Introduction to Biochemistry Part One Objectives: Evaluate the benefits and risks of each vitamin discussed. Describe various deficiency symptoms or disorders.

Introduction to BiochemistryPart One

Objectives:• Evaluate the benefits and risks of each vitamin discussed.• Describe various deficiency symptoms or disorders.• Explain common causes of deficiency.• Predict which deficiency exists based on the symptoms given.• Explain the need for each vitamin.• Research vitamin and mineral information.• Explain the interaction vitamins have with other substances.

Vocabulary:

Vitamin * beta-carotene * thiamin * biotin * macronutrients *

micronutrients * minerals * synthesis * leukemia * retinol *

retina * glucogenesis * Kreb’s cycle * beriberi * edema *

normochromic normocytic anemia * eclampsia * nicotinic acid *

metabolism * homocysteine * oral * topical * anemia *

spina bifida * pituitary * thymus * adrenal glands * scurvy *

scorbutus * rickets * osteoporosis * osteomalacia *

coagulation * hemoglobin * ATP

Introduction to Biochemistry All life requires organic molecules. Proteins, fatty acids, and

carbohydrates are considered macronutrients because we need them in large quantities.

Other organic molecules, like vitamins, are also needed but in smaller quantities so they are known as micronutrients. Finally, inorganic

substances such as many of the metals, or minerals, listed in the periodic table are also needed for life and are part of our needed micronutrients.

Vitamins were originally considered vital amines (amino acids) but it was later found that they were not all amines. Minerals are metals but for use by animals, they are usually complexed with specific anions.

Vitamins often act as coenzymes, indirectly supplying energy for life by helping to drive metabolic reactions, usually transferring electrons or protons. Some vitamins are fat soluble, such as A, D, E, and K. These require fat in order to be absorbed by the intestines. These can also be stored in our body fairly easily. All of the rest of the vitamins are water soluble and are not stored well so need to be replaced regularly through our diet.

Vitamin A is important for bone growth, reproduction, membrane integrity, vision, and cell division and differentiation. It also plays a role in the immune system through cell differentiation into white blood cells and by helping lymphocytes fight infections more effectively. True vitamin A is also known as retinol (an alcohol) or retinal (an aldehyde). Notice the similarity between “retinal” and “retina” (the part of your eye with rods and cones for vision). Retinal is needed to transmit light sensations in the retina. It binds to a protein called “opsin” to form “rhodopsin” (visual purple) which allows rod cells to transmit in low light levels. One of the first signs of vitamin A deficiency is night blindness. Severe deficiency can lead to total blindness and the deterioration of all membranes and skin. This opens the way for diseases and early death. Retinoic acid, combined with protein, binds to chromosomes in the nucleus where it regulates the rate of transcription and the synthesis of some proteins. Retinoic acid also acts on thyroid hormone receptors and vitamin D receptors.

Vitamin A is needed during fetal limb development, and for formation of the

heart, eyes, and ears. And, it regulates the expression of the gene for growth

hormone. Vitamin A is also important for forming red blood cells through

myeloid stem cell differentiation in the bone marrow. It also likely helps move

iron from storage sites to developing RBC’s for use in the hemoglobin portion

responsible for carrying oxygen. In fact, some people diagnosed with iron

deficient anemia do not improve with iron supplementation until vitamin A is

also added.

Zinc is also extremely important. If it is low, retinol binding protein, which

carries retinol throughout the body to the tissues (like the retina of the eye), will

see a decrease in synthesis (manufacture). Zinc is also needed to convert

retinol to retinal for use in the eye.

Women who were HIV positive and deficient in vitamin A were 3 to 4 times

more likely to transmit HIV to their infants. There is also a strong link to death

from measles and vitamin A deficiency. A mutation of receptors for retinoic

acid has been found in one form of leukemia (proliferation of immature white

blood cells). High vitamin A supplementation sometimes helps.

