Vitamins fulfill important functions in countless processes in the body. The B vitamins play a major role in the formation of energy from carbohydrates. Vitamin C and flavonoids (OPC) play a role in the formation of connective tissue. Vitamins A, C and E protect against harmful oxygen compounds. A (marginal) shortage of one or more vitamins means that the bodily functions for which they are needed do not go as well. A (marginal) shortage will, depending on the severity and duration, lead to complaints directly or after a longer period of time. Many vitamins are cofactors and play a role in conversions. They can be used in the reaction (after regeneration they can be reused) or they can be used. They will then have to be supplied again through food.
Of the nearly 3900 enzymes in our body, over 20% use a cofactor. The majority of these co-factors are from eight important vitamins such as pyridoxine (P5P), thiamine (TPP), riboflavin (FAD), pantothenic acid, folic acid and vitamin B3. Small changes in the DNA can strongly influence the binding of these cofactors. Sometimes it appears that more of a certain cofactor is needed to make the process run equally quickly. It is remarkable that one in three mutations within an enzyme has an influence on the binding of the cofactor.
Therapies with high doses of vitamin have been shown to be effective in improving more than fifty genetic diseases. The diseases are usually due to a deviation in the enzyme, which reduces the affinity for the vitamin-derived cofactors (increased Km value). Different SNPs (snips) in which another amino acid is encoded in a coenzyme binding site lead to reduced enzymatic activity. This enzyme activity appears to be able to be restored by increasing the cellular cofactor concentration by administering high doses of certain vitamins.
The examples discussed here probably represent only a small fraction of the total number of defective enzymes that could respond to a therapeutic dose of vitamins. It appears that many enzymes require higher concentrations of P5P, TPP, NAD (P), FAD or other cofactors. That genetic variants that influence cofactor binding will be found. Only more than 100 enzymes are known for P5P and FAD.
Folic acid, vitamin B6 and vitamin B12 can help reduce homocysteine levels in the blood, possibly preventing vascular dementia. Out of every 100 people with dementia, about sixty have Alzheimer’s disease, fifteen vascular dementias and about twenty a combination of Alzheimer’s and vascular dementia. The others suffer from other forms of dementia. A higher concentration of the amino acid homocysteine is a risk factor for the development of cardiovascular diseases. The excess of homocysteine accumulates in the vessel walls, causing them to slowly clog up. The brain can also be affected. In that case, we speak of vascular dementia. With age, the homocysteine value increases by about 5 to 10% per year. About half of the elderly over 75 years have a too high homocysteine level. Research has shown that the quantities and forms of vitamins that are necessary to reduce the content can vary enormously.
The effect of vitamins can be greatly reduced by the use of medicines. For example, the estrogen in the contraceptive pill can disrupt the vitamin balance in the body. The contraceptive pill lowers the concentrations of vitamin B6, vitamin B12 and folic acid, but also of other nutrients such as vitamin B1, B2, C and magnesium and zinc. Of many commonly used drugs it is known that (long-term) use can lead to deficiencies in vitamins and minerals. The risk is high that the nutritional deficiencies that are disguised as ‘side effects’ are treated with other medicines. For example, a prolonged use of antacids may lead to a deficiency of vitamin B12. When someone uses stomach medicines for at least four years, a determination of the vitamin B12 level is indicated. While the manifestations of a B12 deficiency (such as anemia, neurological complaints, cognitive decline or psychopathology) are irreversible. Gastric acid inhibitors also lower the magnesium content in the blood. Meanwhile, it is striking how many people develop early dementia after prolonged use of certain gastric acid inhibitors. In the US, the Food and Drug Administration (FDA) issued an official warning about this in 2011.
The determinations of vitamins in blood can be used for:
- Determining deficiencies – and possibly also of excess – of vitamins in case of complaints / illness.
• Determining an increased consumption of a vitamin (for medication use)
• Establishing shortages of vitamins when there are no complaints (yet); prevention.
• Determining the effect of supplementation with vitamins.
Conditions where it can be useful to have a vitamin determination:
- Disorders of the gastrointestinal tract (celiac disease, lactose -and fructose intolerance), leaky gut
- Abnormalities in the blood picture
- Alcoholism and drug use
- Heart and vascular disease
- Liver diseases
- Neurological disorders
- Persons who are taking medicines
- Signs of malnutrition
- Problems during pregnancy