Nutrition & Diet B12 deficiency and psychosis

[Blobbenstein]

A case study of B12 deficiency from 2009 has been sitting in my “to read” folder and I finally got to it due to being confined to an airplane for a few hours today. The patient was a 31-year old Taiwanese male. Over the course of a few years he became more and more paranoid and schizophrenic until he was admitted due to alarming paranoid behavior. At first he was placed on an anti-psychotic drug. 7 weeks later, he was back in the hospital and this time it was discovered that he had been vegetarian since his teenage years with his only source of vitamin B12 being “minimal intake of dairy products.” The anti-psychotic drug was replaced with 1,000 µg per day of oral cobalamin. His state improved in 2 weeks and 1 year after discharge he had not had another episode. His B12 levels went from 136 to 227 pg/ml in the first 2 months of therapy.
Another more recent paper (2013) reported that of 19 patients demonstrating psychiatric illness at an Indian clinic, 14 had followed a “strict” vegetarian diet. Not many details were given, though 15 of the 19 patients had low B12 levels, defined as < 225 pg/ml.
I have no more papers on B12-deficient vegetarians in my “to read” folder. I hope it lasts for awhile…

http://jacknorrisrd.com/more-b12-psychosis/


I saw this on the VV tweets on the front page.

 

[Music Platter]

Shoot. I'm pretty sure that I don't get a lot of B12.

One of the comments on the page was interesting, with bold added by me:

Dan Says:
August 9th, 2013 at 6:36 am
Thanks for sharing these case reports, Jack. I once had a B12 level of 104 pg/ml and yet was not psychotic at the time. I am wondering if low B12 level somehow unmasks an underlying tendency towards psychosis in certain vulnerable individuals – i.e. it is a sufficient but not necessary factor. There is far more low B12 in the population than there are chronic schizophrenics and psychotics – up to 25% of elderly people have below normal values of B12, yet psychosis in the elderly is not 1 in 4. This is why we are seeing “case” reports and not cohort studies on this phenomenon. Still, it does point out the connection between failure to replenish B12 on vegan diets and adverse neuropsychological consequences. The peripheral neuropathy manifestation of this disorder, due to subacute combined degeneration of the spinal cord, is also very significant.

I'm not very experienced on vitamin information. Does anyone know if this is possible?

 

[KLS52]

I don't know about the psychosis part, but my co-worker/friend has permanent nerve damage (peripheral neuropathy) due to low B12.

I have my levels checked yearly and thankfully, they are fine. I do supplement.

 

[SummerRain]

How frightening.

 

[Dedalus]

I don't know about the psychosis part, but my co-worker/friend has permanent nerve damage (peripheral neuropathy) due to low B12.

I have my levels checked yearly and thankfully, they are fine. I do supplement.

What do you supplement with? My wife has become very concerned about this sort of thing.

Here are the two articles that are worrying her:

http://articles.mercola.com/sites/a...e-most-dangerous-side-effect-of-veganism.aspx

http://chriskresser.com/what-everyone-especially-vegetarians-should-know-about-b12-deficiency

 

[shyvas]

I'm also a bit worried and only have a yearly test for B12 levels.

 

[KLS52]

What do you supplement with? My wife has become very concerned about this sort of thing.

Here are the two articles that are worrying her:

http://articles.mercola.com/sites/a...e-most-dangerous-side-effect-of-veganism.aspx

http://chriskresser.com/what-everyone-especially-vegetarians-should-know-about-b12-deficiency

I use the liquid B12. And I'm not even that regimented about it. I will take it faithfully for a few weeks then skip a few then get back on it. I do consume quite bit of nutritional yeast...probably 5 days out of seven.

 

[Blobbenstein]

I go through phases of not taking the depressing veg1 pills, but I take a multi vit with b12 every day, so that is something, although that is only 100% rda.

 

[KLS52]

The second link is interesting and concerning. I may switch to a B12 spray and see if I can get a more advanced blood test. I know I am getting on in years, but I do not like the changes I am seeing over the last 12-18 months or so...can relate to the brain fog, memory issues and lack of interest in things I used to love to do. It's too easy to dismiss it to menopause and aging. I'd rather be sure.