Because vitamin A is a fat soluble vitamin, it can be stored in our body. We can actually get too much, although this is not very common. Too much vitamin A, just like too little, can cause birth defects. Some prescriptions, such as accutane for severe acne, are similar to high levels of vitamin A and can cause severe birth defects even months after stopping the prescription. Other risks of hypervitaminosis include liver problems, decreased bone density (possibly leading to osteoporosis), nervous disorders and dry itchy skin. To avoid any chance of toxicity, many vitamins contain beta-carotene instead of true vitamin A. Beta-carotene is considered a provitamin. Beta-carotene can be converted by MOST people to vitamin A. It takes about 12 mcg of beta-carotene from food to make 1 mcg of retinol. Beta-carotene in oil converts at about a 2:1 ratio. There are more than 560 carotenoids but less than 10% of these can be converted to vitamin A. Of these beta-carotene converts at the highest ratio. Lycopene and lutein are important anti-oxidants in the carotene family that do not convert. (Both are good for the eyes, etc.) One IU (international unit) equals 0.3 mcg. of retinol. An upper daily limit of 10,000 IU of retinol is considered safe for most non-alcoholics or people without liver or cholesterol problems.

Thiamin (old spelling = thiamine) or vitamin B1 (aneurine) is a water soluble vitamin. Water soluble vitamins are not stored in large quantities by the body. A deficiency leads to beriberi which is characterized by burning feet sensations (peripheral neuropathy), exaggerated reflexes, numbness and weakness in the arms and legs, muscle pain/weakness, rapid heart rate, an enlarged heart, difficulty breathing, edema (severe swelling), abnormal eye movements, lack of coordination, memory problems/amnesia and possibly seizures. Not all symptoms are present in individuals with beriberi. For free thiamin to become a coenzyme, it requires magnesium. This coenzyme is needed to extract energy from food. Thiamin is also part of an enzyme required for synthesis of DNA, RNA, ATP (our energy source), and NADPH. Thiamin, as thiamin triphosphate, is needed for cell membrane ion channels in nerve cells and muscles. Without the movement of sodium and potassium ions, for example, across membranes, normal nerve and muscle function is prevented. Congestive Heart Failure patients can experience better left ventricular ejection with thiamin supplementation. Alcoholism, HIV, and diets high in carbohydrates but low in thiamin (ex: rice based) are major reasons for deficiency. Cancer cells have a high need for thiamin. Cancer patients may be deficient but supplementing is controversial.

Riboflavin, or vitamin B2, is a water soluble vitamin needed in many

coenzymes (ex: FAD in the electron transport chain), called flavins and in

enzymes called flavoproteins. Riboflavin helps produce energy through

oxidation-reduction redox reactions. It’s needed for protein, carbohydrate, and

fat metabolism (breakdown of a substance in order to maintain life). It is also

needed to breakdown drugs and other toxins.

Other vitamins, such as vitamin B6, niacin, and folic acid, require

flavoproteins for use by the body. These vitamins, in turn, are needed in other

enzymes. So, a riboflavin deficiency can impact many other vitamins and their

enzymes. It can also indirectly (through folate) affect the formation of

methionine (amino acid) from homocysteine (a nasty indicator of potential heart

attack). So, riboflavin, along with the other B vitamins, can decrease blood

homocysteine levels and, therefore, the risk of heart attack.

Riboflavin deficiency alters iron metabolism and can be the cause of

decreased hemoglobin. Supplements sometimes help recovery from “iron-

deficient anemia”.

Usually, if a person is deficient in riboflavin, they are also deficient

in other water soluble vitamins. Riboflavin deficiency symptoms

include: sore throat; cracks/sores on the outside of the lips (cheliosis)

and corners of the mouth; an inflamed tongue mouth, and throat lining;

moist, scaly skin patches (seborrheic dermatitis); blood vessel

formation over the clear cornea covering of the eye; higher risk of pre-

eclampsia (high blood pressure, proteinuria, and edema during

pregnancy) and decreased red blood cell count (normochromic

normocytic anemia - meaning the RBC’s that are formed have normal

amounts of hemoglobin giving them the usual red shade of color and

they are of normal shape and size. There are just fewer RBC’s than

normal.) Migraines and cataracts might also increase with deficiency.

