Welcome to Functional Friday where I use my knowledge as a functional blood chemistry specialist, to help you uncover what may be going on in your body! Like always, this is not medical advice, so please always verify with your practitioner ☀️

If you want to check out previous posts, check out the Functional Friday archives and feel free to comment if you have any requests for topics 🌈

Now let’s get started, todays topic is dehydration which is a bit more complex than not drinking enough water. Cellular hydration is dependent on a variety of factors and you can be dehydrated at a cellular level even though you are drinking plenty of water.

To assess cellular hydration, we need to look at a marker on the Complete Metabolic Panel called albumin.

Albumin is the bodies must abundant carrier protein and plays a big role in osmotic gradient, which makes it a good marker to assess hydration status. It helps to deliver water, fatty acids, minerals, hormones and other compounds across cell membranes using sodium potassium pumps which we will explore next week. If albumin cannot get into the cell, it cannot bring in water, and levels will build up in the blood while intracellularly the cell is depleted of nutrients and water.

The functional range for albumin is 4.3-4.8. Functional means that that’s the range win which the human body is healthiest, rather than the lab range which is the average of the population (not taking its health into account).

Since there is no known pathology that causes the liver to produce extra albumin, it’s a good way to assess if you’re dehydrated since higher levels will only show up if the blood is more concentrated (less water, therefore dehydrated). Hemoconcentration (Dehydration) can effect other markers on the panel, making some appear abnormally high/low or even abnormally normal.

Low albumin levels can occur if someone has liver pathologies or an infection/lots of inflammation. Pathologies like this in addition to dehydration can result in albumin that looks in range, could be a “false normal” since infection is pulling it down, and dehydration pulls it up, hence it looks like it’s perfectly in range! It’s always important to look at the big picture, look at patterns and understand your body to spot places you may need some help.

I would like to add that since albumin is so critical for health and nutrient transport, the body will even break down its own muscle in times of famine to produce albumin.

What can I do?

If this sounds like you, it’s a great idea to add electrolytes to your water to support your sodium potassium pumps to let albumin into the cell. Since albumin also binds to water, the cell will become hydrated intracellularly.

My favorite electrolyte product is LMNT which is a perfect blend of sodium, potassium and magnesium to power those sodium potassium pumps in appropriate ratios! I take up to 3 packets a day, since I live in a hot climate, sweat a lot and eat low carb.

I also make an effort to remineralize all the water I drink (we filter our water) with trace mineral drops since our soil is so depleted that our food no longer contains sufficient amounts of minerals.

If you simply drink plain, mineral/electrolyte free water, it’s actually possible that you’ll dehydrate yourself since you’re diluting the sodium and potassium that is in your system. This can have serious consequences and is sometimes the reason why distance runners experience heart attacks towards the end of the race when their sodium and potassium levels are depleted (either via sweat or excess fluid intake).

If you’re on a low carb diet particularly, your need for sodium especially will increase. Firstly because your body excretes more, and secondly because you will be cutting out lots of processed foods which are rich in sodium.

And no, consuming lots of sodium will not increase your blood pressure since dietary consumption of minerals do not impact blood levels- a hormone called aldosterone does, which we will explore next week.

Learn more about salt and electrolytes here!

I’ve also made electrolyte gummies 🍬

Salt your foods heavily with a high quality sea salt like Maldon’s, Redmond’s Real Salt or Celtic Sea Salt. Stay clear of the refined table salt! It is highly processed and leached of all its trace minerals.

Feel free to comment with any questions or requests for next week 🌈

In last weeks Functional Friday, we discussed how to assess a B9/B12 need based on a marker found on most yearly bloodwork- the MCV, which stands for mean corpuscular volume (the size of the red blood cells).

While the lab range for MCV on the report is a bit broader, the functional range for the MCV is 83-91! When the MCV is below 83, one has microcytic red blood cells (often with anemia) which is usually due to deficiencies in nutrients needed to create hemoglobin. Microcytic red blood cells will be the topic of todays post!

So why are some red blood cells smaller than average ?

