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

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Published on

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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Chris Kresser in kitchen

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.

1,962 Comments

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  1. I was diagnosed with B12 deficiency in June when I was feeling dizzy and had the tremors. I have come to realise I have a lot of neurological symptoms that can be due to B12 def. I tested negative for the antibodies that affect intrinsic factor so the GP said not classic PA. I was put on the loading doses for 2 weeks then told I will get a blood test at Christmas. I went back as my neuro symptoms were getting worse. I was then offered 2 monthly injections after a further 3 weeks of loading doses. The haematologist told the GP that any symptoms remaining at the end of 3 weeks were not due to PA. My symptoms are still bad and worsen each day but the GP will not give me any frequently than every 2 months. I wrote to the practice manager stating my treatment needed changing and the GP then referred me to the haematologist (still waiting for that appointment). Seen the gastro today and he said my vit D levels were good despite the GP saying they were very low and I need vit D tablets for life. He said my b12 levels (133) were not low enough to produce symptoms. He said my def could be due to Crohns but did not want to do a colonoscopy. I told him to do the calprotectin stool tests and he did agree to that. I also asked for the breath test to check for H pylori but he said there is no link to B12 deficiency. I am worried that I will not be able to do the career I am training for in the future (midwife). I am being fobbed off by every medical professional I see. The lack of knowledge and the refusal to provide adequate treatment scares me. I do not know how to get the right treatment. Occupational health wanted 6 weekly blood tests to keep an eye on my levels and see if working near entonox affects my levels but the GP has refused to do it (despite agreeing at first). I feel if it is left to the heath professionals I could end up disabled.

    • My podiatrist tested my feet when I visited for a routine check on my plantar fasciitis. She was horrified the GP has not referred me for a spinal check. She said I am unable to detect temperature change on my feet. If it gets worse I am to go back to her as an emergency and she will carry out the tests again and write to my GP.

    • SLEEPYPUSS – Read Could It Be B12 by Sally Pachlok (excerpts on Amazon). Sally also features with her husband in a fantastic You Tube video – Diagnosing and Treating Vitamin B12 Deficiency which will set you on the right path straight away.

  2. I’ve struggled with undiagnosed b12 deficiency in the past. I had severe nerve conduction problem for about a year that got progressively worse several years ago. All the doctors I went to couldn’t figure it out despite me telling them I had a history of nerve problems, didn’t eat red meat and was into endurance exercise… all that sweating of course washing out my already meager stores of water soluble B vitamins.

    Finally I woke up one day without a voice! My vocal cord had become paralyzed! I’d read that its roughly the same nerve branch that gets affected in Bell’s Palsy. Some studies show that B12 injections speed recovery of Bell’s. The ear, nose and thoat guy who was treating me for Idiopathic paralysis of the vocal cord refused to give me B12 so I found a doctor who gave me a bottle of Methylcobalamin and some needles. I was injecting myself once a week during the vocal therapy I was prescribed. Suddenly the vocal cord started to wake up. According to the first doctor I was the speediest recovery of paralysis he’d ever had. It still was 8 weeks with no voice!

    The profound B12 deficiency was not only caused by the fact I ate no red meat but that I also have the gene variations that make it difficult to absorb B12 it turns out. The final key to this sudden B12 crisis was a stool test showing that I was creating anti-bodies to gluten and that I had stomach inflammation that had progressed to leaky gut. I was deficient in B vitamins and magnesium… both are common deficiencies when food allergies are involved.

    I now take the stool test every couple of years to check on the condition of my stomach and bacterial ecology. I need to eat gluten for a few days before the test to get the antibodies on alert. I started eating gluten last week because I’m going to test soon but I actually extended my gluten eating for for over a week because I miss all these foods so much. Key lime pie and bread at Joe’s Stone crab in Miami! I’ve paid for it though! I immediately started to get lots of mucus and a need to clear my throat often… no big deal. Then I started to get a mouth full of canker sores. Very small but irritating sores that I think probably extended down my digestive tract in response to being exposed to gluten. I choked on and spit out water while taking a drink twice because of my vocal cords allowing water into my lungs. Then I started to get hoarse and could tell that I’d lost part of my upper vocal range! I’d been though this before so I know what’s happening to me.

    That scared me enough to run and get a B12 injection at the doctor since I no longer inject myself. As I was paying the $15 and thinking about traffic on the way home I suddenly got a cramp in my vocal cords and as I stood there the pain moved down my esophagus to my sternum. I almost stayed there at the doctor to see how bad the pain would get but I felt a release of the cramped muscles after about 15 minutes or so. Within a hour my vocal range started to come back too. A few hours later I felt a burning in the muscle in my back that is still mildly atrophied from previous nerve conduction problems I experienced. So there it is… I must have been heading into another deficiency crisis brought on by introducing gluten back into my diet and not keeping up with the B12 supplementation.

    I’m just posting this because I didn’t find a lot of help with my vocal paralysis issues on the internet. I just want to say that my vocal paralysis is absolutely the result of B12 deficiency and MY vocal cords and the nerves that control them are very, very sensitive to B12 levels. I do not believe that it is a rare as the study below would have you believe. If you have a weak voice with excessive need to clear your throat then I suggest methylcobalamin B12 injections or 5000mcg sub-linguals. The results for me are almost immediate in the strength of my vocal cords.

    Vitamin B₁₂ deficiency: an unusual cause of vocal fold palsy

    DISCUSSION:
    To our knowledge, this is the first reported case of unilateral vocal fold palsy secondary to vitamin B12 deficiency. Central and peripheral neuropathies have been described; however, other than the optic nerve, the cranial nerves are very rarely affected. It is important to consider vitamin B12 deficiency as a cause, as speedy identification and treatment can help prevent permanent neurological damage.

    http://www.ncbi.nlm.nih.gov/pubmed/21791159

    • Thank you for this, I do have a weak voice, and I clear it all the time just in order to speak, and yes, I am B12 deficient but it is not as simple a fix as I would like, I suffer from chronic fatigue as well – likely a methylation issue.
      I take B12 sublingually as 2000mcg methylcobalamin and 2500mcg adenosylcobalamin, along with a b-complex that contains 800mcg folate. It helps, but it is not a cure, I have slowed the degenerative spiral downward, but have neither stopped nor reversed it. I am still working on it.
      Thank you for this invaluable comment, I had no idea voice could be another symptom! I too have lost my voice, due to stress, for 3-4 days each time, but it returned on its own. Good thing because I knew nothing about this.
      Thank you, thank you, thank you!

    • I haven’t heard that, but I try my best to avoid artificial sweeteners. As far as I am concerned, they are poison. Check out “A Poisoned World” for the story of aspartame. I streamed it on Netflix, but I don’t know if it still available there. I personally had problems with sucralose. I used to eat these liquid filled mints — I haven’t seen them in years now — and I noticed that I was jittery and paranoid. I stopped eating them, and I was o.k.. I started to eat them again, jittery and paranoid.

      The problem is that they sneek artificial sweeteners into EVERYTHING now.

    • Methyl folate and some form of B12 other than cyanocobalamin. And make sure you are supporting all of the other b-vitamins. And be careful with dosages of methyl folate and methyl b12; some people are very sensitive.

