pH ADJUST Alkalinizing Formula is one of the few products from any company I take daily. I have taken it every day for at least three years. My pH balance is better than ever.
pH Adjust an alkalinizing product formulated to rapidly alkalinize and buffer acidity in the body. pH Adjust is a powder product formulated by my father (Dr. Hank Liers) using just four natural ingredients: potassium bicarbonate, magnesium carbonate, potassium glycinate, and sodium bicarbonate.
Adding pH Adjust to water is one of the fastest ways of creating alkaline water that also provides healthy minerals. It mixes well in water, juices, tea, coffee, or in foods.
Modern diets and lifestyles tend to produce acidic conditions (acidosis) in the body. Diets too low in fruits and vegetables, and too high in meats and carbohydrates result in pH levels lower than recommended for good health. A blood pH level of lower than 7.35 is considered to be acidic, according to the American Association for Clinical Chemistry (AACC). Ideally, you should be slightly alkaline with a pH of about 7.35–7.45.
pH Adjust provides four main benefits: 1) ALKALINIZE, 2) BUFFER, 3) REMINERALIZE, 4) REPLENISH BICARBONATE RESERVES
Many alkalinizing supplements alkalinize effectively, but few offer all the additional benefits of buffering, remineralization, and support for bicarbonate reserves.
FOUR BENEFITS OF pH ADJUST ALKALINIZING FORMULA
We will discuss the four main benefits of pH ADJUST in a bit more detail:
• REPLENISH BICARBONATE RESERVES
1. ALKALINIZE: The main benefit of pH Adjust is its ability to rapidly increase pH levels in the body. pH Adjust will boost your pH levels within a short period of time—usually less than 30 minutes, and sometimes much faster. This is testable using pH paper, which HPDI recommends using as a means of measuring salivary or urinary pH.
2. BUFFER: Increasing your pH levels is good. But not to the point of alkalosis—that is, going too far the other way—creating conditions that are too alkaline. The wonderful thing about pH Adjust is that is carefully designed NOT to push the body into extreme alkalinity, or alkalosis.
Instead, pH Adjust tends to bring the body to a pH of about 7.4. This is true whether the body is imbalanced toward the acidic or the alkaline side of the pH scale. pH Adjust is all about pH balance. It helps “adjust” pH levels toward normal.
3. REMINERALIZE: As mentioned above, the body uses minerals to alkalinize the body, including the blood. When acidic conditions prevail, the body may rob bones of minerals important for health, as a means of buffering the acidity to maintain optimal pH levels (7.35–7.45). When this happens, bones, joints, and connective tissues may suffer losses of the minerals from which they are composed. This says nothing of the loss of minerals used by the body for critical everyday purposes, like enzyme reactions, muscle activity, or brain function. pH Adjust helps remineralize the body.
4. REPLENISH BICARBONATE RESERVES: Bicarbonate or alkaline reserves are maintained by the kidneys. The body actually produces bicarbonates for the purpose of maintaining normal pH levels (7.35–7.45) and kidneys control the release of bicarbonate ions. There are also bicarbonate reserves in the bloodstream that the body uses for neutralizing acids.
Bicarbonate reserves decline with age, and there is an increased tendency toward acidic conditions in aging, as well. Therefore, it can be seen that maintaining adequate or optimal bicarbonate reserves can be important for acid-alkaline balance throughout life.
pH Adjust is a water-soluble powder supplement that balances pH levels, as well as supports and maintains alkaline conditions. Because pH Adjust alkalinizes the body, it can help counteract overly acidic conditions (acidosis), including those in the digestive tract, blood, kidneys, and other organ systems. pH Adjust provides a simple, powerful means for achieving healthy acid-base balance in the body.
Alkalinize with Potassium and Sodium Bicarbonate and Magnesium Carbonate
Acts Rapidly to Balance pH Levels; Helps Maintain a Healthy pH of 7.35–7.45
Mixes Well in Water, Juices or Other Drinks, and Foods
Tastes Good; Easy-to-Use Powder; 250 Servings per Container
Gluten-Free, Non-GMO, Vegan/Vegetarian; No Artificial Ingredients; 250 Grams
pH Adjust mixes well in water, coffee, tea, juice, or any healthy beverage.
pH Adjust Alkalinizing Formula contains only potassium bicarbonate, magnesium carbonate, potassium glycinate, and sodium bicarbonate. It has no additional fillers. It is made in the USA (from domestic and imported source materials all of which are USP (United States Pharmacoepia) grade.
pH ADJUST BALANCES pH LEVELS
The main thing to remember is that keeping pH levels in the range of 7.34–7.45 supports an alkaline state in the body and prevents over-acidification. It is normal over the course of a day for pH levels to fluctuate (e.g., after meals), but most important is giving your body the foods and supplements that will help preserve a state of alkalinity.
Diet should your first line of defense. An adequate and steady dietary intake of fruits, vegetables, and purified water is vital to maintaining alkalinity. Unfortunately, this may not always be easy for everyone. As many studies show, average daily intake of fruits and vegetables is far lower than recommended for most people.
The processed food diets with a high protein and low vegetable content consumed by many people in the US and elsewhere often produce conditions in the body of acidity. This in turn leads to decreased oxygenation of cells and encourages a greater amount of anaerobic processes in metabolism. In addition, when the body is acidic calcium can be taken from bones and teeth in order to balance the acidity. This can lead to leaching of minerals from teeth and poor healing of bone fractures, for example.
Whether or not you fall into the category of consuming fewer than the recommended fruits and vegetables daily, you can still rely on a well-designed alkalinizing supplement like pH Adjust. pH Adjust contains only USP-grade (United States Pharmacoepia) ingredients. It is extremely easy to take (just mix with water or another suitable liquid, like coffee or tea), mix, and drink. It mixes easily in water with perhaps a few undissolved solids at the bottom of your cup. You can drink these, too.
Taking pH Adjust Alkalinizing Formula—and keeping a bottle of it ready for use—is an easy way of ensuring you maintain a pH level of about 7.4–7.6. This is especially true today when diet and lifestyle factors—including travel, eating out, insufficient fruit and vegetable intake, and the prevalence of acidifying foods like carbohydrates, sugars, and alcohol—don’t always predispose people to being alkaline, even most of the time.
As noted, your body strives to maintain a blood pH of 7.4 (slight alkalinity) at all costs. This means that when an individual—whether due to diet or lifestyle—falls into an acidic state, their body will rob minerals from bones in order to buffer acids to bring pH levels back to normal. This is where a formula like pH Adjust comes in handy, as it can help reduce stress on the body by providing the alkalinizing substances and minerals to maintain slight alkalinity.
pH Adjust mixes in water, juice, coffee, or your favorite beverage.
A NOTE ON ALKALINE WATER
Alkaline water is big business. You see it in most grocery stores in the bottled water section and many companies costly sell home water alkalinizer units. Alkaline water may be worth of cost for many people because of the many benefits it provides. For example, alkaline water offers proven benefits for people with high blood pressure, diabetes, high cholesterol, and other issues.
A recent study found a significant difference in whole blood viscosity after consuming high-pH water compared to regular water after a strenuous workout. Viscosity is the direct measurement of how efficiently blood flows through the vessels, and it can increase oxygen delivery throughout out the body.
Additional benefits of alkaline water may include:
• Immune system support • Anti-aging properties (liquid antioxidants absorb more quickly) • Superior hydration • weight loss • Better sleep and reduced symptoms for those suffering from RLS (restless leg syndrome)
But you don’t need to purchase expensive waters to get these effects. In fact, alkalinizing water has never been easier, and you can do a better job of it on your own.
Adding pH Adjust to water is one of the fastest ways of creating alkaline water that also provides healthy minerals. It’s also far more economical! pH Adjust mixes well in water, juices, tea, coffee, or in foods. Many alkalinizing supplements alkalinize effectively, but pH Adjust provides the additional benefits of buffering, remineralization, and support for bicarbonate reserves.
pH Adjust is more cost effective than buying alkaline water—and provides additional benefits.
HOW TO USE
As a dietary supplement, take 1 gm (about 1/2 tsp) of pH Adjust in 4–8 ounces of purified water preferably away from food, or as directed by a health care professional. For extremely acidic conditions, try 4–10 doses per day, depending on acidity level. Use pH paper to ensure pH levels remain balanced.
TESTING pH LEVELS: The best way to test pH levels is to use litmus paper, which HPDI offers in rolls (Hydrion brand) for this purpose. You can test salivary or urinary pH. In order to test salivary pH, simply use a small strip of pH paper to dip into a small amount of saliva. Advantages of pH paper include rapid results, ease of use, and cost effectiveness.
• Try taking pH Adjust away from food first thing in the morning and wait at least 20 minutes before eating. You can take it at other times of the day 30 minutes before or 30 minutes after eating.
• Measure your salivary or urine pH first thing in the morning in order to determine the pH status of your system. Most people have an acid pH (less than 7.0). As you start to take pH Adjust you may see the pH of your urine increase. You can slowly increase your dose of pH ADJUST until your morning saliva or urine pH is in the range of pH 7.0–7.5.
Use litmus paper to measure pH levels before and after taking pH Adjust
Today I show how to use pH ADJUST Alkalinizing Formula to make coffee alkaline. When pH Adjust is added to coffee, it rapidly changes from an acidic pH level to an alkaline pH level.
