Are you a dedicated vegetarian or vegan? Perhaps you decided to follow a plant-based diet to improve your health but over time you’ve started to experience troubling symptoms such as brain fog, fatigue, poor memory, and even numbness or tingling in your hands and feet—issues you never had previously. If you can relate, then you may have a vitamin B12 deficiency.
Research indicates that vitamin B12 deficiency is far more prevalent than previously estimated, with at least 40 percent of Americans demonstrating suboptimal levels, and millions more going undiagnosed altogether. The consequences of B12 deficiency are serious and can cause irreversible damage if left untreated.
Read on to learn about the health implications of B12 deficiency and why it is significantly underdiagnosed, the best methods for testing your B12 status, and how to optimize your B12 intake with food and supplements.
What a B12 Deficiency Means for Your Health
Vitamin B12 works with folate to synthesize DNA and red blood cells and assists in the production of myelin, which protects your nerve cells (neurons) and regulates nerve impulse transmission. A deficiency of vitamin B12 can have significant health implications for multiple body systems.
Vitamin B12 deficiency is exceedingly common—especially if you’re following a vegan diet. Find out how to tell if you have a deficiency and learn how eating nutrient-dense foods can help you correct it. #nutrientdeficiency #vegetarian #vegan
The classic association of vitamin B12 deficiency with macrocytic anemia, a condition in which red blood cells are larger than normal due to impaired cell division, speaks to the importance of vitamin B12 for regulating DNA synthesis. However, anemia is but one symptom of B12 deficiency. There are many other B12 deficiency symptoms that occur long before anemia sets in, including:
- Dementia
- Cognitive decline
- Memory loss
- Brain fog
- Depression
- Cardiovascular problems
- Peripheral neuropathy (numbness, tingling, burning in the hands, legs and feet)
- Impaired immune function
- Infertility
- Developmental and learning disabilities
Unfortunately, many of these symptoms are often mistaken for other health conditions, including Alzheimer’s disease and multiple sclerosis. As a result, B12 deficiency is often missed by physicians in the clinical setting, with serious implications for patients’ long-term health.
If You Have an Undiagnosed Deficiency, You’re Not Alone
B12 deficiency is far more common than most healthcare practitioners and the general public realize. A study from Tufts University found 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 neurological symptoms can occur. Nine percent had an obvious B12 deficiency, and 16 percent exhibited “near deficiency.” (1) Surprisingly, the researchers also discovered that low B12 levels were just as common in young people as in the elderly.
Given the prevalence of B12 deficiency, why aren’t more clinicians and health organizations drawing attention to this serious problem? The answer lies in the fact that B12 deficiency is significantly underdiagnosed. Here’s why it’s frequently missed:
- B12 status is not routinely tested by most physicians.
- Serum B12, the conventional marker of B12 status, only drops in the later stages of B12 deficiency. Relying on serum B12 testing misses many, if not most, people who have an insufficient B12 intake.
- The low end of the laboratory reference range for serum B12 is too low. This is why most studies underestimate the true levels of deficiency.
- The standard serum test for B12 measures the total amount of B12 in the blood but does not rule out functional B12 deficiency. (A “functional” deficiency means that B12 levels are too low for optimum health, but symptoms like anemia may not yet be apparent or diagnosable.) (2) The determination of functional B12 deficiency requires other measures that are infrequently used by physicians.
New and Improved Testing Methods for B12
Fortunately, new, more sensitive tests for B12 deficiency are now available, including tests for methylmalonic acid (MMA) and holotranscobalamin II (holo-TC). Studies using these improved methods of B12 assessment reveal much higher levels of deficiency than studies using only serum B12 testing.
MMA
MMA is a compound in the body that helps with metabolism, via a vitamin B12-dependent enzyme; if MMA levels are high, it suggests that vitamin B12 is lacking. There are two ways to have MMA measured: in the blood serum and in the urine. (3) Some experts believe that urinary MMA is superior to serum MMA as a biomarker of B12 deficiency because MMA is more concentrated in urine than in the blood. However, elevations in urinary MMA can also be caused by kidney dysfunction. Serum MMA, on the other hand, can be elevated in the presence of small intestinal bacterial overgrowth.
