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A Silent Epidemic with Serious Consequences—What You Need to Know about B12 Deficiency

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Reviewed by Chris Masterjohn, PhD

This tired man rubbing his eyes may be experiencing B12 deficiency.
Fatigue is a common symptom of B12 deficiency.

What do all of these chronic diseases have in common?

  • Alzheimer’s, dementia, cognitive decline, and memory loss (collectively referred to as “aging”)
  • Multiple sclerosis (MS) and other neurological disorders
  • Mental illnesses like depression, anxiety, bipolar disorder, and psychosis
  • Cardiovascular disease
  • Learning or developmental disorders in kids
  • Autism spectrum disorder
  • Autoimmune disease and immune dysregulation
  • Cancer
  • Male and female infertility

Answer: Their signs and symptoms can all be mimicked by a vitamin B12 deficiency.

An Invisible Epidemic

B12 deficiency isn’t a bizarre, mysterious disease. It’s written about in every medical textbook, and its causes and effects are well-established in the scientific literature.

However, the condition is far more common than most healthcare practitioners and the general public realize. Data from a Tufts University study suggests that 40 percent of people between the ages of 26 and 83 have plasma B12 levels in the low normal range—a range at which many experience neurological symptoms. Nine percent had an outright nutrient deficiency, and 16 percent exhibited “near deficiency.” Most surprising to the researchers was the fact that low B12 levels were as common in younger people as they were in the elderly. (1)

That said, this type of deficiency has been estimated to affect about 40 percent of people over 60 years of age. It’s entirely possible that at least some of the symptoms we attribute to “normal” aging—such as memory loss, cognitive decline, and decreased mobility—are at least in part caused by a deficiency.

Why Is It Underdiagnosed?

B12 deficiency is significantly underdiagnosed for two reasons. First, it’s not routinely tested by most physicians. Second, the low end of the laboratory reference range is too low.

This is why most studies underestimate true levels of deficiency. Many deficient people have so-called “normal” levels of B12.

Yet, it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL—levels considered “normal” in the U.S.—have clear vitamin deficiency symptoms. (2) Experts who specialize in the diagnosis and treatment of a deficiency, like Sally Pacholok, R.N., and Jeffrey Stuart, D.O., suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL. (3) They also recommend treating patients who show normal B12 levels but also have elevated urinary methylmalonic acid (MMA), homocysteine, or holotranscobalamin, which are other markers of a deficiency in vitamin B12.

B12 deficiency can mimic the signs of Alzheimer’s, dementia, multiple sclerosis, and several mental illnesses. Find out what this vitamin does and learn how to treat a deficiency. #B12 #B12deficiency #cognitivedecline

In Japan and Europe, the lower limit for B12 is between 500 and 550 pg/mL. Those levels are associated with psychological and behavioral symptoms, such as:

  • Cognitive decline
  • Dementia
  • Memory loss (4)

Some experts have speculated that the acceptance of higher levels as normal in Japan and the willingness to treat levels considered “normal” in the U.S. explain the low rates of Alzheimer’s and dementia in that country.

What Is Vitamin B12 and Why Do You Need It?

Vitamin B12 works together with folate in the synthesis of DNA and red blood cells. It’s also involved in the production of the myelin sheath around the nerves and the conduction of nerve impulses. You can think of the brain and the nervous system as a big tangle of wires. Myelin is the insulation that protects those wires and helps them to conduct messages.

Severe B12 deficiency in conditions like pernicious anemia (an autoimmune condition where the body destroys intrinsic factor, a protein necessary for the absorption of the vitamin) used to be fatal until scientists figured out death could be prevented by feeding patients raw liver, which contains high amounts of B12. But anemia is the final stage of a deficiency. Long before anemia sets in, deficient patients will experience several other problems, including fatigue, lethargy, weakness, memory loss, and neurological and psychiatric problems.

The Stages of a Deficiency

B12 deficiency occurs in four stages, beginning with declining blood levels of the vitamin (stage I), progressing to low cellular concentrations of the vitamin (stage II), an increased blood level of homocysteine and a decreased rate of DNA synthesis (stage III), and finally, macrocytic anemia (stage IV). (5)

Common B12 Deficiency Symptoms

The signs can look like the symptoms of several other serious disorders, and the neurological effects of low B12 can be especially troubling.

Here are some of the most common vitamin B12 deficiency symptoms:

  • Tingling or numbness in the hands and feet
  • Brain fog, confusion, and memory problems
  • Depression
  • Premature aging
  • Cognitive decline
  • Anemia
  • Weakness
  • Fatigue
  • Reduced appetite and weight loss
  • Constipation
  • Trouble balancing (6)

Children can also show symptoms, including developmental issues and learning disabilities if their B12 levels are too low.

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Why Is It So Common?

The absorption of B12 is complex and involves several steps—any of which can go wrong. Any of the following can cause B12 malabsorption:

  • Intestinal dysbiosis
  • Leaky gut and gut inflammation
  • Atrophic gastritis or hypochlorhydria, or low stomach acid
  • Pernicious anemia
  • Medications, especially proton pump inhibitors (PPIs) and other acid-suppressing drugs
  • Alcohol
  • Exposure to nitrous oxide, during either surgery or recreational use

This explains why a deficiency can occur even in people eating large amounts of B12-containing animal products. In fact, many of my patients that are B12 deficient are following a Paleo diet where they eat meat two or three times daily.

Who Is at Risk for a Deficiency?

In general, the following groups are at greatest risk for a deficiency:

  • Vegetarians and vegans
  • People aged 60 or over
  • People who regularly use PPIs or acid-suppressing drugs
  • People on diabetes drugs like metformin
  • People with Crohn’s disease, ulcerative colitis, celiac, or IBS
  • Women with a history of infertility and miscarriage

Note to Vegetarians and Vegans: B12 Is Found Only in Animal Products

You cannot get B12 from plant-based sources. This vitamin is only found in animal products. That’s why vegetarians and vegans need to know the signs of deficiency—and the steps necessary to fix the problem.

B12 is the only vitamin that contains a trace element (cobalt), which is why it’s called cobalamin. Cobalamin is produced in the gut of animals. It’s the only vitamin we can’t obtain from plants or sunlight. Plants don’t need B12, so they don’t store it.

A common myth among vegetarians and vegans is that it’s possible to get B12 from plant sources like:

  • Fermented soy
  • Spirulina
  • Brewers yeast

However, plant foods said to contain B12 actually contain B12 analogs called cobamides that block the intake of and increase the need for true B12. (7) That explains why studies consistently demonstrate that up to 50 percent of long-term vegetarians and 80 percent of vegans are deficient in B12. (8, 9)

Seaweed is another commonly cited plant source of B12, but this idea is controversial. Research indicates that there may be important differences in dried versus raw purple nori; namely, raw nori may be a good source of B12, while dried nori may not be. One study indicated that the drying process used for seaweed creates B12 analogs, making it a poor source of the vitamin, while animal research suggests that dried nori can correct a B12 deficiency. (10, 11) Seaweed may provide B12, but it’s not clear if those benefits are negated when that seaweed is dried. I recommend caution for that reason.