When you drink alkaline coffee, you are helping your body keep the healthy pH level of 7.34–7.45 it strives to maintain. Moreover, by changing to an alkaline state from an acidic state, you avoid health issues known to be associated with acidosis or ongoing, highly acidic pH levels.
pH ADJUST makes an already health-giving beverage into an alkaline-forming powerhouse supporting your best heath and brain performance. pH Adjust also effectively increases pH when used in water, juices, smoothies, or your favorite beverage.
pH ADJUST works by providing key minerals potassium (bicarbonate and glycinate) and magnesium (carbonate), as well as some sodium bicarbonate (baking soda) that act synergistically to boost pH levels in the body. HPDI recommends users measure pH using litmus paper to accurately test their pH levels.
Ideally your body pH is 7.35–7.45. Coffee itself is typically acidic with pH levels of about 5.0 to 6.0. pH Adjust therefore is an ideal supplement for adding into coffee to increase the pH of the coffee you drink and thereby increase your pH levels.
WHAT IS pH ADJUST?
pH ADJUST is an alkalinizing formula (powder) that is designed to increase pH levels in the body rapidly and effectively for good health.
Here is how we describe pH ADJUST on the label: “Alkalinizing Formula, 250 gm – Alkalinize with Potassium Bicarbonate, Magnesium Carbonate, Potassium Glycinate, and Sodium Bicarbonate”
pH ADJUST Features and Benefits
• Alkalinize with Potassium and Sodium Bicarbonate and Magnesium Carbonate
• Helps Counteract Overly Acidic Conditions; Increases pH Levels in the Body
• Balanced Supplemental Minerals; Unique 3:1 Potassium to Sodium Ratio Improves Taste and Reduces Salt Intake
• Tastes Good – Easy to Use Fluffy Powder
• 250 One-Gram Servings Per Container (250 grams)
• Suitable for Vegetarians & Vegans; Gluten-Free
pH ADJUST may be used to assist in overly acidic conditions in the digestive tract, blood, and kidneys; increase salivary and urinary pH to healthy levels; and to supplement the body with the minerals potassium, magnesium, and sodium.
INGREDIENTS:pH ADJUST contains (in powder form): potassium bicarbonate, magnesium carbonate, potassium glycinate, and sodium bicarbonate.
Each one gram serving (about ¼ tsp) contains about 300 mg of bicarbonate, 260 mg of carbonate, 133.4 mg of potassium ((from KHCO3 & glycinate), 99.1 mg of magnesium (from MgCO3), 48.1 mg of sodium (from NaHCO3) and 100 mg of glycine.
DIRECTIONS: As a dietary supplement, take ¼ tsp in 4–8 ounces of purified water preferably away from food, or as directed by a health care professional. For extremely acidic conditions, try 4–10 doses per day, depending on acidity level. Use pH paper to ensure pH levels remain balanced, and do not become too alkaline (alkalosis may occur above pH 8.2).
TEST pH LEVELS: The best way to test pH levels is to use litmus paper, which HPDI offers in rolls (Hydrion brand) for this purpose. You can test both salivary and urinary pH. Advantages of pH paper include rapid results, ease of use, and cost effectiveness.
MORE INFORMATION ABOUT pH ADJUST
pH ADJUST is fluffy white powder that mixes into water, juices, other liquids, and foods. It acts rapidly to raise pH levels in the body. It is easy to use, mild-tasting, and highly effective for balancing pH levels. It is gluten-free, non-GMO, vegan/vegetarian, and contains no artificial ingredients.
NUTRITIONAL CONSIDERATIONS AND APPLICATIONS
The minerals potassium, sodium, and magnesium are key substances that are involved in many important functions in the body. When combined in bicarbonates (potassium & sodium), carbonates (magnesium), and glycinate (potassium) these chemicals can help to adjust and balance pH levels that are crucial to body function.
pH ADJUST provides a 3:1 ratio of potassium to sodium. This ratio keeps potassium levels relatively high with respect to sodium. The processed food diets with a high protein and low vegetable content consumed by many people in the US and elsewhere produce conditions in the body of acidity. This in turn leads to decreased oxygenation of our cells and a greater amount of anaerobic processes in metabolism. This, in turn, leads in inadequate ATP (energy) production and the presence of unwelcome anaerobic cells and organisms.
Bicarbonate is a major element in our body. Secreted by the stomach, it is necessary for digestion. When ingested, for example, with mineral water, it helps buffer lactic acid generated during exercise and additionally reduces the acidity of dietary components. Additionally, it has a preventive effect on dental cavities. Each ¼ tsp of pH ADJUST contains about 300 mg of bicarbonate.
Bicarbonate is present in all body fluids and organs and plays a major role in the acid-base balances in the human body. The first organ where food, beverages and water stay in our body is the stomach. The mucus membrane of the human stomach has 30 million glands which produce gastric juice containing not only acids, but also bicarbonate. The flow of bicarbonate in the stomach amounts from about 24 mg/hr for a basal output to about 73 mg/hr for a maximal output.
Thus, at least half a gram of bicarbonate is secreted daily in our stomach. This rate of gastric bicarbonate secretion is 2–10% of the maximum rate of acid secretion. In the stomach, bicarbonate participates in a mucus-bicarbonate barrier regarded as the first line of the protective and repair mechanisms. On neutralization by acid, carbon dioxide is produced from bicarbonate.
One serving (about ¼ tsp) of pH ADJUST contains about 300 mg of bicarbonate.
pH ADJUST contains about 260 mg of carbonate (and 99 mg of Mg) in the form of magnesium carbonate. Magnesium carbonate is used as an antacid that gets converted to Magnesium Chloride (MgCl) and CO2 by stomach acid. MgCl is a well absorbed form of magnesium.
TRY pH ADJUST IN YOUR COFFEE
We strongly recommend trying pH Adjust in your coffee (or ketogenic coffee) to help alkalinize the body rapidly. Many people gain major benefits from drinking this simple, easy-to-use formula that is highly effective for raising pH levels. Beyond coffee, it works well in other drinks! Like water, teas, juices, or smoothies. Try pH Adjust and see how effectively it can alkalinize you.
I previously wrote METHYLATION CYCLE, GENETICS, B VITAMINS in which I considered in-depth how the Methylation Cycle functions, how genetics affect metabolic pathways, and how B vitamins (including vitamin B12, folate, vitamin B6, and vitamin B2) are used in Methylation Cycle pathways. In today’s article, I take an in-depth view of what you need to know about vitamin B12, including the effects of not having sufficient amounts of Vitamin B12 in the body.
Vitamin B12 is one of eight B vitamins. It is the largest and most structurally complicated vitamin. It consists of a class of chemically related compounds (vitamers), all of which show physiological activity. It contains the biochemically rare element cobalt positioned in the center of a chemical ring structure.
Vitamin B12 (also called cobalamin) is a water-soluble vitamin that is involved in the metabolism of every cell of the human body. It is a cofactor in DNA synthesis, and in both fatty acid and amino acid metabolism. It is particularly important in the normal functioning of the nervous system via its role in the synthesis of myelin and in the maturation of developing red blood cells in the bone marrow.
Vitamin B12 contains the biochemically rare element cobalt positioned in the center of a chemical ring structure.
YOUR NEED FOR VITAMIN B12
Vitamin B12 deficiency is thought to be one of the leading nutritional deficiencies in the world. An extensive 2004 study showed that deficiency is a major health concern in many parts of the world, including the North America, Central and South America, India, and certain areas in Africa. It is estimated that 40 percent of people may have low levels of vitamin B12.
Vitamin B12 affects your mood, energy level, memory, nervous system, heart, skin, hair, digestion and more. It is a key nutrient regarding adrenal fatigue and multiple metabolic functions including enzyme production, DNA synthesis, and hormonal balance.
Because of vitamin B12’s extensive roles within the body, a vitamin deficiency can show up in many different symptoms, such as chronic fatigue, mood disorders such as depression, chronic stress, and low energy.
SOURCES OF VITAMIN B12
The only organisms to produce vitamin B12 are certain bacteria and archaea. Some of these bacteria are found in the soil around the grasses that ruminants eat. They are taken into the animal, proliferate, form part of their gut flora, and continue to produce vitamin B12.
Products of animal origin such as beef (especially liver), chicken, pork, eggs, dairy, clams, and fish constitute the primary food source of vitamin B12. Older individuals and vegans are advised to use vitamin B12 fortified foods and supplements to meet their needs.
Salmon is a good source of Vitamin B12
Commercially, Vitamin B12 is prepared by bacterial fermentation. Fermentation by a variety of microorganisms yields a mixture of methylcobalamin, hydroxocobalamin, and adenosylcobalamin. Since multiple species of propionibacterium produce no exotoxins or endotoxins and have been granted GRAS status (generally regarded as safe) by the United States Food and Drug Administration, they are the preferred bacterial fermentation organisms for vitamin B12 production.
Methylcobalamin and 5-deoxyadenosylcobalamin are the forms of vitamin B12 used in the human body (called coenzyme forms). The form of cobalamin used in many some nutritional supplements and fortified foods, cyanocobalamin, is readily converted to 5-deoxyadenosylcobalamin and methylcobalamin in the body.
Hydroxocobalamin is the direct precursor of methylcobalamin and 5-deoxyadenosylcobalamin. In mammals, cobalamin is a cofactor for only two enzymes, methionine synthase (MS) and L-methylmalonyl-coenzyme A mutase (MUT).
Unlike most other vitamins, B12 is stored in substantial amounts, mainly in the liver, until it is needed by the body. If a person stops consuming the vitamin, the body’s stores of this vitamin usually take about 3 to 5 years to exhaust. Vitamin B12 is primarily stored in the liver as 5-deoxyadenosylcobalamin, but is easily converted to methylcobalamin.
