Product review references from: ConsumerLab.com

A word of caution on taking multi-vitamins:

Multi-vitamins /minerals are America’s most popular dietary supplements. Referred to as “multis,” the ingredients vary widely by brand. There are no established standards on what multis should contain.

One reason for not having uniform standards is that people’s diets and their needs differ. Nutrient requirements and cautions vary depending on age, gender, health status, use of substances such as alcohol or tobacco, and medications taken.

A major update of the recommendations for daily nutrient intake was issued by the Institute of Medicine in 2001. However, The U.S. Food and Drug Administration (FDA) has yet to require product labeling to include much of this new information in the “% Daily Value” (“DV”) listing that appears in the “Supplement Facts” panel on supplements. The current DVs are largely based on nutritional recommendations dating from 1968.

Products also can remain on store shelves for months or even years before being replaced with newer versions. Consequently, even if a manufacturer has re-formulated its product to meet new recommendations, consumers may still be buying the older version.

What to look for in a Multi-Vitamin

In addition to selecting a product that appears to have the right ingredients, one should be confident that it: contains what it claims; breaks down properly once in the body so its ingredients can be effectively utilized; and is free of impurities.

Keep in Mind:

Neither the U.S. government nor any agency is responsible for routinely testing multis or other dietary supplements for their contents or quality.

I trust Consumerlab

ConsumerLab.com, as part of its mission to independently evaluate products that affect health and nutrition, purchases many of the leading multivitamin/multimineral products sold in the U.S. and Canada and tests them for their quality and evaluates them against the most recently recommended Dietary Reference Intakes (DRIs).

Quality Concerns:

Multivitamins/multiminerals are among those supplements most likely to have quality problems. They contain multiple ingredients and, therefore, more possibility for error. Earlier tests by ConsumerLab.com have found multis that were short on ingredients, failed to dissolve properly, or were contaminated with heavy metals.

ConsumerLab.com tests products for their amounts of several common labeled ingredients: folic acid, calcium, and vitamin A (retinol and beta-carotene) as indicators of product quality. Not all of the products were labeled to contain every one of these ingredients. Therefore, some were alternatively tested for other ingredients — such as vitamin C (ascorbic acid) in the absence of folic acid, and iron or zinc if calcium was not present.

Products are also tested to determine if they: disintegrated properly in order to dissolve and be absorbed in the body; and did not contain excessive and/or potentially harmful levels of lead, a contaminant of some mineral and herbal-based products.

Products have to pass testing on all of these criteria to be considered APPROVED. In addition, ConsumerLab.com reviews the levels of vitamins and minerals to determine if any product provided doses high enough so as to carry a risk of adverse side effects.

What CL Found in their most recent tests:
Among twenty-one products for adults and children that ConsumerLab.com independently selected and tested, only ten met their claims and other quality standards. The reasons why products failed are indicated in the table and described below by category of multivitamin/multimineral supplement.

This is not a complete list. I’ve highlighted several multi-vitamins from Consumerlab.com’s most recent review. You should consider looking up your own multi at consumerlab.com

General (Adult):

NOT Approved:

• Eniva® VIBE™, a liquid sold in packets, had only 54% of its claimed 5,000 IU of vitamin A.
• Healthy Moments™ Mint Cream Flavor Vitamin Strips contained none of its claimed vitamin A. It also contained 180% of its claimed 2 mg of niacin per strip.
• Swanson® Daily Multi-Vitamin & Mineral had only 77.5% of its claimed 400 mcg of folate per capsule.
• The Greatest Vitamin in the World had only 85% of its claimed 800 mcg of folate in its suggested nine capsules per day — although this still meets the adult RDA.
• WEIL™ Andrew Weil, M.D. Daily Multivitamin for Optimum Health had only 73% of its claimed 10,000 IU of vitamin A (as beta-carotene) per tablet — although this still meets the adult RDA. It also had 251% of it claimed 60 mg of calcium — possibly an oversight of the calcium contributed by di-calcium phosphate, a binding agent listed among its inactive ingredients.

