I met up with some long-time friends recently, who wanted to know the secret to ageing gracefully. They were surprised when I told them that methylation is the key.

Methylation is the latest buzzword in the health industry, and for a good reason. In this column, I will explain why optimising methylation is the key to maintaining health, especially as we grow older.

Methylation is a fundamental biochemical process that occurs at the cellular level in the body. It is the addition of a single carbon and three hydrogen atoms (called a methyl group) to another molecule. The removal of a methyl group is called demethylation.

Every time methylation and demethylation occurs, it is akin to billions of little switches inside your body turning on and off. These switches control everything:

• Stress, immune and inflammation response
• Energy production
• Repair of DNA and genetic expression
• Repair of cells damaged by free radicals
• Production and recycling of glutathione
• Detoxification of hormones, chemicals and heavy metals
• Balancing of brain chemistry and neurotransmitters like serotonin, dopamine and GABA

These processes are taking place billions of times every second in your cells – even right now, as you go about your daily activities and when you sleep at night.

If you have a shortage of methyl groups, or your methylation cycle is interrupted, your cells and your body’s systems wouldn’t be able to function normally, and any or all of the above processes can become compromised, making you sick.

In fact, research has clearly linked impaired methylation with all autoimmune conditions.

Methylation is very closely linked to homocysteine levels in the body. Homocysteine is a naturally occurring amino acid that is produced as part of methylation.

If homocysteine is efficiently metabolised by the body, then its levels are usually low. However, when methylation breaks down, the level of homocysteine increases.

High levels of homocysteine in the body increase the risk of cardiovascular disease, Alzheimer’s, dementia, miscarriage and migraines.

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Several factors can contribute to impaired methylation and low glutathione levels, including alcohol, cigarette smoke, petrochemicals, pesticides and herbicides.

When Methylation Breaks Down

Just like any process in the body, methylation can be disrupted by various factors that occur within and outside the body.

Let me describe some of the possible scenarios.

As mentioned above, methylation is responsible for the production and recycling of glutathione, the body’s master antioxidant.

Glutathione can become depleted due to a high toxic load from alcohol, cigarette smoke, petrochemicals, pesticides and herbicides. What this means is that it gets used up faster than the body can make it.

Poor nutrition, especially low protein or vegan diets, can leave you without the essential building blocks for glutathione production.

Your unique genetic “personality” might have difficulty creating and recycling enough glutathione.

You could be lacking the important nutrients (methyl donors), such as B12, folate and betaine, which are needed to produce and recycle glutathione.

Low levels of these nutrients could be due to a deficiency in your diet, low stomach acid or other factors like drinking too much alcohol, which impairs your ability to absorb these nutrients.

Furthermore, your body could also contain toxins, such as heavy metals, blocking your methylation pathways.

Another possible scenario is that you could have a genetic trait that impairs your ability to process folate, which is necessary for methylation.

It’s estimated that up to 40% of Americans have the MTHFR trait and are unable to convert folate from food into its active form (l-methylfolate).

The bottomline is that there are several factors that can contribute to impaired methylation and low glutathione levels. If you have an autoimmune condition, chances are you have one or more of these disrupting factors.

B vitamins play a major role in ensuring that methylation occurs smoothly in the body. Therefore, any conditions or unhealthy habits that adversely affect B vitamins will cause methylation to break down.

Obviously, the diet is the main source of B vitamins. Diets that contain excess animal protein, sugar, saturated fat, coffee, alcohol and irradiated food will also deplete the B vitamins.

Smokers are at risk of methylation disruption because the carbon monoxide from cigarette smoke inactivates vitamin B6.

Certain medications like acid blockers, methotrexate (for cancer, arthritis and other autoimmune diseases), oral contraceptives, hydrochlorothiazide (a diuretic medication for high blood pressure) and phenytoin (medication for seizures), can affect levels of B vitamins.

You may have preexisting medical conditions that reduce absorption of B vitamins, such as a digestive disease, food allergy, hypothyroidism, kidney failure, cancer, or even pregnancy. You should also take note of conditions that can reduce stomach acid, as this will reduce absorption of vitamin B12.

How To Assess Methylation

As methylation is the foundation for so many processes and functions in the body, there are several ways to check whether it is occurring at the optimal level.

A complete blood count will show you the health of your red blood cells. Large red blood cells or megaloblastic anaemia will show up in the blood test, signalling poor methylation.

You should also check your homocysteine level to ensure that it is at an ideal level of between six and eight, and no higher than 13.

Tests that reveal B vitamin deficiencies will also give you a clue regarding the methylation in your cells.

The serum or urinary methylmalonic acid test is a very specific test for vitamin B12 insufficiency.

Even if you have normal serum vitamin B12 or homocysteine levels, an elevated urinary methylmalonic acid level indicates poor methylation.

You can test for even more specific urinary amino acids, which can indicate unusual metabolism disorders involving vitamins B6 or B12, or folate.

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Liver, seen in this filepic in the form of pan-seared duck liver, is a good source of vitamins B6 and B12, as well as folate, which help optimise methylation.

Want Better Methylation?

It’s always a good idea to practise the healthy habits that optimise methylation.

1. Eat more dark green, leafy vegetables – Leafy greens are the most abundant sources of nutrients that help keep methylation running smoothly. Eat one cup a day of siew pak choy, kale, watercress, spinach, kai lan or choy sum.

2. Get more Bs – Fill your diet with sunflower seeds and wheat germ (vitamin B6); fish and eggs (vitamin B6 and B12); cheese (B12); beans and walnuts (vitamin B6 and folate); asparagus, almonds and whole grains (folate); and liver (all three).

3. Eat less animal protein, sugar and saturated fat – This recommendation should come as no surprise.

Animal protein directly increases homocysteine, while sugar and saturated fat deplete the body’s vitamin stores.

4. Eat natural, whole foods – Avoid processed and canned foods as these contain fewer vitamins.

5. Limit caffeine, smoking and alcohol – Smoking, as well as excessive amounts of caffeine and alcohol, cause the body’s vitamin B levels to decrease.

6. Maintain healthy gut bacteria – Take probiotic supplements and maintain healthy bacteria in your gut so that you can properly absorb the vitamins from your diet.

7. Get advice to take supplements – Seek advice from a doctor or dietitian for the right amount of folic acid, B6, B12 and betaine supplements. These can boost depleted vitamin levels and support proper homocysteine metabolism.

As I told my friends, we may get older, but we can still stay healthy and well. The key is to optimise methylation by avoiding toxins, lowering your stress, healing your gastrointestinal tract, and consuming foods and supplements that support methylation and can enhance your body’s ability to naturally detoxify and heal.

And of course, to have laughter and conversation with great friends!


Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician and gynaecologist. For further information, visit www.primanora.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.