Who Might Be At Risk Of A Vitamin B12 Deficiency
Anyone who is unable to eat a varied and balanced diet or whose digestion is compromised, including the elderly, may be more at risk of B12 deficiency. Additionally, people with certain medical conditions, such as coeliac disease and Crohn’s disease, may be unable to absorb adequate B12 from food.
Strict vegans who do not include any fish, poultry, eggs or dairy products in their diet and are not taking vitamin B12 supplements are at increased risk of deficiency. For those eating an exclusively plant-based diet, it is recommended to get B12 levels checked regularly. Vegetarians who do not regularly include dairy in their diet and do not include fortified foods such as plant-based milks and spreads may also be at risk and should see their GP if they are concerned.
Furthermore, women who are pregnant or breastfeeding should consult their GP for guidance if they are concerned that they may be deficient in vitamin B12.
Anyone considering taking a B12 supplement should talk to their GP or associated health professional first.
Tests To Check For Vitamin B12 Deficiency
So what are you supposed to do if you think that you have a problem with low vitamin B12 levels?
Well, the first step is to TEST!
Testing for vitamin B12 will not only tell you if there is enough B12 in your bloodstream but it will also help you to know if your body is actually using that B12 .
And while you may think it’s as easy as just checking your serum B12 levels, you’d be wrong and you would miss out on 3 other important tests!
If you want to accurately diagnose vitamin B12 deficiency then THESE are the tests that you need to get:
#1. Serum B12 Level
The first test you should be aware of is known as the serum B12 level.
Serum is just a fancy way of describing what is in your bloodstream.
So serum B12 refers to the amount of B12 that is floating around in your bloodstream and in your body.
But there’s one big problem…
Just because this B12 is floating around in your bloodstream does NOT mean that your body is actually using it.
And this is a concept I want to make sure you understand.
Just because something is in your blood does not mean that your body can use it.
In fact, in the case of B12, it’s often the case that even though serum B12 levels are “normal” that the body isn’t actually able to utilize the B12 floating around because it’s in the wrong form or because of genetic mutations.
And doctors know this!
This is first year medical school stuff that all doctors should be taught and it’s why the next test exists .
But back to the MMA test for a second.
Which Foods Contain Vitamin B12
Vitamin B12 is mainly found in meat, offal, milk, fish and eggs. The richest sources are liver, clams, kidneys and oysters.
For vegetarians and vegans, it is harder to obtain vitamin B12. It is found in some fermented foods, such as tempeh and more commonly in nori and nutritional yeast . Alternatively look out for vegan and vegetarian foods that are fortified with vitamin B12, such as some plant milks and breakfast cereals. Supplements are also widely available.
There is some evidence to suggest that the form and bioavailability of B12 found in vegetarian/vegan sources is not as able to meet our bodys requirements as animal sources. Those with a reduced intake of animal foods should speak to their GP or health professional in order to determine whether they should consider taking a supplement.
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What Are The Main Sources Of Vitamin B12
Most people get enough vitamin B12 from their diet. It is found in meat, fish, eggs, milk and milk products. It is generally not found in plant foods, but many processed foods have added vitamin B12, such as breakfast cereals. Vegan dietary sources of vitamin B12 include fortified cereals, fortified non-dairy milk, nutritional yeast and Marmite.
Should I Take Vitamin B12 Supplements
You should talk to your doctor about taking a vitamin B12 supplement if you don’t have enough B12 in your diet for example, if you are vegan or avoiding animal foods. It is very important for pregnant or breastfeeding vegan and vegetarian women to have enough vitamin B12 to reduce the risk of their baby developing a vitamin B12 deficiency.
You might also need a supplement if you can’t absorb enough vitamin B12 from food if, for example, you have a problem with your gut or an autoimmune condition. Your doctor can order a blood test to see if you have enough B12 in your body.
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Folate And Folic Acid
Folate is a B vitamin found in many foods. The manmade form of folate is called folic acid.
Folate is also known as folacin and vitamin B9.
- the body form healthy red blood cells
- reduce the risk of birth defects called neural tube defects, such as spina bifida, in unborn babies
A lack of folate could lead to folate deficiency anaemia.
Dietary Reference Values For Vitamin B12
Several organizations have followed different approaches to set the dietary reference values for vitamin B12 . The dietary reference values for adult men and women aged > 18 years range between 2 and 4 g/d depending on the judgments used. Generally, the increased requirements for vitamin B12 in women during pregnancy and lactation have been acknowledged and translated into higher reference values compared with non-pregnant women. No special intake recommendations exist for elderly people, despite the evidence that vitamin B12 malabsorption and deficiency are common in the elderly. Furthermore, the intake recommendations for infants were mainly based on outdated observational studies and on vitamin B12 content in human breastmilk. Measurement of vitamin B12 in breastmilk has been hampered by methodological problems due to the high milk haptocorrin that interferes with most available assays. In general, the European Food Safety Authority panel defined the Adequate Intake of vitamin B12 based on three indicators of vitamin B12 requirements :
1- Maintenance of heamatological markers in patients with pernicious anemia in a remission phase .
