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Ep70 – The Micronutrient Series: Water Soluble Vitamins Part 3 (Vitamin B)

Updated: Jan 30, 2023


Hello, I’m Katie Bradbury, a nutritional therapist and registered nurse. Today’s podcast episode is called The Micronutrient Series – Water Soluble Vitamins – Part Three.


So hello, and welcome to today’s episode. I really hope that you’re doing well. I am continuing this episode with the final instalment of the vitamins section of my micronutrient mini-series. Now, that might be a bit of a mouthful, and it might not sound particularly exciting. If you’re on a fertility journey, and you’re new to the podcast, you might want to start an episode that feels more relatable to you in terms of where you’re at right now. I’ve got plenty of previous content, including things such as how gut health relates to fertility, and I’ve got episodes on pregnancy loss, I’ve got lots of episodes on nutrition and nutrition as a whole and its impact on fertility. I’ve got episodes on stress and the impact of disordered eating and vaginal health and sperm power. So lots and lots of things to choose from. If you’re a bit of a ‘Fertility and the first 1000 days’ podcast connoisseur, then this is absolutely the right place for you. And even if you’ve got an in-depth knowledge or an in-depth interest in nutrition, then this could be really interesting for you. So the micronutrient mini-series, I’ve been just shining the spotlight on the micronutrients. So the micronutrients, mainly we’re thinking about the vitamins and minerals – and there are lots and lots of different vitamins and minerals. I’m slowly working my way through them because I speak a lot about the balance of the macronutrients in terms of carbohydrates, proteins and fats. I speak a lot about proportions – what sort of proportions on a plate we should be looking at, ideally in terms of those three food groups and how vegetables fit into that as well. But really, within that are these little superheroes, which are the micronutrients and the micronutrients are responsible for hundreds or thousands of processes within the body. That includes for fertility; whether that’s to do with hormone synthesis, whether it’s to do with egg health, whether it’s to do with gene transcription when we’re actually creating a baby, whether it’s to do with any kind of chemical messaging within the brain. Each of the micronutrients has a super important role to play and if you’ve been listening to the micronutrient series, within this podcast so far (because I have already covered the fat-soluble vitamins, so vitamins A, D, E, and K, and I’ve covered most of the water-soluble vitamins, so vitamin C, and I gave a bit of an overview of the B vitamins last episode) if you have been listening to that so far, then hopefully you’re starting to get an idea of the importance, individually, of some of these nutrients. So it really is a matter of letting no man be left behind when it comes to these micronutrients. I’m hoping that these episodes, will help you to reflect on what your current nutrient intake looks like at the moment. I’m not thinking about supplements here; I’m thinking about diet, I’m thinking about what you’re actually consuming because we always need to be thinking about nutrition first, the diet always comes first and the supplements are there to supplement that. So thinking about your own diet and hopefully, this might help you, this micronutrient mini-series, to identify whether there might be any possible nutrient, even if not nutrient deficiencies then nutrient insufficiencies, like not getting enough for your needs from a fertility point of view. So without further ado – I said last episode that there are quite a few B vitamins, so we’ve got B1, B2, B3, B5, B6


B9 and B12, so there are quite a number of them – and rather than shine the spotlight on every single one of them as an individual in each episode as I’ve done in the previous episodes, because the B vitamins, as I explained last week, work really well collectively together. That’s why they’re often found in a B complex in supplements and in vitamin products. And there’s a lot of overlap, there’s a lot of crossover in the roles they play. So overall, as I said, last week, we’re thinking about energy production, we’re thinking about gene transcription. And I thought I’d just follow last week’s episodes, where I gave a bit of an overview on the B vitamins as a whole, I thought I’d just shine the spotlight this week on three of my favourite B vitamins because I do have favourites. And these are ones that I’m often thinking about in the context of fertility, and they’re often ones that I’m wanting to ensure are found in adequate amounts for my fertility clients. And I often check the levels of some of these B vitamins using blood testing. So starting from B6, whereas I explained last week, about the B vitamins as a whole being linked to energy production and metabolism, and I guess, being quite excitatory in that respect for our cells, B6, although it is involved in energy production, it’s genuinely seen as quite a calming micronutrient. And the reason for that is because it’s linked in with our neurotransmitter production. And it’s specifically it’s a bit of an enzymatic precursor to serotonin, which is, you know, it’s quite, it’s a bit of a happy hormone, I guess. And so, I’m often thinking about vitamin B6. And I’d love to know if this is you because this is a lot of my clients. And a lot of my clients are really caught up in their heads. And that’s easily done when you’re on a fertility journey, because it’s a rough ride, and I get that, but lots of the people that come to me as one-to-one clients are, and I’m the same I’ve done a lot of work on this, but my predisposition, is to be quite high anxiety and lots of people are and so if you are typically a bit of an anxious person, and especially if you get anxious or angry even around the time of your menstrual cycle, so you know, in that premenstrual period, then I’m often thinking about B6 for those kind of clients. And wondering whether their B6 might be either a bit on the low side because of dietary intake, or because they’re using it up a little bit faster. And because of that anxiety disposition, so B6, that’s why it’s one of my favourites because it is quite a calming one and it’s often overlooked as well. So B6 in terms of its, of course, it does still do all those other functions around helping to convert food into energy. It helps to make red blood cells as well which is super important. And critically, it helps to maintain and these three super B vitamins if you like these B6, B9 folate and the B12 that I’m talking about today, these all worked together really beautifully these three to help maintain normal levels of homocysteine in the blood. Now homocysteine is an inflammatory marker. So when homocysteine is elevated over time, for various reasons, it can contribute to long term inflammation and it is a risk factor for cardiovascular disease and those big killers in the modern world.