ABSORPTION OF VITAMIN B12
Vitamin B12, bound to protein in food, is released by the activity of hydrochloric acid and gastric protease in the stomach. Intestinal absorption of vitamin B12 requires successively three different protein molecules: Haptocorrin, Intrinsic Factor and Transcobalamin II. If there are deficiencies in any of these factors absorption of Vitamin B12 can be seriously decreased.
When vitamin B12 is added to fortified foods and dietary supplements, it is already in free form and, thus, does not require the separation from food protein step. Free vitamin B12 then combines with intrinsic factor, a glycoprotein secreted by the stomach’s parietal cells, and the resulting complex undergoes absorption within the distal ileum by receptor-mediated endocytosis.
Approximately 56% of a 1 mcg oral dose of vitamin B12 is absorbed, but absorption decreases drastically when the capacity of intrinsic factor is exceeded (at 1–2 mcg of vitamin B12).
Vitamin B12 deficiency can be difficult to detect, especially since the symptoms of a vitamin B12 deficiency can be similar to many common symptoms, such as feeling tired or unfocused, experienced by people for a variety of reasons.
Vitamin B12 deficiency is commonly associated with chronic stomach inflammation, which may contribute to an autoimmune vitamin B12 malabsorption syndrome called pernicious anemia and to a food-bound vitamin B12 malabsorption syndrome. Poor absorption of vitamin B may be related to coeliac disease. Impairment of vitamin B12 absorption can cause megaloblastic anemia and neurologic disorders in deficient subjects. In some cases, permanent damage can be caused to the body when B12 amounts are deficient.
It is noteworthy that normal function of the digestive system required for food-bound vitamin B12 absorption is commonly impaired in individuals over 60 years of age, placing them at risk for vitamin B12 deficiency.
A diagnosis of vitamin B12 deficiency is typically based on the measurement of serum vitamin B12 levels within the blood. However, studies show that about 50 percent of patients with diseases related to vitamin B12 deficiency have normal B12 levels when tested. This can cause individuals to ignore taking in adequate levels of vitamin B12 with potential serious consequences.
FUNCTIONS AND ISSUES ASSOCIATED WITH VITAMIN B12 STATUS IN THE BODY
Vitamin B12 or cobalamin plays essential roles in folate metabolism and in the synthesis of the citric acid cycle intermediate, succinyl-CoA.
Vitamin B12 deficiency is commonly associated with chronic stomach inflammation, which may contribute to an autoimmune vitamin B12 malabsorption syndrome called pernicious anemia and to a food-bound vitamin B12 malabsorption syndrome. Impairment of vitamin B12 absorption can cause megaloblastic anemia and neurologic disorders in deficient subjects.
Normal function of the digestive system required for food-bound vitamin B12 absorption is commonly impaired in individuals over 60 years of age, placing them at risk for vitamin B12 deficiency.
Vitamin B12 and folate are important for homocysteine metabolism. Elevated homocysteine levels in blood are a risk factor for cardiovascular disease (CVD). B vitamin supplementation has been proven effective to control homocysteine levels.
The preservation of DNA integrity is dependent on folate and vitamin B12 availability. Poor vitamin B12 status has been linked to increased risk of breast cancer in some, but not all, observational studies.
Low maternal vitamin B12 status has been associated with an increased risk of neural tube defects (NTD), but it is not known whether vitamin B12 supplementation could help reduce the risk of NTD.
Vitamin B12 is essential for the preservation of the myelin sheath around neurons and for the synthesis of neurotransmitters. A severe vitamin B12 deficiency may damage nerves, causing tingling or loss of sensation in the hands and feet, muscle weakness, loss of reflexes, difficulty walking, confusion, and dementia.
While hyperhomocysteinemia may increase the risk of cognitive impairment, it is not clear whether vitamin B12 deficiency contributes to the risk of dementia in the elderly. Although B-vitamin supplementation lowers homocysteine levels in older subjects, the long-term benefit is not yet known.
Both depression and osteoporosis have been linked to diminished vitamin B12 status and high homocysteine levels.
The long-term use of certain medications, such as inhibitors of stomach acid secretion, can adversely affect vitamin B12 absorption.
Vitamin B12 is required for proper red blood cell formation, neurological function, and DNA synthesis.
MORE DETAILS ASSOCIATED WITH VITAMIN B12 STATUS IN THE BODY
1. Vitamin B12 is required for proper red blood cell formation, neurological function, and DNA synthesis. Vitamin B12 as methylcobalamin functions as a cofactor for methionine synthase. Methionine synthase (MS) catalyzes the conversion of homocysteine to methionine. Methionine along with ATP is required for the formation of S-adenosylmethionine (SAMe), a universal methyl donor for almost 100 different substrates, including DNA, RNA, hormones, proteins, and lipids.
2. Vitamin B12 as 5-deoxyadenosylcobalamin functions as a cofactor along with L-methylmalonyl-CoA mutase (MUT) to convert L-methylmalonyl-CoA to succinyl-CoA in the degradation of propionate, an essential biochemical reaction in fat and protein metabolism. Succinyl-CoA is also required for hemoglobin synthesis.
3. Vitamin B12, bound to protein in food, is released by the activity of hydrochloric acid and gastric protease in the stomach. When synthetic vitamin B12 is added to fortified foods and dietary supplements, it is already in free form and, thus, does not require this separation step. Free vitamin B12 then combines with intrinsic factor, a glycoprotein secreted by the stomach’s parietal cells, and the resulting complex undergoes absorption within the distal ileum by receptor-mediated endocytosis. Approximately 56% of a 1 mcg oral dose of vitamin B12 is absorbed, but absorption decreases drastically when the capacity of intrinsic factor is exceeded (at 1–2 mcg of vitamin B12).
4. Pernicious anemia is an autoimmune disease that affects the gastric mucosa and results in gastric atrophy. This leads to the destruction of parietal cells, achlorhydria, and failure to produce intrinsic factor, resulting in vitamin B12 malabsorption. If pernicious anemia is left untreated, it causes vitamin B12 deficiency, leading to megaloblastic anemia and neurological disorders, even in the presence of adequate dietary intake of vitamin B12.
5. Vitamin B12 status is typically assessed via serum or plasma vitamin B12 levels. Values below approximately 170–250 pg/mL (120–180 picomol/L) for adults indicate a vitamin B12 deficiency. However, evidence suggests that serum vitamin B12 concentrations might not accurately reflect intracellular concentrations. An elevated serum homocysteine level (values >13 micromol/L) might also suggest a vitamin B12 deficiency. However, this indicator has poor specificity because it is influenced by other factors, such as low vitamin B6 or folate levels. Elevated methylmalonic acid levels (values >0.4 micromol/L) might be a more reliable indicator of vitamin B12 status because they indicate a metabolic change that is highly specific to vitamin B12 deficiency.
6. Vitamin B12 deficiency is characterized by megaloblastic anemia, fatigue, weakness, constipation, loss of appetite, and weight loss. Neurological changes, such as numbness and tingling in the hands and feet, can also occur . Additional symptoms of vitamin B12 deficiency include difficulty maintaining balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue. The neurological symptoms of vitamin B12 deficiency can occur without anemia, so early diagnosis and intervention is important to avoid irreversible damage. During infancy, signs of a vitamin B12 deficiency include failure to thrive, movement disorders, developmental delays, and megaloblastic anemia. Many of these symptoms are general and can result from a variety of medical conditions other than vitamin B12 deficiency.
7. Typically, vitamin B12 deficiency is treated with vitamin B12 injections, since this method bypasses potential barriers to absorption. However, high doses of oral vitamin B12 can also be effective. The authors of a review of randomized controlled trials comparing oral with intramuscular vitamin B12 concluded that 2,000 mcg (I like 5,000 mcg) of oral vitamin B12 daily, followed by a decreased daily dose of 1,000 mcg and then 1,000 mcg weekly and finally, monthly might be as effective as intramuscular administration. Overall, an individual patient’s ability to absorb vitamin B12 is the most important factor in determining whether vitamin B12 should be administered orally or via injection. In most countries, the practice of using intramuscular vitamin B12 to treat vitamin B12 deficiency has remained unchanged.
8. Large amounts of folate can mask the damaging effects of vitamin B12 deficiency by correcting the megaloblastic anemia caused by vitamin B12 deficiency without correcting the neurological damage that also occurs. Moreover, preliminary evidence suggests that high serum folate levels might not only mask vitamin B12 deficiency, but could also exacerbate the anemia and worsen the cognitive symptoms associated with vitamin B12 deficiency. Permanent nerve damage can occur if vitamin B12 deficiency is not treated. For these reasons, folate intake from fortified food and supplements should not exceed 1,000 mcg daily in healthy adults.
Groups at Risk of Vitamin B12 Deficiency
The main causes of vitamin B12 deficiency include vitamin B12 malabsorption from food, pernicious anemia, postsurgical malabsorption, and dietary deficiency. However, in many cases, the cause of vitamin B12 deficiency is unknown. The following groups are among those most likely to be vitamin B12 deficient.
Older adults: Atrophic gastritis, a condition affecting 10%–30% of older adults, decreases secretion of hydrochloric acid in the stomach, resulting in decreased absorption of vitamin B12. Decreased hydrochloric acid levels might also increase the growth of normal intestinal bacteria that use vitamin B12, further reducing the amount of vitamin B12 available to the bodY.
Individuals with atrophic gastritis are unable to absorb the vitamin B12 that is naturally present in food. Most, however, can absorb the synthetic vitamin B12 added to fortified foods and dietary supplements. As a result, the IOM recommends that adults older than 50 years obtain most of their vitamin B12 from vitamin supplements or fortified foods. However, some elderly patients with atrophic gastritis require doses much higher than the RDA to avoid subclinical deficiency.