The Impact of a Deficiency on Children

The effects of B12 deficiency on kids are especially alarming. Studies have shown that kids raised until age six on a vegan diet are still B12 deficient even years after they start eating at least some animal products. In one study, the researchers found an association between a child’s B12 status and their performance on testing measuring:

  • Spatial ability
  • Fluid intelligence
  • Short-term memory

Researchers found that formerly vegan children scored lower than their omnivorous counterparts in each area. (12)

The deficit in fluid intelligence is particularly troubling, the researchers said, because this area impacts a child’s ability to reason, work through complex problems, learn, and engage in abstract thinking. Defects in any of these areas could have long-term consequences for kids.

I recognize that there are many reasons why people choose to eat the way they do, and I respect people’s right to make their own choices. I also know that, like all parents, vegetarians and vegans want the best for their children. This is why it’s absolutely crucial for those that abstain from animal products to understand that there are no plant sources of B12 and that all vegans and most vegetarians should supplement with B12.

This is especially important for vegetarian or vegan children or pregnant women, whose need for B12 is even greater. If you’re not willing to take a dietary supplement, it may be time to think twice about your vegetarian or vegan diet.

How to Treat a Deficiency

One of the greatest tragedies of the B12 epidemic is that diagnosis and treatment are relatively easy and cheap—especially when compared to the treatment patients will need if they’re in a late stage of deficiency. A B12 test can be performed by any laboratory, and it should be covered by insurance. If you don’t have insurance, you can order it yourself from a lab like DirectLabs.com.

As always, adequate treatment depends on the underlying mechanism causing the problem. People with pernicious anemia or inflammatory gut disorders like Crohn’s disease are likely to have impaired absorption for their entire lives and will likely require B12 injections or high-dose oral cobalamin indefinitely. This may also be true for those with a severe deficiency that’s causing neurological symptoms.

Typically in the past, most B12 experts recommended injections over high-dose oral cobalamin for people with pernicious anemia and an advanced deficiency involving neurological symptoms. However, recent studies have suggested that high-dose oral or nasal administration may be as effective as injections for those with B12 malabsorption problems. (13, 14)

Try Supplementing

Cyanocobalamin is the most frequently used form of B12 supplementation in the U.S. But recent evidence suggests that hydroxocobalamin (frequently used in Europe) is superior to cyanocobalamin, and methylcobalamin may be superior to both—especially for neurological disease.

Japanese studies indicate that methylcobalamin is even more effective in treating neurological symptoms and that it may be better absorbed because it bypasses several potential problems in the B12 absorption cycle. (15, 16) On top of that, methylcobalamin provides the body with methyl groups that play a role in various biological processes important to overall health.

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Change Your Diet

Nourishing your body through whole food is the best way to get the vitamins and nutrients you need. If you’re low on B12, try eating some vitamin-rich foods like:

Eating other kinds of seafood, like octopus, fish eggs, lobster, and crab, can also help you attain normal B12 levels. If you’re seafood-averse, you can also get this vitamin from:

  • Lamb
  • Beef
  • Eggs
  • Cheese

It’s important to note, though, that the amount of B12 in these foods is nowhere near as high as the levels in shellfish and organ meats.

What to Do if You’re Experiencing Vitamin B12 Deficiency Symptoms

If you suspect you have a deficiency, the first step is to get tested. You need an accurate baseline to work from.

If you are B12 deficient, the next step is to identify the mechanism causing the deficiency. You’ll probably need help from a medical practitioner for this part. Once the mechanism is identified, the appropriate form (injection, oral, sublingual, or nasal) of supplementation, the dose, and the length of treatment can be selected.

So, next time you or someone you know is “having a senior moment,” remember: It might not be “just aging.” It could be B12 deficiency.

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1,962 Comments

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  1. excellent article, Vitamin B like Vitamin D has numerous powerful effects on the body. Women are especially vulnerable to vitamin B deficiency. You can find supplement give away’s at supplementadvisor.org However eating foods high in vitamin B is also helpful (liver, fish, fortified cereals)

  2. I’ve had B12 deficiency since my teenage years. My mainstream doctors would give me B12 injections, get my levels back and then stop giving injections. Since seeing my Naturopath in June, I’ve been diagnosed with pernicious anemia. My levels were below 200 (187 in fact) and I was having serious neurological symptoms … many of the ones mentioned in this article. I started off receiving weekly shots of methylcobalamin. I’m now getting them once every 3 weeks and the majority of the neurological symptoms are gone now. My insomnia and anxiety are almost completely gone now … it’s amazing how much a deficiency can affect.

    • Hey, glad that you are feeling better now.
      How long did it take for the neuro symptoms to recede?

  3. Please help! My wife started having seizures a few years ago that present as grand mal seizures, but she is totally awake and can communicate. She has had every test you can think of. Recently, we were working with a neurologist and a rheumatologist and found out her b12 levels were insanely low and that that could possibly be the reason for the “seizures”. She started with sublingual b12, because the rheumatologist suspected that she was not processing the b12 inher intestines. Her levels did not improve. We started injections and they seemed to work at first but slowly the results diminished, with the only result be back acne. She was re tested and her levels were 83l…nmol/L. I don’t know how to read that! All of her other results were in pg/ml and she was at 186 then. She is in constant pain-nerve, muscular and joint. The rheumatologist just informed us that there’s nothing else she can do that we need to see the neurologist. My wife is done, she is so upset and depressed she is suicidal. I do not know what to do. She does not want to waste any more time with another doctor or waste our time and money. If anyone knows anything or can help I would be eternally in your debt!

