Why care about demyelination?

We need to care about demyelination as a society because it may be a factor underlying many conditions that have been occurring at increasing rates. The high cost of health care is not just due to the cost of individual medications or the price of hospitalization but is due to the additive cost of increased numbers of individuals needing care. Autism care alone is estimated to likely reach $500 billion by 2025 for care in the U.S. alone, (link), demyelination or disordered myelin formation is thought to be involved. Our food supply may provide calories but it may no longer be supporting health due to imbalance in some nutrients and lack of sufficient amounts of other nutrients – in addition to personal choices for some people leaning toward convenient and tasty foods that provide very few nutrients besides calories.

The other reason to care about demyelination as a society is because the early symptoms can occur for years without clear reasons and may disrupt relationships or the ability to hold a job – personality changes including anxiety and anger, paranoia and a short temper – problems with impulse control and the ability to follow through on planned actions or with communication and the ability to tell the truth instead of substituting other statements that may seem illogical and obviously far from the truth. Problems with impulse control and a tendency toward mood problems may also include an increased risk for suicide or self injury or violence towards others.

The medical research is complex and I haven’t seen all the loose threads together yet, so I will summarize my summary points in a more concise list here and am working on a more organized document elsewhere. This list combines my tips from the previous post with the work of the other summary article (22) — I was also given the link to another summary article which also has tips which I have not incorporated here. It provides an excellent overview about myelin production and function –selfhacked/myelin – what I and the authors of (22) and {selfhacked} have in common is that we all got sick and sought information about regaining our health for ourselves and are sharing the information in case it might help others.

My personal goal is to not become paralyzed (post: ALS & CBD receptors), number of clicks on a website is not something I pay attention to. The loose threads that I’ve woven together in this series of posts which are not included in the excellent selfhacked article are that a) many of the herbs or phytonutrients found helpful for myelin regeneration are Nrf2 promoting which is also important for myelin regeneration and/or reducing oxidative stress that may lead to more degeneration of myelin. b) Foods that are good for promoting Nrf2 often are also good sources of cannabinoids or phospholipids which can be protective. c) And preventing excessive cell death or excess intracellular calcium may decrease the excess production of cytokines by decreasing release of cannabinoids from cell membrane storage and their breakdown into arachidonic acid and eventual transformation into cytokines and other inflammatory chemicals.}: 

Strategies to help prevent the breakdown of myelin or help promote regeneration of myelin:

{In the past at different points in time, I personally have experienced and improved with supplementation or diet changes physical and mental symptoms of vitamin B1, B5, B6, folate and B12 deficiencies; iodine, magnesium, calcium and zinc deficiencies; vitamin/hormone D and calcium excess at a different stage of health;  cannabinoid/phospholipid deficiency; inadequate protein and general malnutrition due to the zinc deficiency which can greatly reduce appetite at one stage and due to severe bowel mal-absorption more recently; omega 3 fatty acid/omega 6 fatty acid imbalance; and also lack of sleep/melatonin and lack of oxygen/excess toxins in the air; health requires all of the nutrients and adequate oxygen, exercise, sleep and stress coping.}

