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I began my medical practice on July 1, 1990. I was the “new” doc in town having taken over the practice of a retiring physician. He gave a multitude of B12 shots. It seemed everyone received them. B12 shots were the cure for any ailment, affliction, malady and perhaps even true B12 deficiency. I thought I knew better, that it was just a placebo effect, but those patients sure believed that B12 shot made them feel better. As time moved forward, ubiquitous B12 injections fell out of vogue. Recently, however, B12 has really been making news. Are we going back to the “good old days”?
Dear Doc,
I was told recently to take a B12 supplement of 1,000 mcg daily. I can't seem to find it. Can you help, and why do I need so much?
Needing B12 in Bond
Dear Needing B12,
Although vitamin B12 is found in many foods, they all are animal based. Vitamin B12 then is found in foods such as fish and shellfish, meat, poultry, eggs, milk and milk products. Liver has the highest amount of B12 per ounce. Vegans should take a B12 supplement as their diets are poor in this important vitamin. An acidic pH in the stomach is also important for absorption as well. As we age, our stomach pH often drops so those over the age of 51 should eat B12 fortified food or take a B12 supplement.
Vitamin B12 is remarkably safe even taken in high doses. Because individuals may vary quite widely in their B12 needs and ability to absorb it, high dose replacement is often recommended. 1,000 mcg of vitamin B12 daily will almost always be sufficient and may be found at local pharmacies and grocery stores. Nutrition stores like GNC or Vitamin Cottage will stock it as well. It is often available as a tablet or an orally disintegrating lozenge. Either form is fine, as there is no evidence that one or the other is more effective.
Vitamin B12, also called cobalamin, has been the subject of a lot of recent attention. While it has been long recognized as a cause of anemia, recent focus has been on its heart and neurologic benefits. Symptoms of B12 deficiency may include:
• Anemia.
• Fatigue.
• Low white blood cell counts and low platelets.
• Numbness and tingling of the extremities.
• Dizziness.
• Peripheral neuropathy.
• Irritability.
• Personality changes.
• Memory loss.
• Depression.
• Psychosis.
• Possible increased risk of myocardial infarction and stroke.
A small study from the University of Oxford in England suggested that higher levels of Vitamin B12 in healthy adults over 61 years of age decreased the risk of brain atrophy or shrinkage, a process normally associated with aging. While the exact implications of this finding are unclear, it poses intriguing questions on our aging brains and the effect Vitamin B12 may have on them. B12 deficiency has also been associated with numerous psychiatric conditions, although the exact reason for this relationship remains unclear. Vitamin B12 seems to have broad benefits to our brains, spinal cord, and peripheral nerves, as well as stabilizing our mood and sense of well being.
The benefits of vitamin B12 to our heart health are also earning a lot of recent attention, and those reasons are becoming better understood. Like folic acid, B12 acts as a cofactor in converting homocysteine to methionine. Low levels of vitamin B12 then can lead to elevated homocysteine levels which are recognized as an independent risk factor for atherosclerotic cardiovascular disease, or “hardening of the arteries.”
Despite all the recent attention, it is not known how common B12 deficiency is. Some researchers have estimated that as many as 15 percen t of people over the age of 65 are low in vitamin B12. At the same time, a simple blood test of your B12 may not be accurate enough to predict whether you are actually deficient. The range of normal vitamin B12 levels is quite large, so measured levels at the lower end of the normal range may still cause symptoms in sensitive individuals.
While the average American diet should contain plenty of Vitamin B12, there are many reasons someone can become deficient. Do not assume that because you eat healthy your B12 levels are normal. In my next article, I will talk about diseases and conditions that cause vitamin B12 deficiency as well as how more information regarding how it is treated, so stay tuned!
Let me know what's on your mind at editor@vaildaily.com. I'd love to hear.
Remember, your health is your responsibility. Health is our greatest asset, and it doesn't happen by accident. If something doesn't seem right, or questions are left unanswered don't wait — call your doctor.
