Vitamin B12 deficiency

Vitamin B12, also known as cobalamin, is an important water-soluble vitamin. It plays an essential role in the production of the red blood cells and DNA in the body. It also helps keep proper functioning of the nervous system.

Vitamin B12 (cobalamin) is important in the formation of all cells in the body, especially red blood cells and the covering of nerve cells (myelin). The body needs myelin for nerves to heal and function properly. B121 also helps with the immune system. ^{[WebMD, 2012]}

Vitamin B12 is essential for the preservation of the myelin sheath, around neurons and for the synthesis of neurotransmitters. The Myelin Sheath is the part of the Neuron, Nerve Cell, damaged as a result of Schwann Cell overgrowth, development of Schwannoma tumors.

Vitamin B12 is a water-soluble vitamin that is naturally present in some foods, added to others, and available as a dietary supplement and a prescription medication. Vitamin B12 is required for proper red blood cell formation, neurological function, and DNA synthesis. ^{[NIH, 2011]}

1. Neurofibromatosis Type 2 (NF2)

Individuals with Neurofibromatosis Type 2 (NF2) can develop different tumor types that can result in nerve damage. Since Schwannoma are an overgrowth portion of nerves, the Schwann Cell, a person with NF2 is in a constant state of battling some nerve damage as long as they have even one of these tumors. Other NF2 tumors often compress nerves in other ways which would also result in nerve damage.

Unfortunately, not only does NF2 result in nerve damage from tumors, but can result in things that make it impossible for the body to absorb B12 in food like; stress, brain surgery, other surgery, prescription medications and digestive issues, resulting in B12 Deficiency. If a person with NF2 has B12 deficiency it means; 1) the body is not just unable to heal nerve damage, 2) prevents the body from normal nerve cell growth compromising nerves other tumors may be starting to damage faster, 3) increase Tinnitus and 4) lower the immune system.

During any form of injury, like nerve damage, the Immune Systems response is to immediately fight the damaged area, this makes it more complicated for the body to also fight protect against disease and germs.

2. Other Names

Adenosylcobalamin, AdoB12, B complex, B complex vitamin, B-12, bedumil, cobalamin, cobalamins, cobamin, cyanocobalamin, cyanocobalamine, cyanocobalaminum, cycobemin, hydroxocobalamin, hydroxocobalaminum, hydroxocobemine, idrossocobalamina, mecobalamin, methylcobalamin, vitadurin, vitamin B-12, vitamina B12 (Spanish), vitamine B12 (French).^{[Mayo Clinic, 2013]}

3. Food

Vitamin B12, bound to protein in food, is released by the activity of hydrochloric acid and gastric protease in the stomach. It is naturally found in animal products, including fish, meat, poultry, eggs, milk, and milk products.^{[NIH, 2011]}

While protein in food can help raise B12 levels, food alone is not enough to replace the ongoing nerve damage caused by NF2 and is a supplement generally recommended by many NF2 doctors.

4. Vitamin B12 Intakes

Some people-particularly older adults, those with pernicious anemia, and those with reduced levels of stomach acidity (hypochlorhydria or achlorhydria) or intestinal disorders-have difficulty absorbing vitamin B12 from food and, in some cases, oral supplements. ^{[NIH, 2011]}

Individuals who have trouble absorbing vitamin B12 from foods, as well as vegetarians who consume no animal foods, might benefit from vitamin B12-fortified foods, oral vitamin B12 supplements, or vitamin B12 injections.^{[NIH, 2011]}

5. Vitamin B12 Deficiency

Vitamin B12 deficiency is characterized by megaloblastic anemia, fatigue, weakness, constipation, loss of appetite, and weight loss. Neurological changes, such as numbness and tingling in the hands and feet, can also occur. Additional symptoms of vitamin B12 deficiency include difficulty maintaining balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue. ^{[NIH, 2011]} Vitamin B12 deficiency can also cause or increase Tinnitus.

