Could you be at risk of B12 deficiency? For decades it was thought that the risk was limited to the elderly and those on a diet free of animal source foods. However, more recent research by Sally Pacholok, R.N., B.S.N. and Jeffrey Stuart, D.O. as reported in their book, Could It Be B12? An Epidemic of Misdiagnoses, has demonstrated that B12 deficiency is a silent crippler that involves people of every age and every walk of life. You cannot afford to be ignorant of the prevalence of this deficiency and the lack of proper testing by the medical community. Undiagnosed B12 deficiency can have a devastating impact on your family. Find out why blood tests for B12 are not accurate, how to really test your B12, and how to overcome a deficiency.
What Are B12 Deficiency Levels?
The standard medical evaluation for B12 levels is by way of a blood test to determine the serum B12 levels. Normal blood levels are considered to be 200 – 900 pg/mL (pictograms per milliliter). Deficiency is normally diagnosed with serum levels below 200.
Sally Pacholok, co-author of Could It Be B12? An Epidemic of Misdiagnoses indicates that deficiencies begin to appear in cerebral spinal fluid with B12 levels below 550 pg/mL and suggests that normal serum B12 levels should be greater than 550 pg/mL. She further suggests that in older adults for prevention of disease and to maintain brain and nervous system health, serum B12 levels should be maintained near or above 1,000 pg/ml.
Back in 2000, when I completed my research on the B12 status of the select group on The Hallelujah Diet, I suggested the blood test for B12 was not adequate and recommended the MMA (methylmalonic acid) test of the urine. According to Dr. Eric Norman of Norma Clinical Lab, MMA is 40 times more concentrated in the urine than the blood and is the preferred test for ruling out a B12 deficiency when serum levels are questionable. As blood levels of B12 decrease, MMA levels of the urine increase. Urinary MMA levels should be less than 3.8 mcg/mg creatinine. Elevated levels of homocysteine (Hcy) in the plasma may indicate a vitamin B12, vitamin B6 or folate deficiency.
While the Hcy test is not necessary in evaluating a B12 deficiency, it can be a valuable adjunct when deficiency is suspected. Many B12 deficient patients will have elevated levels of homocysteine and be at greater risk of heart disease.
B12 Deficiency — Do You Have It?The prevalence of B12 deficiency is underestimated due to reliance on what is considered “normal” serum levels. Soon, we'll review the fallacy and tragedies of relying on this test alone.
“Tufts University researchers, analyzing data from the large-scale Framingham Offspring Study, found that nearly 40 percent of participants between the ages of 26 and 83 had plasma B12 levels in the “low normal” range – a level at which many people begin experiencing neurological symptoms. Nearly 9 percent had outright deficiency, and 16 percent exhibited near-deficiency. Remarkably, low serum B12 was as common in younger participants as in the elderly.” ~ Could It be B12? An Epidemic of Misdiagnoses by Pacholok and StuartIn August 2000, the Annals of Nutrition & Metabolism reported the results of the B12 study I conducted as Hallelujah Acres researcher. In this study, 49 participants who had followed The Hallelujah Diet for at least two years were evaluated with 49% showing elevated urine MMA (methylmalonic acid) indicative of B12 deficiency. Other studies suggest that over 80 percent of long-term vegans and 50 percent of long-term vegetarians without adequate B12 supplementation show evidence of deficiency.
“This crippler is a master of masquerade, striking different people in different ways. It afflicts one person with tremors, makes another depressed or psychotic, and causes agonizing leg and arm pains or paralysis in still another. It can mimic Alzheimer’s disease, multiple sclerosis, early Parkinson’s disease, diabetic neuropathy, or chronic fatigue syndrome. It can make both men and women infertile, or cause developmental disabilities in their children. Other times, it lurks silently, stealthily increasing its victims’ risk of deadly diseases, ranging from strokes and heart attacks to cancer.” ~ Could It be B12? An Epidemic of Misdiagnoses by Pacholok and Stuart
Conditions Associated with B12 DeficiencyVarious body systems may manifest symptoms that are related to an underlying B12 deficiency. More often than not the deficiency goes undiagnosed due to the standard utilization of serum B12 levels as the primary diagnostic tool.
Neurological symptoms such as: numbness, tingling, and/or burning sensations in arms and/or legs; difficulty walking, falling, weakness, tremors and paralysis; confusion, forgetfulness, dementia, depression, and mental illness; incontinence, impotence, headaches, and vision loss may have an underlying B12 deficiency as a root cause.
Symptoms associated with disorders of the blood may include: fatigue, anemia, shortness of breath, enlarged spleen or liver and enlarged red blood cells (macrocytes). When the immune system is impacted, one may be at increased risk of infection, poor wound healing and increased cancer risk. If the cardiovascular system is impacted, one might experience heart attack, blood clots, stroke or coronary artery disease. Impotence and infertility may also be related to B12 deficiency. With the broad array of body systems that rely on B12, one can readily see how important it is to properly evaluate and maintain the body’s B12 levels when symptoms of ill health manifest.
Overcoming B12 Deficiency
If a person is dealing with unresolved issues, experiencing symptoms that could be related to a B12 deficiency, it is wise to have B12 levels evaluated prior to supplementing with B12. Otherwise, if supplementation is started, there will be no way to accurately evaluate levels and know if the issues were B12 related or not. If a person is using a B12 supplement and experiencing what may be symptoms related to deficiency, a comprehensive B12 test may help determine if the current B12 supplementation is inadequate.
For significant or long-standing B12 deficiencies, intramuscular injections are the most efficient way of overcoming the deficiency. The injections need to be individualized as some people may be OK with monthly injections while others may require bi-monthly or even weekly injections. When more frequent injections are necessary, an individual may get a prescription from the doctor and administer their own injections.
The preferred form of B12 is the active form methylcobalamin (available without preservatives at compounding pharmacies). It is not widely used in the U.S. If methylcobalamin is not readily available, hydroxocobalamin would be an option that is still superior to the typical form, cyanocobalamin. Oral supplementation with methylcobalamin sublingually may be sufficient for many folks in overcoming a deficiency. The Hallelujah Diet B12, B6 & Folate supplement is a great option in maintaining B12 status once a deficiency is overcome. It should be noted that oral supplementation with an oral, sublingual B12/B6/Folate can help support a more optimal (lower) homocysteine level - elevated homocysteine is associated with cardiovascular disease.
I strongly encourage reading the book Could It Be B12? to grasp a much greater understanding of the potential for B12 deficiency, especially in people over the age of 40 regardless of diet. There are many factors apart from diet that can impact this devastating, silent crippler that is so easily preventable. Two Ways To Get Your B12! Both Hallelujah Diet's B12, B6 & Folate - B Vitamin Supplements and B-Flax-D Fiber supplements contain over 16,000% daily value of B12 (methylcobalamin) per serving!