Vitamin B12 – New Uses

The Vitamin B₁₂ Shot – Signs You Might Need One

By Rahim Habib ND, Naturopathic Doctor

Most doctors think about testing your vitamin B₁₂ levels if you have neurological symptoms such as tingling, numbness, or burning sensations in your arms or legs, weakness, or loss of balance.  They may also think of testing it if you have a type of anemia showing large red blood cells on your routine tests.

However, in the past decades, newer research has shown that many other symptoms or illnesses have been associated with low levels of this crucial vitamin.

Newer Signs & Symptoms of Low Vitamin B₁₂

In fact, the usual (and most common) way to test your levels of vitamin B₁₂ has been through your blood, to literally test the level of B₁₂ in your blood.  However, this method of testing has proven to be not very accurate of the actual levels in your body, or what is actually available in your tissues and cells.  Instead, newer and much more accurate and sensitive ways to test your functional level of tissue-containing B₁₂ is through specific additional tests, for what is called “methylmalonic acid” (MMA) and for “homocysteine.”  These are substances that build up in your blood if there isn’t enough functional vitamin B₁₂ in your tissues.  Many studies have shown that including MMA and homocysteine tests would be a much more effective way to confirm vitamin B₁₂ sufficiency.

More people are deficient in vitamin B₁₂ than we think

A 2009 case report appearing in Practical Neurology, from Oxford University’s Department of Neurology refers to a person who developed significant brain and spinal cord neurological damage, due to delayed detection of vitamin B₁₂ deficiency, having relied on the standard method of serum vitamin B₁₂ testing.  Once this patient finally received a series of vitamin B₁₂ injections, after testing with the MMA marker, the symptoms reversed.  It makes you wonder how many people are suffering with such profound neurological damage due to outdated methods of testing.  Other research has shown that the MMA test can predict which patients with poor cognitive function will decline faster; other studies have also shown the benefit of a neurologically active form of vitamin B₁₂, called methylcobalamin, in some children with Autism and schizophrenia.

In my naturopathic practice, I suspect a vitamin B₁₂ functional deficiency in about one-third of my patients (keep in mind that some of the same vitamin B₁₂ deficiency symptoms can also be explained by the effect of pesticides or solvents on the nerves). Often, I use a B₁₂ ‘challenge’ test, or a ‘therapeutic trial’ where I administer an intramuscular injection of preservative-free vitamin B₁₂, and wait up to two days for a response.  Often patients will tell me that their energy significantly improved, the ‘black cloud’ (representing their mood) cleared up, they slept better, their mind felt a bit sharper, or some other specific improvement.  Usually you would need a few injections to correct the deficiency, or a few months of sublingual B12 supplementation, to notice a lasting improvement.

Of course, determining the underlying cause of the vitamin B₁₂ deficiency is important.  Is it related to an inadequate vegetarian diet, maldigestion of food, low intestinal absorption, blood-glucose regulating medications or stomach-acid suppressing medications (since you require sufficient stomach acid to ensure vitamin B₁₂ absorption into the body).

Is B12 absorbed from mulitvitamins?

Yes and no.  If you have healthy digestive function, then the answer is likely yes.  However, if you experience signs of poor digestion (bloating, abdominal discomfort or pain, H. pylori infection) then you likely have a reduced level of digestion and less absorptive capacity for vitamin B12.  As we age, our natural digestive functions decline gradually and so does our ability to absorb vitamin B12 – this is why it is so commonly low in older adults (though I’ve found many adolescents and children and even infants to be low as well).

Vitamin B₁₂ is a fascinating essential factor in our health.  It is likely that many people are low in this vitamin but are not aware of it themselves, or to their doctors.  In time, I expect the methylmalonic acid and homocysteine tests will likely complement or replace the inadequate serum vitamin B₁₂ test, as a more accurate method of testing vitamin B₁₂ levels; learn more about accurately diagnosing B12 deficiency. You can call the office to book a Vitamin B12 Screening Visit for testing and possible treatment – 905-597-7201.

Rahim is a registered naturopathic doctor who has a general family practice, with a special interest in helping patients comprehensively detoxify their bodies for preventative and therapeutic benefit.  He also has a special interest in children’s learning and behavioural health, and chronic conditions in adults.  He is the director of the Four Seasons Naturopathic Clinic for Detoxification and Healing and can be reached at 905-597-7201 or www.FamilyNaturopath.ca.