My hubby had a B12 deficiency and the doctors thought he had M.S. He had memory loss, headaches, dizziness, numbness in extremities, twitching, MAJOR exhaustion. B12 deficiency can take a long time to happen in some cases, but it can cause permanent neurological damage if severe.
Not to hurt anyone's feelings aver what was said above, but I'm going to highlight some of this very long but interesting article by a vegan doctor:
Check out this article by a vegan doctor:
The Mysterious B12
*by Gabriel Cousens
M.D.,M.D.(H)
_________________
The work at the Tree of Life and in all my nutrition books, Spiritual
Nutrition and the Rainbow Diet, Conscious Eating and Rainbow Green Live Food
Cuisine is to provide an optimal situation for everyone to be successful
vegan and live food practitioners. To that end, we address every single
issue that is connected with being successful. The B-12 issue is one that is
critical to a successful and healthy vegan and live food way of life.
To understand the significance of this issue, we need to understand a little
about the importance of B-12 in the diet. The average non-vegetarian stores
between 2,000 and 3,000 picograms (pg., same as micrograms) of B-12 and
loses about 3 pg. per day. About 60 percent of the total amount of the B-12
in the body is stored in the liver and 30 percent is stored in the muscle.
The body has a special circulation pattern between the digestive tract and
the liver. Through the bile, we secrete 1.4 pg. per day of B-12 into the
small intestine, and healthy people reabsorb about 0.7 pg. Research suggests
that if people have a low B-12 intake, the absorption increases to even draw
more B-12 into the system. However, there is still a general potential for
slow loss, depending on the variation in this special, what is known as
enterohepatic circulation, before we develop the potential of B-12
deficiency symptoms.
B-12 has two functions: one, methylocobalamin is used by the enzyme
methionine synthase to change homocysteine into methionine. When this enzyme
is not working, we increase the homocysteine in our system, which recent
research has associated with the increased potentiality of heart disease and
deterioration of the arteries and nerves. When the homocysteine is high, it
appears to be a nerve toxin, as well as a blood vessel toxin. The second
function of B-12 is as a coenzyme is using 5'-deoxyadenosylcobalamin in the
enzyme methyl malonyl-CoA mutase in the conversion of methyl malonyl-coA to
succinyl-CoA.
Elevated homocysteine also happens with deficiencies in B-6 or folic acid.
One of the major symptoms of B-12 or folic acid deficiency is macrocytic
anemia. Folate, also called folic acid, is needed to turn the uracil into
thymidine, an essential building block of DNA. This DNA is needed for
production of new red blood cells and for red blood cell division. B-12 is
involved because it is involved in the pathway that creates methyl
cobalamin. This B-12 also produces a form of folate needed to make DNA. So,
if there is no B-12, folate can become depleted and DNA production slows
down.
Another little side part of the methyl malonyl-CoA to succinyl-CoA
conversion is that when the B-12 is not available, the methyl malonyl-CoA
levels increase and are converted to methyl malonic acid, which accumulates
in the blood and urine. Since the B-12 is the only co-enzyme required in
this pathway, methyl malonic acid levels are considered the gold standard as
an indicator of B-12 deficiency. Other causes of high methyl malonic acid
(MMA) are genetic defects, kidney failure, low blood volume, dysbiosis,
pregnancy and hypothyroid. The MMA test is important because the progressive medical community no longer considers serum B-12 levels an accurate
measurement of appropriate amounts of B-12. In other words, a normal serum
B-12 may not mean that B-12 levels are healthy. We need a urinary assay of
methyl malonic acid to really determine that. This is an important point,
because when I first wrote about this issue in Conscious Eating, the
establishment of the methyl malonic acid assay as the gold standard had not
taken place yet. I based some of my statements at that time on the world
research, which was using serum B-12. A serum B-12 of 200 pg. or less was
considered deficient. As a result of the new gold standard and what we know
about MMA and homocysteine, the B-12 serum levels should be around 450 pg.
to maintain a normal homocysteine level. Therefore, serum B-12 levels less
than 450 pg. may be considered as indicating a B-12 deficiency.
