancer/

            When it comes to blood types and diet, that idea has never been supported by scientific evidence. The idea comes from studies done on petri dishes with blood cells but there is no human data suggesting such and when humans are studied for any comparisons between diet and blood type they find that everyone benefits from a plant based diet regardless of their blood type. These are exactly the types of nutrition ideas that are passed around the scientific community that nutritionfacts.org attempts to clarify. https://nutritionfacts.org/video/blood-type-diet-debunked/

            You finished by comparing our teeth to that of a rabbits; however, we don’t eat diets similar to that of rabbits. Our digestive tract is much more similar to that of our ape cousins and thus our diet follows suit. If you look at the teeth of a chimpanzee, bonobo, or gorilla, if anything their teeth are larger and sharper than ours even though they don’t consume meat.

            At the end of the day, Nutritionfacts.org is here to inform the public. The goal is not to tell people what is right or wrong, but to provide them with the information and resources to allow them to make the decision for themselves. With that said, I hope you find this useful and continue to look for nutrition information on this website while implementing whatever changes you feel are beneficial based on the information provided.

            Matt, Health Support Volunteer

        2. There is no contradiction between the moderator’s statement that kimchi is a good source of B12 (ie it contains significant amounts) and Dr Greger’s statement that kimchi consumption is associated with increased gastric cancer risk. Why would you think that these statements are contradictory?

          1. Who said anything about “contradictory”? Just the kimchi word even uttered at this joint seemed like a no-no. IMHO.

            Jack, Fumbles will disagree with me, but always listen to your body. Except for the red meat, my diet is similar to you. If your blood work is okay and you have no health issues (I don’t), why worry?

            1. You said that Dr G and a moderator didn’t appear to see eye-to-eye because the moderator made the factual observation that kimchi is a good source of b12 in the Korean diet and Dr G made the factual observation that high kimchi consumption is associated with high rates of gastric cancer. That statement made no sense to me.

              Unfortunately most people’s bodies tell them to eat pizza and ice cream and to drink beer. I think that scientific evidence about nutrition and health is a safer and more reliable guide to what we should eat.

              1. Okay, “eye-to-eye” was an unfortunate choice of words. I’m sure on the whole, they do agree about things.

                However, if a mod feels that eating a small amount of animal foods can be part of a healthy diet, would she/he verbalize the thought at this particular site? Probably not. By the same token, as Dr. G. has given his opinion (because of so many Science Findings, of course) that sauerkraut and Kimchi, etc. can cause stomach cancer, would said mod even mention the word? Oh come on, am sure you understand what I’m saying here — yer not that dumb! :-)

                “Unfortunately most people’s bodies tell them to eat pizza and ice cream and to drink beer.”
                – – – – – –

                “Most” people? Uh-uh. Yes, there are tons of blimps waddling around, to be sure. (Maybe by their next lifetime they’ll have wised up.) But most people have what we call common sense. We use it when we cross at the light, take out the garbage, floss and brush our teeth….

                We also have what they call a conscience. Oxford dictionary tells us: “an inner feeling or voice viewed as acting as a guide to the rightness or wrongness of one’s behavior:” Just what IS that “inner feeling”? Think about it.

                  1. Laughing.

                    YR, he has a point.

                    People are eating the wrong foods so much that they have lost sensitivity. Their stretch receptors aren’t working properly. Their ghrelin responses are all off. Their insulin responses are all off. Their immune system is protecting their cancer because they are confused.

                    They do not understand things. They really don’t.

                    Some people who were raised by people who taught them properly may well just be not listening to their conscience, but I can’t even list the number of people who switch to chicken and bologna and cheese and diet soda and things like that as how to follow their conscience. They feel guilty and give up potatoes and grains and rice. The list of people around me who followed their conscience in that direction is very long.

                    I had someone say it at Christmas. They said, “We eat very, very healthy. We gave up things like all rices and grains.” I have maybe 4 or 5 people who gave up grains to be better at eating. Maybe more than that. I have so many people who eat so healthy and the first word out of their mouths would be “chicken” as a health food.

                    The pet store seems to agree with them. It is so hard to find dog food or dog treats without chicken. I did succeed but that took a lot of time.

                    1. “YR, he has a point.”
                      – – – – –

                      “What we’ve got here is a failure to communicate.”

            2. I guess I am just trying to stay ahead of the curve. Reading some of these posts about what average people are experiencing with regard to health issues can be quite alarming. I am not a hypochondriac and I realize we all have to die of something, even old age, but trying to strike a balance between good health and nutrition, and not analyzing every ingredient I consume gets a bit daunting. Maybe my expectations are too high and I should try not to be so overly concerned which may cause stress. Does anyone know of a healthy natural remedy that gives you a sense of calming? I looked up the more common natural supplements such Kava, 5-htp, etc… but they all seem to have warnings also. I do meditate and do Tai Chi, but having something to take the edge off would be very helpful. Thanks.

          2. Mr. Fumblefingers: I am not sure what you are saying with your statement. “The moderator stated that kimchi is a good source of B-12, and Dr, Greger’s statement that kimchi consumption is associated with increased gastric cancer risk.” If the doctor is stating that kimchi causes stomach cancer and the moderator (one of his volunteers) says its a good source of B-12, well its a moot point. Who wants to use a source of B-12 that causes cancer? If you have an issue with severe ear wax, a .357 magnum round fired down the ear canal will certainly cure the wax problem…The two statements contradict common sense.