  1. Vitamin B1, thiamin deficiency, chronic, severe – Wernicke’s encephalopathy may be more of a risk for severe alcoholics and people with anorexia – severe lack of appetite or the eating disorder anorexia nervosa.
  2. Vitamin B12 deficiency – may be more of a risk for people with low stomach acidity, due to older age or chronic use of calcium type antacids; or due to genetic reasons limiting production of Intrinsic Factor; or due to a vegan diet without supplementation of vitamin B12 or inclusion of Nutritional yeast flakes in the diet.
  3. Zinc deficiency (22or copper  excess (link).
  4. Adequate but not excessive lithium may increase myelin production. (22)
  5. Adequate but not excessive iron intake is needed for production of myelin.
  6. Magnesium deficiency or poor intestinal absorption of magnesium, or lack of adequate protein and phospholipids in the diet for the body to be able to store magnesium in the normal manner within the intracellular fluid.
  7. Inadequate calcium or vitamin D can be a factor but excessive intake of either can also be a factor in cell breakdown and risk of demyelination. If taking vitamin D as a supplement the vitamin D3 form may be most bioactive and taking vitamin K2 with it may help with myelin production (22) and protect against osteoporosis. Green leafy vegetables are good sources of vitamin K.
  8. Adequate intake of cholesterol is needed as a building block for our own production of vitamin D and other steroid hormones and as a building block for myelin. (22) Pregnenolone is a steroid hormone precursor that may benefit some people when used as a supplement. It and other steroid hormones are involved in signaling increased production of myelin. Testosterone insufficiency may also negatively affect myelin production. (22)
  9. Excessive intake of free glutamate or aspartate – excitatory amino acids that are commonly used as flavoring or sweetening agents in foods or may occur naturally in fermented foods or alcoholic beverages.
  10. Adequate protein is needed to support a variety of body functions in addition to supporting magnesium levels. Uridine is a nucleotide base (part of DNA that is a combination of a type of sugar and an amino acid) that is also is involved in energy metabolism, fasting occasionally may increase our own production (more info). Insufficient amounts may negatively affect myelin production and use as a supplement may help some people. (22)
  11. Insufficient calories to provide the body enough glucose to support mitochondrial health. They can use protein or fats for energy but it shifts the metabolism more towards oxidative stress.
  12. Occasional fasting and/or a low carbohydrate diet may help promote autophagy due to increased use of ketones for energy (22) but may cause health problems due to excess oxidative stress or an increased burden of nitrogen waste removal for the kidneys when followed long term.
  13. Lack of antioxidants due to lack of Nrf2 within the body to promote our own production of antioxidants internally; and/or lack of antioxidants within the diet, including vitamin C, (22), would decrease our ability to detoxify the reactive oxidative chemicals produced during normal metabolism or which are produced at increased rates when protein or fats are being used for energy instead of glucose.
  14. Use of the herb ashwagandha or Gingko biloba (22) may help protect against oxidative stress and protect against demyelination by promoting Nrf2. (ashwagandha & Nrf2) (an overview of Nrf2 metabolism, its potential benefits for conditions such as Multiple sclerosis, and Gingko biloba and pomegranate are mentioned as promoters of Nrf2: nutricology/newsletter, see first article) (other Nrf2 promoting phytonutrients/foods and menu ideas: G10: Nrf2 Promoting Foods.) Flavonoids are one of the groups of phytonutrients that helps promote Nrf2; and also may help protect myelin production. (22) Medicinal mushrooms, including Hericium Erinaceus, Lion’s Mane Mushroom,(22), may also help protect myelin production and prevent breakdown by reducing oxidative stress (link) and promoting Nrf2. (link)
  15. Having a healthy balance of omega 3 fatty acids and omega 6 fatty acids in the diet helps reduce risk of inflammation/oxidative stress and also helps us build healthy membranes which are necessary to control flow of minerals and other chemicals from the exterior to interior of cells and organelles such as the mitochondria.
  16. Inadequate iodine for healthy thyroid hormone production, (22); may be a combined problem of excess presence of bromide, fluoride and perchlorate in the diet or environment.
  17. Lack of oxygen due to poor air quality, or smoking, or health problems causing inadequate breathing function. Emotional or physical stress may also increase the need for oxygen or increase the tendency to hold our breath; Take ten deep breaths and think before you speak is good advice for any emotionally stressful situation because oxygen is needed to think rationally and we tend to hold our breath when we are upset.
  18. Avoid extreme physical and emotional stress.
  19. Avoid toxins.
  20. Get adequate sleep at night, and a brief nap during the day may be beneficial for some people. Melatonin helps promote myelin production and inadequate sleep and having lights on at night can disrupt our production of melatonin. (22)
  21. Adequate exercise (22) and stretching regularly helps move nutrients throughout the body and remove toxins in the lymphatic fluid for further detoxification and eventual removal from the body.
  22. Wear a helmet for any activity that may cause head trauma and avoid sports which may cause frequent closed head trauma and especially when helmets are not used (sorry soccer, football, hockey, (link), and boxing fans).
  23. Adequate phospholipid and other phosphonutrients or cannabinoids may be necessary to include from external sources if genetic differences or other health problems or age interferes with the body’s internal production capability. Dark cocoa products, cardamom powder, pomegranate and pumpkin seeds are a few legal dietary sources.
  24. Use of ibuprofen and/or ginger (approximately 1/2 teaspoon per day) may help prevent breakdown of our body’s supply of cannabinoids, breakdown of which may then lead to increased breakdown of cells and may then lead to increased degeneration of myelin.
  25. Lack of any B vitamins or genetic differences in the ability to remethylate folate and vitamin B12 may disrupt the ability of mitochondria to generate usable energy from glucose or proteins and fats, and may reduce production of myelin. (22) Inositol and choline may be particularly important for myelin production. They are considered to be in the B vitamin group but was discovered more recently than the numbered series of B vitamins. (22)
  26. Low Level Laser Therapy – I am not familiar with this, see #10: (22), but I have read elsewhere that certain types of light can stimulate activity levels. (Haier)
  27. Practice, practice, practice – new things. (22Myelin is produced in response to learning [45] so remaining mentally stimulated with new experiences and learning new topics or techniques keeps signalling the body to produce myelin. 
  28. Brain-derived Neurotrophic Factor, (BDNF), the brain’s growth factor, may help increase production of myelin by increasing production of brain cells, which include oligodendrocytes. (22) Ways to promote BDNF (link, from within 22) fortunately overlap with the strategies for protecting against demyelination already mentioned above or included in the list of Nrf2 promoting foods.
  29. Reducing exposure to electromagnetic fields (EMF) – energy leakage from laptops, smartphones, WiFi, televisions, and other strong sources of electicity may help protect against myelin degeneration. (22)