  3. I was wondering if someone could help me. I was affected by B12-deficiency when i was a teenager. Due to age prejudice doctors didn’t diagnose this until I was 18. By that time I was always tired and didn’t do anything except sleep and torturing myself to go to school. I had problems communicating myself because I couldn’t remember the right words and my longterm and shortterm memory was a mess. Before that I was an excellent student and I always loved studying and i am very ambitious. I’m 23 now and i have gotten shots regularly since then and yet my memory and ability to communicate myself hasn’t gotten to the level that is was before the symptoms begun. Now I am very aware that I am a very slow learner and it doesnt matter how much i concentrate or try my memory is very bad and I still mess up words when i’m speaking. It makes me really sad because i wanted to go to university and i had it all planned but I know that I am not capable of what they expect from us. I suspect some sort of neurodamage due to the b12 deficiency but the doctors say its unlikely. I ask, is it really that unlikely and what can I do ? Is it possible to find it out if there is damage ? I just want them to aknowledge their mistake if that is the case.

    • Have you been tested for heavy metal toxicity? I urge you to find a practitioner whose niche/speciality is heavy metals and chelation. You would be surprised how many of your symptoms are because of heavy metals. Heavy metals also displace minerals in the body and can contribute to health issues that way as well.

    • I am a 52 year old women with Pernicious anemia and have been taking B-12 shots since I was 40 years old I got admitted to the hospital This is when I found out I had no B-12 at all I have been taking the shot every 3 weeks since. I have trouble saying things sometimes like for instance Go get the pan off the table when I mean stove I turn my my words around an I realize I have said what I say after I do it but sometimes it just comes out wrong I to find it hard sometimes to talk to people because you just don’t know when im going to twist my words It doesn’t happen a lot but enough to notice I find it happens more when my B- 12 is low I get sleepy a lot even with the shot and get mood swings Now about your education Go part time and take extra time to study lots of schools have tutors

      • Teresa, you are the first person I have come across that does the EXACT same thing as I do with my words!!! I am a 47 year old woman and have been dealing with this for more than 4 years now. I just had a metobolic panel done including B12. This is the first time my Dr. has ever checked my B12 levels. They came back at 133, which according to the chart shows very low. She recommended I take 1000mg of B12. Can you tell me whether taking the B12 shots have helped your word finding/ saying the wrong thing (as I call it)?

        • I did the same word mix-up routine. I had never ever had problems like that before. Sometimes I couldn’t come up with the right word so I would describe the missing word….and that can sound really weird! At my age I worried people would think my brain was declining. The methyl B12 shots have helped me and I think I can feel it when they wear off. Right now I get one shot a week. The word mix-ups are about 90% gone now. I hope this helps. One more thing. I see a Functional Medicine nurse practitioner and she is very knowledgeable about B12 and other supplements.

    • Vigdis, please do not make the truly fatal error of assuming that you have been damaged for life because if you do you may make it a self fulfilling prophecy. Learn as much as you can about optimising your methylation and consider going on a very healthy nutritional ketogenic diet. If you enter into a healthy state of ketosis I expect that you will discover that your brain is quite fine. The best way to do this will be to get some guidance from a doctor who fully understands the principals of a ketogenic diet. You can try do it alone but you then run the risk of assuming that you are permanently damaged if you do not get it right. (I hope you get your life back very soon!)

    • Hi Vigdis,

      The idea of checking for heavy metals is a good one. If you have fillings that contain mercury, that could be it.

      What kind of B12 is in the shot? Does it contain preservatives? People here have talked about the different kinds of B12, so read all the posts.

      Take Magnesium, D3 and B2.

      Have your thyroid checked. Thyroid can affect memory, and it is a problem with people with B12 deficiency.

      You’ll find that once you have B12 deficiency, your body is kind of like an old house — you fix the roof, and the plumbing goes, you fix the plumbing, and the plaster starts crumbling. So don’t be surprised if you have years of doctor visits ahead of you. You will eventually reach a point where you say to yourself, “You know, I still feel rotton, and yet I’m feeling pretty good.”

      Good luck, and let us know what happens.

      • I a going through everything that you stated, and although I am 63, I have had iron deficiency and low B 12 since I was young. I never took it as anything ore than, ( oh I just need to ear a few more vegetables) it is not serious,but I am dilibated this time, with not being able to stay awKe, or even and sturdy o y feet.. I have gained weight and I feel worse Thani have come during much more seriousilless’ ..please aside from the pills twice daily , is there anything else I can do to speed up the healing. Devastatingly tired out?

        • Hi Brenda,

          I don’t know if you will be reading this…

          but I was recently introduced to a new supplement unlike any other on the planet. It is called, ASEA. It is said to increase “redox signaling” in our bodies(a much needed function for every function in our bodies). It also is said to increase our glutathione by up to 500%. Glutathione is so very important. It is a major antioxidant and there are many studies that support it as a detoxifier and healer in our bodies.

          If you are interested in learning more, you can go to

          health2cells.teamasea.com

          Since I have been taking it(about 6 oz per day), my energy is much better.. and I mean MUCH better.

          I also have started taking Stem Worx.. available on Amazon.com This product, too, has had remarkable results and I have only started taking it a week or so ago. It stimulates our own stem cells. That too has increased my energy.

          Before taking these 2 supplements, my energy was quite low and I was taking numerous other supplements. I am pretty good at research and believe that the supplements I was taking prior to the 2 mentioned above, were pretty good..quality-wise.

          Anyway, we are all different, however, we all have redox signaling molecules in our bodies. Every cell function requires them. However, they lessen by 10% every 10 years after age 30.

          “A balanced Redox potential in the tissues increases the efficiency at which oxygen, fuels and wastes can be transferred in and out of the cells and tissues, making the natural aerobic processes more efficient. If aerobic capacities are increased, then the natural length of time that aerobic activity can be sustained under high energy demands is also increased.” (Special Report: Redox Signaling Molecules” Optimizing Your Cells To Stay Healthier, Younger, Longer”)

          There is a lot of science behind the importance of well-functioning Redox Molecules. All I know is I feel a lot better.

          I have a doctor friend who was tested using dark field microscopy before and after taking ASEA. This is a post I wrote on youtube about her experience with ASEA:
          ————————————————————-

          I have a friend who came over on May 6, 2016 to tell me his daughter’s (to whom I also know), along with her boyfriend’s, experience with Dark Field Microscopy and ASEA.

          She is a doctor of Chinese Medicine and Acupuncture. He told me that she was introduced to ASEA by a health professional contact of hers. At first, she had her doubts about the product.. and wanted to be certain that it would work for not only her patients, but also for herself.. due to Lyme Disease.

          So, she called a friend who is an MD who also does Dark Field Microscopy and made an appointment. She and her boyfriend intentionally did not try any ASEA beforehand. When she arrived to her MD friend’s she and her boyfriend’s saliva and blood were both tested. The results for the boyfriend showed numerous parasites.. including liver flukes. As it was told to me by her father.. “he was loaded”.

          For her, the test results showed up spirochetes and numerous co-infections (she has been very ill for the past 3 years). The test also showed she had no white blood cells.

          After they were tested, they each drank ASEA. Being that she is so ill, she only tried a quarter dose (1/2 ounce) of ASEA, whereas her boyfriend drank 2 ounces.

