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PATTI CAREY, L.Ac., MTOM, MS
AOMA DAOM Student
PRINCIPLES OF NUTRITIONAL MEDICINE SP6012

What is Betaine (pronounced “BEET-uh-een”)
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First isolated from sugar beets, thus the pronunciation
Neutral chemical compound that serves as an organic osmolyte that protects
against osmotic stress, drought, high salinity, or high temperature – serves
as a
methyl donor
Non-perturbing to enzyme function, protein structure, and membrane
integrity
Permits water retention in cells, protecting from dehydration
Prevents build-up of amino acid homocysteine which can harm blood vessels, contribute to
heart disease, stroke, or circulation problems
Used in genetic condition homocystinuria (homocysteine amino acid builds up in the body) –
but is not a cure
Important component of one-carbon metabolism changing homocysteine into methionine & providing
methyl groups for DNA methylation
http://en.wikipedia.or/w/index.php?title=Betaine
Ross AB et al. Cereal foods are the major source of betaine in the Western diet – Analysis
of betaine and
free choline in cereal foods and updated asessments of betaine intake. Food Chem 2014. 145C:p.859-865.
Health Defence: Chapter 11 Betaine – a new ‘B vitamin” pp162-164
 Original
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betaine was TMG
Small N-trimethylated amino acid in
“zwitterionic form”: has + and – charges on
different atoms so has a neutral ph
Know as TMG – trimethylglycine
TMB is actually glycine betaine to distinguish
from other betaines in microorganisms, plants,
animals
http://wisegeek.com/what-is-betaine.htm
 As
methyl donors to bodily functions:
Assists in liver function
 Prevention of liver disease
 Cellular reproduction
 Prevention of heart disease
 May enhance exercise performance *
Betaine/TMG is NOT Betaine Hydrochloric Acid!
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*Trepanowski JF, Farney TM, McCarthy CG, Schilling BK, Craig SA, Bloomer RJ.
The effects of chronic betaine supplementation on exercise
performance,skeletal muscle oxygen saturation and associated biochemical
parameters in resistance trained men. J Strength Cond Res. 2011
Dec;25(12):3461-71
BETAINE
BETAINE HCL
“Betaine with Choline (betaine’s precursor) shows beneficial effect
on nasopharyngeal cancer” (Zeng FF et al, Br.J.Cancer 2013 Oct 29 10.1038)
“Signficantly alleviated altered glucose & lipid metabolism in
diabetic mice, reducing endoplastimic reticulum & oxidative
stress, improves hyperlipidemia” (Jung GY et al, Toxicol Res 2013 March;29
(1):7-14)
“Reduces serum uric acid levels & improves Kidney function in
hyperuricemic mice by regulating protein levels of renal organic
ion transporters” (Liu YL et al, Planta Med 2013 Dec 11 (Epub ahead of print)
“Cereal foods are a major source of betaine western diets but intake
is well below those used in intervention studies to lower
homocysteine”. (Ross AB et al. Food Chem 2014. 145C:p.859-865 )
“Early betaine treatment can prevent mortality and allows normal
psychomotor development in patients with severe MTHFR
deficiency (important for newborn screening)” (Diekman EF et al. JAMA
Neurol, 2013)
“Betaine in human nutrition – growing body of evidence shows
important nutrient for prevention of chronic disease”
J Clin Nutr 2004; 80:539-49)
(Craig S. Am
“Effect of betaine supplementation on cycling spring
performance”. (Pryor, JL, et al. J Inter Soc Sports Nutrition 2012, 9;12;
electronic version http://www.jissn.com/content/9/1/12)
“Betaine.” Taking 3 g before and after workout optimizes
muscle growth strength, and fat loss.Stoppani J. (JYM
Supplement Science 1/9/2014. http://jymsupplementscience.com/betaine/)
“Betaine supplements may support muscle growth and
improve body composition: Human data.” (Daniells, S.
Nutraingredients-usa.com.1/11/2014.
usa.com/content/view).
http://nutraingredients-
“Betaine supplementation increased power, force, and
maintenance in selected performance measure and were
more apparent in smaller upper-body muscle groups. (Lee
EC et al. J Int Soc Sports Nutrition. 2010; (7):27)
 BETAINE:
lowers homocysteine (heart disease,
liver disease, homocysteinuria, possibly
improved athletic performance, &dry mouth;
found in beets, broccoli, grains, shellfish,
spinach, eggs. No verified dosages…varies for
condition and for research purposes
 BETAINE
HYDROCHLORIDE: acidic form of
betaine, is a synthetic created by adding
chloroacetic acid and sodium hydroxide to
betaine; treatment for hypochlorydia. Doses
vary by individual usu. 325mg up to 5000mg.