Alcoholism, anorexia, lactose intolerance (milk is a good riboflavin

source), hypothyroidism, adrenal insufficiency, increased sweating from

hard labor or sports, or light therapy can increase risk of deficiency.

Niacin, also known as B3 or nicotinic acid. Because nicotinic acid sounds

too much like nicotine, a harmful substance, the name was changed using the

“ni” from nicotinic, the “ac” from acid, and the “in” from vitamin.

Nicotinic acid reacts with myoglobin (in muscles) and hemoglobin to make

the reddish color very bright. So, it’s sometimes used on ground meat to make

it look fresher.

The liver can make niacin from the essential amino acid tryptophan but it

requires 60 mg of tryptophan and ample vitamin B6 and riboflavin to SLOWLY

make only 1 mg of niacin.

Niacin deficiency is almost always accompanied by riboflavin deficiency.

Symptoms of deficiency include diarrhea, fatigue, headache, emotional

instability, memory loss, decreased cold tolerance, and poor appetite. Severe

deficiency is known as pellagra and includes dermatitis, dementia, and death.

Deficiency can be induced by the anti-tuberculosis drug, Isoniazid.

Niacin is used to decrease cholesterol (particularly LDL) and increase HDL.

It is important for metabolism. Over 200 enzymes require niacin coenzymes

like NAD and NADP which accept or donate electrons for redox reactions.

High doses of niacin are sometimes prescribed for high cholesterol. Excess

niacin can cause flushing of the skin and burning/tingling of the feet. This

occurs because high doses can trigger histamine release. Histamine is the

same chemical that swells respiratory tissues in allergies and asthma. Another

form, niacinamide, doesn’t cause flushing but isn’t effective against high

cholesterol.

Pantothenic acid, also called vitamin B5, is needed for coenzyme A (CoA).

CoA is needed to generate energy from food and for the synthesis

(manufacture) of steroid hormones, cholesterol, acetylcholine (a

neurotransmitter), and melatonin, an antioxidant that is also associated with a

good night’s sleep but can cause SAD (seasonal affective disorder) when too

much is present during the daytime. The liver also requires CoA in order to

break down drugs and other toxins. CoA is also needed for the production of

fatty acids called sphingolipids (part of the myelin sheath around nerves) and

phospholipids (cell membranes).

Wounds heal faster and have stronger scar tissue when pantothenic acid is

taken orally (by mouth) and applied topically (on the skin) as pantothenol.

Pantethine, another form of pantothenic acid, can reduce cholesterol and

triglycerides. Some reports suggest pantothenic acid can help fight acne.

Acne may be due in part to fatty acids and other lipids depositing under the skin

and forming sebum if not enough CoA is present to properly metabolize them.

However, HUGE doses of pantothenic acid are required to counter acne and

this success is based on a single study which was not a controlled double-blind

experiment.

High doses are not known to be toxic but can cause diarrhea. There may

be an increased need for pantothenic acid (and other B vitamins) due to use of

birth control pills.

Vitamin B6, or pyridoxine, is important for: sodium/potassium balance; production of red blood cells (heme) and their ability to pick-up and release oxygen, RNA, and DNA; homocysteine control (heart attack trigger); blood sugar control (especially for gestational diabetes); the production of neurotransmitters such as serotonin and dopamine, the ability to block steroid hormones like estrogen and testosterone from affecting gene transcription (cancer prevention), melanoma (skin cancer) inhibition, immunity and the thyroid’s ability to use iodine. (Candida prevents B6 from becoming active.) Vitamin B2, riboflavin, is needed to activate pyridoxine. Therefore, a riboflavin deficiency could lead to a pyridoxine deficiency. In addition, for homocysteine control, B12 and folic acid are needed along with vitamin B6. Alcohol consumption, hormone replacement therapy, birth control pills, cortisone use and antidepressants can increase the need for B6. This vitamin is needed for over 100 enzymes in the body involved with protein metabolism. A deficiency can lead to decreased antibody production, dermatitis (skin inflammation), tongue soreness, depression, anemia (literally this means “without blood”), irritability, insomnia, acne, asthma and allergies, kidney stones, bone changes such as osteoporosis and arthritis, headaches or migraines, chapped lips, ridged nails, and possibly carpal tunnel syndrome. Pyridoxine is also needed to make niacin in our bodies. Excessive B6 can cause neuralgia (painful tingling) in the arms and legs.