2- Maintenance of the total body stores of vitamin B12 by adjusting the daily requirements for the daily loss of the vitamin. The absorption efficacy of vitamin B12 from foods is assumed to be 40% and the daily loss is between 2 and 6 g/d .
3- Maintenance of normal serum levels of vitamin B12 markers .
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Identification Of Liver As An Anti
During the 1920s, George Whipple discovered that ingesting large amounts of liver seemed to most rapidly cure the anemia of blood loss in dogs, and hypothesized that eating liver might treat pernicious anemia.Edwin Cohn prepared a liver extract that was 50 to 100 times more potent in treating pernicious anemia than the natural liver products. William Castle demonstrated that gastric juice contained an “intrinsic factor” which when combined with meat ingestion resulted in absorption of the vitamin in this condition. In 1934, George Whipple shared the 1934 Nobel Prize in Physiology or Medicine with William P. Murphy and George Minot for discovery of an effective treatment for pernicious anemia using liver concentrate, later found to contain a large amount of vitamin B12.
It Helps Prevent Vitamin B12 Deficiency In Vegans
Vitamin B12 is needed for a healthy nervous system, DNA production, energy metabolism and the creation of red blood cells (
One study including 49 vegans found that consuming 1 tablespoon of fortified nutritional yeast daily restored vitamin B12 levels in those who were deficient .
In this study, the nutritional yeast contained 5 mcg of vitamin B12 per tablespoon, which is slightly more than double the daily recommended amount for adults.
Vegans should look for fortified varieties of nutritional yeast to ensure that adequate amounts of B12 are in the product.
Summary Fortified nutritional yeast contains high amounts of vitamin B12 and can be used to help prevent deficiency in vegans.
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Low Doses Do Not Always Cover The Rda
Many vitamin experts remain doubtful as to whether a low dosage of vitamin B12 is really enough for the average person. In older people, for example, it has been proven that daily doses of 300 µg produce significant improvement, while only doses of 600 µg achieve the complete normalisation of blood levels . These cases are certainly at the extreme, but still provide insight into how different the demand can be. So, when is a minimum dose sufficient?
How Much Vitamin B12 Is Too Much
Vitamin B12 is a water-soluble nutrient that plays many critical roles in your body.
Some people think that taking high doses of B12 rather than the recommended intake is best for their health.
This practice has led many to wonder how much of this vitamin is too much.
This article examines the health benefits, as well as potential risks of taking megadoses of B12.
Theres no question that vitamin B12 is essential for health.
This nutrient is responsible for numerous functions in your body, including red blood cell formation, energy production, DNA formation and nerve maintenance .
Though B12 is found in many foods, such as meat, poultry, seafood, eggs, dairy products and fortified cereals, many people dont get enough of this important vitamin.
Health conditions such as inflammatory bowel disease , certain medications, genetic mutations, age and dietary restrictions can all contribute to an increased need for B12.
Vitamin B12 deficiency can lead to serious complications such as nerve damage, anemia and fatigue, which is why those at risk should add a high-quality B12 supplement to their diet .
While people who consume adequate amounts of B12-rich foods and are able to properly absorb and utilize this nutrient dont necessarily need to supplement, taking extra B12 has been linked to some health benefits.
For example, studies show that supplemental B12 may benefit people without a deficiency in the following ways:
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Why Is Nutritional Yeast Good For You
Nutritional yeast is a popular food product often used in vegan cooking.
It gets its name from the protein, vitamins, minerals and antioxidants it contains.
Studies have shown it has a wide range of potential health benefits, ranging from lowering cholesterol to protecting the body from free radical damage.
This article explains what nutritional yeast is, reviews its health benefits and suggests creative ways to use it.
Biomarkers Of Vitamin B12
Several biomarkers exist to evaluate vitamin B12 status in blood. The most used biomarker is total vitamin B12, which measures vitamin B12 bound to both transport proteins , which gives a generally estimation of the vitamin B12 status in the blood . In addition, holoTC , which is the transcobalamin-bound vitamin B12 has been suggested to be an early marker of vitamin B12 status. HoloTC can be used as an initial test to measure vitamin B12 status in blood . Both total vitamin B12 and holoTC are applied in laboratory diagnostics and functional tests such as homocysteine and MMA are used to confirm diagnosis in case of low-normal vitamin B12 status. No consensus exists about which cut-off values should be applied and which is the best marker or combination of markers to assess vitamin B12 status . In general, reference intervals are used or alternative cut-off values are chose based upon sensitivity and specificity . However, these cut-off values are not generally applicable, as total vitamin B12 and active vitamin B12 tests are not harmonized, which hampers interpretation difficult for general practitioners.
