Absorption of B-12 can start in the mouth – but only tiny amounts of pure B-12 crystals can make their way across the thin membranes in the mouth directly into the bloodstream. This is how sublingual B-12 supplements work – pure B-12 crystals under the tongue. However, this isn’t incredibly effective given that only a small amount can be absorbed and the sublingual supplement is only in contact with the thin membranes for a few seconds.

So while you can get pure B-12 into the bloodstream through the mouth, B-12 in food can only be absorbed in the digestive track. Once the food comes into the stomach, enzymes work go to work and pull out the B-12 from the food. Taking antacid medication can foul up the enzymes and the B-12 absorption, however – the enzymes need acid to work!

When the enzymes have done their work and the B-12 is dissolved out of the food, it then makes it’s way into the duodenum. Once inside the duodenum an enzyme called intrinsic factor (IF) picks up the B-12 and forms a B-12 complex. This B-12 complex then moves into the small bowel and the B-12 is (finally!) absorbed into the bloodstream. Only this intrinsic factor/B-12 complex can enter the bloodstream from the digestive tract.

So having enough acid in your stomach and having intrinsic factor are both really important. Without those, you won’t be able to digest B-12 at all. Unfortunately, as people age the digestive system stops working as well, the stomach stops making as much acid, and you get ‘gastric parietal cell atrophy’. With parietal cell atrophy, the cells that make intrinsic factor simply wear out and stop producing it. Lack of intrinsic factor is also a problem for those who undergo gastric bypass surgeries, as the cells making intrinsic factor are no longer part of the digestive tract.

So patches are a great solution for vitamin B-12 deficiency related to gastrointestinal issues of surgery! The digestive track is taken completely out of the picture – the B-12 is sent straight into the bloodstream, over the whole day, in a highly bioavailable form for your body to use. Much better than oral supplementation, which needs stomach acid and intrinsic factor, or sublingual B-12, which is limited in the amount of vitamin B-12 that can be easily absorbed! Transdermal vitamin B-12 is definitely the way to go if you’ve had gastric bypass surgery or are just getting older.

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Dr. John Hong talks (incredibly fast!) about vitamin B-12 deficiency on NBC 29’s “Ask The Doctor.”  It’s a good (and quick!) overview in video format.

Dr. Hong hits pretty much all of the important parts in two and a half minutes.  He first lists the major issues that can arise – poor memory, depression, neuropathy, fatigue, megaloblastic & pernicious anemia, etc.  He then goes over some of the causes – old age, gastric disease, gastric bypass surgery, small bowel disease, pancreatic deficiency, medication (particularly PPI antacids), and following a vegan diet or a vegetarian one if you’re pregnant.

Dr. Hong also has a vitamin B-12 deficiency article on his website.

Related posts:

1. How Does The Body Absorb Vitamin B-12?
2. Vitamin B12 Basic Facts

• The technical name for B-12 is cobalamin.
• There are four types of cobalamin.
• Cyanocobalamin is synonymous with cobalamin, and is the form found most often in oral supplements.
• Cyanocobalamin is the least effective form of B-12 – cyanocobalamin may actually contribute to B-12 deficiency.
• Hydrocobalamin is the natural form of B-12 found in foods.
• Methylcobalamin is the form of B-12 used in injections.
• The best vitamin B-12 patch we’ve found, Healthy Habits’ Vitamin B-12 Energy Patch, uses methylcobalamin just like injections do to ensure high bio-availability and effectiveness.
• B-12 is a key factor in the body’s use of iron and formation of red blood cells.
• B-12 is essential component ofr the creation and maintenance of the myelin sheath that lines nerve cells.
• In conjunction with pyridoxine (vitamin B6 and folic acid), B-12 reduces harmful homocysteine levels (high homocysteine levels are a huge risk factor for cardiovascular disease).
• Helps metabolize food.
• Helps keep the immune system operating smoothly.

Disease & Injury:

• Prevents megaloblastic anemia.
• Treatment for pernicious anemia.
• Helps regulate homocysteine, a risk factor for cardiovascular disease and weak bones.
• Those who have infections, burns, some types of cancer, recent surgery, illnesses that cause decay or loss of strength, or high amounts of stress may need more B-12.
• Other conditions that B-12 may help include: asthma, atherosclerosis (hardening of the arteries caused by plaque formation in the arteries), bursitis (inflammation of a bodily pouch, especially the shoulder or elbow), Crohn’s disease (chronic recurrent inflammation of the intestines), depression, diabetes, high cholesterol, osteoporosis, and vitiligo (milky-white patches on the skin).

