B-vitamins are critical cofactors in a myriad of chemical reactions in the body including energy metabolism, neurotransmitter and hormone production, activation of DNA, and red blood cell formation. They are important in immune and nervous system function, adrenal function, and maintenance of skin and muscle tone. Although they are abundant in certain foods, there are many reasons for insufficiencies that can lead to a wide array of patient symptoms including poor digestion and absorption, poor food choices, and increased stress. B-vitamin insufficiencies can translate into fatigue and lack of vitality, decreased ability to handle stress, mood imbalances and sleep disturbances, decreased concentration and memory, blood sugar regulation difficulties, dermatitis and skin disorders, anemia, and cardiovascular disease.
All B-vitamin status compounds measured on the Organix Profile are metabolic intermediates in the degradation of amino acids. The enzymes responsible for their catabolism are heavily dependent on B-vitamins. Remember the figure I showed you in week one describing the “functional” assessment of nutrients? That figure shows how organic acid levels can be used to determine B-vitamin deficiencies, and often times is much earlier than direct measurements of the vitamins in blood.
Notice in the figure below that the amino acids valine, leucine, and isoleucine are converted to the corresponding a-keto acids. These keto-acids are further metabolized via large enzyme complexes, BCKA dehydrogenases that require thiamin, riboflavin, niacin, lipoic acid, and pantothenic acid (B5). Without those B-vitamins, the keto-acids can’t be metabolized and they spill in the urine. Poor metabolism of these compounds can lead to poor energy production and inefficient use of the amino acids.
Similarly to the keto-acids, methylmalonate and b-hydroxyisovalerate are formed from the catabolism of the amino acid isoleucine. In order to further metabolize these compounds, B12 and biotin, respectively, are necessary cofactors for the reaction. Elevations in either methylmalonate or b-hydroxyisovalerate in the urine are sensitive indicators of B12 and biotin deficiencies. Notice in the figure below, B12 deficiency that can lead to anemia can be detected nearly two weeks earlier in urinary methylmalonate than in serum B12 (10 days vs. 22 days).
Finally, folate status can be determined by looking at the compound forminoglutamic acid (FIGLU) in the urine. The same concept applies here—the catabolism of FIGLU requires folate, and if there isn’t enough folate, FIGLU spills into the urine.
This section can take a bit of a readjustment in thinking. Upon first glance, a “High” result would intuitively mean that there are high amounts of B-vitamins, and no need for supplementation. But remember, these compounds are functional markers of vitamin deficiencies, meaning that in order for their metabolism, the B-vitamin must be present in sufficient quantities. A high level, then, indicates B-vitamin insufficiency. High levels of many of the compounds measured indicate an even more severe need for b-vitamins. Therefore this section is useful in not only identifying specific b-vitamin deficiencies, but also the severity of the deficiency.
Next week we'll take a look at Step 3: Neurotransmitters. Post your comments below.
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Cass Nelson-Dooley, MS (18)