RE-lax. Don’t RE-act. Tips for RE-lationships this Holiday Season.

Little things irritate me.  Do they irritate you?  Stupid things.  Unimportant things.

Like people chomping apples when you’re not.  (You can relate, can you?  Well, then, you’ll want to read about misophonia.  Yeah.  It has a name.)

Or rudely driving below the speed limit in front of you when you’re late.  (You did know that’s why it irritates you, right?  It’s rude.  I mean people have places to go and be, and just because somebody doesn’t, doesn’t mean they should drive slowly in front of us and keep us from getting where we need to be on time.  I mean, it takes me 12 minutes and 32.125 seconds to get to dance class, and that’s how long I’ve allotted.  No more.  No less.  My kid shouldn’t be late due to some driver’s disrespect now should they?)

Or asking what’s for supper.  (Does it matter?  You’ll have to eat it anyhow.  I’m not making anything else.  And, frankly, I don’t even know, so don’t ask.)

However, this is not where or how I want to be in this matter!  And I firmly believe that we don’t have to stay where we don’t want to be.  We have the power to invoke change, if not a tangible change, certainly a mental one.  Kind of like that Thoreau quote, “It’s not what you look at that matters, it’s what you see.”  I see–I see–I see a calm, peaceful, controlled, and open mom, wife, friend, and daughter.  (No, not me.  Literally.  I’m watching The Waltons.)

The Holidays are upon us.  Tensions will run high due to overloaded schedules, overloaded expectations, and overloaded populations in small houses.  People are going to irritate us more (and more and more and more).  Try using the R and E method to keep relationships productive and not destructive.  Use it throughout the next month and one week.  And then keep right on using it all year-long.


When you want to RE-ACT.

RE-SIST.  Stop.

RE-LAX the shoulders.  The jaw.  And the brain.  Some people truly have no idea how they come across.  Some people do.  Maybe Bob’s doing it on purpose, and maybe Bob’s not.

Don’t RE-AD (read) into questions or statements or motives.  Don’t.  Too many misunderstandings happen right here.  But neither brush things under the rug to let hard thoughts fester.  Not good.  Take some comments at face value.  (Your mini-van is a mess.  Yes, it is.  Your shoes were expensive.  Yes, they were.  Your mom is difficult.  Yeah, sometimes she can be.  I don’t make corn casserole that way.  No, you don’t.  I’m tired.  Okay.)

RE-PHRASE the question or statement that bothers you so you can determine what the other person is really feeling. This way you don’t look like an idiot if you misunderstood what the person was saying and you overreact, and the situation escalates.  This also applies to looks that you think people gave you.  The goal is to calmly learn how the other person’s brain ticks.  There should be NO edginess, whining, or high pitch to your voice.  If there is, you’re not doing it right.  Start over. (My mini-van is a mess, but is there a reason you want to tell me?  My shoes cost too much–are you worried about our budget?  Mom likes things done her way–can we still go home for Christmas?  I didn’t know how you made corn casserole, do you mind if I make it my way?)

RE-MEMBER to listen to all answers and not react.  Discuss.  Ask more probing questions to learn about the other person and their feelings.  Again, if there is edginess, whining, or a high pitch to your voice, you’re not doing it right.  Start over if necessary.

RE-CEIVE your fault in the situation.  This is the ouchy part, but if we

  • RELAX,
  • don’t READ,
  • REPHRASE, and
  • REMEMBER to listen, and
  • REPEAT as needed,

we are more likely to see if we need to own up.  (The van is messy, but I’ve been feeling too lazy to clean it.  My shoes did cost too much, and I know it wasn’t good timing to buy them.  You’re tired.  I know I’ve over committed our schedule.)

Don’t settle to be where you are in any area of life that really counts.  Always listen.  Always learn.  Always laugh.  Always move forward.  People are important, not things and appearances.  RE-member the “RE”s.

Have a wonderful Thanksgiving!




How Do You Eat THAT Vegetable? Butternut Squash.

