Vitamin B12 Therapy

Why Vitamin B12?

• After water and oxygen, vitamin B12 is the next essential micronutrient molecule vital for health.
• Vitamin B12 deficiency is common and can manifest at any age, and is largely unrecognised.
• Vitamin B12 is crucial for many systems of the body to function correctly.
• Pernicious anaemia is just one illness related to a deficiency in vitamin B12.
• It is believed that vitamin B12 deficiency is not always detectable on blood tests.
• Symptoms such as depression, anxiety and psychosis, as well as the early onset of dementia, are common with vitamin B12 deficiency.
• Causes of B12 deficiency include genetic disorders, poor diet, gastrointestinal illness or surgery, alcoholism and use of antacids.
• Vitamin B12 is non-toxic – even at really high doses.

What is Vitamin B12?

Vitamin B12 is the generic name for a group of compounds based on the cobalamin molecule that has cobalt as the trace mineral at its core. Cobalamin is a highly active complex organometallic molecule. It is the largest and most chemically complex of all of the 13 known vitamins and is generally red in colour. Like other B & C vitamins, cobalamin is water soluble, a characteristic that affects how it is absorbed, excreted and stored in the body. Vitamins A, D, E & K are all fat-soluble.

It is classified as a vitamin as it is an essential nutrient for the human body and is regularly obtained from the food we eat. Like other vitamins, its role is to catalyse or regulate metabolic reactions in the body. Vitamin B12 plays an important role in the body responsible for hematopoiesis (producing all types of blood cells), neural metabolism, DNA & RNA production, and carbohydrate, fat and protein metabolism. It also helps to improve iron function in the metabolic cycle and assists folic acid in choline synthesis.

Vitamin B12 can only be made by microorganisms, such as bacteria and algae if the cobalt mineral is available in the soil or water. The main source for humans to obtain vitamin B12 is from the consumption of meat and fish. The vitamin is made by microbes in the digestive tract of animals, where it is absorbed and deposited into their tissues. As well as meat and fish, vitamin B12 can also be obtained by the consumption of cheese, milk and eggs. There are no known sources of vitamin B12 in plants, although some species of seaweed have been found to contain it. Therefore it is quite common to see vegetarians or vegans present with vitamin B12 deficiencies.

Vitamin B12 is absorbed into our tissues through the digestive tract; however, this process can be disrupted from poor digestion, intestinal disease or the use of some medications etc. The main causes are due to atrophic gastritis and lack of Intrinsic Factor (IF), a glycoprotein produced by the stomach that is required for the absorption of B12. As well as from poor diet and digestion, vitamin B12 deficiencies can also be affected by a genetic condition such as:

• Pernicious anaemia
• Crohn’s disease
• Treatment with proton-pump inhibitors
• Atrophic gastritis
• Coeliac disease
• Use of antacids (acid is required to release B12 from food)
• Gastrointestinal surgery
• Use of certain medications
• Use of illegal drugs and substances, including nitrous oxide

The true prevalence of vitamin B12 deficiency today is not known. This is because studies may be more focused on specific groups such as vegetarians.

A recent World Health Organisation (WHO) technical consultation on folate and vitamin B12 deficiencies noted that B12 deficiency had the potential to be a worldwide public health problem that could affect millions of people.

In the UK, the nutritional status of the population is assessed through the National Diet and Nutrition Survey (NDNS) rolling programme, begun in 2008, funded by the Public Health England (PHE) and the UK Food Standards Agency (FSA). This is done on a small representative sample of just 1000 people and a very low cut off point for serum B12 of 150 pmol/L. A deficiency rate of 6% of the population under 60 in the UK is suggested; however, this will probably be far higher.
Vitamin B12 deficiency can occur at any age but is more prevalent in the elderly due to malabsorption issues. The range of B12 deficiency in this age range is thought to be between 5-40%. The body systems where B12 is important Vitamin B12 plays a key role in many-body systems and organs, and this list is increasing. It is needed for energy production through the Krebs Cycle, for the synthesis of DNA via the folate cycle, which affects trillions of cells in the body, and for the expression of genes through epigenetic processes. It affects the proper functioning of the nervous and peripheral systems, mood and cognitive functions and the formation of blood in the bone marrow, skin and mucous membranes, bones, the glandular system, the immune system, the digestive system, fertility and pregnancy and development of the embryo.

Vitamin B12 deficiency consequently manifests as a wide range of different symptoms, some of which appear to be unrelated or may even be misdiagnosed. B12 is fundamental to animal life and metabolism that the symptoms are also widespread.

B12 is responsible for:

• Manufacture and normal function of blood cells.
• It rapidly divides all cells from epithelial cells to bone marrow cells.
• Energy production through the Krebs Cycle.
• Metabolism of fats, carbohydrates and proteins.
• Nerve cell conduction.
• Neurotransmitters.
• Endocrine systems.
• Immune systems.
• Conversion of homocysteine to methionine, then to SAMe (mood enhancing) and amino acids, with effects on many metabolic processes.
• Correct synthesis and transcription of DNA.
• Removal of toxins.

How vitamin B12 deficiency is diagnosed

The traditional way of diagnosing vitamin B12 deficiency has been with a serum B12 blood test to determine the patients B12 levels as well as the presence of any signs or symptoms of pernicious anaemia. The problem with this is that many sufferers of a B12 deficiency may not have anaemia or have a serum B12 blood level within an abnormally low range in accordance with the ‘normal’ ranges set. There are no national or international agreements of what a normal range is. The tests can also give false readings where they do not assess the bioavailability of the B12 or whether it is functional of not.

It is, therefore, better practice to look for trigger symptoms and undertake a one-minute health check to see if a client will benefit from B12 injections.

B12 Safety

Experience has shown that vitamin B12 is completely safe at any concentration in the diet and in the blood.

The non-toxicity of Vitamin B12 is confirmed by the US National Institute of Health Office of Dietary Supplements, which states that the US Institute of Medicine (IoM) has not established an upper limit for B12 ‘because of its low toxicity.’ The IoM states that ‘no adverse effects have been associated with excess vitamin B12 intake from food and supplements in healthy individuals.

The European Food Safety Authority (EFSA) states that the European Committee on Food (SCF) has concluded that ‘it is not possible to derive an upper intake level, mainly because no clearly identified adverse effect could be identified’.

Withdrawing treatment

It is important that the client is made aware that stopping further vitamin B12 injections may cause a quick relapse back to their original symptoms.

Recommended daily amounts of B12

What to expect post injection

• Within hours = Enjoyment of friends, Sociability, Mood improvements
• Within a day = Fatigue lessens (although this can sometimes take some weeks), Become more sociable
• Within a week = Brain fog lifts, Numbness and pins and needles start to remit
• Within 2 weeks = Strength may return to muscles and joints
• Within a month = Pains in hands and feet remit, Strength and grip improve, Cyclical hormones such as fertility cycles normalise, Thyroid and cortisol hormones normalise