Now I know this podcast isn’t about kind of cardiovascular disease and overall health. However, if you listen back to my most quoted podcast in the series, which is the fire that stops you from getting pregnant, we can really pinpoint that inflammation and various inflammatory mechanisms over time is really one of the key drivers that we want to be minimising, we really want to be dampening down those inflammatory responses when we’re thinking about fertility, because when we’re thinking about if the body is inflamed for whatever reason, then it’s going to be prioritising that, because inflammation is critically associated as far as that on a cellular level with a threat to life. And so our body will always be prioritising the threat to life over reproductive health. So we want to be keeping inflammation in check. And so these three B vitamins work together to actually help recycle homocysteine into another product called methionine, which in turn turns into a product called SAM-e, which is called a methyl donor, which just helps in the methylation process, which is responsible for normal hormone production and general metabolism, detoxification and gene transcription. So all of those things, all of those processes are really important in the context of fertility, the three super B vitamins that I’m talking to you about today, the B6, B9 and B12, they all work together to help to normalise levels of homocysteine in the bloodstream and thus lower inflammation. So good sources of B6 include fish, so things like salmon, tuna, halibut, any kind of fish really, but those three are probably the highest. Poultry – so chicken, turkey, duck, and also nuts. So hazelnuts, walnuts, pistachios, those are all really nice sources of vitamin B6. So to move on to vitamin B9, which is folate, so I do have a whole podcast episode related to folate in a previous one. So this is a bit more of a snapshot of folate, but if you do want to hear more about the importance of folate, and how critical it is for reproductive health, please do go back and listen to that episode. I’ll link to it in the show notes. But folate, vitamin B9, you may know it as folic acid. So lots and lots of people do supplement with folic acid and indeed the NHS recommendations of everyone who’s trying to get pregnant to supplement with folic acid for at least three months before trying to conceive. And the reason for that is because of this link. And it’s actually because of this link to that methylation process that I just mentioned. But how that plays out is, it was found in the research, that people who had lower levels of folate are at higher risk for having birth defects, namely neural tube defects like spina bifida. So as a preventative measure for that the NHS guidelines is to take 400 micrograms of folic acid prior to conceiving to help reduce the likelihood of that, now, that is a bit of a contentious issue. I’m not going to sit here and talk about the debate between folate and folic acid today. If you want to know more about that, feel free to talk to me come and join my free Facebook group ‘Fertility and the first 1000 days’ and we can definitely get the conversation started in there about the difference between folate and folic acid. The key difference just to briefly touch on it is that folate, or 5-methyltetrahydrofolate (5-MTHF) is the natural and active form of folate. So if you take folic acid, it has to be converted into 5-methyltetrahydrofolate in the body in order to do what it needs to do within the methylation cycle.


And what a lot of people have going on is that they have genetic variants. So up to 40% of the population have genetic variants, which can impact their ability to actually convert that well, from folic acid, which is the synthetic form, into folate, or 5-methyltetrahydrofolate, which is the active form. Now, whether that applies to you or not, we don’t know – things that I run in my practice to help us ascertain that include doing DNA testing, so we actually facilitate people to run genetic tests in my practice to see whether they have these predispositions but also just testing the levels of folate in the blood as well. So these are all a really important part of your clinical picture. So before any of you run to go and take really high doses or choose which form is right for you, just from listening to this podcast, please know that it is different for everyone. And I couldn’t possibly tell you in this podcast, which would be right for you. If anyone does want to explore that, though, if anyone is interested in looking at testing, for fertility in these kind of really in depth ways and wants to get really specific nutrient advice for them as an individual, then please do get in touch. There’s a link to book a call with me in the show notes if you want to talk about what it might look like to work with me. So the folate I’ve kind of given an overview there. So congenital abnormalities, neural tube defects, DNA transcription, again, modulating that impact of homocysteine and in the blood so that, that inflammation, all really really important part of the picture for folate, so super important. So specifically really important for the DNA synthesis, support cell growth and repair. And unlike a lot of the other B vitamins, folate is actually linked to the the Latin word, which escapes me now off the top of my head, but it links to the Latin word for foliage. And so when we’re thinking about folate, it actually is found a lot more in plant foods compared to the other B vitamins. So things like dark green leafy vegetables are just lovely forms of folate. And also legumes, so things like beans, peas, and lentils. Any of your dark green leafys are going to be really great sources of folate. Folate is quite depleted in the population at large. So lots of products out there like cereals, breads, etc, are actually fortified with folic acid as well, just for your information. So that’s it for folate, that’s kind of like an overview of folate, and you can start to build this picture now of the way that these three vitamins work together. And then vitamin B12 is great, I love vitamin B12. Again, it’s really, really associated with that energy production. But also, it is very much involved in the methylation cycle that I just described. And as that relates to homocysteine and gene transcription and everything else. But it also is an interesting one, because it takes a lot to actually absorb vitamin B12. Once you consume vitamin B12, it has to go through a hell of a process, starting in our stomach, that kind of breaks it down and then something else sticks to it and carries it to another place and then that needs to be broken apart. And then lots of lots of different actions have to happen before it’s actually transported into the cell in its usable form. And what that really means is that our digestive health, and particularly our stomach acid, really needs to be on top form to actually absorb vitamin B12. And again, there are genetic predispositions that actually impact our ability to methylate vitamin B12, our ability to convert it into that usable form. And so, in some people, it’s all very well and good having enough vitamin B12 in your diet, but if you’re not absorbing it properly, then we really do need to be thinking about that.