Squash up some butternut squashVegetable Series: When we changed our eating two years ago, I resolved to be afraid of no vegetable. Not knowing how to cut it or cook it was NOT going to keep it out of my cart. For a long time I’ve wanted to do a series of posts on all the different vegetables we have tried and what we do to the poor things. May you, too, vow to try any and all vegetables in your supermarket! Go get ‘em, tiger.

Okay. We’re back on the vegetable trail.  Have you tried rutabaga yet? Artichoke? Kohlrabi? Jicama?  If not, you ARE missing out!  Today’s featured vegetable, butternut squash, should be one of your favorites.  Why?

1.  It’s long-lasting , edible interior décor AND does not require a face.  While pumpkins are great for edible, fall interior décor too, those with young kids know that all orange orbs require faces.  (Halloween is over.  That’s not a Jack-O’ Lantern.  That’s a Pilgrim now.  See the arms?)pumpkin

2.  Sweet potato . . . sweet potato . . . where are you?  Drat.  I’m out of sweet potatoes.  Where’s a pumpkin?  I’ll substitute with pumpkin.  Pump-kin . . . pump-kin . . . where are you?  Oh.  No pumpkin either, canned or otherwise.  Well, shoot.  What’s left to substitute?  I AM making this recipe today. . .

Aha!  Butternut squash.  Butternut squash can often be substituted for pumpkin and sweet potato in pies, casseroles, and soups.  Great for poor planners.  (No.  That’s self-deprecating.  Let’s practice re-phrasing and positivity to help reduce stress levels which lead to chronic disease.)  Great for busy moms who prefer to spend time with their kids–rather than shop with them.

3.  “National” pride:  Apples originated from Asia.  Potatoes from South America.  Brussels from Europe.  What about North America?  Don’t we have any yummy, native vegetables and fruits to call our own?  Yep!  Squash.  (I use that tid-bit factoid to get my kids to eat it, along with the miraculous story of how the Native Americans graciously taught the immigrant Europeans how to grow and prepare it.)

Do not be intimidated by squash.  Butternut, acorn, pumpkin, and delicata squashes are usually interchangeable.  Spaghetti squash is NOT interchangeable.  And yellow, summer squash is NOT interchangeable.  Let’s make sure we are on the same page here.   Here is a pile of butternut squash:Cucurbita_moschata_Butternut_2012_G2


We eat a lot of hard squashes in our house, particularly butternut and pumpkin, but here is a no-frills recipe which is simple and gets the following remark:  “What is this?  Sweet potato?  Tastes like sweet potato casserole.”  The hardest part of working with hard, winter squashes is cutting them.

  • Get out your biggest butcher knife to cut that thing in half!
  • Then, lay a half on its flat surface and start cutting it into half-rings.
  • Cut the half-rings into wedges–like you would a pineapple!
  • Use a smaller knife to then slice off the peel left on one side of the wedge.


Butternut Squash Up

What you’ll need:

1 medium-sized butternut squash, cut into pieces
1/4 cup maple syrup
1/4 cup oil (I used melted coconut oil but olive oil or melted butter would be great, too)
1 teaspoon cinnamon
1/2 teaspoon nutmeg
Dash of salt

1.  Preheat oven to 350 degrees Fahrenheit (177 degrees Celsius).
2.  Cut your squash if you haven’t already.
3.  Place the chunks into a casserole dish.  (You don’t want it to really fill the dish by more than half.)
4.  In a smallish to medium-sized bowl, whisk together maple syrup, melted oil, and spices.  Pour over squash and give a quick stir to coat squash.
5.  Bake for about 45 minutes to an hour.  (Baking time will vary based on your oven and on sizes of the squash pieces.)  Squash is finished baking when it is fork tender.
6.  You are not done!  Use a large fork or a hand-masher gadget to squish up the squash.  Then, give it a few good stirs.
7.  Transfer to a pretty serving dish and serve warm.

Family “gustar” report: 6/7 eaters liked this.  (We have company staying with us.)  My youngest eater took her mandatory bite. She used to be my best eater, but she is going through a picky time.  I also served this at a large family get-together, and it was well-received by my mom, dad, and sisters, a fussy, honest crowd.