    • Hi Frank, it sounds like the rheumatologist was part of your solution. Chronic inflammation such as in rheumatoid arthritis eventually leads to B12 deficiency, which can explain the symptoms. Once you are deficient, oral or sub-linguals are not really a very good option. If she hasn’t responded to the B12 injections, it was probably because it was cyanocobalamin, not methyl/adenosyl cobalamin. Many people can’t process cyanocobalamin (a pro-vitamin) into the two active forms adenosyl and methyl cobalamin. Now the problem is that after the injections, she will show up as having very high levels of B12 in her blood. This is a real reading, however, the B12 will be the B12 that was injected. Thus, if it is cyanocobalamin, what you measure in serum will also be cyanocobalamin, not the active adenosyl and methyl cobalamin. The next problem is that if she can’t actually process the cyanocobalamin you will have to wait until the levels drop until she gets the proper Adenosyl/methyl B12 (cobalamin). As she was so low, she will need months of daily injections to get better. Alternatively you could use the topical Adenosyl/methyl mix from b12oils.com , which I have used before. It is probably best to contact enquiries there and ask for their help

    • Frank,
      I agree with Madge that her B12 injections were likely cyanocobalamin. People with common genetic polymorphisms can’t metabolize cyanocobalamin and need either methylcobalamin or hydroxycobalamin, which the body uses in the cytosol of cells. People also need adenosylcobalamin, which is used in the mitochondria. Using the topical B12oils that Madge mentioned may be the easiest course of action right now, unless you can get a doctor to prescribe high dose methylcobalamin injections. Adenosylcobalamin can be taken orally.

      Was your wife tested for pernicious anemia, where the body makes antibodies against intrinsic factor? That could explain why her B12 was so low.

      Your wife might also have a deficiency of B12 in her central nervous system. That will require very high dosing of B12 to overcome. To learn about that, go to forums.phoenixrising.me/index.php?forums/detox-methylation-b12-glutathione-chelation.6/ and search on “central nervous system” for posts by Freddd.

      The serum B12 test measures both active and inactive forms of B12, and it measures what is in the blood, not in the cells. A high value doesn’t mean there is enough of the active transcobalamin form, especially if there is a CNS deficiency. As long as your wife has symptoms, the serum B12 level is probably meaningless. A urinary MMA test is a better test than the serum B12 test.

    • HI – Any chance your wife has been test for the MTHRFR mutation that affects how B vitamins are metabolized? I have both mutations (C667T) so I have trouble metabolizing folic acid and B12 especially (estimates range from 5% – 30% efficient). I take methylcobalamin (B12) and methylfolate – bioavailable forms – and avoid regular B12 and folic acid supplements (or fortified foods). Note: I have learned there are very few doctors aware of the mutation or its implication beyond pregnancy and neural tube defects. BTW there are estimates that 30-50% of the population have one mutated gene and 5-10% have both copies mutated.
      Prayers and warmest wishes on your search and healing!

    • No caffeine, no alcohol, no processed foods. Protein and good fats at every meal. No more than 2 starches a day, not to eaten with protein. A cup of homemade ginger tea (3-4 tbls of chopped ginger steeped for 10 minutes) 1/2 hour before meal, no fluids consumed with meal. Cabbage, sea salt, tomatoes, olive oil, home made nut milks, sardines, clams, beef liver, plain yogurt, 2% milk. Vitamin supplements: iron, cod liver oil, ( vit D depending on where you live), K2 and a zinc tablet before bedtime.

      I also take enzyme Q10 and brewer’s yeast tablets. Breakfast: Sunflower seed/almond milk, vegetable and cheese omelet with half an orange. Snack: glass of milk or a small bowl of oatmeal. Lunch: a quick clam tomato sauce over a large bowl of lettuce. Recipe: 1/4 – 1/3 cup of olive oil med heat add one peeled chopped carrot sauté for 3 minutes add 4 – 8 minced garlic cloves, 30 seconds later add two medium chopped tomatoes, 1/4 tsp salt, 1 tsp dried oregano, 1 tsp dried basil, 1/4 tsp chili pepper, some ground black pepper and 1/4 cup white vermouth simmer on medium for 4 – 5 minutes. Remove from stove, add 1/2 can of drain clams and juice of half a lemon and stir. Pour your sauce over bowl of washed and dried lettuce. Optional finely grated Parmesan cheese. This recipe also works with a can of sardines, replace carrot with 1/2 a fennel bulb, less 1/2 a tomatoe and 1 tsp of fennel seeds. Snack: Julia Child’s potato salad made with white vermouth. Dinner protein and veges. Snack: 2% milk.

      Never give up hope! 🙂

    • I know this is an older post but I am doing my own research for me and this came up. However, in reading your post this sounds exactly like what my daughter-in-law was going through and it was diagnosed as Celiac disease. She cut out all gluten and within days she was feeling much better. She too had suicidal thoughts from the pain being so bad. This may not be the case with your wife, but you might want to check it out if you haven’t already.

      • i too believe that celiac disease can cause this. i have learned that i am allergic to wheat. i was wondering if it could be a gluten allergy. a few days after stopping wheat (and gluten) my nerve, stomach, and heart problems went away. my nerve pain and twitching, stomach pain, and heart palpitations were scaring me. my heart would beat rapidly, stop (skip few beats), continue slowly, then quickly, etc. my stomach would cause me so much pain, swell up, felt like it was full of razor blades.. since i was a child i remember having pain after eating bread, didn’t know it could be an allergy. i went to the doctor who (i know i’m not the first one to experience this) basically said i was making it up. i never thought the heart and nerve problem could be related to wheat. i stopped eating wheat because of my stomach. i didn’t know it would solve the other issues. it’s been a few months of not eating wheat and i’ve had a few accidents of eating wheat. usually i first notice when my muscles start twitching. then i realize i had wheat. maybe it allows b12 to be absorbed, maybe it’s independent of b12.

    • This is not intended to be disregard the tremendous suffering your wife is experience but your post reminded me of this video. Some argue that conversion disorders do not exist but the mind/body is an infinitely complex system so who knows.

  4. My daughter starting loosing her eyesight about eight weeks ago an after a lot of tests the dr has said he thinks it down to her b12. She had to get injections for 14 days every day an now twice a week until things improve but the eyesight hasn’t got any better. She is only 19 so this is a very worrying time for everyone, we have been told there is no guarantee the sight will return to normal

    • It may help to find a doctor who works with genetic methylation and the MTHFR genes to see if they can help your daughter with the B12 problem. There are companies that do genetic testing that could refer you to a doctor.

    • What type of vision loss is she experiencing? Has she had a lumbar puncture to determine her intracranial pressure? Many folks with Idiopathic Intracranial Hypertension (IIH) seems to also have low B12 (not sure why), but one of the symptoms of IIH is Papilledema. IIH is often misdiagnosed, and incredibly frustrating and painful for the patient and loved ones. I hope it’s just B12 – much easier to treat, but vision loss is not something to sit around waiting idly hoping for a solution.

