B12 Deficiency And Hypothyroidism

[Louisa]

Read this everyone..
Vitamin B-12 warning: Avoid cyanocobalamin, take only methylcobalamin

 

[LucH]

The same warning with folate. Gene defect to metabolize cobalamin and folate.
1 in 2 people have some form of MTHFR defect, folic acid is not the best form of folate to use. The best form of folate to use is methyl folate which is now readily available by prescription and over the counter. At times, folinic acid, another form of quality folate, is recommended.
See details in "Methylation, MTHFR and Thyroid Dysfunction" By Benjamin Lynch, ND.
Link on demand.
Note: The defect may be partial (30 - 70 %)

 

[Amazoniac]

Dermatologic manifestations:

• http://www.tandfonline.com/doi/abs/10.3109/15569527.2013.861477?journalCode=icot20

Ear ringing ameliorated after b12 repletion:

• http://www.sciencedirect.com/science/article/pii/019607099390046A

Not much to comment except that pboy is the CEO of earth:

• An Error Occurred Setting Your User Cookie

Jaundice is mentioned, and it's expected since it's a cofactor for vitamin A metabolism. Excess of vitamin A or carotenoids use b12 stores:

• Update on Vitamin B12 Deficiency - American Family Physician

Tongue and other oral manifestations:

• Oral signs and symptoms in patients with undiagnosed vitamin B12 deficiency
• http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.574.3496&rep=rep1&type=pdf
• http://www.jaad.org/article/S0190-9622(08)01149-3/abstract

Blood levels can be misleading, check references:

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934218/

Deficiency (even if marginal) and cognition:

• http://home.kpn.nl/hindrikdejong/ActaPsychiatrica-2003.pdf

Bacterial overgrowth in the lower small intestine causes malabsorption of b12, I think that it's the place where it's mostly absorbed:

• http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2141.1986.tb02894.x/abstract
• https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2015/11/zaidelarticle-July-03.pdf

Antibiotics assisting repletion:

• http://annals.org/aim/article/688366/small-intestinal-function-vitamin-b-12-deficiency

Interaction with nitric oxide:

• http://www.tandfonline.com/doi/abs/10.1300/J092v08n02_04

It's not known exactly/discussed but it's tied to strong and unpleasant body odor that corrects itself along with the repletion:

• http://orthomolecular.org/nutrients/b12.html

And I already commented that gelatin in excess might require extra b12:

• https://raypeatforum.com/community/...elatin-might-require-extra-vitamin-b12.13884/

 

[beachbum]

Then how would can you explain my b12 on lab report flagged high and my antibodies flagged high as well. My t3,4, tsh were normal range.

 

[Amazoniac]

So, members that, like me, finish reading a line and proceed reading the same line;
The following book is the one that he mentions in almost every post. Since he didn’t offer any reference in that brief video, I decided to check if he got most of that information from his usual source, and indeed, most of what he commented is there:

Wolters Kluwer - Modern Nutrition in Health and Disease

The intensive absorption (that they refer to as Intrisic Factor-dependent) is the way that we absorb most of our b12, and that’s the efficient process that saturates with “doses larger than a few micrograms”. So, even if you eat meals that are rich in b12, you won’t get much more that; it’s more about consistency, than single and occasional colossal loads. It also explains why he commented that a large dose will provide you more or less just enough for a day, and if you exceed your needs in every meal, you can slowly start to store. Food-bound cobalamin freeing and use also depends on a digestive chain, which is why he suggests to spread the intake throughout the daily meals.

The uniqueness of active cobalamin absorption resides in an IF-mediated system of limited capacity that maximizes the bioavailability of ingested cobalamin, whether free or food-bound, while simultaneously preventing excess absorption, perhaps especially to exclude nonfunctional or even harmful corrinoid analogs.

More than 50% of the cobalamin in a typical meal will be absorbed actively if the IF system, which includes IF and its uptake system, is intact. However, IF cannot accommodate much more than 2 mcg cobalamin at a time (Table 27.2[*]). Larger doses, such as those found in many supplements, exceed the capacity of the IF system. The excess cobalamin then becomes dependent on passive, nonspecific absorption, which is much less efficient (1% to 2% of the dose is absorbed) even though it is nonsaturable and linearly related to the amount of cobalamin presented.

The estimated daily loss of 1 mcg cobalamin is minute when compared with the body stores of approximately 2500 mcg (17, 64). This large disparity explains why depletion of body stores takes years and why clinically apparent cobalamin deficiency, as opposed to SCCD [sub-clinical cobalamin deficiency], only infrequently arises because of poor dietary intake. Bioavailability approximates 50% at usual intake levels (see Table 27.2[*]), and this explains the recommended dietary allowance of 2.4 mcg.

So the credit goes not only to him, but also to the authors of the book for condensing a lot of good information. The book is as big as burtlan's balls of steel.

*

You can see how getting more than 2mcg per meal is as hard as asking pboy on a weekend date, no matter how much you ingested.
Column B shows those that have impaired digestion and rely on the passive and inefficient absorption only.

