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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by ed_uk on June 16, 2005, at 18:54:26
Vitamin B12 deficiency can cause a wide variety of psych symptoms including.......
Depression
Paranoia
Fatigue
Confusion
Hallucinations
Delusions
Insomnia
Anxiety and panic
Mania
Slow mentation
Obsessive-compulsive disorder
Personality changes.........and all can occur in the absense of anemia - the classic feature of B12 deficiency.
N Engl J Med. 1988 Jun 30;318(26):1720-8.
Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis.
Lindenbaum J, Healton EB, Savage DG, Brust JC, Garrett TJ, Podell ER, Marcell PD, Stabler SP, Allen RH.
Department of Medicine, Columbia-Presbyterian Medical Center, New York, NY 10032.
Among 141 consecutive patients with neuro-psychiatric abnormalities due to cobalamin deficiency, we found that 40 (28 percent) had no anemia or macrocytosis. The hematocrit was normal in 34, the mean cell volume was normal in 25, and both tests were normal in 19. Characteristic features in such patients included paresthesia, sensory loss, ataxia, dementia, and psychiatric disorders; longstanding neurologic symptoms without anemia; normal white-cell and platelet counts and serum bilirubin and lactate dehydrogenase levels; and markedly elevated serum concentrations of methylmalonic acid and total homocysteine. Serum cobalamin levels were above 150 pmol per liter (200 pg per milliliter) in 2 patients, between 75 and 150 pmol per liter (100 and 200 pg per milliliter) in 16, and below 75 pmol per liter (100 pg per milliliter) in only 22. Except for one patient who died during the first week of treatment, every patient in this group benefited from cobalamin therapy. Responses included improvement in neuropsychiatric abnormalities (39 of 39), improvement (often within the normal range) in one or more hematologic findings (36 of 39), and a decrease of more than 50 percent in levels of serum methylmalonic acid, total homocysteine, or both (31 of 31). We conclude that neuropsychiatric disorders due to cobalamin deficiency occur commonly in the absence of anemia or an elevated mean cell volume and that measurements of serum methylmalonic acid and total homocysteine both before and after treatment are useful in the diagnosis of these patients.
Posted by Phillipa on June 16, 2005, at 21:30:59
In reply to Have YOU been tested for vitamin B12 deficiency???, posted by ed_uk on June 16, 2005, at 18:54:26
Ed, when they were doing my lymes testing my Bl2 was high! How could that be? Fondly, Phillipa
Posted by Emily Elizabeth on June 16, 2005, at 22:29:17
In reply to Have YOU been tested for vitamin B12 deficiency???, posted by ed_uk on June 16, 2005, at 18:54:26
Posted by ed_uk on June 17, 2005, at 8:11:11
In reply to Re: Have YOU been tested for vitamin B12 deficiency??? » ed_uk, posted by Phillipa on June 16, 2005, at 21:30:59
Hi PJ!
I've no idea - I think that's a question for Larry! Do you take a supplement?
Ed xxxx
Posted by Phillipa on June 17, 2005, at 18:24:03
In reply to Re: Have YOU been tested for vitamin B12 deficiency??? » Phillipa, posted by ed_uk on June 17, 2005, at 8:11:11
Me too. Too bad he's blocked. Fondly, PJ O
Posted by Jakeman on June 17, 2005, at 19:54:45
In reply to Re: Have YOU been tested for vitamin B12 deficiency??? » ed_uk, posted by Phillipa on June 17, 2005, at 18:24:03
> Me too. Too bad he's blocked. Fondly, PJ O
Why was he blocked? Do you know for how long?
Sheesh!
Posted by ed_uk on June 17, 2005, at 20:03:43
In reply to Re: Have YOU been tested for vitamin B12 deficiency??? » Phillipa, posted by Jakeman on June 17, 2005, at 19:54:45
He was blocked for 6 weeks - see admin. It's vey sad, I miss Lar!
~Ed
Posted by Phillipa on June 17, 2005, at 20:44:06
In reply to Re: Have YOU been tested for vitamin B12 deficiency??? » Jakeman, posted by ed_uk on June 17, 2005, at 20:03:43
Read the stuff over there. I thought I would never get involved but it pulled a string. We need Larry back! Fondly, Phillipa
Posted by Jakeman on June 17, 2005, at 20:47:52
In reply to Re: Have YOU been tested for vitamin B12 deficiency???, posted by Phillipa on June 17, 2005, at 20:44:06
> Read the stuff over there. I thought I would never get involved but it pulled a string. We need Larry back! Fondly, Phillipa
Yeah, me too. I posted a comment over there.
