All vitamins play a crucial role for our health, although some do affect our body more that others. The B vitamins are a group of eight vitamins that include B1 (thiamine), B2 (riboflavin), B3 (Niacin), B5 (pantothenic acid), B6, B7 (biotin), B9 (folic acid, or folate), and B12 (cobalamin).
Vitamin B7 (biotin) is a form of coenzyme that helps enzymes with the release of energy from carbohydrates, fats, and proteins.
Other B vitamins play important roles in metabolism, for example, vitamin B6 assists enzymes that metabolize amino acids, and vitamins B9 (folate) and B12 help cells to multiply.
Among these cells are the body’s red blood cells, as well as cells lining the GI (gastro intestinal) tract — cells that deliver energy to all of the others. Their collective effects are particularly crucial for healthy brain function, with strong evidence suggesting that adequate levels of all B vitamins are essential for optimal physiological and neurological functioning.
The B vitamins may not actually provide energy, however without adequate amounts of them the body would lack energy. In this article I will focus on explaining the particular importance of vitamin B12.
All B vitamins are water soluble, which means that any excess is generally excreted in urine, and not stored in the body. Vitamin B12 is essential for the production of red blood cells, cell activity and metabolism, and aids in the maintenance of a healthy nervous system.
It is a crucial element in the construction of DNA, and B12 deficiency can result in symptoms ranging from severe anemia requiring blood transfusions to serious and permanent damage to the nervous system, brain, spinal cord, peripheral nerves, and the nerves of the eye.
As a co-enzyme, vitamin B12 is not always directly responsible for these processes, but its presence is essential for them to take place.
For example, B12 and folate (B9) are closely related, and each depends on the other for activation. The regeneration of the amino acid methionine and the synthesis of DNA and RNA depend on both folate and B12. If there is a lack of B12, it can have dramatic effects on overall health.
The digestion and absorption of vitamin B12 depends on several steps. In the stomach, hydrochloric acid and the digestive enzyme pepsin release vitamin B12 from the proteins to which it is attached in foods.
Then, as the B12 passes from the stomach to the small intestine, it binds with a stomach secretion called intrinsic factor, and together they travel to the end of the small intestine where receptors are waiting.
Importantly, the receptors do not recognize B12 without intrinsic factor. The vitamin is gradually absorbed into the bloodstream as the intrinsic factor is degraded.
There are many factors and conditions that can elevate the risk of vitamin B12 deficiency. These can include digestive problems, leaky gut, chronic stress, diabetes (especially when using Metformin), anemia, dementia or Alzheimer’s disease, gastric bypass, mental status changes, neurologic symptoms, being over 60 years of age, following a strict vegetarian or vegan diet, eating disorders, and certain medications such as proton inhibitors and corticosteroids, such as Prednisone.
The most common, and very wide ranging symptoms for a vitamin B12 deficiency include chronic fatigue, difficulty concentration, muscle weakness, pain, tingling, sleeping difficulties, confusion, numbness or tingling in extremities, paralysis, nerve pain, coordination difficulties, visual impairments, coordination difficulties, depression, anemia, constipation or diarrhea and inflammation.
Vitamin B12 deficiency is very often misdiagnosed. The reason why even the most severe symptoms are often not associated with the a B12 deficiency straight away is because although vitamin B12 performs such basic functions in the body, the corresponding symptoms are enormously varied.
One way to help understand this is to picture the human body as a very tall structure — vitamin B12 works right at the bottom of this, meaning that a deficiency in B12 works its way through every level, leaving the symptoms to be felt at the very top.
When then trying to locate the cause of the symptoms, there are so many other factors along the way which could cause the same symptoms, leading to false assumptions as to what the real cause could be.
If you have, or you know someone who has multiple sclerosis (MS), Alzheimers or dementia, autism, fibromyalgia, chronic pain, Crohn’s disease, paralysis, chronic psychological illnesses (such as depression, paranoia, schizophrenia), or impotence and infertility, then it’s important to understand that they can all be caused by a simple yet serious vitamin B12 deficiency.
Of course I am not saying that the cause of these symptoms for everyone is always a B12 deficiency, however most doctors do not look at the relationship between B12 deficiencies and these conditions, so the symptoms are very often misdiagnosed.
You can easily test your vitamin B12 levels, and I highly suggest this for everyone, especially if you already have any of the symptoms. The easiest way is using a methylmalonic acid urine testing.
During a B12 deficiency, the concentration of methylmalonic acid rises, both in the blood and in the urine. A distortion in results is only clinically possible with certain rare hereditary diseases, serious nutritional deficiencies, and a rare bacterial overgrowth in the intestinal tract, so mostly the test is a reliable indicator as to whether a functional vitamin B12 deficiency is present or not. The HoloTC test is another alternative for determining a vitamin B12 deficiency.
B12 has different forms. Cyanocobalamin is synthetically produced and is almost never found naturally. In the body it is broken down into cobalamin and the toxin cyanide (hydrogen cyanide/prussic acid). People can react badly to cyanide, sometimes with severe reactions, although the amount absorbed from vitamin B12 supplements is of course very small.
As long as the renal function is working well then the cyanide will largely be excreted. Most supplements contain Cobalamin. Hydroxocobalamin is the form of vitamin B12 that is naturally produced by most bacteria. To be biologically usable in the body it must first be converted into methylcobalamin and adenosylcobalamin.
Unlike cyanocobalamin, it has the advantages of producing no toxins, not being excreted so quickly, being more readily available for use in the body, and due to its superior protein binding qualities it can be stored better.
Methylcobalamin is considered to be the best form of vitamin B12, due to its immediate effectivity.
B12 is found naturally in animal foods including meat (grass fed beef and lamb) fish (wild caught salmon and sardines), shellfish, poultry, dairy products (feta and cottage cheese), nutritional yeast, and eggs, as well as in algae, spirulina, and chlorella (naturally produced).
With correct nutrition and supplementation it is fairly easy to correct a vitamin B12 deficiency, however some of the damage done may not be completely reversible. We are what we eat, so it is so important that we are getting all of the vitamins that we need in the correct amounts for our body to survive.
I wish we didn’t need to take any supplementation, however most of us are not living our whole lives in pure nature — and the further away from a completely fresh and natural diet we are, the more supplements we will probably need. Just be sure to learn how much your body really needs before taking any supplements.
Ayda Ersoy is a nutrition and fitness director at The Diet Doc Hawaii. She can be reached at DietDocHawaii.com, Ayda@DietDocHawaii.com or (808) 276-6892