You can see below the casserole dish I chose, the “wedges” of squash I described, and squashing it up (and why I suggest putting it in another serving dish).

photo 1 photo 2

Do you eat squash?  Which is your favorite?  How do you fix it?


Photo credit:  Wikipedia, public domain photo.   Butternut squash, cultivar variety of Cucurbita moschata, ripe fruits. Ukraine.  Photographer, George Chernilevsky.


Talk About Your Medicines

Doctors and lawyers don’t mix. Well, maybe they do—but they hide their feelings about each other well, which is why I can’t mix with lawyers.  I possess this strange connection between my brain and my face.  Think thought.  Thought plastered on face.  So I have all kinds of friends, but no lawyer friends.  Oops.  Take that back.  My first boyfriend from elementary school is now a lawyer, but he’s a good-guy lawyer.  His last name is a first name.  Don’t you hate that?  So confusing.  “Excuse me.  I can never remember.  Is your name Thomas Todd?  Or Todd Thomas?”

I’m talking about lawyers because American Recall Center asked me if I would run a post with the theme “Talk About Your Medicines.” After checking it out, I saw the site, which seems fair and unbiased, was sponsored by a law firm.  “Dang.  I’m shot if I do and will be looking over my shoulder forever if I don’t.”  So I will.  No strings were attached to this post.  They simply asked if I would write a post on medication safety, approaching it based on my experience.  (They did give me a little picture I could use, but I decided I shouldn’t take anything.  Just to be safe, you know.)  I don’t have one of those wordy disclaimers (yet).  But let me say, which I know you all know:  Don’t use anything on my site for medical advice.  It is not intended for that.

Without further ado—three important questions to ask your healthcare providers:

What does this medicine do? Ask them to write what the medicine is for on the prescription. 

The “sig” of a prescription is the line which tells how the medicine is to be taken. It is written in language your doctor and pharmacist understand.  Some alien code derived from Latin.  Example:   ii gtts OD QD.  Translation:  Instill 2 drops in the right eye daily.

I want to ask you to do something for me. When your doctor writes a prescription (or types it to be sent to the pharmacy via computer), please ask him or her to please write what the prescription is for in the sig.  The new sig for the above Martian talk would look something like this:  ii gtts OD QD for glaucoma.  Your bottle would then read:  Instill two drops in the right eye daily for glaucoma.  That way you’ll know that it is not your dry-eye eye drop or an antibiotic eye drop.

Here are a couple more examples:

i po qd for HTN= Take one tablet by mouth daily for hypertension i po bid for depression=  Take one tablet by mouth daily for depression.

Having worked as both a pharmacist and doctor, I have seen first-hand how confusing all those bottles are for people. It gets even more confusing when one medicine can be used for different conditions.  Help keep organized by asking the doctor to add the indication at the end of the directions.  Your pharmacist can usually do this for you as well if you ask them at the time you drop off your prescription.  If the prescription was called in ahead of time for you, then call the pharmacy before you go to pick it up and have them do this for you if they can.  (Laws vary by state)  Alternatively, you can write it on the label yourself, but you’ll have to do it every time.


Is this addictive? Ask your doctor if the medicine has potential to be a habit-forming drug.

Our whole pharmacy staff knew “the seekers.” People who had gotten themselves mired down with addictive prescription medicines.  They’d call in for their medicines way too early.  They’d doctor shop.  They’d feign new health conditions.  Medical doctors get dinged and criticized for not controlling people’s pain nowadays, but let me tell you, I’ve seen “the seekers” and their desperation.  It’s not usually physical pain they try to calm.  It is heart-wrenching the anguish that prescription drug dependence can cause.

It starts simply. Some Xanax for insomnia or wedding jitters.  Some Tussionex for a cough.  Some Vicodin for dental pain.  Some people soar on those drugs and crave more and more and more.  They just can’t stop no matter how much they lose.  Nobody really wants to end up an addict.  But who knows exactly where our Achilles’ heel is?  Having been behind the counter handing out Vicodin and Darvocet right and left, I feel controlled substances are dished out too easily.  (Don’t take offense.  I well-know that they are also needed by many and used responsibly.)  Ask your doctor when he or she prescribes you something, “Could this be addictive?” If so, consider asking if there is an alternative.  There often is.  Or ask him or her to prescribe only a few so there is no temptation if you end up being someone who thirsts for the substance.  And for goodness sake, never use the medicine beyond what it was intended for or share it with somebody else.

