Maximizing Methylation: The Key to Healthy Aging

TAKING JUST A FEW vitamins CAN optimize the function of ALL your body’s systems. It’s
true. But you have to know what to take and you have to know why these supplements
work …
That’s why, in this week’s blog, I am going to discuss one of the most important biochemical
processes for long-term health and how you can keep it running at its very best with
supplements and other measures.
Unfortunately, many people suffer from one or more of the 8 factors that negatively impact
this biochemical process, so problems in this area are widespread though many don’t
realize they are suffering.
The good news is that there are MANY things that you can do right now to optimize this
critical biochemical process that may have a dramatic impact on your health. In today’s blog
I will review the 8 factors that can lead to problems in this area, and outline 12 tips that will
help you optimize this essential part of your biology.
But first, I’d like to tell you about two of my patients with seemingly unrelated health
problems that were actually caused by a breakdown in this biochemical process. And I want
to share a study done on Chinese babies who had a birth defect known as spina bifida.
You’ll be amazed at how all three — my two patients and these Chinese babies — were
affected by the exact same thing …
Interestingly, these Chinese babies, Mr. Roberts, and Mr. McNally all have something very
important in common. They all have inadequate levels of specific vitamins, either acquired
or genetic, …
What an Elderly Golfer, a College Professor, and Chinese Babies have in Common
One of my patients, Mr. Roberts, was an 88-year-old businessman who didn’t let his age
slow him down. He still golfed three times a week, worked two days a week, flew around
the world in his private jet, and was “romantic” once a week with a wife 30 years his junior.
He also loved his 6 ounces of Grey Goose vodka every night.
Of course, he did have some health problems. Mr. Roberts had been treated well for mild
heart disease. His doctor even recommended 800 mcg of folic acid and 250 mcg of vitamin
B12 — megadoses by any standard.
Mr. Roberts also had a check-up at the Mayo Clinic and was told that he was healthy,
despite having mild anemia and large red blood cells. Yet he still complained of mild fatigue
and trouble with his short-term memory. Plus, I noticed a slightly wide gait common in
someone with poor balance.
Then there was Mr. McNally, a Boston college professor who was 50 years old, fit, and lean
but wore a worried look as he walked into my office.
He recounted the sad tale of his 7 brothers. Four had died of a heart attack and three
others had had bypass operations at a young age. Concerned about his own fate, he ate a
low-fat diet, exercised regularly, didn’t smoke, had normal blood pressure and cholesterol
levels, and took antioxidants and a multivitamin. Perhaps his only vice was the multiple
Starbuck’s grande lattes he downed each day. Living under a constant state of impending
doom, Mr. McNally came to me asking for a stress test to see how his heart was doing.
Strange as it may seem, these two men reminded me of my time in China. When I lived in
Beijing, a study was done on a group of women in Harbin, the northern most industrial city
in the Gobi desert, just north of Beijing. It seemed that there was an unusually high rate of
birth defects in the area, specifically spina bifida.
The Chinese have a tradition of holding weddings during the Chinese New Year in
February. In Harbin, many of the babies born 9 months later had birth defects. This study
 sought to determine what the link was and found that the major factor was the lack of fresh
greens or vegetables in the Gobi desert in the middle of winter.
Interestingly, these Chinese babies, Mr. Roberts, and Mr. McNally all have something very
important in common. They all have inadequate levels of specific vitamins, either acquired
or genetic, and their methylation systems are not working properly as a result. I’ll explain
more about what “methylation” is in a second. First let’s analyze the similarities in these
cases.
Take Mr. Roberts. Our romantically active 88-year-old took high doses of B vitamins. But he
still had very high levels of homocysteine and methylmalonic acid — indicators of folic acid
and B12 deficiency.
Mr. McNally had similar problems. Our college professor had a genetically sluggish
metabolism of homocysteine which caused extremely high levels of this toxic amino acid to
build up in his blood. This was the likely cause of all the heart disease in his family.
Again we see a similar set of problems in those Chinese babies. Their mothers were
conceiving in the middle of winter — when their folate intake was low from the absence of
fruits and vegetables. This is what triggered such a high rate of birth defects.
The common link in all three of these cases is a problem with methylation. Let me tell you
more about that that actually means.
Methylation is a key biochemical process that is essential for the proper function of almost
all of your body’s systems. It occurs billions of times every second; it helps repair your DNA
on a daily basis; it controls homocysteine (an unhealthy compound that can damage blood
vessels); it helps recycle molecules needed for detoxification; and it helps maintain mood
and keep inflammation in check.
To keep methylation running smoothly you need optimal levels of B vitamins. Without
enough B vitamins methylation breaks down, and the results can be catastrophic. In these
cases we see more birth defects like spina bifida (as with the Chinese babies), more cases
of Down’s syndrome, and more miscarriage.
A breakdown in methylation also puts you at higher risk for conditions like osteoporosis,
diabetes, cervical dysplasia and cancer, colon cancer, lung cancer, depression, pediatric
cognitive dysfunction ( mood and other behavioral disorders), dementia, and stroke. And
like Mr. Roberts and Mr. McNally, you may be at higher risk for cardiovascular disease.
To avoid all of these problems, the key is to maximize methylation. That means avoiding
the things that cause your methylation to break down, testing to find out how well your
methylation is working, and including the things that support proper methylation. Let’s look
at how to do that.