Like I explained in the previous post, red blood cells come from stem cells in the bone marrow that split once their nucleus has matured. To mature, the nucleus needs B9/B12. If the nucleus doesn’t have those vitamins to synthesize DNA, the cell does not split causing macrocytic red blood cells (large MCV). This is because the cytoplasm grew to create 2 cells (like it should), but the nuclei did not, since they lacked the nutrients.

Red blood cells are filled with hemoglobin which helps them carry oxygen around the body. Hemoglobin is also synthesized in the bone marrow from iron, as well as co-factors like copper, vitamin A, zinc and B6. If there is not enough hemoglobin, your red blood cells will be not be full, therefore they will be smaller (think of a balloon) 🩸 aka microcytic.

Making hemoglobin is a rather complicated process, many steps go into its making, the last one being the insertion of an iron molecule into the porphyrin ring. The enzymes that create hemoglobin are dependent on B6 and zinc, so if you are deficient in those, the iron molecule cannot be added and you won’t have enough hemoglobin.

Additionally, the iron that is in our bodies needs to be made bioavailable so that the enzymes can use it. To do so, we need Ceruloplasmin, which is the active form of copper. Ceruloplasmin converts iron from its ferrous form into its ferric form, which the body can then insert into the hemoglobin structure. Vitamin A (retinol) is needed to activate copper so it can grab, transform and transport iron to the bone marrow.

In other words, if you’re retinol or copper deficient, you won’t be able to use your iron to make hemoglobin.

Although most people are told they have iron deficiency anemia if they have a low MCV, iron deficiency is most likely not the reason your MCV is low- it’s usually that one or more cofactors (Vitamin A, zinc, B6, copper) depleted. Always check your iron levels before supplementing with iron, because excess iron can be very inflammatory. A good marker to check is ferritin which is a topic for a future post!

What can you do?

As with an elevated MCV, I like to always take a food first approach. After 3-6 months, recheck your MCV since it takes about 3 months for your red blood cells to turnover.

A good food for anyone who is struggling with microcytic anemia is liver, since it has all nutrients necessary for hemoglobin production and is the correct ratio. For those who don’t want to regularly eat liver, you can take freeze dried liver capsules!

Copper is found in shellfish, nuts, sesame, cacao and organ meats, as well as salmon, mushrooms and avocados! 🥑

Zinc is found primarily in seafood, meats like poultry, eggs, dairy and some nuts and seeds 🥩

Some grains and beans also have zinc but they also have anti-nutrients like phytic acid which inhibit it’s absorption, so I would not count on it to achieve the daily amount. If you do choose to eat nuts, seeds, legumes and grains, prepare them properly by soaking and sprouting them prior to consumption!

Vitamin A is best consumed in its active form (retinol) through egg yolk, full fat dairy, butter, cod liver oil, beef liver, and oily fish such as sardines or anchovies 🐠

Betacarotene is a retinol precursor with a pretty low conversion rate, but you may be able to get some retinol precursors from orange and yellow vegetables like carrots and bell peppers 🥕🌶

Vitamin B6 is also found in beef liver and other organs, eggs , seafood, poultry and some leafy greens and walnuts 🍣

Iron comes in 2 forms: heme and non-heme iron. Heme iron is found in meat, fish and eggs and is the bio-available form.

You can also get non-heme iron from plants, but that needs to be converted and ideally consumed with vitamin C to absorb it properly. Sources include beans, spinach, broccoli and nuts, as well as grains that are fortified.

As you can see, most of these nutrients are abundant in animal products, which makes me very hesitant to recommend a vegetarian or even vegan diet.