If you decide to undergo MMA testing to determine your B12 level, your current health status matters. I recommend urine MMA if you have SIBO, whereas serum MMA is a better option if you have a history of kidney dysfunction.
Holo-TC
B12 is transported around the body by two proteins: transcobalamin II (TCII) and haptocorrin. Eighty percent of B12 is bound to haptocorrin, while only 20 percent is bound to TCII. Holo-TC, the marker that measures TCII, falls almost immediately after B12 intake drops. Serum B12, by comparison, measures total cobalamins (a name for cobalt-containing compounds, like B12). But it measures mostly haptocorrin, and doesn’t decrease until B12 deficiency has been going on for some time.
Homocysteine
Homocysteine is an amino acid in the blood. It’s a marker of B12 deficiency when elevated, though not exclusively. Elevated homocysteine can also be caused by folate and vitamin B6 deficiencies. Homocysteine is more sensitive than serum B12; however, if it is high, you will need additional testing to determine whether the cause is B12, folate, or B6 deficiency.
Holo-TC, MMA, and homocysteine are considered measures of functional B12 deficiency because they reflect whether B12 is being appropriately utilized in the body.
Your Best B12 Testing Option
So, which one of these markers is best?
- Holo-TC is the earliest, most sensitive indicator of B12 deficiency.
- Urinary MMA and homocysteine typically don’t become elevated until the mid to late stages of B12 deficiency.
- Serum B12 is the least sensitive indicator and usually doesn’t fall until the final stage of B12 deficiency.
While holo-TC testing is often the best way to catch an early B12 deficiency, it isn’t widely available in the United States (though it is in Europe). Here, we generally rely on a combination of serum/urine MMA, homocysteine, and serum B12 testing.
If you choose to get a serum B12 measurement, you will need to refer to a different range than the one provided by the lab when interpreting your results. Although most labs define deficiency at <200 pg/mL, it is well documented that many people experience signs and symptoms of B12 deficiency at levels between 200 pg/mL and 350 pg/mL. (4) Also, be aware that a high serum B12 does not necessarily rule out a functional B12 deficiency, which is best detected with MMA or holo-TC.
The same is true for homocysteine. The lab range often goes up to 15 nmol/L, but research has shown that a homocysteine level of 10 to 15 nmol/L is a substantial risk factor for heart disease, and that relationship is linear—the higher the homocysteine, the higher the risk. (5)
The Earlier You Notice a Deficiency, the Better
There are four stages of B12 deficiency, and the earlier B12 deficiency is detected in the progression of these stages, the more likely it is that the symptoms can be prevented or reversed.
Stages I and II
During the first two stages of a deficiency, your plasma and cell stores of B12 become depleted, and the concentration of holo-TC is reduced. Holo-TC is the only available marker for assessing the first two stages of B12 depletion. It’s likely that you won’t experience any noticeable symptoms if you’re in stages I or II.
Stage III
This stage of functional B12 deficiency is characterized by elevated homocysteine and urinary MMA concentrations in the blood. Serum homocysteine and serum/urine MMA are the best markers for detecting Stage III deficiency. At this stage, some people will experience mild symptoms like fatigue or brain fog, but others may not notice any signs or symptoms.
Stage IV
If you’re in the fourth stage of a deficiency, you’ll experience clinical signs, such as anemia, fatigue, and brain fog. Serum B12 and other markers of Stage IV deficiency may not decrease until this point. For some Stage IV patients, the cognitive and neurological symptoms are so severe that many believe they have Alzheimer’s or Parkinson’s disease. (6)
As you can see, signs like macrocytic anemia and symptoms like peripheral neuropathy or brain fog do not appear until the final stage of B12 deficiency. Stages I and II of depletion can precede deficiency (Stages III and IV) by months or even years!
To complicate matters further, the physical manifestations of B12 depletion can take years to appear. In the case of neurological symptoms, it may be too late to reverse them by the time the late stage of deficiency has been reached. (This particularly serious for children and young adults whose brains are still developing, as well as any adult at risk for Alzheimer’s or dementia.)