References and more details for some of this information were included in the last two posts:

  • Good News/Bad News about Multiple sclerosis Research (7/26/2018)
  • Demyelination, continued. (7/28/2018)

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./ 

Choline and betaine – water soluble nutrients

Choline is a newer discovery in the nutrient world. It is considered to be a member of the water soluble B vitamins group which are nutrients involved in metabolism – the use of energy within the body. We can produce small amounts of choline so it isn’t considered a vitamin but as we can not produce enough for health it is considered an essential nutrient. (1) Betaine is a slightly different form of choline. Choline is found throughout the body but is particularly important within the brain and is needed for the neurotransmitter acetylcholine. Betaine is a metabolite of choline.

Choline, a water soluble nutrient. Foods Sources and symptoms of deficiency.

Choline is most typically found within phospholipids (such as phosphatidylcholine) which are important in membranes and as messenger chemicals within the brain and in the immune system. It may play a role in prenatal brain development but research on supplementation within pregnancy r to protect cognitive skills in the elderly is still in early stages. (1)

Choline is a  methyl donor (1) which means it can share a methyl group – essentially one carbon atom with three hydrogen atoms with an overall neutral charge.

An important role of methyl groups is in the release of energy from sugar within mitochondria. The methyl group is passed back and forth between nutrients and enzymes that are involved in breaking down a molecule of fat or sugar for use of the stored energy that is released when a double bond is broken. The methyl group is combined with an acetyl group when it is removed from the area on the chain of carbon molecules when a double bond is broken. An acetyl group is an atom of carbon combined with one atom of hydrogen and the group has a negative charge. The process for breaking down the glucose sugar molecule is called the Krebs cycle and most beginning level organic chemistry or nutrition students will remember having to memorize all of the steps involved. My summary may be inaccurate – college was a long time ago – the important point is that B vitamins and methyl donors are needed for mitochondria to be able to release energy from glucose/sugar molecules).

  • (The Krebs cycle is also known as the “citric acid cycle or the tricarboxylic acid (TCAcycle.” More info: Krebs cycle.)

Methyl groups are also important in controlling gene activity. They act like an on/off switch for genes. A gene that is fully methylated – all the available double bonds between carbon atoms are broken into single bonds with a methyl group added instead – is in the off position, the protein that the gene would encode is not being made. Genes that are unmethylated have double bonds and are in the on position, the pattern for assembling amino acids into a protein can be read by a matching strand of RNA and the protein can be formed (generally in the endoplasmic reticulum or Golgi apparatus areas of a cell).

Betaine and the more familiar B vitamins folate (B9 if anyone is counting), B6 and B12 are also methyl donors. Folate deficiency has been associated with less gene methylation (a histone is part of a gene). (2) More about methyl donors as a group is available here:  Methyl Donors and BPA.

  • The number system for naming B vitamins was derived at an earlier stage of research and some of the chemicals that were given numbers at the time were discovered to not be essential nutrients – meaning the body was able to form them within the normal health and didn’t essentially need to have them included in the diet (so that is why we don’t hear about a B4, B8, B10 or B11).

