April 16, 2018

B12: also known as cobalamin because it contains cobalt, is an essential nutrient for the expression of genes as well as as a cofactor in folate related cycles. It is a cofactor for methionine synthase and methyl malonyl CoA mutase. This B vitamin is also the focus of much study right now as it is critical to human health.

It is a water soluble vitamin that cannot be made by mammals. It is used as a cofactor in gene expression systems as well as the production of

neurotransmitters, nucleic acids and hemoglobin for red blood cells. This is a vitamin that is profoundly necessary for your nervous system.

We need B12 to help folate's methylation reaction occur in the body. It allows a carbon atom group called a methyl group to be transferred to certain locations on the DNA sequence that puts a silencing sticky note in place. B9 and B3 are necessary for the completion of this function. These events help prevent abnormal DNA transcription made famous by Randy Jirtle's Agouti mouse. Inappropriate function at this methylation level is linked to cancer and many other disorders. It is part of the basis of the exploding field of epigenetics.

We need B12 to make methionine from its precursors. The amino acid homocysteine builds up when this enzyme function is not working. It is critical during periods of rapid cell growth including pregnancy, infancy and puberty.

B12 is also critical for the development of succinyl CoA via methyl malonyl CoA mutase. Succinyl CoA is the precursor to the citric acid cycle via fat and protein metabolism. It is also necessary to produce hemoglobin for red blood cells to carry oxygen around the body.

B12 deficiency is uncommon except in groups that avoid meat including vegans and some rare vegetarians. Diets deficient in cobalamin present the same way as B9 as B12 is necessary for folate function. They present with megaloblastic anemia which is a large red blood cell anemia. Patients are fatigued, pale, have a swollen red tongue and diarrhea . Neurologically, depression, mood dys-regulation, numbness/tingling of extremities and other emerging associated neurologic diseases.

A disease known as pernicious anemia occurs when antibodies attack the stomach reducing acid production which prevents food bound B12 from being liberated. B12 is also low due to a lack of intrinsic factor that is produced in the stomach and attacked by autoantibodies. Treatment is intramuscular cobalamin.

Babies born with neural tube spine defects are known to have prenatal maternal B12 deficiency.

Insufficiency is of great concern in our population. Current literature is showing that inadequate levels of B12 will cause mood problems, hair greying, diarrhea and other issues based on genetic risks.

Homocysteine and methylmalonic acid are amino acids that build up in humans with cobalamin deficiency. Getting the level to a recommended range is the current target for neurobehavioral/degenerative, anti cardiac and cancer risk stratification protocols.

Methylated versions of B9 and B12 are being used to bypass problems with single nucleotide polymorphisms of genes like MTHFR.

Keeping B12 and all B vitamin levels adequate should be a first line therapy coupled with a sleep regimen for anyone with mood issues.

In adult and child populations, there are no known serious side effects of excessive B12 intake.

Food sources of B12 are meats, eggs and dairy products. The US government has been fortifying breads and cereals for years as an added source.

Most adults need 2.4 mcg/day. Incrementally less for kids. This nutrient is easily obtained from an anti-inflammatory diet. Pregnancy and infancy are times of increased B vitamin needs. We highly stress the need for adequate B vitamin stores for all females of child bearing age.

People at risk for insufficiency or deficiency have: atrophic gastritis, h. pylori infection, alcoholism, pancreatic enzyme dysfunction, intestinal dysbiosis, inflammatory bowel disease, eating disorders, celiac disease and people using antacid medicines for GERD/reflux gastritis. There are many other drugs that interfere with B12.

That concludes our tour through the B complex of vitamins. It is beyond important to maintain adequate levels of these nourishing chemicals. Eat right and supplement where necessary.

Dr. M

 

*With many of these micronutrients, you will see a pattern that the brain, gut and skin are often affected. These highly metabolic and rapid cell turnover organs are most susceptible to insufficiency states that occur with a modern human processed, government subsidized diet that promotes gut dysfunction, malabsorption and inflammation.