Mommy Book Report: Could it be B12?

Could It Be B12? An Epidemic of Misdiagnoses

I purchased this book, “Could it Be B12? An Epidemic of Misdiagnoses” ,after a friend (thank you T.G.) recommended it to me. It caught my interest because recently some testing showed some deficiency in this vitamin for a few members of our family. What I expected to learn as I began to read it was the basics of B 12 and why it was important… What I ended up learning is so much more!I will share some highlights!

If you don’t have time to read this book- please spare about an hour to watch this video documentary which hits on some of the high points of the book:

If you want more details here is my book report

First, I loved how the book was laid out, 13 chapters each dealing with a different potential “misdiagnosis” of B12 deficiency (as well as a few chapters on testing and treatment and a chapter to share with your physician). I love that the authors, a husband/wife team who are medical professionals (ER doc and nurse), wove their personal experiences, observations and tons of case study examples into the text, along with a ton of reference to the medical literature , backing their claims.

Here are some staggering statistics that jumped off the page at me (book was published in 2005, so it is possible these stats are more drastic now):

• As many as 20% of people over 60 ( 40% of seniors with severe mental or physical issues) are impacted by B12 def.
• According to the Framingham offspring study, Tufts researchers found 40% of people ages 26-83 had plasma B12 levels in the low normal range (levels where many start experiencing neurological symptoms)
• 1/3 of people with B12 deficiency never develop large red blood cells (macrocytosis) or anemia, thus this deficiency is invisible to routine blood testing.
• This disorder is largely missed by the medical community although you will find it discussed in the text books of any first year medical students.
• B12 is a vitamin that your body cannot make and must be replenished each day (bc it is water soluble and not stored in fat), however it is only found in animal products and cannot be obtained from plants or sunlight. Therefore vegetarians are at high risk for B12 deficiency without proper supplementation.
• The 1934 Nobel Prize was awarded to researchers who found feeding lg amounts of liver to patients with pernicious anemia ( autoimmune form of B12 deficiency) greatly improved their symptoms… That was nearly 80 years ago… What have we learned???
• Fortification of foods with synthetic folic acid MASKS B12 deficiency on bloodwork, because folic acid normalizes the blood cell size that would normally appear enlarged (macrocytic). Thus government rules to enrich foods with folic acid starting in 1998 that was meant to save babies from conditions such as spina bifida may be harming other babies with B12 def who go undetected on standard blood tests!

Pages 4-5 of the book outline the 5 step metabolic pathway required for B12 to be absorbed from food into a useable form your body can benefit from.

Pages10-11 clearly outline testing available for B12 deficiency, including the authors recommendation for methylmalonic acid urine testing and homocysteine testing.

Page 18 chart summarizing who is at greatest risk for B12 deficiency… Are you or a loved one on this list?

What do these medical diagnoses have in common? The answer lies in ruling OUT B12 deficiency! I will summarize the 1-2 most interesting points I learned about each disease and its link to b12 deficiency, plus a link to 1-2 research articles for each here:

1. Aging, Alzheimer’s and Dimentia

-It is estimated that for the 39 million US elderly- 60,000 new cases of B12 deficiency per year are possible. (Norman ej, blood 1993)

-One study found 1 in 7 demented patients had subnormal B12 levels ( source: journal of neurology 1996 teunisse, bollen)

-Pg 23-24 lists common drugs that put seniors at risk for B12 deficiency and those that mask B12 deficiency

2. Multiple Sclerosis

-Case study of 21 year old after fractured leg, developed numbness and tingling. She was diagnosed with MS, 6 years later, she found out she had B12 def (a doctor picked up her FAMILY HEALTH HISTORY… Clues to B12 def: she was delayed in walking and talking, poor coordination, her mother had 2 unsuccessful pregnancies, father had hypothyroidism and early death from heart disease. She was diagnosed with an inborn error of metabolism called cobalamin G. She improved on B12 injections but suffers from irreversible neurological damage from going undiagnosed for so long. (New eng j med 1988 Carmel)

-It is estimated that 10% of people diagnosed with multiple sclerosis don’t actually have the disease (neurological sciences 2001)

-B12 def should be ruled out in all cases of MS by ordering serum B12, Homocysteine, and urine MMA levels. (p52, authors advice)

3. Mental illness

– A Dutch study that screened at 4,000 older individuals for depression and compared lab results with a non-depressed control group found that HIGH HOMOCYSTEINE levels, VITAMIN B12 Deficiency and FOLATE deficiency (to a lesser extent) were ALL related to depressive disorders. (source)

-The authors share a case study about 2 women in an Israeli hospital who were having horrible hallucinations in addition to depression, anxiety, and severe lack of sleep. Blood testing showed they were profoundly deficient in B12, yet neither showed blood abnormalities (such as megaloblastic anemia) probably due to their diets rich in BREAD, canned vegetables, with minimal intake of dairy, meat or eggs (ie. a diet rich in FOLIC acid that can mask the blood abnormalities). Both were started on B12 injections and completely recovered in 6-8 weeks.