There are a variety of symptoms of B-12 deficiency, which are important to
vegans and live fooders. The first is actually low energy. It could be a
reason why some people just don't feel well on these diets, besides not
getting the right protein/carbohydrate/fat mix for their constitutional
type. There are specific neurological symptoms, often described as "subacute
combined degeneration". Some of this damage can be almost irreversible, if
it becomes chronic. This nerve system degeneration affects peripheral nerves
and the spinal cord. Some of the typical neurological feelings include
depression, numbness and tingling in the hands and feet, nervousness,
paranoia, hyperactive reflexes, impaired memory and behavioral changes. With
a B-12 deficiency, one can also have diarrhea, fever, frequent upper
respiratory infections, impotence, infertility, sore tongue, enlargement of
the mucous membranes of the mouth, vagina, and stomach, macrocytic anemia,
low platelets, increased bleeding, low white blood cell count. Some of the
causes of B-12 deficiency are low dietary intake of B-12 and/or poor
absorption, which usually comes through loss of intrinsic factor and/or a
lack of stomach acid.
Consistent research over the last decade has shown that vegans and live food
people of all ages and sexes have a much higher risk of becoming B-12
deficient. This does not mean that everyone becomes B-12 deficient. This
deficiency is particularly true with newborn babies, especially babies of
vegan live-food nursing mothers who are not using B-12 supplementation. In
contrast to the average adult storage of 2,000-3,000 pg. of B-12, newborns
of mothers with normal B-12 have about 25 pg. Studies have shown that the
milk during the first week of life does contain large amounts of B-12. This
means that the B-12 storage in infants at birth is normally adequate to last
the first few weeks of life. Afterwards, they must get it from breast milk
or other sources. If a vegan or live-food mother is already B-12 deficient
during pregnancy, the baby may be born with seriously low B-12 levels and
develop clinical signs of deficiency as soon as two weeks. The general
research suggests that even among non-vegetarians, B-12 can be insufficient
in infants, and that perhaps all breastfeeding mothers should consider B-12
supplements for themselves and their infants during the time of
breastfeeding. This lack of B-12 in the mother's diet during pregnancy has
been associated with a lack of myelin production, which is the coating of
the nerves. It takes somewhere between one to twelve months to develop, and
manifests as failure to thrive and slow developmental progression. The
babies are often lethargic, lose their ability to use muscle adequately, and
even their sensory attunement decreases. They also have irregular macrocytic
anemia.
The good news that one major study in the United Kingdom in 1988 showed, in
studying 37 vegan children was that there was normal growth and development
in children who were breastfed for 6 months at a minimum, when there was
B-12 supplementation.
Young childrenand teenage children who were supplemented with B-12 were
found to grow normally. Adults who were vegetarian without B-12
supplementation for greater than six years usually had a lower B-12 than
non-vegetarian adults in the general research. In one study of adults in
1994, 81% of the vegan adults had a B-12 lower than 200 pg. That is
approximately the percentage of adults on a live food diet who are low in
B-12. In my clinical experience, meat eaters, vegans and live-fooders tend
to have a fairly high percentage of B-12 deficiency, although meat eaters do
have less incidence. My experience is that cooked food vegans have a higher
incidence of B-12 deficiency than live fooders, but there is still a
significant occurance in live fooders. In vegetarians and vegans, there is
also a high percentage under 200 pg., about 54%. A study in 1982 by Dunn and
Scott of raw food vegans with 83 subjects from the Natural Hygiene Society
showed that 92% of the vegans had a B-12 less than 200 pg., and in 53% it
was less than 100 pg. The World Health Organization (WHO) considers B-12
deficiency to be less than 200 pg. The percentages of B-12 deficiency tend
to increase over time on a natural hygiene diet. Another study in Finland in
1995 that examined B-12 status of long-term 100% raw vegans found that 66%
of the people had a B-12 lower than 200 pg. One study done in 2000 by
Donaldson at Hallelujah Acres on primarily live food diet people, but with
some B-12 supplementation via nutritional yeast, showed only about 15% of
the people were less than 200, and none of them less than 160. The
supplementation with nutritional yeast was 5 pg. of B-12 from one tablespoon
of Red Star Vegetarian Support.