Biotin, also known as B7, or vitamin H, is a water soluble vitamin with the

formula C10H16N2O3S. (Notice that it has all of the components of a protein but

they are not arranged to form an amine group and a carboxyl group.) Biotin is

required to convert amino acids and fats into carbohydrates (glucogenesis), for

making fatty acids, and for metabolizing (the ability to use) leucine (an essential

amino acid) in the body. It is important in the Krebs Cycle, the process where

energy is released from food. Biotin is also needed to maintain a steady blood

sugar.

Biotin levels tend to be low in type II diabetics. Brittle nails and hair can benefit

from supplementation. Babies born with cradle cap might be biotin deficient.

Deficiency symptoms include: dry skin, hair loss, fine & brittle hair, rashes,

numb or tingling extremities.

Biotin is abundant in egg yolks but egg whites contain “avidin” which binds to

biotin IF the egg whites are not cooked (Heat denatures avidin, which is a

protein, so it no longer binds biotin). Biotin forms a complex with the amino

acid lysine in the body. An enzyme is needed to break this bond to use the

biotin which is recycled but not at 100%.

Folate, or folic acid (B9), is needed for DNA, RNA, and protein synthesis. It helps prevent damage to and helps regulate the expression of the genome through its use in DNA replication and repair. It forms yellowish orange crystals. Folate deficiency may allow more uracil (an RNA base) to be incorporated in DNA. A deficiency in pregnant mothers can lead to the birth of babies with spina bifida (the spinal nerve protrudes outside of the vertebral column). Neural tube closure usually occurs about 24 to 28 days after conception so the woman might not even know she is pregnant when the damage is done. Recently, spina bifida babies have been born at a higher rate in moms using tanning booths. It is now believed that UV light can destroy folate in the body. However, the problems associated with low folate might all be related to high homocysteine. Low folate is the most common cause of high homocysteine,

although B6 and B12 also play a role. Induced high homocysteine levels in animal studies have been shown to cause neural tube defects. About 10% of the human population has a defect in an enzyme needed for folate metabolism.

As a result, they have high homocysteine levels. The defect is caused by a single amino acid substitution from alanine to valine!

Folate deficiency symptoms include a certain type of anemia (similar to B12

anemia), fatigue, weakness, headache, palpitations, shortness of breath, a sore

tongue, high homocysteine, cramps, increased risk of cardiovascular disease,

Alzheimer’s, depression, and increased risk of cancer.

Alcohol use can impair folate absorption and metabolism. Problems with

digestion, like Crohn’s disease or celiac disease (sprue), can also cause a

deficiency state. Low folate is associated with cerebral cortex atrophy in the

brain.

People with major depression, who do not respond well to antidepressants

have frequently been found to be low in folate. Schizophrenics are often found

to be low in folate (many are also found to have sub-clinical gluten intolerance

which upsets absorption of many nutrients from the intestines.) Some limb

defects and facial clefts might be due to folate deficiency.

Folate might also help prevent oxidation of LDL (bad) cholesterol which is

believed to only clog arteries when it is oxidized.

Folic acid might reduce zinc absorption.

