Cobalamin (vitamin B12) is a water soluble vitamin that is essential to maintaining the nervous system and in creating healthy blood cells that can carry oxygen and nutrients around the body efficiently. it also has a role in assisting the formation of DNA in every cell. Low levels of vitamin B12 can cause many symptoms and problems in the body. The main sources of vitamin B12 are animal based - meat, poultry, eggs and dairy. This means it is an essential nutrient to be supplemented by vegetarians, vegans and those who don`t eat any of the foods mentioned above.
The body can store Vitamin B12 for around 2 years. This means that many people who turn vegan feel that their diet sustains them enough at the start, but can develop symptoms after 2 years of becoming vegan.
Vitamin B12 relies on healthy stomach acid levels to be able to be absorbed. This is because stomach acid will stimulate the production of a substance called intrinsic factor, which is responsible for it`s absorption. This means that if you have low levels of stomach acid or instrinsic factor, you can have low levels of Vitamin B12, despite eating plenty of animal products. B12 is also affected by enzyme deficiency. Enzymes are needed to help to break town the haptocorrin that surrounds B12 in the gut. This means that if you have trouble with your enzyme production, you can also be low in vitamin B12.
Vitamin B12 absorption can also be affected by disorders of the small intestine, such as Crohn`s, colitis, coeliac disease, SIBO, parasites or dysbiosis. Certain medical conditions may also affect B12 levels including: immune system disroders, Grave`s disease and Lupus. Certain medications can affect it`s aborption, including: Metformin, PPI`s and H2 blockers. Alcohol consumption that is greater than the accepted levels of 14 units per week can also block the absorption of B12 Pernicious Anaemia
Pernicious anaemia is an autoimmune condition that requires lifelong support with B12 injections. The body produces antibodies that attack the intrinsic factor secreting cells. This can be diagnosed with a blood test.
B12 deficiency is known as megaloblastic anaemia. When B12 drops low enough, red blood cells become abnormally large and can no longer function properly.
Symptoms of deficiency are very similar to iron deficiency anaemia and include:
Debilitating fatigue, not relieved with sleep
sore, red tongue
numbness or tingling of the extremities
cognitive issues such as short-term memory loss or confusion
Nutrition for healthy B12 levels
It is strongly advisable if your B12 levels are low that you avoid any B12 blocking items:
Avoid or reduce alcohol intake to a maximum of 5 units per week.
Discuss any drugs that may be affecting your B12 levels with your GP
Foods high in B12
Increase B12 rich foods such as animal products: dairy, eggs, meat and fish.
Ideally, B12 should be in it`s methylated form - methylcobalamin as this is easier for the body to absorb. B12 should always be supplemented alongside other B vitamins so that the vitamin status is not imbalanced. People with low stomach acid or enzymes would benefit from a sublingual form of vitamin B12 (under the tongue) .
Thrive Clinical Nutrition and Naturopathic Health Eve Morley BA hons. NT. FNTP. AMNNA. Soc Nat
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