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Can a B12 Deficiency Cause Vitreous Eye Floaters?

LynnJ

Senior Member
Messages
121
I'm curious if anyone here knows whether a B12 deficiency can cause vitreous eye floaters. I've seen a few people online talking about how they got floaters when their B12 was low (some even said their floaters resolved with treatment), and I also found this:

"Eye floaters and b12 deficiency are connected by way of a complication involving protein metabolism. When the body is deficient in vitamin b12, it is not uncommon for abnormal protein metabolism to occur and this, ultimately, can lead to the development of eye floaters. While not all eye floaters are related to an issue with b12 deficiency, it is worth asking your physician to address your nutritional deficiencies to determine if these are causing the floaters to develop.

If you are truly deficient in vitamin b12, your doctor can prescribe b12 shots, recommend oral b12 supplements, or may even advise to use sublingual b12 tablets. Once your b12 deficiency is resolved, you should find the eye floaters begin to diminish although many patients may continue to have them simply due to natural aging."

I'm not sure whether it's accurate or not, however.
 

Jonathan Edwards

"Gibberish"
Messages
5,256
It seems to me vanishing unlikely that B12 deficiency causes floaters. Where did the quote come from? This looks like a soft sell advert to me.
 

LynnJ

Senior Member
Messages
121
Just a blog about eye floaters/eye health. No sales or links to products.

The other posts from people who mentioned having floaters with low B12 were from a B12 deficiency website. I can track it down again if need be.
 

LynnJ

Senior Member
Messages
121
I know iron deficiency can cause floaters, as well as a lack of hyaluronic acid. High doses of B2 have also been linked to eye problems including floaters. So while I'm not sure if B12 CAN be connected to floaters, it didn't sound too crazy to me. :)
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
Is there good evidence about what causes floaters? It's never occurred to me to present myself to my GP about these. I just thought they were a random thing.
 

LynnJ

Senior Member
Messages
121
There are lots of different causes for floaters. They can be just a normal part of aging. Most doctors don't take them seriously, which is unfortunate, as they can have a huge impact on one's quality of life. Some people have THOUSANDS of them in their eyes.
 

Jonathan Edwards

"Gibberish"
Messages
5,256
I know iron deficiency can cause floaters, as well as a lack of hyaluronic acid. High doses of B2 have also been linked to eye problems including floaters. So while I'm not sure if B12 CAN be connected to floaters, it didn't sound too crazy to me. :)

I don't know of any reason to think iron deficiency would cause floaters either to be honest. And I don't think there is such a thing as lack of hyaluronic acid is there? I used to work on hyaluronic acid metabolism in my lab and I cannot think of any mechanism for having a lack of it.

It still sounds like a soft sell to me. Soft sells don't mention specific products but at least B12 is mentioned and soft sells often appear in the form of unwitting customer testimonials. I cannot find anything referring to this based on any medical evidence.
 

LynnJ

Senior Member
Messages
121
Well, we produce less HA as we age. The human body is rich in HA when we're young, but that changes as we age, and our levels begin to go down. That's why people use it to combat aging "issues" like wrinkles and joint pain. It's been doing great things for some knee pain I have (even though I'm under 30).

HA can also be degraded by too much ascorbic acid. That's why megadoses of vitamin C can (eventually) cause eye issues, including floaters. There was an old newspaper article about a medical study done on how floaters are becoming more common among young people because they're supplementing with high doses of vitamin C for long periods of time. Can find the link again if anyone wants it.

Floaters can indeed be caused by anemia according to my doctor... But of course, he could be wrong.

Studies have also shown that floaters can be caused by megadoses of B2, which like vitamin C can degrade HA. And there are a few medications out there which have floaters as well-documented side effects.

Again, note that I found multiple people stating they believe their floaters were due to low levels of B12, two of which said their floaters resolved with B12 treatment (along with their other symptoms). That, more than the little blurb I posted above, is what led me to wonder if there's indeed a connection.
 