Up until this time, many of us have felt that additional supplementation for
live fooders with sea vegetables or probiotic formulas was sufficient for
protection against B-12 deficiency. This does not seem to be the case. In
macrobiotics, who primarily cook their food, we see a very high percentage
of children actually having growth retardation due to low B-12 intake. Many
of us have felt that spirulina, Klamath Lake Algae, all the sea vegetables
had enough active B-12 to avoid a B-12 deficiency. Although the research is
not fully in, we do know that, as I pointed out in Conscious Eating, these
substances do have human active B-12. The problem is they also have a
significant amount of analog B-12 that competes with the human active B-12.
This analog amount was not measured in my studies. Using the methyl malonic
acid reduction approach, which is now the gold standard, research showed
that when people used dry and raw nori from Japan, the dried nori actually
made the methyl malonic acid (MMA) status worse, which means it actually
reduced the B-12 status. Therefore it could possibly worsen a B-12
deficiency. Raw nori seemed to keep the methyl malonic acid at the same
level, meaning it did not harm the B-12 status, but the research showed it
did not particularly help it either. No food in Europe or the U.S. has been
tested for lowering methyl malonic acid. Research absolutely has to be done
to answer this question fully.
There is one exception to this lack of vegetarian B-12 active food, which is
that we do produce B-12 from bacteria in our large intestine, but since this
B-12 is produced in the area below where B-12 is reabsorbed, it is really
not available for absorption. Some people have argued that a lot of species
of lower mammals do not need B-12. The reason why this is true is that a lot
of species that are primarily vegetarian animals eat their feces. Human
research also has shown if you eat your feces, you will get enough B-12. Dr.
Herbert sponsored research in England where vegan volunteers with a
documented B-12 deficiency were fed B-12 extractions made from their own
feces. It cured their B-12 deficiency. So, there is a natural vegan way to
do it. It may not be the most tasteful way, however.
Some have theorized that organic foods, in various regions, would improve
the B-12 tests by lowering the serum malonic acid, but again, the research
has not shown that washed or unwashed organic food has made a difference.
Many animals, aside from eating their own feces, will ingest a variety of
eggs, insects, small vertebrates or soils. For example, gorillas, who are
the closest to vegan of all the species, will eat insects and sometimes
their feces. So there are ways to do this for vegans, but again, they may
not be the most aesthetic or tasteful. I would love, at this point, to come
up with an alternative to this, however it doesn't seem to be the case.
There are many ideas of vegan foods that have active B-12, but few are
proving to actually raise B-12 or prevent its loss. The research has shown,
for example, that tempeh does not supply human active B-12. Research in both
the U.S. and the Netherlands has confirmed this. There was one paper that
showed that tempeh from one particular source in Thailand did have some
B-12, but what they basically found was that fermented soybean did not
contain B-12. Other foods such as barley, malted syrup, sourdough bread,
parsley, shitake mushrooms, tofu, and soybean paste, had some B-12 in them.
Amazake rice, barley miso, miso, natto, rice miso, shoyu, tamari, umeboshi,
and a variety of nuts, seeds and grains did not contain any elements or even
any detectable B-12 analog. My study using the earlier gold standard test
for B-12 active bacteria did show indeed that arame, dulse, kelp, kombu and
wakame had significant human active B-12. Other studies have shown that
dulse did have a certain amount of B-12 analog per serving. Until research
is done to see if it actually lowers the methyl malonic acid levels, the
question has to be raised that we can't assume that because a food has human
active B-12 it will help avoid a B-12 deficiency, because the actual
non-human active analogs may be blocking the human active B-12. The same
question arises now with the aphanizomenon flos-aqua and spirulina, as well
as chlorella. So, until we actually do the gold standard test of these,
through the methyl malonic test, to see if it actually lowers the methyl
malonic acid, I think it is reasonable to eat these foods, but not expect
that they are actually going to raise your human active B-12. My serum B-12
of 600 pg. may have thrown off my conclusions when I wrote my summary in
1990. I may have been in that 20% of vegans and live food people that don't
seem to be affected. But I am more concerned about the other 80% that are
B-12 deficient and that 50% whose B-12 levels go down to less than 100 pg. A
study done in 1991 by Miller found that serum B-12 appeared to be unrelated
to consumption of wakame, kombu, and other sea vegetables or tempeh in
macrobiotic children. Other researchers feel that it is possible that raw
nori, not dried nori, is a source of active B-12. Some of these conclusions
are not finalized. This brings me to the next issue, which is, what is a
normal level of B-12?