 

[shyvas]

The second link is interesting and concerning. I may switch to a B12 spray and see if I can get a more advanced blood test. I know I am getting on in years, but I do not like the changes I am seeing over the last 12-18 months or so...can relate to the brain fog, memory issues and lack of interest in things I used to love to do. It's too easy to dismiss it to menopause and aging. I'd rather be sure.

I also read that the older you get the harder it is for the stomach to absorb vit B12 and one should consider having injections.

 

[Calliegirl]

I had a deficiency many years ago when I was still a lacto-ovo vegetarian. My symptoms were so bad, they were testing me for MS. The doctor said it wasn't due to my diet, I just wasn't able to absorb it. They gave me injections, but they barely did anything. Now I take a Methyl-B12 supplement and it's made all the difference. It's already converted to a form your body can use, so there aren't any absorption issues. My levels are around 1000 now (it was under 200), but when I don't take it for awhile (I tend to forget) my level drops quickly.

You should stay far, far away from anything Mercola (aka Dr. Quack) says.

 

[thefadedone]

I always take the sublingual pills. I was taking 2-3 500mcg pills a day. I also take a multi vitamin every day. I have my blood tested frequently and apparently the results show "super human amounts of B12" according to my dr. I've been advised to cut back. They are just so tasty though!

 

[Freesia]

I agree about the Mercola website. There are some good articles and ideas on there about some health issues, but when it comes to veg*nism, it is a strongly Paleo influenced website. I would rather look at articles by vegans experienced and knowledgeable about B12, such as Ginny Messina.

 

[Calliegirl]

I agree about the Mercola website. There are some good articles and ideas on there about some health issues, but when it comes to veg*nism, it is a strongly Paleo influenced website. I would rather look at articles by vegans experienced and knowledgeable about B12, such as Ginny Messina.

He tends to jump on whatever trend is popular at the time and will make him the most money.

 

[shyvas]

I had a deficiency many years ago when I was still a lacto-ovo vegetarian. My symptoms were so bad, they were testing me for MS. The doctor said it wasn't due to my diet, I just wasn't able to absorb it. They gave me injections, but they barely did anything. Now I take a Methyl-B12 supplement and it's made all the difference. It's already converted to a form your body can use, so there aren't any absorption issues. My levels are around 1000 now (it was under 200), but when I don't take it for awhile (I tend to forget) my level drops quickly.

You should stay far, far away from anything Mercola (aka Dr. Quack) says.

That must have been very frightening Callie. I hope that all is well and your symptoms have dissapeared.

I usually have a few tablets per week; NOw Methyl B12 5000 mcg. I wonder whether I should get tested every 6 months for B12 levels ?

 

[KLS52]

Does anyone know why it is stated to put B12 liquid under the tongue and hold it there for 30 seconds before swallowing? It's already liquid...what exactly does keeping it under the tongue do? I understand that you want to do that with a tablet...so it dissolves.

 

[shyvas]

Does anyone know why it is stated to put B12 liquid under the tongue and hold it there for 30 seconds before swallowing? It's already liquid...what exactly does keeping it under the tongue do? I understand that you want to do that with a tablet...so it dissolves.

It is absorbed much quicker into the blood stream in this way. The same thing applies for homeophatic remedies.

 

[Dedalus]

Good information - I knew there must be another (sane) viewpoint. Thanks all.

 

[Calliegirl]

That must have been very frightening Callie. I hope that all is well and your symptoms have dissapeared.

I usually have a few tablets per week; NOw Methyl B12 5000 mcg. I wonder whether I should get tested every 6 months for B12 levels ?

Yes, I am much better now. I have some permanent damage because it took so long to get diagnosed (I was seeing a nurse practitioner and she thought it was all in my head, so it took forever to get a referral to an actual doctor), but most of the problems are gone.

If your B12 level has been consistently at a good level at your yearly testing, I wouldn't worry about doing it every six months.

 

[Second Summer]

Does anyone know why it is stated to put B12 liquid under the tongue and hold it there for 30 seconds before swallowing? It's already liquid...what exactly does keeping it under the tongue do? I understand that you want to do that with a tablet...so it dissolves.

Some of it can be absorbed directly through the tongue, I believe. I would think the longer you can hold it, the more is absorbed, but maybe there is a limit, so maybe more than 30 seconds isn't going to do you any good? Just guessing, really.