Addictive prescriptions are called “scheduled” drugs in the United States. They have specific rules and regulations.  Commonly scheduled drugs are those used for anxiety, pain, cough, and ADHD.  I don’t like people to be in acute pain, but neither do I want them to live a lifelong nightmare with prescription drug abuse.

How can I get off of this medicine? Ask your doctor if there are ways to get off of medicines.

I started blogging when I realized how important nutrition was in my family’s health. We have shed numerous medicines by overhauling our diet (and not in the way I was trained to overhaul a diet which talked about very low fat, calories, and lots of grains).  We have ditched Prilosec (GERD), Flonase (allergies), Miralax (constipation),  Flovent (asthma-type symptoms), albuterol (asthma-type symptoms), and Aleve (for headaches).  As I continue to read and learn, I see more and more that our prescription drugs can be detrimental–drugs that I dispensed and prescribed thousands of times.  Sure, there are times you need them, but often they are just a crutch and excuse to not take the bull by the horns and eat for the body instead of the tongue.

Prilosec and other proton pump inhibitors block acid production and the factor (intrinsic factor) needed for you to absorb vitamin B12 (methylcobalamin). They also change the acid balance being made by the stomach, which in turn decreases the amount of pancreatic enzymes needed to absorb your food, so you’re not absorbing food nutrients as much as you should.  Lipitor and other statin medicines block the formation of not only cholesterol, but also coenzyme Q 10.  Coenzyme Q 10 is necessary for your cells’ production of energy for themselves to function.  I could go on about SSRIs, steroids, NSAIDS, and antibiotics.  All these medicines have downstream effects in the body, and if you can get off of them by changing your diet, THEN DO IT.  Dang it.  Do it.

Ask your doctor what it would take to get off of the medicine. It is true.  There are some medicines that will be required forever.  However, if he mentions diet and exercise, then I encourage you to check out different kinds of nutritional changes such as Wahls’ Protocol, Perfect Health Diet, Paleo, Primal, SCD, GAPS, Wheat Belly, or another REAL FOOD type of plan.  If he doesn’t mention diet and exercise (like for headaches, irritable bowel, depression, GERD, respiratory issues, sinus issues, acne), I still encourage you to do a bit of searching and start asking questions.

One medicine leads to another, and soon you’re on 10 drugs. Investigate the role of nutrition and lifestyle in your health, and don’t take the answer, “Oh, it’s fine to take it as long as you need it.” as the end of the conversation.

Multiple flowersI wish you health. Be safe taking medicines.  Don’t be afraid to ask questions.


Digestive Link Sharing

Fall leavesThere are so many helpful, fascinating topics I really want to get a chance to read on and summarize for my blog posts.  Writing and explaining helps solidify the information in my mind and hopefully the summarized information helps some readers too.  Sadly, I just can’t keep up with all that I want to do in a timely fashion.  So today I’m going to share three links which have been shared with me that some readers may be interested in.  Eventually, I’d like to read and summarize on the methanogens and progesterone links.  But, honestly, I can see it may take me a year to do it.

Link ONE is about how certain microorganisms in the gut make methane which then slows the intestinal transit leading to chronic constipation.  This may lead to the idea that a breath test could be diagnostic and certain antibiotics helpful.

Methanogens in Human Health and Disease

Link TWO is about the effect of progesterone and prostaglandins on women’s colons.  Women with chronic constipation and slow transit have been found to have abnormal levels of prostaglandins and cyclooxygenases in their colons.  When researchers applied progesterone to colon cells from women without constipation, they were able to bring about the abnormal levels seen in cells from constipated colons.  So there is clearly a role between progesterone, prostaglandins, and chronic constipation. 