Women’s:

NOT Approved:

• Nature’s Plus® Especially Yours® Women’s Multi-Vitamin failed to break apart properly, requiring more than one hour to disintegrate rather than the 30 minute limit established by the U.S. Pharmacopeia (USP). Such products may pass through the body without being fully utilized. It also contained 292% of its claimed 50 mg/tablet of calcium — possibly due to an oversight of the calcium contributed by the di-calcium phosphate in the product.
• The Vitamin Shoppe® Multivitamins Especially for Women was contaminated with 15.3 micrograms of lead per daily serving. This is more than ten times the amount of lead permitted without a warning label in California — the only state to regulate lead in supplements — and several times the normal daily exposure to lead. Lead at this level may not in itself be toxic to adults, but lead is stored in the body and unnecessary exposure should be avoided. This product should not be shared with children, as they are susceptible to lead poisoning at levels as low as 6 micrograms per day. This product also contained only 54% of its claimed 200 mg of calcium in its suggested daily dose of two tablets.

Approved:

Men’s:

NOT Approved:

• Now® Adam™ Superior Men’s Multi failed to break apart properly, taking 40 minutes to disintegrate rather than the 30 minutes set by the USP.
• Win™ Fuel Men’s Formula had only 81% of its claimed 4,000 IU of vitamin (although this is still above the RDA of 3,000 IU for men) and only 75% of it claimed 400 mcg of folate.

Approved:

Seniors:

NOT Approved:

• AARP Maturity Formula failed to break apart properly, taking 50 minutes to disintegrate rather than the 30 minutes set by the USP.

Approved:

Children’s:

NOT Approved:

• Hero Nutritionals™ Yummi ® Bears contained 216% of its labeled amount of vitamin A, potentially delivering amounts in excess of those tolerable in children up to eight years old. The product contained 5,400 IU of vitamin A in the retinol form in a daily serving of three bears. The upper tolerable level (UL) set by the Institute of Medicine is 2,000 IU for children one to three years of age and 3,000 IU for those four to eight years old. Children of these ages only need to get 1,000 to 1,333 IU of vitamin A. Excess vitamin A in the retinol form is of concern as it may lead to bone weakening and other problems.

Approved:

Some products, by design, provided specific nutrients at doses above the tolerable upper intake levels (ULs) established by the Institute of Medicine for certain groups of people. We use these standards in our online meal planner. Adverse effects — such as skin tingling from niacin, nausea and weakness from magnesium, and immune deficiency and anemia from zinc — may occur when these levels are exceeded for long periods of time. More serious toxicities would not be expected at the doses in these products. You should always know what you are getting for individual nutrients from whole food first.

For Complete Test Results by Product:
Go to ConsumerLab.com to check your supplement

Bottom Line:

If you get caught up in the hype or pressure of buying a product from a friend, family member or infomercial trying to sell you supplements, I would STRONGLY suggest you consult with ConsumerLab.com first to see if your supplement passed independent testing. Also I suggest you speak with a nutrition professional and your physician about any possible drug and nutrient interactions you should know about before supplementing.

Go to ConsumerLab to check your supplement

My-Nutrition-Coach.com chooses Puritan’s Pride because they score high in all categories with ConsumerLab and were the best price found for a quality, independently tested and verified product. Direct shipping-no markup for the middleman or rep-

My-Nutrition-Coach.com finds that Puritan’s Pride also has the best combinations of researched ingredients. For example, the last webinar by Consumerlab.com on Glucosamine/Chondroitin supplements showed that they had their ratios exactly with the latest science.

For more on multi-vitamins and supplements replay part 3 of my Metabolism Matters workshop here

If you missed this webinar- sign up for my newsletter to get access to all the back issues of Health-E-News

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More tips for choosing smart multi-vitamins are in my new book

preview and order a copy of my Smart Moves 7-Day Nutrition Action Guide here

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to find out if your current diet makes the grade.