Posted by Phillipa on June 17, 2005, at 20:50:22
In reply to Re: Have YOU been tested for vitamin B12 deficiency???, posted by Jakeman on June 17, 2005, at 20:47:52
Jakeman, Just read it. We want Larry Back! Fondly, Phillipa
Posted by Jakeman on June 17, 2005, at 21:02:28
In reply to Re: Have YOU been tested for vitamin B12 deficiency??? » Jakeman, posted by Phillipa on June 17, 2005, at 20:50:22
> Jakeman, Just read it. We want Larry Back! Fondly, Phillipa
So do I. Something is awry here. That's the most polite way I can say it.
Posted by 4WD on June 17, 2005, at 22:22:22
In reply to Have YOU been tested for vitamin B12 deficiency???, posted by ed_uk on June 16, 2005, at 18:54:26
Is B-12 the one you need to take sublingually? Would tabs be acceptable? And what amount? The study didn't say any of this. I know many people get B-12 shots.
Marsha
Posted by fires on June 17, 2005, at 22:52:19
In reply to Have YOU been tested for vitamin B12 deficiency???, posted by ed_uk on June 16, 2005, at 18:54:26
Yes. I take the nasal gel because I have GERD and the meds for it can interfer with B 12 absorption.
Even though I take it and folic acid my homocysteine level is still in the high normal range.
Posted by gromit on June 18, 2005, at 0:04:07
In reply to Re: Have YOU been tested for vitamin B12 deficiency??? » Jakeman, posted by ed_uk on June 17, 2005, at 20:03:43
Yep, even though I tested a little high I still got a shot, did nothing.
I saw the thread on Admin, a board to avoid reading if possible, may cause depression, anger or confusion.
Posted by ed_uk on June 18, 2005, at 9:46:03
In reply to Re: Have YOU been tested for vitamin B12 deficiency??? » ed_uk, posted by 4WD on June 17, 2005, at 22:22:22
Hi!
For dietary B12 deficiency (eg. in vegans), you can take oral cyanocobalamin at a dose of 50-150mcg daily in one to three divided doses. Some people take higher doses.
In malabsorption, the dose of oral cyanocobalamin is much higher eg. 1000-2000mcg daily.
RE injections. B12 can be given as cyanocobalamin or hydroxocobalamin. AFAIK, cyanocobalamin is mainly used in the US, hydroxocobalamin is popular in the UK. In fact, I'm not even sure whether hydroxocobalamin is available in the US. Hydroxocobalamin is very convenient because it only needs to be given once every 2-3 months.
~Ed
Posted by Elroy on June 19, 2005, at 10:24:27
In reply to Re: Have YOU been tested for vitamin B12 deficiency??? » 4WD, posted by ed_uk on June 18, 2005, at 9:46:03
A key here is to have your B12 levels thoroughly checked. If they are low - or even borderline low - then supplementation (via either IM shots or high-dose sublinguals: 1,000mgc to 5,000 mcg) is necessary. Otherwise the B12 that you're getting in a good B complex supplement or even a good multi-vitamin is fine.
Running aound and taking extra high dose supplements on a "shotgun approach" not only doesn't work, it can, at times be counterproductive.
People come up with lists showing all the physical and mental problems that candida yeast can be responsible for. And much of that is true. But the fact is that there are tests now that have VG capabilities of determining candida infestation and those tests should be done prior to jumping into a long-term, expensive and maybe unnecessary anti-candida program.
Same-same here.
Find out first if you're even borderline for needing B12.
Elroy
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> Hi!
>
> For dietary B12 deficiency (eg. in vegans), you can take oral cyanocobalamin at a dose of 50-150mcg daily in one to three divided doses. Some people take higher doses.
>
> In malabsorption, the dose of oral cyanocobalamin is much higher eg. 1000-2000mcg daily.
>
> RE injections. B12 can be given as cyanocobalamin or hydroxocobalamin. AFAIK, cyanocobalamin is mainly used in the US, hydroxocobalamin is popular in the UK. In fact, I'm not even sure whether hydroxocobalamin is available in the US. Hydroxocobalamin is very convenient because it only needs to be given once every 2-3 months.