    • A friend of mine had an episode where she lost her sight for some time then returned. At the time, they put it down to the fact that she was pregnant. A few years later she was diagnosed with an under active thyroid and told that her loss of eye sight will have been linked to this – maybe worth getting tested? Must be very scary for your daughter I hope she finds a resolve x

    • I have no real idea what has happened to your daughter, but please also consider taking a look at other vitamin deficiencies as well, notably vitamin A. Many people cannot convert carotenes into vitamin A efficiently, so they become deficient – this particularly applies to vegans and vegetarians. Only animal foods have actual vitamin A in them, and supplements almost all have synthetic – not as good. The best source I can find seems to be cod liver oil that has not been stripped of its vitamins in the processing techniques. There are only a very few, most American cod liver oil has synthetic vitamin A added back in at the end of the process, unfortunately. Synthetic may be better than nothing, but the real deal is always best.

      You can find info here: http://www.westonaprice.org/health-topics/cod-liver-oil-basics-and-recommendations/
      And here: http://www.rositarealfoods.com/cod-liver-oil/2-artisan-extra-virgin-cod-liver-oil
      And here: http://www.ratfishoil.org/rosita-ratfish-oil/about-ratfish-and-ratfish-liver-oil This is not cod liver oil but ratfish liver oil. This is what I use.

      You can find cod liver oil here:
      1 – http://ratfishoil.net/ This is from Norway, not cheap, but excellent. I use their ratfish oil, and my kids take it as well.

      2 – http://www.greenpasture.org/public/Products/index.cfm This is fermented cod liver oil, very good for health, but very strong tasting. I used it, but my kids refused to take it.

      3 – Carlson’s cod liver oil is a good second choice, and is available at market’s like Whole Foods and co-ops and health food stores, as well as online, like Amazon.

      I wish you the very best.

    • Dear Veronica and well wishers, My parents and I have experienced temporary vision loss/complaints/weakness of some sort at varying levels. Both parents suffer from other underlying problems, and I was recently diagnosed with B12 deficiency! Please give “schizandra berry” a go for your eye problems as it’s worked a treat for us. It also helps aid a healthy liver (which we all know stores our B12). To good health x

  5. Can anyone help me?
    I don’t know if it’s because of the B12 deficiency or something else, but I have asthma and sinus problems. The problem is mucus ( sorry, gross I know) that goops up my whole respiratory system and even traps food on the way down.
    Any vitamins I should take, teas I should drink, foods I should eat or avoid? Anything? It’s kind of the last thing that’s holding me back, but it’s really a big thing.

    • Hi Ann, you might want to check into Patrick Mckeown’s dvd/book/cd set called “Buteyko Clinic Method 2hr DVD, CD, Manual; the Complete Instruction to Reverse Asthma…”. It’s available on Amazon.
      I bought it for a reason other than asthma, but it’s really directed at asthma sufferers. I find the excercises helpful so far and I believe will help you resolve your symptoms.

    • My wife had sinus problems all her life and two years ago it was so bad that she was coughing for four months non stop. Every winter she was on different kinds of antibiotic and her nasal was always congested and very weak as a whole.
      As a result of her sinuses she got pneumonia few times in past and consequently she got scar on her lungs. Two years ago pathology expert suspected of aggressive cancer in her lung, but thank God he was wrong. As a result of that we went to a lung specialist and the doctor diagnosed my wife with severe sinusitis which was the cause of her pneumonia problem.
      They put her on heavy antibiotics, but after clearing this time, I thought enough is enough, and after long research on internet I asked my wife to start to take (Bragg)Apple Cyder vinegar with mother in it, and as a result of that, for the first time in her life she is free from sinus problem for last two years.
      She was a frequent visitor to doctor for common cold and influenza but thank God for this simple solution she hasn’t visited doctor since two years.
      She started taking one tea spoon mixed with water three times a day before breakfast, lunch and dinner.

      Hope this help. God Bless.

      • Robert,
        Thanks! I kind of do take a tablespoon of Bragg (the best!) with water and honey, but only once a day. Though I like the taste, and it makes me feel pretty good, I’ve unfortunately only taken it sporadically. I think I’ll get another bottle today and stick with it.
        I started a cold on September 3, and it’s just going away now. My sinuses still hurt. So, here’s hoping it works as well for me.

        • I can’t take Braggs for my coughing(asthma/mucus)because I also have Barrets(esophigyle erosion)it burns too much.Has anyone tried ACV tablets with any luck?

          • Bee,
            I’ve taken Swanson Double-Strength Apple Cider Vinegar that I bought from Amazon.
            I haven’t taken it for long enough periods of time to tell how good it is, though it does give me that calm feeling that Bragg gives me, but it received good reviews on Amazon.

            By the way, I don’t know if it still helps anything when cooked (I don’t see why not), but I use it in things like pancake batter. The batter smells of vinegar, but the pancakes don’t taste of it. They taste gooood.

          • Bee,
            I forgot to say that the pills helped my heartburn. The one time, they worked instantly, even better than Tums. I figured I’d let you know if they helped with that, they must be doin’ sumpin’.

      • finndian,
        Thanks for your help! I looked up NAC on Amazon, and quite a few people complained about stomach upset, so I think I’ll wait to see how the Apple Cider Vinegar and the breathing exercises go, but I’ll definitely try NAC if things don’t improve in 6 months.

    • Thanks so much for everyone’s help. My inhaler barely works, and this past month and a half has been really bad. I must admit, I have been pretty lazy, and not followed through with a lot of health plans, but your quick replies have made me determined to get better, starting today. In six months, I’ll let you know how it’s going.

  6. I have the opposite issue- my levels of B12 are very high -1300 per last blood test done (without supplementation). I have a huge gut issues for already 8 months (not digesting anything without help of digestive enzymes) and everything started with Advil pill I took on an empty stomach. After this, my digestion completely stopped. Having all this indigestion/malnutrition issues , one would think that I would not absorb B12 as well. Homo-cysteine levels are normal and I don’t have MTHFR gene mutation. The blood tests don’t show any sign of malignancy (often connected with high levels of B12).
    The only thing I could think of is that my liver is not working properly (although standard liver tests are OK) and it’s dumping B12 into my blood instead of inserting it into the cells so the test show high levels although my cells are maybe lacking B12.
    Any other ideas?

    • Did you just have a blood test, or MMA, or any other test mentioned here? It could be just that the test you took is at fault. You are right to be concerned. It is strange that with such a bad digestive problem that any test would show a high B12 level.
      As for your stomach issues, have you thought of a cleansing fast done at a facility? I have heard quite a few stories about how it can release toxins and “reset” your system. However, I would wait for a few more months to see if your body slowly but surely heals itself.

      • Thank you Ann for responding to my post.
        This B12 level was determined by routine blood test- so I guess it’s total B12. I didn’t get MMA test as I didn’t know it exists- I will have to check with my FD if I can do more specific testing.
        As for the digestive issues- I didn’t try fasting diet as I lost 30 lbs because of all of these digestive issues (I had 90 something lbs on 5”5′ heigth) and I regained half of it back now….but when this all started I barely ate anything for 2 weeks and it didn’t help at all:)
        Answer is somewhere there I just need to keep searching for it.

