DRHOOK- FTo B12? Deficiency of crucial vitamin dangerous

the handsome doctor John Hong of Charlottesville

"She may be weary, Women do get weary, Wearing the same shabby dress..." Don't you ever get tired and demoralized, feeling like you've been run down by a 100-ton freighter? 

This is not a multivitamin commercial, as I'm not an advocate for multivitamins; I'm an advocate for eating balanced healthy meals to get vitamins naturally. But vitamins and supplements have made some people multi-millionaires overnight. If I ever sell a vitamin, it will be Vitamin R, as in "Really, folks, do you need it?"

Are some vitamin supplements worth taking?

Notice I said multi-vitamins are not my cup of tea. But when someone is deficient in a specific vitamin, or has a medical condition that benefits from higher levels of vitamins, then taking that vitamin makes sense.

Vitamin B12 deficiency is such a case.

B12 deficiency can make a person feel awful: tired, forgetful– even demented– depressed, physically weak, uncoordinated, suffering tingling/numbness in the hands and feet. (Sounds like a party of Betty Ford Clinic drop-outs– and in actuality, alcoholics are at risk of B12 deficiency.)

B12 deficiency has also been linked to heart disease, osteoporosis, incontinence, and vaginal problems.

Because B12 is essential in keeping the nervous system healthy, a deficiency of this important vitamin can be the reason grandmother or grandfather appears to have Alzheimers. About five percent of folks 65-74 years old have B12 deficiency, and 10 to 24 percent of those 75 or older.

Tingling or burning in the toes, especially in bed, is often the first sign of nerve damage from B12 deficiency. You don't want to have the "twinkle toes" for long, because if the B12 isn't restored in time, the nerve damage can be permanent. Weakness can follow: folks complain their legs don't have the va-va-voom they used to have. So going upstairs, getting out of a chair, or going for walks is difficult.

Megaloblastic anemia from B12 deficiency can also contribute to fatigue because hemoglobin can't form correctly without B12.

Vitamin B12 comes from meat and dairy products, and the liver is pretty good at storing B12 for years. So it's hard to become deficient from a diet lacking in B12, as some strict types of vegetarians may experience. 

Usually B12 deficiency is due to poor gut absorption. Pernicious anemia is a main cause of B12 deficiency because the autoimmune antibodies block B12 absorption. It affects about 4.1 percent of white and black women and 2.1 percent white and black men (not so many Asians or Hispanics). This autoimmune disorder is associated with vitiligo (the skin turning white— the malady Michael Jackson claims he suffers), and thyroid disease.

It seems every celebrity has had bariatric surgery nowadays, and this can interfere with B12 absorption. So if Randy Jackson starts saying "Cat" instead of "Dawg" on American Idol, we know he needs some B12 injections (or he's been hanging around Paula too long).

Gastritis can interfere with B12 absorption. But PPIs (like Prilosec, Nexium, and Prevacid) and other anti-acids can reduce absorption of B12. Waning of the stomach cells in the elderly (gastric atrophy) is a common cause of B12 deficiency.

Small bowel diseases like malabsorption syndrome and Crohn's disease are a problem for B12 absorption. Those with pancreatic insufficiency might also have problems.

"To be or not to B12"– that is the question. B12 deficiency can be diagnosed by a simple blood test for B12 and methylmalonic acid. If a deficiency is identified, however, finding the underlying cause is more complex.

If I ever sell B12, I think I'll call it, "I'd rather B12 than B100." What do you think?


Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.