Vitamin B12, cobalamin, contains cobalt, giving it a reddish color. B12 is very complex and is similar to hemoglobin, chlorophyll, and cytochromes. B12 works with folate to make DNA and RNA and to keep them safe from defects. “Bad” bacterial overgrowth in the small intestine and certain tapeworms can cause a deficiency by competing for the B12 in your diet. Low stomach acid or low “intrinsic factor” can cause inability to absorb B12 from our diet. Elderly people often need B12 shots in order to get adequate amounts. People with chronic fatigue or HIV might have problems absorbing B12. Along with vitamin B6 and folate, B12 helps convert homocysteine to methionine. This reduces the chance of a heart attack. B12 can also combine with sulfite, reducing sensitivity to it. A deficiency of B12 can result in a specific type of anemia (similar to the anemia from folate deficiency) and/or neurological problems such as tingling and numbness of the extremities (especially the legs or toes), irritability, altered balance, memory problems (including Alzheimer's), Babinski’s responses (toes extend upward instead of curl when the bottom of the foot is tickled), vision problems, and age related hearing loss. Alternating diarrhea and constipation, flatulence (gas), increased breast cancer risk, burning tongue sensation, anorexia, shortness of breath and palpitations also can occur. One type of congenital blindness due to cyanide exposure (cigarettes) is more common with B12 deficiency. B12 in forms other than cyanocobalamin, can help detoxify cyanide.

Vitamin C, or ascorbic acid, can also come in other forms like ascorbyl

palmitate. Except for this palmitate form, vitamin C is water soluble. Vitamin C

is concentrated (100 x more than in the blood plasma) in the pituitary (master

control for the endocrine system), adrenal glands (fight or flight response),

thymus (T cells for the immune system), and retina (part of the eye). Vitamin C

is also in fairly high concentrations in the brain, spleen, lung, thyroid, liver,

pancreas, kidney, etc.

Vitamin C is also needed to synthesize (make, manufacture): collagen for

blood vessels, tendons, ligaments, and bone; norepinephrine; and ,carnitine

which is needed to transport fatty acids into the mitochondria for use as energy. A deficiency of vitamin C can lead to: easy bruising, loose teeth, poor

healing ability, low immunity, and mild anemia. Severe deficiency is known as

scurvy. Scurvy (also known as scorbutus) can lead to severe internal bleeding

(hemorrhaging) and death. Sailors at sea for long periods without fresh fruit

(cooking can destroy vitamin C) often died from scurvy. The AMA did not like

vitamin C being named “ascorbic acid” (against or “anti” scorbutus) because it

implies a cure for scurvy. Limes were grown in one of the British holdings so

were readily available to sailors which were then called “limeys”.

There are claims that vitamin C helps prevent or shorten a cold’s duration.

Best results are probably seen when vitamin C is taken frequently throughout

the day rather than in one large dose since its half life in the blood is only about

30 minutes. Linus Pauling proposed that a combination of vitamin C, lysine,

and Vitamin B3 (niacin) could help heart disease and reverse arterial plaque

build-up.

Vitamin C can help prevent lead poisoning by possibly binding to it and

removing it from the body (chelation). This might also happen when vitamin C

and selenium are taken together. We need selenium, so that’s not good in this

case. Vitamin C is believed to help the absorption of iron.

Vitamin C might help fight some cancers but large doses taken by mouth

can cause diarrhea so intravenous therapy might be more beneficial. Also,

ascorbic acid is acidic and can alter pH so it is often recommended as calcium

ascorbate, sodium ascorbate, or magnesium ascorbate instead.

Vitamin C is so important to life that most animals make their own.

Primates, guinea pigs, some fish, some birds, etc. cannot. We have only 3 of

the 4 necessary enzymes to make vitamin C.

Vitamin C is also believed to be necessary for the prevention of cataracts.

It can help dilate blood vessels with as little as 500 mg. This can lead to a

blood pressure drop of as much as 9% if taken regularly for 4 weeks.

Birth control pills are known to lower vitamin C levels in blood plasma and

white blood cells (immune system). Aspirin can also lower vitamin C levels by

increasing its excretion.

Large doses of vitamin C can cause certain medical tests to give false

positive or negative readings. These include: serum bilirubin, serum

creatinine, and occult blood tests. Large doses can also give false negatives

for glucose, nitrate, and/or bilirubin on urine dipstick tests.

