I heard an interesting story recently from a colleague about a man whom I’ll call Bill.
One night, while watching TV, Bill began to feel nauseated, sweaty, and out of breath. He could feel his heart racing.
Suddenly, his legs began to shake and jerk. Bill rushed to the ER, where he told doctors he had not really felt right for about a year. He’d been dizzy (hint 1), tired (hint 2), and depressed (hint 3). And in the previous two weeks, he had begun to feel off balance when he was standing (hint 4).
Doctors did find that Bill’s blood pressure dropped when he stood up. But they didn’t take any of the other hints, and sent him home with no answers and no help.
Bill figured that these seemingly unconnected health issues were due to aging and he would just have to live with them. But within a few days, the problems started all over again and he went back to the ER.
This time, doctors observed that Bill walked with an abnormal, flat-footed gait (major hint 5), which could be a sign of a neurological disorder like multiple sclerosis or Parkinson’s disease. However, tests for both of these conditions came back normal.
Finally, the doctors did a basic physical exam (when all else fails, examine the patient). They discovered that Bill had impaired sensation in his feet and that he couldn’t feel the floor when he was standing. These findings are consistent with peripheral neuropathy—a condition often caused by diabetes. Excess sugar in the blood slowly damages the small blood vessels that supply peripheral nerves in the hands and feet.
But Bill didn’t have diabetes. Nor did he have a circulatory problem or a degenerative nerve disease. Finally, after ruling out everything else, doctors concluded that Bill had a simple deficiency of vitamin B12. Correcting it completely cured his neuropathy. And boosting his intake of all B vitamins helped with his dizziness, fatigue, and depression.
Why you probably aren’t getting enough essential “neurovitamins”
This sounds simple, right? Scientists have long known that B vitamins are important for every cell in the body. And the effects of B vitamins on brain and nerve tissue are so well-established that in Europe they call them “neurovitamins.” In particular, insufficient B12 can first manifest in sensitive nerve cells, which may lead to peripheral neuropathy.1
But despite all of this knowledge, Bill’s case is not rare. In the famous Framingham Heart Study, researchers found that 39 percent of the nearly 3,000 subjects had B12 levels in the low-normal range. More than 16 percent had below normal levels, and 9 percent had outright deficiency.2
All this in the “well-nourished” USA, protected by the government’s so-called “experts” on nutrients–and dosages.
Normally, B12 comes from the diet, but the best sources are eggs, meat, and dairy—foods we’ve all been told to avoid. Yet even if you (wisely) ignore the pseudo-science and eat these healthy foods, research shows that about 10 to 30 percent of all people over age 50 may still have trouble digesting vitamin B12.3
Why? First of all, you need a healthy gastrointestinal tract to absorb B12 into your bloodstream. Gastrointestinal surgery can interfere with B12 absorption, as can IBS and other bowel disorders.
Stomach acids help the body absorb B12, so beware of medications that reduce these acids. A recent study of nearly 210,000 adults found that the people who took proton-pump inhibitor drugs like Prilosec, Nexium, and Prevacid for two years had a 65 percent increase in vitamin B12 deficiency. Other types of antacids—most notably, Tagamet and Pepcid—increased B12 deficiency by 25 percent.4
But stomach acid–suppressing drugs aren’t the only pharmaceuticals that can hamper B12 absorption. A common example is Metformin, an otherwise safe and effective drug for diabetes.5 That’s why I recommend that everyone who takes Metformin also take a vitamin B-complex supplement.
Statins are another culprit. I’ve warned how these overused anti-cholesterol drugs can cause serious side effects—and one of those is neuropathy.6
Even if you don’t take any of these medications, a vitamin B-complex supplement is a good idea. Make sure it has at least 5 to 10 mg of B6, 20 to 40 micrograms of B12, and 800 to 1,000 micrograms of folic acid.
The reason you never hear about natural cures like vitamin B12
So what have we learned from Bill’s story? First of all, that there is plenty of research showing that vitamins and dietary supplements promote health, prevent illness, and reduce the risk of chronic diseases. But whenever people speak about the ability of vitamins to actually “cure” medical conditions like neuropathy, it is often in hushed tones.