        • Yeah, I don’t know if barely eating and fasting are the same thing, I would assume they are. Any info I have on fasting is anecdotal, so I don’t know the specifics. It should be done as one of the last things to try, I don’t know why it popped into my head right away, maybe because I heard when something stops working, fasting helps to start it again.

          Glad to hear that you’re slowly coming back. I am still puzzled about your B12. Maybe your liver is releasing extra B12 in order to help heal yor stomach, or to compensate for it, or maybe your levels were even higher before. Let me know if you find anything out.

        • Hi Tanja,

          I have really high b12 – been tested for blood disorders like PV and leukemia and liver function is fine. Did you ever manage to get a resolution/answer to your high b12?

    • I sure do have comments. My b12 level on the CBC test is more than 1500. A few years ago my b12 level was at 235 and my doctor put me on b12 shots. Getting an injection every month did not do the trick. I was exhausted and dizzy. I asked to have injections at least twice a month. I became so much better. By big mistake was to quit the injections and started on b12 tablets. I was so ignorant and did not know that the tablets were not being absorbed through my small intestine. For the last year and a half stayed at home because I suffered from sudden bouts of diarreha

      • Sorry I was cut off. Anyway, I had many symptoms of b12 deficiency fatigue, dizziness, anxiety. I went many doctors who practically threw me out of their office because my b12 levels were so high due to taking high doses of tablet b12. I begged to have a parietal antibody cell test and the folate which both showed problems with the absorption of b12 through the small intestine and that despite the high levels of CBC test I was b12 deficient.

        I have pernicious anemia in my family. Unbelievably, the doctors still deny me b12 shots. I am about going crazy. I was able to find a b12 supplement that absorbs more easily and some of my symptoms have subsided. I know that injections are the true answer for helping my b12 problems. Keep your fingers crossed for me I am going to another hematologist, hopefully he will give me the help. I need.

        • Hi Dorie,

          You have another option available : B12 patches , you will baypass the gut this way. I don’t know if the patches really work but a lot of people say they helped them.
          And there is also a sublingual B12 spray.

          • I use the oils from http://b12oils.com/Home.htm
            These are great. They have even been shown to be of great benefit to people with acute B12 deficiency such as is found with chronic fatigue syndrome. You simply rub them on your skin. They gradually release the B12 over hours and hours. Much easier to use than the Patches, which I have tried and which didn’t work

        • I have the same issues as my B12 is over 2000 no suppliments at first.Been doing injection now once a week.Forget the hematologist go find a N.P. to prescribe it.Down side it’s a self injection.No biggie after a couple of times!

    • Have you had your lithium levels tested? That helps transport B12 into the cells. I would also suggest getting a DNA test from a place like 23andme. I did and I found out I had genetic errors that cause me to be unable to convert b12 into methyl b12.

    • You are deficient in B12 – in US anything under 300 is.
      And if you ask EU/Japan – anything under 500.

      I suggest starting with B12 shots or big doses of sublingual methylcobalamin ASAP.

  7. I have to have B12 injections, and will have to have them for the rest of my life, my Doctor is not very knowledgeable on the subject and feels normal levels should be between 200 and 600, I was so ill with a level of 192 I was falling over and so tired I was unable to function I am a young 77 year old and believe these levels quoted are much too low. Ann

    • Ann, I totally agree that the levels used are much too low and need to be revised. My level was 196 and I was severely ill, fatigued, depressed, shooting pains in my legs, lost a lot of weight, and had to use a walker. Referring to the minimum of 200, my doctor said he doubted that my slightly decreased B12 level was causing my symptoms. Wow was he ever wrong about that!

      I’m so very thankful for the internet, because I did some research and learned that my symptoms matched those of B12 deficiency. I knew that had to be what was ailing me. I had to be a real pest to get my doctor to start treatment.

  8. Sadly a lot of drs are not aware of the genetic mutations MTHFR with Vit b 12 .Both my husband & I have been diagnosed.So an infant can be born with it especially if the mother is a vegetarian.My lifesaving book was Sally’s book Could it be B12 ? Just so frustrating when I have seen 15 drs including 7 specialists waste of money A dr at Ed suggested because of my symptons but was dismissed as level was 290 in norm range.My husband almost killed himself with memory loss .I just wish we could get it out there istead of being told its in your mind hardly with severe tinnitus numb feet approx 25 other symptons.

    • That is a revelation to me that tinnitus can be a symptom of Vitamin B12 deficiency! I have recently been diagnosed with a very low Vitamin B12 level. My Naturopath was amazed I could still function normally with the levels I had. But my tinnitus is pretty bad. Perhaps with me that is where a low Vitamin B12 level has revealed itself.

  9. I was diagnosed as being anemic when I was very young. Maybe 8 or so. About 30 years ago my B-12 level reached a low of 75 and I was having problems remembering where I was going, almost falling asleep at traffic lights, and not remembering peoples names. I also was getting short and upset and having heart problems. I went to several doctors and no one checked my B-12 levels. One day when I was driving on the freeway, my vision became double and I had to close one eye in order to get off safely. My wife and I spent several days going to various doctors, when a neurologist finally discovers I had a b-12 deficiency. They started me on immediate injections and told me I would have to take them the rest of my life. I was told that my body destroyed any B-12 orally and that my body no longer produced it. I found that when my level was over 1000 I felt best and had more energy and strength. Because of health insurance I have had to switch doctors. So far I have had to train 4 different ones on my condition. Perhaps it would be good for them to teach this in medical school. I did have the same problem walking when this started as many of you. Everything was on my left side and that is the way I kept walking. My wife had to hold me by the belt to keep me going in a straight line. When my level of B-12 went up, I was able to correct the nerve that controlled the eye and get ride of the double vision. It took about 8 weeks.

  10. I was diagnosed with a B12 deficiency at 8 years old. My teacher called my mom to tell her there was something wrong with my health, and it was discovered I was severly anemic due to a B12 deficiency. I was given B12 shots at first but since I was needle phobic, I ended up taking prescription B12 pills. I am now 40 and take B12 pills to this day. It is a scary thought to know that if I had been born just 100 years earlier, I would most likely not have survived to adulthood.

  11. Hi there,

    I have what my MD is calling neuropathy in my left arm. It tingles and there’s a spot that itches although there’s nothing there to be itchy. It kind of travels down my arm and sometimes feels kind of like an electric shock. She’s never done any tests just said that’s what it is. After reading about B12 and how people who take acid reducers and Metformin have a higher chance of their levels being depleted I decided I should have it checked. I just got back the results on just a straight up B12 test and the result is 540. I’ve read on some websites that even though the blood test says number is normal that it’s still low. Does anyone know? Could the level I have still cause neuropathy? I’m considered “pre-diabetic” my A1C is 5.3. Thanks for any ideas!

