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B12 ABC of Health


ABC’S of Health

By Dr. Jo Gjelsten

Love Your Heart


In  February,  we all like to celebrate Valentine’s  Day with a ton of chocolate or at least a few pounds of it per year, in and on you unless you run up a hill on a daily basis, so I thought it might be nice to talk a little or a lot about heart function.  We just came indoors after shoveling a ton of snow. Our wonderful neighbor plowed our driveway,  did a great job, then the street plowed us in again, leaving us with the heaviest, deepest snow right in front of the vehicle we intend to pry out of our driveway.  I often wonder why, in 2011, here we are throwing white stuff over our shoulders like they did in the 1700’s. Ok, we tried our dear neighbors snow blower  (thank you dear neighbors) on that exact same lump last time we had the storm of the century, and even with getting mad at it and attacking it with that machine; fun at first but hard to push, my shoveling techniques are far faster, I think. Why, I wonder, don’t we all have driveways that melt snow like we have under the sidewalk  that leads from the street to the building at the office in Nyack, which has a built in melting wire thing under the concrete.  Just flip a switch and sip your hot chocolate until all is clear! “Did you turn on the sidewalk?” is a common phrase heard around the office. Patients turn their heads:   “huh?”  I try not to say that around folks in the office anymore, me being me to begin with, and you, if you read my column, (Neighbor Tim) may struggle sometimes to get my sense of humor.

After 3 snowfalls so far in the last few weeks, and for me writing this on the 12th of January I imagine more to come, we need to talk about keeping you from dropping like stones on your snow shovels because you haven’t been doing this for at least a few days, years or months.  You would not, or maybe you would, but don’t, climb Mt. Kilimanjaro, Eric, unless you trained for it, athlete that you are. Why? Because you know that it’s likely you won’t make it to the top, if you’re flabby, and you’ll embarrass yourself, dropping like a baby elephant in front of all those porters who carry your dining room table for you up that big hill. Your muscles would be really sore.  Your heart, like any muscle, is either conditioned or not. It also needs nutrients and co-enzymes to function. One big one is CoQ-10, used by your mighty little mitochondria which you may have heard, powers your cells.  Statins like Lipitor, blood pressure meds as well, LOWER your CoQ-10. Your muscles cramp just about anywhere in your body. But some may experience something serious, a condition called Rhabdomyolysis, (or “rabdomylosis” should you wish to mispronounce it as an actor who plays a Doc on a new show said recently when interviewed),  as I cringed.  Along with taking CoQ-10, to replace that which isn't manufactured due to statin use, the right kind at the right dose for the right reason, I like to say, we need to avoid inflammation of the arteries, which is the real cause of plaque build-up, not cholesterol. Cholesterol is lowered by statins, sometimes too low, without using the proper, or enough CoQ-10, then some have heart attacks anyway. Nice job. You drug companies scare the “bejeesus” out of folks, overcharge them for their meds, then have no part in the result, despite the fact that you’ve got a patent on statins that includes CoQ-10, but do you use it??!!  No!  Dr. Jo will now simma’ down and “un-inflame” a word I made up. We can keep inflammation in check with several products. My personal favorite is Dr. Jo’s O’s which I shamelessly plug, one per day, because I get them in small batches, a dozen per order, enteric coated for you fish burp folks, small fish, deep water, and I know the source. (Norway). Other anti-inflammation products, one I just ordered for us because I literally ingest  all products I give to my patients, sometimes before I give it to them (ok, I kid you). It’s from the best lab I can find, a hypoallergenic  patented product  that uses curcumin in a form really absorbable to the body. On to homocysteine, B-12, and your heart Henry.  Low B-12 can raise your homocysteine.  You don’t want high homocysteine, whether controversial or not, as it’s not just a cardiac health marker; if it’s high your may be low in B-12. You also need B-12 for your nervous system Nellie.   B-6, B-12 or folic acid deficiencies can raise homocysteine. It can be lowered with specific products that support these and other levels responsible for high homocysteine.

Diabetics, if you take Metformin, you may be deficient in B-12. Metformin aka Glucophage, lowers your B-12, which can make you really tired. Why? Other than homocysteine effects, both folic acid and B-12 deficiencies can produce a “macrocytic”  (large cell) anemia, which means the red blood cells aren’t maturing to their smaller size, yes that’s what I said, and you’re cells aren’t getting “fed” from these “baby Huey”  sized cells.  So, here are three things to remember about heart health though there is always more.  1) Get in shape before you lift that shovel Shirley!  2) Make sure if you’re on Meds like statins and blood pressure lowering drugs that you get proper advice regarding nutrients that are lowered (and not just CoQ-10) on these meds.   If you’re on Metformin aka Glucophage for diabetes get a B-12 blood level. 3) Pay attention, via a blood test called CRP (c-reactive protein) to your inflammation levels, and homocysteine levels, also a blood test.  I have a presentation called “Drug Induced Nutrient Deficiencies” that I’m happy to do for your group. (Will work for chocolate). Now go back to your TV where likely if a storm is on the way or here,  you’ll see several thousand shots of piles of salt, people describing the snow as if we never heard of the stuff, weather maps every 5 seconds where weather guys and gals warn you in no uncertain terms that a weather “bomb” is on the way, which is what happened last night.  So we woke up to the sun today. Enjoy your hot chocolate, and get a kid to shovel for you!! www.GoDrJo.com my new and improved website, a work in progress, like me! ©Jan 2011.