What Is a Normal B12 Level?
As I mentioned before, the cutoff for serum B12 of 200 to 230 pg/mL, used by most studies and labs, is too low. Other studies suggest that B12 levels greater than 400 pg/mL, double the accepted lower limit of normal, boost the beneficial metabolic effects of B12 and prevent neurological damage.
Importantly, research also indicates that at least one-third of B12 in serum is not cobalamin, the metabolically active form of B12 in humans, but corrinoids, which are not metabolically active. This profound finding means that some people with “normal” serum B12 may actually be deficient because the test is counting metabolically inactive corrinoids as B12.
As a rule of thumb, if your serum B12 level is between 200 and 350 pg/mL, B12 deficiency may be a problem. Just remember that a normal serum B12 does not rule out functional B12 deficiency, which can only be assessed with holo-TC, MMA, and homocysteine.
If You’re a Vegetarian or a Vegan, You Should Be Concerned about B12 Deficiency
Vitamin B12 is found almost exclusively in animal foods. For this reason, vegetarians and vegans are highly prone to B12 deficiency. While early studies showed that vegetarians and vegans had only slightly higher rates of deficiency than omnivores, these studies used relatively insensitive markers, such as serum B12, and less stringent cutoffs for holo-TC, MMA, and homocysteine.
For example, one study that used serum B12 (the less sensitive method) indicated that 7 percent of vegetarians and 52 percent of vegans were B12 deficient, whereas when holo-TC was used, deficiency was detected in 77 percent of the vegetarians and 92 percent of the vegans. (7, 8)
Essentially, conventional B12 testing is missing 70 percent of vegetarians and 40 percent of vegans that are B12 deficient! This is a massive oversight that may have devastating consequences for the long-term health of both vegetarians and vegans.
Interestingly, I have noticed in my clinic that other signs of B12 deficiency, such as elevated mean corpuscular volume (a marker known as MCV), can be obscured in vegetarians and vegans. This occurs because vegetarians and vegans often have iron deficiency and a high folate intake; these factors lower MCV and effectively “cancel out” any increase that B12 deficiency would cause. (9) Calcium deficiency, which is common in vegans, can also lead to B12 deficiency because free calcium is required for the absorption of B12. (10) The possibility of multiple nutritional deficits is just one reason to think twice about following a vegetarian or vegan diet.
Omnivores: You Need to Pay Attention to B12, Too
While rates of B12 deficiency are much higher in vegetarians and vegans than in omnivores, that doesn’t mean it’s rare in omnivores. Approximately one in 20 omnivores is B12 deficient. (11) B12 deficiency is also more common in people with risk factors like:
- Gut problems that decrease intestinal absorption of B12
- Past or present use of gastric acid-suppressing medications, metformin, or antibiotics
- A history of miscarriage and infertility
Vegans: You May Need More Supplementation Than You Think
Proponents of vegan diets promote B12 supplementation as the solution to B12 deficiency. However, supplements do not always solve the problem. In fact, research indicates that even well-educated vegetarians and vegans are not supplementing adequately!
Presumably well-educated vegetarians and vegans at a summer camp in the Netherlands were found to have serum B12 levels less than 200 pmol/L, a level associated with reduced DNA synthesis and other harmful metabolic effects. In another study, vegans taking B12 supplements demonstrated a paltry average level of 192 pmol/L.
Furthermore, the rate of B12 deficiency in vegans who supplemented with B12 was higher than in vegans who didn’t supplement! It is not clear why vegans who supplemented had higher levels of deficiency, but it could be due to the interference of supplemental B12 with active B12 levels. (12) In both of these studies, the subjects were from vegetarian/vegan societies and thus likely to be better educated than the general population. However, this did not prevent them from having a B12 deficiency. (If you need help choosing proper supplements, see the last section of this article for more specifics.)
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Your Kids Need B12 throughout Childhood
Women who consume vegetarian and vegan diets during pregnancy and breastfeeding and families that feed their children vegetarian and vegan diets during infancy and childhood are playing with fire and increasing their children’s risk of serious developmental and health problems.
