Vitamin B12

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Found this today, thought I'd pass it along. It's part of an article found at the link about halfway down:

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Special Test Needed For Vitamin B12 Deficiency

Getting tested for vitamin B12 deficiency is extremely important; however, scientists have indicated that the standard test -- measuring blood levels -- may not be sensitive enough to detect a deficiency. Due to this insensitivity, scientists have discovered an alternative way to detect vitamin B12 deficiency.

It seems that elevated levels of the body's natural compound, methylmalonic acid (MMA), indicate low levels of vitamin B12. Low vitamin B12 levels have been linked to several neurological conditions, such as:

? Dementia

? Spinal cord disease

? Peripheral neuropathy

While vitamin B12 deficiency is most commonly found in the elderly, it can affect people of all ages. Other high-risk groups include:

? Vegetarians and their newborns

? Those who have undergone stomach stapling bariatric surgery

? Those exposed to laughing gas anesthesia or nitrous oxide

Nitrous oxide, a general anesthetic commonly used in dental offices and hospital operating rooms, can inhibit the action of B12 when tissue stores are low. This has become a major health problem particularly for the elderly undergoing surgery that have been either undiagnosed or untreated for a deficiency. For this reason, doctors are strongly encouraged to check for vitamin B12 deficiency by measuring both vitamin B12 as well as MMA in patients prior to surgery.

Another problem that stems from nitrous oxide: Nitrous oxide abuse. This remains a concern among certain medical personnel, teenagers and young adults who use it for its euphoric effects. Such abuse can lead to severe neurological damage to the spinal cord or peripheral nerves.

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Multiple sclerosis can be difficult to distinguish from B12 deficiency, cautioned a companion piece also presented at the conference.

Saint Louis University researchers Chitharanjan Rao, M.D., neurology resident, John Selhorst, M.D., chair of neurology, and Thomas found that patients with either condition can have pain, problems with vision and gait and similar MRIs.

The potential confusion makes careful search for B12 deficiency even more critical, Thomas says, since B12 deficiency can easily be reversed, while multiple sclerosis may be a life-long disease.

Thomas and Kinsella urge doctors to more rigorously check for B12 deficiency by measuring both serum B12 and MMA in patients before surgery and to test patients who are over 65 for the problem every two years. Nitrous oxide abuse resulting in B12 deficiency should be considered especially in younger adults presenting with unusual neurological conditions.

Science Daily November 5, 2004

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Dr. Mercola's Comment:

About 40 percent of the United States population is deficient in B12. With such an enormous number of people suffering from this deficiency, I have made special efforts to research information on this incredibly common condition.

For those of you who are suffering from vitamin B12 deficiency, it is important to know that most oral vitamin B12 supplements do not work well at all. Vitamin B12 is the largest vitamin known; it is a very large molecule, and it is not easily absorbed. Your body has developed a very sophisticated system to absorb B12, which involves the production of intrinsic factor in the stomach that attaches to the B12 and allows it to be absorbed in the end of the small intestine.

If your stomach lining is damaged from an ulcer or a Helicobacter infection, you will not produce intrinsic factor very well, and you will not be able to absorb B12 very well, if at all. An imbalance of bacteria in the small intestine can also produce impaired absorption, as would removal of a portion of the small intestine (commonly done in Crohn's disease).

Vitamin B12 deficiency is quite common in vegetarian and vegans who do not supplement with B12 or use fortified foods, since B12 is not readily available, if available at all, in plants. If you are a vegetarian who eats eggs or fish, the risk for B12 deficiency is considerably reduced, though you should still consider B12 supplementation. If you are a vegan avoiding all animal products, and you do not already supplement with B12 (it seems many already do), you should seriously consider it.

So, if you suspect you are deficient in vitamin B12, I would encourage you to obtain your B12 in a more absorbable form. The common recommendation is to use injections. My recommendation for that would be to use 1 ml once a day for two weeks and then three times a week until the 30-ml bottle is finished.

An alternative to the injections would be to use DMSO and vitamin B12. The DMSO causes the B12 to be absorbed very similarly to an injection without the cost or pain of a needle. Intranasal B12 is also available, but unless you have a prescription card I would not recommend it, as it is VERY expensive.

One strong inhibitor of vitamin B12 absorption is the very popular drug Prilosec, which has been clearly shown to decrease B12 absorption.