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Jonathan Edwards

"Gibberish"
Messages
5,256
Well, we produce less HA as we age. The human body is rich in HA when we're young, but that changes as we age, and our levels begin to go down. That's why people use it to combat aging "issues" like wrinkles and joint pain. It's been doing great things for some knee pain I have (even though I'm under 30).

Hmm! I worked on HA in joints in my lab for several years and with Rodney Levick worked out the role of HA in synovial fluid homeostasis in the 1980s. I don't honestly think that injecting it can have more than a placebo effect and that is what the meta-analysis of trials showed. (Diseased joints generally have more HA in them than normal.) I have to be honest this sounds like pseudoscience to me. Lots of stuff gets written up in all sorts of places that sounds plausible but that does not mean that it is valid. I would like to see some scientific references.
 

LynnJ

Senior Member
Messages
121
Curr Eye Res. 1994 Jul;13(7):505-12.
Mechanisms of photo-induced vitreous liquefaction.
Akiba J, Ueno N, Chakrabarti B.
Schepens Eye Research Institute, Department of Ophthalmology, Harvard
Medical School, Boston, MA.

To understand the mechanisms of photo-induced vitreous liquefaction, this
study investigated the effects of free radicals on collagen and hyaluronic
acid (HA). Bovine vitreous collagen or HA was irradiated by visible light in
the presence of riboflavin (RF) as a photosensitizer. The changes in the
molecular weight of collagen and HA were monitored by sodium dodecyl
sulfate-polyacrylamide gel electrophoresis and high-performance liquid
chromatography, respectively.

Free radicals were shown to cause an increase
in the high-molecular-weight components and insolubilization of the vitreous
collagen and a decrease in the molecular weight of HA. The change in
molecular properties of the vitreous collagen could be attributed to
extensive crosslinks of the molecules. Since RF is present in the vitreous,
which is irradiated by visible light over a lifetime, both cross-links of
vitreous collagen and degradation of HA may contribute to age-related
vitreous liquefaction.

Nippon Ganka Gakkai Zasshi. 1992 Jun;96(6):731-6.
[Photodynamically induced vitreous liquefaction in vivo]
[Article in Japanese]
Akiba J.
Department of Ophthalmology, Asahikawa Medical College, Japan.
Photodynamically induced vitreous liquefaction in rabbit eye was
investigated. Photosensitizer, riboflavine phosphate, was injected into the
vitreous cavity of the rabbit before white-light irradiation. After the
irradiation (0, 1, 3, 6 hr) the rabbit vitreous body was separated into gel
and liquid portions. The liquid vitreous body was weighed, and the vitreous
liquefaction percentage was calculated.

One hour irradiation caused 38% of liquefaction of the eye; 3 hr, 50% liquefaction; 6 hr, 59% liquefaction. Although irradiated control eye (without photosensitizer) and the dark
adapted control eye (non-irradiated) showed 10-15% liquefaction throughout
the experimental period, the liquefaction percentage of the experimental
vitreous bodies was significantly larger than that of the control vitreous.
Inhibition experiment showed that the radical scavengers (Cu, Zn-superoxide
dismutase, catalase, and mannitol) could suppress the photodynamically
induced vitreous liquefaction.

Results indicated that free radicals, including hydroxyl radical and superoxide
anion, which are generated by photosensitizer and visible light irradiation,
may contribute to the age-related vitreous liquefaction of humans.
Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1975;194(4 Suppl):277-81.

[The influence of riboflavin on vitreous homogenate (author's transl)]
[Article in German]
Hofmann H, Schmut O.
Sunlight causes a decrease of viscosity of a mixture of riboflavin and ox
vitreous homogenate while without riboflavin no reaction can be observed.
The mechanism of this reaction is not yet clarified. It is possible that the
reaction is closely related with the degradation of the viscosity of a
hyaluronic acid solution by ascorbic acid cause of the production of H2O2 in
both reactions. As an other mechanism the transfer of light energy on
hyaluronic acid by riboflavin can be assumed.