So inadequate levels of vitamin B12 can actually cause inflammation in the gut as well so is very much linked with the gastrointestinal tract, and so vitamin B12 and folate as well are linked to a type of anaemia as well in terms of our red blood cells, called megaloblastic anaemia, so if we have folate deficiency or vitamin B12 deficiency, then sometimes that can present then with this megaloblastic anaemia. And if we’ve got any conditions, any kind of anaemia, regardless of the cause, then we really do want to be addressing that before pregnancy, because anaemia in pregnancy your blood volume increases by one and a half times and your blood is there to actually nourish your baby in utero. We really really do want to make sure that there isn’t any anaemia happening before you even get pregnant. So it’s definitely something that’s worth looking at. So, vitamin B12 absorption or ability to absorb does also decrease with age because stomach acid tends to decrease with age. So it’s just worth noting that as well. So really, as I say, thinking about the stomach acid. Again, to sound like a broken record, these three together do impact this homocysteine metabolism, and help to keep that inflammation in check. It’s also involved in neurotransmitter reduction as well. So really important picture in terms of that. As with the B6, in terms of anyone who has that anxiety presentation, then I’m always wanting to test B12 as well. The other thing to say or to note about B12 is that it is involved in hormone production. And indeed, people who have been on the oral contraceptive pill for years and years and years are often depleted in the B vitamins by the time they come off and particularly B12. So overview of B12: It helps to make red blood cells that’s why it’s linked to anaemia, required for proper nerve function and helps to maintain normal levels of homocysteine in the blood. Lots of people who have numbness in the their extremities or tingling in their extremities – that can often be linked with vitamin B12 deficiency as well. So if that is you, then it’s always worth getting your B12 levels tested. Another point is that over the counter antacids, so any medicines that are there to help with heartburn that actually reduce your stomach acid, as I said at the start, because you need adequate stomach acid to actually start that B12 absorption process, and the over the counter antacids will impact vitamin B12 absorption as a result of that. So as I say symptoms of B12 deficiency include low energy, tingling and numbness in the extremities, nerve damage and memory loss even, so it’s really important to note, so in terms of sources of B12. Vitamin B12 is only found in animal products. So what that means is that if you are a vegan, unless you’re supplementing, and unless you’re having foods that have B12 added in, then you will not be getting any. So seafood is really good source of B12, poultry, red meat again. So more or less any animal product is going to contain some vitamin B12. So really, just be mindful of that, that if you’re on a vegan diet, that is something that we need to look out for. And typically this often happens that, vitamin B12, we can store vitamin B12 in our body. And usually after about a couple of years, our B12 stores will run out if we’re not consuming it.

23:33 So lots of people who move on to a vegan diet feel really, really great at first because they’re naturally having a lot more plant foods. And so lots of people feel really great at first and then after a couple of years, the energy levels will plummet, they’ll be like ‘what is wrong with me, I felt so good when I started doing this’. And actually that is the reason why, typically speaking is because their B12 stores have run out. And once they run out, then they’re not getting any through the diet. So really interesting stuff. B6 is not something that you typically get tested in your blood, but folate is and so is B12. And those are tests that I run really commonly with a lot of my clients. So I will always do comprehensive blood testing as standard with all of my one to one clients so that we look at this. And it’s really important to get a unique picture of where you’re at, so that we can take you as a whole individual person into account and make a plan that is suitable for where you are at and the messages that your body is telling us. So overall, I hope that’s been helpful. That really wraps up the vitamins as a whole. It’s been a real pleasure to come and talk to you. I hope you can tell that a lot of this was the real bread and butter of my studying nutrition. We went into so much depth about the vitamins and I just find it fascinating. I really do. So I hope that you have found it interesting too. And I look forward to coming back and speaking to you next time, where I’ll be starting to talk about some of the minerals which believe you me are equally as exciting! So I will speak to you again soon. Have a lovely, lovely week and take care. Bye bye

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