Individuals with pernicious anemia: Pernicious anemia, a condition that affects 1%–2% of older adults, is characterized by a lack of intrinsic factor. Individuals with pernicious anemia cannot properly absorb vitamin B12 in the gastrointestinal tract. Pernicious anemia is usually treated with intramuscular vitamin B12. However, approximately 1% of oral vitamin B12 can be absorbed passively in the absence of intrinsic factor, suggesting that high oral doses of vitamin B12 might also be an effective treatment.
Individuals with gastrointestinal disorders: Individuals with stomach and small intestine disorders, such as celiac disease and Crohn’s disease, may be unable to absorb enough vitamin B12 from food to maintain healthy body stores. Subtly reduced cognitive function resulting from early vitamin B12 deficiency might be the only initial symptom of these intestinal disorders, followed by megaloblastic anemia and dementia.
Individuals who have had gastrointestinal surgery: Surgical procedures in the gastrointestinal tract, such as weight loss surgery or surgery to remove all or part of the stomach, often result in a loss of cells that secrete hydrochloric acid and intrinsic factor. This reduces the amount of vitamin B12, particularly food-bound vitamin B12, that the body releases and absorbs. Surgical removal of the distal ileum also can result in the inability to absorb vitamin B12. Individuals undergoing these surgical procedures should be monitored preoperatively and postoperatively for several nutrient deficiencies, including vitamin B12 deficiency.
Vegetarians: Strict vegetarians and vegans are at greater risk than lacto-ovo vegetarians and non-vegetarians of developing vitamin B12 deficiency because natural food sources of vitamin B12 are limited to animal foods. Fortified breakfast cereals and fortified nutritional yeasts are some of the only sources of vitamin B12 from plants and can be used as dietary sources of vitamin B12 for strict vegetarians and vegans. Fortified foods vary in formulation, so it is important to read the Nutrition Facts labels on food products to determine the types and amounts of added nutrients they contain.
Pregnant and lactating women who follow strict vegetarian diets and their infants: Vitamin B12 crosses the placenta during pregnancy and is present in breast milk. Exclusively breastfed infants of women who consume no animal products may have very limited reserves of vitamin B12 and can develop vitamin B12 deficiency within months of birth. Undetected and untreated vitamin B12 deficiency in infants can result in severe and permanent neurological damage.
The American Dietetic Association recommends supplemental vitamin B12 for vegans and lacto-ovo vegetarians during both pregnancy and lactation to ensure that enough vitamin B12 is transferred to the fetus and infant. Pregnant and lactating women who follow strict vegetarian or vegan diets should consult with a pediatrician regarding vitamin B12 supplements for their infants and children.
Health Risks from Excessive Vitamin B12
The IOM did not establish a UL for vitamin B12 because of its low potential for toxicity. In Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline, the IOM states that “no adverse effects have been associated with excess vitamin B12 intake from food and supplements in healthy individuals”.
Findings from intervention trials support these conclusions. In the NORVIT and HOPE 2 trials, vitamin B12 supplementation (in combination with folic acid and vitamin B6) did not cause any serious adverse events when administered at doses of 0.4 mg for 40 months (NORVIT trial) and 1.0 mg for 5 years (HOPE 2 trial).
Interactions with Medications
Vitamin B12 has the potential to interact with certain medications. In addition, several types of medications might adversely affect vitamin B12 levels. A few examples are provided below. Individuals taking these and other medications on a regular basis should discuss their vitamin B12 status with their healthcare providers.
Chloramphenicol: Chloramphenicol (Chloromycetin®) is a bacteriostatic antibiotic. Limited evidence from case reports indicates that chloramphenicol can interfere with the red blood cell response to supplemental vitamin B12 in some patients.
Proton pump inhibitors: Proton pump inhibitors, such as omeprazole (Prilosec®) and lansoprazole (Prevacid®), are used to treat gastroesophageal reflux disease and peptic ulcer disease. These drugs can interfere with vitamin B12 absorption from food by slowing the release of gastric acid into the stomach. However, the evidence is conflicting on whether proton pump inhibitor use affects vitamin B12 status. As a precaution, healthcare providers should monitor vitamin B12 status in patients taking proton pump inhibitors for prolonged periods.
H2 receptor antagonists: Histamine H2 receptor antagonists, used to treat peptic ulcer disease, include cimetidine (Tagamet®), famotidine (Pepcid®), and ranitidine (Zantac®). These medications can interfere with the absorption of vitamin B12 from food by slowing the release of hydrochloric acid into the stomach. Although H2 receptor antagonists have the potential to cause vitamin B12 deficiency, no evidence indicates that they promote vitamin B12 deficiency, even after long-term use. Clinically significant effects may be more likely in patients with inadequate vitamin B12 stores, especially those using H2 receptor antagonists continuously for more than 2 years.
Metformin: Metformin, a hypoglycemic agent used to treat diabetes, might reduce the absorption of vitamin B12, possibly through alterations in intestinal mobility, increased bacterial overgrowth, or alterations in the calcium-dependent uptake by ileal cells of the vitamin B12-intrinsic factor complex. Small studies and case reports suggest that 10%–30% of patients who take metformin have reduced vitamin B12 absorption. In a randomized, placebo controlled trial in patients with type 2 diabetes, metformin treatment for 4.3 years significantly decreased vitamin B12 levels by 19% and raised the risk of vitamin B12 deficiency by 7.2% compared with placebo. Some studies suggest that supplemental calcium might help improve the vitamin B12 malabsorption caused by metformin, but not all researchers agree.
Background: Low vitamin B-12 status is prevalent among the elderly, but few studies have examined the association between vitamin B-12 status and intake.Objective: We hypothesized that vitamin B-12 concentrations vary according to intake source.Design: Plasma concentrations and dietary intakes were assessed cross-sectionally for 2999 subjects in the Framingham Offspring Study. The prevalence of vitamin B-12 concentrations <148, 185, and 258 pmol/L was examined by age group (26–49, 50–64, and 65–83 y), supplement use, and the following food intake sources: fortified breakfast cereal, dairy products, and meat.Results: Thirty-nine percent of subjects had plasma vitamin B-12 concentrations <258 pmol/L, 17% had concentrations <185 pmol/L, and 9% had concentrations <148 pmol/L, with little difference between age groups. Supplement users were significantly less likely than non-supplement-users to have concentrations <185 pmol/L (8% compared with 20%, respectively). Among non-supplement-users, there were significant differences between those who consumed fortified cereal >4 times/wk (12%) and those who consumed no fortified cereal (23%) and between those in the highest and those in the lowest tertile of dairy intake (13% compared with 24%, respectively), but no significant differences by meat tertile. Regression of plasma vitamin B-12 on log of intake, by source, yielded significant slopes for each contributor adjusted for the others. For the total group, b = 40.6 for vitamin B-12 from vitamin supplements. Among non-supplement-users, b = 56.4 for dairy products, 35.2 for cereal, and 16.7 for meat. Only the meat slope differed significantly from the others.Conclusions: In contrast with previous reports, plasma vitamin B-12 concentrations were associated with vitamin B-12 intake. Use of supplements, fortified cereal, and milk appears to protect against lower concentrations. Further research is needed to investigate possible differences in bioavailability.
It has finally arrived — the exciting new Terraflora™ synbiotic. A synbiotic is a combination of probiotics and supporting prebiotics. This advanced soil-based organisms formula fills the need for a superb probiotic/prebiotic in Health Products Distributors’ arsenal of highly effective formulas. Terraflora is extremely supportive of your entire microbiome and gut-based immune system.
ADVANCED GUT MICROBIOME SUPPORT
INTRODUCING THE MICROBIOME
For centuries, scientists have recognized a limited number of pathogenic bacteria for which antibiotic therapies have become the mainstream treatment. However, advanced DNA sequencing techniques coupled with data revealed from the Human Genome Project have made it possible to study a vast world of ‘germs’ – both pathogenic and beneficial – that dwarf our previous knowledge.
While we inherit more than 22,000 genes from our parents, the bacteria that exist in and on our bodies contain at least eight million bacterial genes which amounts to 360 times more bacterial genes than human genes! The genetic material from bacteria that populate the human body is known as the human microbiome.
Your microbiome is likely similar to that of your immediate family, as we naturally inherit our family’s microbiota. Through the course of our lives, we pick up other bacteria from food, water, and various components of our environment. Scientists estimate that we each carry 100 trillion bacteria in our intestinal tract alone!
In this teeming landscape of bacteria, both you and the bacterial communities derive benefit. Many researchers use the term “mutually beneficial” when describing the evolving bacterial communities in our gut.
THE BALANCE OF BACTERIA AND YOUR HEALTH
In 2010, the Human Microbiome Project published an analysis of 178 genomes from bacteria that live in or on the human body. 10,000 different types of bacteria in the human body have been identified, including novel genes and proteins that serve functions in human health and disease. The vast numbers of bacteria discovered appear to provide benefit to the human body, not harm.
Martin J. Blaser, chairman of the Department of Medicine and a professor of microbiology at the New York University School of Medicine states: Germs make us sick, but everyone focuses on the harm. It’s not that simple, because without most of these organisms we could never survive.
As scientists map the human microbiome, they are beginning to understand the difference between normal and abnormal. Proper bacterial balance is vital to healthy immune function, providing appropriate protection against potential infections, playing a critical role in the digestion and absorption of food and nutrients, and even regulating mood. The interaction of multiple strains of bacteria is an essential element in health and wellbeing.
The optimal balance of bacteria can be altered in many ways such as broad spectrum antibiotics that kill bacteria in the gut indiscriminately; prescription medications; disease-carrying bacteria, fungi, parasites, and yeasts; stress; lack of sleep; poor diet & lifestyle; geography and travel; and physical disconnection with nature.