          They each were retested (20 minutes later). The results were astounding. Her boyfriend’s test showed him to be almost clear of the parasites and pathogens. For her, the results showed numerous white blood cells at work, whereas before taking ASEA it showed she had no white blood cells.

          All my best,

          PJ
          ————————————————————–
          All the above statements are not to be construed as a treatment nor cure for any disease condition or affliction.
          I am not a licensed medical health care provider.
          Always seek the advice of your physician or other qualified health care provider with any questions about your medical condition, especially before implementing any dietary changes or adding supplementation to your diet.
          Also, do not disregard professional medical advice or delay seeking advice or treatment based upon information gained above.
          All shared information are either from my own opinions, the opinions from others, from personal experience or experience by others and/or are based upon that which I have read from scientific studies, medical doctors, doctors of acupuncture, herbalists, nutritionists, homeopaths or other health care providers, and is provided to the best of my understanding, ability and recall.
          Any implementation or change in diet, exercise, supplementation, herbs, medications, medical care is done so at your sole risk and responsibility. These and any subsequent considerations in your health care should first be discussed with your medical doctor/provider.
          Consider all information gained here for educational purposes only.
          My licenses/degrees include:
          Biofeedback
          B.A. Fine Arts, English
          Masters in Education

          • Also, so what does this have to do with Vitamin B12?

            Before learning about ASEA & Stem Worx, I was studying Biomagnetismo(I highly recommend this healing modality). What I learned, from Dr. Goiz who developed this healing protocol, is that just about any disease you can think of is or can be caused by a pathogen(viruses, bacteria, fungus, parasites). I also learned that these pathogens can rob us of many vital nutrients, including B12… not to mention iron, manganese, magnesium, etc.

            To rid the pathogens is to rid many of our deficiencies as well.

            ———————————–

            All the above statements are not to be construed as a treatment nor cure for any disease condition or affliction.
            I am not a licensed medical health care provider.
            Always seek the advice of your physician or other qualified health care provider with any questions about your medical condition, especially before implementing any dietary changes or adding supplementation to your diet.
            Also, do not disregard professional medical advice or delay seeking advice or treatment based upon information gained above.
            All shared information are either from my own opinions, the opinions from others, from personal experience or experience by others and/or are based upon that which I have read from scientific studies, medical doctors, doctors of acupuncture, herbalists, nutritionists, homeopaths or other health care providers, and is provided to the best of my understanding, ability and recall.
            Any implementation or change in diet, exercise, supplementation, herbs, medications, medical care is done so at your sole risk and responsibility. These and any subsequent considerations in your health care should first be discussed with your medical doctor/provider.
            Consider all information gained here for educational purposes only.

    • I am experiencing the same problem as V. I was already iron deficient but started experience b12 deficiency symptons at 20 ( 150) and was told its just bit on lower side.I couldn’t remember words, my short term memory was extremely bad and had balance problems. I used to have an extremely good memory and had a sharp brain. Now at age 26, have realized the severity. I got used to all the symptoms(tingling, forgetfulness) and couldn’t figure out what was wrong as my doctor said everything was fine.I can say that I feel very dumb and its taking toll on my life. I have been feeling emotionally numb for years and have no motivation to do anything( no hobbies and no desire to date). I just want to be how I used to be but I am afraid damage is permanent 🙁

      • Hi Menak

        I was also recently found with B12 deficiency (126). The constant fatigue, the memory loss, losing the words I want to speak out has also made me feel dumb and very emotional. I thought I was going crazy. I have since had to quit work as my performance and ability to deliver were affected. Even typing out this email is more challenging than before. Despite the injections my levels seem to be dropping to quickly once the injections stop. I dont know what else I can do to restore my life to normal. Your sharing does help though. You are not alone.

        • I could cry as all these symptoms are mine why are we ignored and if the doctor felt like we do sure would do something

        • Hi, what has worked for me for the last few months while trying to find a Dr./specialist who truly understands B12 deficiency is very high levels of sublingual METHYLcobalamin (5,000 mcg) tablets. I used to tske 60 a day, 5 under my tongue at a time every hour for 12 hours every day for a couple of months. I am now taking half that. I know it sounds excessive, but it has worked. I had to take matters into my own hands since doctors have not been helpful for me so far. Remember the shots are usually 1 ml. There are a million micrograms in a milileter. I checked in on a conversion chart in order to figure out how many to take. Expensive, obviously, but until a knowledgeable Dr. prescribes the shot, well desperate times call for desparate measures..I am back to myself again, and I had just about every symptom B12 deficiency comes with.

          • Kymm,

            Yikes! That is a lot! I know it’s sake and all, but don’t forget, your liver and kidneys have to deal with it, and they might not be too happy. Also, everything is really like a tangled bunch of strings in your body — you pull too much on one, ten more are pulled — so that amount might throw everything else out of whack.

            You don’t have to worry about converting all that tablet amount into shot amount. Remember, the shots go directly into your blood stream.

            • Oh, hi, Thanks for the reply. Yeah, the problem is getting a doctor to prescribe the shots, believe me I would prefer that! weight loss clinics do and I tried that, but I do not respond well to cyanocobalamin, which is what they use. My doctor okayed me taking 30 sublinguals a day, I asked her about shots, she said for now keep taking them and after more tests we’ll talk about it again…

    • Hello,
      Please research B1 and B2 deficiency, as these can be correlated to B12 deficiency. Also, nerves can take a long time to regenerate, so don’t give up and keep researching. (Phoenix Rising is a good site.)

  4. Hi There,
    Is there anyone who can help me out?
    I have a low b12level of 102 pmol/l. Normal range is between 130 and 700 pmol/l. I have been having symptoms for years (just never knew about b12, neither did my gp). So my levels must’ve been low during my pregnancy as well. My baby who is now 13 months old had a score of 240 on vit b12. I haven’t seen any symptoms yet which is a relief. Thankfully I only breastfed for a short period of time. But still I wonder what to do now. My gp doens’t know much about b12 she said and thinks this is a good score, because it lies in the normal range…So what would be best? I have read that it is good to supplement children but I don’t know what would be the best dose, because I read different things on that. Also, I read that even though you can’t have too much b12, it cán lead to an imbalance when it comes to other vitamins. I have read that potassium levels can drop once you take on high doses of vit b12. I want to be a good parent and give my child whatever is necessary, however I am afraid of consequences like these in the longterm. I also can’t find anyone who treats children. I hope you can help me! Thank you very much in advance.

    • Hi Stefanie,

      Sally Pacholok has a new book out called “What’s Wrong with My Child?: From Neurological and Developmental Disabilities to Autism…How to Protect Your Child from B12 Deficiency” which you should purchase, it’s available from Amazon. Disclaimer: I haven’t read it, but I do own “Could It Be B12? An Epidemic of Misdiagnosis” and it is a real eye opener. This is a serious problem that the medical community is misinformed and not doing enough about.

      Don’t believe the range your doctor uses. I don’t know why it is so low but there are many who get neurological damage within the so-called “normal” range. For adults, below 500 is considered too low, normal is 900 or higher. I believe children should have higher levels because they haven’t yet built up their stores. The liver stores 4 – 5 years worth of B12.