Natural Sources:

• Found only in animal source foods.
• Fresh food is best, as freezing and exposure to light can destroy vitamin content.
• The best food sources are clams, beef liver, chicken liver, beef, lamb, tuna, flounder, liverwurst, eggs, and dairy products.
• Some plants may contain B-12, but not in a form that can be used by the human body.

People At Risk Of B-12 Deficiency:

• Vegans & vegetarians.
• Older adults (more likely to have insufficient intrinsic factor available to digest B-12)
• Malabsorptive disease sufferers.
• Those who have had stomach surgery.

Contraindications:

• Hypersensitivity to B-12 may cause swelling, itching and shock.
• Leber’s disease (a hereditary optic nerve atrophy).

Interactions:

• Large amounts of vitamin C taken within an hour of vitamin B-12 supplements will destroy the B-12.
• B-12 absorption may be impaired by deficiencies of folic acid, iron or vitamin E.
• B-12 absorption may be improved by taking it with other B vitamins or calcium.
• B-12 absorption may be impaired or B-12 levels may be depleted by medications such as colchicine, corticosteroids, methotrexate, metformin, phenformin, oral contraceptives, cholestyramine, colestipol, clofibrate, epoetin, neomycin, or supplemental potassium.
• B-12 levels may be depleted by use of nicotine products or excessive alcohol.

YouTube Video Summary:

From illumistreamhealth.com

Related posts:

1. How Does The Body Absorb Vitamin B-12?
2. Good Newsclip Covering B12 Deficiency Basics

The suspected culprit behind this is problems with the binding and transport of vitamin B-12 in the gut. Which seems to be the case for most medical reasons for B-12 deficiency! As was mentioned in this post you can do some ugly damage to your nervous system without enough B-12: the sheaths of fat (myelin) on certain types of neurons are destroyed. If it goes on long enough, the damage is permanent. And with severe deficiency, you get enough destruction to cause MS-like symptoms. Even with just minimal B-12 deficiency you can have symptoms of fatigue, depression and memory loss.

Fortunately, vitamin B-12 supplementation is easy – especially with a transdermal patch! Patches are much less expensive than visits to a doctor’s office for vitamin B-12 injections. Less painful, too. Make sure to talk to your doctor and get his opinion on the patch option. You should also talk to your doctor and make sure smoking, drinking or any of these medications aren’t contributing to your B-12 deficiency.

Oral supplementation may not work well, given the digestive issues sometimes accompanying MS, and can upset your stomach to boot. Tho if you can, you should eat more foods that are naturally B-12 rich.

Further reading:

• “Vitamin B-12 Metabolism in Multiple Sclerosis”, Reynolds et al., Arch Neurol.1992; 49: 649-652.
• Miller A, Korem M, Almog R, Galboiz Y. “Vitamin B-12, demyelination, remyelination and repair in multiple sclerosis.” Journal of the Neurological Sciences Volume 233, Issues 1-2 , 15 June 2005, Pages 93-97.
• “Vitamin B-12 and its Relationship to Age of Onset of Multiple Sclerosis.” Int J Neurosci. 1993 Jul-Aug;71(1-4):93-9.

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Many girders simply won’t leave the factory – some days there just won’t be enough to make the girders at all. So, no girders go out to building sites where they’re needed.

Other girders may go out, but they don’t have the strength they should because of shortages of the material. What happens to a building made from those girders? Well, it may still hold up for a while, but it will have all kinds of problems with the floors and walls and will eventually just collapse onto itself in a heap of rubble.

In your body, the building is a nerve cell. The girder is a part of the nerve cell called myelin. Vitamin B-12 is the critical material missing for the girder-making process. B-12 (the material) is important in metabolizing the fatty acids (the steel) that are essential for myelin (the girders), a vital component of a certain type of nerve cell (the building).

So when your nerve cells don’t have enough myelin, they don’t function well – or at all! The ‘buildings’ are collapsing, or have collapsed, or were simply never built. Your body’s nerves are being ground into dust. And these particular neurons play and important role in the brain and musculoskeletal system. It is their destruction that leads to depression, memory loss and low energy.