8 Factors that Affect Your Methylation Process
1. Genetics – Like an estimated 20 percent of us, you could be genetically predisposed to high
homocysteine
2. Poor diet – The word “folate” comes from “foliage.” You need to eat plenty of leafy greens,
beans, fruit, and whole grains to get adequate levels of vitamins B6 and B12, betaine, and
folate. Egg yolks, meat, liver, and oily fish are the main dietary sources of vitamin B12 — so
long-term vegan diets can be a problem. Plus, certain compounds can raise levels of
homocysteine and deplete the B vitamins. These include excess animal protein, sugar,
saturated fat, coffee, and alcohol. Irradiation of food depletes nutrients, so foods treated this
way may be lower in B vitamins, too
3. Smoking – The carbon monoxide from cigarette smoke inactivates vitamin B6
4. Malabsorption – Conditions like digestive diseases, food allergies, and even aging can reduce
absorption of nutrients
5. Decreased stomach acid – Aging and other conditions can reduce stomach acid — and
therefore absorption of vitamin B12
6. Medications – Drugs like acid blockers, methotrexate (for cancer and arthritis and other
autoimmune diseases), oral contraceptives, HCTZ (for high blood pressure), and Dilantin (for
seizures) can all affect levels of B vitamins
7. Other conditions – These include hypothyroidism, kidney failure or having only one kidney,
cancer, and pregnancy
8. Toxic exposures – Some toxins can interfere with vitamin production
Watch out for these factors and you will go a long way toward protecting your methylation.
Measuring Your Own Methylation Process
To find out if your methylation process is optimal, ask your doctor for the following tests:
 Complete blood count – Like our friend Mr. Roberts, large red blood cells or anemia can be a
sign of poor methylation. Red blood cells with a mean corpuscular volume (MCV) greater than
95 can signal a methylation problem
 Homocysteine – This is one of the most important tests you can ask for. The normal level is less
than 13, but the ideal level is likely between 6 and 8
 Serum or urinary methylmalonic acid – This is a more specific test for vitamin B12 insufficiency.
Your levels may be elevated even if you have a normal serum vitamin B12 or homocysteine
level
 Specific urinary amino acids – These can be used to look for unusual metabolism disorders
involving vitamins B6 or B12 or folate, which may not show up just by checking methylmalonic
acid or homocysteine
12 Tips to Optimize Your Methylation Process
Just as there are many causes of poor methylation, there are lots of things that support its
proper functioning. Here’s how to maximize methylation — and prevent conditions like heart
disease, cancer, dementia, depression, and more.
1. Eat more dark, leafy greens – You want to eat l cup a day of vegetables like bok choy, escarole,
Swiss chard, kale, watercress, spinach, or dandelion, mustard, collard, or beet greens. These
are among the most abundant sources of the nutrients needed for optimal methylation
2. Get more Bs in your diet – Good food sources include sunflower seeds and wheat germ
(vitamin B6); fish and eggs (vitamin B6 and B12); cheese (B12); beans and walnuts (vitamin B6
and folate); leafy dark green vegetables; asparagus, almonds, and whole grains (folate); and
liver (all three)
3. Minimize animal protein, sugar, and saturated fat – Animal protein directly increases
homocysteine. Sugar and saturated fat deplete your body’s vitamin stores
4. Avoid processed foods and canned foods – These are depleted in vitamins
5. Avoid caffeine – Excess amounts can deplete your B vitamin levels
6. Limit alcohol to 3 drinks a week – More than this can deplete your B vitamin levels
7. Don’t smoke – As noted above, smoking inactivates vitamin B6
8. Avoid medications that interfere with methylation – See notes on this above
9. Keep the bacteria in your gut healthy – Take probiotic supplements and use other measures to
make sure the bacteria in your gut are healthy so you can properly absorb the vitamins you do
get
10. Improve stomach acid – Use herbal digestives (bitters) or taking supplemental HCl
11. Take supplements that prevent damage from homocysteine – Antioxidants protect you from
homocysteine damage. Also make sure you support methylation with supplements
like magnesium and zinc
12. Supplement to help support proper homocysteine metabolism – Talk to your doctor to determine
the best doses and forms for you. Here are a few suggestions:
Folate (folic acid): Amounts can vary based on individual needs from 200 mcg to 1 mg. Some
people may also need to take preformed folate (folinic acid or 5 formylTHF) to bypass some of
the steps in activating folic acid
Vitamin B6: Take 2 to 5 mg a day. Some people may need up to 250 mg or even special
“active” B6 (pyridoxyl-5-phosphate) to achieve the greatest effect. Doses higher than 500 mg
may cause nerve injury
Vitamin B12: Doses of 500 mcg may be needed to protect against heart disease. Oral vitamin
B12 isn’t well absorbed; you may need up to 1 or 2 mg daily. Ask your doctor about B12 shots
Betaine: This amino acid derivative is needed in doses from 500 to 3,000 mg a day, depending
on the person
By working to optimize your methylation you can protect yourself from virtually all the so
called “diseases of aging.” When you do, you will be well on the road to lifelong vibrant
health.
Now I’d like to hear from you …
Do you have symptoms of poor methylation?
What are you doing to optimize this process?
Do you take B-vitamin supplements? Have you noticed any results?
Please share your thoughts by adding a comment below.
To your good health,
Mark Hyman, M.D.