    • Hi There, your B12 levels would not normally be considered to be low at over 500, but it depends if you have been supplementing and what you have been supplementing with. Other causes of peripheral neuropathy can be low intracellular folate, low B group vitamins in general, and low vitamin D. Your intracellular folate should be above 7 ng/ml, whilst with vitamin D, it should be as high as possible (.50 ng/ml).

      • Thanks for the response Madge, no I hadn’t been taking any vitamins except for Vit. D. Before I started taking the D years ago my level was 8. So, I guess I need to ask my doc to check my folate then. I’ve started supplementing some B12 now just in case. It’s just some cheapy stuff I got at the drug store. 5000mc I figured that might help some even if it’s not a better brand. 🙂

        • Hi Zowiezombie, looks like you have a bit of sleuthing to do. If your genetic profile is normal it will be different to if you have methylation associated mutations. If you are deficient in B12 you will have to try to work out why. If you have a vegan or vegetarian diet, then it is quite simple, you need to supplement with B12. If you are hypothyroidic (and you will need tests to determine this) you will need to fix this. Folate and B12 are very inter-related in how they work together. It is actually quite hard to get enough folate if you don’t eat lots of green leafy vegetables. If your genetics is fine then normal folate will also be, but if you have methylation problems, particularly MTHFR, you will need 5-MTHF (deplin). The easiest thing will be identifying why you are deficient.

    • ZowieZombie…From what I’ve gleaned from the internet, the serum B12 test doesn’t differentiate between active and inactive B12. Your result can actually be up to as much as 90% inactive B12. I have ‘failed’ all my B12 tests. They all come back as normal to high B12, but my RBC count was as low as 3.8 at one stage, MCH and MCV levels were both slightly elevated, I felt like a rag doll, had no energy, just couldn’t function at all unless I took transdermal B12. GP swears I don’t have a B12 issue even though I now have a swollen tongue. I am doubling my dose of B12 in case I’m just not taking enough. It would be a big help if doctors would go back to the old ways and read the symptoms. Numbers on a chart are totally useless IMHO.

      • @Rose,

        that is very interesting.
        once i was diagnosed with severe anemia (RBC was also like 1/2 of lowest normal & many others also abnormally low;
        my B12 was really high

        (800 i think; i don’t remember the numbers — dont’ have the test results handy right now)
        i was tired all the time & hair was brittle & thinning.

        then i ate liver everyday for 2 months & finall bright it to low end of normal.
        mmm i wonder if my high B12 level was “inactive” so even it was high.

    • Please contact me about your story on Vitamin B 12 I also have a story that has helped me a lot!!!

  12. Should I take my B Complex containing Folic Acid and C, with my B12, or some hours later? I know B12 travels with folic acid, and was wondering if that’s a good thing, or if they have troubled separating.

    Also, all my life I feel sea sick whenever I read. Does anyone know if that’s B12, or something else, like some form of dyslexia? I can read well, it’s just that I feel sea sick.

    • Ann, I just have to chime in here and tell you to go google Irlen Syndrome. My daughter has it and it made a huge difference in her life when she started wearing her special glasses, and later, contact lenses. I think it’s something that too few people are aware of, and I hope the info helps you.

      • Laurie,
        Thanks for the info. I looked very quickly, but I don’t think that’s it, because it seams that the quick info I looked at pairs it with trouble with reading comprehension, or some other learning difficulty. The only problem I have is the nausea, but I definitely will look further into it. I’ve had sinus problems for a long time, and I’m kind of thinking that is really what it is. However, I saw a show — “The Incurables”, I think — and a man had problems reading, along with a feeling of motion as he tried to concentrate on the words on the page. He was diagnosed with dyslexia, but found a doctor in California that prescribed a certain color glasses for him to wear, which make his dyslexia go away. Are your daughter’s contacts tinted? Was her only symptom the feeling of movement? What type of doctor can diagnose this?

        • It’s thought that Irlen Syndrome may be a form of dyslexia, so the man in the movie being helped by colored glasses would make sense. My daughter hated to read because it caused her discomfort. She would get headaches, preferred to read in the dark, and although brilliant, she had a lot of trouble with comprehension because of what she perceived as movement of the words on the page. The end of one word would “run” into the beginning of the next sometimes. Florescent lights are the worst! My daughter’s contact lenses were specially colored (several layers of colors, in fact) and looked light gray. She actually no longer needs them because she learned over time to adjust and be aware of circumstances in which she might have a problem. After struggling to get through 8th grade, she went on to be graduate High School as Salutatorian of her class, get an Associate Degree in Graphic Design, a B.S., then a Master’s in Teaching by the time she was 22! The glasses/contacts got her through a tough time. I hope you figure out what your problem is.

          • Great! I’m a classic underachiever myself, and I admire people with drive, like your daughter.
            The man in the show described what he was experiencing almost the exact same way. I’ve had sinus problems for most of my life, and I just had a virus that lasted for over a month and a half and really did a number on my sinuses — even the pressure of my readers made me queazy. That’s why I was thinking recently that that must be the cause. However, some of what you said does sound like it could be right, and the one site did have as an added note that some people only experience nausea. So I will definitly look into it some more.
            Who diagnoses it, though, a regular Ophthalmologist, or someone else?

    • You would be better off taking folate rather than folic acid, which is a synthetic substance, High intakes of folic acid have been associated with cancer, they can mask a low B12. Also, regarding B12 there are a couple of paragraphs above that read: “A high intake of folic acid might mask detection of vitamin B12 deficiency and lead to a deterioration of central nervous system function in the elderly. In one study, consumption of folic acid in excess of 400 micrograms per day among older adults resulted in significantly faster rate of cognitive decline than supplement nonusers. (11) Another study found a higher prevalence of both anemia and cognitive impairment in association with high folic acid intake in older adults with a low vitamin B12 status. (12) As vitamin B12 deficiency is a common problem for many older adults, these studies suggest that high folic acid intake could cause serious cognitive consequences in the elderly.

      Despite the risks associated with high levels of folic acid intake, it is well established that adequate folate intake from the consumption of folate-rich foods is essential for health. Folate aids the complete development of red blood cells, reduces levels of homocysteine in the blood, and supports nervous system function. It is well known for its role in preventing neural tube defects in newborns, so women of childbearing age must be sure to have an adequate intake prior to and during pregnancy.

      Excellent sources of dietary folate include vegetables such as romaine lettuce, spinach, asparagus, turnip greens, mustard greens, parsley, collard greens, broccoli, cauliflower, beets, and lentils. (13) Not surprisingly, some of the best food sources of folate are calf’s liver and chicken liver.”