>
> ~Ed
Posted by ed_uk on June 19, 2005, at 11:21:40
In reply to Re: Have YOU been tested for vitamin B12 deficienc » ed_uk, posted by Elroy on June 19, 2005, at 10:24:27
Hi Elroy,
>A key here is to have your B12 levels thoroughly checked.....
I agree. My post was intended to encourage people with mental health problems to be tested for B12 deficiency.
After all, my post was titled.......
'Have you been tested for vitamin B12 deficiency?'
>Running aound and taking extra high dose supplements on a "shotgun approach" .............
At no point did I recommend that.
>People come up with lists showing all the physical and mental problems that candida yeast can be responsible for.
True. My list was intended to show the diversity of psych problems which can be associated with B12 deficiency - it's wasn't supposed to be a diagnostic tool.
Kind regards,
Ed.
Posted by iforgotmypassword on June 19, 2005, at 13:00:56
In reply to Re: Have YOU been tested for vitamin B12 deficienc » Elroy, posted by ed_uk on June 19, 2005, at 11:21:40
my b12 is always low, but i don't really remember feeling any better after taking supplements for god knows how long.
Posted by fires on June 19, 2005, at 14:16:35
In reply to Re: Have YOU been tested for vitamin B12 deficienc, posted by iforgotmypassword on June 19, 2005, at 13:00:56
> my b12 is always low, but i don't really remember feeling any better after taking supplements for god knows how long.
Have you had the following blood tests:
methylmalonic acid and homocysteine levels
It would be interesting to see what they are.
"measurements of metabolites such as methylmalonic acid and homocysteine have been shown to be more sensitive in the diagnosis of vitamin B12 deficiency than measurement of serum B12 levels alone.3,10-14"
Posted by Elroy on June 19, 2005, at 15:22:15
In reply to Re: Have YOU been tested for vitamin B12 deficienc » Elroy, posted by ed_uk on June 19, 2005, at 11:21:40
Exactly right on.
My concern was that your post seemed to have then "evolved" the intended thread into a "let's try this supplement".
With today's poor agriculture practices, depleted soils, etc., it's probably not a bad idea for most of us to do a basic level of supplementation (i.e., a good multi-vite with some extras as needed). And I am a big proponent of using natural cures whenever possible (amino acids instead of pharmaceuticals whenever effects are practical, for example).
But often we seem to jump on the "supplement of the month" bandwagon.
Someone mentions Tyrosine (for example) and everyone wants to do Tyrosine. How much, who has best prices, etc. Yet if one has anxiety as primary problem or an agitated type of depression, tyrosine would be terrible to take as it increases dopamine production which can then increase adrenaline hormones which could then escalate one's symptoms (p.s. I found that out the hard way).
Many herbals are the same way.
But, yes, your initial posting started the thread out with a completely correct position.
(In fact, I often find it funny out threads will not only evolve away from their intended stance, but often evolve into completely different topics!).
Elroy
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Posted by Elroy on June 19, 2005, at 17:31:27
In reply to Re: Have YOU been tested for vitamin B12 deficienc, posted by iforgotmypassword on June 19, 2005, at 13:00:56
#1. Taking mega-dose levels of sublingual (under-the-tongue) B12... like in range of 1,000mcg to 5,000 mcg daily?
#2. If yes, try high dose (usually 1,000 mcg) of B12 shots?
Some people's primary problem with B12 is that they lack the factor that "digests" and processes the B12 for their body to be able to use.
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> my b12 is always low, but i don't really remember feeling any better after taking supplements for god knows how long.
Posted by ed_uk on June 19, 2005, at 18:08:33
In reply to Re: Have YOU been tested for vitamin B12 deficienc » ed_uk, posted by Elroy on June 19, 2005, at 15:22:15
Hi Elroy,
>My concern was that your post seemed to have then "evolved" the intended thread into a "let's try this supplement".
That wasn't my intention! I was just giving some information on doses and different forms of B12 in case anyone was interested :-)
>But often we seem to jump on the "supplement of the month" bandwagon.
Is B12 really that fashionable at the moment? I had no idea!
Kind regards,
Ed.
This is the end of the thread.
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