I’ve also jotted down some great notes and am reserving further comments for future posts. However, with one ear still tied to these hearings (some 5 hours later) the best questions raised, in my opinion, came from Congressman Bruce Braley when asking Clemens his reasons for injecting “B12″. He asked Clemens if he was anemic, suffering from dementia or a vegan and trying to arrive at a conclusion on why an athlete might even need this type of injection.

So the day is not a total loss, I’d like to at least provide the nutritional truth, thanks to ConsumerLab’s trusted research, on what vitamin B12 can and can’t do for any body .

Source: Consumerlab.com

Vitamin B12

Cyanocobalamin (B-12) deficiency can cause anemia, irreversible nerve damage, and low sperm count. It has also been used along with vitamin B-6 in reducing the risk of heart disease. Vitamin B-12 is found in abundant quantity in meats and is also plentiful in poultry and fish but not found in foods from plants. A healthful diet should meet the vitamin B-12 RDAs, but supplementation is often needed for strict vegetarians, alcohol and drug abusers, people recovering from surgery or burns, or those with bowel or pancreatic cancer. Deficiency may also occur in people with low stomach acidity, such as older individuals or those taking medications that reduce stomach acid, because stomach acid is necessary to allow absorption of vitamin B-12 from foods. The purified vitamin B-12 found in supplements does not require stomach acid for absorption. Consequently, it is advisable for people over 50 years of age as well as those taking medications such as Prilosec or Zantac to meet their RDA by consuming foods fortified with purified vitamin B-12 or by taking a dietary supplement.

Recommended Intake: The RDA is 0.9 mcg for children 1 to 3, 1.2 mcg for those 4 to 8, and 1.8 mcg for those 9 to 13. For individuals 14 years and older the RDA is 2.4 mcg. However, the RDA for pregnant women is 2.6 mcg and for lactating women it is 2.8 mcg. Higher doses of vitamin B-12 (about 400 mcg per day) have been proposed for helping to prevent heart disease. Vitamin B-12 in far high dosages has also been proposed for the treatment of other conditions including asthma, fatigue, and male infertility, but there is no reliable evidence that it is effective.
Upper Limit: No UL has been established for vitamin B-12. This appears to be a very safe ingredient.

Supplement Forms/Alternate Names
Cobalamin; Cyanocobalamin; Hydrocobalamin; Methylcobalamin

Principal Proposed Uses
Correcting Deficiency

Vitamin B ₁₂, an essential nutrient, is also known as cobalamin. The cobal in the name refers to the metal cobalt contained in B ₁₂. Vitamin B ₁₂ is required for the normal activity of nerve cells and works with folate and vitamin B ₆ to lower blood levels of homocysteine, a chemical in the blood that might contribute to heart disease. B ₁₂ also plays a role in the body’s manufacture of S-adenosylmethionine (SAMe).

Anemia is usually (but not always) the first sign of B ₁₂ deficiency. Earlier in this century, doctors coined the name “pernicious anemia” for a stubborn form of anemia that didn’t improve even when the patient was given iron supplements. Today we know that pernicious anemia comes about when the stomach fails to excrete a special substance called intrinsic factor. The body needs the intrinsic factor for efficient absorption of vitamin B ₁₂. In 1948, vitamin B ₁₂ was identified as the cure for pernicious anemia. B ₁₂ deficiency also causes nerve damage, and this may, in some cases, occur without anemia first developing.

Vitamin B ₁₂ has also been proposed as a treatment for numerous other conditions, but as yet there is no definitive evidence that it is effective for any purpose other than correcting deficiency.

Requirements/Sources

Extraordinarily small amounts of vitamin B ₁₂ suffice for daily nutritional needs. The official US and Canadian recommendations for daily intake are as follows:

