Growing evidence supports the importance of B12 with regard to hormone balance, in that many of the disorders associated with a hormone imbalance are also associated with a vitamin B12 deficiency. Without adequate B12, overall health is compromised in fundamental ways.
One of the reasons people become deficient in vitamin B12 is that, with age, the digestive system gradually loses its ability to produce hydrochloric acid, which is necessary for releasing vitamin B12 from food. Dr. Mercola suggests that “If you’re over 50, it’s safe to assume you are not absorbing vitamin B12 at an optimal level.”
Symptoms of a vitamin B12 deficiency include:
- Unexplained fatigue or loss of energy
- Muscle weakness
- Poor circulation
- Tingling in the extremities
- Lack of motivation
- Mental fogginess
- Memory problems
- Unusual mood swings
While working as an emergency department nurse, Ms. Pacholok frequently observes “patients presenting with generalized weakness, anemia, shortness of breath, neuropathy, difficulty ambulating, mental status changes, mental illness, and fall-related trauma” only to find that they are deficient in B12. She suggests that all too often these types of symptoms fall under a diagnosis of “normal aging” or other conditions when vitamin B12 is the real culprit.
Although vitamin B12 is water-soluble, it does not exit the body quickly in urine. When everything is functioning properly, there is nearly a year’s supply stored throughout the body, primarily in the liver. Dr. Mercola warns that “a deficiency may not show itself for a number of years, depending on your diet and your body’s ability to efficiently absorb B12. This time lag is a serious concern because after about seven years of B12 deficiency, irreversible brain damage can result.”
Dementia and Alzheimer’s Disease
A vitamin B12 deficiency can seriously impair proper functioning of the nervous system, affecting an individual’s mental state, and leading to memory loss, fuzzy thinking, personality changes, and erratic moods. These symptoms all appear as classic dementia when it just might be a vitamin B12 deficiency.
Fortunately, there is growing recognition of the link between vitamin B12, dementia, and Alzheimer’s disease. Joseph G. Hattersley, MA, proposes that an early launch of high dose vitamin B12 treatment, soon after the first warning symptoms appear, may even turn off the process. And Dr. John V. Dommisse states that “most cases of Alzheimer’s dementia are actually missed B12 deficiency cases.” He believes that approximately 75 percent of the dementia cases brought on by B12 deficiency could be reversed if the condition is discovered early enough.
Researchers conducted a 7-year investigation involving a group of 271 healthy individuals, 65-79 years of age, to explore the relationship among homocysteine levels, vitamin B12 levels, and a diagnosis of Alzheimer’s disease. They found that elevated homocysteine levels were associated with an increased risk of Alzheimer’s disease, while increased B12 decreased the risk of Alzheimer’s disease.
As mentioned earlier, B12 is important to the health of nerve cells in the brain that control moods and behaviors. And, while a vitamin B12 deficiency may not be the direct cause of most cases of mental illness, it is believed to play some role, particularly in cases involving depression. According to Dr. Mercola, depression is believed to be associated with a shortage of monoamine neurotransmitters, which are produced by the central nervous system, with the help of B12.
One type of depression is postpartum depression. Ms. Pacholok and Dr. Stuart note that “Pregnancy can drastically worsen a pre-existing B12 deficiency because B12 is transferred to the growing fetus throughout pregnancy.”
Unfortunately, people of all ages who suffer from severe depression, anxiety, paranoia, and a rash of other psychiatric disorders are prescribed dangerous narcotics or other drugs, when the underlying problem may actually be a vitamin B12 deficiency.
While there are many different causes of female and male infertility, B12 deficiency is one factor that is often overlooked. In some cases, doctors have reported that anovulation (a failure to release an egg during the monthly cycle) occurs in some women with B12 deficiency. In these cases, a cause of the B12 deficiency is the decreased production of intrinsic factor (IF), a protein normally made in the stomach, which is necessary for proper absorption of B12. This leads to the development of malformed red blood cells, known as pernicious anemia.