Nippon Ganka Gakkai Zasshi. 1995 Dec;99(12):1342-60.
[Changes in vitreous structure caused by oxygen free radicals]
[Article in Japanese]
Ueno N.

Department of Ophthalmology, Osaka University Medical School, Japan.
Vitreous liquefaction in humans is considered to be part of the normal
ocular aging process and is associated with vitreoretinal pathology. Because
hyaluronic acid (HA), one of the main components of the vitreous gel
structure, is degraded by reactive oxygen species (ROS) including oxygen
free radicals, the structural changes in the vitreous may be caused by ROS.
To investigate the effect of ROS on the vitreous gel structure, we treated
animal vitreous with ROS, which was generated from various sources. Using
riboflavin as a photosensitizer, calf vitreous was irradiated with visible
light (two 15-W fluorescent lamps) and found to be considerably liquefied.
The liquefaction resulted from HA depolymerization induced by ROS. Because
of the small amount of riboflavin naturally present in the vitreous, a
riboflavin-sensitized photochemical reaction may contribute to age-related
vitreous liquefaction.

Hematoporphyrin (HP), which is similar in chemical
structure to heme in blood, was also used as a photosensitizer. Irradiation with HP destroyed the calf vitreous gel structure and caused liquefaction. A HP-sensitized photochemical
reaction may contribute to vitreous liquefaction observed after vitreous
hemorrhage. Because metal ions, including Fe2+ and Cu2+, can catalyze to
generate ROS, liquefaction occurred when we treated calf vitreous with Fe2+
or Cu2+ at 4 degrees C. Adding ascorbic acid to the vitreous during the
reaction increased the rate of liquefaction. Therefore, metal ion catalyzed
ROS may also contribute to vitreous liquefaction, such as that found in an
injured eye with siderosis.

To investigate the relation between inflammatory
cell mediated ROS and vitreous liquefaction, an endotoxin-induced uveitis
model was created in the rabbit eye. Upon inflammation, the vitreous gel
contracted and released a water-like liquid. Because superoxide dismutase
can suppress the liquefaction, the destruction of the vitreous gel structure
resulted from ROS generated from inflammatory cells. Although many unknown factors contribute to vitreous liquefaction, ROS may be the main cause of vitreous structure alterations. To prevent or delay the progress of vitreous liquefaction in the normal
aging process or vitreous pathology, a new therapeutic procedure based on
clear scientific studies is needed.
Publication Types:
Review
Review, Tutorial


Free Radic Biol Med. 1997;22(7):1139-44.
Degradation of hyaluronic acid by photosensitized riboflavin in vitro.
Modulation of the effect by transition metals, radical quenchers, and metal
chelators.

Frati E, Khatib AM, Front P, Panasyuk A, Aprile F, Mitrovic DR.
INSERM-U.349, Lariboisiere Hospital, Paris, France.
The effect of photoexcited riboflavin (RF) on the viscosity of hyaluronic
acid (HA) solutions has been investigated. UV irradiation of RF causes under
aerobic conditions fragmentation of HA and a decrease in the viscosity of
its solutions.

A decrease of HA viscosity occurs in PO(4)-buffered solutions
and is accelerated by high pH, Fe2+ (but much less so by Fe3+), certain
metal chelators, and horseradish peroxidase (HRP); it is partially inhibited
by catalase and less so by superoxide dismutase (SOD). The reactivity of the
system was completely blocked by Tris, ethanol, aspirin, d-manitol,
dimethylthiourea (DMTU), dimethylsulfoxide (DMSO), and sodium azide. These
results indicate that the most likely chemical species involved in the
reaction is the hydroxyl radical. Singlet oxygen ((1)O(2)) generation is
suggested by the ability of NaN3 and DMSO to completely inhibit the
reactivity of the system.

