So a couple years ago I was doing my regular teaching call with my mentor, Dr. Richard Lord, and he very excitedly posed a question to challenge me as he often does. It was, “what is THE most essential nutrient to life, all life, not just human beings, but all animals and other life forms?” I panicked since I didn’t really know where he was going with this but the clue was “all life forms”. When we look at how essential an essential nutrient is, we run up against a problem. Humans would drop dead pretty quickly without a lot of things. Magnesium for sure, potassium too, calcium, and that’s just a few of the minerals. If any of those were suddenly and completely absent, you’d be dead pretty fast as your heart would stop contracting, and you wouldn’t be able to move any of your muscles without those minerals.
Omega 3’s maybe you could hang on for a while using some alternate fatty acids, but it wouldn’t be very pleasant and eventually your cell membranes and brain would fall apart. There are essential amino acids that are required, but honestly I think if all the lysine were suddenly drained from your body you’d last at least a few minutes, maybe hours or days. For sure if your glutathione levels vaporized every cell would die quickly. If you couldn’t methylate I think your DNA would probably stop working, so that means no cell replication, not sure about time frames but you’d be gone sooner or later.
It’s an interesting question, because if we reverse the thought pattern in a way and instead say what would happen to a human body if you gradually decreased magnesium levels over time? Well you’d get tired because you need magnesium to make cellular energy (ATP), your blood pressure would go up and your cardiovascular system would gradually fade out and fail, you wouldn’t be able to regulate your blood sugar or sleep very well, and eventually you’d be in pain all the time because your muscles wouldn’t relax properly. Fatigue, cardiometabolic problems, sugar cravings, insomnia, weight gain and chronic pain. Does that sound familiar? Sounds like just about every functional medicine patient I treat.
So when we think about nutrients, we can think not what they do, but what happens if they gradually fade out and levels drop. Almost every American is chronically low in magnesium, so metabolic problems, sleep disorders and energy deficits really make sense. The interesting thing about functional medicine is that when you test someone and see their magnesium levels are low and fix that the migraines, fatigue, cravings and insomnia get better! It seems like a miracle every time but it’s really just as miraculous as someone being thirsty, drinking a glass of water and then not being thirsty. Replace what is missing. How complicated is that?
Given that human physiology is dependent on nutrients to work, it makes a fair amount of sense that if a patient is chronically low in B6, they are going to have neurological or hormone-related issues sooner or later, and it’s also just common sense that these problems will respond to nutrient therapies just like dehydration responds to water. For some reason the way our entire culture thinks about vitamins and minerals is as if they are optional - Like something you take as a booster.
Richard’s question was intended to unseat that mindset, and bring me back to biochemistry. In the world of biochemistry, essential nutrients are essential for LIFE. We stop living if we don’t have them, and we get sick when our essential nutrient levels drop sufficiently.
To use vitamins as an example, they are vitamins because we can’t make them. So if your diet lacks a vitamin, you won’t have enough of it. Now we are on even thinner cultural ice. Does diet impact human health? If people really believed that diet could make or break human health, that diet could determine lifespan, when you will die and what will kill you, then the entire fast food industry would not exist. We eat as if the vitamins will just show up somehow. The biochemistry says otherwise.
Well, the answer to Richard’s question that day was thiamine. He had spent a few weeks reading the updated scientific literature on thiamine and decided that all life as we know it would cease quickly without plain old vitamin B1. As we work as clinicians to determine the links between human illness and clinical nutrition, we really work in the fields of biochemistry, proteomics, genomics and the like. And I believe you can begin to get a sense of the vast importance of a given nutrient when you see its varied role in the body.
Magnesium for example is critical for 350, maybe 400 enzymes. That means if a patient is low in magnesium, several hundred normal body processes will start to go bad, the lower the magnesium levels get the more severe and widespread the problems become. Several of the B vitamins are similarly involved in hundreds of enzyme reactions and their deficiency states can reverberate creating neurological problems, endocrine disruption and a damaged metabolism and poor cardiovascular health. One single nutrient, just replacing one single nutrient properly like thiamine can reverse problems experienced in hundreds of pathways.
The power of applied nutrition and lab-based programs constantly amazes me, but as the years go by and I learn more and more about patients and tie that learning back to the biochemical changes in pathways we are invoking, it all starts to make more sense.
You can test for all of the B vitamins with an organic acids profile; They are a little tricky to interpret but well worth investing your time in understanding. I continue to learn more and more each year and become more interested and excited by this work with every new decade.
I had a patient a few months ago who reversed her daughter's chronic fatigue using a lab-based, personalized nutrition program with B complex and exceedingly high dosages of thiamine and niacin. We observed on a lab test that her 13 year old daughter’s enzyme system involving keto acid dehydrogenase was extremely dysfunctional, and based on an unusual genetic disorder the test uncovered (I’d never seen it before) we were able to restore normal enzyme function for this child by giving her body and nervous system the amount of B vitamins it requires to work properly. The more you study biochemistry, genomics and metabolomics the more patients you can help.