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Vitamin B12: Surprising New Findings

December 2000

By Terri Mitchell

H. Pylori and vitamin B12 deficiency

Researchers have discovered a connection between anemia, B12 deficiency, and infection with H. Pylori, the organism that causes stomach ulcers. The study enrolled 138 people with B12 deficiency and anemia. Fifty-six percent of them tested positive for H. Pylori. Many had no symptoms; others had “heartburn” or other stomach problems.

When the bacteria were eradicated with antibiotics, vitamin B12 levels returned to normal without supplementation. It took a month for this to occur, and three to six months more for full improvement. In people where the antibiotic treatment didn’t work, anemia and B12 levels didn’t improve. The difference in B12 levels before and after treatment is striking: after treatment, levels were approximately four times higher. H. Pylori may partly explain mysterious studies showing that elderly people are taking in enough B12, but turning up deficient anyway. Older people are prone to atrophic gastritis, a condition where there is not enough acid and pepsin in the stomach to properly digest food. This creates a friendly climate for unfriendly bacteria such as H. Pylori. It also impairs the stomach’s ability to acquire vitamin B12 from food.

People with stomach pain or “heartburn” often take antacids, including drugs such as Prolisec or Prevacid. While these types of drugs temporarily ease the pain, they further suppress acid necessary to maintain B12 levels and proper stomach bacteria. If the stomach is infected with H. Pylori or other pathogenic bacteria (overgrowth of bacteria in the small intestine can cause similar symptoms), the answer is to kill the bug, allow the ulcers to heal, then augment (not suppress) stomach acid with supplements designed to maintain acidity and discourage bacterial growth.

Oral B12 works

Despite what it says on the package insert of injectable B12, oral B12 works. For example, gastrointestinal surgery usually causes B12 depletion and anemia. Japanese researchers used 500-1500 mcg/day of oral B12 to treat B12 deficiency after total gastrectomy. This amount reversed the deficiency quickly and efficiently. B12 blood levels of patients receiving 750+mcg were comparable to patients receiving 500 mcg by injection every two months. Japan has long recognized the benefits of using the methylated form of B12, methylcobalamin. Despite strong evidence that oral B12 is effective, physicians are slow to recommend this form to their patients. A study published in 1998 reports that 71% of the internists surveyed don’t believe that oral B12 works as well as injections.

Widespread deficiency

A new study from Tufts University reports that B12 supplements are the most important source of vitamin B12 for Americans. Those taking supplements or eating cereal supplemented with B12, are half as likely to be B12 deficient than those who don’t. Meat, the primary source of B12 for Americans, is not as good a source. This is probably due to problems in digestion and prescription drugs that interfere with the absorption of B12 when it’s attached to proteins such as meat. Cooking may also affect the vitamin B12 content of meat.

B12 deficiency has gotten so bad in America that the RDA has been increased from 2.0 micrograms a day to 2.4. It’s not only older people who are deficient these days. The Tufts study looked at the children of people who took part in the original Framingham heart study. They were stunned to see that in one generation, B12 deficiency in kids had caught up to the generation before. Pizza, one of the foods evaluated, is apparently not a good source of vitamin B12.

Vegetarians continue to be at risk. The only non-animal sources of B12 presently known are some types of seaweed and fermented foods such as tempeh. Forty percent of participants in one study and almost 50% in another (vegan) study were B12 (and iron) deficient. This may have consequences for immunity. In a study from Japan, B12 deficiency caused serious changes in immunity, including lower natural killer cell activity and skewed T-cell balance. Natural killer cells are important for destroying viruses and cancer. Abnormal T-cell balances show up in autoimmune diseases and HIV infection.

Methylcobalamin (B12) and immunity
Methylcobalamin (B12) and immunity

Methylcobalamin enhances the activity of natural killer and T-cells. These immune cells are important for killing cancer and viruses. Japanese researchers have discovered that ratio of T-helper cells to T-suppressor cells is abnormal in people with anemia. Methylcobalamin corrects this defect. Vegans with B12 deficiency have lowered numbers of immune cells. People infected with HIV are more likely to get AIDS if their B12 levels are low, irrespective of whether they take antiviral drugs. Methylcobalamin is required for both the synthesis and function of immune cells. In a study on people with low tissue levels of B12, methionine synthetase activity was very low, indicating that very few immune cells were being synthesized. Treatment with methylcobalamin restored immunity almost immediately.

Hadded EH, et al. 1999. Dietary intake and biochemical, hematologic, and immune status of vegans compared with nonvegetarians. Am J Clin Nutr 70(3 Suppl):586S-93S.

Hall CA, et al. 1986. Methionine synthetase activity of human lymphocytes both replete in and depleted of vitamin B12. J Lab Clin Med 108:325-31.

Tamura J, et al. 1999. Immunomodulation by vitamin B12: augmentation of CD8+ T lymphocytes and natural killer (NK) cell activityin vitamin B12-deficient patients by methyl-B12 tratment. Clin Exp Immunol 116:28-32.

Tang AM, et al. 1997. Low serum vitamin B-12 concentrations are associated with faster human immunodeficiency virus type 1 (HIV-1) disease progression. J Nutr 127:345-51.

Symptoms of deficiency

Other than anemia, the symptoms of B12 deficiency are rarely documented. Researchers involved in the gastrectomy study above took the uncommon step of doing an in-depth analysis of the symptoms of B12 deficiency. They found that lassitude (exhaustion), fatigability (tiring easily), chills (cold hands and feet), numbness in the extremeties (no feeling in arm, leg, foot), dizziness, glossitis (painful tongue), leukoplakia (white spots on the tongue) and erectile dysfunction were symptoms of B12 deficiency.

Although the body needs minute amounts of vitamin B12, Americans are not getting enough for general health, let alone optimal DNA and heart protection. H. Pylori infection, drugs, over-cooking meat, increased demand and other factors may be robbing us of this highly crucial vitamin. The mistaken belief that B12 has to be given by injection may be keeping people from getting the extra B12 they need. High amounts of the vitamin are not toxic; and may in fact be more beneficial than we currently know. Evidence is stacking up that amounts of vitamin B12 above and beyond the current recommended daily allowance may help protect nerves and protect us from cancer, infections and a host of other adverse conditions.