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Bone Fractures, Lung Cancer, and Vitamin B12 Supplements?

The AHA! Team — Fri, 14 Feb 2025 06:21:08 +0000

Michael Greger M.D. FACLM via Nutrition Facts – What do randomized controlled trials of high-dose daily vitamin B12 supplementation show about its effects on cancer risk, death, and longevity? In 2019, “Association of High Intakes of Vitamins B6 and B12 from Food and Supplements with Risk of Hip Fracture Among Postmenopausal Women in the [Harvard] Nurses’ Health Study” was published. Note, though, that only the combined high intake of vitamins B6 (≥35 mg/day) and B12 (≥20 mcg/day) was associated with an increased hip fracture risk. We know that treatment with high doses of vitamin B6 may increase hip fracture risk on its own. After a decade or so, those who had been taking high-dose (40 mg) B6 supplements had about a 40 percent higher hip fracture risk, but not those taking B12, as you can see below and at 0:35 in my video Do Vitamin B12 Supplements Cause Bone Fractures and Lung Cancer?. That’s what the Harvard study found, too. High intake of vitamin B12 alone was not associated with increased risk. In fact, some observational studies suggest a slightly lower fracture risk at high B12 blood levels. What we care about most, though, are interventional studies, where people are randomized to B12 so we can see what happens, and when we look at those, we find there is no increased fracture risk among those given B12. In conclusion, based on randomized controlled trials, high doses of vitamin B12 have not been shown to be associated with the risk of fractures. Okay, but what about this? In 2017, a study found that men taking vitamin B12 supplements appeared to have increased lung cancer risk. Now, the researchers didn’t find any such association in women, and the increased risk was mostly among men who smoked. Could it be that B12 was feeding budding tumors? It’s hard enough imagining a vitamin being carcinogenic on its own, especially if it somehow only affects men and not also women. “Replication of these ﬁndings in additional prospective studies with careful measurement of B vitamin supplement use is warranted.” And, indeed, when you put together all the observational studies, there is no signiﬁcant correlation between lung cancer and levels of B12 in the blood, whether you’ve smoked or not. If anything, most studies seemed to trend towards higher B12 levels being protective, as you can see below and at 2:03 in my video. Then, in 2018, a new study found an association between overall lung cancer risk and higher circulating levels of B12, again appearing to be more of a concern with smokers, as seen here and at 2:16 in my video. Now, this was another observational study. Those with higher B12 levels were just observed to have higher cancer levels. Those of you who have been following my work know the drill: There are two potential issues that arise in observational studies that prevent us from ascribing cause-and-effect: confounding factors, also known as “lurker variables,” and reverse causation. What might be a lurker variable in this case? What might be a third factor associated with both higher B12 levels and cancer that may be the true cause? Well, who has higher levels of B12 circulating in their blood? Those who eat a lot of meat and dairy, which are, in fact, “the most important contributors to serum vitamin B-12,” that is, B12 in our blood. And those who eat more meat do tend to have more lung cancer: “Dose-response analysis showed that consumption of red meat for 120 g per day might increase the risk of lung cancer by 35%, and consumption of