Vitamin D3 is essential for: energy production, healthy thyroid function, the immune system, lowering risk of falls by improving balance and muscle performance, maintaining muscle and bone, reducing the risk of cancer, and promoting healthy hair and nails. Goal vitamin d levels are at least 60 or at least 80 in patients with a history of a solid organ cancer, but levels should not be higher than 100. About 30% of the population has a vitamin d polymorphism, and they will have to take huge doses of vitamin d to get adequate vitamin d levels. High vitamin d doses WITHOUT K2 can increase micro calcification of vascular beds. Vitamin d is a fat soluble vitamin and should be taken with OrthoMAX or healthy fats (avocado, peanut butter, salmon, eggs) to aid in absorption. Typical Dosing: If vitamin d level is < 40 start Dynamic D-K2 2 tabs daily for 3 months then transition Dynamic D-K2 1 tab daily for maintenance dose or BioTe ADK 10 for 3 months then transition to BioTe ADK 5 daily for maintenance. All adults should be on Vitamin D/K2 unless vitamin d levels are above 100. In PREGNANCY you take vitamin D3 alone (not extra vitamin A or K).

Vitamin B12 and methylation is essential for: producing energy at a cellular level, helping to prevent cancer, processing chemicals and toxins, building neurotransmitters (dopamine, serotonin, epinephrine), producing a protective coating on our nerves to prevent neuropathy in diabetes, processing and metabolizing hormones, and building immune cells, DNA, and RNA. Goal is for vitamin B12 level to be > 650 and for the patient to have no symptoms of poor methylation. About 60% of North Americans do not convert inactive folate to active 5-MTHF which is known as MTHFR. MTHFR (methylenetetrahydrofolate reductase) is an enzyme that breaks down amino acids homocysteine and folate. Homocysteine is an amino acid that works to maintain the body’s cells. Folate is a B vitamin needed to make red and white blood cells in the bone marrow. Folate also converts carbohydrates into energy and produces DNA and RNA so both play an important role in the body’s daily functions. MTHFR gene mutations can lead to high levels of homocysteine in the blood and low levels of folate and other vitamins, mostly B vitamins. An increase in homocysteine levels caused by MTHFR can lead to hypertension, blood clots, strokes, heart attacks, pregnancy loss, nerve pain, migraines, depression, anxiety, bipolar disorder, schizophrenia, and leukemia. Some symptoms of MTHFR gene mutations include: ADHD, autism, autoimmune thyroid disease, cardiovascular disease, chronic fatigue, IBS, PCOS. Treatment of MTHFR deficiency involves taking B complex vitamins along with a methyltetrahydrofolate supplement. Mighty Methylfolate has specific B vitamins for the homocysteine cycle, folate instead of folic acid, and is the same a pharmaceutical deplin! Typical Dosing: 1 capsule of Mighty Methylfolate per day with food along with OrthoMAX and Dynamic D-K2 to optimize vitamin d levels as well. Another option is Methyl Factors Plus from BioTe. If elevated homocysteine level or B12 level < 300 take 3 tabs per day with food, B12 level < 500 take 2 tabs of BioTe Methyl Factors Plus per day with food, and if symptoms and B12 level > 500 take 1 tab of BioTe Methyl Factors Plus per day with food.

Iron Deficiency is essential to physiologic function of the body as it has a role in red blood cell production. Deficiency can cause fatigue, decreased libido, migraines, loss of balance, hair loss, nail changes, and heart failure. The greatest source of women’s iron loss is menstrual bleeding, but other sources like GI bleeding are common in men and women. Goal ferritin levels are at least 50, but levels closer to 100 are preferred. Ferritin levels of less than 20 can be dangerous and ultimately lead to heart failure. Patients with ferritin levels this low should consider an iron infusion as it is more difficult to absorb iron from your gut at levels this low. Typical Dosing: Elemental iron should be taken at night before bed on an empty stomach or with crackers or orange juice as vitamin c aides in absorption of iron. Do not take with any dairy, vitamin d3, or magnesium.