B12 Basics

The Natural Connection

Undoubtedly among the readers of this newspaper, there are some folks who bounced out of bed this morning, feet pointed in the right direction, ready to take on the world. They are relentlessly cheerful, their car always starts, they never feel down or depressed. They have never forgotten to pay the mortgage or the water bill, and always know where their keys are hiding. They flawlessly remember the names of all their grade school teachers after thirty years.

They feast on purely organic fruits and vegetables, and possibly a few free- range chemically free chickens, being careful to follow the food pyramid exactly. They drink their water filtered, and are sure to get the recommended 30 minutes of aerobic exercise daily at the gym (even when it rains). You three people, you know who you are. You can just put the paper down now and go out and play. This article is not for you.

The rest of us struggle along just hoping to make it until our next birthday without a medical disaster, or bravely attempt to recover from the last one. It behooves us to pay attention to the little messages that sometimes appear in scientific literature designed to make our lives more comfortable and/or more complicated, depending on your point of view.

Vitamin B12 deficiency is getting a lot of attention these days from the medical research community. Also termed cobalamin, this water-soluble vitamin is most commonly found in animal products such as liver, milk, eggs, fish, and cheese. These foods may also be high in fat, which doctors advise the circumferentially challenged to avoid.

For a number of reasons, not all related to changes in diet, it now seems that up to 40% of Americans over the age of 65 have Vitamin B12 deficiency. Formerly considered a problem primarily in the elderly, Tufts University reported in September that it is now commonly found in adults in their 20’s and 30’s as well.

Most Americans develop Vitamin B12 deficiency not because of what they eat, but because of what happens to their food after they eat it. Through a very complicated process, the small amount of B12 available in food must be cleaved from the food in the presence of stomach acid and bound to a protein in the stomach called “intrinsic factor” before it is transported to the tissues.

You may have noticed that Stomach Acid is not popular in America right now. Billboards and TV ads proclaim its evils. A significant amount of our health care dollar is spent on medication designed to decrease the levels of acid in the stomach. Some elderly do not make enough intrinsic factor as well. The end result can also be a decrease in our ability to absorb Vitamin B12.

In its most severe form, called pernicious anemia, Vitamin B12 deficiency causes changes in the red blood cells, making them overly large and misshapen. This form of deficiency is relatively easy for doctors to detect, and is the form that is usually most widely discussed throughout medical training.

Newer data shows that long before this occurs, however, there are insidious changes that happen in the central nervous system that are harder to detect, and can cause a variety of symptoms in the patient. The central nervous system is attacked because the vitamin forms part of the myelin sheath that covers the nerves in our body, not unlike the insulation around the electrical wires in our home.

Patients with even mild Vitamin B12 deficiency frequently develop numerous changes in behavior that include listlessness, confusion, memory changes, extreme fatigue, and depression. During later stages, paralysis may even result. In the elderly, these mental changes can mimic Alzheimer’s disease, and it is known that Alzheimer’s patients often suffer from unrecognized B12 deficiency.

Studies show that many of their mental changes can improve if they are given vitamin supplementation in the early stages. Sadly, if the B12 deficiency has been present for longer than six months, the changes may not be reversible. Also common in patients with B12 deficiency are complaints of numbness and tingling in the hands and feet, or burning and stinging of the tongue.

Vitamin B12 deficiency can be tested by blood or urine tests. Due to the increasing prevalence in our population, as well as the availability of simple and inexpensive treatment, experts recommend that all Americans over the age of 50 either take supplemental vitamin preparations, or be tested for the condition. In some high-risk populations, such as strict vegetarians or those taking medications that interfere with B12 absorption, patients should be tested at an earlier age.

Vitamin B12 deficiency is easily treated with high dose oral preparations of the vitamin, or sometimes with monthly injections. There is also a newer form of the vitamin that is delivered by nasal gel. Your doctor will be able to advise you if you should be tested for B12 deficiency, and the best way to treat the condition if it is present.

For a Patient Information Sheet on Vitamin B12, please write to:

The Natural Connection, c/o Dr. Pauline Bellecci, PO BOX 777, Waycross, GA 31502 or visit www.swampdocs.com

9/25/00