Vitamin B12 deficiency

I cannot begin to tell you the importance of Vitamin B12 and the problems of not getting enough in your diet can have on your health. About twenty years ago my levels were so low that every time I touched a hard surface it would feel like cotton wool. My sensory touch sensations had vanished, together with shaky nervy tingly legs and an inability to feel the soles of my feet at certain times. The issue with Vitamin B12 is that so many of the deficiency symptoms are similar to other serious diseases, like depression, alzheimers, anxiety, mental illness, psychosis, MS, memory loss, and cardiovascular disease to name a few.

Vitamin B12 Deficient

It’s not a new problem and not a difficult one to solve, but still it goes unnoticed. Usually it’s missed because it is not routinely tested and the lower end of the reference range is too low. Therefore many people will be walking around with “normal” B12 levels when in fact the very opposite is true. The reference ranges change and have changed in recent years. “Normal” values are 200 – 900 pg/mL but it can vary – I have seen reference ranges of 190-600 pg/ml. As most of you know who read my newsletter, I have a real problem with differing reference ranges. It is often assumed that most people will get the same deficiency symptoms with the same result. A borderline result for someone will be giving them symptoms when perhaps it wouldn’t for someone else. In my twenty years experience, borderline B12 results need to be treated. It is interesting therefore that in Japan and Europe reference ranges start at 500 pg/ml. So the reference range issue starts to look slightly ludicrous. Maybe co-incidence but Japan has a low level of dementia and alzheimers but that is an entirely different newsletter! My levels by the way when I was symptomatic were 150pg/ml, one doctor told me I was fine, another gave me an injection immediately and within two days the symptoms disappeared.
What is vitamin B12 and why do we need it?

Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Vitamin B12 also helps prevent a type of anemia called megaloblastic anemia that makes people tired and weak. Two steps are required for the body to absorb vitamin B12 from food. First, hydrochloric acid in the stomach separates vitamin B12 from the protein to which vitamin B12 is attached in food. After this, vitamin B12 combines with a protein made by the stomach called intrinsic factor and is absorbed by the body. Some people have pernicious anemia, a condition where they cannot make intrinsic factor. As a result, they have trouble absorbing vitamin B12 from all foods and dietary supplements. Vitamin B12 synthesis is known to occur naturally in the human small intestine (in the ileum), which is the primary site of B12 absorption. As long as gut bacteria have cobalt and certain other nutrients, they produce vitamin B12.
People at risk

There are groups of people who are more at risk of B12 deficiency than others. These include:

• Vegetarians and vegans
• Non meat eaters
• People over 60
• Users of Proton Pump inhibitors (PPI’s) or acid suppressing drugs
• Type II diabetes sufferers using metformin
• Ulcerative colitis, crohns, IBS, gastritis or hypochloridia (low stomach acid)
• Alcoholics and heavy drinkers
• Parasitic infections
• SIBO – small intestinal bacterial overgrowth

Where can I find Vitamin B12 in food?

• Canned pilchards
• Canned salmon
• Crab
• Fish – white, Tuna, Sea Bass
• Steak
• Lamb
• Soya Milk
• Liver
• Eggs
• Pork
• Milk
• Marmite
• Plain yoghurt
• Clams
• Swiss Cheese

Symptoms of Vitamin B12 deficiency

• Extreme fatigue
• Low mood
• Blurred vision
• Dizziness
• Mood swings
• Weepy
• Irritability
• Agitation
• Snappy
• Tingling or numbness in hands and feet
• Depression
• Dry skin
• Unexplained hair loss
• Gastritis
• Loose stools
• Weakness of limbs
• Constant headaches
• Neuralgia
• Sore tongue
• Bleeding gums
• Cracks at the corners of the mouth
• Loss of taste
• Shortness of breath
• Palpitations
• Anxiety
• Panic attacks
• Confusion
• Delusion
• Alopecia
• Lemon yellow complexion
• Mild jaundice

Pernicious anaemia

This is a condition caused by too little Vitamin B12 in the body. It is a form of Vitamin B12 anaemia. It is diagnosed using family and medical history, a physical exam and diagoistic tests and procedures. The most common cause of PA is the loss of stomach cells that make intrinsic factor. Intrinsic factor helps the body absorb vitamin B12 in the intestines. The loss of parietal cells may be due to destruction by the bodys own immune system. Therefore PA is seen as an autoimmune disease. It can cause permanent damage to nerves and other organs if it goes on for a long term without being treated. It also raises the risk of developing stomach cancer.

Common signs are feeling tired and weak, tingling and numbness in hands and feet, a bright sore tongue and a lemon yellow tinge on the skin. It is easy to treat and often injections and diet changes will keep you non symptomatic. However it is a life long problem and needs life long treatment. PA effects half a million people in the UK and some people do not get access to enough injections. Martyn Hooper, executive chairman of the Pernicious Anaemia Society says that people with PA are suffering needlessly as many patients need more than the three monthly injections that are currently available and are having to buy in vials from Europe or North America where vials are available over the counter.

New evidence is forming that low levels of B12 can be linked to alzheimers. A recent study of 271 Finns found that those with the greatest level of B12 were least likely to be diagnosed with dementia. Vitamin B12 is also vital to break down homocysteine (I will be writing more about that in another newsletter) – this can raise the risk of both strokes and alzheimers and yet it is still not routinely tested on the NHS. Another recent trial found that brain shrinkage which has been associated with alzheimers was slower in older people taking higher doses of Vitamin B12.

Vitamin B12 is particularly low in the elderly. Personally I would love to visit all nursing and retirement homes and test everyone’s B12 levels and see how they respond after injections if the levels are low. The problem with Vitamin B12, like Vitamin D is.. Well nothing.. It’s cheap, but you don’t make millions of dollars in profit by its production!

Headaches? Tired All the Time? IBS? Fuzzy thinking? Aches and Pains? Not feeling your best? I offer a two hour 1-1 MOT service. Call 01323 737814 or visit www.katearnoldnutrition.co.uk