• Infants

· 0-6 months: 0.4 mcg

· 7-12 months: 0.5 mcg

• Children

· 1-3 years: 0.9 mcg

· 4-8 years: 1.2 mcg

· 9-13 years: 1.8 mcg

• Males and Females

· 14 years and older: 2.4 mcg

• Pregnant Women

· 2.6 mcg

• Nursing Women

· 2.8 mcg

Vitamin B ₁₂ deficiency is rare in the young, but it’s not unusual in older people: Probably 10% to 20% of the elderly are deficient in B ₁₂.^1-4 This may be because older people have lower levels of stomach acid. The vitamin B ₁₂ in our food comes attached to proteins and must be released by acid in the stomach in order to be absorbed. When stomach acid levels are low, we don’t absorb as much vitamin B ₁₂ from our food. Fortunately, vitamin B ₁₂ supplements don’t need acid for absorption and should, therefore, get around this problem. However, for reasons that are unclear, one study found that B ₁₂ -deficient seniors need very high dosages of the supplements to normalize their levels, as high as 600 to 1,000 mcg daily.⁶⁵

Similarly, people who take medications that greatly reduce stomach acid, such as omeprazole (Prilosec) or ranitidine (Zantac) also may have trouble absorbing B ₁₂ from food and could benefit from supplementation.^5-10

Stomach surgery and other conditions affecting the digestive tract can also lead to B ₁₂ deficiency. Vitamin B ₁₂ absorption or levels in the blood may also be impaired by colchicine (for gout), metformin and phenformin (for diabetes), and AZT (for AIDS).^11,12,69 Exposure to nitrous oxide (such as may be experienced by dentists and dental hygienists) might cause B ₁₂ deficiency, but studies disagree.^14,15 Slow-release potassium supplements might impair B ₁₂ absorption as well.¹⁷

Vitamin B ₁₂ is found in most animal foods; it is also found only in animal food. Beef, liver, clams, and lamb provide a whopping 80 to 100 mcg of B ₁₂ per 3.5-oz serving, at least 40 times the dietary requirement. Sardines, chicken liver, beef kidney, and calf liver are also good sources, providing between 25 and 60 mcg per serving. Trout, salmon, tuna, eggs, whey, and many cheeses provide at least the recommended daily intake.

Note: Total vegetarians (vegans) must take vitamin B ₁₂ supplements or consume B ₁₂ -fortified foods, or they will eventually become deficient.^59,60 Contrary to some reports, seaweed and tempeh do not provide B ₁₂. (Some forms of blue-green algae, such as spirulina, contain B ₁₂, but it is not in an absorbable state.⁶¹ )

Vitamin B ₁₂ is available in three forms: cyanocobalamin, hydrocobalamin, and methylcobalamin. The first is the most widely available and least expensive, but some experts think that the other two forms are preferable.

Severe B ₁₂ deficiency can cause anemia and, potentially, nerve damage. The latter may become permanent if the deficiency is not corrected in time. Anemia most often develops first, leading to treatment before permanent nerve damage develops. However, folate supplements can get in the way of this “early warning system.” This is why people are cautioned against taking high doses of folate without medical supervision. When taken at a dosage higher than 400 mcg daily, folate can prevent anemia caused by B ₁₂ deficiency, thereby allowing permanent nerve damage to develop without any warning. More mild deficiencies of vitamin B ₁₂ may cause elevated levels of homocysteine in the blood, potentially increasing risk of heart disease. (See the Homocysteine article for more information.) Mild B ₁₂ deficiency (too slight to cause anemia) may also impair brain function.^24,25

Therapeutic Dosages

For correcting absorption problems caused by medications, taking vitamin B ₁₂ at the level of dietary requirements should suffice.

For other purposes, enormously higher daily doses—ranging from 100 to 2,000 mcg—are sometimes recommended.

Therapeutic Uses

It appears that individuals who take medications that dramatically lower stomach acid, such as H2 blockers or proton pump inhibitors, would benefit by taking B ₁₂ supplements.^18-23 Other individuals likely to be deficient in B ₁₂, such as the elderly, or those taking the medications listed in Requirements/Sources, might well benefit from a daily B ₁₂ supplement to prevent B ₁₂ deficiency.