Vitamin D, is actually a group of vitamins numbered D1 through D5 . In

humans, D3 is the active form and is also known as cholecalciferol. This is a fat

soluble vitamin. We can make vitamin D if we are exposed to 10 - 15 mins. of

sunlight when the sun is high in the sky (about 1 pm) but only during the

summer in northern latitudes like Wisconsin. (UVB rays are needed for vitamin

D synthesis.) This also assumes we have enough cholesterol (the vitamin D

precursor) and a healthy liver and kidneys because these organs are needed to

convert vitamin D to its active form.

Vitamin D, by maintaining correct levels of calcium and phosphorus in the

blood, is needed for bone growth. It promotes calcium absorption. Vitamin D

is also needed for a strong immune system and for regulation of cell growth

and differentiation. It might also prevent some cancers and help treat psoriasis.

We also know that there are vitamin D receptors on pancreatic cells that

secrete insulin, so it may play a role in diabetes control.

Some scientists consider vitamin D a hormone, since we can synthesize it in

our bodies and it can act like steroids do. And, more than 50 genes in our

bodies are regulated by the active form of vitamin D.

The most obvious problems associated with vitamin D deficiency are rickets, osteomalacia, and osteoporosis. Rickets usually occurs in growing children. Their bones are soft and can easily bow due to poor mineralization from lack of vitamin D. Babies’ fontanels (the soft spot) may not close by the usual age and the ribs may be misshapen from the diaphragm pulling on these softer than normal bones. Osteomalacia is a similar problem in adults. Although bones aren’t growing in size, they are constantly torn down and rebuilt. If there is not enough vitamin D, re-mineralization will not occur and the bones have soft areas. Many cases of hip fracture in the elderly are due to osteomalacia rather than osteoporosis. Osteoporosis is when bones become brittle. This can be due to too little calcium being absorbed due to lack of vitamin D. Deficiency is also associated with “auto-immune” diseases like multiple sclerosis, rheumatoid arthritis, muscle weakness, and high blood pressure if it is due to too much renin (produced in kidneys) because D affects this gene’s expression. Vitamin D deficiency can be due to too little time in the sun or not enough D in the diet, poor kidney or liver function failing to convert it to its active form, intestinal problems (Crohn’s disease, etc.), lack of fat in the diet (fat soluble vitamin), prolonged steroid use (like prednisone), and obesity.

Vitamin E is also a fat soluble vitamin which is really a group of vitamins which includes 4 “tocopherols” and 4 “tocotrienols”. Alpha- tocopherol is the form most often considered “vitamin E” but gamma- tocopherol is gaining in importance as more research is being done. All forms seem to have some anti-oxidant effect. A deficiency of vitamin E in rats causes severe fertility problems. Deficiency could also lead to wasting (dystrophy) of the skeletal muscles and degeneration of the kidneys and liver. Deficiency in young children leads to the rapid development of neurological problems (adults show symptoms more slowly - these include loss of balance and coordination). Deficiency can lead to hemolytic anemia (red blood cells break apart). Vitamin E helps protect fats from oxidation and can actually be used commercially to help prevent fats/oils from going rancid. Our cell membranes are a bi-lipid (fatty) layer which require vitamin E to maintain their integrity. LDL cholesterol is also only considered harmful and sticky enough to cling to blood vessels when it oxidizes. Vitamin E prevents oxidation of low density lipoproteins (LDL) and therefore might help prevent cardiovascular disease. Vitamin C can help regenerate the ability of vitamin E as an anti-oxidant.

