A common issue that Nancy Lonsdorf, MD, finds in her patients is a lack of energy that can stem from a vitamin B12 deficiency. Through phone, video call, or in-person consultations at her Fairfield, IA, office, Dr. Lonsdorf examines the patient's symptoms and energy experience to determine the cause and proper course of individualized treatment.
Forgetting names lately? Battling brain fog? Lost your “edge?” Don’t write it off to just “getting older.” It could be something as simple, and curable, as vitamin B12 deficiency.
Once thought to occur only in vegetarians or the elderly, the Framingham study recently found that nearly 40% of Americans of all ages, whether vegetarian or not, have suboptimal levels of vitamin B12. That puts virtually everyone at risk.
Known as the “energy vitamin,” vitamin B12 is essential for many critical functions in the body, including energy production, DNA synthesis, and blood formation. However, B12 is most critically needed to form myelin, the protective “insulation” that surrounds nerve endings and helps nerves “talk” to each other efficiently.
Without adequate B12, myelin can break down and cause symptoms that mimic multiple sclerosis, depression or dementia. Other common symptoms include poor memory and mental fogginess, loss of motivation, apathy, mood swings, low energy, fatigue, muscle weakness, soreness or redness of the tongue, tingling, numbness or crawling sensations in the arms, legs or feet, lack of coordination and hair loss.
Here are several real-life cases of B12 deficiency—out of several dozen— that I have treated in the past few years:
Suzanne is a 57-year-old teacher who came to me worried that she was developing multiple sclerosis, like her brother. She was experiencing “cramps” in her legs, along with numbness in her hands and feet while walking, which she stated were the same symptoms her brother had first developed. A neurologist diagnosed a nerve dysfunction of unknown cause, so she came to me for further evaluation. Fortunately, her blood test showed B12 deficiency, and her symptoms disappeared within 3 months of starting B12 supplements.
Bruce, a 52-year-old broker, had tried “everything” for his recalcitrant depression. His B12 tested low, and within days of beginning B12 supplements, his mood improved dramatically.
Tom, a 62-year-old retired businessman, came to see me for his “stiff toes.” He wondered if he were getting arthritis. A quick examination revealed the joints in his feet were normal, but lacking in vibration sense, a classic sign of B12 deficiency. Indeed, a blood test showed a very low level that was sure to cause him some pretty serious problems if not corrected soon. Fortunately, sensation in Tom’s feet returned within a few months of beginning B12 supplementation, and he was spared possibly irreversible long-term nerve problems.
Rob, a usually tireless globe-trotting reporter felt unusually fatigued after completing a big project. He also felt uncharacteristically lacking in motivation and ambition. A B12 test showed a level of nearly zero. Within a few weeks of supplementation, his usual drive and energy returned.
Anyone can have B12 deficiency. The Framingham study found that taking supplements, eating fortified cereal or drinking milk helps protect against deficiency, but interestingly, not meat consumption. In my clinical practice, I find that many vegetarians who get plenty of milk and dairy still have low B12 so lacto-vegetarians should not feel they are protected from B12 deficiency.
If you are over 50, are mainly vegetarian, have digestive problems, do not take vitamin supplements or eat fortified cereal containing B12 regularly, or you take 500 or more mg of vitamin C with your food daily (which blocks B12 absorption,) you are at increased risk of B12 deficiency.
Of course, it’s ideal to find out before symptoms appear. So, if you have one or more of the risk factors above, or have mental, emotional or nerve symptoms, get a prescription for a B12 blood test from your doctor. Experts give various opinions on the “gold standard” test, but a simple B12 blood level will do.
Do keep in mind (and challenge your doctor if needed) that the “normal” low cutoff of about 200 pg/ml is not enough in the case of B12. Lab norms simply means that 95% of the results fall within that range. But with 40% of the population deficient, that means many with a “normal” level are actually deficient.
B12 levels below 300 double your risk of Alzheimer’s disease and increase your risk of hearing loss with age. Even children and teenagers with low B 12 are at risk for reduced learning ability and intelligence. So your B12 level should be above 350 or 400 to be safe.
If you can’t afford a test and do not have symptoms, you may simply start taking a daily B12 supplement. 500 to1000 mcg per day is needed regularly for life for effective prevention. However, I generally recommend getting tested rather than blindly starting supplements, because without knowing whether you are truly deficient, it’s all too easy to quit over time and possibly end up with irreversible damage to your mind, brain, and nervous system.
Vitamin B12 is essential to life and good health and must be consumed in our food.It is found naturally only in animal products, including dairy, and in certain seaweeds, tempeh and nutritional yeasts. However, some sources state that the B 12 in non-animal products are not active in the human body and may even block the effects of active vitamin B 12. More research in needed in this area, but for now, it is safest not to rely on these products for your B 12 source. Keep in mind that if you are deficient, it is not possible to correct it with food alone.
Fortunately, oral supplements are as effective for most people as getting shots, which were the treatment choice in the past. Methylcobalamin, the form naturally in your body, is preferable to the more prevalent cyanocobalamin tablets (which contains toxic cyanide, albeit in trace amounts.) Over-the- counter B12 patches, sublingual tablets and nasal sprays are available and may enhance absorption.
In summary, B12 deficiency is common today in all age groups, whether you are vegetarian or not. If you are at increased risk, take supplements regularly to prevent future health problems. If you have symptoms now, see your doctor for a check up and blood test. B12 deficiency is preventable and treatable, and correcting a deficiency may be just what you need to perk up your memory, mood, and overall well-being.
Nancy Lonsdorf MD is formerly the medical director of The Raj Ayurveda Health Center and practices integrative medicine for women in Maharishi Vedic City, IA.
As originally published in the Iowa Source, by Dr. Nancy Lonsdorf, MD