For pernicious anemia, B ₁₂ injections are traditionally used but research has shown that oral B ₁₂ works just as well, provided you take enough of it (between 300 and 1,000 mcg daily).^26-29

Weak evidence suggests that B ₁₂ supplements may improve sperm activity and sperm count; on this basis, they could be useful for male infertility.^30,31 Some cases of recurrent miscarriage might be due to vitamin B ₁₂ deficiency.⁶²

One placebo-controlled, double-blind study, enrolling 49 people with eczema, found benefit with a cream containing vitamin B ₁₂ at a concentration of 0.07%.⁶⁶ Topical B ₁₂ is hypothesized to work for eczema by reducing local levels of the substance nitric oxide (not related to nitrous oxide).

On the basis of weak and sometimes contradictory evidence, vitamin B ₁₂ has been suggested for HIV,^33-37 amyotrophic lateral sclerosis,³⁸ carpal tunnel syndrome,⁶⁷ diabetic neuropathy,^39,40 multiple sclerosis (MS),^41-45 restless legs syndrome,^46,47 and tinnitus.⁴⁸

Some evidence suggests that people with vitiligo (splotchy loss of skin pigmentation) might be deficient in vitamin B ₁₂, and supplementation along with folate may be helpful.^52,53 However, the evidence is very weak and not all studies agree.⁵⁴

Some alternative practitioners recommend the use of injected vitamin B ₁₂ for Bell’s palsy. However, the only scientific support for this approach comes from one study that was not double-blind.⁶³

Vitamin B ₁₂ is also sometimes recommended for numerous other problems, including asthma, depression, osteoporosis, and periodontal disease, but there is essentially no evidence as yet that it really works.

A double-blind trial of vitamin B ₁₂ for seasonal affective disorder (SAD—a type of depression related to lack to lack of light during the winter) failed to find evidence of benefit.⁵⁸

One double-blind, placebo-controlled study of 140 people with mildly low B ₁₂ levels failed to find the supplement helpful for improving mental function and mood.⁶⁸

Another study failed to find evidence that vitamin B ₁₂ improved general sense of wellbeing among seniors with signs of mild B ₁₂ deficiency.⁶⁴

Although vitamin B ₁₂ has been proposed as a treatment for Alzheimer’s disease, this recommendation is based solely on the results of one small, poorly designed study.⁴⁹ More recent and better-designed studies found little to no benefit.^50,51

What Is the Scientific Evidence for Vitamin B ₁₂ ?

Vitamin B ₁₂ deficiencies in men can lead to reduced sperm counts and lowered sperm mobility. For this reason, B ₁₂ supplements have been tried for improving fertility in men with abnormal sperm production. In one double-blind study of 375 infertile men, supplementation with vitamin B ₁₂ produced no benefits on average in the group as a whole.⁵⁵ However, in a particular subgroup of men with sufficiently low sperm count and sperm motility, B ₁₂ appeared to be helpful. Such “dredging” of the data is suspect from a scientific point of view, however, and this study cannot be taken as proof of effectiveness.

Safety Issues

Vitamin B ₁₂ appears to be extremely safe. However, in some cases very high doses of the vitamin can cause or worsen acne symptoms.^56,57

Interactions You Should Know About

If you are taking:

Colchicine, AZT, medications that reduce stomach acid (such as the H2 blocker ranitidine [Zantac] or the proton pump inhibitor omeprazole [Prilosec], oral hypoglycemics (such as metformin or phenformin), slow-release potassium supplements, or if you are exposed to nitrous oxide anesthesia: You may need extra B ₁₂. Another option is to take extra calcium, which may, in turn, improve B ₁₂ absorption.

References

1. Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B ₁₂ absorption. J Am Coll Nutr. 1994;13:584-591.

2. van Goor L, Woiski MD, Lagaay AM, et al. Review: cobalamin deficiency and mental impairment in elderly people. Age Ageing. 1995;24:536-542.

3. Pennypacker LC, Allen RH, Kelly JP, et al. High prevalence of cobalamin deficiency in elderly outpatients. J Am Geriatr Soc. 1992;40:1197-1204.

4. Yao Y, Yao SL, Yao SS, et al. Prevalence of vitamin B ₁₂ deficiency among geriatric outpatients. J Fam Pract. 1992;35:524-528.