Chronic constipation in women linked to prostaglandins

Link THREE is about an online, digestive conference coming up.  It is free.  There are some good speakers involved who are on the cutting edge, or at least reading up on the cutting edge, of digestive health.  The speakers are from a wide variety of backgrounds, some MDs and some not.  Usually something like this is a good place to listen, generate ideas, and then verify ideas with research or run them by your doctor.

The Digestion Sessions


Information is key.  Help your doctor help you by learning the new information out there.  Your doctor is like a good coach.  They have strong knowledge and experiences, but they’re trying to orchestrate many, many players all day long.  There is no way on God’s great earth doctors can ever keep up on all of the new information.  Print off credible articles, highlight important information in it which you think applies to you, and then say, “Hey, Doc.  I found this article about my problem.  Could we try it for me or do you think it’s a bad idea?”

Thank you Ashwin, Nishka, and Toni for the links.  I can’t wait to delve into them more.



The Things Children Steal


I am a three months postpartum mother of four.  It is no wonder I have lost a few things.

1.  The sash to my bathrobe.  Due to its perfect length and knotting ability, it can be used for many important things.  Holding on American Girl toilet paper dresses.  Tying together Stuffies and Pillow Pets.  Holding up the corner of blanket tents.

2.  My kombucha.  I swore they didn’t like this green flavor.  That’s why I bought the nasty tasting stuff.

3.  My bed.  I about fell off my allotted sliver last night.

4.  My butt.  Traded in butt-bump for mummy-tummy.  But did you know that DHA is actually stored in a pregnant and lactating woman’s thigh and butt fat?  All that DHA comes right off the butt and goes right to baby’s brain!  So our sagging buttocks are the glory of our children’s cerebral capacities.

5.  My scissors.  I’ve only got about 6 pairs.  Six lost pairs.  This isn’t even including the three, pink-handled children’s craft scissors lost in the depths of clutter.  (They stole my clean house too.)

6.  My time.  Does getting my upper lip waxed at a salon have to count as my free-time?

7.  My mind.  I wish all that DHA would go to MY brain!

8.  My lip gloss.  Although I suspect my girls, sometimes I think I see a pink shimmer on my husband’s lips.

9.  My temper.  I’ve lost it so much I’m down to whisper-yelling.

10.  My bathroom.

11.  My bath.  Tip-toe.  Tip-toe.  Super quiet.  Sneak off.   Fill tub with bath salts and lavender.  Get ready for “Aaaah.  Relaxation.”  Pitter-patter.  Pitter-patter.  “I heard you, Mommy.  Can I take a bath too?”

12.  My hand mirror to look at the back of my hair.

13.  My toothbrush.  This was the last straw.  The one that broke me down.  The one that made me remember the backwash floating in my mom’s Diet Pepsi from my stolen drinks.  The one that made me remember my Dad bellowing through the house looking for his nail clippers tucked on my bedroom vanity.  The iron I took to college from mom’s washroom without a backwards thought. . . Back to the breaking straw.  So, I had bought this cool, spinning toothbrush to cut down on plaque by 90% and stop any receding gum lines.  I loved it.  All my kids have had them in the past, but I finally bought one for me. . .  One day, I knocked on my closed bathroom door.  I heard some rustling.  I walked on into my bathroom.  And there was one of my darlings sheepishly trying out my new toothbrush.  “No worries,” I said.  “Finish up.  It’s a cool toothbrush, isn’t it?”

I could go on and on.  Kids are pretty special.  Love them.  Cherish them.  Call yourself to higher living (but come downstairs for supper occasionally).  Call them to higher living (but the top of the refrigerator is not safe).  Work on your marriage.  Keep it sound.

With our fourth child, I feel like my quality time with my husband has plummeted.  By the end of the day, I just want to slip away for some uninterrupted, quiet time.  I had forgotten how frazzling managing the house was with a baby in tow.  When I was pregnant with my first child, I looked at my husband and said, “No matter what, this child is here because of us.  No matter what, we must work to keep our marriage and love for each other strong.  We need to keep that no matter what.”  And we have.  With all that becomes lost in parenting, I refuse to lose the wonderful relationship with my husband.  May you, too, fight to always keep that special relationship growing.