      Spend some time perusing the rest of the comments below. I’ve posted quite a few, search for my name (there are a few at the end that are from a different person with the same first name).

    • Diagnosing and Treating Vitamin B12 Deficiency
      YouTube video featuring Sally Pachlok is a must-watch for you and your baby. Given what you say about your baby it is essential to watch the whole thing right to the end. I echo Tracey’s advice wholeheartedly – good luck and God Bless.

  5. Hi,
    From past few years (around 5 to 6 years) I stopped eating Non vegetarian (except egg – taking one or two eggs per week). From that time on wards I gradually lost weight. I was around 65Kgs and now I became 50Kgs. I have no fatigue and any other problems. Daily I am doing Yoga, meditation etc. Yesterday I undergone blood test for B12 levels and came to know that I have only 133 reading. Doctor suggested to take me B12 supplementation which will make you observe the food what you take daily. Please let me know do I really lost the weight because of B12 deficiency. Do I have chance to regain at least 3 to 5 Kgs weight after taking B12 supplements. Waiting for reply.

    • Hi Ganesh,

      First, are you male or female? Also, what is your age and height? Did you Want to gain a little weight back, or are you afraid of gaining some weight back?

    • Hi Ganesh,

      First, are you male or female? Also, what is your age and height? Did you Want to gain a little weight back, or are you afraid of gaining some weight back?

      If you are B12 deficient, you can gain weight, like 1 dress size worth, here and there with no apparent reason. When you start taking B12, this stops happening, and losing weight becomes a little easier. I hope this answers your question.

      Since you are a vegetarian, you should take B12 methylcobalamin 1000mcg tablet under your tongue every day. You should also take a multivitamin, B-complex vitamin, B2, D3, magnesium, and eat a banana a day.

      • So many people don’t realize that there are different types of vitamin B-12, Methylcobalamin Vitamin B-12 1000 mcg being the best type. If you take B-12 orally then check the label’s ingredients to make sure you’re getting the best kind.

        • I should have also mentioned that not all B12s are for vegetarians. Find out which ones aren’t made from meat. There aren’t that many.

  6. Hi,

    I was recently diagnosed with b12 deficiency, my levels were just 71 (UK). I have lots of symptoms, the main ones being pain, burning skin, extreme fatigue, dizziness, breathlessness and confusion. I’ve had the initial six loading doses, and now have to wait three months for the next one, which is ridiculous. I’ve seen no improvement after the loading doses and asked to either continue them or be referred to a specialist, doctor declined both. I’m the last month I’ve caught both mumps and tonsilitis, which I feel must be connected as normally don’t get more than a bit of a cold. I’ve been reading everything I can, this seems to be a hidden disease which gps don’t know enough about.

    • If you are in the UK, the main forms of B12 for injection are hydroxyB12 or cyano-B12. I don’t know why because the EP has got methyl and adenosyl passed as food additives. If you are B2 deficient or have hypothyroidism (very common in women) you can have troubles converting the “Pro-vitamin” forms of B12 to the active forms. Your blood levels will go up, BUT these basically only measure what you have been injected/supplemented with, and don’t measure the active forms. The problem then is that the docs don’t know this and when they check your B12 levels they will say that they are find and therefore your problem can’t be B12. This message has been around for decades, yet the problem persists. There are other problems as well. Do you know which form you were injected with?

    • Hi Tess,

      I was watching “Living With the Fog” on YouTube, which is about trying to get shots for people in the U.K.that need it as OFTEN as they need it. To tell you the truth, if you usually don’t get sick that often, then the mumps and tonsilitis are probably just bad luck, or if they were within a month apart, one probably helped the other get a foothold.

      Ask your doctor if taking sublinguals or using the oils will interfere with being allowed to get more shots. If not, then I would definitely supplement.

  7. Hi, i have just had my blood tested by a locum doctor who has said i have symptoms of vit b12 deficiency. My results have come back as 170 but i have been told by my usual doctor that the level is normal? can anyone please tell me if 170 is classed as normal i am at a loss as to what to do. I have a follow up appointment to look at my symptoms with my normal gp as he wants to do more tests. I have been trying to get to the bottom of this for at least two years now and my symptoms are getting worse. I am suffering daily with not fatique but more like exhaustion, i have pins and needles in my hands and feet and when i do get myself up and try to get motivated my legs feel un co ordinated and like jelly if that makes sence. I often feel nauseous and poor appetite I fall asleep most of the time when sat down, cant focus on my work especially training days in a classroom. Iv started feeling a bit faint this week with dizziness and sometimes become breathless ( like im just not getting enough oxygen ) so have been signed off for a week. My vit d levels are 38 and been told they are slightly low so have brought some supplements. I have been taking omeprozole for approx 4 yrs. Would that have anything to do with it? Any advice people please.

    • kath,

      Yes long term use of omeprazole (Prilosec) very likely has a lot to do with your symptoms. It reduces stomach acid, which is needed along with the intrinsic factor created by your stomach to absorb B12 from your food. Since your liver stores 4 – 5 years’ worth, using omeprazole for the short term should be okay. But it’s EXTREMELY dangerous to take it for years as you won’t be replenishing your B12. There ought to be a strong warning on the box about the potential for B12 deficiency and permanent nerve damage if used long term.

      In the book “Could It Be B12? An Epidemic of Misdiagnosis” Sally Pacholok says 200 – 450 pg/mL is the gray area where neurological damage can occur and you are below that. I’m assuming the units for your B12 is pg/mL (or ng/L in the UK which is equivalent)*. The range used by most doctors is far too low. Usually 200 is the low cutoff, your B12 is way under that. Why is your regular doctor using such a very low cutoff that 170 is considered normal?

      * Some countries use nmol/L and the corresponding range is 147 – 332 nmol/L. Multiply your B12 number by 1.355 to convert to pg/mL.

      You have likely depleted your stores and need to get loading doses of B12 ASAP. Supplements probably won’t do it, you need shots. But – first you should get your MMA and homocysteine tested, which can confirm you are deficient. You should also be tested for pernicious anemia (intrinsic factor antibodies test and parietal cell antibodies test). These tests must all be done BEFORE you supplement B12 as it will skew the results.

      You really are going to need to get off the omeprazole which can be difficult. Do an internet search, others have suggestions. Most people who take it really had the opposite problem, too little stomach acid, which has similar symptoms. The drug companies have gotten it all wrong and have sold the public on a very dangerous cure for stomach problems. And what’s worse is that it is now available over the counter so there isn’t a doctor monitoring the use of this drug (not that they all even realize what can happen, nor are they aware of the symptoms of B12 deficiency).

      I’ve made other detailed comments in this thread, search for my name.

      • I have been on Omeprazole for years,and have Osteoporosis,discovered Omeprozole affects youe bones and now that ir affects your B12 levels,I now take Ranetidine which isnt as effective for my gastritis,asked Dr to check my B12 and they constantly say my B12 levels are fine because the levels in this country are too wide compared to other countries,but I have symptoms,what can I do

    • Hi There,
      Your levels are way, way low. Many studies have shown that even 400 is sub-clinically low, with brain shrinkage of 2% per annum occurring in one study. Homocysteine and MMA have been shown to increase at levels below 300, so your levels are way below that. Be careful with what you supplement with as some people have found that if they get cynanoB12, it can result in increased levels of homocysteine, presumably because this inactive form of the vitamin competes with the active forms of B12 and blocks their “good” activity.