5. Marcuard SP, Albernaz L, Khazanie PG. Omeprazole therapy causes malabsorption of cyanocobalamin. Ann Intern Med. 1994;120:211-215.

6. Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B ₁₂ absorption. J Am Coll Nutr. 1994;13:584-591.

7. Streeter AM, Goulston KJ, Bathur FA, et al. Cimetidine and malabsorption of cobalamin. Dig Dis Sci. 1982;27:13-16.

8. Aymard JP, Aymard B, Netter P, et al. Haematological adverse effects of histamine H ₂ -receptor antagonists. Med Toxicol Adverse Drug Exp. 1988;3:430-448.

9. Salom IL, Silvis SE, Doscherholmen A. Effect of cimetidine on the absorption of vitamin B ₁₂. Scand J Gastroenterol. 1982;17:129-131.

10. Belaiche J, Zittoun J, Marquet J, et al. Effect of ranitidine on gastric intrinsic factor and cobalamin (vitamin B ₁₂) absorption [translated from French]. Gastroenterol Clin Biol. 1983;7:381-384.

11. Webb DI, Chodos RB, Mahar CQ, et al. Mechanism of vitamin B ₁₂ malabsorption in patients receiving colchicine. N Engl J Med. 1968;279:845-850.

12. Adams JF, Clark JS, Ireland JT, et al. Malabsorption of vitamin B ₁₂ and intrinsic factor secretion during biguanide therapy. Diabetologia. 1983;24:16-18.

13. Flippo TS, Holder WD Jr. Neurologic degeneration associated with nitrous oxide anesthesia in patients with vitamin B ₁₂ deficiency. Arch Surg. 1993;128:1391-1395.

14. Baum MK, Javier JJ, Mantero-Atienza E, et al. Zidovudine-associated adverse reactions in a longitudinal study of asymptomatic HIV-1 infected homosexual males. J Acquir Immune Defic Syndr. 1991;4:1218-1226.

15. Deleu D, Louon A, Sivagnanam S, et al. Long-term effects of nitrous oxide anaesthesia on laboratory and clinical parameters in elderly Omani patients: a randomized double-blind study. J Clin Pharm Ther. 2000;25:271-277.

16. Bauman WA, Shaw S, Jayatilleke E, et al. Increased intake of calcium reverses vitamin B ₁₂ malabsorption induced by metformin. Diabetes Care. 2000;23:1227-1231.

17. Drug Evaluations Annual. Vol. 3. Milwaukee, WI: American Medical Association; 1993.

18. Marcuard SP, Albernaz L, Khazanie PG. Omeprazole therapy causes malabsorption of cyanocobalamin. Ann Intern Med. 1994;120:211-215.

19. Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B ₁₂ absorption. J Am Coll Nutr. 1994;13:584-591.

20. Streeter AM, Goulston KJ, Bathur FA, et al. Cimetidine and malabsorption of cobalamin. Dig Dis Sci. 1982;27:13-16.

21. Aymard JP, Aymard B, Netter P, et al. Haematological adverse effects of histamine H ₂ -receptor antagonists. Med Toxicol Adverse Drug Exp. 1988;3:430-448.

22. Salom IL, Silvis SE, Doscherholmen A. Effect of cimetidine on the absorption of vitamin B ₁₂. Scand J Gastroenterol. 1982;17:129-131.

23. Belaiche J, Zittoun J, Marquet J, et al. Effect of ranitidine on secretion of gastric intrinsic factor and absorption of vitamin B ₁₂. Gastroenterol Clin Biol. 1983;7:381-384.

24. Carmel R, Gott P, Degiorgio C, et al. Abnormal P300 event-related potentials in mild, preclinical cobalamin deficiency [abstract]. Int J Hematol. 2000;72(suppl 1):207.

25. Louwman MW, van Dusseldorp M, van de Vijver FJ, et al. Signs of impaired cognitive function in adolescents with marginal cobalamin status. Am J Clin Nutr. 2000;72:762-769.

