by Lorette C. Luzajic

Continuation of Lorette’s interview with Sally M. Pacholok, the author of Could it Be B12? (with Jeffrey J. Stuart) and the woman behind National B12 Awareness Year. Click here for Part I of the interview.

Question: Proponents of the Paleo diet get plenty of meat and seafood in our diet. So we don’t have to worry, right?

Sally: don’t get tunnel vision in to thinking one is safe because they eat meat or foods with B12 in them. You can’t even be safe if you are taking vitamins. I would like to make clear that this is not a vegan/vegetarian problem versus a meat-eater’s problem. All people can have a deficiency. Plain and simple, if a person is having signs or symptoms of B12 deficiency that person should be tested and have it ruled out, regardless of whether or not they eat meat. They can have a B12 deficiency for a variety of reasons.

I would hate for non-vegetarians to think they are in the clear—and that B12 deficiency has to do with one’s diet.

We can all be B12-deficient for a variety of reasons. Yes, vegans are at an increased risk, because their diet does not contain B12 unless they use supplements. There is nothing wrong with choosing to be vegetarian, as long as you know what you are doing—-and making sure you are getting enough B12, iron, and zinc in supplements. Don’t forget, vegans, vegetarians and people on macrobiotic diets can also have malabsorption problems, autoimmune disorder, surgical removal of stomach, ileum, bacterial overgrowth, specific drugs which lower B12 levels and stores similar to meat-eaters. So no one is exempt.

Heavy meat eaters may be deficient if they have a malabsorption problem. This could be because of chronic atrophic gastritis, poor hydrochloric acid in the stomach, autoimmune pernicious anemia, celiac disease, H. pylori, and pancreatic problems. Certain drugs used chronically such as metformin (for diabetes) proton-pump inhibitors, antacids, and H-2 blockers can exacerbate or cause a B12 deficiency over time in some people. The anesthetic nitrous oxide can cause B12 deficiency.

(N.B. Sally’s helpful book lists a number of reasons why anyone might be deficient. The list is long, and includes: pernicious anemia, ileal irradiation, aging, nitrous oxide anesthesia, inadequate diet, congenital metabolic errors, celiac disease, Crohn’s, other intestinal problems, increased demands from pregnancy or hyperthyroid, among other issues, alcoholism or alcohol use, antacids, and numerous prescription drugs. Somewhere in that list is you!

She also lists symptoms or diseases that may indicate or be caused by B12 deficiency- ready? Here’s a few: fatigue, falling, balance problems, vitiligo, premature graying, autism, congestive heart failure, senility, Parkinson’s, infertility, schizophrenia, incontinence, paranoia, violent behaviour, pins and needles in limbs and feet, memory loss, cervical dysplasia, bladder problems, poor wound healing, easy infections, chronic fatigue syndrome, restless leg syndrome, vision loss or blindness, tremors, blood clots, heart attacks, stroke, fractures, impotence…. get the picture?)

Question: I have a great relationship with my doctor and trust him/her implicitly. And the B12 tests are normal every time. Does that mean I’m fine?

Sally A persons B12 test may show a “normal” level because the accepted “normal-range” for a serum B12 is too vast. For example, a common range for normal B12 is 211-911pg/ml. This is a very large range. For over two decades, medical researchers have warned that patients who have a serum b12 of 400pg/ml or less may really have a B12 deficiency, and state that a methylmalonic acid and homocysteine test should be also tested to rule out B12 deficiency. So, why don’t we change this very wide range for a “normal” B12? Japan has been reported to have the lowest rate of dementia, and their B12 range starts at 550pg/ml. Look at vitamin D; they thought only 400IU per day, now they are recommending 1,000 to 2,000 IU daily.

For example, if you have depression, you need to have B12 deficiency ruled out by proper testing… prescribing patients who have a B12 deficiency with anti-depressants is dangerous and sub-standard care. It is also negligence. Why?

Because untreated B12 deficiency causes increasing neurological injury over time. Physicians who prescribe anti-depressants must always rule out B12 deficiency. It would also be reasonable for physicians to try high dose B12 as a therapy for depression, in patients whose serum B12 is below 600pg/ml. It would be a lot cheaper and safer, and if it works, why not? I’m sure many drug companies out there making billions of dollars on anti-depressants wouldn’t like to hear this. Yet some drug companies have been sued by families saying their family member was placed on an anti-depressant and then committed suicide. Maybe these are side effects from their drugs; maybe the patient had an unknown B12 deficiency, which is highly possible since most doctors do not rule out B12 deficiency before placing them on such drugs. We have a real problem in the health care community regarding their knowledge deficit regarding B12 deficiency.

