B12 is essential for  Antiageing

B12 Deficiency is very common and often misdiagnosed as

    Multiple sclerosis , Infertility, Early dementia, incontinence, psychosis, insomnia, fatigue, tremors, numbness and tingling,  Parkinson's disease,erectile dysfunction, dementia, dizziness, vertigo,  schizophrenia, depression.

How common is this

    In USA 40 percent of people over the age of 60 years are deficient in B12

    This is a country where 70% food intake is from animal foods

    Prevalence has to be higher in Sri Lanka where animal food intake is less.

    Obviously eating animal foods is not the solution

What is normal B12 level

    Earlier it was thought B12 level 200pg/ml were deficient. Now we know 200-350 pg/ml are also deficient.

    Even patients with normal levels could be deficient  and can be found through other tests such as Urinary MMA,

Common causes of B12 deficiency

    Pernicious Anemia

    Removal of stomach or ileum

    Gastritis, Nitros oxide usage, Celiac disease, blind loop syndrome, Chrons disease.

Many neurological symptoms caused by B12

     irritability, apathy, sleepiness, suspicousness, personality changes, depression, memory loss, dementia, hallucinations, violent behaviour, Autistic behaviour,

Neurological Signs of B12 deficiency

    Pain tingling numbness, Diminished touch pain or temperature, Loss of position, Weakness, Clumsiness, Tremor, Mimicking parkinsons or multiple sclerosis. Spasticity of muscles. Incontinence, Paralysis, Vision Changes, Damage to optic nerve.

Other conditions arising from B12 deficiency

     TIA, CVA, CAD, MI, CHF, Palpitations, Orthostatic hypotension, DVT, PE,
 Dyspnea, Generalized weakness, Chronic fatigue, Loss of apetite, weight loss or anorexia.
 Epigastric pain, Poor digestion, Diarrhea constipation, Osteoporosis, Increased infections, Failure to thrive in children, Tinnitus, Vitiligo or hyperpigmentation, Gray hair. Infertility, abnormal pap smears

Suspect B12 in these patients

    vegans, over 60, any gastric surgery, Using Proton pump inhibitors, Eating disorders, Alcoholism, Family history of pernicious anemia, Anemia, Crohns disease, irritable bowel syndrome, Gluten enteropathy, Autoimmune disease, Infertility, 

Common Stomach conditions

    Atrophic gastritis found in 30 percent in seniors

    Gastric acid is essential to free b12 from animal proteins. Gastritis treatments also take stomach acid away. Antacids, H2 blockers and PPIs can cause b12 deficiency.

Many drugs cause B12 deficiency

    Metformin, Glucophage, Riomet, Fortamet, Glumetza, Obimet, Dianben, Diabex, Diaformin and ?Glucovance also does decrease B12.
diuretics and potassium supplementation also decrease B12. Colchicine, Questran
Neomycin and PAH deccrease b12.

B12 Deficiency mimic and may even cause worsening of alzheimers

    With alzheimers people deficient in B12 progressed faster.  High levels of homocysteine causes microinfarts that trigger formation of plaques and tangles in alzheimers patients. B12 causes brain atrophy just like alzheimers.

Homocysteine

    Elevated with B12

    High levels of homocysteine is a better indicator than cholesterol for heart disease and atheresclerosis.

    TIA, CVA, MI, PE, DVT.Tremors, Mimick parkinsonism, Caused reduced vision and blindness. Also causes cataracts.

Homocysteine facts

    You need both folic acid and B12 and Magnesium to decrease homocysteine levels. Men with high homocysteine are three times likely to get heart disease. Reducing homocysteine levels in a Swiss study of 553 patients folowing angioplasty reduced major adverse events by one third.

High homocysteine causes

    cognitive impairment, dementia, alzheimers, depression, fetal neural tube defects, inflammatory bowel disease, osteoporosis, age related far sightedness, DM type 1 and 2 complications. High homocysteine in pregnant women causes neural tube defects

Spiriluna and Tempeh dont have Beware of pseudo B12

    Spiriluna, tempeh or Nori contain a pseudo B12 which can block absorption of b12.

    In USA only 0.5 percent are vegans 3.5 percent are vegetarians

    78 percent of vegans have B12 deficiency. Vegetarians have 53% incidence of hyperhomocysteinemia.

Consider B12 deficiency in these conditions as well

     B12 deficiency causes, psychiatric, cognitive and visual disturbances first.  Numbness and tingling, difficulty walking, balance problems. Paresthesias of limbs even trunks like wrapping sensation. reduced sense of touch, pain and temperature. Loss of vibration sense, changes in tendon reflexes, clonus, extensor plantar response. Variable degree of spasticity, contracture. Vision loss and beginning dementia.   All post partum psychosis patients.

Autistic children respond to B12 Treatment

    50 percent of autistic children responded to B12 treatment. In another study 90 percent improved symptoms Language and communication, awareness, cognition and higher reasoning, engagement, eye contact, better behaviour, ability to focus vocalization and trying new things.

Lack of b12 causes cancer

     Long known that b12 deficiency causes gastric cancer.
 John Hopkins study proved that women with lowest B12 levels developed breast cancer two to four times more than people at highest levels. Also cervical cancer, lung cancer and oral cancer are connected. Broken DNA leads to mutations and cancer. B12 decreases homocysteine and increases immunity. Lack of methylation of DNA causes cancer. B12 folic acid, b6 and choline required for methylation.

Testing for B12 Deficiency

     Humans are born with b12 levels about 2000 pg/dl then decline thereafter.

    Consider levels below 400 as deficient if symptomatic.

    Urinary MMA is better since it is 40 fold more concentrated in the urine

B12 for Antiageing

     B12 is essential for antiageing regardless of the diet

     Combine with plant based diet,

     Mg and vitamin D3

     Avoid sun, Avoid alcohol, smoking, avoid sugar as well as Fruits

     Antiageing exercises

     Glutathione injections and other supplements as needed,  Melatonin