Vitamin B12--You Better Have It

Disclaimer.  I am not a licensed health practitioner.  This is just another post on nutritional needs and deficiencies that you might wish to make sure you have covered in your food storage supplies and plans.  No medication or supplement, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care.  A qualified, licensed physician or other medical provider should be consulted before beginning any herbal or conventional treatment.
(This post first appeared 13 February 2019.)

Like the other B vitamins, vitamin B12, also known as cyanocobalamin (yeah, think I'll stick with B12 here), is water-soluble.  However, in contrast to the other B vitamins, B12 has some surprising differences--differences we better pay attention to.  Vitamin B12, unlike the other B vitamins, can be stored in the body for up to two years.  That is really nice.  But B12 deficiency is also the most common vitamin deficiency seen in the developed world.  While most of us get adequate B12 from our diets, as we age our bodies have an increasingly difficult time absorbing B12, so supplementation may become necessary.

Risk factors for vitamin B12 deficiency include heavy alcohol use, gastric bypass surgery, Crohn's disease, pernicious anemia, celiac disease, parasites, Graves' disease, and lupus.  Vegans and vegetarians who do not consume eggs and dairy products (plants do not provide B12) are also at high risk.

But those at highest risk are the elderly and anyone taking proton pump inhibitors or H2-receptor antagonists.  B12 deficiency is found in 20% of the population over the age of 60 years in the US, and in 6% of individuals under the age of 60.  Those are pretty high numbers.  Proton pump inhibitors such as omeprazole (Prilosec) and Prevacid as well as H2-receptor antagonists like Tagamet, ranitidine (Zantac), and Pepcid all interfere with the body's ability to assimilate B12 from dietary sources.  The same holds true for metformin.  Fortunately, these drugs do not affect the body's ability to utilize supplemental B12.  Stocking a generous supply of supplemental B12 for anyone taking the aforementioned drugs (or who may in the future) and for all those approaching the age of 60 (or past it) is going to be a really wise move. 

Recent studies show that an early sign of B12 deficiency may be glossitis, a painful swelling of the tongue, with long, straight lesions.  Mild deficiency is marked by fatigue, depression, heart palpitations, shortness of breath, pale skin, smooth tongue, numbness, tingling, vision loss, difficulty walking, memory loss, and behavioral changes.  More moderate deficiency may manifest as irritability, easy bruising, bleeding gums, and anemia.  Nerve damage due to B12 deficiency may be irreversible. In children, B12 deficiency may stunt growth and development, and without treatment this may be permanent.

Where do we get B12?  It's all from the animals, folks, or from supplements.  Meat, including fish and seafood, eggs, and dairy.  That's it.  Well, ok, B12 is also found in some seaweed and algae and tempeh, some kind of fermented soybean product originating from Indonesia. Are you growing those or do you have access to them?  If not, it's probably best to turn to the animal sources and supplements, especially if on the aforesaid medications or over the age of 60. 

Rounding out the B vitamins that haven't previously been addressed are vitamins B5 (pantothenic acid), B6 (pyroxidine), and B7 (biotin).  (Vitamins B4, B8, B10, and B11 lost their status as vitamins.)  Dietary deficiencies of B5 and B6 are extremely rare; B5 is found in almost every food.  B6 occurs in a wide variety of foods and deficiencies really only occur in the face of other B vitamin deficiencies which are more likely to be identified sooner and hopefully treated and thus resolve B6 deficiency at the same time.

Biotin (B7) deficiency is rare, mostly because intestinal bacteria synthesize B7 for us.  However, scientists do not yet know whether these bacteria synthesize adequate amounts of B7 in general.  Pregnant women are at particularly high risk for biotin deficiency, so supplements might be a consideration if you are of child-bearing age.  Biotin is found in a wide variety of foods; beef liver, butter, split peas, lentils, peanuts, walnuts, pecans, sunflower seeds, and brewer's yeast are particularly rich sources of biotin.  Symptoms of deficiency include brittle fingernails, hair loss, and conjunctivitis.  The patient may also present with dermatitis in the form of a scaly red rash around the eyes, nose, mouth, and genitalia.


Links to related posts:
Dietary Deficiency and Consequences--Vitamin A
                                                                Vitamin B1
                                                                Vitamin B2
                                                                Vitamin B3
                                                                Vitamin B9
                                                                Vitamin C  
                                                                Vitamin D
                                                                Calcium  
                                                                Iodine  
                                                                Iron
                                                                Magnesium
                                                                Potassium  
                                                                Zinc

For more information:
https://www.webmd.com/diet/vitamin-b12-deficiency-symptoms-causes#2  (Accessed on 9 January 2019)
https://www.ncbi.nlm.nih.gov/pubmed/12671582 (Accessed on 9 January 2019)
https://www.ncbi.nlm.nih.gov/pubmed/19231648/ (Accessed on 9 January 2019)
https://www.drugs.com/health-guide/vitamin-b12-deficiency.html (Accessed on 9 January 2019)