NOTE: Nothing in this article should be construed as medical advice. It is informational in purpose only and taken from numerous readily available articles written by physicians and researchers. For medical advice consult with an informed physician.

VITAMIN B-12 Here's an OLDER article by Dr. Jo on B-12 B-12 aka Cobalamine aka cyanocobalamin & hydroxycobalamin (the synthetic forms)

A little cobalt, a little cyanide (cyanocobalamine), mmm, sounds good! Actually it is! We call it B-12, and you probably do too, but you have no idea what you’re talking about, but that’s OK. Famous in the “shot” form, and I don’t mean at the bar, if you have too little, you may get pernicious anemia (weak, fatigued, with memory impairment). Without it you can also elevate your homocysteine levels (a promoter of hardening of the arteries ) and that’s no fun either. It is essential to the development of the blood and nervous system. A condition called “stocking and glove” parasthesia (pins and needles or numbness in those areas) may occur. (I hate it when my gloves are numb). To be absorbed in the gut, B-12 needs something called “intrinsic factor”, enough calcium present, and proper ph, (acidity, so stay away from the TUMS) . Iron, calcium, and B-12 WILL NOT get absorbed in an alkaline (non-acid) stomach. What school did those Antacid research guys go to anyway?? NOTE: Taking Folic Acid can mask a B-12 deficiency on a blood test however so don’t do this at home without your mother er, a professional standing by to monitor you. Both B-12 and folic acid deficiencies show up in your blood as macrocytic anemia. Macro meaning BIG, and cytic meaning cell, tells you that big (immature) blood cells aren’t a good thing. B-12 is found in milk, eggs and red meat so a deficiency is rare, medium rare, or well done, whatever. WHO gets this? VEGETARIANS can be at risk for low B-12 therefore, so we Docs monitor, (or should), your neurological (nerve) symptoms with that fact in mind. There can also be musculoskeletal symptoms called “shortening of the myofascial sheath”, that must be addressed with, again, things you should not self treat with from a health food store, so I won’t go into it here, and they never heard of it there. Also, alcoholics and those with digestive diseases such as Crohns, are subject to low B-12. Since Red Blood Cells (RBC’s) live 120 days (4 months for arithmetically impaired folks) then supplementation should be for at least that amount of time and then another blood test would be smart, assuming you had one to BEGIN with. NOT FOR YOU IF: you have an eye condition called Lebers Disease B-12 can make it worse. Recent studies show a link between H. Pylori, the bacteria that causes ulcers, pernicious anemia and B-12 deficiency. Taking care of the infection can allow B-12 to be absorbed again and fix the problem. Listen up menopausal gals: Memory loss, fatigue, and confusion should be worked up with blood (for anemia) tests and salivary hormone tests to make sure we’ve covered all the bases. Ten to 15% if those over 60 are affected by a cobalamin (B-12) deficiency, which is one of many reasons I like to do a history, physical, and giving my “spit kit” before treating menopausal problems. B-12 shouldn’t be taken with hot foods; take 1 hour before or after. Heat or moisture will break it down. RDA 2 mcg’s; Ha ha. Therapeutic dose 1000 mcg’s. Whew  




"Vitamin B12 deficiency in Australian residential aged care facilities," Mirkazemi C, Peterson GM, et al, J Nutr Health Aging, 2012; 16(13): 277-80. (Address: G. Peterson, Unit for Medication Outcomes Research and Education, School of Pharmacy, University of Tasmania, Private Bag 26, HOBART, Tasmania 7001, Australia. E-mail: G.Peterson@utas.edu.au ).
Summary: In a study involving 130 residential aged care facility residents in southern Tasmania, Australia, without a prior diagnosis of vitamin B12 deficiency or recorded serum B12 level within the previous 6 months, 14% were found to be vitamin B12 deficient (serum <150 pmol/L), 36% were equivocal (150 pmol/L to 250 pmol/L), and 50% had normal serum B12 levels (>250 pmol/L). Supplementation with a multivitamin was associated with an increased mean serum B12 (+137 pmol/L), while anti-psychotic medication was associated with decreased mean serum B12 (-70 pmol/L) level. The authors conclude, "As vitamin B12 deficiency can manifest in a range of symptoms that are frequently misdiagnosed, the finding of undetected deficiency in 14% of residents is a cause for concern. Oral multivitamin supplementation may help prevent deficiency, and potentially treat existing deficiencies in older institutionalised people."
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August 11, 2016
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Joanne Gjelsten

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