Question: I want to get more B12 into my body to restore my health. But I’m skeptical of artificial methods outside of diet. What if I overdose on B12 injections?

Sally: You cannot overdose on B12. You cannot overdose with B12 shots. In fact, B12 is extremely safe even in very high doses.

Let’s Help Sally Celebrate National B12 Awareness Year

“It is the year of bringing vitamin B12 deficiency to the forefront by educating the public and health care community to the dangers of B12 deficiency. An estimated 15% to 25% of older adults have a B12 deficiency, but many of them are never tested or diagnosed. B12 deficiency causes suffering and serious injury—even death. Yet many health care professionals mistakenly attribute signs and symptoms of B12 deficiency to aging. B12 deficiency causes symptoms such as paresthesias, dementia, mental illness, tremor, difficulty ambulating and frequent falls. It is commonly misdiagnosed as Alzheimer’s disease, depression, diabetic neuropathy, vertigo, and mini-strokes. B12 deficiency … can mimic multiple sclerosis, chronic fatigue syndrome, and post-partum depression/psychosis. It can make men or women infertile and cause developmental disabilities or autistic-like symptoms…It lurks silently, increasing its victim’s risk of deadly disease ranging from stroke and heart attacks to cancer.

Other groups at risk for B12 deficiency include vegans, vegetarians, alcoholics, and people with celiac disease (gluten enteropathy), Crohn’s disease, gastric bypass, autoimmune diseases, and AIDS. The year of B12 Awareness is the year of reeducating the health care community, educating the public, and holding health care professionals and health care institutions accountable to the patients they serve. It is the year of saving lives, preventing injury, disability, and saving billions of health care dollars. It is the year we expose health care’s dirty little secret and put an end to not screening symptomatic and at risk people. We cannot tolerate one more B12 related injury. Until the health care community is reeducated and up to date, the public is at great risk for unnecessary injury and poor health.”

September 23 2009 will be B12 Awareness Day. Mark it down on your calendar, and spread the love to your friends. Or better yet, do so all this year long.

Back to the BBQ

You did yourself a great favour with your succulent rare-grilled T-bone, no doubt about it (though charred meat raises some carcinogen concerns that are hotly debated.) With that stunning slab of beef and raw veggies piled high on your plate, you can be confident you’re getting the best that Mother Nature has to offer.

But it might not be enough. Maybe your prescription drugs are masking symptoms, maybe you enjoy wine with those meals, or you are gluten intolerant and don’t even know it. Maybe you’re getting older. Maybe you took a lot of antacids, or your liver isn’t functioning optimally. For these and a million more reasons, you could be low in B12, one of the most vital nutrients you need. Your diet may be fantastic, but if you have any unexplained symptoms- or even symptoms that have been explained by something else - it’s a good idea to take Sally’s book in with your next check up. Ask your doctor to run the more accurate serum tests Sally recommends. B12 tests and therapy are cheap, easy, safe, and lifesaving. What are you waiting for?  

by Lorette C. Luzajic

You just tore into a grilled-to-perfection steak big enough for Fred Flintstone. It was the first BBQ of the summer, accompanied by a super salad of a half-dozen colourful veggies, and ice cold watermelon for desert. This simple cornucopia was delicious, and there’s no question that you ingested every nutrient on the chart. With tomatoes, peppers, mixed-greens, and onions piled high, you got fibre and antioxidants and Vitamin C for days to spare. And though your vegetarian neighbours might question how much steak one really needs, with all that toxic fat and protein, you know meat has been nature’s perfect food for much longer than industrial plant oil monopolies have been trying to convince you otherwise. The human body has been thriving on meat for millions of years, and you know you just had a walloping dose of all the good stuff: the most bioavailable iron, very necessary stearic acid, a vital nutrient in saturated fat, zinc from its best source, complete and perfectly balanced protein, selenium, and the whole B-vitamin family, including Vitamin B12.

The list of reasons why animal food products are nutrient-dense is a long one, but at the top of it is the fact that B12 is only found in animal foods. Yes, bacteria synthesize it, and yes, it is found in some fungi, soy products and sea vegetables- but not in the essential form humans require for every single function in the body. All vitamins and minerals are important, of course, but Vitamin B12 is so crucial that 2009 is National Vitamin B12 Awareness Year.