Excessive intake of choline above 7500 milligrams may cause a drop in blood pressure, sweating, vomiting and digestive upset, and change in body odor. The recommended Upper Limit is 3,500 mg/day. It would be difficult to reach that amount with food sources. (Safety information, lpi.oregonstate.edu)

Food Sources of Choline:

Good sources of choline include meats, fish & shellfish, eggs/egg yolks, cheese, milk, yogurt, broccoli, cauliflower, cabbage, kale, kohlrabi and other cruciferous vegetables, green leafy vegetables, pomegranate seeds, sesame seeds, tahini, peanuts,  soybeans, beans, brown rice, whole grains.

Food Sources of Betaine:

Sweet potatoes, meats, cheese, beets, basil, spinach, green leafy vegetables, brown rice, whole grains.

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

References:

  1. Choline, Linus Pauling Institute, Oregon State University, http://lpi.oregonstate.edu/mic/other-nutrients/choline
  2. Benjamin A. Garcia, Zigmund Luka, Lioudmila V. Loukachevitch, Natarajan V. Bhanu, Conrad Wagner, Folate deficiency affects histone methylation,

    Medical Hypotheses, Volume 88, March 2016, Pages 63-67, ScienceDirect, https://www.sciencedirect.com/science/article/pii/S0306987716000116

  3. Foods used in the 30% Calories from Carbohydrates Menu Plans, https://effectiveselfcare.info/2018/05/19/healthy-hair-is-the-proof-of-a-healing-diet/

Pantothenic Acid – vitamin B5

Vitamin B5 is typically referred to by its chemical name Pantothenic Acid. Why some of the B Vitamins are called a name and some by the number may have to do with the variety of the forms commonly found in the body or in the food supply. Vitamin B6 has several important chemical forms as do vitamin D and vitamin E. Getting a variety of foods within the diet on a regular, daily, weekly or even monthly basis can help to provide some of the various forms. Vitamin E in a supplement might only provide one of the bioactive forms of the group of nutrients while eating nuts and seeds would be providing some of all of the group in addition to B vitamins and other minerals.

Pantothenic Acid – vitamin B5. Food Sources and Symptoms of Deficiency.

Pantothenic Acid is a water soluble B vitamin that is essential in metabolic pathways in all forms of life, plants, animals and microbes. It is a precursor chemical for coenzyme A which is involved in many reactions that help sustain life and is needed for other proteins that are needed for making fatty acids – fats of different lengths and types. It does have other active chemical forms but is not typically referred to by their names, pantothenol – may help with healing skin wounds, research is in early stages; and pantethine – may help lower cholesterol and lipid (fat) levels in the blood. (1)

Dietary deficiency of Pantothenic Acid is very rare as the vitamin is found in most animal and plant food products. There have been no known cases of overdose/toxicity so no Upper Limit for safety has been set. Deficiency is so rare it has only been documented in prisoners of war (POWs) and the symptoms relieved by supplementation of Pantothenic Acid were reported by the POWs to be “numbness and painful burning and tingling in their feet.” (1)

Pantothenic Acid is involved in converting the B vitamin folate into an active form so a deficiency in Pantothenic Acid might result in folate deficiency symptoms, (1) (megaloblastic anemia with fatigue and normal levels of iron but with fewer red blood cells that are immature, too large (macrocytic) and nonfunctional (2). Vitamin B12 deficiency can also be a cause with similar lab values but supplements or injections of that B vitamin wouldn’t help if deficiency of the active form of folate was the cause. Supplements of folic acid, the inactive form most commonly used in multi-vitamins or fortified foods, wouldn’t help either. Beans, peas and asparagus are good food sources of folate, more information about that B vitamin is available here: (Folate is essential and Folic Acid is commonly available)

Genetic differences may affect some individual’s ability to phosphorylate (add atoms of the mineral Phosphorus) to the molecule of Pantothenic Acid for the transformation of the vitamin precursor into the bioactive coenzyme A. The enzyme is needed for transporting fatty acids (lipids/fats) into the mitochondria for use for energy production. Someone with a genetic difference might not be able to use fats for energy as well as someone with typical ability to phosphorylate the Pantothenic Acid molecules in the production of Coenzyme A. One known gene that could inhibit the production of Coenzyme A is Pantothenic acid kinase II (PANK2) . Symptoms of people with a double gene difference in PANK2 may include changes in movement control (dystonia), and impaired vision, intelligence, speech, and behavior, and personality disorders (15). (1)

Symptoms of deficiency of Coenzyme A might include gaining weight more easily than average and more readily getting tired when exercising for longer amounts of time. That is my interpretation though.