26. Elia M. Oral parenteral therapy for B ₁₂ deficiency. Lancet. 1998;352:1721-1722.

27. McIntyre PA, Hahn R, Masters JM, et al. Treatment of pernicious anemia with orally administered cyanocobalamin (vitamin B ₁₂). Arch Intern Med. 1960;106:280-292.

28. Waife SO, Jansen CJ Jr, Crabtree RE, et al. Oral vitamin B ₁₂ without intrinsic factor in the treatment of pernicious anemia. Ann Intern Med. 1963;58:810-817.

29. Berlin H, Berlin R, Brante G. Oral treatment of pernicious anemia with high doses of vitamin B ₁₂ without intrinsic factor. Acta Med Scand. 1968;184:247-258.

30. Kumamoto Y, Maruta H, Ishigami J, et al. Clinical efficacy of mecobalamin in treatment of oligozoospermia—results of double-blind comparative clinical study [in Japanese; English abstract]. Hinyokika Kiyo. 1988;34:1109-1132.

31. Sandler B, Faragher B. Treatment of oligospermia with vitamin B ₁₂. Infertility. 1984;7:133-138.

32. Wright J. Vitamin B ₁₂: Powerful protection against asthma. Int Clin Nutr Rev. 1989;9:185-188.

33. Rule SA, Hooker M, Costello C, et al. Serum vitamin B ₁₂ and transcobalamin levels in early HIV disease. Am J Hematol. 1994;47:167-171.

34. Richman DD, Fischl MA, Grieco MH, et al. The toxicity of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo-controlled trial. N Engl J Med. 1987;317:192-197.

35. Shor-Posner G, Morgan R, Wilkie F, et al. Plasma cobalamin levels affect information processing speed in a longitudinal study of HIV-1 disease. Arch Neurol. 1995;52:195-198.

36. Kieburtz KD, Giang DW, Schiffer RB, et al. Abnormal vitamin B ₁₂ metabolism in human immunodeficiency virus infection. Association with neurological dysfunction. Arch Neurol. 1991;48:312-314.

37. Baum MK, Shor-Posner G, Lu Y, et al. Micronutrients and HIV-1 disease progression. AIDS. 1995;9:1051-1056.

38. Kaji R, Kodama M, Imamura A, et al. Effect of ultrahigh-dose methylcobalamin on compound muscle action potentials in amyotrophic lateral sclerosis: a double-blind controlled study. Muscle Nerve. 1998;21:1775-1778.

39. Ide H, Fujiya S, Asanuma Y, et al. Clinical usefulness of intrathecal injection of methylcobalamin in patients with diabetic neuropathy. Clin Ther. 1987;9:183-192.

40. Yaqub BA, Siddique A, Sulimani R. Effects of methylcobalamin on diabetic neuropathy. Clin Neurol Neurosurg. 1992;94:105-111.

41. Kira J, Tobimatsu S, Goto I. Vitamin B12 metabolism and massive-dose methyl vitamin B ₁₂ therapy in Japanese patients with multiple sclerosis. Intern Med. 1994;33:82-86.

42. Goodkin DE, Jacobsen DW, Galvez N, et al. Serum cobalamin deficiency is uncommon in multiple sclerosis. Arch Neurol. 1994;51:1110-1114.

43. Baig SM, Qureshi GA, Minami M. The interrelation between the deficiency of vitamin B ₁₂ and neurotoxicity of homocysteine with nitrite in some of neurologic disorders. Biogenic Amines. 1998;14:1-14.

44. Reynolds EH. Multiple sclerosis and vitamin B ₁₂ metabolism. J Neuroimmunol. 1992;40:225-230.

45. Simpson CA, Newell DJ, Miller H. The treatment of multiple sclerosis with massive doses of hydroxocobalamin. Neurology. 1965;15:599-603.

46. O’Keeffe ST. Restless legs syndrome: a review. Arch Intern Med. 1996;156:243-248.

47. Silber MH. Restless legs syndrome. Mayo Clin Proc. 1997;72:261-264.

48. Shemesh Z, Attias J, Ornan M, et al. Vitamin B ₁₂ deficiency in patients with chronic tinnitus and noise-induced hearing loss. Am J Otolarygol. 1993;14:94-99.