So vitamin B-12’s role is really pretty straightforward! And you can see how important it is to make sure you have enough B-12 in your body to keep the basic infrastructure sound.

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While I would never recommend eating a prepackaged breakfast cereal (oatmeal is far better for you and much cheaper), fortified breakfast cereals can also be a good source.

Here’s a quick list of some items high in B-12 – this is a handy chart, as most nutritional labels don’t list a food’s vitamin B-12 content:

Looks like seafood is the big winner for foods rich in vitamin B-12! Lucky for me, as I love fish.

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This part is amazing: apparently B-12 deficiency can potentially cause severe and irreversible brain and nervous system damage! And it doesn’t take all that much to be deficient, either. Scary.

At levels even slightly below normal you get a range of symptoms like general fatigue, depression and poor memory. While they’re too nonspecific to diagnose deficiency, it might help to try supplementing more if you have those symptoms. Deficiency can also cause symptoms of mania and psychosis. Looks like if you have any kind of mood disorder, you’d be wanting to make SURE you’re getting enough B-12 into your system.

Here’s what happens inside you when you have B 12 deficiency:

• Your neural tissues decay into a spongiform state – like BSE (bovine spongiform encephalopathy), commonly known as mad cow disease! You get holes in your brain.
• Other neural tissues swells up, putting pressure on surrounding nerves. (possibly choking off their blood supply!)
• As it goes on, your nerves also harden over with fat. (sclerosis)
• The worst of these changes are in the spine, but the brain is affected too!

Biermer’s disease is the main syndrome; it’s composed of three primary symptoms: anemia, gastrointestinal symptoms and neurological symptoms. That’s kind of vague, but that’s all that was listed. I’ll add more details as I find them. Mental disorders that can occur include irritability, focus and concentration problems, depression with suicidal tendencies and paraphrenia.

More scary news: these symptoms might not reverse after you start getting enough B-12!!!

I always knew supplementation was important, especially with the lack of nutrients in the average American’s diet, but I had no idea how sensitive the body was to B-12 deficiency. It makes me wonder if a lot of the psychiatric drug users would be better off with increasing B-12 or if drugging would even be necessary in the first place with adequate vitamin B-12 in the diet or from supplements!

Update #1: Thanks to Arlene McElhinney for pointing out in the comments that tingling/numbness in the hands and feet are another symptom.

Related posts:

1. How Does B12 Deficiency Lead To Low Energy, Mood Issues And So On?

Here’s the list:

• Alcohol (excessive, lasting more than two weeks)
• Anticonvulsants
• Aspirin
• AZT
• Cimetidine
• Clofibrate
• Colchicine
• Cycloserine
• Erythromycin
• Famotidine
• Fenofibrate
• Gabapentin
• Gentamicin
• H2-blockers (such as Tagamet, Pepcid, Axid, and Zantac)
• Isoniazid
• Lansoprazole
• Metformin
• Methyldopa
• Neomycin
• Nicotine
• Nitrous Oxide
• Nizatidine
• Omeprazole
• Oral Contraceptives
• Phenobarbital
• Ranitidine
• Sulfamethoxazole
• Tetracycline
• Tricyclic Antidepressants
• Trimethoprim
• Valproic Acid

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Much like low levels of folic acid have been shown to increase the risk of brain and spine malformation (including spina bifida), researchers are reporting that women having low vitamin B-12 levels approximately 28 days before and after they get pregnant are at significantly greater risk.

Vegans and women who eat little or no meat, fish, eggs, milk or cheese are at the highest risk. Also at high risk are women with stomach or intestinal problems (including inflammatory bowel disease) that keep them from absorbing enough B-12.

“Nobody should get pregnant with low vitamin B-12 level.”
- Dr. James Mills (a senior investigator with the U.S. National Institute of Child Health and Human Development)

The research confirms a previous study at St. Michael’s Hospital in Toronto two years ago. The study reported said that low vitamin B-12 triples the risk of neural tube defects, and estimates that a third of neural tube defects in Canada are due to B-12 deficiencies.

Overall, the researchers say women who start pregnancy with blood levels of B-12 below 300 ng/L are at “significantly higher risk” for neural-tube defects.

The study appears in the journal Pediatrics.

From Canada.com’s article “Vitamin B-12 deficiency linked to birth defects“

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