For those of you wanting to eat heart-healthy, it is good to know that fish and seafood can provide both omega-3 fats and a magnificent source of vitamin B12
ONE of the most common nutrient deficiencies I come across in my clinic is B12 – or cobalamin deficiency.
This essential water soluble vitamin plays an essential role in energy production, red and white blood cells' and all cells' DNA production as well as the normal functioning of the nervous system, so it affects every single cell and system in the body - including the immune system.
Its deficiency signs might be vague and often misdiagnosed. You might be tired, pale, get out of breath easily, have tinnitus or whistling in the ear, pins and needles, restless legs, poor balance, recurring mouth ulcers, a red, swollen tongue, burning or itching sensation in the mouth. Some people may only experience low moods and are put on antidepressants to deal with the symptoms and mask the problem. Some evidence also links dementia to low B12 levels – as it is one of the necessary nutrients for normal brain function.
Vitamin B12 is naturally found in animal foods, including meats, fish, poultry, eggs and some also found in dairy. Cobalamin is strongly bound in these foods, so you need a good digestive system with lots of stomach acid to be able to release the vitamin, then a well-balanced intestine to be able to absorb it. The elderly, or those with poor digestion – stomach ulcers, gastritis, heartburn, IBS, SIBO, those with autoimmune disorders affecting the stomach and small intestines and those on acid blocking medications may get easily deficient of B12. Other autoimmune disorders also interfere with B12 metabolism – including thyroid disorders.
Unfortunately, Vitamin B12 levels are not routinely tested – and even if your doctor arranges it for you, the normal range is very wide; between 200 and 1000 ng/mL.
Due to genetic and epigenetic differences some people may need much higher levels than others for their metabolism to work efficiently, in which case a different form of supplementation (methyl-cobalamin) might be necessary on top of ensuring adequate dietary supply and good digestion.
Another way to detect cobalamin – and most nutrient deficiencies, is with a simple urine test that shows your MMA – methylmalonic acid levels. This is a by-product of normal metabolism, which builds up if you are low on vitamin B12. The best routine blood marker is MCV, or mean corpuscular volume, which indicates the size of the red blood cells. If it is larger than 90 – you may benefit from extra B12 and dietary folate from green vegetables.
Either way, the root of the problem, as always, should be found and addressed. It is not enough to supplement, you need to absorb and activate your nutrients; sort out your digestive problems with nutritional therapy. If you produce immune cells against your parietal cells that assist B12 absorption, no amounts of dietary and supplemental B12 can help you – regular injections are needed to bypass the digestive system.
After a few months a special sublingual supplement that dissolves and gets absorbed under the tongue may replace injections – but your levels should be regularly monitored.