Now the next question really is, what is a healthy level of B-12 in the
serum? The answer is that a serum level of 450 pg. keeps the homocysteine
level within normal levels. Some might just say that dulse and raw nori and
an algae called cocolithophorid algae, also known as pleurochritias cartera,
may provide sufficient human active B-12. They have not been fully tested
with the gold standard. The normal serum homocysteine level is 2.2 -
13.2micromoles/liter. The normal adult urine MMA is .58 -
3.56 micromoles/mmol/cr. The normal level of B-12 for breast milk is 180 -
300 pg. per ml. The normal urine level for children is 820 - 11,200
micromoles/mmol/cr of MMA. The normal serum B-12 level of children is 160 -
1300 pg. per ml.
Using the methyl malonic acid study as the gold standard, elevated methyl
malonic acid was found in subjects with a B-12 up to 486 pg. This is a
really important statement, because up 'til this time, most of the studies
in the world health basically say that 200 pg. and above is not considered
deficient. That was somewhat how I based my ideas that B-12 in many vegans
and raw foodists was low normal, but still within normal. Using the gold
standard methyl malonic acid test, studies show that without supplementing
with B-12, vegans have higher homocysteine levels than lacto-ovo vegetarians
and non-vegetarians, which means they are deficient in B-12. The good news,
of course, is that B-12 supplementation will decrease these high
homocysteine levels back to normal range. High homocysteine levels are
connected with the potential for heart disease, arterial destruction and
neurological pathologies. Other diseases associated with an elevated
homocysteine are: Alzheimer's, age related hearing loss, neural tube
defects, recurrent loss of pregnancy, increased mortality. Many
non-vegetarians also have a poor B-12 status because there are many factors
that can cause B-12 deficiency. They include malabsorption or inadequate
intake of protein or calories or B-12, radiation exposure, drugs, and a
variety of toxins, paraminosalicylic acid, alcohol, pancreatic tumors,
failure of the small intestine to contract and move food associated with
bacterial overgrowth, oral contraceptives, fungal infections, liver and
kidney disease, tobacco smoking and B-6 or iron deficiency.
*The research conclusion is that: it is a reasonably safe bet that about 80%
of the vegan and live food population, over time, runs the risk of a
subclinical or clinical B-12 deficiency and increased homocysteine levels.*
An even higher percentage of newborns run this risk. My suggestion, out of
my concern for all of my clients, for my fellow live fooders and vegans is
that it is well advised to supplement with an actual B-12 human active
supplement. There are vegan B-12 supplements, which allow us to be totally
successful vegan live fooders.
My general recommendation is that if you have symptoms of B-12 deficiency,
you can even start with a 100 pg. injection, or according to the research,
an oral administration of 1,000 pg. per day for two to four weeks is equal
to repeated monthly injections. After about a month of the oral, the dose
can be cut in half. One can even cut that in half again. I don't really
recommend nutritional red star yeast, because of the fungal potential; I
think that the safest and healthiest approach is via supplementation.
Some people eat according to their philosophy and belief of what is natural,
and this may be an impediment. For example, the black Hebrews, a group of
African-Americans who have migrated to Israel, have horrendously high levels
of infant B-12 deficiency, as well as adult B-12 deficiency. They did not
believe in taking supplements. Data in a 1982 study showed that of the
infants who were breastfed for three months, and then were given diluted
homemade soymilk for three months to one year, 25 of them (a significant
percentage) had protein deficiency, iron and B-12 anemia, as well as zinc
deficiency. In the 1982 study, three of the infants were dead on arrival,
five more died within a few hours of hospital admission, despite treatment.
Serum levels were low in 9 of 15 cases and undetectable in three of them. I
don't feel this is a very good example of what we want to show to the world
in the way we want to treat our children. We can make those choices. We have
a theory of natural, and we also have a theory of what it means to be
healthy.
This is the first time in history that we can be completely successful live
food vegans. What I mean by being successful is completely healthy,
including no B-12 deficiency and no elevated homocysteine levels. It is my
medical opinion, as a vegan since 1973 and live fooder since 1983, and as a
person committed to supporting all those who choose to become healthy live
food vegans, that it would be wise to incorporate some B-12 supplementation
in your diet. I believe it is more natural to be healthy than it is to be
anything less than that.