Vitamin K, another “group” of fat soluble vitamins, got its name from the German word “koagulation”. Coagulation is the ability to clump, or stick

together. Vitamin K1 from plants and K2 from bacteria are useful but synthetic

(man-made) K3 should not be taken in very large amounts by humans. Vitamin K is important to several proteins involved in blood clotting. Vitamin K is needed to bind calcium in 7 clotting factors in the series of reactions that occur in the body to stop bleeding. Bones also have at least 3 proteins dependent on vitamin K. A deficiency could lead to easy bruising, easy bleeding, nosebleeds, bleeding gums, blood in urine or stools, and heavier cycles in women. It may also impact bone mineralization (osteoporosis). While bones don’t mineralize well with a K deficiency, blood vessels tend to calcify. This decreases their

elasticity but increases the likelihood of heart attack or stroke. Vitamin K2

May be the most effective form for pulling Calcium from blood vessels and depositing it in the bones where it belongs. A deficiency may occur if there is liver damage (recycles K), if there is prolonged use of antibiotics, if warfarin/coumadin (a blood thinner and rat killer) is used, or if excesses of vitamin A are taken (interferes with absorption)

Choline is a member of the B family of vitamins. A deficiency of choline can lead to fatty build-up in the liver and cirrhosis (scar tissue) of the liver. Choline can help the liver burn fatty acids. The liver is unable to detoxify substances, metabolize proteins or carbohydrates, or regulate electrolytes when choline is deficient and the liver becomes fatty. Saturated fats are a double “whammy” to the liver because they are low in choline but add to the liver’s fat burden. Choline is part of normal cell membrane composition and repair, healthy brain function, and helps keep homocysteine low (along with folic acid, B6, and B12). It is essential for fetal brain development. A deficiency can cause cell death (apoptosis), especially in the hippocampus and septum area (memory processing) of the brain which often shows significant damage in Alzheimer’s disease. Choline and inositol are components of lecithin, a phospholipid needed to prevent fats from clumping. A decrease in the ratio between phospholipids and cholesterol seems to increase the risk of gallstones. People with gallstones often have only one third of the amount of phospholipid that healthy people have in comparison to their cholesterol level. Choline is also needed for the neurotransmitter, acetylcholine, platelet-activating factor and for phosphatidylcholine, another phospholipid. VERY high doses of choline can cause low blood pressure (hypotension).

Inositol (a sugar alcohol very similar to glucose) is a partner with choline in helping the liver deal with fats. It may also be beneficial for those with sugar/insulin balance problems (Ex: hypoglycemia or diabetes). People with renal (kidney) problems, multiple sclerosis, diabetes mellitus, etc. have altered production of inositol. It exists as 9 different isomers and is “related” to the B family of vitamins. It has some neurological effects, such as “relaxing” the nerves, just like the B vitamins. It affects the mobilization of calcium in the body which then helps control the release of neurotransmitters due to depolarization. Sodium and magnesium are also important to this function. People suffering from depression are often low in inositol. It has also improved cases of obsessive compulsive disorder, neonatal Respiratory Distress Syndrome Disorder (it decreases the stickiness of the lung lining in premature babies) and panic disorder at doses of 12 to 18 grams. Lithium (manic-depressive treatment) can deplete inositol in the brain. Increasing inositol intake may help alleviate some of the side effects of lithium treatment. Pregnant women should avoid inositol as it may induce contractions,

Other important nutrients include:

Carnitine - it helps burn body fat, decreases problems with heart rhythm

disturbances, protects the heart, improves high triglyceride and low HDL (good

cholesterol) levels, reduces lactic acid accumulation, helps metabolize

carbohydrates, prevents muscle atrophy, and protects kids against Reyes

syndrome. Carnitine can help with low energy levels and weight gain

tendencies of people with hypothyroidism. Kidney dialysis removes carnitine

from the body.

Lipoic Acid (aka thiotic acid) - this is the only antioxidant that is both water

and fat soluble. It helps with diabetic neuropathy, protects pancreatic cells and

the liver, and fights insulin resistance by stimulating cells to take up glucose,

inhibits HIV replication, and removes excess body copper (chelation).

Taurine - This amino acid does not get put into proteins. It can help balance

potassium and magnesium inside the cells and sodium outside, much like

diuretics but without harming the kidneys. Therefore, it can help with body

edema (swelling) and high blood pressure from excess fluid build-up (kidneys).

It also helps with macular degeneration, diabetes, digestion, arrhythmia,

epileptic seizures (MSG decreases taurine, so does estrogen), and asthma.