Vegetarian Moms: You Need to Get Enough B12 during Pregnancy
If you’re pregnant and you have a B12 deficiency, your child could have low B12 throughout infancy and childhood. The longer a mother has been a vegetarian, the higher the likelihood she’ll have low serum and breast milk B12 levels that correlate with a deficiency in her infant. (13, 14, 15)
High homocysteine resulting from low maternal B12 status may promote neural tube defects and congenital heart defects in utero. (16)
The Impact of a Deficiency for Your Child
The prevalence of B12 deficiency is 67 percent in American children, 50 percent in New Zealand children, and 85 percent in Norwegian infants who have followed vegetarian or vegan diets their entire lives. (17) This is extremely concerning, as B12 deficiency can have “extensive, severe, and irreversible” consequences for brain and body development in children. (18)
B12 deficiency impairs fluid intelligence, spatial ability, and short-term memory in children; in fact, vegan children score lower than their omnivorous peers in all of these areas. (19)
B12 deficiency in children leads to:
- Poor school performance
- Depression
- Weakness
- Fatigue
- Nerve damage
- Failure to thrive
Even if a vegan or vegetarian child switches back to a diet that includes animal products, they may not be able to reverse all of the problems that come with low B12. A study of kids raised on a vegan diet found that they were still B12 deficient years after they started eating animal products. (20)
B12 deficiency also has serious health repercussions for adults. Notably, it raises homocysteine, a risk factor for cardiovascular disease, dementia, and Alzheimer’s disease. (23) Ironically, many vegetarians and vegans choose a plant-based diet to reduce their risk of cardiovascular disease, yet several studies have shown that homocysteine levels are higher in vegetarians than omnivores and higher in vegans than vegetarians. (24) Vegetarians and vegans with low vitamin B12 status are at risk of developing circulatory health problems regardless of their favorable profile of traditional heart disease risk factors. (25)
What to Do If You Think You Have a Deficiency
The first step I recommend is to get a holo-TC and/or urinary MMA test. If either of them is abnormal, you should immediately take steps to increase your B12 levels. There are two ways to do this:
- Eat B12-rich foods
- Supplement
How to Get More B12 in Your Diet
B12 contains a trace element (cobalt), which is why it’s also called cobalamin. Cobalamin is produced in the gut of animals and is found almost exclusively in animal foods. Some of the best sources of B12 are:
- Liver
- Clams
- Oysters
- Mussels
- Fish eggs
- Octopus
- Fish
- Crab and lobster
- Beef
- Lamb
- Cheese
- Eggs
A common myth among vegetarians and vegans is that it’s possible to get B12 from plant sources like:
- Seaweed
- Fermented soy
- Spirulina
- Brewer’s yeast
Nearly all seaweed tested has been revealed to contain vitamin B12 analogs (that is, chemically similar) called cobamides that block the intake of—and increase the need for—true B12. (26) The one exception is a combination of dried purple laver (nori) and wild mushrooms, which were shown in one study to reduce MMA.
Using a Supplement
Cyanocobalamin is the most frequently used form of B12 supplementation in the United States. But recent evidence suggests that hydroxocobalamin is superior to cyanocobalamin, and methylcobalamin may be superior to both—especially for neurological disease. This is because methylcobalamin bypasses several steps in the B12 absorption cycle and, unlike cyanocobalamin, readily crosses the blood-brain barrier. (27, 28) On top of that, methylcobalamin provides the body with methyl groups that play a role in various biological processes critical to overall health.
We now know that the dose of B12 in a supplement needs to be 100 times higher than the RDA of 2.4 micrograms/mL to be effective (this comes to approximately 250 micrograms/day). If you’re deficient, your dose should be even higher, at approximately 500 micrograms/day.
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Hi Chris,
I was diagnosed with Pernicious anemia, shortly after they found carotids in my stomach. I’m taking b12 supplements but as you know, my body can’t absorb B-12 so it still futile. I have nerve damage already, but they’re attributing it to the bulging disc in my neck that are cutting into my spinal cord. My Neurologist and thoracic Surgeon can’t 100% tell my why my arm goes numb, ice cold and is in pain 24/7. I’m 44 and at the end of my rope.