  8. Hi there, just wanted to correct you on something.

    B12 is NOT only found in animal products. B12 is a bacteria, found in the dirt. The B12 in animal products comes from the dirt those animals ate. In fact, livestock no longer feed on grass and dirt on factory farms because pesticides KILL B12 producing bacteria. Plus, animal products high in B12 also heighten risk of cancer and heart disease… (try vegan!!!)

    B12 is also killed as soon as it is cooked, so whatever limited traces of B12 there might of been in the animals flesh is eliminated as soon as its cooked. Oh, and did you know that 90% of the worlds B12 supplements are fed to livestock?! That says A LOT.

    Grab a carrot and don’t wash it and there is bound to be an abundance of B12 on it. This generation is too clean, no wonder our immune systems are crap.
    For all vegans/vegetarians, B12 can be found in any fortified plant based milk and nutritional yeast.

    ANYONE can have a B12 deficiency, regardless of diet.

    • A minor point, but… B12 is NOT a bacteria, it is MADE by bacteria from cobalt and other nutrients.
      Pesticides and industrial fertilizers (rather than compost or fermented compost) are a modern day scourge, deadly to all living things, I agree with you.
      There is no hard evidence that I have seen or can find that claims that too much B12 can lead to heart disease. B12 is water soluble, and in the body too much will wash out and is excreted in urine. On the other hand, too little B12 can cause heart disease, among other issues, some of which mimic MS (Multiple Sclerosis).
      As far as cancer is concerned, information is conflicting. There is only one study that claims that high levels of both folate and B12 may increase the risk of prostate cancer. The authors also note that this is only one study. That the authors found what they think they found I have no doubt, but I would like to know what form of supplements may have been used, if any, and I would like to know all the details of the study. Without the details, we cannot really know much of anything, sadly. There are several studies that claim the opposite, that more B12 prevents or suppresses cancer.
      http://www.ncbi.nlm.nih.gov/pubmed/15499634?dopt=Abstract
      http://www.westonaprice.org/health-topics/abcs-of-nutrition/vitamin-b12-vital-nutrient-for-good-health/

      I agree about scrubbing carrots rather than peeling them, but this small amount of soil bacteria assumes several things that have not been shown to be true, and that have in fact been shown to not be true.
      The assumptions are:
      1 – Healthy soil fertilized by compost
      2 – And filled with healthy bacteria.
      3 – The presence of just the right bacteria that manufacture cobalamin(s) in said soil.
      4 – The correct other nutrients in the gut to enable these soil bacteria to manufacture cobalamin(s).
      5 – A large enough population of B12 producing soil bacteria on the food that is eaten to produce enough B12 in the gut to prevent deficiency.
      6 – And last but not least, the ability of the gut to absorb this B12 from the gut bacteria.
      These have been shown to be highly unlikely, and vegans often are deficient.
      “Preliminary results show that, unlike other B-vitamins, humans don’t get enough B12 just from bacteria in their gut, and need more of it through exogenous food sources.”
      https://www.quora.com/Exactly-what-kind-of-bacteria-produces-Vitamin-B12-and-under-what-kind-of-natural-habitat-and-climatic-conditions-does-it-thrive-in
      http://www.veganhealth.org/b12/int
      http://plenteousveg.com/b12-intestinal-bacteria/

      B12 is not “killed” as soon as it is cooked, though its activity is reduced. Vitamin B12 is heat stable. The cobalamin molecule breaks down at 250˚ C. B12 is therefore destroyed on the surface of grilled meat, but not in the interior. Gentle braising or cooking steaks to rare or medium-rare best preserves B12 in meat.
      Though B12 (cobalamin) is heat stable, it is not stable in either acid or alkali environments. It slowly loses its activity when exposed to light, oxygen, and acid or alkali environments. Please keep in mind that the stomach is an acidic environment, which may be why sublingual drops or tablets seem to work so much better than pills that are swallowed. The B12 bound in food is another story altogether, the digestion of which is much more complicated than that of supplements.
      Vitamin B12 is present in liver, organ meat, muscle meat, shellfish, eggs, cheese, fish, and can be manufactured in the body only by gut bacteria. (Again, these gut bacteria are not enough all by themselves to prevent deficiency in humans. B12 is manufactured below the point of absorption, the ileum.)
      Vitamin B12 can not be manufactured by any plants, it is only found in animal products. The possibility that some B12 producing soil bacteria may adhere to fresh root vegetables still does not make the case for plants producing B12 – they do not, nor do they contain any B12.
      Vitamin B12 is produced commercially from bacterial fermentation.
      http://orthomolecular.org/nutrients/b12.html

      Your idea of drinking or eating fortified foods seems to be a sound one concerning B12, but it is not possible if one chooses to eat only whole foods. Vegans can make their own nut milks, I have done, but where is the B12? Missing, though I wonder if a crushed tablet or a drop of liquid B12 might just work. The dose would have to be carefully calculated, but it could be done. However, the milk would be exposed to light and air for a time, so I could not say what B12 activity would remain.
      http://www.beyondveg.com/walsh-s/vitamin-b12/vegans-1.shtml

      Here is good news: “Several probiotic bacterial species such as Lactic-acid bacetria (LAB)- Lactobacillus spp.(species), Propionibacterium spp. or Bifidobacterium spp. can produce B12 and other B-vitamins. Two species that possess all the genes for B12 synthesis are Propionibacterium freudenreichii (A genetically-engineered strain of this bacteria is used to make B12 commercially) and Lactobacillus reuteri (naturally found in most human intestine).”
      https://www.quora.com/Exactly-what-kind-of-bacteria-produces-Vitamin-B12-and-under-what-kind-of-natural-habitat-and-climatic-conditions-does-it-thrive-in
      So perhaps we should all take our probiotics and eat homemade yogurt regularly.

      Here’s a good article that complements Chris’s on how it all works:
      http://www.westonaprice.org/health-topics/abcs-of-nutrition/vitamin-b12-vital-nutrient-for-good-health/

      • Hey Molly, I think you’ve cleared up a mystery for me. Last year I had blood tests done by a GP who informed me that my folate and B12 were too high and to be sure not to supplement any further. This is the thing, he assumed I was supplementing because I consume mainly vegan foods. I was not taking any such supplements though. I was however taking lots of probiotics and experimenting with different ferments. So perhaps that is why my levels were high? Margaret

        • Hi Margaret,
          I just stumbled on this website and your post caught my eye. I, too, had high serum levels of B12 without supplements. I am not a vegetarian. I had also been on PPIs for many years. They were looking at B12 because I had a long history of fatigue and ‘brain fog’. My levels came back more than 25% above the upper limit. Dr said ‘we only worry if it is low’. It really bothered me, and awhile later I saw a nutritionist who recommended intracellular micronutrient testing. B12 levels were deficient intracellularly. I was found to be homozygous for the MTHFR a1298c polymorphism, which presumably affected my ability to get B12 out of my bloodstream and into my cells. I Have been supplementing daily with 1000 mcg of sublingual methylcobalamin and have seen noticeable improvement. So, even ‘high’ levels of B12 in your blood may be misleading. I have lots of things wrong with me – all stemming from a 20 history of RA and consequent treatment with steroids and other meds, but have found many approaches that have helped improve well-being and this was definitely one of them.

