B12

B12 notes

From: https://pastebin.com/HzkBxgBd

Summary

• Methylcobalamin works better.
• List of symptoms. http://fitnessedge.net/lipotropic-injections/b-complex/b12-injections-health-weight-loss-benefits/

My symptoms:

• Fatigue for 30+ years.
• Memory problems for 30+ years.
• Oral B12 shows no improvement.
• Weight gain might be related to low B12.
• Depression and anxiety. (Currently taking meds for these.)
• Dermatitis (scalp).
• Occasional dizziness, 3-5x per week.
• Frequent tremor.
• Irritability.

Studies

1. Shipton MJ, Thachil J. Vitamin B12 deficiency - A 21st century perspective. Clin Med (Lond). 2015 Apr;15(2):145-50. doi: 10.7861/clinmedicine.15-2-145. Review. PubMed PMID: 25824066. https://www.ncbi.nlm.nih.gov/pubmed/25710280
   • Vitamin B12 deficiency is a common condition which can present with non-specific clinical features, and in severe cases with neurological or haematological abnormalities. Although classically caused by pernicious anaemia, this condition now accounts for a minority of cases and vitamin B12 deficiency occurs most often due to food-bound cobalamin malabsorption. Since missing the diagnosis can result in potentially severe complications, including degeneration of the spinal cord and pancytopaenia, vitamin B12 deficiency must be diagnosed early and managed appropriately. Intramuscular injections have been the mainstay of treatment, but oral replacement therapy can be effective in many cases. There is accumulating evidence that high vitamin B12 levels (values varied from 350-1,200 pmol/l) are associated with haematological and hepatic disorders, in particular with malignancy. This review focuses on the developments in the clinical features and management of vitamin B12 deficiency over the last decade.
2. Dharmarajan TS, Adiga GU, Norkus EP. Vitamin B12 deficiency. Recognizing subtle symptoms in older adults. Geriatrics. 2003 Mar;58(3):30-4, 37-8. Review. PubMed PMID: 12650116. https://www.ncbi.nlm.nih.gov/pubmed/12650116
   • Vitamin B12 deficiency is a common but under-recognized, yet easily treatable disorder in older adults. Although several causes exist, food-cobalamin malabsorption is now believed to be the most common etiology. Complications of vitamin B12 deficiency are myriad, ranging from lethargy and weight loss to dementia. Causes of deficiency include failure to separate vitamin B12 from food protein, inadequate ingestion, absorption, utilization, and storage as well as drug-food interactions leading to malabsorption and metabolic inactivation. The roles of B12 deficiency, elevated homocysteine and elevated methylmalonic acid in various disease states are still evolving. Timely screening and replacement of vitamin B12 will help prevent many complications.
3. Oh R, Brown DL. Vitamin B12 deficiency. Am Fam Physician. 2003 Mar 1;67(5):979-86. Review. PubMed PMID: 12643357. https://www.ncbi.nlm.nih.gov/pubmed/12643357
   • Vitamin B12 (cobalamin) deficiency is a common cause of macrocytic anemia and has been implicated in a spectrum of neuropsychiatric disorders. The role of B12 deficiency in hyperhomocysteinemia and the promotion of atherosclerosis is only now being explored. Diagnosis of vitamin B12 deficiency is typically based on measurement of serum vitamin B12 levels; however, about 50 percent of patients with subclinical disease have normal B12 levels. A more sensitive method of screening for vitamin B12 deficiency is measurement of serum methylmalonic acid and homocysteine levels, which are increased early in vitamin B12 deficiency. Use of the Schilling test for detection of pernicious anemia has been supplanted for the most part by serologic testing for parietal cell and intrinsic factor antibodies.
4. Hannibal L, Lysne V, Bjørke-Monsen AL, Behringer S, Grünert SC, Spiekerkoetter U, Jacobsen DW, Blom HJ. Biomarkers and Algorithms for the Diagnosis of Vitamin B12 Deficiency. Front Mol Biosci. 2016 Jun 27;3:27. doi: 10.3389/fmolb.2016.00027. eCollection 2016. Review. PubMed PMID: 27446930; PubMed Central PMCID: PMC4921487. https://www.ncbi.nlm.nih.gov/pubmed/27446930
   • Vitamin B12 (cobalamin, Cbl, B12) is an indispensable water-soluble micronutrient that serves as a coenzyme for cytosolic methionine synthase (MS) and mitochondrial methylmalonyl-CoA mutase (MCM). Deficiency of Cbl, whether nutritional or due to inborn errors of Cbl metabolism, inactivate MS and MCM leading to the accumulation of homocysteine (Hcy) and methylmalonic acid (MMA), respectively. In conjunction with total B12 and its bioactive protein-bound form, holo-transcobalamin (holo-TC), Hcy, and MMA are the preferred serum biomarkers utilized to determine B12 status. Clinically, vitamin B12 deficiency leads to neurological deterioration and megaloblastic anemia, and, if left untreated, to death. Subclinical vitamin B12 deficiency (usually defined as a total serum B12 of <200 pmol/L) presents asymptomatically or with rather subtle generic symptoms that oftentimes are mistakenly ascribed to unrelated disorders. Numerous studies have now established that serum vitamin B12 has limited diagnostic value as a stand-alone marker. Low serum levels of vitamin B12 not always represent deficiency, and likewise, severe functional deficiency of the micronutrient has been documented in the presence of normal and even high levels of serum vitamin B12. This review discusses the usefulness and limitations of current biomarkers of B12 status in newborn screening, infant and adult diagnostics, the algorithms utilized to diagnose B12 deficiency and unusual findings of vitamin B12 status in various human disorders.
5. Brescoll J, Daveluy S. A review of vitamin B12 in dermatology. Am J Clin Dermatol. 2015 Feb;16(1):27-33. doi: 0.1007/s40257-014-0107-3. Review. PubMed PMID: 25559140. https://www.ncbi.nlm.nih.gov/pubmed/25559140
   • Vitamin B12, also known as cobalamin, is a water-soluble vitamin that is important in the hematological and nervous systems, and it has a complex relationship with the skin. Altered cobalamin levels can lead to dermatological manifestations, which may indicate a deficiency or excess of this vitamin. The biochemistry and metabolism of cobalamin is complex, and diseases can be associated with alterations of this metabolic pathway. The cutaneous manifestations of cobalamin deficiency include hyperpigmentation (most commonly); hair and nail changes; and oral changes, including glossitis. Additionally, several dermatologic conditions, including vitiligo, aphthous stomatitis, atopic dermatitis, and acne are related to cobalamin excess or deficiency. The cutaneous complications of cobalamin therapy include acne, rosacea, and allergic site reactions, or anaphylaxis with cobalamin injections. As cobalt is a component of cobalamin, patients with cobalt sensitivity have been reported to have cutaneous manifestations when receiving cobalamin replacement therapy.
6. Solomon LR. Vitamin B12-responsive neuropathies: A case series. Nutr Neurosci. 2016 May;19(4):162-8. doi: 10.1179/1476830515Y.0000000006. Epub 2015 Feb 24. PubMed PMID: 25710280. https://www.ncbi.nlm.nih.gov/pubmed/25710280
   • OBJECTIVES: Neuropathies often accompany vitamin B12 deficiency. Since many neuropathies are linked to oxidative stress and since B12 has both antioxidant and neurotrophic properties, B12 may also be effective treatment in non-deficient subjects. Thus, the characteristics and predictors of B12-responsive neuropathies and their relationship to disorders associated with increased oxidative stress (oxidant risks) were examined.
   • METHODS: Retrospective review of 78 subjects with neurological abnormalities treated with B12 and evaluated by the measurement of B12 and the B12-dependent metabolites, methylmalonic acid (MMA), and homocysteine.
   • RESULTS: Sixty-five subjects had neurological improvement (83%), including 35 with other known causes of neuropathy. Only two responders had B12-responsive macrocytosis. Pretherapy B12, MMA, and homocysteine values were normal in 72, 33 and 54% of responders, with all three normal in 23%. Moreover, B12 therapy did not significantly decrease elevated MMA and homocysteine levels in 20 and 37%, respectively, of responders tested but did decrease both metabolites in 75% of evaluable non-responders. At least one oxidant risk was present in 41 of the 46 responders with normal B12 levels (89%). Oral therapy was effective, but parenteral B12 improved responses in four subjects.