Chris, can you recommend any supplements (especially b12m,, magnesium and vitamin A) that do not use any magnesium stearate? I have lupus, leaky gut, etc., and when I take any thing with magnesium stearate, I my face literally bleeds! I get horrible blisters that turn into open wounds. That sounds graphic, but from trial and error I have found that this is absolutely connected to magnesium stearate. I can’t have anything containing rice syrup or gluten, either. Any suggestions would be so appreciated!
Do you have B12 suppliment recommendations for people with diabetes who have been on Metformin for years? Most of my doctors are not familiar with B12 deficiency as a side-effect of metformin.
I development numbness in both toes after taking Metformin for 5-6 years. I went through a bout of accupuncture and realized that the numbness had gone away. But it comes and goes. Dr. Oz had an episode about Vit B12 deficiency.
Since then I have been taking sublingual B12 starting at 5,000mcg. My doc suggests taking 1000mcg per day. My question is that while I no longer have the neuropathy in my toes, I still have other symptoms, can’t recall people’s names or words and have general fatigue and problems sleeping. \
What is a reasonable amount to take both orally or in a shot. It’s been difficult finding doctors to give shots.
Hi Chris,
I love your site, so informative!
Do you know of a brand of B-Complex that contains folate and NOT folic acid? I’ve been trying to find one to no avail. I cannot ingest folic acid due to MTHFR mutation. I do supplement with 5-methyltetrahydrofolic acid but want to also take a B-complex. I do eat a Paleo diet.
Thanks!
One of the most commonly prescribed drugs is Nexium (for acid reflux). I was on this drug for years, only recently stopped taking it. One day I went to the doctor, she ordered a blood test, and the result showed a vitamin B12 deficiency. I did more research and apparently Nexium decreases absorption of B12, meaning most people taking Nexium will find themselves B12 deficient.
The Nexium pharmaceutical drug is quite insideous. You can’t stop taking it or you will get really, really bad heart burn. The drug is probably designed to achieve that result. Thankfully I have been able to significantly lessen the need for it by upping my intake of raw unpasturized saurkraut and also cutting out wheat and processed foods from my diet.
Hi Chris,
I love that you’re writing about B12. I have a personal interest in it, and specifically methylcobalamin. As an RD, I see tons of patients with nutritionally related problems and thanks to having access to great, advanced labs and genetic screening, I get to also help them with methylation pathway concerns.
I know that I carry the two heterozygous mutations of MTHFR genes (677 and 1298) so my methylation is reduced quite a lot. I take 15mg Deplin (l-methylfolate) daily, and have in the past supplemented with methylcobalamin, although, admittedly not as frequently and regularly as I should.
My question is what are your findings, if any, with people who carry a methylation defect like that? I’ve never had low B12 on a standard serum test, but I don’t think the serum tests are very accurate for someone in my circumstances. I eat red meat almost daily, as well as eggs daily, so I don’t doubt that I consume enough B12, but I know that I’m also very sensitive to some food proteins (soy, gluten and casein), and I know that if I don’t take a high dose probiotic every day, my skin breaks out. All these lead me to the conclusion of gut dysbiosis of some degree.
So I guess my question is really, despite the fact that I eat a lot of B12 containing foods, am I possibly not absorbing a lot of it, and, I don’t know if you know the answer to this, but were I to regularly take my methylcobalamin supplement, would there be a noticeable difference in energy levels, etc after a certain amount of time? Just some random thoughts 🙂 keep up the great content!!
Hi Sarah,
I carry one copy of 677T and have high serum levels of B12. I do take a sublingual form of methylcobalamin 5,000 mcg. 4-5 times a week. I also question how accurate the serum test results are as I also had to have 10 inches of my mid-jejunem removed due to perforation so I know my absorption is somewhat compromised. Have you worked with clients who have had some of their small intestine removed?
Have you checked out http://www.mthfr.net? Great info and suggestions on how to mitigate the effects of carrying the gene mutation.
