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Wednesday, April 29, 2009

The importance of B-12

What are the symptoms of a vitamin B-12 deficiency?
  • Energy. Even minor deficiencies of vitamin B-12 can cause anemia, fatigue, shortness of breath and weakness.
  • The Nervous System. Deficiencies of B-12 can cause neurological changes including numbness and tingling in the hands and feet, balance problems, depression, confusion, poor memory and Alzheimer's-like symptoms. Long-term deficiencies of B-12 can result in permanent impairment of the nervous system.
  • The Gastro-Intestinal System. B-12 deficiency can cause decreased appetite, constipation, diarrhea or alternating constipation/diarrhea (also called Irritable Bowel Syndrome), weight loss and abdominal pain.
  • The Immune System. Vitamin B-12 is necessary for normal functioning of white blood cells. Studies show that B-12 helps regulate Natural-Killer T-cells and prevents chromosome damage.
  • The Cardiovascular System. Vitamin B-12 participates in the conversion of homocysteine to methionine. Elevated homocysteine levels are a known independent risk factor for heart attack, stroke and thrombosis. Without adequate B-12 levels, homocysteine levels typically rise.
  • Special Senses. Degenerative changes in the central nervous system caused by B-12 deficiency can also affect the optic nerve, resulting in blue-yellow color blindness.
  • Other Symptoms of vitamin B-12 deficiency include sore mouth or tongue
  • In Infants and Children, signs of vitamin B-12 deficiency include failure to thrive, movement disorders, delayed development, and megaloblastic anemia. (ProHealth)
Who suffers from B-12 deficiency and why?

Recent studies show that up to 78% of senior citizens are B-12 deficient.  Though no specific percentage was reported for the general population as a whole, it is reported that the segment is much larger than previously thought.

78% of fibromyalgia patients, and 77% of patients with chronic fatigue syndrome, suffer from irritable bowl syndrome (IBS), which is a major cause of vitamin B-12 deficiency.  Which came first? Are fibromyalgia patients B-12 deficient because of IBS, or is IBS a result of a cellular or neurological insult caused by a B-12 defiency?

Other high-risk groups for B-12 deficiency include:

  • Those who use acid-blocking or neutralizing drugs (such as Prilosec, Prevacid, Nexium and others);
  • Those who use drugs which impair intestinal absorption (such as Metformin, Questron and Chloromycetin);
  • And people who have had gastric surgery.

The most recent and disturbing studies suggest that vitamin B-12 deficiency is more prevalent in young adults than previously thought. One study found that vitamin B-12 deficiency was similar in three age groups (26-49 years, 50-64 years, and 65 years and older), but that early symptoms were simply less apparent in the young. This study also found that those who did not take a vitamin B-12-containing supplement were twice as likely to be deficient as supplement users, regardless of age.

Secondly, unlike other water-soluble vitamins, B-12 is stored in the liver, kidneys and other tissues. Deficiencies of B-12 often appear so slowly and subtly as to go unnoticed, and blood tests for vitamin B-12 levels miss early deficiency states at least 50% of the time.

Which form of B-12 should you take?

Vitamin B-12 is a collection of four related, but different, cobalt-containing molecules.  Each of these forms plays a distinct role in the body:

Hydroxycobalamin is a unique form of B-12 that quenches excess nitric oxide (NO-), the precursor to peroxinitrite (ONOO-). Hydroxocobalamin (and methylcobalamin) also play a more important role in addressing neurological disorders than cyanocobalamin.

Hydroxocobalamin participates in detoxification, especially cyanide detoxification. Cyanide levels are typically elevated in smokers, people who eat cyanide-containing food (like cassava) and those with certain metabolic defects. Excess cyanide in the tissues blocks conversion of cyanocobalamin to methylcobalamin or adenosylcobalamin. In such instances, hydroxocobalamin is the vitamin B-12 of choice. Hydroxycobalamin is FDA- approved as a treatment for cyanide poisoning.

Methylcobalamin is considered by many researchers to be the most active form of vitamin B-12. It is the requisite form of vitamin B-12 in the methylation cycle. Methylcobalamin protects cortical neurons against NMDA receptor-mediated glutamate cytotoxicity and promotes nerve cell regeneration. Methylcobalamin is the only form of vitamin B-12 that participates in regulating circadian rhythms (sleep/wake cycles). It has been shown to support improved sleep quality and refreshment from sleep, as well as increased feeling of well-being, concentration and alertness.  (Read: constant fatigue and fibro-fog!).

Adenosylcobalamin (dibencozide), another highly active form of vitamin B-12, is essential for energy metabolism and is required for normal myelin sheath formation and nucleoprotein synthesis. Deficiencies are associated with nerve and spinal cord degeneration.

Cyanocobalamin, the most common form of B-12 found in nutritional supplements, is a synthetic form of B-12 not found in nature. It has the lowest biological activity and must be converted in the liver to more biologically active forms. This conversion is inefficient and some people who may not benefit from cyanocobalamin due to lack of assimilation or conversion. However, the cyano form of B-12 is needed to balance hydroxycobalamin in performing its NO-quenching function and should therefore be included in hydroxocobalamin supplements.

Since vitamin B-12 (especially the hydroxocobalamin and methycobalamin forms) offer such potential benefits for multi-system disorder sufferers (fibromyalgia, chronic fatigue syndrome, etc) - without known risks - it seems reasonable to suggest that anyone suffering with fibromyalgia should consider taking a supplement containing these two important forms of vitamin B-12.

Furthermore, because of the balancing effect that cyanocobalamin has on hydroxycobalamin and the protective and regenerative effect that adenosylcobalamin exerts on the myelin sheath of nerves, these forms should also be considered as an important part of any complete vitamin B-12 supplement.

B-12 in the cyanocobalamin form can be found everywhere and the other forms are extremely hard to find.  Major drug stores and supermarkets will not carry any form other than the cyano. After much search, I found the best place to get these other forms of B-12 is through Amazon. Of course, I find everything I need from Amazon (which is why I share the links with you).  Thus, I am including links for these forms of B-12 to be purchased through Amazon.  If you can find the products cheaper anywhere else, please share your find!

Gentle hugs and an abundance of B-12 to all!



Myatt, Dana. (2008). B-12 Deficiency in ME/CFS and FM May Provide Clues & Relief. Retrieved from


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