6. Folic Acid and Vitamin B12

Large amounts of folic acid can mask the damaging effects of vitamin B12 deficiency by correcting the megaloblastic anemia caused by vitamin B12 deficiency without correcting the neurological damage that also occurs.^{[NIH, 2011]}

7. People at Risk of Vitamin B12 Deficiency

1. Older adults
2. Individuals with pernicious anemia
3. Individuals with gastrointestinal disorders
4. Individuals who have had gastrointestinal surgery
5. Vegetarians
6. Pregnant and lactating women who follow strict vegetarian diets and their
7. Infants^{[NIH, 2011]}

8. Items and Medications that Lower Absorption of B12

1. Nicotine
2. Alcohol
3. Chloramphenicol: Chloramphenicol (Chloromycetin™) is a bacteriostatic antibiotic.
4. Proton pump inhibitors: Proton pump inhibitors, such as omeprazole (Prilosec™) and lansoprazole (Prevacid™), are used to treat gastroesophageal reflux disease and peptic ulcer disease.
5. H2 receptor antagonists: Histamine H2 receptor antagonists, used to treat peptic ulcer disease, include cimetidine (Tagamet™), famotidine (Pepcid™), and ranitidine (Zantac™).
6. Metformin: Metformin, a hypoglycemic agent used to treat diabetes.^{[NIH, 2011]}

9. B12 is taken for the Following

Aging, AIDS, allergies, amyotrophic lateral sclerosis, asthma, autism, bleeding, blood clots, chemotherapy side effects, chronic fatigue syndrome, diabetes, energy level enhancement, growth disorders (failure to thrive), immunosuppression (decrease in immune function), improving concentration, inflammatory bowel disease, kidney disease, Leber's disease, liver disease, male infertility, malignant tumors, memory loss, mood (elevate), mouth and throat inflammation (atrophic glossitis), mental disorders, movement disorders (tremor), multiple sclerosis, myoclonic disorders (spinal myoclonus), neural tube defects, periodontal disease (dental and mouth disorders), prevention of pregnancy complications, protection from tobacco smoke, ringing in the ears (tinnitus), skin disorders (seborrheic dermatitis), skin pigmentation disorders (vitiligo), seizure disorders (West syndrome), tennis elbow (tendonitis), thyroid disorders (increased thyroid hormone). ^{[Mayo Clinic, 2013]}

10. Interactions with Herbs and Dietary Supplements

Vitamin B12 may interact with herbs and supplements for bone loss, cancer, cholesterol, gout, high blood pressure, and for stomach and intestine disorders, herbs and supplements that affect blood products and that affect the nervous system, Alzheimer's herbs and supplements, antibacterials, anti-seizure herbs and supplements, birth control, cardiovascular herbs and supplements, folic acid, omega-3 fatty acids, potassium, salicylates, stimulants, tobacco, and vitamin C. ^{[Mayo Clinic, 2013]}

11. Conclusion

NF2 results in many issues that likely result in Vitamin B12 deficiencies. Therefore eating foods with B12 as well as taking a supplement has been recommended by different doctors for neurological issues that cause Neuropathy; Poor Circulation, Nerve Pain and Muscle Weakness. Talk to your doctors. Follow the resources listed for proper doses amounts of B12.

12. Sources

1. National Institute of Health. Vitamin B12, Dietary Supplement Fact Sheet. (June 24, 2011) http://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional
2. Mayo Clinic. Natural Standard Patient Monograph (2014). "Vitamin B-12 (cobalamin)" http://www.mayoclinic.org/drugs-supplements/vitamin-b12/background/hrb-20060243
3. Web MD. "Vitamin B12." (2012) http://www.webmd.com/hw-popup/vitamin-b12
4. Linus Pauling Institute. Oregon State University. "Vitamin B12" (Retrieved January 2017) http://lpi.oregonstate.edu/mic/vitamins/vitamin-B12
5. Linus Pauling Institute. Oregon State University. "Glossary" (Retrieved January 2017) http://lpi.oregonstate.edu/mic/glossary/
6. "Suggested move to plant-based diets risks worsening brain health nutrient deficiency by British Medical Journal"
   https://medicalxpress.com/news/2019-08-plant-based-diets-worsening-brain-health.html