 As
a supplement provides increased HCL
for the stomach
 Best results if taken with pepsin which
digests protein
 “Increases hydrochloric acid in stomach
necessary for digestion and assimilation of
nutrients from food, extraction of Vitamin
B12 from food, and absorption of amino
acids”
Wright, S, Lenard L., How to Supplement with Betaine HCL for Low Stomach
Acid. Why Stomach Acid is Good For You. 2001.pp 137-140.
Not just for Low Stomach Acid – but many health issues
may be caused by LSA:
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Acne Rosacea
Allergies/Food Sensitivities & Food Allergies
Asthma
Chronci Candidasis
Dermatitis Herpetiformis
Gallstones
GERD (Indigestion, heartburn)
Hives
Rheumatoic arthritis
Vitiligo
ibid
 TOO
MUCH: Nausea, loss of appetite, burning
sensation, vomiting, excess gas, burping stomachache
 TOO
LITTLE: Bloating, belching, feeling of fullness
after little or no food, diarrhea/constipation, acne,
food allergy, fatigue
Low stomach acid often overlooked as being
linked to other diseases such as gastric CA,
asthma, RA, etc.
 1.
“You don’t feel good when you eat meat”
(more typical in women than men)
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“You experience frequent acid reflux after
eating (NOT caused by HIGH stomach acid!)
 3.
“You burp, fart, or get bloated after
eating” (usually shortly after or 1-2 hours
after eating)
Wright S. http://scdlifestyle.com/2012/06/hypochlorhydria-3-common-signs-of-lowstomach-acid
Betaine HCl aids in absorption of pH-dependent drugs
et al. Mol Pharm.2013 Sep 10 (Epub ahead of print)).
(Yago MR
Betaine HCl co-administered with anticancer agents may be a
“viable strategy in humans treated with acid-reducing
agents” for better absorption (Pang J. et al, Mol Pharm 2013 Sept 11
(Epub ahead of print))
H. Pylori infection precedes hypochlorhydria and likely
increases risk of gastric CA (Argent RH et al. Clin Cancer Res
2008;14(7) April 1,2008)
Formation of carcinogenic nitrosamines exists in
hypochlorhydric and achlorhydric stomach, increasing
possible mechanisms for high incidence of gastric CA
(Ruddell WSJ, et al. The Lance Vol 308, Issue 7994, 13 November 1976 Pages 10371039)
“Hypochlorhydria due to atrophic gastritis can result in
malabsorption of food-bound vitamin B12.” (Russell RM. JAMA
1997; 278(20):1659)
“Omeprazole (Prilosec) causes protein-bound vitamin B12
malabsorption and ingestion of acidic drink
improves…absorption.” (Saltzman JR et al. J.Am Coll Nutr. Vol. 13,
No. 6, 584-59 (1994))
BETAINE (aka Cystadane): varies by age, weight,
medical condition, response to therapy
- homocystinuria: <3y/o 100mg/kg/day; >3/y/o 6g/day
- performance/lowering homocysteine in health males and
females: 0.5-2g/day, avg . 1.5 g/2x/day
BETAINE HCl: 5-7 of 650mg/meal (with pepsin),avg.
325to 650 mg/meal~3250-4550 mg/meal (or more)
(Thorne Research)
BETAINE:
*possible interactions with other medications
*diarrhea, stomach upset, nausea, persistent
headaches, vision changes
*kidney disease – do not take – possible interaction
with drugs for kidney disease
*overweight, heart disease or at risk for heart disease
– do not take without talking with health care
professional
* allergic to betaine – do not take – rash, itching,
swelling esp. face/tongue/throat severe
dizziness trouble breathing
* pregnancy – only if needed per OB; may pass into
breast milk
BETAINE HCl:
* pain burning gas or other discomfort esp if not taken
appropriately (usu.has thinned stomach lining with
increased sensitivity to HCl – atrophic gastritis)
* do not take if ulcers or esophageal reflux
* do not take if not eating protein with meal (~15 g)
* only taken if have lower than normal gastric acid – need to
test for it
* do not take if using corticosteroids aspirin, Indocin,
Ibuprofen (increase risk of bleeding or ulcer), IBS on
steroids
* should be taken with pepsin to help with protein breakdown
* must customize dosages (not same dosage each meal)
 BETAINE
– maybe if someone has a very high
CRP (C-reactive protein)
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prefer to encourage food sources (beets,
broccoli, shellfish, spinach)
??? Cycling/ performance enhancement – tempted
to test it on myself!
further research is needed for use other than
homocystinuria
 BETAINE
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HCl: yes – but must be tested first
Requires very extensive nutritional history
Provide instructions/guidance on home-testing:
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Heidelberg stomach acid test (clinical conditions)
Baking soda test (at home)
Betaine HCl challenge test (at home)
Requires careful follow up and guidance until
appropriate levels of betaine HCl are obtained and
patient knows how to utilize it properly and safely