49. Martin DC, Francis J, Protetch J, et al. Time dependency of cognitive recovery with cobalamin replacement: Report of a pilot study. J Am Geriatr Soc. 1992;40:168-172.

50. Kwok T, Tang C, Woo J, et al. Randomized trial of the effect of supplementation on the cognitive function of older people with subnormal cobalamin levels. Int J Geriatr Psychiatry. 1998;13:611-616.

51. Teunisse S, Bollen AE, van Gool WA, et al. Dementia and subnormal levels of vitamin B ₁₂: Effects of replacement therapy on dementia. J Neurol. 1996;243:522-529.

52. Montes LF, Diaz ML, Lajous J, et al. Folic acid and vitamin B ₁₂ in vitiligo: a nutritional approach. Cutis. 1992;50:39-42.

53. Juhlin L, Olsson MJ. Improvement of vitiligo after oral treatment with vitamin B ₁₂ and folic acid and the importance of sun exposure. Acta Derm Venereol (Stockh). 1997;77:460-462.

54. Kim SM, Kim YK, Hann S-K. Serum levels of folic acid and vitamin B ₁₂ in Korean patients with vitiligo. Yonsei Med J. 1999;40:195-198.

55. Kumamoto Y, Maruta H, Ishigami J, et al. Clinical efficacy of mecobalamin in treatment of oligozoospermia–results of double-blind comparative clinical study [in Japanese; English abstract]. Hinyokika Kiyo. 1988;34:1109-1132.

56. Sheretz EF. Acneform eruption due to “megadose” vitamins B ₆ and B ₁₂. Cutis.. 1991;48:19-20.

57. Braun-Falco O, Lincke H. The problem of vitamin B6/B12 acne. A contribution on acne medicamentosa [in German; English abstract]. MMW Munch Med Wochenschr. 1976;118:155-160.

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Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Coach David Dansereau, MS,PT

Licensed Physical Therapist

Nutritionist (formerly a Registered Dietitian for 17 years)*

Owner of One Body Health Sports Nutrition and Physical Therapy – 15 years

Founder of Smart Moves Internet Publishing,LLC a health and technology education company for consumers and health professionals.

Author of the Smart Moves Fitness Guidebook

The founder of One Body Health, David P. Dansereau, MS, PT ,RD* is committed to remain current with the latest in nutrition and exercise/rehabilitation sciences, technology and the emerging wellness trends. David has grown his company for 15 years and has build its success on a broad foundation of education and training. His experiences include having worked in multiple clinical settings as both a Registered Dietitan (RD)* and Licensed Physical Therapist (PT). David has also developed innovative fitness and nutrition programs for several corporations in Rhode Island and southeastern Massachusetts. He has studied and learned in the research setting at the Miriam Hospital’s Behavioral Medicine Department where he worked on multiple physical activity and nutrition projects funded by the National Cancer Institute studying how and why individuals change health behaviors and most importantly how they maintain change.

Education

Finally, David backs his commitment to education through an advanced degree (MS) in Physical Therapy, a (BS) in Dietetics and a minor in Exercise Science. David believes strongly in continued education and has completed advanced courses in Nutrition/Metabolism, Manual Physical Therapy, as well as Orthopedic and Sports Physical Therapy techniques. Professional memberships include the American Physical Therapy Association (APTA), American College of Sports Medicine, member of Sports Physical Therapy Practice Group of the APTA, as well as the American Dietetic Association (ADA). One Body Health’s strength is enhanced by David’s broad foundation of solid clinical training both as a researcher and educator ensuring that our programs are based upon sound clinical studies and enhanced functional outcomes.

* “Retired” RD from clinical dietetics as registered dietitian after 17 years. Continue to maintain a professional membership in the American Dietetic Association (ADA).

Goal

One Body Health is committed to excellent service and the content presented on my WebLog at wordpress and my articles at My-Nutrition-Coach.com will be held to the same standards of care.