Dr. Drew Werner is the vice chief of staff at Valley View Hospital in Glenwood Springs and the Eagle County Health Officer. He lives in Eagle with his family. E-mail comments about this column to cschnell@vaildaily.com.
Dear Doc,
I was told recently to take a B12 supplement of 1,000 mcg daily. I can't seem to find it. Can you help, and why do I need so much?
Needing B12 in Bond
Dear Needing B12,
Although vitamin B12 is found in many foods, they all are animal based. Vitamin B12 then is found in foods such as fish and shellfish, meat, poultry, eggs, milk and milk products. Liver has the highest amount of B12 per ounce. Vegans should take a B12 supplement as their diets are poor in this important vitamin. An acidic pH in the stomach is also important for absorption as well. As we age, our stomach pH often drops so those over the age of 51 should eat B12 fortified food or take a B12 supplement.
Vitamin B12 is remarkably safe even taken in high doses. Because individuals may vary quite widely in their B12 needs and ability to absorb it, high dose replacement is often recommended. 1,000 mcg of vitamin B12 daily will almost always be sufficient and may be found at local pharmacies and grocery stores. Nutrition stores like GNC or Vitamin Cottage will stock it as well. It is often available as a tablet or an orally disintegrating lozenge. Either form is fine, as there is no evidence that one or the other is more effective.
Vitamin B12, also called cobalamin, has been the subject of a lot of recent attention. While it has been long recognized as a cause of anemia, recent focus has been on its heart and neurologic benefits. Symptoms of B12 deficiency may include:
• Anemia.
• Fatigue.
• Low white blood cell counts and low platelets.
• Numbness and tingling of the extremities.
• Dizziness.
• Peripheral neuropathy.
• Irritability.
• Personality changes.
• Memory loss.
• Depression.
• Psychosis.
• Possible increased risk of myocardial infarction and stroke.
A small study from the University of Oxford in England suggested that higher levels of Vitamin B12 in healthy adults over 61 years of age decreased the risk of brain atrophy or shrinkage, a process normally associated with aging. While the exact implications of this finding are unclear, it poses intriguing questions on our aging brains and the effect Vitamin B12 may have on them. B12 deficiency has also been associated with numerous psychiatric conditions, although the exact reason for this relationship remains unclear. Vitamin B12 seems to have broad benefits to our brains, spinal cord, and peripheral nerves, as well as stabilizing our mood and sense of well being.
The benefits of vitamin B12 to our heart health are also earning a lot of recent attention, and those reasons are becoming better understood. Like folic acid, B12 acts as a cofactor in converting homocysteine to methionine. Low levels of vitamin B12 then can lead to elevated homocysteine levels which are recognized as an independent risk factor for atherosclerotic cardiovascular disease, or “hardening of the arteries.”
Despite all the recent attention, it is not known how common B12 deficiency is. Some researchers have estimated that as many as 15 percen t of people over the age of 65 are low in vitamin B12. At the same time, a simple blood test of your B12 may not be accurate enough to predict whether you are actually deficient. The range of normal vitamin B12 levels is quite large, so measured levels at the lower end of the normal range may still cause symptoms in sensitive individuals.
While the average American diet should contain plenty of Vitamin B12, there are many reasons someone can become deficient. Do not assume that because you eat healthy your B12 levels are normal. In my next article, I will talk about diseases and conditions that cause vitamin B12 deficiency as well as how more information regarding how it is treated, so stay tuned!
Let me know what's on your mind at editor@vaildaily.com. I'd love to hear.
Remember, your health is your responsibility. Health is our greatest asset, and it doesn't happen by accident. If something doesn't seem right, or questions are left unanswered don't wait — call your doctor.
Dr. Drew Werner is the vice chief of staff at Valley View Hospital in Glenwood Springs and the Eagle County Health Officer. He lives in Eagle with his family. E-mail comments about this column to cschnell@vaildaily.com.