Kids are great, but they are challenging!  Thanks for reading, and I look forward to trying to get back to blogging here more.  We recently had a great vacation to Indiana to spend time with friends and family.  Then I had to catch up on post-vacation laundry–plus some (and then some more) continuing medical education requirements I am happy to report that I completed.

Hang on for the ride, parents.  We can do this.



Photo credit:  By Jonas Bergsten [Public domain], via Wikimedia Commons



What Role Could Constipation Be Playing in Your Child’s Bed Wetting and Bowel Habits?

Miralax (polyethylene glycol)Someone sent me a link, “What Every Parent Should Know About Bedwetting, Accidents, and Potty Training,” relating constipation to bedwetting, and I found it a good read.  Constipation is prevalent in our society, and kids are not exempt.  The author of the article is a physician, specifically a pediatric urologist, who deals with urinary issues in children day in and day out.  He feels that constipation–which can be difficult to diagnose in children because they leak liquid stool around hard, large impeding stools in the rectum, appearing to have diarrhea instead–is a leading cause of urinary problems in kids.  He also, like me, is frustrated at the medical community’s blasé “just take Miralax and eat fiber” treatment of constipation.

“Constipation is a distasteful subject. No one wants to talk about it.”

As distasteful as it is, constipation is a health condition that needs talked about.  Headaches.  Back aches.  Tooth aches.  Poop aches.

I had a child who used Miralax daily and still had constipation issues.  She would sit on the toilet screaming and crying for her “poop medicine” as I stood there trying to decide whether or not to torture her further with a suppository.  Traumatized by constipation issues, we decided to figure out what was causing constipation problems.  We eventually found that complete dairy elimination cured her constipation.   We next undertook a complete overhaul of our family’s diet, providing foods to help her GI tract recover a good barrier so the foods she ate wouldn’t cause her problems anymore.  Luckily we succeeded, and on the way we learned the importance of proper fuel and the devastation caused by improper fuels–and how each body is unique.

I believe, unlike my conventional medicine colleagues, that bowel habits are a good indicator of health.  Band-Aids won’t help a festering wound, and Miralax won’t really change chronic constipation.  Causes and good treatments for constipation and urinary issues should be sought.  Sometimes it’s as simple as feeding your kids real food. Or identifying a sensitivity to gluten or dairy, even minute quantities.  Or incorporating probiotics or probiotic foods.  Treatment may require more diligence with a bowel retraining program or an elimination diet.  But I am confident that constipation can be improved, especially in young children.

I encourage you to check out “What Every Parent Should Know About Bedwetting, Accidents, and Potty Training” written by Dr. Steve Hodges. Click on the blue texted excerpts below to go there.:


“Reality: Most children wet the bed because their rectums are clogged with poop. The hard, bulging poop mass presses against the bladder, compromising its capacity and irritating the nerves feeding it… The most rigorous studies ever conducted on childhood wetting were led by Sean O’Regan, a kidney specialist drawn to the topic because his 5-year-old son wet the bed every night. A test called anal manometry showed his son’s rectum was so stretched by stool that the boy couldn’t detect a tangerine-sized air balloon inflated in his bottom…

Ultimately, O’Regan’s Canadian research team tested several hundred children with enuresis, encopresis, and recurrent UTIs. Virtually all were, like O’Regan’s son, stuffed with poop. When their rectums were cleaned out with enemas, the wetting, soiling, and infections stopped… A couple years back, I tracked down Dr. O’Regan, now retired and living in Arizona. I asked him why he thought his research, compelling as it was, never made a splash.

He told me: ‘Constipation is a distasteful subject. No one wants to talk about it.'”

If you have kids who have urinary issues or constipation, check it out.

Nothing on my blog should be construed and used as medical advice.  But I do hope it makes you think and start asking questions.

Health to you and yours–


(Protect The Brain.) What Was The Role Of Methylcobalamin In The Alzheimer’s Study?