*B12 ... in response to letters about the above article *
I was pleased by the general positive response to the B12 article. It was
nice that so many people understood the integrity of my intent, which is to
create the understanding and support for everyone to be successful on a live
food diet. The ethics of live food lifestyle are wonderful, but we need to
remember that we are still in the first few generations of a worldwide live
food movement. We need to give honest feedback so we can attain the highest
level of health and make this a truly successful worldwide movement.
Contrary to what a few people wanted to interpret from my article, there was
more than one study that showed live food people were B12 deficient. There
were at least three studies on adults and two on children. All five of these
published live food studies showed the participants had serious
deficiencies. These are no studies that show live food vegans do not get B12
deficient overtime. There are at least fifteen vegan studies on adults that
have shown identical results. Cooked food and live food vegans show the same
resultsÂ…approximately 80% of those who do not use B12 supplements or B12
fortified foods sooner or later develop symptoms of B12 deficiency. These
may include physical symptoms such as the inability to walk, tremors,
weakness, fatigue, diarrhea, fever, upper respiratory infections, impotence,
infertility, anemia as well as neurological symptoms such as depression,
anxiety, panic attacks, hyperactive reflexes, numbness and tingling in the
hands and feet, impaired memory, and paranoid delusions. These appear in
children as well, but in children if they are not caught in time, they often
result in death. Sickness and death due to B12 deficiency do not support the
expansion of the vegan live food movement. These symptoms are not just "a
misunderstood healing crises or poorly functioning colon or a poor live food
diet."
Although bacteria in the colon do produce B12, it is not reabsorbed into the
system. Published research has shown that if people eat an extract of their
feces they will not get a B12 deficiency. Although this may be considered
natural, it is not something that I recommend. There are far easier and
tasteful ways to build the B12 such as taking a supplement or eating B12
fortified foods. Whether one's colon is clean or not, B12 does not get
absorbed from the colon. A reasonable dose is 10-100 micrograms per day.
Research shows that a daily intake best approximates the natural intake
pattern. Vegan tablets are available from a variety of companies; Twin Labs
has gelatin in its tablet and therefore is not vegan. There are three forms
of B12: cyanocobalamin, methylcobalamin, and hydroxycobalamin. Although all
three forms work, but cyanocobalamin probably should not be used in people
with kidney problems or who smoke. In some studies with people with severe
B12 deficiencies oral doses of 1000 micrograms per day for two months worked
as well as 1000 microgram injections repeatedly given.
A published report cites a man in his eighties who had been in excellent
health as a vegan for 38 years, when suddenly he began to suffer from mental
disturbances, developed confusion and sadness, lost bowel control, and lost
motor control skill to the point where he could marginally stand up. After
one shot of B12 his physical and mental health began to rapidly return and
by one week many of his symptoms had disappeared. A personal communication
with Nazariah Owen who developed weakness, fatigue and impaired motor and
nervous system symptoms including the loss of the ability to walk following
a seven year history of lacto-vegetarian diet followed by a five year
history of a pure raw vegan diet tells of a too common story. His symptoms
disappeared after starting B12 supplementation and eating B12 fortified
foods. He found many people who had similar B12 deficiency symptoms, but who
were afraid to share publicly. An additional health problem associated with
a low B12 is elevated homocysteine which is associated with an increased
incidence of heart attacks, neurological problems, neural tube defects in
children especially if the folic acid is low, increased incidence of hearing
loss with age. In one study women with higher homocysteine levels had 170%
chance of two or more pregnancy losses in the first trimester.
If the live food movement is to mature, it requires that we do not suppress
honest feedback so we can solve the problems that do arise in this young
mass movement. YesÂ…there are 20% who may not get an immediate or even a
deficiency after 20 years. There are one million four hundred thousand
genetic variations in our DNA. Some people are going to get B12 deficient
sooner than others or not at all because of their particular enzyme systems
and metabolic patterns. For some it may be like the man in his eighties who
took thirty-eight years before becoming deficient.
For those who do not want to risk the eighty percent chance of becoming
deficient, oral supplementation is the simplest way to avoid a B12
deficiency and elevated homocysteine levels. The personal physical, moral
and spiritual reasons for succeeding at live food vegan diet, the shift in
world consciousness and healing of the planetary ecology brings is a far
greater gift than the ego gratification of holding on to a concept of
naturalness.
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