The Importance of Vitamin B-12

27 Apr 2018

Vitamin B-12 Deficiency

Are you or do you know of anyone who is vitamin B-12 deficient? And, why does it matter? I can tell you that when I was a young doctor, I had a patient who was hospitalized because he could not feel his feet when he walked. I was on a Neurology rotation at the time and it was my job to find out what was causing his neuropathy. It turns out that he was profoundly vitamin B-12 deficient and with treatment, much of the neuropathy reversed itself. He was left with some residual numbness but he could feel his feet again.
This is a profound case of vitamin B-12 deficiency but more and more of us are developing this deficiency annually; over a million of us. And, the percentage of Americans affected is now around 15%. That is one in seven individuals. I diagnose a new case of vitamin B-12 deficiency at least weekly where I rarely saw a case in my sophomore years of medical practice. What’s more, we are seeing this deficiency in more young people. Why?
Well, it all starts with where vitamin B-12 is found naturally in foods. Meats such as fish, beef, pork, poultry and other red meats, eggs, milk and milk products are the primary source of this essential vitamin. Fortunately, this is a fat-soluble vitamin and our bodies have the ability to store up excess quantities for the days we do not consume it. By the way, no plants contain enough vitamin B-12 to sustain us.
We need about 2.4 micrograms of vitamin B-12 per day. I made up a small chart of foods that are high in vitamin B-12.

Where do we find Vitamin B-12 in our diet?
Salmon: 4.8 micrograms (mcgm) per 3 ounce serving
Trout: 5.4 mcgm per 3 ounce serving
Tuna: 2.5 mcgm per 3 ounce serving
Steak: 2.4 mcgm per 6 ounce serving
Chicken breast: 0.6 mcgm per 6 ounce serving (white meat)
Milk: 1.2 mcgm per cup
Egg: 0.6 mcgm per egg
Cheese: 0.9 mcgm per slice

As you can see from this list, you would need to a pound and a half of chicken breast to get enough vitamin B-12 from this source.  You would need to eat about four eggs or drink two cups of milk.  The goodness is that if you consume several foods containing vitamin B-12, you will probably acquire enough to meet your body’s needs.

Vitamin B-12 deficiency leads to:
Anemia
Fatigue
Constipation
Weight loss
Weakness
Loss of appetite
Neuropathy in the extremities
Poor balance
Depression
Confusion
Dementia
Poor memory
Sore tongue/mouth

Individuals who are at risk for developing vitamin B-12 deficiency include the those who may be suffering from or affected by the following:

Chronic gastritis
Autoimmune gastritis
Celiac Disease
Crohn’s disease
Gastric bypass surgery
Vegan diet
Vegetarian diet
Cardiac Disease from the Metabolic Syndrome (elevated homocysteine levels)

Lack of Vitamin B-12 in our Diet

One of the primary reasons why we are seeing so many individuals being diagnosed with vitamin B-12 deficiency is because of the Western diet. We have been instructed to avoid red meats (the primary source of vitamin B-12). We have been advised to avoid eating seafood (a great source of vitamin B-12) due to heavy metal toxicity or it is too expensive to serve with any regularity. We have been advised to avoid saturated fats (there go the eggs and cheese). The primary meat on the dining room table today is chicken breast and it contains very little vitamin B-12 as you can see from the chart above.

Fruits, vegetables and grains do not contain any appreciable vitamin B-12 and these foods, along with boneless, skinless chicken breast, now make up the vast majority of our daily caloric intake. Additionally, we are seeing more and more vegans and vegetarians who are avoiding all the primary sources of vitamin B-12 in their diets.

What are we to do? I advise patients to take a sublingual vitamin B-12 supplement (one 1000 microgram tablet) once per week to guarantee adequate intake of this very important vitamin. Even though that seems like such a high dose, we only absorb about 20 micrograms out of that 1000 micrograms. Luckily, we can store it up for the days we don’t get any in our diet or take a supplement. Having extra vitamin B-12 stored in our bodies does not seem to have any known adverse issues for us.

Finally, get a blood test once every year or two to make sure you are getting enough vitamin B-12. Once, you have developed dementia or peripheral neuropathy from this deficiency, some of the nerve damage is not reversible. Prevention is key. I hope this is helpful for you.
Dr. M. Frank Lyons