Food as medicine - Part 3: Essential Vitamins and Deficiencies: Bone Health, Mood, and Energy

This session of the "Food as Medicine" series featured Dr Tanya Denne, ND, who provided an exhaustive look at the biochemical requirements for managing Parkinson's. The discussion focused on addressing the "whole person" through precise lab testing and targeted supplementation to manage bone health, mood, and energy.

Vitamin D: The Multi-Functional Hormone:

• Vitamin D is a critical regulator of over 1,000 genes and acts as a hormone, nutrient, and vitamin. Deficiency is highly prevalent, affecting 40% to 68% of people with the condition.

• Optimisation Targets: A blood level goal of approximately 75 ng/mL is recommended. This should be monitored every 3 to 6 months to ensure the levels stay within a safe range of 60–80 ng/mL.

• Safety Warning: High megadoses can lead to kidney stones and a liver burden. Because the condition is often associated with low liver enzymes like ALT, slow optimisation over 3 to 4 months is much safer than aggressive dosing.

• Absorption Tips: As a fat-soluble nutrient, it must be taken with a meal or fish oil to be effective. Some people find their levels do not rise despite supplementation until they include these healthy fats.

• Dietary Sources: While rare in food, sources include wild salmon (600–1,000 IU), sardines (270 IU), tuna (230 IU), and eggs. Interestingly, mushrooms only provide vitamin D if they are dried in UV light.

Bone Health and Calcium Management:

People with the condition face a 2.6x higher risk of osteoporosis and a 2.3x higher risk of fractures.

• Dopamine’s Role: High levels of dopamine naturally suppress the breakdown of bone; therefore, the loss of dopamine directly increases the risk of bone thinning.

• Calcium Strategy: The goal is 1,200 mg total daily, with roughly 800 mg coming from food sources like tofu, dark leafy greens, nut milks, and sardines.

• Supplement Caution: High-dose "horse pill" calcium can increase the risk of kidney stones and cardiovascular events. Focus on dietary sources and elemental forms instead.
  Physical Intervention: Resistance weight-bearing exercise, weighted vests, and vibration plates are recommended to increase bone-building cells (osteoblasts) by putting weight on the spine and axial skeleton.

The Homocysteine and B-Vitamin Connection:

Homocysteine is an amino acid intermediate that can become toxic if not properly cleared (methylated). High levels (the goal is under 7) are linked to increased risks of osteoporosis, dementia, and cardiovascular issues.

• Levodopa Impact: Levodopa therapy can actively drive up homocysteine levels, which makes consistent B-vitamin support vital.

• MTHFR and Methyl Forms: Over 50% of the population has a genetic variant (MTHFR) that prevents them from processing synthetic folic acid or cyanocobalamin. Only methylated forms, such as Methylcobalamin (B12) and Methylfolate (B9), should be used.

• Vitamin B12: Essential for nerve health, DNA synthesis, and red blood cell formation. Low levels are associated with faster motor progression and cognitive decline. Sublingual forms are best as they dissolve under the tongue to bypass liver metabolism.

• Vitamin B1 (Thiamine): Critical for mitochondrial energy and nerve signalling. While megadoses are debated, thiamine influences the activity of the enzyme needed to convert tyrosine into levodopa.

• Vitamin B6 Caution: While essential for converting levodopa to dopamine, high doses can lead to peripheral neuropathy. It is best to check blood levels to ensure you aren't exceeding the reference range.

Strategic Magnesium Supplementation:

Magnesium is involved in hundreds of reactions, but the compound it is bound to changes its clinical use:

• Sleep and Anxiety: Magnesium Glycinate is the preferred form for relaxation.

• Brain Health: Magnesium Threonate is unique because it is the only form that effectively crosses the blood-brain barrier.

• Constipation: Magnesium Citrate is highly effective for digestive regularity.

• Energy and Fatigue: Magnesium Malate helps support energy production.

• Heart Health: Magnesium Taurate is often used for cardiovascular support.

Omega Fatty Acids and Inflammation:

The brain requires healthy fats for dopamine synthesis and mood regulation.

• Omega-3 (Anti-inflammatory): The goal is an "Omega check" total of above 8%. Sources include fatty fish like salmon and sardines, as well as walnuts, hemp, and chia seeds.

-Arachidonic Acid (Pro-inflammatory): This Omega-6 fat, found in red meat and dairy, should be kept low (ideally below 10%) to balance the inflammatory load.

Cooking Tip: Use heat-stable oils like coconut or avocado oil rather than unstable seed oils.

Hormones and Stress Management:

• DHEA: This steroid hormone supports energy, bone health, and metabolism. It should never be used without screening for hormone-sensitive cancers.

• Cortisol: Elevated cortisol is linked to worse motor function and neuroinflammation. Levels should be tested before 9:00 AM.

Melatonin: Beyond sleep, melatonin is a potent antioxidant. Immediate-release (IR) helps with falling asleep, while extended-release (XR/SR) helps with staying asleep.

Final Guidance on Quality:

Dr Denne warned that supplements are often poorly regulated; research showed some contained only 6% of their label claims. Adulteration with lead or arsenic is also a concern. Using practitioner-grade third-party dispensaries like Fullscript ensures accuracy and safety.

Always work with your healthcare providers to suggest and interpret the following blood lab work:

LABS:

CMP (complete metabolic panel)
CBC (complete blood count)
Vitamin D
Homocysteine
B12, B6
A1c, insulin, fasting glucose
OmegaCheck (Quest Labs specific)
DHEA
Cortisol (before 9am)
Magnesium, RBC
Iron panel with Ferritin