-In a study that reviewed the lab data on PSYCHIATRIC patients found that 20 percent of the patients had serum B12 levels below 22pg/mL and 10 percent below 160pg/mL (severe deficiency). the researchers concluded “The true prevalence may be even greater since low serum levels may underestimate the actual extent of vitamin B12 deficiency.” (source)

4. Stroke/heart disease/vascular problems

– this chapter started with a staggering quote: ” High Homocysteine can increase the rick of heart attack as much as high cholesterol.” Abbott Laboratories… if you are like me, you may be asking yourself- “then WHY have I never heard of it and WHY has my doctor not tested me for it??” Homocysteine is an amino acid that can be very harmful to your cardiovascular system and high levels put you at risk for all sorts of issues including: heart attacks, strokes, blood clots and other vascular problems.

-B12 becomes important inthe HOMOCYSTEINE story because B12 (and folate) helps recycle homocysteine back into methionine (which you get from food and which your body needs to function).

-Studies show that high HOMOCYSTEINE  Precedes the onset of CARDIOVASCULAR Disease. (source) but when treated with Folate and B12 in many cases High Homocysteine can be lowered.

– PREGNANT MOMS and UNBORN CHILDREN: high levels of Homocysteine ARE linked to increase risk of neural tube defects (which is why prenatals contain folic acid) but also why they should ALSO contain B12.  High Homocysteine is also a risk factor for PREECLAMPSIA (those in a research study with the highest 25% of homocysteine levels have almost 3x greater risk of developing preeclampsia than the others). (source)

5. Developmental delay in children and learning problems

-This chapter also begins with a quote that rocks me to my core: “My baby became symptomatic, not me. The result was irreversible brain damage in my BREAST-FED child.” – A B12 deficient mother

-“Ironically it’s often the most health-conscious mothers who put their children at greatest risk (of B12 deficiency complications). This is because if a mother is vegetarian or vegan and eats little if any animal products that contain B12, and if this mother does not supplement B12 and then breastfeeds her baby, she is in danger of having low B12 levels and low B12 supplies (in her breast milk) to pass along to her rapid brain developing baby.

-The case study of Baby Lisa on page 92-93 is a story I have heard too many times to count- a perfectly normal developing baby saying mama and dada until 8 months old and something goes terribly wrong, stops talking, can’t stand up, stops smiling, and can’t sit up without help, arms twitching, eyes not following, not growing, abnormally small for age… until after testing her for every “genetic” disorder under the sun, a doctor notes that her mom is a vegetarian and she is breastfed and tests mom and baby for B12, mom’s is in normal range, but baby Lisa is severely depleted. Immediate treatment with B12 and she rapidly improved, 9 years later she was reported “normal” by the doctor. (source)

– A recent study found: B12 serum deficiencies in 24% of vegetarians, 78% of vegans and 0% of omnivores.

-The story of Patricia Stallings and her son and Methyl Malonic Acidemia is a must read on page 104.

-B12 and AUTISM: Dr. Neubrander gave 85 autistic children methyl B12 shots and reported that 50 percent of them improved in 15 or more symptoms (source) Another doctor, Dr. Brenner, tested autistic patients in his practice:only 2 had borderline low levels of B12, MOST HAD NORMAL or even HIGH LEVELS… thus the doctor concluded, ” there are no clear biological markers as to who may benefit.” Yet when given B12, many improved.

– RED FLAGS (p.109) for B12 deficiency in Infants, Children and Teenagers: movement problems (writing/walking), mental changes (irritability, flat tone, autistic like withdrawal), vision problems, slowed weight and height gain, leg pains, fatigue, enlarged beefy red tongue, loss of speech, language or skills, loss of appetite, small head circumference, apathy, involuntary movements, gray hairs, areas of hypopigmented skin, rooting reflex after 8 months of age.

6. Cancer and autoimmune disease

– Pericious anemis (a form of B12 deficiency) HAS LONG BEEN KNOWN to increase your risk of GASTRIC CANCER.

-Breast Cancer- a John’s Hopkins study found- women whose B12 leves fell into the lowest fifth were 2 to 4 times MORE LIKELY to develop breast cancer than those in the upper four- fifths. (source)

-Abnormal Pap Smears: B12 Deficiency causes the lining of the cervix cells to be deformed. A case study of a 57 year old woman with MS like symptoms and abnormal pap smears for 8 years, she was diagnosed with pernicious anemia and started on B12 injections for that and her very next Pap smear was NORMAL for the first time  in 8  years, and have continued to be normal for 4 years since being on B12 injections.