 

[Honest2Pete]

"It is known that the total amount of vitamin B12 absorbed increases with vitamin B12 intake but that the percentage absorption decreases with increasing doses [13]. One study using vitamin B12 crystalline supplements reported that 50% was retained at a 1 mcg dosage, 20% at a 5 mcg dose and 5% at a 25 mcg dose suggesting saturation of the absorption mechanism [14]. The absorption capacity is thought to return to baseline levels at 4-6 hours allowing sufficient absorption of the next dose [11]. Approximately 1% of large doses of crystalline B12 found in some supplements (1,000 mcg), are absorbed through a mass action process, even in the absence of IF [15], indicating crystalline vitamin B12 in high doses and food vitamin B12 are absorbed through different mechanisms."

From the ncbi.nlm.nih.gov articles. (As a new member I cannot post links yet).

 

[misery guts]

Transdermal B12 oils

The OP in that thread seems quite useful. I'm getting pretty fed up with the 5000mcg Jarrows... 2 hours of a chunky pill slowly dissolving on your upper lip/gum. The oils aren't cheap though :/

 

[misery guts]

Speaking of b12!

@tyw you recently mentioned the methylation support you use, and it didn't include b12. Would really appreciate if you could give the reason(s) for why. I noticed a source you are fond of has it recommended under Interventions (1) at the bottom - Aging, health and disease – view from the DNA Methylome | AGINGSCIENCES™ – Anti-Aging Firewalls™

 

[Honest2Pete]

Plus the Jarrows has Silicon as an ingredient, a no-no on Peat's excipient list.

 

[tyw]

Speaking of b12!

@tyw you recently mentioned the methylation support you use, and it didn't include b12. Would really appreciate if you could give the reason(s) for why. I noticed a source you are fond of has it recommended under Interventions (1) at the bottom - Aging, health and disease – view from the DNA Methylome | AGINGSCIENCES™ – Anti-Aging Firewalls™

That's because B12 supplementation:

(a) needs to be tailored to the individual's requirements (eg: presence of different SNP polymorphisms will require different forms and dosage of B12)
(b) not necessary in many cases (though needed in other cases)
(c) can cause imbalances in the status of other mineral (lithium is often implicated)

I personally have not, and still do not need B12. Other people may be different.

.....

 

[misery guts]

Thanks :3

 

[Amazoniac]

ARE U.S. LOWER NORMAL B12 LIMITS TOO LOW? - Goodman - 2015 - Journal of the American Geriatrics Society - Wiley Online Library

Reported is a single case study of a dementia in an 85-year old white male with "normal" B12 values reversed with intermuscular B12 injections. A.S., an 85-year-old, lefthand dominant, white male with a 10-year history of controlled hypertension, presented with memory slippages and lethargy that developed gradually for 2 years.

The serum vitamin B12 level was 368 (pg/mL), which is well within normal range, and was found reliable on repeated analyses.

[Our] patterns of findings were inconsistent with an Alzheimer's dementia because of the intact frontal lobe functioning, but rather they were suggestive of a global/metabolically induced dementia. In addition, our previous NCAs [neurocognitive assessments] have demonstrated a similar pattern of results and deficits in four other geriatric patients treated successfully and reversed with intramuscular B12 , despite "normal" serum vitamin B12 levels.

With a working diagnosis of B12 deficiency, the patient received intramuscular [daily] supplementation [and his] mental status improved gradually. [..] Lethargy and cognitive slowing had disappeared, and he was now taking the initiative in conversation.

These reported NCA deficits have proved to be a consistent pattern in identifying four previous, similar cases of reversible (350-400 pg/mL) vitamin B12 dementias in our clinic.

As with other reports.l-3 this case supports the notion that mental manifestation of B12 deficiency can precede hematologic abnormalities. A IV-stage model of the development of B12 deficiency has suggested that myelin or other neurological damage can occur in the first two stages when B12 levels can still be within the "normal" range."

The current lower normal parameter limit of 200 pg/mL used in the United States is based on hematological criteria," and should not be accepted automatically when encountering a psychiatric/dementia-like disorder. In fact, the lower limits of vitamin B12 in Japan and some European countries are 500-550 pg/mL,7,8 which are based on neurological criteria.

A reassessment of United States normal serum vitamin B12 levels based on neurological criteria with age and gender norms may be warranted.

 

[Amazoniac]

A long time ago, I think it was year two (bp.*), I went to an endocrinologist that had a specialization in nutrition to ask for a lab test to evaluate b12 levels.
- How can I help you?
- I want to check if my b12 levels are good.
- Ok, but why b12?
- I haven't been eating much meat lately.
- So..?
- What do you mean?
- What it has to do with the exam?
- Aren't meats the main sources of b12?
- Really? <looks away puzzled and paused> <resumes contemplation, opens his browser in front of me and checks> - No way, indeed!
- ??
And so I did the exam. As soon as the result was released I checked, the value was fine, within the acceptable range. "It must be in my head then".
The doctor asked me to return to his office. After arriving he checked the exam and replied: the value is fine, anything else that I can help you with? He was being paid by the insurance company for every return, regardless of the length of the visit.