Researchers have shown that changes in gut bacteria even affect the brain and personality. For example, germ-free mice have been shown to be dramatically more anxious and hyperactive than their counterparts with a normal microbiome. These changes have also been associated with neurochemical changes in the mouse brain.
Evidence supports the concept that microbiota balance can have a large impact on healthy metabolic processes. This delicate balance has a definite impact on nutrient acquisition and overall energy regulation.
The impact of the gut microbiota is far reaching in the body. Continued investigation into the microbiome will yield powerful data, enabling the development of novel options to support healthy mood, metabolism, signaling molecules and much more.
FEATURES OF TERRAFLORA
Terraflora is a novel broad spectrum synbiotic formulated with a combination of spore form probiotics, and advanced, food-based, ancient prebiotics designed for robust support of gastrointestinal health.
Innovative gut microbiome support
Multi-strain, soil-based, beneficial bacteria to support microbial diversity in the GI tract
Proprietary blend of ancient, wild-harvested, certified organic prebiotic support
Terraflora’s advanced formulation of beneficial strains and ancient prebiotics are designed to support the biodiversity reflected in ancestral diets
Shelf stable and requires no refrigeration
Highly bioavailable strains are protected by a natural seed-like structure, guarding against environmental factors and stomach acid
Strains effectively generate highly bioavailable riboflavin (vitamin B2) and antioxidant carotenoids, right at the sight of absorption
Induces anti-inflammatory effects to foster gut homeostasis
Supports immune health
TERRAFLORA KEY BENEFITS
VIABILITY – The natural seed-like structure encasing the probiotc bacteria in Terraflora protects them against degradation by stomach acid, so they reach their target destination — the lower GI tract — intact and alive.
ADVANCED PREBIOTIC SUPPORT – Uniquely formulated with organic seaweeds (see reference 2 below), mushroom extracts (see reference 1 below), and humic acid (see reference 3 below). Terraflora’s advanced prebiotic complex contains a diverse spectrum of naturally occurring food-based polyphenols and polysaccharides designed to support healthy intestinal flora
ANTIOXIDANT BENEFITS – Terraflora features Ribospore™ (Bacillus pumilus) and Bacillus megaterium EM144™, two novel probiotic strains shown in studies to produce highly bioavailable, gastric stable antioxidant carotenoids, right at the site of absorption.
CONVENIENT — NO REFRIGERATION REQUIRED! – To ensure potency and viability, most probiotics require refrigeration and have a short shelf life. The inherently resilient bacteria in Terraflora are heat-stable, and require no refrigeration, uniting convenience and efficacy.
WHY SOIL-BASED ORGANISMS?
Through diet and lifestyle, our earliest ancestors were routinely exposed to spore-based bacteria found in healthy soils and our natural environment. In our modern and hyper-sanitized world, this primitive yet vital connection to nature has been all but lost.
Soil-based organisms (SBOs) define a class of probiotic supplements based on a greater understanding of the incredible diversity of the human gut, coupled with a deeper appreciation for how humans and their commensal “helper” bacteria work together to produce a healthy system.
Soil-based bacteria have a three-stage life cycle, with each stage triggered by nutrient availability: vegetative growth, sporulation, and germination. The sporulation phase is particularly relevant to its potential as a probiotic. The spore structure preserves the bacteria in a dormant phase and against any harm whether in any terrestrial environment or in the acidic environments of the stomach and upper intestines. When these probiotic microbiota are ingested, they travel all the way to the lower intestine where they come alive. Like a seed, warm temperatures, moisture, and nutrients stimulate the germination stage where bacteria emerges from dormancy. Soil-based probiotics are well-adapted to the environment of the gut, and have been shown to remain in the digestive tract where they can provide long term benefit.
SBO probiotics are characterized by two traits that make them superior to other probiotics: 1) the spore phase enabling natural resistance to the harsh environment of the upper digestive tract and stomach, and 2) inherent environmental stability that does not require the addition of specialized coatings or preservatives to ensure a clinically relevant amount reaches the appropriate areas of the gut.
Though SBO probiotics are based directly on symbiotic communities of bacteria found in natural soil environments, these organisms are not harvested directly from the earth to be packaged as a supplement. They are instead produced in a safe, monitored environment to ensure specificity of the strains.
Why are soil-based probiotics so popular among clinicians, and what makes them so important? The answer to this question lies in an understanding of the human gut microbiome.
MULTI-STRAIN BACILLUS COMPLEX
Bacteria are incredibly ubiquitous, highly adaptable ancient life forms that evolved relatively unchanged over nearly 4 billion years. Bacillus, in particular, is arguably Earth’s most resilient bacteria―the oldest of which having been cultured and identified from the abdominal contents of extinct bees preserved in amber for 25 to 40 million years.
Through diet and lifestyle, our earliest ancestors were routinely exposed to bacillus spores found in healthy soils and our natural environment. Yet we no longer have routine exposure to bacillus spores due to the hyper-sanitization of our post-industrial civilization. Terraflora’s unique probiotic + prebiotic bio-complex of commensal bacillus strains reconnect humans with their ancestral environment.
Terraflora bridges the lost connection to our natural environment, with a sophisticated probiotic bio-complex of specific, commensal Bacillus strains. Selected for their unique characteristics, Bacillus are gram-positive bacteria that can exist in two forms. Under favorable conditions the bacteria grow in a vegetative form, but when starved of nutrients they differentiate into a dormant life form known as an “endospore” or simply a “spore”. These spores come alive when introduced to an ideal environment, like the human gut.
Terraflora’s innovative DNA verified strain combination introduces Ribospore™ (Bacillus pumilus) and Bacillus megaterium EM144™, microorganisms scientifically proven to effectively produce highly bioavailable antioxidants and riboflavin, right at the site of absorption. Riboflavin is an essential nutrient for maintaining a healthy digestive tract.
In addition to our proprietary new RibosporeTM (Bacillus pumilus) and Bacillus Megaterium EM144TM—Bacillus subtilis, Bacillus clausii, and Bacillus coagulans complete Terraflora’s multi-strain probiotic bio-complex.
ADVANCED PREBIOTIC BIO-COMPLEX
Terraflora™ contains a prebiotic blend of certified organic, wild-harvested seaweeds, mushroom extracts, and humic acid. These ancient, food-based prebiotics support commensal microbiota with a diverse spectrum of naturally-occurring polyphenols and polysaccharides designed to strengthen healthy intestinal flora. This bio-complex includes:
LARCH ARABINOGALACTAN: A solvent-free water extract that retains all bioactive polyphenolic flavonoids present in Larch, including taxifolin and quercetin. Larch arabinogalactan is a densely branched, non-starch polysaccharide consisting of galactose and arabinose molecules. It has been shown to increase production of critical short-chain fatty acids (SCFAs) such as butyrate in the gut. Butyrate is the principle fuel for intestinal cells and supports healthy tight junctions in the gut lining. In addition, Larch arabinogalactan enhances beneficial gut flora and increases levels of beneficial intestinal anaerobes, particularly Bifidobacterium longum.
FUCUS VESICULOSUS (BLADDERWRACK) & UNDARIA PINNATIFIDA (WAKAME) EXTRACTS: These are certified organic solvent-free water extracts that are wild-harvested from clean ocean waters of Patagonia and Nova Scotia. They are rich in marine polyphenols and complex, sulfated, fucose-rich polysaccharides called fucoidans. Fucoidans are found in edible brown seaweeds and are shown to have multiple bioactivities including the support of healthy inflammation response in the GI tract. In vitro studies show that fucoidan effectively inhibits adhesion of pathogenic bacteria Helicobacter pylori and Escherichia coli to human cells. Furthermore, they increase the abundance of beneficial bacteria and significantly decrease inflammatory response and antigen load of the gut microbiota. In addition, they may also help maintain levels of beneficial bacteria in the gut during antibiotic use and are known to increases the integrity of tight junctions in the gut lining.
NORDIC CHAGA EXTRACT: This ingredient is a certified organic hot-water extract obtained exclusively from the mushroom fruiting body. It is sustainably wild-harvested in the Arctic (Finnish Lapland forest) and contains a diverse spectrum of polysaccharides and polyphenols. This extract has been shown to help protect against acute colonic inflammation and shown to decrease the Firmicutes-to-Bacteroidetes bacterial ratios. Decreased Firmicutes-to-Bacteroidetes ratios are significantly associated with lower body mass index (BMI).
RED REISHI EXTRACT: A certified organic extract obtained by traditional hot-water extraction methods exclusively from the mushroom fruiting body. It contains a diverse spectrum of polysaccharides and polyphenols that have been shown to increase microbiota richness and regulate intestinal barrier function. It is known to support the health of the gut lumen. Furthermore, is has been shown to decrease Firmicutes-to-Bacteroidetes ratios and endotoxin-bearing Proteobacteria levels.
HUMIC ACID: The humic acid in Terraflora is water extracted from ancient freshwater humate deposits. It has been shown to significantly increase the overall concentration of colonic microbiota.
Abstract Mushrooms have long been used for medicinal and food purposes for over a thousand years, but a complete elucidation of the health-promoting properties of mushrooms through regulating gut microbiota has not yet been fully exploited. Mushrooms comprise a vast, and yet largely untapped, source of powerful new pharmaceutical substances. Mushrooms have been used in health care for treating simple and common diseases, like skin diseases and pandemic diseases like AIDS. This review is aimed at accumulating the health-promoting benefits of edible mushrooms through gut microbiota. Mushrooms are proven to possess anti-allergic, anti-cholesterol, anti-tumor, and anti-cancer properties. Mushrooms are rich in carbohydrates, like chitin, hemicellulose, β and α-glucans, mannans, xylans, and galactans, which make them the right choice for prebiotics. Mushrooms act as a prebiotics to stimulate the growth of gut microbiota, conferring health benefits to the host. In the present review, we have summarized the beneficial activities of various mushrooms on gut microbiota via the inhibition of exogenous pathogens and, thus, improving the host health.