  13. How long does B12 from an injection stay in the body?
    ND says could be around and affect blood test result after 2.5 months; MD says it can only be around 2-3 weeks.

    • I don’t know about blood tests, but I’ve heard some people say that for them, the effects only last one day.

    • Hi Lan, the real answer is “it depends”. Thus, the half-life of stored B12 is over 200 days. The half-life of injected B12 is different, and it depends upon how it is administered. IV injected material seems to have a half-life of around 16 hours. Thus a 1 mg dose would be almost totally gone (less than 4 ug left) by 9 days. IM injected material lasts slightly longer, but probably not much. Topically administered material in b12oils would be longer due to the depot effect of the skin. IM injected material given 4-6 weeks apart doesn’t actually top up areas such as the brain or restock the liver, because if it did, you would only need to have 3 or 4 injections every 4-5 years, In stead the IM injected material give you this massive peak and trough effect. What is also important is that the B12 has to be around to saturate any “free” transcobalamin (holotranscobalamin), as this is the protein that is required in order to get cellular uptake. Only about 25% of protein bound B12 in serum is bound to TC.

  14. Great post, thank you. I have ulcerative colitis so B12 deficiency is a big concern for me. Just wish I could find a doctor who took it as seriously.

    • Sorry to hear about your UC. Make sure that you get your vitamin D levels up as high as you can. Vitamin D is supposed to be very good for UC. Apparently there are lots of vitamin D receptors on the gut wall, and they help with the maturation of the gut cells. I’d also make sure that you check out on iron deficiency as well as B12 deficiency. Apparently 85% of people with IBD conditions, including UC get iron deficiency. The reason is most likely due to poor maturation of the gut wall, plus loss of uptake of recycled transferrin as this is compromised in UC. Sorry haven’t tracked out the best method for iron supplementation, but evidence suggests that you are wasting your time unless you get injections. You will of course need vitamin B12 via a non oral route, such as injection or transdermal oils.

    • Can you take vinegar with UC? I know the unfiltered Apple Cider Vinegar — the one that is cloudy, and has a goo on the bottom called the mother — is good for heartburn/ acid reflux, and many other gastro-intestinal issues. I would also avoid wheat products, and I believe you should avoid dairy, but you can still take pills for any nutritional loss.

  15. I have pernicious anemia and have received injections monthly for years. I am told there is a shortage of the vaccine now and am unable to receive the injection. I have had balance issues and extreme tiredness for no reason recently. I now take one 1000 mcg daily. Having trouble figuring how much I really need. This concerns me. Doc says ask pharmacist, Anyone know?

    • Yeah, and when you ask your pharmacist, she’ll say to ask your doctor. I was taking 20,000 mcg for over a year — probably 2. That was 2 5,000mcg sublinguals in the morning, and 2 at night. I eventually lowered the dose to 1 sublingual a day, but pain in my legs kept coming back after a month or two, so now I’m keeping it at 2 pills once daily, and that seems to work well. there is someone on here touting an oil version, and I might give that a try. In my opinion, 1,000 is O.K. for anyone who hasn’t shown symptoms yet. As I’ve said elsewhere, there are VERY, VERY few cases where someone can’t take B12, but everyone else should take it, because it’s so important.
      Also, make sure your D levels and Magnesium levels are good. I ignored Dr. Oz about magnesium, saying to myself, “It’s a trace element, I’m sure I get enough,” but he was right, and I was wrong.

      • You basically can’t overdose with methyl or adenosylcobalamin, although some people react badly to cyanocobalamin (the normal supplement type in the US) or hydroxycobalamin (now a replacement). If you are one of 30% of people you have trouble converting cyanocobalamin or hydroxocobalamin to the two active forms methyl and adenosylcobalamin due to mutations in the methionine synthase reductase gene. This doesn’t normally affect people that much if they are getting dietary B12, as the forms in the diet are adenosyl and methyl B12 (cobalamin). This may be a reason why the ultra high doses are not really doing much for you. I had this problem which is why I use the mixed Ado/MeCbl from b12oils. It is an oil that you rub into your skin. Works a treat.

        • Thank you for reply. I started taking magnesium on ma own because of severe leg cramps. Still get them but less frequent and shorter in duration. I am learning a lot from you and others input. I agree, most drs. do not know much about b12 or pernicious anemia. Would you or others recommend a neurologist instead of internist?
          I also was on folic acid many years ago but new doc says do not take. I am losing faith.

          • Doe,
            It really depends on the doctor, from what other people write, neurologists don’t seem any better than any other type of doctor. I don’t know how to find one that actually believes in vitamins as therapy. I complained to mine all the time about symptoms I was having, but she was just worried about my BP and if the medicine lowered it enough, nothing, and I mean nothing more.

            Anyway…did your doctor say why he didn’t want you to take folic acid? As far as I have seen, most doctors advise to take a general B supplement, and specifically, Folic Acid. My reading has advised this as well.

        • Madge,
          There are one or two diseases I’ve read about where taking extra B12 can be harmful. I can’t remember what they are, because I didn’t have them, but if you do have them, you more than likely have seen a doctor and know. I think they even advise against eating liver and other things high in B12.

          • Hi Ann, that is very curious. It must be extremely rare as I have never heard of it. There is one disease Leber’s disease where you shouldn’t give cyanocobalamin, but adenosyl and methyl are fine. VB12 is essential for life. If you don’t have it you basically die, so it is hard to imagine that these conditions ever survive the womb, and anyway the foetus gets B12 from the mother, to the baby so it would die before birth. Can you give us more details? Was it from a publication, or from “web” chatter?

            • Sorry, but as I said, I didn’t have them (I think there were 2), so I didn’t pay too much attention, but I did feel a little guilty saying EVERYONE should take B12.
              I believe I read about one on, is it NIH or NIMH website?, or some other med site like that. The other was an ailment that has to to with the digestive tract, especially the colon, I’m pretty sure. Or maybe the bladder, I think I was looking up Interstitial Cystitis because I had been looking at marshmallow root tea on Amazon, and a lot of people used it that had IC. So, I googled and looked and followed links, and it could be IC, or one of the dozen or more other diseases that had links — now you know why I don’t know which disease it was…and why my house never gets cleaned.
              Sorry I can’t be of more help, but I definitely know I saw the warning(s) against B12.

  16. The exact same article could be written about magnesium. Just replace “Vitamin B12” with magnesium, and, well, same article. You could say the same about thiamine too – another B vitamin.