Mom's hollyhocksReversal of cognitive decline:  a novel therapeutic program is a recent, small Alzheimer’s study reporting some treatment success using a multi-faceted regimen which addresses sleep, stress, nutrition, and supplements.  I enthusiastically encourage lifestyle change, particularly regarding food, to address health, and many of the things done in this study, my husband and I adopted about two and a half years ago into our lifestyle–with fantastic health results. I’ve been an evangelist ever since.  (It’s not the stuff they bombarded me with in pharmacy and medical school, by the way.)  Somebody who read that Alzheimer’s-related post posed a question regarding why methylcobalamin was used as a supplement:

Hi Terri, thanks for your great post. I love hearing about diet and lifestyle changes reversing disease. Lately I read about coconut oil and its usefulness in Alzheimer’s – Alzheimer’s Disease: What If There Was a Cure?  Terri, can you tell me why the methylcobalamin and CoQ10 were used?  What were their specific roles?”

In the study (follow the link above), there is a nice table listing all the specific interventions taken and why the researchers chose them.  If you are interested, I think it’s a good read.  There’s not too much detail, so today’s post on methylcobalamin and the last post regarding Co Q 10 definitely elaborate on a deeper level.

And let me tell you before we get started and I lose you to the jibber-jabber, these people were not eating breakfast cereal and drinking juice as part of the plan.  And neither should you or your kids.  My kids will never see a Pop-Tart again.

I see the researchers used methylcobalamine.  Why didn’t they just use the kind of vitamin B 12, cyanocobalamin, I have in my multi-vitamin?

Take 1
Because your vitamin sucks.  That’s why.
Take 2
Because cyanocobalamin is cheaper.
Take 3
My apologies.  There are different forms of vitamin B 12.  The vitamin B 12 commonly in our vitamins or in our injections is called cyanocobalamin and is not naturally occurring, but man-made.  The vitamin B 12 used in this study is methylcobalamin and is one of the forms active in our bodies.  Let’s talk about the differences in these two entities using an analogy about hats.

On hats
Sometimes you wear a hat.  You might wear a baseball cap.  Or a top hat.  Or a cowboy hat.  If you’re going to a formal restaurant with a great reputation and you wear a baseball cap, you won’t fit in.  In fact, you may not even be let in!  Well, cyanocobalamin, a synthetically made vitamin B 12, is wearing the wrong hat to the body’s party.  To change its cyanide (whoa) side-chain group to an appropriate hat requires lots of steps by the body.

On Methylcobalamin
Methylcobalamin is also a kind of vitamin B 12, and it is wearing the right hat to the body’s party!  Specifically it is vitamin B 12 with a  methyl group on it instead of a cyanide (whoa) group and has more success getting into the central nervous system than cyanocobalamin.  The vitamin B 12 in most Walgreen’s or CVS supplements is likely to be cyanocobalamin, the synthetic vitamin B 12.  (Man. I worked for CVS during medical school as a pharmacist to make money to cover Indian food and a movie.  I worked so hard there, I swear they were trying to kill me.  Made medical school feel like a breeze.)  Anyhow, here we go again (remember my folate posts), a synthetic vitamin supplement that needs converted by multiple steps to the active form.  Not a good idea if the active form is absorbable, effective, and not too cost prohibitive.

In an Alzheimer’s patient (heck, any of us for that matter!!!), oxidative stress (see last post for an oxidative stress easy explanation) is rampant and taking a toll on the biochemical pathways of the body.  Providing the active form of vitamin B 12 bypasses the reactions that have become broken and faulty due to oxidative stress.  (And providing dense nutrition and well-placed supplements can allow these broken and faulty reactions to be restored, like in the Alzheimer’s study.)  In addition, Alzheimer’s patients probably, being older patients, have low stomach acid, a condition which decreases vitamin B 12 absorption orally.  They may also be on the diabetic medicine metformin or the proton pump inhibitor Prilosec and thus have low stomach acid, exacerbating vitamin B 12 deficiency.  A GREAT REASON to change your diet and see if you can get OFF those medicines!

OK.  But what does the methylcobalamin do?