These two agents, however, may also interact with
OH. radical, as well and suppress the reactivity of the system. H(2)O(2) and O(2).- seem also to be produced in significant amounts, because catalase and SOD partially block the
reactivity of the system. The effect of HRP may be due to hydrogen
subtraction from HA and H(2)O(2) reduction to water. Photoexcitation of RF
may potentially occur in vitro and in vivo in the organs and tissues that
are permeable to light, such as the eye or skin, and damage HA and other
cell-matrix components causing inflammation and accelerating aging.
 

daisybell

Senior Member
Messages
1,613
Location
New Zealand
I'm more inclined to believe that the appearance of floaters is linked to inflammation, and that perhaps they are more common earlier in life in PWME. I have a large one in my left eye which annoyingly is sufficiently big that I am always aware of a windscreen-wiper effect of blurring. I saw a specialist at the time and he said that my eye looked like that of a 70 year old, and had lots of white cells floating around in it... My left eye has always seemed to reflect how I feel - if I'm not good, it's red and streaky!
 

LynnJ

Senior Member
Messages
121
Very interesting, ahmo. Thanks for sharing. You're the third person I've heard that from.

I think one of the causes of floaters can be inflammation. But for me personally, I've taken things like Turmeric (usually makes me sick, unfortunately) and Zyflamend for a long time. No results, really.

You're saying your floaters were white blood cells?
 

daisybell

Senior Member
Messages
1,613
Location
New Zealand
Very interesting, ahmo. Thanks for sharing. You're the third person I've heard that from.

I think one of the causes of floaters can be inflammation. But for me personally, I've taken things like Turmeric (usually makes me sick, unfortunately) and Zyflamend for a long time. No results, really.

You're saying your floaters were white blood cells?
No, the floaters are made of vitreous. But I also had lots of white cells in my eye. As the specialist put it "your eye is full of junk!"
 
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LynnJ

Senior Member
Messages
121
Huh. So I'm curious - can you SEE them?

I mean, I know some floaters/visible spots due to bleeding or trauma are in fact made up of blood cells.
 

daisybell

Senior Member
Messages
1,613
Location
New Zealand
Huh. So I'm curious - can you SEE them?

I mean, I know some floaters/visible spots due to bleeding or trauma are in fact made up of blood cells.
I don't know! I can see some of my floaters for sure, especially the big one in my left eye. The folk looking into my eye could see the white cells at my first visit, but I think at the follow-up, most of them had gone....
 

LynnJ

Senior Member
Messages
121
What do your floaters look like?

I have probably 40+ white transparent bubbles that are the least annoying (although I still want them gone), at least two larger "crystal worm" types - basically a transparent floater in a worm-like shape.

And the two worst floaters that TRULY bother the heck out of me are fairly dark, greyish dots that, when I can get a clear look at them when my eye is positioned just so (because usually the floaters dart around like crazy), are actually probably 50-100 tiny transparent bubbles all stuck together.

If I only saw them occasionally, they wouldn't be such an issue. But alas, the dark ones can be seen pretty much all the time. Very stressful and surprisingly depressing.
 

daisybell

Senior Member
Messages
1,613
Location
New Zealand
My main floater is like having a windscreen wiper constantly swishing back and forward across my left eye. If I keep my focus fixed on one point, I can ignore it but as soon as I move my gaze, flick there it goes! And at night, it really impacts on my vision when I drive.... Which isn't often!!
 

LynnJ

Senior Member
Messages
121
Huh. That sounds bizarre, and not fun AT ALL.

I was poking around the internet some more last night, and saw a few recommendations for floater sufferers to take glutathione. Someone here said their floaters cleared up after supplementing with it: http://mthfr.net/forums/topic/eye-floaters/

However, it looks a little complicated... Some people say to take it, others say to take cysteine, glutamine, and glutamic acid rather than a glutathione supplement that they feel won't be absorbed.

Ugh. It's never simple, is it?