Misc studies

1. B12 injection and autism. https://www.ncbi.nlm.nih.gov/pubmed/26889605
2. Response to vitamin B12 and folic acid in myalgic encephalomyelitis and fibromyalgia.
   Regland B, Forsmark S, Halaouate L, Matousek M, Peilot B, Zachrisson O, Gottfries CG.
   PLoS One. 2015 Apr 22;10(4):e0124648. doi: 10.1371/journal.pone.0124648. eCollection 2015. https://www.ncbi.nlm.nih.gov/pubmed/25902009
3. Thakkar K, Billa G. Treatment of vitamin B12 deficiency-methylcobalamine? Cyancobalamine? Hydroxocobalamin?-clearing the confusion. Eur J Clin Nutr. 2015 Jan;69(1):1-2. doi: 10.1038/ejcn.2014.165. Epub 2014 Aug 13. PubMed PMID: 25117994. https://www.ncbi.nlm.nih.gov/pubmed/25117994

Sources

1. https://vitaminb12direct.com/shop/my-account/
2. CVS needs prescription. http://www.cvs.com/minuteclinic/services/vaccinations-and-injections/vitamin-b12-injection/N-d8ZbtyzZd5

Weight loss clinic.

1. 877-228-2158. https://www.thehcginstitute.com/grand-rapids/
2. Born Clinic. https://www.bornclinic.com/weight-loss/