Some studies have noted a link between B12 deficiency and abnormal estrogen levels that may interfere with the implantation of the fertilized egg. Dr. Michael Bennett describes a connection linking B12 deficiency with not only a failure to get pregnant but also a failure to successfully carry a baby full-term.
A vitamin B12 deficiency has also been associated with abnormalities of the cells of the reproductive tract, extending to the lining of the uterus and cervix, which might be diagnosed as cervical dysplasia. Observation of these abnormalities caused by a B12 deficiency can also be mistaken for a precancerous condition.
The Framingham Osteoporosis study demonstrated a strong link between low levels of vitamin B12 and osteoporosis, characterized by thinning, weakened bones. A follow-up study by Tucker, et al. found that B12 is important to DNA synthesis, thereby affecting bone formation. Another study by van Meurs, et al. examined levels of homocysteine, which increases with low B12, and the likelihood of bone fractures. In both men and women, those with the highest concentration of homocysteine were much more likely to fracture a hip or experience a broken bone.
These studies all suggest that vitamin B12 may benefit bone health, while low levels of B12 can lead to the development of osteoporosis. Ms. Pacholok and Dr. Stuart go on to state that these findings are not surprising as vitamin B12 is crucial to the function of osteoblasts (bone-forming cells). Insufficient levels of B12 may result in decreased amounts of bone-forming cells and thus compromise the strength and durability of bones.
DNA, which contains the genetic instructions for each cell, is continually being damaged and therefore needs to be constantly repaired. Because methylation controls both the production and repair of DNA, nutrients that provide methyl groups are linked to the cancer process.
Dr. Martin Lajous led a study that investigated the connection between B12 and breast cancer. The results suggest that a high intake of folate, vitamin B6, and vitamin B12 may lower the risk of breast cancer. Conversely, low levels of folic acid, vitamin B6, and vitamin B12 are associated with increased breast cancer risk.
Vitamin B12 Testing
If you believe that you may have a vitamin B12 deficiency or any of the related health concerns described here, a healthcare professional can administer or request a test to measure your B12 levels. The most common B12 test is a serum test that measures the level of vitamin B12 in your blood serum. According to Ms. Pacholok and Dr. Stuart, experts advise further testing if your level is below 350 picograms/milliliter (pg/ml).
The methylmalonic acid (MMA) test is more sensitive and specific. This test measures the level of MMA in either urine or blood. The principle behind this test is that vitamin B12 is required to metabolize MMA; in short, an elevated level of MMA indicates decreased B12 activity.
Another way to determine if you are deficient in B12 is to test your homocysteine (Hcy) level. Elevated levels of homocysteine in the blood indicate a B12 deficiency, and possible deficiencies in vitamin B6 or folate as well. Although this test is not necessary to diagnose a B12 deficiency, it is considered a valuable tool, along with either a serum B12 or MMA test.
Vitamin B12 Supplements
Supplemental vitamin B12 is available in three forms—cyanocobalamin, methylcobalamin, and hydroxocobalamin—and can be supplemented orally, nasally, dissolved under the tongue or by injection.
While there is some controversy over which form is most preferred, or considered to be most effective, current evidence suggests that methylcobalamin may be superior to the others, especially in cases involving neurological disease. According to Ms. Pacholok and Dr. Stuart, methylcobalamin is believed to be more effective because it is able to cross the blood-brain barrier, thereby leaving the bloodstream and actually entering into the brain tissue where it is needed.
For most people, there is very little (if any) downside to supplementing vitamin B12, and a lot of downside to living with a B12 deficiency. However, according to Drugs.com, if you are allergic to cobalt (or cobalamin, the other name for B12) or if have a family history of Leber’s disease (a hereditary eye disease), you should avoid injectable vitamin B12 (cyanocobalamin), as it may cause more harm than good in these cases.
For optimal health, it is important to work with your healthcare practitioner to monitor your vitamin B12 levels.