          • HI Maureen- my husband has been dealing with RA and gastrointestinal issues for years. we just had his b12 and folate tested and they were above normal. (i foolishly made him take a b complex vitamin the morning of his blood work) so that may have something to do with it as well. He has been on PPI’s for 2 years due to severe acid reflux. he also has low iron. we are currently on a waiting list for a functional medicine doctor but in the mean time i’m looking for insight because his RA, family and gastro doc offer us nothing in terms of a solution. only more medications. thank you! J

            • Hi Jen!
              Embarrassed because I seldom check the email I used for this post and never saw your comment until now. I am glad the info I shared about my experience was helpful to you and your husband! I am curious to know whether you were able to see the integrative medicine specialist and/or if your husband has found anything that helps.

              A few other commonalities we might share: I was originally on PPI because of presumed risk due to prednisone. However, I remained on them for years after I stopped prednisone b/c then I had reflux. I also used to get a lot (4/yr) of sinus infections & the otolaryngologist told me that many with chronic sinus problems are now believed to have GERD. in any event, I no longer have reflux and I believe that is because I eliminated gluten from my diet. I do not have celiac disease, but I notice that my body does not seem to like gluten:). I have had a small but noticeable improvement in joint pain also. Haven’t had a sinus infection in at least 4 years (knock on wood – don’t want to jinx myself.)

              Like other posters I have also been diagnosed with vit D deficiency and have had to supplement with as much as 100,000 units/week at times. DRAMATIC improvement from vitamin D3.

              Lastly, the micronutrient testing revealed low or borderline low results for about 15 vitamins and minerals. I have taken supplements for each seperately and have an overall improvement in well-being. I took each for a couple of weeks before introducing a new one so that I could identify any changes and tie to a specific supplement. I did not notice anything special except for the B12, D3 and also magnesium. Great effect from magnesium malate. Improved joint pain, greatly improved sleep, helped lower BP, felt calmer. I think the cumulative effect of supplements targeted to areas I was deficient in has been responsible for me being so much better. Hope this helps, too, and let me know how you are doing if you pick up the message.

  9. Thanks to whomever suggest B2. I can really feel it working. Sorry, but people should know, it helps with my pooping.

  10. Hi,

    10 years ago I fell very ill and was in hospital for a week. The consultant said they did not know what was wrong but that my white blood cell count was ‘way too high’. I was exhausted, the glands in my neck were so enlarged that I had lumps the size of oranges leaving me looking deformed (they carried out an ultrasound to look for non-hodgkins / hodgkins in the lumps but this was clear), my tonsils were swollen too. I was ill for 2 years following this suffering with weight loss, hundreds of mouth ulcers, UTI’s etc. I had further blood tests but the results went missing for 6 months so I assumed all clear when I didn’t hear anything then my doctor called saying it showed that I was vitamin B12 deficient but as it was 6 months ago and the ulcers had gone he would ‘file his papers’.

    I’m 33 & have a healthy diet but it’s been a running joke that I catch every bug going around.

    Almost 2 years ago I caught Molluscum Contagiosum and have been unable to fight it off leaving me feeling very down.

    My doctor finally carried out a blood test a week ago and I got a call 1 day later saying I need to see the doctor asap as I have a vitamin B12 deficiency.

    I am seeing the doctor on Thursday but want to be more informed this time. Is it possible that I have been deficient all of this time? Could this explain why I seem to catch everything and not be able to fight it off like a normal healthy adult? I do have other symptoms (out of breath, palpitations & tiredness).

    Can this affect the immune system?

    Any advice would be appreciated seen as my previous doctor just ‘filed his papers’!!

    Thank you

    • Hi Lisa,
      My sons had Molloscum, and it took a very long time to go away. What really helped was Grandpa’s Pine Tar Soap in the bodywash form, and dabbing then with alcohol pads. Once they started washing and dabbing, the molloscum cleared up in two to four weeks.

      When you say healthy diet, what do you mean?

      Had you had some illness before you started getting sick all the time? About 20 years ago, this woman on the bus kept coughing right in my face. A few days later, I became ill for three weeks. My old family doctor, ” I don’t know what you got, but you got it good!” ( I miss my old doctor). After that, someone would have the sniffles, and I would get the flu.
      After I started taking my vitamins that I have listed elsewhere here, I did start having more resistance. I don’t exercise because of my asthma, but now that it’s cooler, I’ll start going for walks, and I am sure that that will help my resistance even more.

      So, my advice to you, is to take my list of vitamins, plus B2, and do calm exercise like walking, even in cold weather, and you should start seeing an improvement before you know it.

    • Get checked for the genetic mutation MTHFR. If you have any of the mutation SNPs, you will likely have issues with folate and Vitamin B12, maybe other methylation pathways. Can get it done yourself through 23 and Me for $99.

  11. There are four different types of B12 that I know of (the one you didn’t mention is adenosylcobalamin), and each has different functions & tends to live in a different part of the body.

    When you don’t respond to one type of B12 (this is a common problem with cyano & hydroxy) it’s advisable to trial what the others will do for you. Most responses seem to come from methyl.

    MethyB12 (methylcobalamin) is perhaps the most commonly deficient one – & still isn’t well-known.

    The Japanese may be resistant to neurological disease not because they eat more B12, but because the supplemented form there is methyl, unlike in the West.

    Finally, methyl & adenosyl B12 are crucial to the methylation system, but often can’t work well without cofactors such as each other, & methylfolate & carnitine (which crank up ATP). There is a protocol – named the Freddd Protocol – which addresses the whole picture.

    This rather radical paper by British oncologist Carmen Wheatley seems to have changed the landscape re adenosyl B12:

    http://www.hy-ls.org/index.php/hyls/article/download/92/92-325-1-PB.pdf

  12. I have been vegan for 1 year and just had my blood tests done just to make sure i was getting enough nutrition as a vegan.
    my b12 levels came back as (<125).
    I have lots of energy and had no symptoms that everyone else in the comment section had.
    I am now taking a spray under the tongue once per day.

    It's very strange that if you're levels are below 500 in japan then you are classed as deficient, but in the uk it's 180.

    • I believe something happened in Japan during the 1960s that caused them to raise their minimum level to 500. From what limited information I could find on the internet, there was an antibiotic that caused a B12 deficiency. Most likely a large number of people were severely affected, resulting in raising the low cutoff value. I have read that there are very few instances of Alzheimer’s in Japan, though their diet is quite different from the US diet so there may be other factors involved, and not just B12 levels.

      We do know there are many instances of people getting neurological damage due to the current low cutoff (myself included). It is a major undertaking to change this across the US in all medical organizations, change happens slowly in medicine. Some labs are now including notices in reports where measured B12 is in the gray area of 200 – 450 pg/mL.

      What units was your B12 measured in? If pg/mL (US) or the equivalent ng/L (UK), then your B12 was very low. If it was pmol/L then not quite as bad (cutoff of 200 pg/mL = 147 pmol/L). Was your MMA tested? An elevated MMA value can back up a B12 deficiency. Were you tested for pernicious anemia? If not, to get any of these tests you may have to stop taking B12 for a period of time which you may not want to do. Don’t bother getting your B12 tested again while supplementing as it will be high. Some doctors try to use this as evidence of being “cured” but if you have pernicious anemia your B12 levels will eventually fall again.