But what’s to know? The body stores B12 for years, and one requires very little. The RDA is low- a few micrograms in the United States, and less in Europe. The Mayo Clinic says deficiency is extremely rare. And you eat all the good stuff: eggs, seafood, beef, lamb, liver. Your neighbours and their rabbit food diet might need to think about supplements, but you’ve got nothing to worry about, right?

Not so fast.

I talked to Sally M. Pacholok, a nurse who has made it her life mission to raise awareness about the unacknowledged prevalence of B12 deficiency, which is contributing to everything from depression to psychoses to multiple sclerosis to autism. Without it, your brain shrinks, your heart attacks you, your DNA gets deformed, you go crazy, and you die. Not necessarily in that order!

Sally’s the author of Could it Be B12? (with Jeffrey J. Stuart) and the woman behind National B12 Awareness Year. In her exhaustive research she has found that the precious vitamin of which our DNA is made is fragile stuff. Deficiency is extremely common, and those of us committed to our natural heritage carnivorous diet are just as likely to come up short as our neighbours.

Question: What is Vitamin B12?

Sally: Vitamin B12 is a water-soluble vitamin needed for normal nerve cell activity, DNA replication, and production of the mood-affecting substance SAMe (S-adenosyl-L-methionine). Vitamin B12 is critical for health and life. You need it for a healthy nervous and immune system. You also need it for healthy red blood cells and to prevent anemia.

Vitamin B12 is required for blood formation and rapidly growing tissues. It is needed to make healthy red blood cells. When a person doesn’t have enough red blood cells to carry oxygen around your body, you develop anemia. B12 deficiency can cause anemia, which can lead to the following symptoms: shortness of breath, fatigue, tiredness, fainting spells, and dizziness. B12 is also needed for the different cells in your immune system, including white blood cells.

B12 works with the other B vitamins to assist in turning carbohydrates, fats, and protein in your food into energy in your cells. Vitamin B12 also keeps homocysteine levels down (preventing the blood vessel damage which often leads to strokes and heart attacks).

Severe vitamin B12 deficiency can cause death. Before this vitamin was discovered, people in the early 19th century frequently died from B12 deficiency. So this is no laughing matter, and why the health care community does not diligently rule out B12 deficiency in symptomatic and high-risk groups is beyond my comprehension.

Question: Are there any other important roles for B12, or symptoms of deficiency to watch for?

Sally: B12’s biggest role is the making of myelin, the protective fatty layer that lines your nerve cells. The myelin sheath is the insulating layer around our nerves, similar to the insulation on electric wires. If B12 deficiency is present, this sheath becomes damaged, causing symptoms of the central and peripheral nervous systems. The following are common neurological indicators of B12 deficiency: numbness and tingling, paresthesias, dizziness, tremor, gait and balance problems, falling, visual disturbances, headaches, restless legs. Because the brain in part of the central nervous system, psychiatric signs and symptoms are also common with B12 deficiency: irritability, concentration difficulties, depression, anxiety, nervousness, forgetfulness, impaired memory, dementia, paranoia, suicidal ideations, hallucinations, mood swings, sleeping difficulties.

Question: Many sources argue that our natural diet should be plant-based, and that there are enough B12 bacteria in soil, and in seaweed. I don’t buy it.

Sally: The literature I have read conveys that seaweed, spirulina and tempeh do not contain active B12. They contain an inactive form of B12 not used by the human body. Plant foods that are not fortified do not contain B12. For example, fortified yeast products contain vitamin B12, but not brewer’s yeast or baker’s yeast. Plant products do not provide B12. B12 is not found in plants, except when they are contaminated by bacteria, so they are not a reliable source of the vitamin. B12 is naturally found in foods derived from animals, including meat, fish, eggs and dairy products. To ensure adequate B12 intake, vegans/vegetarians must eat fortified foods and take supplements. Bacteria in the human gut produce vitamin B12, but not enough to prevent deficiency. Furthermore, I believe the RDA for B12 is way too low, and people should be taking 1,000 mcg supplements verses 6mcg.

Also, keep in mind that for many people upping meat content is not going to protect you. It is really simple and really not a vegan verses meat eater argument. People who are symptomatic or have risk factors for B12 deficiency need to be screened for health.. (It does if the person fails to supplement properly). Also, people (of whatever food-diet practice they follow) don’t realize (and neither do most doctors, that the small amounts of B12 in multi-vitamins are not enough.

For Part II of Lorette’s interview with Sally M. Pacholok click here.