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WP: Vitamin B12s reputation as an energizer exceeds evidence; deficiency rate is low

Discussion in 'General ME/CFS News' started by Firestormm, Apr 3, 2012.

  1. Firestormm


    Cornwall England
    Vitamin B12s reputation as an energizer exceeds evidence; deficiency rate is low

    2 April 2012:

    Hey, Doc, Ive been dragging lately. How about a shot of B12? asked a patient of Consumer Reports chief medical adviser, Marvin M. Lipman. My mother-in-law had one, and it put her on top of the world.

    According to Lipman, primary-care practitioners have been fielding such requests about this reputedly potent fatigue-fighter for at least half a century. So you would think the revitalizing properties of Vitamin B12 for healthy individuals would be well established by now. Think again. And you might also be surprised by how many people truly are B12-deficient.

    The oversize reputation of B12 probably stems from long-ago research that established the vitamins importance in relieving the fatigue associated with pernicious anemia, a disease that impairs the absorption of B12 from food.

    The injectable red liquid quickly gained a reputation as a magic antidote for everyday fatigue in otherwise healthy people with normal B12 blood levels.

    This belief has persisted despite the lack of good scientific evidence for its use as an all-purpose energizer. In 1985, the National Ambulatory Medical Care Survey recorded about 2.5 million B12 injections, of which fewer than 400,000 were for diagnoses compatible with B12 deficiency disorders.

    When to treat

    It wasnt until 1973 that the first randomized controlled clinical trial of the vitamin involving 29 subjects and lasting only six weeks took place.

    The participants, all with normal B12 blood levels, were given either a twice-weekly dose of the vitamin or a placebo for two weeks, followed by a rest period of two weeks and a final two-week phase in which the vitamin and placebo recipients were secretly switched.

    The study was flawed because only the group that received the vitamin first was analyzed. No statistical differences were noted in appetite, sleep patterns and fatigue, but those initially given B12 were happier and felt better.

    In another small study from 1989, 15 people with chronic fatigue syndrome were given either a placebo or a mixture of liver extract, folic acid and B12 at different phases of the month-long study. Their fatigue levels were the same regardless of which phase they were in.

    The role of B12 has been much better established as replacement therapy for people who are deficient in the vitamin, which is essential for DNA synthesis, red blood cell development, peripheral nerve integrity and cognitive function.

    B12 is not made in our bodies and can be obtained only from animal proteins or artificially fortified grains. Once its ingested, stomach acid is necessary to pry it from food, after which the vitamin combines with intrinsic factor, a substance made in the stomach, before eventually being absorbed in the small intestine.

    Whom to test

    According to the 2001-2004 National Health and Nutrition Examination Survey, 3.2 percent of those over the age of 50 have true B12 deficiency. More in that age group are at risk: Up to 30 percent lack sufficient stomach acid to extract B12 from food.

    Even greater decreases in stomach acid can occur in patients using proton pump inhibitors, such as omeprazole (Prilosec and generic) and esomeprazole (Nexium), and H2 blockers, such as famotidine (Pepcid and generic) and ranitidine (Zantac and generic).

    Another medication associated with B12 deficiency is the diabetes drug metformin (Glucophage and generic). Strict vegetarians should consume extra B12 from fortified food or supplements. Malabsorption due to inflammatory bowel disease (Crohns and regional ileitis) can also cause a deficiency.

    There are no guidelines on screening for B12 deficiency in people without symptoms. Still, it seems reasonable to check high-risk individuals, especially since oral Vitamin B12 has been shown to be as effective as injected B12, and in any event supplementation is not harmful.

    Ask your physician to check your Vitamin B12 level if you:

    ?are older than 50;

    ?take a PPI or an H2 blocker

    ?take metformin

    ?are a strict vegetarian

    ?have inflammatory bowel disease.

    Copyright 2012. Consumers Union of United States Inc.
  2. richvank

    richvank Senior Member

    Hi, Firestormm.

    Thank you for posting this. I posted a comment on this article at the Washington Post site. Click on "All Comments" to see it.

    Best regards,

    Jarod likes this.
  3. richvank

    richvank Senior Member

    Hi, nanonug.

    Sorry about that. When I go to the site, it says "1 Comments" and if I click on "All Comments" my comment comes up.

    Best regards,

  4. nanonug

    nanonug Senior Member

    Virginia, USA
    OK, I am seeing it now.

    It's a great comment (as usual). I think it clearly and concisely addresses the simple mindedness of WaPo's article.
  5. alex3619

    alex3619 Senior Member

    Logan, Queensland, Australia
    I liked Rich's reply to this. I do agree that for most B12 will not be beneficial. However, who is most? Everyone is an individual, population based measures to curb B12 use will harm those who need it. The study mentioned in the article also used folic acid - which is not a good thing in my view. I have become very anti-folic acid lately. Once I started looking for information I found lots of places that are now hestant about folic acid. It is quite possible that converting the supplementation/fortification to folinic acid may solve the issue for most, and that will leave a minority who require methyl folate.

    The other thing is that hydroxocobalamin has antioxidant properties quite separately from its vitamin property.

    It occurs to me that methyl folate dependence might indicate they had ancestors who ate a high meat diet.

    Bye, Alex
  6. *GG*

    *GG* senior member

    Concord, NH
    thanks for your activism/educational out reach Rich!

    Jarod likes this.
  7. taniaaust1

    taniaaust1 Senior Member

    Sth Australia
    It (hydroxocobalamin) didnt help my fatigue at all but it certainly did help my brain .. and I didnt have B12 deficiency show up on the normal test done. Pity that that CFS study didnt look at more then the "fatigue" symptom.

    Has there been any ME/CFS study which looked at if it improved ANY symptoms?
  8. richvank

    richvank Senior Member

  9. Sallysblooms

    Sallysblooms P.O.T.S. now SO MUCH BETTER!

    Southern USA
    I can't imagine what would have happened without my B12 injections early on.... I was horribly ill and then everything improved. That was even before I took any other supplements, years ago. I was so low, doctors finally found it. Thanks for the reply Rich!

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