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B12 Facts

  • B12 is NOT a placebo. It is a vitamin essential to life, required by all body systems.

  • The B12 serum test has known limitations and your treatment should not be delayed if you are symptomatic and have a within range result - see the links here for more help.

  • B12 therapy does not interfere with other medications.

  • Few doctors are aware that macrocytosis need not be present to be deficient in B12.

  • Serum B12 test can be recording as much as 80% of inactive B12 which is useless to the body. Click here to read the important NEQAS B12 alert and read about the unreliability of this test.
  • It does not just affect woman of 60+ years of age, it can affect anyone at any age, including the unborn child and babies.
  • The UK treatment regime of 4 injections per year is not based on clinical evidence it is down to cost saving exercises - saving time for district nurses. However the financial cost of misdiagnosis in the UK is phenomenal.

  • Folate and iron deficiency often go hand in hand with B12 deficiency. It is important to have folate and Ferritin (iron storage) levels checked alongside B12

  • There is a problem with treating B12 deficiency with oral supplements. This supplementation may increase the B12 serum level but research shows that permanent damage can occur unchecked if the patient's symptoms are ignored and reliance is placed on blood values.

  • Vegetarians, vegans and those following a macrobiotic diet - your access to vitamin B12 will be via fortified foods and supplements which contain B12 made by bacteria and sourced from bacteria cultures. Please Note: Plant sources such as seaweed, fermented soy, brewers yeast and Spirulina, contain B12 analogues, these are not accessible to the body.

  • Symptoms in children may not be completely reversible if left undiagnosed.

  • Read about Inborn errors of B12 metabolism.

  • Many people do not do well on 3 monthly injections and have returning symptoms within a week to ten days of B12 injection.

  • Mental health conditions are not routinely screened for a physical cause - Many psychiatrists consider B12 to be a physical 'drug' and do not understand how low levels of this vitamin affect mental health. Low folate can also have a serious impact on mental health.

  • If a baby is born to and then breast fed by a B12 deficient mother B12 therapy must be given urgently.

  • You cannot overdose on vitamin B12! All B vitamins are water soluble - any excess is excreted in urine. Click here to find out how B12 works.

  • Vitamin B6 is the only B vitamin that can cause problems in high quantities.

  • A vitamin B complex is an important supplement when undergoing B12 therapy. All B vitamins work together.

  • Ferritin and folate levels should be monitored in a B12 deficient patient. Optimum levels are important, to gain the best from your injections.

  • If you are low in ferritin (iron storage), B12 will compensate by taking more from folate stores for the production of red blood cells.

  • Some patients cannot tolerate synthetic folic acid and therefore would require supplementation of the naturally occurring form of folate please click here for more information on this.

  • Low serum folate causes more B12 to be excreted. B12 needs folate as much as folate needs B12, they work hand in hand.

  • Symptoms can be completely reversed if diagnosed and treated quickly and appropriately.

  • NICE guidelines state that in a patient with Chronic fatigue syndrome - unless macrocytosis is present, do not test for B12 deficiency, this is ridiculous since on of the most common symptoms is chronic fatigue!

  • BNF guidelines state that if there is 'neurological involvement' an injection should be given every other day until symptoms stop improving. This crucial instruction is rarely put in to practice by UK GP's.

  • Low B12, Folate (B9), B6, B2, and magnesium cause a rise in homocysteine, an amino acid which can rise to toxic levels and increase incidence of stroke and heart problems.

  • Homocysteine - levels should be checked in those with Factor V Leiden disorder (an inherited blood- clotting disorder), due to increased risk with B12 deficiency.

  • You are 40% more likely to have pernicious anaemia if family member has been diagnosed - get tested!

  • Oral cyanocobalamin will be completely useless unless B12 deficiency is purely diet related (vegan, vegetarian, macrobiotic diet).

  • Taking folic acid (vitamin B9, folate) or eating a lot of folate-containing foods can actually mask the symptoms of a developing B12 deficiency. Let your doctor know this!

  • B12 - Hydroxocobalamin at high levels is a treatment for cyanide poisoning.

  • Some nations allow their citizens to buy their injectable B12 over the counter. These include France, Spain, Germany, Australia and Canada. Many with this condition resort to buying supplies from online pharmacies to maintain their health.

  • History of any surgery (including dental surgeries) involving nitrous oxide can inactivate the body's stores of B12 and cause severe neurological damage.

  • An abnormally high serum vitamin B12 level - Hypercobalaminemia can be accompanied by signs of B12 deficiency but is a warning sign of a number of serious underlying pathologies.

  • Many drugs interfere with B12 absorption. These include Metformin, PPI's, H2 blockers and antacids. Folate can also be depleted by many commonly prescribed drugs.
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