processed meat for 50 g per day might increase the risk of lung cancer by 20%.” So, we’re generally talking about 35 percent more risk for every quarter-pound burger eaten each day and about 20 percent increased risk for every breakfast sausage link. It’s no wonder those with higher B12 levels in their blood could have more lung cancer. The B12 could just be a marker for meat intake. And, if you remember, reverse causation is when X may not lead to Y, but, instead, Y may lead to X. So, instead of high B12 blood levels leading to cancer, maybe cancer leads to high blood levels of B12. And, indeed, nearly 75 percent of patients diagnosed with cancer exhibit elevated B12 levels. So, elevated B12 levels may simply be a marker for cancer. Besides taking extra B12, there are all sorts of reasons your levels can rise, such as liver problems, kidney problems, bone marrow problems, and cancer, as you can see below and at 3:50 in my video. So, high B12 levels may just be a marker of brewing, but not yet diagnosed, cancer. What about observational studies specifically linking B12 supplement use to lung cancer, though? Those could also be reverse causation: “The consequence of being at risk for cancer is that patients will engage in healthier behaviors, including taking multivitamins (reverse causality). The well-established causes, such as smoking, chronic obstructive pulmonary disease, and previous cancers, are the real lung cancer risks.” So, we’re left with this “chicken or the egg causality dilemma,” which is why, ideally, we need randomized controlled trials to see if there’s any cause and effect. This became even more urgent with genetic evidence suggesting that those born with higher lifelong levels may be at increased risk. Thankfully, as you can see below and at 4:47 in my video, we do have randomized controlled trials—more than a dozen randomized controlled trials randomizing thousands of people up to 2,000 micrograms of B12 every single day for years, in fact. The findings? “Vitamin B supplementation does not have an effect on cancer incidence, death due to cancer, or total mortality.” And this includes specifically looking at lung cancer, as seen below and at 5:02 in my video. In fact, if anything, vitamin B supplements may actually lower the risk of the most dangerous form of skin cancer. If you missed my previous video, check out Do Vitamin B12 Supplements Cause Acne?. For my other B12 updates, see related posts below. All of these videos can be found in one digital download: Latest Vitamin B12 Recommendations. I’ve also explored vitamin B12’s role in stroke risk. See the related posts below. That series is available for digital download, too: Why Do Vegetarians Have Higher Stroke Risk?. Key Takeaways High intakes of vitamins B6 and B12 together are associated with an increased risk of hip fractures in postmenopausal women, but high B12 alone does not increase this risk. High doses of vitamin B12, based on randomized controlled trials, have not been shown to increase the risk of fractures, unlike high doses of vitamin B6. Some studies suggest that B12 supplementation may be linked to an increased risk of lung cancer in men, particularly smokers, though this association has not been consistently observed. Higher B12 levels in observational studies might be linked to higher meat consumption, which could be the true cause of increased cancer risk, rather than B12 itself. Elevated B12 levels may indicate underlying health issues like cancer, rather than being a direct cause of cancer, highlighting the importance of distinguishing between correlation and causation. To read the original article click here.