I have a different genetic difference that affects phosphorylation so I may also have trouble producing Coenzyme A. Betaine-homocysteine methyltransferase (BHMTis a gene involved in protein metabolism that could cause reduced Dimethylglycine and methionine.  Chronic Fatigue Syndrome has been associated with a lack of Dimethylglycine (the amino acid – glycine). The metabolic pathways are very complex chemistry and it looks like this gene is more involved in the chemistry of the B vitamins choline and betaine. The phosphorylation problem is more specifically with phospholipids and  glycerophospholipids – both essential parts of membranes and cannabinoids. (Glycerophospholipid biosynthesis) (Phospholipid metabolism)

I will discuss betaine and choline in additional posts. An overview about phospholipids and food sources is available in the post Macro & micro-nutrients, an overview & food sources.

Symptoms of Pantothenic Acid deficiency in lab animals or other groups of animals found to have deficiency of vitamin B5 in their food supply included skin irritations, graying of fur or feather abnormalities, anemia due to reduced heme production,  nerve problems involving reduced myelin sheath, low blood glucose, rapid breathing and heart rate, and damaged adrenal glands. (1)

So it is good that Pantothenic Acid is readily available in many foods because clearly it is very important to our health. However supplements of Pantothenic Acid or rubbing it directly on the scalp or gray hair did not restore hair color in humans with gray hair. (1)

Food Sources for Pantothenic Acid (vitamin B5):

Organ meats (liver and kidney), Meats, Fish and Shellfish, Salmon, Egg yolk, MIlk, Yogurt, Cheese, Avocado, Broccoli Sweet Potato, Carrot, Celery, Mushrooms, Pomegranate Seeds, Sesame Seeds/Tahini, Beans, Nuts, Seeds, Almonds, Walnuts, Whole Grains, Brown Rice, Enriched Flour Products depending on the source – Canadian guidelines require it while the U.S guidelines do not.  (4, 5) “Processing and refining grains may result in a 35 to 75% loss. Freezing and canning of foods result in similar losses (16).” (1)

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

References:

  1. Pantothenic Acid, Linus Pauling Institute, Oregon State University, http://lpi.oregonstate.edu/mic/vitamins/pantothenic-acid
  2. Anemia of Folate Deficiency, https://www.hopkinsmedicine.org/healthlibrary/conditions/hematology_and_blood_disorders/anemia_of_folate_deficiency_85,P00089
  3. Foods used in the 30% Calories from Carbohydrates Menu Plans, https://effectiveselfcare.info/2018/05/19/healthy-hair-is-the-proof-of-a-healing-diet/
  4. Institute of Medicine (US) Committee on Use of Dietary Reference Intakes in Nutrition Labeling. Dietary Reference Intakes: Guiding Principles for Nutrition Labeling and Fortification. Washington (DC): National Academies Press (US); 2003. 3, Overview of Food Fortification in the United States and Canada. https://www.ncbi.nlm.nih.gov/books/NBK208880/
  5. Guidance Document Repository (GDR), Prohibition against the sale of unenriched white flour and products containing unenriched flour. Canadian Food Fortification Guidelines; Grain and Bakery Products,  Canadian Food Inspection Agency, http://www.inspection.gc.ca/food/labelling/food-labelling-for-industry/grain-and-bakery-products/unenriched-flour/eng/1415915977878/1415915979471

15. Kurian MA, Hayflick SJ. Pantothenate kinase-associated neurodegeneration (PKAN) and PLA2G6-associated neurodegeneration (PLAN): review of two major neurodegeneration with brain iron accumulation (NBIA) phenotypes. Int Rev Neurobiol. 2013;110:49-71.  (https://www.ncbi.nlm.nih.gov/pubmed/24209433)

16. Food and Nutrition Board, Institute of Medicine. Pantothenic acid. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, D.C.: National Academy Press; 1998:357-373. National Academy Press,  (https://www.nap.edu/read/6015/chapter/12)