-“B12 deficiency appears to make the body react abnormally to vaccines.” evidence from a pneumonia vaccine in an elderly hospital where those with higher B12 levels had higher antibody levels to the pneumonia than those with lower B12 levels. This impacts the EFFICACY of the vaccine and since it is only 46-70%  efficacy in seniors, underlying B12 deficiency may be to blame! (source)

– HIV/AIDS and B12- B12 deficiency is linked to more rapid onset of AIDS in those infected with HIV. Researches at Johns Hopkins: “development of deficiency  Vitamin A or B12 was associated with a decline in CD4 cell count, while normalization of Vitamin A, B12 and zinc was associated with higher CD$ cell counts” and “these data suggest that micronutrient deficiencies are associated with HIV-1 disease progression and raise the possibility that normalization might increase SYMPTOM FREE survival.” (source)

7. Surgery and anesthesia complications

-THIS CHAPTER I FEEL IS ONE OF THE MOST IMPORTANT for ALL OF US… chances are you or someone you love will go under anesthesia for one reason or another (from dental work to a minor or major operation)-

“If you are B12 deficient, even the simplest of surgical or dental procedures can turn dangerous or even DEADLY… and your doctor or dentist isn’t likely to recognize that you’re at risk until it’s too late.”p.128

–Nitrous Oxide (N2O), best known as “Laughing Gas”: INACTIVATES B12 in the BODY. This won’t be so bad if your B12 levels are normal… but if you are deficient in B12 this can have DEVASTAING CONSEQUENCES!!

– Neurosurgeons Kathryn Holloway and Anthony Alberico say, “N2O is very dangerous in the B12-deficient patient. Because B12 deficiency is not uncommon and the N2O use is ubiquitous, the potential exists in EVERY (surgical) practice for this complication to occur. The surgeon should look for evidence for B12 deficiency in EVERY patient.”  (source)

-The list of stories and comments from surgery patients on page 135 is enough to convince anyone who is going under the knife to go urge their doctor to check their B12 levels.

After reading this book I came across this article about B12 and Nitrous in a well known journal: Lancet article 

8. Female (and male) infertility

-and Yet another opening quote that rocks me to my core as I know way too many friends who have suffered from recurrent pregnancy loss and miscarriage: ” Vitamin B12 deficiency is associated with infertility…pregnancy may occur in the presence of B12 deficiency but may be associated with recurrent early fetal loss”- hematologist Michael Bennett, MD

-Male infertility can be caused by B12 deficiency also.. researchers found in the 80’s that 27% of men with sperm counts less than 20 million were able to increase them to more than 100 million after receiving 1,00mcg per day of vitamin B12. (source)

– Professor Ralph Grasbeck says, “Every case of Infertility in primary health care should be managed by test treatment with micronutrients, before reproduction specialists are consulted.”

9. Autism

Authors theory: immunizations containing mercury tax the systems of genetically vulnerable children ( those with undiagnosed inborn error of metabolism of b12 def ) causing further b12 depletion of already low b12 stores (since b12 binds with mercury in the body to remove it) leading to autistic like symptoms.this depletion of b 12 is exasperated by nitrous oxide anesthesia ( for those undergoing ear tube placement, tonsil removal, circumcision repair).

10. MITOCHONDRIAL- While the authors do not specifically talk about mitochondrial disease in this book… they do mention something I found VERY INTERESTING… ” Vitamin B12 deficiency is quite possibly the SAFEST MEDICAL treatment on EARTH. However ONE SMALL GROUP OF PEOPLE – those with a rare disorder called Leber’s hereditary Optic neuropathy (LHON)- should NEVER take CYANOCOBALAMIN , one specific form of B12.”  GUESS WHAT LHON is… you guessed it a MITOCHONDRIAL disorder…. however it is ONLY this type of B12 that is harmful for these individuals with this condition. Which makes me WONDER why more research is not being done into the connection with B12 metabolism and Mitochondrial Disease?

In closing, I guarantee right now you know at least 1 person that is exhibiting the symptoms listed above that may be suffering from an undiagnosed B12 deficiency. PLEASE share this research with them and URGE them to educate themselves and their doctor so that they may receive the best treatment possible and get to feeling better QUICKLY!!

Here is a chart to help you out:

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Other B12 Resources that I have discovered during my research:

Website for the Book: http://b12awareness.org/

Interview with Author of book:

Part 1

Part2

Pediatrician: Dr. Paul Thomas, speaks about B12 and Spectracell-

Norman Labs: a company that tests direct to consumer for B12

http://b12.com/

CDC b12 course:

http://www.cdc.gov/ncbddd/b12/index.html