The marine environment is an untapped source of bioactive compounds. Specifically, marine macroalgae (seaweeds) are rich in polysaccharides that could potentially be exploited as prebiotic functional ingredients for both human and animal health applications. Prebiotics are non-digestible, selectively fermented compounds that stimulate the growth and/or activity of beneficial gut microbiota which, in turn, confer health benefits on the host. This review will introduce the concept and potential applications of prebiotics, followed by an outline of the chemistry of seaweed polysaccharides. Their potential for use as prebiotics for both humans and animals will be highlighted by reviewing data from both in vitro and in vivo studies conducted to date.
Abstract AIM: To test the effects of humic acids on innate microbial communities of the colon. METHODS: We followed the effects of oral supplementation with humic acids (Activomin®) on concentrations and composition of colonic microbiome in 14 healthy volunteers for 45 d. 3 × 800 mg Activomin® were taken orally for 10 d followed by 3 × 400 mg for 35 d. Colonic microbiota were investigated using multicolor fluorescence in situ hybridization (FISH) of Carnoy fixated and paraffin embedded stool cylinders. Two stool samples were collected a week prior to therapy and one stool sample on days 10, 31 and 45. Forty-one FISH probes representing different bacterial groups were used. RESULTS: The sum concentration of colonic microbiota increased from 20% at day 10 to 30% by day 31 and remained stable until day 45 (32%) of humic acid supplementation (P < 0.001). The increase in the concentrations in each person was due to growth of preexisting groups. The individual microbial profile of the patients remained unchanged. Similarly, the bacterial diversity remained stable. Concentrations of 24 of the 35 substantial groups increased from 20% to 96%. Two bacterial groups detected with Bac303 (Bacteroides) and Myc657 (mycolic acid-containing Actinomycetes) FISH probes decreased (P > 0.05). The others remained unaffected. Bacterial groups with initially marginal concentrations (< 0.1 × 109/mL) demonstrated no response to humic acids. The concentrations of pioneer groups of Bifidobacteriaceae, Enterobacteriaceae and Clostridium difficile increased but the observed differences were statistically not significant. CONCLUSION: Humic acids have a profound effect on healthy colonic microbiome and may be potentially interesting substances for the development of drugs that control the innate colonic microbiome.
Almost daily articles, reports, or studies appear claiming nutritional supplements are not effective. The claims vary, but the verdict is always there is little or no scientific evidence proving supplements (or the nutrients in supplements) work. Others assert that people who take supplements have the world’s most expensive urine. This is nonsense! The scientific evidence is clear, available, and it has been for a long time.
Among the many problems with these reports is bashing supplements based on studies using low dose or non-therapeutic levels of nutrients. There is frequently failure to consider the importance of synergy among nutrients. Often there is data manipulation via statistical methods (often in meta-analyses).
Well beyond the question of whether supplements support health are the factors in modern life that create a greater needs for supplementing with important vitamins, minerals, cofactors, and other nutrients.
This month we present “Seven Arguments for Nutritional Supplements.” As the title implies, there are at least seven solid arguments for nutritional supplementation. There are actually a lot more.
To preview these arguments in favor of taking supplements, they are: 1) reduced food quality, 2) nutrient density varies by location, 3) modern lifestyles and stress, 4) environmental pollution, 5) too low RDAs, and 6) promotion of health and delaying of aging, and 7) the human right to correct information.
Essential Fatty Acids (EFA) are one type of essential nutrient required for health.
We at HPDI re-publish articles from the Orthomolecular News Service (OMNS) because the authors provide much needed truth. Truth the form of correcting the false assumptions of anti-supplement propagandists to clarify the benefits of nutritional supplements. This information can help people be healthier easily and at relatively low cost.
HPDI offers a full line of foundational nutritional supplements, including multivitamins, vitamin C and antioxidant formulas, essential fats, and high-RNA Rejuvenate! superfoods. We also offer nearly 100 other nutritional supplements from single nutrients to condition specific formulas. See our full product overview.
Enjoy this article from the Orthomolecular News Service (OMNS). ~
Seven Arguments for Taking Nutritional Supplements
by Dag Viljen Poleszynski, PhD
(OMNS Sept 12 2018)
One of the most vitamin-restrictive countries in the world is Norway. There, authorities limit potencies to only slightly higher than RDA (Recommended Dietary Allowance) levels for dietary supplements sold outside of pharmacies. The traditional reasoning is that most people receive the nutrients they need from a “balanced diet.” 
The authorities are also obsessively concerned that some vitamins and minerals are harmful in high doses. And, since an intake of water-soluble vitamins in excess of needs is excreted in the urine, Norwegian “experts” advise that taking supplements is a waste of money.
Accordingly, the argument goes, the public should be protected not only from possible harm, but also from wasting money on unnecessary nutrients. The official policies on nutritional supplements vary within OECD (Organization for Economic Cooperation and Development) countries. Some are more liberal, while others are even more restrictive.
The official view on the connection between nutrient intake and possible toxicity is illustrated by the Norwegian Food Authority in a graph. 
Perceived risk from intake of nutrients. (Source: Expert Group on Vitamins and Minerals. Safe upper limits for Vitamins and Minerals. May 2003: Food Standards Agency, UK.)
The graph illustrates the official view on nutrients, assuming that nutrients function in the same way as pharmaceuticals, which they do not. Supplements of most vitamins, but also minerals and other nutrients, do not have very serious side effects even when taken at very high levels – in contrast with most drugs. [3,4] The fact that most of the chemotherapeutic drugs used against cancer have none or even just marginal effects against most cancers , while at the same time cause a lot of serious side effects, is rarely up for discussion.
The idea that nutritional supplements are not safe has a legal underpinning in Norwegian Food Law, which in section 16 prohibits sale of any food which is not safe: “Any food shall be considered not to be safe if it is seen as detrimental to health or not fit for consumption.” 
However, the Norwegian authorities do admit that vitamin D supplements are needed during part of the year.  Only part of the year? One third of Norway is within the Arctic Circle. Norway has far too little sunshine (especially during winter months) to get adequate levels of vitamin D from UVB radiation on the skin.
The authorities also recommend that pregnant women take folic acid to prevent birth defects, and omega-3-fatty acids may be advisable for those who do not eat fish regularly. Norwegians have a long tradition of giving children cod liver oil, which in a daily tablespoon provides enough vitamin A and D and essential fatty acids to cover basic needs.
Essential and conditionally essential nutrients
There are thousands of dietary supplements on the market, including 40+ essential nutrients alone and in various combinations, i.e. vitamins, minerals, trace elements and fatty acids. However, a number of other nutrients are “conditionally essential”, meaning that the body normally can make these molecules, but some people do not make optimal amounts. Examples are L-carnitine, alpha-lipoic acid, the methyl donor betaine,  chondroitin sulfate, coenzyme Q10, choline, amino acids such as tyrosine or arginine, and “essential” sugars normally formed in the body. 
Healthy young people normally make sufficient amounts of conditionally essential molecules in the body, although the levels are not always optimal. With inadequate levels of minerals or vitamins, key enzymes in biochemical pathways may not function optimally.
Due to genetic mutations, some enzymes may have increased needs for certain cofactors (vitamins), which can prevent them from functioning optimally. Some enzymes only function normally when supplied with cofactors in greater amounts than normally required.
If supplements of essential nutrients prove insufficient for optimal enzyme function, “conditionally essential” nutrients may be added as part of a comprehensive, therapeutic program.
Parents are advised to become familiar with the literature on essential nutrients, for instance by consulting the Orthomolecular News Service. Children should be given supplements in appropriate doses and in a suitable form. Pills should not be given before children can control the swallowing reflex. Multivitamin powder can be given dissolved in water or juice. Parents should not dose vitamin C so high that a child comes to school or kindergarten with loose bowels or diarrhea.
In high doses, niacin may cause unpleasant side effects such as flushing and itching lasting up to several hours.  Although this is not dangerous, it may cause a child to feel unwell and anxious. Starting niacin supplementation with a low dose and gradually increasing it will allow the body to adapt and avoid the niacin flush.
A multivitamin supplement containing moderate amounts of niacin is often adequate until a child is 8-10 years old. For younger children, the dosage should start with only a few tens of milligrams, and not increased to more than 50-100 mg/day. Adults may gradually get used to taking 1,000-1,500 mg/d divided into 3 doses per day.
When it comes to omega-3 fatty acids (omega = ω) such as EPA and DHA, children may be given cod liver oil and served fish and/or other seafood 2-3 times a week. It is important to check the dose of vitamin A supplied, as it can be toxic in high doses, especially for children. One problem with cod liver oil today is that vitamin D has been removed during processing, thus changing the natural ratio of the two vitamins so that we ingest relatively too much of vitamin A. 
Higher dosages may be given after having consulted a therapist who has measured the ratio of omega-6 to omega-3 fatty acids in relevant cell membranes (red blood cells). In most industrialized countries, many people get too much of the omega-6 fatty acids, and would therefore benefit from eating more seafood or taking supplements with omega-3 fatty acids derived from organisms low in the food chain (algae, krill).