It was the first time that I confirmed my suspicion that only a few doctors know what they're doing.

The lab considered deficiencies only values lower than 81pg/mL.

--
Vitamin B12 in meat and dairy products. - PubMed - NCBI

--

Deficiency of water-soluble vitamins, especially group B vitamins, is common in cirrhosis

Vitamin B12 deficiency is mainly related to the decrease of its liver reserves. Serum levels may be increased, but tissue levels are decreased.26 This deficiency is associated with anemia, glossitis and neurological symptoms.

*before pboy.

 

[Dante]

A long time ago, I think it was year two (bp.), I went to an endocrinologist that had a specialization in nutrition to ask for a lab test to evaluate b12 levels.
- How can I help you?
- I want to check if my b12 levels are good.
- Ok, but why b12?
- I haven't been eating much meat lately.
- So..?
- What do you mean?
- What it has to do with the exam?
- Aren't meats the main sources of b12?
- Really? <looks away puzzled and paused> <resumes contemplation, opens his browser in front of me and checks> - No way, indeed!
- ??
And so I did the exam. As soon as the result was released I checked, the value was fine, within the acceptable range. "It must be in my head then".
The doctor asked me to return to his office. After arriving he checked the exam and replied: the value is fine, anything else that I can help you with? He was being paid by the insurance company for every return, regardless of the length of the visit.

It was the first time that I confirmed my suspicion that only a few doctors know what they're doing.

The lab considered deficiencies only values lower than 81pg/mL.

--
Vitamin B12 in meat and dairy products. - PubMed - NCBI

--

What if there is insufficient cobalt in the soil(in that way even animals can't make enough B12), it's the cobalt that makes it special right ? (I have a suspicion that broiler feed and generic feed for animals don't contain that much cobalt,hence people have low levels despite eating meat) .

 

[Amazoniac]

What if there is insufficient cobalt in the soil(in that way even animals can't make enough B12), it's the cobalt that makes it special right ? (I have a suspicion that broiler feed and generic feed for animals don't contain that much cobalt,hence people have low levels despite eating meat) .

Speaking of Metallica, I'm not sure but I think that an excess of metals, especially heavy metals in soil interfere with cobalt incorporation, affecting animals later on.

 

[Birdie]

I use the bioalternatives liquid that Jennifer mentioned. For many years I've used injections. My first experience with B12 was back during pregnancy. I had severe sciatica. My doctor gave me B12 injections which resolved it.

I seem to recall hearing or reading Ray saying that he didn't think a lot of methyl type supplements. Now, I feel less confident that they are best. Anybody remember his reasoning on that?

There is another type of B12 injectible I've used. Hydroxycobalamin. I may get that again.

Also remember Ray's saying that the injections can be a problem due to the benzocaine preservative. You gradually get an indentation at the injection cite. I have a couple.

 

[Birdie]

Just remembered that I tried the B12 patches a few years back and had a strong allergic reaction. I'd just used a small part of the patch fortunately. It was a methyl type, but other methyl types never bothered me. Must have been some excipient.

 

[Amazoniac]

https://chrismasterjohnphd.com/2016...thing-about-methylation-facebook-live-062516/

"I think it’s borderline outrageous that [serum B12 is] used for routine screening of vitamin B12 deficiency. I would support looking at –I don’t think holotranscobalamin II is ready commercially, if it is, that’s good– I definitely know that you could get methylmalonic acid or maybe they call it methylmalonyl CoA, MMA, various names, it’s all the same thing. That’s a functional marker of vitamin B12 deficiency. If it’s high then vitamin B12 status is poor. And that’s really important because, like, high B12 in the blood, it’s sort of like, who cares – maybe you have a backup in utilization of that B12." "I would strongly suggest that you measure MMA – and I don’t mean mixed martial arts, I mean methylmalonic acid. I would strongly suggest measuring as a functional marker of B12 status."

"I see people come back with high serum B12 and it’s like: "oh, stop taking B12 or whatever". So first of all, if you want to know anything about your B12 status, measure MMA. If it’s available, holotranscobalamin II."

@Lucas
@Jennifer @Travis - ..when people ask you about your last blood B12 levels.

 

[Jennifer]

Thanks, @Amazoniac! I get MMA tests regularly. Three years vegan without supplementation and so far so good. Hopefully this continues past the five year mark.

A long time ago, I went to an endocrinologist that had a specialization in nutrition to ask for a lab test to evaluate b12 levels.

- Aren't meats the main sources of b12?
- Really? <looks away puzzled and paused> <resumes contemplation, opens his browser in front of me and checks> - No way, indeed!

WOW. Just wow. *shakes head*

 

[Lucas]

Yes, I have high b12 without supplementing and also my serum MMA is high, above the reference range.

The problem is that I can’t tolerate methyl b12 supplements, it makes me worse, more tired, dizzy, etc.