I have been taking 5,000 sublingual VitaminB12,how often can I take this
I am celiac/hashimoto’s and vitamin d deficient as well as low b12. I was taking 1 teaspoon of FCLO which did not make a dent in my vitamin D level so I’ve upped it to 2 teaspoons daily. My question…How often can I safely eat (4 ozs.) of liver for to increase my B12 without having to worry about too much Vitamin A from the FCLO? Can the combined eating of liver with supplementing the FCLO make me Vitamin A toxic? I really prefer to eat the food over supplementing. Thanks for all you do.
Hi Chris,
I have been dealing with chronic illness for 2 1/2 years. My B12 levels from day 1 have been high, especially now that I have been supplementing with standard process and taking what my body needs through applied kinesiology. I do still have neurological problems, tingling etc. We recently did an intrinsic factor test to see if that is why my blood levels were so high but it was normal. Is this test enough to prove I don’t have a b12 deficiency even though my level are in the 1600’s? I have been trying to get some information over the web, but not a whole lot of explanation for those that have high levels. Thanks for you time..
Pam:)
I’m not sure what’s scarier, the sheer volume of hateful, malicious, self-serving comments or the overall fact distortion echoing throughout this entire page (from both sides of the discussion) but anyone blind enough to think any single lifestyle or diet is perfect is fooling themselves.
We’re all humans who are lucky (and unlucky) enough to exist in the world at this one blip in time with more knowledge, more choices and more freedom to shape the world, our health and the health of the entire world (Humans, Animals, Earth, Water, Sky) in its every shape and form for the better!
There are billions of evolving data points that cover every manner of study, every branch of science, biology, ecology, chemistry, archeology, history, past & present with infinite contradictions, numerous correlations and plenty of both. All of that and none of that make it easier to know what to do but at the end of the day there is YOU and there is EVERYTHING else. All the other people, animals, plants, earth, land, water, sky, pollution, health, sickness, happiness and suffering of everything that is and everything that will be and well to me, that means my food, my diet, my health, my choices are about more than just ME.
Of course I want the healthiest, happiest, most nutritionally balanced radiant life possible but when I add it all up, including the infinitely debatable elements of “food” that will inevitably evoke disagreement for all eternity, it’s clear that the individual and collective human effect of living and eating vegan is more positive than negative, more health than sickness, more light than dark.
So I say #GoVegan (….‘cause the entire world is likely worth a few sublingual B12 🙂
If you think that vegan is more positive than negative, you got another think coming.
Bravo! Well said.
might be that a civilization that is based on
bodies-eating-bodies, literally and metaphorically,
is severely limited re natural progression toward
higher states. in all arenas.
terms such as vegetarian and carnivore do not
need to exist. it is a matter of what one is
willing to do/not willing to do in this life to get
what he wants in the moment.
could we be doing many things incorrectly?
just a thought.
cheers –
a
Hello to everyone. Chris, thank you for bringing up the B-12 issue. My husband, Don and I have wondered about nuturtional deficits in my diet. I have had gastroparesis now since 2006 when my vegas nerve was damaged during a hiatal hernia repair. I do pretty good now at keeping food down and have been able to achieve a bit of reserve weight. The comparison for this is 3 years ago I was down to 108# as I was not able to keep food into my system. At one point I was sent to a specialist for memory loss as I have periods of aphasia. This is dietary related aphasia. You don’t eat for 3 weeks, stuff happens. I think I will try adding the b-12 supplement to my herbal supplement and vitamins. It would be great if it could help to defeat some of the aphasia.
Thanks again, and I will see if your diet ends up being one that a dead stomach can deal with.
I credit my aphasia to lamictal. Never had it before and my memory and speech improved dramatically when coming off of it. Are you on any meds?
Hi Ann,
I am also on lamictal. I will email my neurologist today.
Kathy
Hi Kathy,
I’ve talked to many neuros at events (not my MDs) and they all claim there is no problem. While they see many people on the meds, they don’t live with them or take the meds. I’ve been on different meds over 40 years and lamictal made me clueless, affected my speech greatly, which never came back 100% and slowed me down. I would never recommend it (although I didn’t mind the weight-loss side effects). Do ask MDs questions, but go with your gut about what you think is happening as well.