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The 411 on Vitamin B12

The AHA! Team — Fri, 13 Sep 2024 09:11:30 +0000

Michael Greger M.D. FACLM via Nutrition Facts – We cannot mess around with getting vitamin B12. If we don’t get enough, we may face a wide range of disorders of the gut, blood, brain, and nervous system. Vitamin B12 is not made by plants or animals, but by microbes blanketing the earth. We presumably used to get B12 when we drank out of a mountain stream or sipped water from a well, based on studies showing vegetarians in developing countries who drink purified water appear to be at higher risk. Now, we typically chlorinate our water supply to kill off any bacteria. So, most of us don’t get a lot of B12 in our water anymore, but we don’t get a lot of cholera, either. That’s a benefit of living in a much more sanitary world. Vegetarians living in slums in lesser developed regions appear to have fewer B12 problems, though. Basically, the more hygienic our meals, the less B12 we get. Our fellow great apes, like gorillas, get all the B12 they need eating their own feces. I prefer supplements. So, how much should we get, which type is best, and how can we tell if we have a B12 deficiency? The Benefits of Vitamin B12 We cannot mess around with getting vitamin B12. If we don’t get enough, we may face a wide range of disorders of the gut, blood, brain, and nervous system. Many case reports detail ways B12 can be life-changing. For instance, a 47-year-old woman had a five-year history of psychosis. She had been treated with antipsychotic drugs and was cognitively impaired and reported visual hallucinations. After her mother revealed that the patient had been following a strict vegan diet for seven years, vitamin B12 supplementation was started, and her symptoms went away. She had lost years of her life lost in a psychotic haze—apparently just because she didn’t want to take a supplement. Vitamin B12 supplementation is mandatory for anyone eating plant-based diets and, as I’ll discuss later, for every one of us from age 65. Vitamin B12 Deficiency: Symptoms and Treatment As I discuss in my video The Symptoms of Vitamin B12 Deficiency, it can cause everything from abdominal distention and chronic diarrhea to shortness of breath and swollen, red, painful feet. It can also cause Parkinson’s syndrome–like symptoms, skin darkening (that resolved with supplementation), and bilateral useless hand syndrome, a condition I had never heard of before. Being deficient in B12 may also manifest in a variety of neurological symptoms—for example, numbness and tingling in the hands and feet, muscle cramps, dizziness, cognitive disturbances, difficulty walking, and erectile dysfunction—as well as fatigue and such psychiatric symptoms as depression along with psychosis. How can B12 deficiency be treated? Either with B12 supplements or B12-fortified foods. Suggested Vitamin B12 Dosage The ofﬁcial position of associations and governmental agencies is categorical and unequivocal: Supplementation of vitamin B12 is required for anyone on a vegetarian diet—even when consuming eggs and dairy—and I would extend that to include flexitarians eating only a few servings of meat a week. Who else should ensure they have a regular, reliable source of vitamin B12 by supplementing their diet with B12 supplements or B12-fortified foods? Those who’ve had bariatric surgery (which can sometimes impair absorption), those eating plant-based diets, and everyone from the age of 65. As I discuss in my video The Optimal Vitamin B12 Dosage for Adults, adults younger than 65 should take at least one 2,000 mcg (µg) supplement once a week, ideally as a chewable, sublingual, or liquid supplement taken on an empty stomach, or at least one 50 mcg (µg) daily supplement. As we age, our ability to absorb vitamin B12 may decline. So, for those 65 and older, the supplementation should probably be increased up to 1,000 mcg (µg) each day, as I discuss in my video The Optimal Vitamin B12 Dosage for Kids, Pregnancy, and Seniors. Pregnant and breastfeeding women can just follow my 50 mcg (µg) a day recommendation for nonpregnant adults or take 2,000 mcg (µg) a week, perhaps split into two doses to boost absorption. After infants are weaned, they can start on 5 mcg (µg) a day. From ages 4 through 10, kids can take half the adult dose of 25 mcg (µg) a day, then they can take 50 mcg (µg) a day or 2,000 mcg (µg) a week from age 11. Note that these doses are specific to cyanocobalamin, the preferred supplemental form of vitamin B12. (I discuss cyanocobalamin versus methylcobalamin below.) The Best Food Sources of Vitamin B12 If you need supplemental B12 but don’t want to take supplements, you must rely on B12-fortified foods––eating three separate servings of B12-fortified foods a day, each ideally containing at least 190 percent of the “Daily Value” on the product’s nutrition facts label. As I discuss in my video The Healthiest Food Sources of Vitamin B12, B12-fortified nutritional yeast is a common food source, and there are all sorts of other B12-fortified options on the market, including plant-based meats and milks, breakfast cereals, and even energy drinks. The Worst Food Sources of Vitamin B12 What about various algae-type products, like spirulina, which are advertised as natural vitamin B12 sources? Not only do they not actually contain B12 that’s useable for humans, they may contain B12 analogues—look-alike molecules that can even block your absorption of real B12! Can Vitamin B12 Cause Side Effects? You don’t have to worry about taking too much vitamin B12. It’s water-soluble. So, at worst, you’ll just end up with more expensive pee. Injectable forms, though, can trigger acne. Methylcobalamin vs. Cyanocobalamin There are two main types of vitamin B12: methylcobalamin, marketed as methyl B12, and cyanocobalamin, typically marketed as just vitamin B12. Methylcobalamin is more expensive so it must be better, right? Wrong. As I discuss in my video The Best Type of Vitamin B12: Cyanocobalamin or Methylcobalamin, cyanocobalamin is the most used form, thanks to its high stability. Methylcobalamin is less stable and particularly susceptible to being destroyed after exposure to light. The one major exception may be kidney failure, though. Methylcobalamin may be better for those with impaired kidney function. It’s been speculated that oral methylcobalamin or injected hydroxycobalamin may also be preferable in smokers, though it has yet to be conﬁrmed. To read the original article click here.