      Serum B12 is the total of active B12 available to cells plus inactive B12. Perhaps you have a larger percentage of active B12, so even the overall number is low your cells are still getting the active B12 they need. In the UK there is a test to measure active B12 but it is not available in the US from what I can tell.

      • Tracy – what tests should I be having to diagnose non-absorption of B12. My serum B12 was tested at 175 and I was given 7 loading doses over a period of just over two weeks just before Christmas 2015. I was then offered injections every three months. I believe I have peripheral neuropathy in my feet which seemed to improve after the first week, and so, following advice gained in my research on the internet to follow the clinical symptoms to prevent further nerve damage, I asked for injections every other day ‘until my symptoms improved (not stopped improving – as my doctor quoted me as requesting when she discontinued these after only three injections). I was given three more ‘every-other-day’ injections which were stopped after my doctor had consulted colleages. After insisting on the ‘proper treatment’ whilst waiting for a (now promised) referral to a neurologist I was given permission for a further course of injections but only managed to get one before they were again discontinued after my doctor had consulted a haematologist at the local hospital. Last week I spoke to another doctor in the practice and, after further lengthy discussion along the same lines, I have been offered another three injections as ‘an experiment’ – presumably to see if they ‘work’ again …. I did tell her that my doctor had told me that she was ‘at the limit of her expertise’, this after she had pointed out that my B12 now tested normal at 2,000 (UK) but had then agreed (eventually) with me that this was only to be expected after I had received so many B12 injections! My intrinsic factor was tested as was folate and iron, kidney and liver function plus a full blood count but only after the loading doses and at my request (I had been wildly scrabbling around for any information at that point as I was desperate but now I know that these should have been done prior to any treatment). All came back marked ‘no action required’. I have rheumatoid arthritis (10mg steroids daily plus Leflumonide), osteoarthritis, diabetes (Methotrexate), under-active thyroid, asthma and COPD, high blood pressure (is it any wonder???), and have been taking Lansoprazole for a number of years. I am presently being investigated for breathing problems. I have been tested for an impaired immune system with an initial reading of 2.8 and after testing of 4.6 which apparently is acceptable as being on the way up (to 6). Any advice warmly welcomed

  13. Chris,

    I just ordered B12 supplements because I just found out I am deficient. What I don’t understand is for how long I have to supplement. Is that forever or until my B12 is higher? What is the rule of thumb for stopping taking vitamins? Thank you

    • Mary,

      You need to find out the cause of your B12 deficiency. You should be tested for pernicious anemia before taking any B12. I’d be cautious about getting this tested after starting on B12 as it can interfere with the test results.

      Do you have any of these other B12 deficiency risks: vegetarian/vegan, used PPIs or H2 blockers, take Metformin, had nitrous oxide anesthesia for surgery or dental work, gastric surgery?

      If you have pernicious anemia you will need treatment for life.

    • How many micrograms are in the tablets and are they dissolved under your tongue?

      Rule of thumb is, you are on them for life. If you reach your mark and stop taking them, two things can happen, your levels will stay the same, as far as you know between doctor visits, and of course, it depends on what your doctor considers the right level, or, your levels can go down. Believe me, it’s far better to take b12 for life than to chance having the things happen to you that can happen to you when it’s too low. The pills are extremely safe. Don’ t chance it.

  14. hi
    I am having severe vitamin b12 deficiency.(167)
    my doctor prescribed me cyanocobalamin (vitcofol).
    but i would like to take methylcobalamin instead.
    Is it ok.
    also can you tell me how to self inject methylcobalamin by syringe.
    thanks in advance.

    • I did a little researcg on this before and this is what I understand: If you have a high concentration of mercury in your system, methylcobalamin isn’t advisable. This will react with mercury and produce methyl mercury, which is worse as it is more reactive biologically. Perhaps someone else can shed more light on this.

      • There are loads of sources of the methyl group, almost all of them in higher concentrations than you’ll get from MeCobalamin. 1000ug of MeCB will produce just 11ug of methyl radicals. That’s about one thousandth the amount of methyl in a glss of red wine.

    • You could try Hydroxocobalamin. It doesn’t add methyl groups but is, as i understand, easily converted into the active b12s methylcobalamin and adenosylcobalamin when and where it is needed. It is actually said to “eat up” exess methyl groups. I tried methylcobalamin and I had awful symptoms, OCD and anxiety went through the roof.

      • Hi Brandon,
        I have had issues of fast heart rate, insomnia, overwhelming energy since my first b12 shot, it’s been month and a half, did ur anxiety side effects go away ? How long? I had similar issues from supplement dunno why I let dr give me the shot. Thanks Melissa

  15. Hi, Chris – thanks for writing such an important article. I only wish I’d seen it in 2011 when you first published it! For the last 7 years or so, I struggled with many symptoms of an undiagnosed B12 deficiency. In fact, I may have been low in B12 most of my life.

    It reached a crisis level a month ago, and by sheer luck I was able to diagnose it, then confirm via an MMA test at my doctor showing a reading of 340. Details of my story are here:

    http://ghn.thegraychannel.com/uncategorized/my-sobering-wake-up-call-b12-deficiency/

    Neurological symptoms for me, unfortunately, are severe, and while I’ve recovered some, after 3 weeks of supplementation with oral methylcobalamin, 1 mg per day, heavy fatigue is still with me, and my doctor has very little advice for how to proceed.

    I would love it if you could write a follow-up article that focuses on the best approaches to recovery. It’s not clear if taking >1 mg methylcobalamin is necessary to heal long term neurological damage, MTHFR gene mutations add more layers of confusion for the newly initiated, and since this truly is an epidemic, that our doctors usually know very little about, we look to people like yourself to continue speaking out and taking the lead.

    Thanks again.

    TC

    • Hi Terry,

      Three weeks isn’t that long at all, so stick with it. If you are taking sublinguals, you have to seriously increase your dose. I take 10,000mcg, or 10mg a day. I also take Vitamin D, just added B2, iron, zinc, magnesium, a multi, and B complex.

      I knew there was something wrong in my 30s when everything seemed to be getting just to much and was always tired. Symptoms kept piling. The one day I went to the doctor for a cough, and he kind of knee-jerk diagnosed me with acid reflux and prescribed the heavy duty acid blockers an antacids. I didn’t think that was it, so I went online and looked up something like problems with taking antacids for a long time. One of the artcles that popped up was “Antacids Ruined My Life”, where tge author described her B12 deficiency, and there were ALL The symptoms I was experiencing right down to the sore tongue. Symptoms that I did tell my doctor about. She just dismissed them, seemed miffed that I had seen other doctors, and upped my prescription of Amlodipine for my admittedly VERY high blood pressure.

      Anyway, it took about a month for some of my symptoms to go away, but after three years, and adding the other vitamins, I still get very tired. I feel a lot better, but I still go from general to heavy duty fatigue.

      I think it would help if I exercised, but I now have asthma, brought on, I am pretty sure, by the Amlodipine I took for my HBP.