What other foods can I eat for B 12. I have diverticulosis and celiac
Low-carb/high-fat Palaeo. Read Chris’s articles. You don’t need carbs – and you CERTAINLY DON’T need grains!
What other foods can I eat with B12 I have celiac and diverticuloso
I take B12 for energy is it good for diverticulosis
B12 DOES NOT give you energy; it assists in enabling you to convert food to energy, but it doesn’t give you energy in – and of – itself, like caffeine does.
Brain Fog I think it would be helpful to define the term “brain fog.”
I have brain fog. Literally, your brain is in a fog. It’s like being half asleep. Everything is fuzzy. Mine is from a head injury.
I have been diagnosed with B12 deficiency. I went to a hemotologist who put me on weekly injections. This helped bring me out of the fog. I was a walking mess! After two months, she pronounced me cured and told me I would need to learn to do shots twice a month. I tried to live like that but it is just not enough. I have gone back, she then increased it to 3 shots a month. However some of the symptoms are not going away or becoming less. It is worth noting that I take a protein pump inhibitor, metFormin and I do eat meat. I have significant neuropathy in my feet which is progressing up my legs. I feel like I need to see a doctor that specializes in this issue, but do not know where to start!
Alpha lipoic acid helps with diabetic nueropathy. In the form of R-lipoic acid it is most active. You didn’t mention what type of diet you follow but adopting a Paleo diet, eliminating all grains is likely to reverse your diabetes.
Interestingly, the reasons doctors prescribe proton pump inhibitors; acid reflux, heartburn, hiatal hernia are actually due to not enough stomach acid…not too much! You need acid to absorb vitamins and minerals, kill pathogens including h-pylori the cause of ulcers, break down and assimilate your food, especially protein.
My mom took Prilosec for years unnecessarily. I helped her get off the drug by initially taking 1 Tbs. of lemon juice with her meals. She then transitioned to taking hydrochloric acid with pepsin. She did have rebound heartburn for a couple weeks, the lemon juice helped with that, but got off the drug permanently with no ill effects. She still takes the HCI and pepsin and is doing great at age 86.
BTW – our stomach acid production declines as we age which helps explain why so many doctors prescribe acid blockers to older adults.
For what it is worth, I was a vegetarian (no flesh at all) for almost 20 years. At my last Dr.’s appointment, my physician said my B12 was way too low (interesting no other Doc mentioned it before). In addition to a supplement, she ‘ordered’ (in a good sense, of course) me to resume eating meat at least 3 times a week. I can remember trying to ‘negotiate’ that with her, and she would have none of it. I have since gone Paleo and feel so much better. Good for her, and stupid of me for not understanding the science better.
Hi Chris,
I am a long time vegetarian who exhibits a lot of the symptoms of b-12 deficiencies. My b-12 level was considered normal (331 PG/ML), but I pressed for MMA and Homocysteine testing. Can you tell me what the normal range is for MMA and Homocysteine? My doctor tells me my levels are normal, however, I’m not sure what the normal levels are. My MMA result was 286 nmol/L and Homocysteine was 9.9 uMOL/L.
Hello,
I was just diagnosed with a functional B12 deficiency. My B12 is 68. I am so tired and weak. I start weekly B12 injections next week.
My question is what does a functional B12 deficiency mean?
Thanks in advance,
Terri
What does a low MMA mean? I started taking B12 and it has increased, but I’m still dropping in the iron and my MMA was below normal.
My dad has B12 deficiency and was switched to Sub lingual B12 instead of the shots. He seems to be more fatigued. Has anyone found the shots superior over sublingual?
Joan:
For me the sublinguals or the B12 drops never worked. I went back to methylcobalamine shots every 2 weeks for 2.5 month. The tingling stopped within 24 hours of receiving the first one.
Now I am experimenting with B12 patches (ordered from Kevin Gianni) and they seem to work.
I am much more watchful of my B12 and D3 levels nowadays and after reading some of the many comments here have to distrust some of the blood test results.
I would definitely consider the shots for your dad.
Good luck!