Below are some recipe ideas to help you get all those nutrients in the yummiest way possible 😋

Breakfast:

Egg tart with avocado and sautéed spinach and mushrooms in butter 🧈😋

Steak and eggs with avocado 🥑

Baked avocados with smoked salmon 🍣

Grain free toast with avocado, egg and smoked salmon, or liverwurst 🥪

Cacao Noatmeal 🥜🍫

Lunch/Dinner:

Steak with roasted carrots and butter 🥩

Grilled salmon with bell pepper hash and guacamole 🍣

Roasted chicken with bell pepper broccoli bake and tahini 🥰

Ancesteral Burger Bowls 🍔

Bison burger with carrot fries 🍟

Chicken kabobs with tahini veggies 🥗

Shrimp bowls 🍤

Grilled mussels 🦪

Snacks:

Nutty Chocolates 🍫

Roasted ghee nuts 🌰

Bell pepper dip or baba ganoush with meatballs or crudités 🥕

Supplements to help:

Again, like with macrocytic red blood cells, I want to encourage a food first approach and a little bit of patience. Due to the time it takes for a red blood cell to mature, it can take 3-6 months before you are changes in the bloodwork. If you are not seeing anything after that, it’s time to dig deeper and consider supplements.

If you’re not sure which nutrient exactly you’re deficient in, I always recommend liver capsules which are natures multivitamin, and supplies you with all the bioavailable nutrients your body needs to create hemoglobin and make red blood cells. My favorite brand is Heart and Soil but any grass fed organ complex will be good!

Another thing that’s a no-brainer to take are trace minerals, which you can add to water to get micro-doses of zinc, copper and other nutrients throughout the day.

For vitamin A, I suggest you take a high quality cod liver oil, such as Rositas, which will also get you in a dose of healthy anti-inflammatory fats! It’s important to supplement with retinol and nothing synthetic.

When supplementing with copper and zinc, I always recommend that you don’t do it for long and check your blood work regularly, since the two antagonize/deplete each other and need to be present in your body in a special ratio. Some people supplement with powdered oyster shell capsules to get their zinc! You can also take a well formulated multi vitamin, such as that from Designs for Health, which contains a good balance of zinc and copper!

Vitamin B6 can be obtained through a well formulated b-complex! I like Biotics for this, since they do not derive their b vitamins from petroleum. Their Bio B complex is a great source of B6, among other b vitamins!

I never suggest that you supplement with iron capsules, since most supplements are just powdered rust…if you have made sure that you have adequate levels of the above nutrients and you still have low iron levels, I would dig deeper and potentially investigate if you have a parasitic infection, as parasites like to eat iron which makes the iron in the body unavailable for the cells.

I recently completed my functional blood chemistry certification and want to make the art more accessible to you all. Blood chemistry is a great way to discover what your body needs to be balanced, and with a few tricks and tips, you will know exactly what you need to do to support your body’s optimal health.

Every Friday, I will be sharing a new marker and what you can do to bring it into balance through primarily food and sometimes supplementation. Remember- food is medicine 😇

Today we will be starting with Vitamin B12 and B9, which many people are deficient in, especially if they have a history of being plant based or take certain medications like PPIs, or have low stomach acid.

B12 and folate are critical for methylation, DNA synthesis, red blood cell production, the health of our nervous system, and energy production in the body.

A good way to determine a vitamin B12 and/or folate need is to look at your Complete Blood Count (CBC) which most people have run every year by their doctors. The MCV is a Good Marker to help determine this.

The MCV stands for mean corpuscular volume, and measures how big red blood cells are. This marker is very dependent on nutrient status and is influenced by deficiencies.

While the lab range for MCV is a bit broader, the functional range for the MCV is 83-91! In an upcoming post, I will be discussing the implications of an MCV that is too low!

In order for red blood cells to be produced, stem cells in the bone marrow need to grow and split. The red blood cells are composed of a cytoplasm and a nucleus, Which need different substrates to mature. Once the cytoplasm and nucleus have reached a certain size, the cell will split.

The maturation of the nucleus is dependent on B12 and B9 which are needed to synthesize DNA. If you are deficient in these nutrients, your nucleus cannot mature and the cell will not split.

The growth of the cytoplasm is dependent on protein, the body will always find a way to supply amino acids for its growth. In other words, if you are deficient in B9 or B12, the cytoplasm will be the size of that of 2 cells, but the nucleus is only enough for one. The cell will not split, which then results in a larger than average red blood cell volume.

On this patients lab work, you can see that the MCV is elevated which means that the volume of the red blood cells is larger than optimal. This type of red blood cell is called a macroblast.