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This Modern Fad Is Making You Sick

The AHA! Team — Mon, 22 Jul 2024 08:26:47 +0000

Al Sears, MD, CNS – The government declared war on fat almost 50 years ago. And as a result, we got slower, sicker, and fatter. In fact, the results of this big fat lie “led to some pretty disastrous consequences…that caused Americans to get fatter.” Those are the words of one of the most famous nutritionists in the world. Dr. Walter Willett, Chair of the Department of Nutrition at the Harvard T.H. Chan School of Public Health, was one of the first mainstream physicians to admit that the campaign to eliminate fat in the diet was a big mistake. But lately, he’s shifted gears. And today, he’s declared war on meat. I couldn’t disagree more… We come from hunter-gatherers who evolved over millennia to thrive on meat. We have canine fangs like dogs and wolves. These teeth are meant to rip and tear flesh from animals. Being a vegetarian is a modern fad. It was the brainchild of Reverend Sylvester Graham. He believed that all of America’s moral failings could be traced back to an “unholy diet.” So he created a strict meat-free meal plan that would “cure” the country of its “immoral urger.” He preached a gospel of fruits, vegetables, and whole-wheat crackers that would eventually bear his name. But Graham and his followers got it wrong. Big time. They didn’t understand that humans are born meat eaters. And that being vegetarian takes a real toll on your health. When vegetarians give up meat, they force themselves to get the bulk of their calories from wheat or other grain products. So they wind up eating more bread, pasta, cereals, and other processed foods. Being vegetarian takes a real toll on your health In other words, they eat a lot of junk. Sound familiar? It’s the same thing that happened with the war on fat. For more than 20 years, I’ve seen firsthand the health problems of vegetarians in my practice. I’ve found that vegetarians: Have low energy and feel frail Get sick more often and age faster Have poor digestion and weaker bones Can’t produce growth hormones, testosterone, and thyroid hormone Have low sperm counts and more fertility problems And despite what Dr. Walter Willett declares, vegetarians don’t live longer… An important study in the American Journal of Clinical Nutrition looked at data from two studies of more than 60,000 people in the U.K. It found no difference in mortality rates between vegetarians and meat eaters.1 And despite what you hear from the mainstream media, studies show vegetarian diets don’t lower the risk of heart disease2 or cancer.3 But a plant-only vegan diet does cause genetic mutations that increase the risks for both heart disease and cancer.4 The latest research shows that eating a plant-based diet also makes you depressed,5 increases your risk of broken bones,6 and decreases phospholipids.7 Phospholipids are vital for a healthy brain. You see when you don’t eat meat, it’s impossible to get many of the essential nutrients you need every day. If you were – or still are – eating a plant-based diet, you’re missing out on a number of key nutrients. Here’s how to get a few of them back: Supplement with B12. This vitamin, so vital to humans, is only found in meat. While some vegetarians claim that B12 can be found in algae, tempeh (a soy product sometimes used as a meat substitute), or even brewer’s yeast, these are false assumptions. I recommend at least 100 mcg per day. But I advise many of my patients to take as much as 2,000 mcg, especially if they are vegetarians. Replenish your zinc. Most vegetarians have a zinc deficiency. This is a problem. You can’t have a well-functioning immune system without this antioxidant. It also reduces your risk of metabolic syndrome, age-related macular degeneration, osteoporosis, and memory loss. I recommend taking 30 mg a day. CoQ10: CoQ10 is only found in animal products. You’ll find high concentrations of this heart- and brain-critical nutrient in organ meats. But you’ll also get it from the meat itself. CoQ10 supplies your cells with ATP, the energy required by every cell in your body for metabolism, energy production, and life itself. I recommend at least 50 mg of ubiquinol CoQ10 every day. This form is eight times more absorbable than conventional CoQ10. To Your Good Health, Al Sears, MD, CNS References: 1. Appleby P, et al. “Mortality in vegetarians and comparable nonvegetarians in the United Kingdom.” Am J Clin Nutr. 2016 Jan;103(1):218-30. 2. Kaiser J, et al. “A systematic review of the association between vegan diets and risk of cardiovascular disease.” J Nutr. 2021 Jun 1;151(6):1539-1552. 3. “Does being a vegetarian lower your risk of cancer?” https://www.wcrf.org. 2020. Accessed on May 24, 2023. 4. Caspermeyer J. “Are we what we eat? Evidence of a vegetarian diet permanently shaping the human genome to change individual risk of cancer and heart disease.” Mol Biol Evol. 2016 Jul;33(7):1887-8. 5. Kohl I, et al. “Association between meatless diet and depressive episodes: A cross-sectional analysis of baseline data from the longitudinal study of adult health.” J Affect Disord. 2023 Jan 1;320:48-56. 6. Webster J, et al. “Risk of hip fracture in meat-eaters, pescatarians, and vegetarians: results from the UK Women’s Cohort Study .” BMC Med. 2022 Aug 11;20(1):275. 7. Menzel J, et al. “Dietary and plasma phospholipid profiles in vegans and omnivores—results from the RBVD study.” Nutrients. 2022 Jul; 14(14):2900. To read the original article click here.

