*** Ask Dr. Z - Vitamin B12 Deficiency, Alzheimer's, Parkinson's, Depression, Brain, Your Diet, Digestion, Betaine HCL, Dipan-9,

Vitamin B12 - How do we get it?

Vitamin B12 is found in animal protein as a food source.

Hydrochloric acid (hcl) in the stomach releases vitami B12 from the animal proteins as part of the digestive process.

Vitamin B12 then combines and forms a complex with Intrinsic Factor (IF) which is released by the parietal cells of the stomach lining.

This complex can then be absorbed by the intestinal tract.

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Vitamin B12 Deficiency Symptoms

Because vitami B12 deficiency affects the brain and entire nervous system, any and all human functions can be negatively affected:

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Vitamin B12 Deficiency - How common is it?

It is estimated that at least 40% of the US population suffers from Vitamin B12 deficiency. Recent research, however, indicates that the incidence of vitami B12 deficiency may be substantially higher than 40%.

1. Inadequate Digestive Function

Most people who come to my clinic or contact me online suffer from digestive problems. HCL - stomach acid deficiency - seems to be a wide spread problem in the population. Without adequate HCL, vitami B12 cannot be separated from animal protein food sources, and consequently cannot combine with Intrinsic Factor to be absorbed in the intestinal tract.

This problem is even more common in the aging population. Statistically there is a decline of stomach acid production with aging. This leads to inadequate protein digestion, consequently to vitami B12 deficiency.

Many elderly suffer from atrophic gastritis with loss of parietal cells which produce Intrinsic Factor. This again leads to vitami B12 deficiency. This may explain in part the vast increase of neurological/brain problems in the elderly, such as Alzheimer's, depression, Parkinson's, neuropathy, etc.

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2. Vegetarian and Vegan Diets

Vitamin B12 deficiency is obviously widespread among vegetarians and vegans, as their diet does not include any form of animal proteins.

Quote from:

A Nutr Metab. 1982;26(4):209-16.Links Serum vitami B12 and blood cell values in vegetarians. Dong A, Scott SC.

Serum vitami B12 and complete blood count values were determined for 83 volunteer subjects from an American vegetarian society conference (USA). Among subjects who did not supplement their diets with vitami B12 or multiple vitamin tablets, 92% of the vegans (total vegetarians), 64% of the lactovegetarians, 47% of the lacto-ovovegetarians and 20% of the semivegetarians had serum vitami B12 levels less than 200 pg/ml (normal = 200-900 pg/ml). However, their complete blood count values did not deviate greatly from those found for nonvegetarians, even though some had been vegans or lactovegetarians for over 10 years. Macrocytosis among the vegetarians was minimal; none had mean corpuscular volume greater than 103 fl.

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nn 3. Many Pharmaceutical Medications contribute to Vitamin B12 Deficiency

1. Proton pump inhibitors are medications designed to suppress the production of stomach acid. This in turn interferes with protein digestion and leads to vitami B12 deficiency.

Quote from wikepedia

Clinically used proton pump inhibitors:

Omeprazole (brand names: Losec, Prilosec, Zegerid, ocid)nn Lansoprazole (brand names: Prevacid, Zoton, Inhibitol)nn Esomeprazole (brand names: Nexium)nn Pantoprazole (brand names: Protonix, Somac, Pantoloc, Pantozol, Zurcal, Pan)nn Rabeprazole (brand names: Rabecid, Aciphex, Pariet, Rabeloc)

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2. Diabetes Drug Metformin may contribute to Vitamin B12 Deficiency

Quote

Risk Factors of Vitamin B12 Deficiency in Patients Receiving Metforminnn Arch Intern Med. 2006;166:1975-1979.

Results A total of 155 patients with metformin-related vitami B12 deficiency (mean ± SD serum vitami B12 concentration, 148.6 ± 40.4 pg/mL [110 ± 30 pmol/L]) were compared with 310 matched controls (466.1 ± 330.4 pg/mL [344 ± 244 pmol/L]). After adjusting for confounders, we found clinically important and statistically significant association of vitami B12 deficiency with dose and duration of metformin use. Each 1-g/d metformin dose increment conferred an odds ratio of 2.88 (95% confidence interval, 2.15-3.87) for developing vitami B12 deficiency (P<.001). Among those using metformin for 3 years or more, the adjusted odds ratio was 2.39 (95% confidence interval, 1.46-3.91) (P = .001) compared with those receiving metformin for less than 3 years. After exclusion of 113 subjects with borderline vitami B12 concentration, dose of metformin remained the strongest independent predictor of vitami B12 deficiency.

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