      I meant to explain more than complain. My advice, seriously up the B12 dosage and add the vitamins I wrote down.

      Good Luck

  16. I really appreciate this article, Chris. I’ve been struggling with the symptoms of B12 deficiency since the late 1990s, didn’t realize it – and was never tested by any doctor because they assumed a meat-eater wouldn’t require B12 supplementation.

    1 month ago my symptoms reached a crisis point, and I was luckily able to make my own diagnosis, then follow up tests with my doctor confirmed it: an MMA test of 340.

    Unfortunately my neurological problems became advanced enough in recent months that I may not fully recover. I’ve done 3 weeks of supplementation and while much has improved, heavy fatigue has not. More detail on my story can be found here:

    http://ghn.thegraychannel.com/uncategorized/my-sobering-wake-up-call-b12-deficiency/

    Diagnosis is only half the battle. I’d love it if you could do an update on your B12 article that focuses on approaches to recovery. The MTHFR gene mutation and other variables make deciphering and applying protocols really confusing, and since B12 deficiency really is an epidemic that most of our conventional doctors don’t include in their workups, we look to people like you, Chris, to lead the way.

    Thanks again!

    TC

  17. Hello chris
    I have been suffering from hair fall problem since7-8 years. 3 years ago i was diagnosed with iron deficiency. it was 0.7(too low). I started with medications and thought it is the end of the problem but last year (august 2014)along with hair fall a lot of problems such as fatigue,weight loss, improper digestion, farting,weakness engulfed me. It was b12 deficiency(130 pg/ml) i started getting b12 shots and december 2014 all my problems were solved. But from the past 2 months again weight loss, hair fall, weakness, digestive issues(i dont feel like eating anything), gas have started. in 2014 i also had endoscopy done it showed chronic gastritis. What should i do? please help

    • @Divya, Are you still on B12 shots? If you don’t address the reason why you became deficient in the first place, you will become deficient again without constant supplementation.

      The iron issue along with B12 may indicate some other problem such as low stomach acid (achlorhydria) or gut dysbiosis interfering with absorption of nutriets. Chris has a lot of info on this site about gut issues.

      • Yes I have the same symptoms again. Rather more this time. Gastro issues are there. I am not able to eat anything. If i eat anything i have gas, bloating and feeling like vomitting

        • Hi Divya,
          For the last one month, i started developing symptoms of little dizziness and unsteady gait. First i thought its related to Inner Ear and thats why i saw a ENT specialist, he told that it might be related to inner ear inflammation and asked me to wait and watch without prescribing any medicines.
          But the situation remained the same and fatigue also started groping me. I decided to see an experienced neurologist and did CT Scan as well, it came fine.
          The neurologist immediately asked me to get the thyroid and b12 levels checked. The thyroid came normal but my b12 level was 229 and according the neurologist, if the level is below 500, i should get started with b12 injections.
          I had my first injection yesterday evening and i am hoping my symptoms would go in the near future.
          The cause of b12 deficiency according to the doctor is the long term use of Proton Pump Inhibitors (nexpro,parit,acilog etc.) for my acute gastritis.
          Thought to share with you as you have very similar symptoms and please suggest anything that would help me get rid of these uneasy symptoms.

          • Hi Pankaj,

            My steadiness was off before the b12, and the b12 helped, but what really did the trick was also taking Magnesium and D3. Try adding these to your diet. Also, drink Bragg’s Unfiltered Apple Cider Vinegar, a teaspoon in a cup of warmish water with some raw honey in it.

            I would definitely go to see an Endocrinologist and have your Thyroid checked again.

            For several reasons, the main one being that I am lightheaded from trying to breathe because of asthma I have developed, I have started taking Meclizine, and it really helps. You can get a prescription for it, or buy Dramamine NON-DROWSY ( the only one with meclizine is the non-drowsy one). Despite what Dramamine says, it does make you very drowsy, so be careful. I haven’ t taken it every day, just one pill a day as needed. I have had an earache the last few days that goes down my neck and hurts my gums, jaw, and all the teeth on that side. Unable to eat too well, I became nauseous and dizzy. And you know how it is when you are nauseous because you haven’t eaten., the thought of eating makes it even worse. So, the other night, I took one before bed, and in the morning, I didn’t feel lightheaded, and I didn’t feel nauseous! I ran to eat whatever I could find — anything small and soft, that is.

            I hope some of these suggestions help.

            • Hi.. I had been finding myself V tired irritated and have been having mood swings. All the time I feel lightheaded and anxiety could take over me anytime. M drained off my energy. Since a few days I hv been having the same type of pain what u had lyk pain in gums jaw n ear.
              Hv my thyroid function tests done, reports r in normal range
              Pain is sharp, heavy,radiating and my teeth r xtremely sensitive on that side,no sinusitis no cavities
              I hv a long long history to go. There’s tingling in my fingers and toes tips, hv greying of hairs with hairfall, nails hv become brittle..oh god!! Never tried to jot down whatever I had been feeling
              There’s constant fatigue present..nauseous in morning, lack of coordination bit of.. And headaches too take over for no reason..
              Ny of u had such symptoms Pl tell n guide me through.. Suggestions r welcome

          • Hello Pankaj
            I have started taking apple cidar vinegar and that has given a lot of relief to my stomach. I have even started taking as much acid i can take in the form of lemon in ginger tea,pickles or tamarind. It has really helped. The only problem left is oily scalp, skin and hair fall. I am taking b12 shots after one month.lets see. I am waiting.

        • Hi Divya,

          Go to an endocrinologist. It could be your thyroid. I have to make an appointment myself. My pulmonologist did a test and it appears I have an overactive thyroid. I knew something was up because I lost 25 pounds in two months without trying. Before I started to lose the weight, though, I had a stomach virus for about a month. The symptoms are the same for virus and thyroid trouble, but I think, for me, it was the virus that caused the thyroid trouble, and not the thyroid trouble making me ill. Since they both have similar symptoms, and many people with low B12, particularly pernicious anemia, have some kind of thyroid trouble, I would definitely have it checked out.

          FYI. Vitamins can really upset your stomach, too — nausea, vomiting, gas, lightheadedness — if you take them at the wrong time of the day and on an empty stomach. Last month, I started taking ground clove capsules to settle my stomach. I have always felt queasy, and they stopped making the clove gum that used to help, so I tried the capsules. They gave me such gas that the odor kept waking me up! Now that’s some heavy duty gas! Just so you know, it could be something you are eating or taking.

          Also, try Bragg’s Apple Cider Vinegar, one teaspoon in a warmish cup of water with some raw honey. And stop taking those stomach pills if you still are taking them! Lower the dose week by week.

  18. Hi Chris
    I was having problem of hair loss since 8-9 years. I tried many things but nothing worked. Three years ago i was diagnosed with iron deficiency. My ferritin was 0.7(too low). Last year in august 2014 i was diagnosed with vitamin b12 deficiency(pg/ml), vitamin d was also less. I was on bed for almost 2 months with b12 shots. My digestive issues and hair fall got completely solved in december. I am again experiencing a lot off hair fall,weakness, weightloss, poor digestion, farting, burbs(i even dont feel like eating anything). I had endoscopy also done last year. It showed gastritis. i dont have wheat allergy. What should i do? please help