  10. There are things like B12 which come up every single Q&A and over and over and over again.

    It is okay because new people have to learn, but he is a world famous person translating his books into so many languages and he is on television and in movies and speaks at conferences. Time is such a huge problem.

  11. I’m largely WFPB, but still eat meat very occasionally – a beef lasagne or a burger, literally once per month.
    B12 supplements are not available in my part of the world, so I take 250ml fortified soya milk, but that’s only 1.0mcg of B12.
    If I am to get my B12 from animal sources, what’s the recommended frequency and dose, does anyone know?

    1. I just looked at a chart and clams and liver are the highest if you are using animal products. According to the site, 3 ounces of clams would be 1402 percent of the daily value. 3 ounces of liver would be 1178 percent of the daily value of B-12. Not sure if that helps you. Nutritional yeast might be what I would do if you could get that.

        1. Fish would be next after those. 3 ounces of salmon or trout would be 80 to 90% of the daily value.

          Nutrional yeast provides more than trout or salmon.

          Chicken, beef and ham provide very little.

    2. Hello,

      I have a hard time imagining that a single serving of the fortified milk is only 1mcg (microgram) or B12. Are you sure it’s not 1mg (milligram)? That would be more than an adequate amount if that’s the case.
      As for specific amounts of B12 per animal servings, I am not well versed in that information; however, I know it can be variable. Deb has done a great job at summarizing the chart of foods/B12 for you, so you can use that information, but it’s also important to note that it will vary depending on the health of the animals, conditions their raised in, and if there is supplementation in their feed.

      I hope this helps,

      Matt, Health Support

  12. I’m new to posting here and interested in any comments (without abbreviations please).
    I’m 70, a diabetic, also overweight – I don’t eat meat, but fish occasionally – rest veggies, carbs and grains.

    Can’t find answers to my problem which relate to my Vit B12 reading as 1263 pmol/l.
    Please comment and give any relevant advice ….

    1. Hello Heather,

      This is definitely a concern you should speak to your doctor about. Are you currently supplementing at all? It’s not unusual to have levels that high if receiving regular B12 injections.

      Matt, Health Support

  13. I have asked my doctor in the past when getting bloods if she can check my homocysteine levels as well but she never does but tells me she has asked for vitamin b levels.

    My question is this, is there a group of things that need to be tested to find homocysteine levels or is this a more complicated test to ask for hence her reluctance.

  14. Thanks, Fumblefingers. However, I was not satisfied with the explanation the doctor gave me. He simply said high Vit B12 is not a problem because when those who need a Vit B12 injection, they simply pass the Vit B12 out of their system afterwards. He didn’t show any concern for my high Vit B12 staying in my system – hence my concern.

    1. Heather

      Ah, OK. That link I posted suggested that such high levels might indicate possible health issues. They also might not of course, it might just be be a harmless and meaningless quirk …. especially if you have no other symptoms or issues.

      However, you could always seek a second opinion, discuss your concerns and request aome further tests to rule out possible problems.

    2. I don’t believe the claim that excess B12 is invariably excreted since on 1000mcg cyanocobalamin and 300 mcg methylcobalamin per day, my B12 level was above 1000, off the lab testing scale. Months after dropping it to 500 mcg cyanocobalamin- and 300 mcg methyl-, it was still above 900. (The only doctor I know who has ever mentioned that supplemental B12 can drive one’s B12 level too high is Dr. Fuhrman.)

        1. Thanks for the link. I have been vaguely aware there can be various reasons for excessive b12 in blood serum but have never really investigated that. Fortunately I have no overt symptoms of a serious problem but you’ve convinced me I should raise the issue with my doc, to make sure it is not an early warning sign of something sinister.

    3. Heather,

      First let’s be clear on the test used. If your referring to serum b-12 you’re not getting information reflective of tissue levels. If your using the MMA testing your high levels might indeed be present. (“https://labtestsonline.org/understanding/analytes/mma/tab/test”) and yes this test is covered by most insurers. So check before assuming anything relative to the circulating levels.

      As to toxicity please see this site from the NIH: https://ods.od.nih.gov/factsheets/Vitamin%20B12-HealthProfessional/ under Health Risks and their referenced studies

      My experience with high dose injectables is that occasionally a patient will notice side effects of over stimulation with concerns with sleep and occasionally behavior. All are responsive to a simple reduction in dose. Also it depends on which of the 3 forms of B12’s were used.

      Trust this helps.

      Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

  15. I am a vegan and have been taking B12 religiously for years, only to find out that I have a very common gene mutation, MTHFR. There are numerous symptoms that reflect MTHFR, but one of them is the inability to properly absorb B12 and another symptom is elevated homocysteine levels. Even though the mutation exists, you can work with it very easily by taking methyl-folate and, in my case, methyl-B12 daily. Folic acid is the enemy and it’s in every multi-vitamin and also in most store-bought breads. If you see the word “enriched” on the label, it means the bread has folic acid. Please get tested. I have read studies that list range anywhere from 25% – 40% of all people have it and don’t know.

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