It’s not just a vegan problem

Are you feeling tired all the time? Have low mood or feeling depressed?  Hair thinning? Hair loss? Headaches? Joint pain? Muscle weakness? Suffering with constipation or diahorrea? Lost your appetite? Nausea? Feeling off balance? Struggling with memory or just thinking in general?

These symptoms could be due to a number of issues, but one that is easily overlooked is having a B12 deficiency. B vitamins overall are important for making sure the body’s cells are functioning properly as well as helping the body convert food into energy. B vitamins create new blood cells, maintain healthy skin cells, brain cells, and other body tissues. B vitamins may also reduce the risk of heart disease, by helping to lower bad cholesterol (LDL) and increase good cholesterol (HDL), so take a look at your b vitamin levels before reaching for the statins.

B vitamins are also involved with methylation. Methylation is an important chemical process for various biological functions within the body. It can have significant impact on the gene expression of our DNA and on our cellular processes to regulate healing, cell energy, neurological function, liver detoxification, immunity, and more. Health and quality of life are highly dependent on the methylation process. 

Tapan Audhya, Ph.D. from the Health Diagnostics and Research Institute states, ‘Defective methylation processes can lead to a number of serious health conditions. A simple abnormality in the methylation pathway, compounded with further assaults from environmental and infectious agents, can lead to a wide range of conditions including cardiovascular disease, neurotransmitter imbalances, cancer, diabetes, abnormal immune function, chronic fatigue syndrome (CFS), multiple sclerosis (MS), cognitive dysfunction in patients with dementia, neurological and psychiatric disorders, Alzheimers disease (AD), Down syndrome, autism, neural tube defects, chronic inflammation, etc.’

Vitamin B12  plays a crucial role in methylation processes within the body and is essential for maintaining adequate levels of methionine and SAMe, both of which are key players in methylation reactions. Inadequate B12 levels can lead to disruptions in methylation processes that can contribute to health issues.

Vitamin B12, once ingested, is processed by acids and enzymes in the stomach and small intestine. The processed vitamin is then absorbed by the small intestine and stored in the body, especially in the liver. The stored B12 can actually meet the body’s needs for a few years as only a tiny bit is needed each day. So if and when you stop taking in (or stop absorbing) vitamin B12, it can a few years before the body runs out and you start to develop symptoms. Vitamin B12 deficiency tends to come on very slowly with barely any noticeable symptoms, or the symptoms might be attributed to another chronic health condition. This is why, I believe, it can be easily missed as a cause for some health issues.

So what can cause a deficiency in B12? Let start with the most obvious one- being a lazy or uninformed vegan, I have been guilty of both in the past. If you choose to be a vegan or you are unable to consume animal products, it’s important to have a good understanding of what else your body needs. B12 occurs naturally in animal products so it is important to ensure you are getting it from another source. Vegetarians can get some B12 from dairy products but vegans will need to either consume foods fortified with B12,  add nutritional yeast to their meals or include supplementation. Its imperative you keep an eye on your Vitamin B12 levels as a vegan for overall health. Without maintaining proper levels you suffer serious side effects, including nerve damage and depression.

The other main cause is an inability to absorb ingested nutrients, like B12, from your food. So what could be preventing absorption? As I mentioned earlier, acids and stomach enzymes are needed to process vitamins, once processed they are then absorbed and stored. So if your acids and enzymes are low, you won’t be able to process or absorb the vitamin B12 .

There are several reasons why this might be;

• Alcoholism or excessive alcohol consumption can irritate the stomach, this can go hand in hand with a poor diet.
• Medication– some medications can interfere with B12 absorption.
• Surgery– stomach or gastric bypass surgery where parts of the stomach or small intestine are removed.
• Small Intestine Disorders such as Celiac Disease (autoimmune response to consuming gluten), Crohn’s Disease (autoimmune disorder of the GI tract), Tropical sprue (a rare, chronic digestive disorder affecting those living in or traveling to tropical/ subtropical regions.)
• Conditions interfering with the absorption of nutrients (e.g. SIBO (small intestinal bacterial overgrowth), H-pylori (bacterium), increased intestinal permeability (leaky gut), some parasitic infections,  to name a few.)
• Inability or lost the ability to make “intrinsic factor.” When B12 is released from the food, it binds to intrinsic factor, a glycoprotein in the lining of the stomach.  The intrinsic factor protects the B12 from the stomach acid and carries it to the ilieum where the B12 is absorbed. Without intrinsic factor, B12 levels eventually fall.
• Aging – as we get older, we can have problems with acids and enzymes due to a weakening of the stomach lining. Also taking some medications can actually reduce stomach acid.  According to Leslie Kernisan, MD MPH of ‘Better Health While Aging’ experts have estimated that up to 20% of older adults may be low in B12 and it’s often missed by doctors. A B12 deficiency can cause, or usually worsen, cognitive impairment or walking problems. Kernisan states that the most common problems associated with B12 deficiency in older adults are anemia (fatigue, shortness of breath, jaundice), neuropathy (tingling, numbness, burning, poor balance, walking difficulties) and cognitive impairment (memory problems, irritability, and even dementia.)