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Is AMPK an Age-Reversing Powerhouse?

AHA Publisher — Mon, 26 Oct 2020 07:00:58 +0000

Al Sears, MD, CNS – Recently, the Institute for Aging Research at Albert Einstein College of Medicine announced they’re starting a six-year study to test the life-extending properties of metformin on 3,000 older adults. As someone who is interested in health and longevity, I’m sure you’ve heard that some anti-aging specialists hail this diabetes drug as an “anti-aging miracle.” Not only do I disagree, I warn my patients not to take it. And I certainly don’t consider [a] popular diabetes drug to be any kind of anti-aging miracle. Like many drugs, metformin works in the short term. But most diabetic patients end up taking it forever… Metformin comes with a long list of side effects — ranging from mild to severe. These include nausea and vomiting, diarrhea, dizziness, fatigue, sinus infection, heart failure, muscle pain and flu-like symptoms. And over time, metformin blocks your body’s ability to absorb vitamin B12.1 B12 is critical to your health. So why would someone willingly take a pharmaceutical when they don’t need it? Many people — including doctors — believe metformin is an anti-aging powerhouse because it can boost levels of an enzyme called AMP-activated protein kinase (AMPK). AMPK truly is an anti-aging wonder. Found in every cell in your body, it functions as an energy sensor… and turns on when your cellular energy levels are low. It’s often referred to as your “master metabolic switch.” Your body produces energy in its mitochondria. This energy is called adenosine triphosphate, or ATP. It fuels everything your body does. As the energy-creating process gets going, ATP is converted into AMP (adenosine monophosphate), which tells the cell it needs more fuel. That’s when AMPK gets moving, jumpstarting the transport of glucose and fats to your mitochondria so it can make more ATP. The problem is that as you age, AMPK activation slows down. That means less ATP and more malfunctioning cells, which leads to inflammation and disease. Low ATP production is the reason you slow down as you age. But when AMPK is activated, your cells jump into survival mode. Your body no longer stores new fat, but burns fat already in storage. It also boosts insulin resistance and pumps glucose into cells from the blood so they can make more ATP. That’s why AMPK is such a powerful weapon against diabetes. At the same time, it builds new mitochondria to provide your cells with even more energy. This, in turn, boosts cellular efficiency and improves the function of organs and tissues. AMPK has also been shown to: Improve cognitive function Reduce cancer risk Lower inflammation Protect against cardiovascular disease In an animal study at the University of California, scientists found increasing AMPK lengthened lifespan 30%. And the animals stayed energized, healthy and active much longer!2 But there are much better ways to boost AMPK than by taking a synthetic drug. I recommend my patients supplement with the “vine of immortality” — a member of the cucumber family known as Gynostemma pentaphyllum. In China, researchers discovered that a tea made from G. pentaphyllum is key to the surprising number of centenarians on one region.3 Today, we know it works by promoting AMPK activity. I recommend taking 150 mg a day in capsule form. Or you can drink the tea like the centenarians do… Live Better, Longer With “Immortality” Tea Bring water to a boil Add 6 grams of G. pentaphyllum leaves Let the brew steep for 10 minutes Pour tea into cup through a strainer and enjoy To Your Good Health, Al Sears, MD, CNS 1. Ahmed MA, et al. “Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy.” BMC Pharmacol Toxicol. 2016;17(1):44. 2. Ulgherait M, et al. “AMPK modulates tissue and organismal aging in a non-cell-autonomous manner.” Cell Rep.2014;8(6):1767-1780. 3. Blumert M and Liu J. China’s Immortality Herb. Badger, California: Torchlight Publishing, Inc. 1999. This article has been modified. To read the original article click here. For more articles from Al Sears, MD click here.

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