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Vitamin B12

Welcome to the Center for Natural and Integrative Medicine Blog.  In order to serve you better we will be posting small articles weekly at this location.  Our topics will include commentary on health news, services we provide, spotlights on our wonderful staff and other general health tips.  As a disclaimer, nothing that is written here should be construed as medical advice and before starting new medications or supplements, it is important that you make the right decisions with your doctor first.  Now that’s out of the way, let’s begin our first topic.


A lot of people believe that when we are trying to improve someone’s health the goal is to simply treat the disease.  Sometimes however, this paradigm can fail many patients.  If your goal is only to treat disease, often problems can be missed because labs or symptoms will not be “bad enough” to warrant an investigation or workup by their doctor.  In many cases, even if labs are ordered, the “normal values” can be so wide that many patients can have symptoms even when their numbers are “normal”. A great example of this is Vitamin B12.


Vitamin B12 deficiency is one of the most common vitamin deficiencies seen.  Vitamin B12 is found in many meats, dairy, fish and eggs.  It is generally not found in plant sources of food unless they are fortified during processing.  The most common symptoms of B12 deficiency include fatigue, nerve numbness or tingling, low blood counts and anemia, memory loss and brain fog, weakness and problems with balance.  I can’t even count the number of patients I see that after supplementing B12 have improvement in a lot of their symptoms.


Given where it is found, many patients who are vegan or strict vegetarian can be low or low normal on B12.  However, many of my patients who are not vegan or vegetarian can have B12 deficiency as well.  Since B12 is absorbed from the GI tract, often, patients who have changes or irritation in the GI tract and small intestine can have low B12 levels.  Those with recurrent food allergies, gluten intolerance, celiac, leaky-gut, crohn’s disease, ulcerative colitis, prolonged use of acid blocking medications all can have issues with B12 absorption.  So, if you suffer from any of the above conditions please makes sure your B12 levels have been monitored by your doctor.


Knowledge of B12 absorption can also give your Doctor a hint of what is going on.  If we know the patient is eating a diet that is high in B12 and if the patient is noted to have low vitamin B12, that can be a hint that there could be an absorption issue in the gut.  So, if we know that the gut is not adequately absorbing B12, relying on oral B12 can sometimes fail.  In our office when we see a patient with B12 deficiency, will then switch to either IV or Injectable B12.  In this way we can correct any B12 deficiency quickly without relying on the GI tract which hasn’t been absorbing the B12 in the first place!


Please join us next week as we explore some other vitamin deficiencies and more complete methods to resolve chronically low vitamin levels.

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