    When are people, doctors in particular, going to start looking at what depletes cellular minerals and B vitamins? When you start looking at a bigger picture, you might actually find some culprits. The culprits are the pharmaceutical industry. One, of probably many, class of drugs that depletes magnesium, B vitammins and iron – and causes mitochondrial damage / oxidative stress – is fluoroquinolone antibiotics (cipro/ciprofloxacin, levaquin/levofloxacin, avelox/moxifloxacin and floxin/ofloxacin). But doctors give them out like candy despite the 43 PAGE warning label.

    Here is a great article about how fluoroquinolones are a risk factor for type-2 diabetes – http://www.medical-hypotheses.com/article/S0306-9877(14)00217-5/fulltext A similar one could be done for all of the diseases mentioned at the top of this article.

    • Thank you Lisa! I totally agree, and I had no idea about a warning label of any length, let alone 43pgs! I also think there has to be more to this issue (nothing is ever simple, is it?) than just the fluoroquinolones. I have never taken them, yet I have chronic fatigue with fibromyalgia, and I battle chronic migraines – I’m coming down from one right now so if I sound out of it, it’s because I am a bit, sorry. Fluoride and bromine (used to bleach flour in breads) each do a real number on the thyroid and displace iodine, the only nutritive halogen as far as I know.

      Could we add to your knowledge with the hypothesis that any fluoride from any and every source is also a possible contributor? I’m thinking of toothpastes, fluoridated water, fluoride tablets (no joke, this happened to me) that pediatricians and dentists prescribe for small children ‘for their teeth’, and industrial fertilizers. I’m under the impression that those fertilizers have a lot of hidden poisons in them under the ingredient “inert ingredients” and one of those is fluorides. These may either be uptaken by the plant foods we eat or those fed to animals, or they may interfere with normal plant uptake etc. ultimately rendering the plant deficient at best, toxic at worst.

      Some vaccines have or have had fluoride as an ingredient, too. [What genius dreamed that one up?!] Here’s a pdf chart, you have to click on the link:
      http://www.cdc.gov/vaccines/vac-gen/additives.htm

      What’s your thought on all F sources? And possibly bromides as well, since they are also in some vaccines and in our food now, too? I think these ingested and injected toxic halogen compounds can and do ruin many pathways in the body, not the least of which is this B-12 issue.

      • Hi Molly,

        It’s funny, you’re the third person in 24 hours to ask me about the fluoride connection. I think that it may be a sign that I should look into it more thoroughly. 🙂

        Dr. Mercola thinks that the fluoridation of fluoroquinolones is the main problem with them. Here is one of his articles on the topic – http://articles.mercola.com/sites/articles/archive/2013/09/25/fluoroquinolone-antibiotics.aspx

        I believe that the problem with fluoroquinolones (FQs) is more in what they do to cellular magnesium levels and mitochondria. FQs deplete intracellular magnesium. Intracellular magnesium is really, really, really important. It is vital for more than 300 enzymatic reactions – including the utilization of all of the B vitamins within cells and the production of ATP in mitochondria. When cells are deficient in magnesium, the mag/calcium balance is thrown off. Too much calcium can translate into too much superoxide production. Superoxide is a potent oxidant that can wreak havoc on the whole body. FQs are a big culprit in depleting cellular magnesium, but they’re not the only one. Here is a list of drugs that deplete magnesium – http://www.jigsawhealth.com/resources/drug-muggers-suzy-cohen-magnesium

        A fluorine atom was added to the quinolone molecule to make it more potent and so that it could more easily penetrate tissues (and cells?). The fluorine/fluoride may be the key to how FQs break open cells to deplete magnesium. I’m not completely sure about that though.

        Thank you very much for your thoughtful comment! I definitely need to take a closer look at the role of fluoride in the mess that is Fluoroquinolone Toxicity.

        Regards,
        Lisa

        • Thank you very much Lisa, I follow Dr. M too, he’s very helpful. I didn’t realize about the magnesium connection, and I have never taken an FQ, but I’ve had 2 flu shots, and vaccines of course, and I am horribly magnesium deficient. So deficient that I have had to change my (already organic whole foods) diet to try to fix it, and I take a ton of Mg every day. And I have Chronic Fatigue, so I believe it’s all tied together somehow. Thank you for the link and your info which is new to me. Ever onward!

          • Molly, you’ve listed migraines, fatigue, b12 and magnesium deficiency that you can’t seem to cure. All signs point to undiagnosed food allergy and/or under-treated hypothyroidism. You’re sure not going to cure your magnesium deficiency and all those symptoms orally until you cure the problem causing the stomach issue.

      • You know, not to sound all “conspiracy theory-ish” about it, but it seemed to me awhile ago that a lot of municipalities have been quietly stopping the addition of fluoride to the drinking water.
        Also, I noticed about 15-20 years ago that the bleached flour I was buying always tasted stale. Then, on some cooking show, they mentioned that the chemicals that they used to bleach the flour left a taste that some people noticed. I tried unbleached, and no taste! I now only use “big brand, not organic or anything” flour. I thought it would change the look or texture of my baked goods, but it hasn’t. That goes to show you, let your senses be your guide. Unfortunately, a lot of people have overloaded their senses, which also reminds me — and this is partially a do as I say, not as I do thing — try not to wear perfume, cologne, or use scented stuff. I have heard from different sources that prolonged use can screw up your body.

        • Sorry, I meant to write, I now only use “big brand, not organic or anything” UNBLEACHED flour.
          Sure wish there was a way to edit, yeah, ok, and wish I had proofread.

  17. Hi,

    I’m looking for any scientific papers that relate to this paragraph:

    “In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss. Some experts have speculated that the acceptance of higher levels as normal in Japan and the willingness to treat levels considered “normal” in the U.S. explain the low rates of Alzheimer’s and dementia in that country.”

    I have a result of 330pg/mL and I have many symptoms but the NHS won’t treat. I’m hoping to go to my doctor armed with evidence in favour of treating me.

    Thanks
    Becky

    • Hi Becky, there are a couple of points of relevance here. Firstly, what is regarded as normal in any country is actually determined by the pathology labs. It has nothing to do with clinical deficiency. Basically the path labs average out their data and then define normal as what falls within 90% of the values that they assess, with low being the lowest 5%. Thus, normal B12 is different in every country and is totally dependent upon diet. I have no idea who came up with this concept as it is absolutely ludicrous. Second, levels in the USA are relatively high because of B12 and folate supplementation of many foods. In Japan they eat lot of sea-food which tends to boost the levels. Many studies have shown that sub-clinical deficiency (as defined by elevated MMA and Hcy) starts at 250 nmol/L or 340 ng/ml. There are, however, a lot of problems even with this assessment. The most accessible way to tell if you are deficient is via MMA, Hcy levels combined with B12 and most importantly symptoms.