Flax seeds contain a high level of the essential omega-3 fatty acid alpha-linolenic acid, and freshly ground flaxseed meal or flax oil can be mixed with breakfast cereals or smoothies. Note that it may be advisable to limit eating farmed fish to once per week, since their fodder contains less omega-3 fatty acids than the food eaten by wild fish, and possibly also contains more contaminants.  Some researchers even warn against letting children eat too much fish because of the content of environmental toxins. [13,14]
Reasons for high-dose supplements of micronutrients
I have identified a number of arguments in favor of supplementing the modern diet with essential nutrients, here summarized with seven headlines. Most people should consider taking a multivitamin supplement containing vitamins and minerals even if they eat a nutritionally balanced diet.
Additional nutrients may contribute to better health and, in some cases, can be of vital importance in our modern world. The arguments are presented in random order, i.e. the order does not reflect priority.
1. The agricultural revolution has reduced food quality
The transition from an existence as hunter and gatherers to urban agriculture around 10,000 years ago began an epoch when foods were mass-produced but had lower nutritional density, compared with the previous food eaten by our ancestors. The nutritional density in many foods has fallen significantly since human societies transformed from hunter-gatherers into resident farmers. This is especially true in the last 60-70 years after agriculture was changed from small, versatile ecologically driven family farms to large, chemical-based, industrial agriculture. 
The reduction of nutritional content in modern crops, compared with older varieties, is well documented.  It is a consequence of soil erosion, loss of essential minerals from continual heavy use, combined with breeding of new varieties, which has increased the size and growth rate of plants by increasing the content of sugar and water and decreasing their mineral content compared to ancient species. At the same time, the relative content of other macronutrients (fat, protein/amino acids) and antioxidants may have been reduced.
Reduced nutritional density in many foods, combined with the use of refined “foods” like sugar, white flour and refined oils, places a greater priority on eating the most nutritious foods.
Farm produce grown organically generally has higher levels of essential nutrients such as trace minerals because the soil contains higher levels of trace minerals and the produce grows slower and thus has more time to absorb nutrients from the soil. Examples of nutrient dense foods are sardines, wild salmon, shellfish, eggs, liver, kale, collards and spinach, sea plants (seaweed), garlic, blueberries, and dark chocolate. 
2. Nutritional content of food varies with geographical location
Nutritional density varies considerably geographically between different regions, even with the same agricultural methods. This was documented in the United States in 1948 by a researcher at Rutgers University in the so-called Firman Bear report.  At that time agriculture was little mechanized, and artificial fertilizers and pesticides were hardly used.
The analysis found large differences in the content of minerals in the same food. The largest variations were found for potassium, sodium, boron and iron in spinach, while the greatest differences in calcium, magnesium and copper content were found in tomatoes.
The soil in areas with relatively low rainfall may in some cases contain an extremely high concentration of minerals, which is reflected in the plants growing there. This was well documented 70 years ago in the book Tomorrow’s Food.  The dentist George W. Heard found that the soil in Hereford, Texas, was exceptionally rich in minerals.
Hereford became known as the “town without a toothache” after a newspaper article from January 29, 1942, reported that Hereford had the lowest incidence of tooth decay of any city in the United States.  Dr. Heard found that people in Hereford had exceptionally few dental cavities and also that the soil locally was especially rich in minerals. He emphasized that the population in the county ate unprocessed food and was drinking raw milk. 
Recent research shows that differences in the content of the selenium in the soil can cause major differences in the concentration of selenium in meat.  For instance, since the soil in Finland is poor in selenium, the authorities decided in the early 1980s to add selenate to commercial fertilizers. A survey of selenium status among 108 healthy young people showed an increase in the blood selenium level of about 50 percent after four years. 
A similar problem with the level of minerals in the soil exists for the content of magnesium. Often when the soil gets depleted of magnesium from heavy use, this essential mineral is not included in soil amendment with fertilizers. Produce grown in soil with an adequate level of magnesium will contain more magnesium than produce grown in soil deficient in magnesium.
Perhaps as many as 70-80% of the US population is magnesium-deficient, which causes many health problems.  Magnesium supplements (chloride, malate or citrate) can provide an adequate level when vegetables grown in soil with adequate magnesium are not available.
3. Stress and the modern lifestyle increase the need for nutrients
Mental stress increases the excretion and hence the need for many nutrients. Among the most important are magnesium and vitamin C, both of which are used by the body in larger quantities during periods of physical and mental stress. [24,25] Compared with our past as hunters and gatherers, today´s stress is often of a more permanent nature. Instead of experiencing occasional situations where we had to fight or flee, many of us live with recurring stress day in and out.
Vitamin C protects the brain and nervous system from damage caused by stress because the synthesis and maintenance of chemical neurotransmitters such as adrenaline and noradrenaline requires adequate levels of vitamin C. 
Vitamin C is also needed to repair collagen which is essential for skin, blood vessels, bones and joints, and muscles. When these are damaged by physical stress, extra vitamin C is necessary.
A controlled trial of 91 adults who experienced increased anxiety and stress 2-3 months after an earthquake in New Zealand in 2011 was divided into three groups, two were given a broad spectrum supplement of micronutrients in low or higher doses.  The supplements were found to alleviate the experience of stress, with the biggest dose having the biggest effect.
Our sedate, modern lifestyle reduces the need for energy from food, which implies a lower food intake or obesity. Loren Cordain, PhD, and coworkers have estimated that hunter-gatherers had significantly higher energy needs than the typical modern office worker. 
A lower energy intake generally reduces the absolute intake of all nutrients, while the need for some nutrients is not always reduced proportionally with energy intake. Overall this suggests that more exercise along with a more nutritious diet, including supplements of essential nutrients and less carbohydrates, will help to prevent obesity and maintain health.
Processing of food reduces its nutritional content, and the finished products are often based on fractions of the original foods. One example is milling grain to make white flour,  which has a lower nutritional density than whole grain flour.
The reduction in nutritional value has accelerated since whole foods are now divided into pieces, for example, boneless chicken breast. When meat is injected with saline to increase the volume, the relative level of essential nutrients is reduced. In the United States, many supermarkets in low-income rural and inner city areas have a limited selection of nutrient-dense foods, compared with high-income areas. 
4. Environmental pollutants increase the need for nutrients
The need for efficient detoxification and excretion is greatly increased by environmental pollution from the chemical industry, herbicides and pesticides used by industrial agriculture, antibiotic treatment of animals, transport, and plastic packaging. 
In our polluted world, the increased toxic load may be compensated for by an increase in nutrients to promote detoxification. One can respond by taking large doses of supplements of essential nutrients, for example, antioxidants vitamin C and E, and an adequate dose of selenium, which help the body detoxify harmful chemicals. Also helpful is regularly taking sauna baths, fasting periodically, and eating an excellent diet that includes generous portions of dark green leafy vegetables and colorful vegetables and fruits. 
A recent study predicts that global warming may reduce the nutrient density in many foods worldwide.  Atmospheric CO2 is estimated to surpass 550 ppm in the next 30-80 years, leading to larger crops with lower content of protein, iron and zinc per energy unit.
Assuming that diets remain constant, while excluding other climate impacts on food production, the researchers estimated that elevated CO2 could cause an additional 175 million people to be zinc deficient and an additional 122 million people to be protein deficient in 2050. Anemia would increase significantly if crops lose even a small amount of iron. The highest risk regions – South and Southeast Asia, Africa, and the Middle East – are especially vulnerable, since they do not have the means and access to compensate using nutritional supplements.
5. The RDA for essential nutrients is too low
The recommended nutrient reference intake (NRI) has been defined by UK authorities and the EU Food Safety Agency as the dose that is adequate for 95 percent of the population.  These authorities have given recommendations for a total of 41 chemical substances,  including 13 vitamins, 17 minerals/trace elements, 9 amino acids and two fatty acids. The problem with such guidelines is that when using the same 0.95 fraction for just 16 of the essential nutrients, the fraction of the overall population that has their needs met with the RDA is less than half (0.9516 = 0.44).
Given the above assumption, the proportion of the population having all nutrient needs met falls below 25 percent for 30 nutrients (0.9530 = 0.21). These 25 percent will not necessarily get optimal amounts, just enough so that they probably will have no deficiencies in accordance with established standards. Each individual is different and has different biochemical needs, so we all need different doses of essential nutrients. Many vitamins and minerals can give additional benefit when taken at higher doses.
The need for several essential nutrients increases with age and sickness. This applies, for example, to vitamin C, vitamin D, magnesium, and iron. In 2017 the Norwegian Food Safety Authority proposed to revise the official maximum levels for vitamins and minerals in dietary supplements. 
Their proposal introduced four different age categories with separate maximum intakes. Initially, the agencies proposed to revise the daily doses allowed in dietary supplements for folic acid, magnesium, calcium, vitamin C and D. At the same time, maximum rates were temporarily suspended for vitamins A, E, K, thiamine (B1), riboflavin (B2), niacin (B3), pantothenate (B5), pyridoxine (B6), cobalamine (B12), biotin, and for phosphorus, iron, copper, iodine, zinc, manganese, selenium, chromium, molybdenum, sodium, potassium, fluoride, chloride, boron and silicon.
The upper limits for some nutrients may be changed in the future. Unfortunately, Norwegian nutrition “experts” will likely continue to limit allowable doses below those freely available in the US and even Sweden.
6. An optimal nutrient intake promotes health and delays aging
A spokesperson for optimal nutritional intake is the well-known biochemist Bruce Ames, who proposed the “triage theory of nutrients,” in which enzymes responsible for cell maintenance functions evolved to have lower affinity for the essential vitamin and mineral cofactors than the enzymes responsible for short-term survival, to preserve life during times of famine. 