Some studies show that Alzheimer’s patients have low vitamin B12 levels.  A low vitamin B 12 level can lead to damage of myelin, the protective coating of our nerves.  Improving vitamin B 12 status can help in myelin regeneration.  That’s likely to be important, but what they say they were after in this study was lowering homocysteine levels.  Homocysteine, an amino acid, can be elevated in Alzheimer’s disease.  High homocysteine is destructive in the brain.  It overactivates receptors in the neurons known as NMDA (glutamate) receptors and leads to cell death.  It leads to DNA damage and programmed cell death.  It keeps the inhibitory neurotransmitter GABA from doing its job.  It interferes with the important blood brain barrier.  High homocysteine levels are implicated in dementia and just overall decline in thinking ability (cognitive decline).

Low vitamin B 12 and high homocysteine levels can be linked.  A low vitamin B 12 level can result in high homocysteine levels.  Vitamin B 12, specifically methylated vitamin B 12–methylcobalamin, is necessary to take this homocysteine and turn it back into something called methionine.  Methionine then starts a cascade of reactions which provides necessary protection from oxidative stress, which we talked about in the last post.  Oxidative stress is prevalent in Alzheimer’s disease (and most people eating  sugar and grain-rich diets).

Extra credit paragraph:  Converting homocysteine to methionine requires methylated vitamin B 12 (methylcobalamine) AND a methyl group from 5-Methyl THF or “folate.” (Folate post 1 and folate post 2.)  (Eat real food.  Eat your greens and broccoli.  Eat your meat.)  From methionine, SAM is formed, which goes on to assist in many methylation reactions.  For those of you who are getting started in this alternative health area, you may have went googly-eyed over the forums where people start talking about methylation and methylation pathways.  You wanted to pull your hair out and tell them to stop it.  This homocysteine to methionine is a methylation process.  And don’t feel bad.  I used to stop reading right there too.  I didn’t want to go through those pathways again by choice!  But it’s all an onion.  Layer by layer by layer we learn if we persist.


Methylcobalamin was used as part of a multi-faceted approach to reverse symptoms and brain changes in Alzheimer’s dementia.  There was some preliminary success!  Many of the changes we can implement in our own lives and our children’s lives, without popping a pill!  Methylcobalamin helps lower homocysteine and power our “detoxification” systems.  Food sources are mostly, if not entirely, considered to be meats.  Liver is king.  If you are vegan or vegetarian, I encourage you to read up on vitamin B 12 so you do not get deficient.  Also, if you don’t like meat, you pop prescription medicines which could interfere with B 12, or you eat a crummy diet.  This is important.  It is your brain we are talking about here.

And just some last ideas to chew on.  Vitamin B 12 absorption decreases as we age.  Acid reflux medicines can interfere with vitamin B 12 absorption.  Vitamin B 12 lab values can be in normal range and a patient still be vitamin B 12 deficient.

Be diligent.  Don’t use the internet as your doctor.  My blog posts are not meant to be medical advice or treatment advice.  I stay at home and fold laundry, while reading “Go, Dog, Go” all day; don’t trust me.  Discuss all health changes with your favorite doctor.




1.  The Neuropsychiatry of Vitamin B12 Deficiency in Elderly Patients.  Christian Lachner, M.D.; Nanette I. Steinle, M.D.; William T. Regenold, M.D., C.M.  The Journal of Neuropsychiatry and Clinical Neurosciences 2012;24:5-15. doi:10.1176/appi.neuropsych.11020052

2. Low vitamin B-12 status in confirmed Alzheimer’s disease as revealed by serum holotranscobalamin.  H Refsumi, AD Smith.  J Neurol Neurosurg Psychiatry. 2003;74:959-961 doi:10.1136/jnnp.74.7.959

3.  Methylcobalamin Facilitates Collateral Sprouting of Donor Axons and Innervation of Recipient Muscle in End-to-Side Neurorrhaphy in Rats.  Wen-Chieh Liao,  Yueh-Jan Wang,  Min-Chuan Huang,  Guo-Fang Tseng.  September 30, 2013.  DOI: 10.1371/journal.pone.0076302