You see, supplement manufacturers are actually not permitted to tell consumers about the health benefits of dietary supplements because of the FDA’s bureaucratic regulations designed to “protect” consumers from false claims. Unfortunately, these laws also prevent companies from making claims that are 100 percent true.
But aside from all of the legalities, Bill’s story also illustrates the mainstream bias against dietary supplements. After all, drugs are the treatments that are supposed to “cure” diseases, right? Unfortunately, all too often drugs only mask the symptoms that the body uses to tell you something is wrong. Drugs generally don’t address the root causes of those symptoms.
Furthermore, drugs often cause side effects of their own. Ironically, these side effects frequently result from a drug interfering with the body’s absorption and utilization of critical vitamins and other nutrients.
There is a lot of talk these days about complementary and integrative medicine.
A real and practical example would be to “complement” drug treatments by giving patients the dietary supplements they need to correct the deficiencies caused by these drugs, and to “integrate” this routine procedure into the practice of medicine.
Unfortunately, this very basic step is usually not taken—out of ignorance, arrogance, or perhaps even intention. In fact, as Bill discovered, vitamins and dietary supplements are usually the choice of last resort on a mainstream doctor’s diagnosis and treatment list.
Don’t let what happened to Bill happen to you. Take your daily B vitamins, and choose doctors who understand the crucial role that vitamins and other nutrients play in keeping you healthy.
The ABCs of vitamin B
The letters given to vitamins don’t really have biological significance—they just reflect their arbitrary order of discovery.
And when it comes to B vitamins, the numbering is also arbitrary. There are eight different types of these vitamins: B1 (thiamin), B2 (riboflavin), B3 (niacin or niacinamide), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin), B9 (folate or folic acid), and B12 (methylcobalamin or cyanocobalamin).
It’s interesting to note how the various B vitamins got their names. For instance, folic acid, which was first isolated from spinach in 1941, was named after folium, the Latin word for leaf.
Folic acid must first be chemically reduced (deoxidized) in the body with antioxidants. It’s then used in important metabolic processes such as DNA synthesis, cellular reproduction, and homocysteine metabolism—all of which are critical for heart and nerve health.
Folate is a type of folic acid that was developed by the dietary supplement industry. Because folate doesn’t have to go through folic acid’s deoxidizing process, it’s more stable. That’s why you’ll find that some supplements contain folate rather than folic acid.
Likewise, stability is an important issue for B12. This vitamin comes in two forms, methylcobalamin and cyanocobalamin.
People see the “cyano” prefix and assume it has something to do with cyanide, and indeed, a trace amount of cyanide is present in cyanocobalamin. But it is completely safe and no less healthy than methylcobalamin.
In fact, cyanocobalamin is the most common form of B12 for good reason. Methylcobalamin can be chemically unstable, meaning it can break down before it ever gets into your body. Thus, high-quality dietary supplements are made with cyanocobalamin to ensure stability and potency during manufacturing, shipping, and while they’re sitting on your shelf.
Sources:
1 Souza AD, Moloi MW. Involuntary movements due to vitamin B12 deficiency. Neurol Res. 2014 May 22:1743132814Y0000000396. [Epub ahead of print].
2 Tucker KL, et al. Plasma vitamin B-12 concentrations relate to intake source in the Framingham Offspring Study. Am J Clin Nutr 2000;71 no. 2:514-522.
3Institute of Medicine. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Washington, DC: National Academy Press, 1999.
4Lam, JR, et al. Proton Pump Inhibitor and Histamine 2 Receptor Antagonist Use and Vitamin B12 Deficiency. JAMA. 2013;310(22):2435-2442. doi:10.1001/jama.2013.280490.
5Ting RZ, et al. Risk factors of vitamin B(12) deficiency in patients receiving metformin. Arch Intern Med 2006;166:1975–1979.
6Tierney EF, et al. Association of statin use with peripheral neuropathy in the U.S. population 40 years of age or older. J Diabetes. 2013 Jun;5(2):207-15. doi: 10.1111/1753-0407.12013.