The MCV is one of the easiest way to determine if a patient has a B12/B9 need because serum levels of the vitamins can sometimes be elevated even though the client has an intracellular deficiency. However, if blood levels or B12 are below 1000, it can be concluded that the patient is deficient. Serum folate levels are a good way to assess B9 status!

If one wanted to assess B12 levels more directly, it would be best to measure methylmalonic acid, which is a metabolite of B12 produced when our mitochondria utilize B12!

What can I do?

The first thing you can do to support your B12 and folate levels is to increase foods rich in these nutrients. Most people are able to absorb them from food if they have sufficient stomach acid (more about that later).

B12 is found primarily in animal foods, especially beef and beef liver, but also in eggs, seafood, algae, chlorella, seaweed, some cheeses, and bee pollen. As you can see, vegans and vegetarians don’t have much chance and to ensure optimal B12 levels, I don’t think it’s wise to abstain from animal products.

B9 can be obtained from a plant based diet, and is rich in leafy greens, avocado, nuts, cruciferous veggies; and beans. Beef and beef liver are also rich in folate. If one decides to supplement with folate, stay clear of folic acid! Folic acid is the synthetic form of the vitamin and actually blocks our bodies folate receptors, so that the real deal cannot do its job.

Since both vitamins are needed for the proper development of our cells nuclei, it’s best to consume them together. Below are some yummy ideas you can incorporate into your weekly meal plan to help fill up your stores. It’s important to note that B vitamins are water soluble, meaning that your body excretes any excess, and that they need to be replenished ideally daily.

After deliberately consuming more b12 and b9, it’s a good idea to testest 3-6 months later, since it takes about 3 months for a red blood cell to mature and changes to be documented.

Some breakfast ideas include:

Baked avocado eggs with sautéed greens and ghee 🥬

Egg pancakes work guacamole and bacon 🥓

Omelette with spinach, asparagus and avocado slices 🥑

Grain-free breads topped with liverwurst and soft-boiled eggs with buttered spinach 🍳

My go-to breakfast bowl 🍲

Lunch/Dinner:

Fat fueled salad with canned salmon 🐠

Steak and mashed cauliflower with butter or avocado 🥩

Burgers with a lettuce wrap and curried broccoli 🥦

Salmon and egg salad on nut bread 🍞

Veggies with spinach dressing and roasted fish or chicken 🍗

Salmon spinach noodle bowl 🍲

Bolognese Sauce with a Pasta Swap 🍝

Ancestral Taco Bowl 🌮

Supplements:

I always like to make sure that diet is rich in nutrients, but sometimes, we need to help out with supplements. B12 is absorbed with the help of intrinsic factor in the stomach and small intestine. Intrinsic factor is produced in the stomach by parietal cells, which live in the mucosal lining.

Sometimes, parietal cells are attacked and cannot produce intrinsic factor, this is a condition known as pernicious anemia. If you have antibodies against parietal cells or intrinsic factor, you can eat all the B12 you want but your body cannot absorb it. That’s the case with me, so I have to be injected with B12. This condition is pretty rare though, and many people are very responsive to diet and oral supplements.

Other reasons diet alone may not suffice include methylation problems or low stomach acid, since the stomach needs to be acidic enough to cleave the nutrients off of the food.

The best way to supplement B12/9 is sublingually with bioavailable forms like methylcobalamin/hydroxycobalamin (both B12) and methylfolate/folinic acid (B9). 

Stay clear of cyanocobalamin and folic acid which are synthetic forms of the body that can block receptor sites and methylation pathways.

My family takes lozenges from Biotics called B 12 2000 which can be taken under the tongue twice a day until levels are restored and then as needed. B vitamins can boost energy so don’t take them too late in the day!

The lozenges are great because the sublingual delivery is not dependent on the stomachs ability to cleave off the vitamins and is a balance of B6/B9/B12!

Alternatively, you could also supplement with liver capsules, which will give you not only the B vitamins, but other nutrients like zinc, which can help support healthy stomach acid production, As well as vitamin A, iron, and phosphorus.I use Heart and Soil capsules!

I hope you enjoyed this little series, and I will get back to you next week about why your MCV maybe too low.