Thus, higher levels of vitamins and minerals may delay mitochondrial aging, speed up the repair of large molecules such as DNA and collagen, and generally improve other cellular functions. This is an important rationale for taking higher doses of vitamins and minerals than recommended reference intakes.
Dietary supplements can slow the aging process, in part by reducing the harmful effects of free radicals, known to be involved in many diseases such as cardiovascular disease and cancer. 
Naturally occurring hormones and/or supplements of cofactors needed for optimal hormone production in the body can have a significant life-prolonging effect if the body produces less than optimal amounts.  This is especially relevant for those with a genetic predisposition for disease.
An optimum intake of all nutrients is difficult to achieve even for those who eat almost exclusively an excellent diet of nutrient dense foods, such as meat and innards, fish, shellfish, fowl, eggs, nuts, mushrooms, and vegetables, berries and nutritious fruits. Some nutrients such as folic acid or carotenoids in vegetables are absorbed better from processed than unprocessed foods.
Although vegetables are often considered to be a good source of vitamins, for example vitamin A from carrots, vitamin A is only found in animal products such as liver, egg yolk, fish cod and cod liver oil. Although eating raw vegetables is helpful for several reasons (vitamin C, fiber, microbiota), carotenoids (alpha/beta-carotene, lutein, lycopene) in vegetables are less well absorbed from raw than cooked food and better absorbed in the presence of added fat. [38,39].
Nutrients in vegetables are better absorbed when finely chewed, graded, or mashed , and cooking and grinding meat reduces the energy required to digest it  and increases nutrient absorption .
Orthomolecular pioneer Abram Hoffer and Orthomolecular News Service Editor Andrew W. Saul suggested this list of daily intakes of vitamins and minerals.  The Norwegian 2017 recommendations for adult men and women  are given in comparison. Individual needs may vary substantially from person to person and also with health status.
The figures for optimal intake are obtained from the Independent Vitamin Safety Review Panel of physicians, researchers and academics, who concluded:
“People are deceived in believing that they can get all the nutrients they need from a ‘balanced diet’ consisting of processed foods. To achieve an adequate intake of vitamins and minerals, a diet of unprocessed whole foods, along with intelligent use of dietary supplements is more than just a good idea: it is vital.” [44: 55]
A well-known example is vitamin C, which can effectively fight viral infections, prevent or reverse disease caused by bacteria, and help the body detoxify organic and inorganic toxins.  Vitamin C also reduces the risk for cancer, strengthens connective tissues (collagen), and counteracts stress by increasing the adrenal´s production of cortisol. The dose required is set according to the body’s need.
Nobel Price Laureate Linus Pauling suggested that an optimal daily intake of vitamin C could vary from at least 250 mg up to 20 grams per day.  Because unabsorbed vitamin C attracts water into the gut, some people may experience loose stools, gas and/or diarrhea by ingesting only 1-2 grams at a time, while others with a higher level of stress may tolerate 5-6 grams or more. The dose that causes loose stools is called the “bowel tolerance” for vitamin C.  To avoid the laxative effect of high doses, it is best to take vitamin C throughout the day in smaller divided doses.
When the body is stressed by disease, the gut will naturally absorb more vitamin C because the body needs more. To find the optimal dose, the intake should be increased until bowel tolerance is reached. Some people can tolerate more than 100,000 mg/d of vitamin C in divided doses during serious illness without having loose stool.
Liposomal vitamin C bypasses the normal bowel tolerance because it is absorbed directly through cell membranes, so higher doses can be tolerated without diarrhea.
7. A human right to receive correct information
Access to correct information about food and essential nutrients, including knowledge about the importance of food for health is a fundamental human right. Such information should not only provide a summary of the nutrient content of food, but in our opinion should also explain how dietary supplements can counteract deficiencies and prevent and reverse disease caused by nutrient deficiencies.
We should be free to purchase quality-controlled supplements of essential nutrients and to use them to counteract aging and damage from stress as part of a long-term health plan. The right to reject recommendations by doctors for symptomatic treatment with synthetic, some times life-threatening, drugs to alleviate symptoms should be included. [48,49]
I have not found any formulation of such rights from the Norwegian authorities. The role of parents and their right to receive correct health information is addressed in a book by lawyer Anne Kjersti C. Befring, a fellow at the University of Oslo since 2014. 
The use of dietary supplements is widespread. High doses of vitamins are thought to be helpful because they help the body recover from damage and maintain itself long-term. Many vitamins are not harmful in doses even 10 to 100-fold higher than officially recommended.
Some governments warn about possible negative side effects, even including increased mortality from “excessive” intake of certain supplements. However, supplements of essential nutrients have been available for more than 80 years. They are known to be safe, and the observed side effects are generally mild with few exceptions.
It is possible to ingest too much of certain vitamins and minerals (vitamin A, calcium, iron, copper, selenium) which may exacerbate an existing imbalance or lack of another mineral (magnesium, zinc). It is also important to balance intake of fatty acids in the omega-6 and omega-3 series, as most people get too much omega-6 and not enough omega-3.
Small children can be overdosed with adult doses of for example vitamin A or iron, and pills may be dangerous for babies or young children because they can get stuck in the throat. Therefore, I recommend consulting a doctor or nutritionist educated in orthomolecular medicine. Most people are likely to benefit from taking a broad-spectrum multivitamin/mineral supplement as a basic insurance against deficiencies.
Compared to pharmaceutical drugs, supplements of most essential nutrients are quite harmless. However, some supplements may have poor quality, or contain toxic metals such as lead or cadmium. Therefore, it is the duty of our authorities to ensure that potentially hazardous products or supplements of poor quality are not sold, and that consumers are offered fair prices in a free market.
An example where the Norwegian authorities do not follow up such basic duties is that pharmacies demand more than 1,600 Norwegian Kroner (about $190) per kg of vitamin C in powder form, which would cost less than $20 with free competition and no restrictions in permitted doses or outlets.
Those who want to use natural healing methods, such as the use of food and supplements of essential nutrients to prevent or reverse illness, should consult therapists who are qualified to give advice on how natural therapies can help.
I recommend that anyone interested in supplements read the references for this article as well as the archives of the Journal of Orthomolecular Medicine http://orthomolecular.org/library/jom/ and the Orthomolecular Medicine News Service http://orthomolecular.org/resources/omns/index.shtml . Both are free access online.
(Dag Viljen Poleszynski, PhD, is the editor of Helsemagasinet [Health Magazine] https://vof.no/arkiv/ . He has translated and published a large number of OMNS releases in Norwegian.)
1. National Nutrition Council. Dietary advice to promote public health and prevent chronic disease. Directorate of Health, Oslo January 2011.
22. Hintze KJ, Lardy GP, Marchello MJ, et al. Areas with high concentration of selenium in the soil and forage produce beef with enhanced concentrations of selenium. Journal of Agricultural and Food Chemistry 2001; 49: 1062-7. https://pubs.acs.org/doi/abs/10.1021/jf000699s
23. Mäkelä AL, Näntö V, Mäkela P, et al. The effect of nationwide selenium enrichment of fertilizers on selenium status of healthy Finnish medical students living in South Western Finland. Biological Trace Element Research 1993; 36: 151-7. https://link.springer.com/article/10.1007/BF02783174
24. Dean C. The Magnesium Miracle. Second Edition. New York: Ballantine Books, 2017. ISBN-13: 978-0399594441
25. Hickey S, Saul AW. Vitamin C: the real story. Laguna Beach, CA: Basic Health Publications, Inc., 2008. ISBN-13: 978-1591202233
26. Rucklidge JJ, Andridge R, Gorman B, et al. Shaken but unstirred? Effects of micronutrients on stress and trauma after an earthquake: RCT evidence comparing formulas and doses. Human Psychopharmacology and Clinical Experience 2012; 27: 440-54. https://onlinelibrary.wiley.com/doi/abs/10.1002/hup.2246
27. Cordain L, Gotshall RW, Eaton SB. Evolutionary aspects of exercise. In: Simopoulos AP, ed.: Nutrition and fitness: Evolutionary aspects. World Review of Nutrition and Diet 1997; 81: 49-60. https://www.ncbi.nlm.nih.gov/pubmed/9287503
28. Zenk SN, Powell LM, Rimkus L, et al. Relative and absolute availability of healthier food and beverage alternatives across communities in the United States. American Journal of Public Health 2014; 104: 2170-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202991/
29. Waldbott GL. Health effects of environmental pollutants. Second edition. St. Louis, MI: The C. V. Mosby Company, 1978. ISBN-13: 978-0801653308
36. Halliwell B, Gutteridge HMC. Free radicals in biology and medicine. 5th edition. Oxford, NY: Clarendon Press, 2015. ISBN-13: 978-0198717485
37. Hertoghe T. The hormone handbook. Copyright (c) 2006 Thierry Hertoghe. Surrey, UK: International Medical Publications, 2006.
38. Edwards AJ, Nguyen CH, You CS, et al. a- og ß-carotene from a commercial carrot puree are more bioavailable to humans than from boiled-mashed carrots, as determined using an extrinsic stable isotope reference method. Journal of Nutrition 2002; 132: 159-67. https://academic.oup.com/jn/article/132/2/159/4687130
39. Unlu NZ, Bohn T, Clinton SK et al. Carotenoid absorption from salad and salsa by humans is enhanced by the addition of avocado or avocado oil. The Journal of Nutrition 2005; 135: 431-6. https://www.ncbi.nlm.nih.gov/pubmed/15735074
40. Boback SM, Cox CL, Ott BD et al. Cooking and grinding reduces the cost of meat digestion. Comparative biochemistry and physiology. Part A, molecular & integrative physiology 2007; 148: 651-6. https://www.ncbi.nlm.nih.gov/pubmed/17827047
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