Table 2. Biomarkers of vitamin B12 status in serum or plasma.
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Is Vitamin B12 Essential
What should I eat to get vitamin b12? Vitamin B12 is an essential vitamin for living organisms. It contributes significantly to the development of DNA, the formation of blood cells, and helps the nervous system considerably.
What happens when your vitamin B12 is low? According to several studies, including one from Harvard University, a lack of this vitamin can lead to severe health issues
Vitamin B12 deficiency can cause severe, sometimes irreversible, neurological damage:
- Peripheral nerves are often the first to be affected, and patients may complain of paresthesias.
- Also, the spine is damaged, and can sometimes result, as mentioned above, in paresthesia.
- The lack of vitamin B12 in our body can lead to the complex neurological syndrome.
- It also causes megaloblastic anemia in this case, this anemia will react well to vitamin B12 injections.
For these reasons, we always recommend that instead of practicing veganism, you start a vegetarian diet. This diet is much more flexible, and you will not have to take vitamin B12 supplements.
If you are determined to start a vegan life, you should consider taking vitamin B12 supplements.
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Getting An Adequate Amount Of B12
National recommendations for B12 intakes vary significantly from country to country. The US recommended intake is 2.4 micrograms a day for ordinary adults rising to 2.8 micrograms for nursing mothers. The German recommendation is 3 micrograms a day. Recommended intakes are usually based on 50% absorption, as this is typical for small amounts from foods. To meet the US and German recommendations you need to obtain sufficient B12 to absorb 1.5 micrograms per day on average. This amount should be sufficient to avoid even the initial signs of inadequate B12 intake, such as slightly elevated homocysteine and methylmalonic acid levels, in most people. Even slightly elevated homocysteine is associated with increased risk of many health problems including heart disease in adults, preeclampsia during pregnancy and neural tube defects in babies.
Achieving an adequate B12 intake is easy and there are several methods to suit individual preferences. Absorption of B12 varies from about 50%, if about 1 microgram or less is consumed, to about 0.5% for doses of 1000 micrograms or above. So the less frequently you consume B12, the higher the total amount needs to be to give the desired absorbed amount.
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How Can I Find Out If I Have It
Anemia can make you feel tired and short of breath. Here are some other signs:
- Your skin looks pale or yellow.
- You feel dizzy.
- You often have mood changes.
- You’re confused or forgetful.
Because these can also be symptoms of other conditions, see your doctor for a diagnosis. Your doctor will do a physical exam and might order one or more of these tests:
- Complete blood count. This test checks the size and number of your red blood cells. If you’re low in vitamin B12, your red blood cells won’t look normal. They’ll be much bigger and shaped differently than healthy ones.
- Vitamin B12 level. This test checks to see if you have enough of it in your blood.
- Intrinsic factor antibodies. These proteins tell your immune system to attack intrinsic factor. If you have pernicious anemia, you’ll have them in your blood.
- Schilling test. This test uses a radioactive form of B12 to see if your body has enough intrinsic factor.
- Methylmalonic acid level . This test measures the amount of MMA in your blood. When your vitamin B12 level is low, your level of MMA rises.
Why Do We Need B12
Your body needs vitamin B12 to make red blood cells and keep your nervous system healthy and working properly. The nutrient B12 also helps to release the energy you need from food and it also helps your body to use folic acid. If you dont get enough B12 from the foods you eat or supplements you could develop a vitamin B12 deficiency and anaemia.
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Home B12 Diagnostic Kit Vs A Blood Test From Your Doctor
Its only natural at this point to ask why you would want to test your vitamin B12 levels at home when you can go and get one free from your GP? Well, first of all, you get to choose what sort of blood test youre getting.
The NHS have stated that there is a bit of a flaw with the current way B12 is tested. The most widely used blood test only measures the total amount of vitamin B12 in your blood. This means that it tests both the active and the inactive levels of vitamin B12 .7
One problem with lumping active and inactive vitamin B12 levels into the same test result is that you may be showing normal B12 levels, even if most of is inactive and your body cant use it.
When you can choose your own test, you can go for a test that measures only the active B12 levels, so you get a better picture of your vitamin B12 status.
High Dose Vitamin B12
High dose vitamin B12 of around 1000 µg per day is needed if there is an increased requirement, due to a number of factors that we will discuss below, or if B12 deficiency is suspected. It also plays a role in the treatment of a whole range of diseases.
Since B12 is a water-soluble vitamin, there is no danger of overdose when a high dose is administered only a small portion of the dose is actually absorbed by the body.
In essence, high dose B12 is useful in treating a deficiency. For healthy people, a B12 dosage of between 250 500 µg will safely cover the daily requirement. It should be noted that this information refers to oral supplements the dosage of vitamin B12 injections is discussed in a separate article.
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