You are quite not yourself and you just can’t put a finger on it. You feel listless, tired, moody, and have bouts of weakness and shortness of breath. You may be suffering from a deficiency of Vitamin B12.

There are complications which come with the diagnosis though. A lot of times, and it may not be the doctor’s fault, the deficiency may not be caught or caught on time. This is because the symptoms are shared by so many other diseases that it’s easy to attribute the deficiency of B12 to something else.

It’s also tricky because it does not happen at once. It creeps slowly. It may take years for you to eventually realize that you have a deficiency. And all these time, you may attribute your symptoms to just life, stress and general fatigue.

So how would you start to know that you may have a deficiency of B12? Here are some symptoms that will tell you:

1. The first thing would be anaemia. Even by itself, it’s a disease that’s slow to manifest. It is basically a shortage of the red blood cells that carry oxygen around the body. And these of course are critical as oxygen is life. They start to deplete slowly and eventually, you have no energy. Even breathing is a labour. Your palms and the insides of your eyelids are pale. You may even start to experience fainting spells.
2. You will feel sudden itchiness of the tongue. It starts then stops as suddenly as it started. All this is related to the lack of oxygen – transportation of it is cut off and suddenly resumed thus the tingling or itchy feeling.
3. You’ll notice that you start to forget things. This one is a hard one to use for diagnosis because it’s usually attributed to too much to do and the stresses of life. What should mark it as a symptom for you is that it gets worse and worse.
4. You lose your appetite. Again, this is a symptom that comes with many other illnesses so you may not attribute it to a deficiency of B12.
5. You’ll get alternating diarrhoea and constipation. The problem again with these two is that many times you’ll think it’s your diet or your lifestyle and not necessarily a deficiency.
6. Your hands and feet start to tingle suddenly – that pins and needles feeling only its much more pronounced and does not come as a result of awkward posture. The tingling will stop as suddenly as it started when the area gets enough oxygen once again.
7. You’ll notice that you have permanently cold hands and feet. Some people are born naturally this way, but if you are not and notice that you are developing them, it should be a pointer to have yourself checked.
8. Your heart is now struggling to feed oxygen to your body because all vital bodily functions need to be kept going. You will feel palpitations of the heart as it fights.
9. As this is happening, you will be struggling to breath and may have chest pains. You’ll get more and more out of breath and the chest pains will get worse.
10. If you are woman, you’ll notice a big change in your menstrual pattern. It will become unpredictable and when it does happen it’s either too heavy or too light.

There are many more symptoms – as the deficiency gets worse, it may even reach your nervous system and eventually cause worse problems.

Since it’s hard to detect the symptoms of a B12 as they stand, the best thing to do is to guard yourself. You can get B12 tablets without a prescription. They can be either regular tablets or sublingual b12 ones. You can even get the occasional B12 shot just to make sure that your body is well supplied.

Sources:

1. The Vegetarian Society of the United Kingdom
   Parkdale, Dunham Road, Altrincham, Cheshire, England WA14 4QG
2. www.vitab12.com
3. An Essential Part of a Healthy Plant Based Diet
4. Dietary Fact Sheet: Vitamin B12
   

Vitamin b12 is an essential element needed for the proper function of our bodily systems. Without it, the body can easily acquire mental disorders like dementia and can be at risk for heart disease. Although available in its oral form, sublingual b12 is mostly suggested by doctors today. Let us find out why.

The Tablet

The tablet form of the vitamin is said to be a lot less inefficient than its sublingual b12 counterpart. There are actually various reasons involved.

• The tablet form is taken orally and would undergo a normal process of digestion. Inside the digestive tract, certain enzymes can lessen the effect or absorption of the supplement in the body. Therefore, the results can be non-therapeutic to some.

• Tablets often take time to consume than the sublingual type. You have to drink a glass of water to push the medication to the stomach. For some individuals, this can be quite inconvenient.

• Oral supplements can interact with some drugs during the digestive process. You may have to schedule your intake of vitamins if you’re drinking it together with other drugs.

• Some individuals cannot tolerate the oral form of the supplement. They need to drink copious amounts of water to finally deliver the pill to the stomach.

• Oral b12 can take time to be absorbed by the body. One couldn’t expect the therapeutic effects right away because the tablet has to go through the proper digestive process.

Sublingual B12

There are several reasons why doctors opt for the sublingual type of vitamin b12.

• When placed under the tongue or between the cheek and the gums, the medication is directly absorbed by the blood stream. It is then easily absorbed by the body for immediate use.

• The nutrients found in the supplement are not destroyed by the strong acids found inside the digestive tract. Since it is given sublingually, the medication does not have to enter the stomach for absorption.

• One can experience the benefits right after taking sublingual b12. There is a faster rate of absorption for this method of administration.

• Most people find the sublingual type more convenient. They simply place the pill under their tongue and they enjoy a sufficient amount of b12 supplementation in the body.

Minor Side Effects to watch out for when taking Sublingual b12 or the tablet form

Both the oral and sublingual b12 pose different risks to the individual using it. Although such conditions are rare, there may be chances that person can develop certain reactions to the two routes of administration.

When Taken Orally

• If the supplement is taken by mouth, the acid normally found inside the stomach may cause the medication to be less potent.

• If combined with other treatments, the vitamin can either enhance or lessen the therapeutic effect of that drug

When Taken Sublingually

• Incidents of allergic reactions have been noted on some patients. Although no severe cases were recorded, there may be a chance for the person to develop allergy to the sublingual form of this supplement.

• Some dietary ingredients may also react with the sublingual b12. It is best, therefore, to inform the physician of your allergies before starting the supplementation.

If you want to take in vitamin B12, there are several recommended ways to do it:

• You can try and get it through diet – an uphill task because it is extremely rare in natural foods. Non-vegans can get it from meat and eggs, but even then, to get it in the right amounts is not easy bearing in mind that you can only consume so much of these in a healthy diet.
• You can get a B12 shot. This would likely be recommended by your doctor and in most cases to someone with severe lack of vitamin B12 that is affecting their health significantly.
• You can get it in tablet form as a supplement. This can come as a tablet with multiple vitamins in it, or just as a B12 tablet by itself. It has to go through your digestive system and do its best to get absorbed before it leaves your body.
• In sublingual form – the easiest and fastest and most effective way to take vitamin B12. Sublingual simply means you put in under your tongue. The membranes that are underneath your tongue are stimulated by the tablet to produce saliva, which dissolves the tablet and it’s absorbed directly into your bloodstream. All of it is utilized. This method has advantages over all the others:

1. Faster Absorption

It’s placed under the tongue as a tablet or in the form of drops. Beneath the tongue, there are numerous blood vessels. Just placing it underneath your tongue stimulates production of saliva which very quickly dissolves the tablet or drops. On absorption, it goes straight into the bloodstream. Studies have shown that this method provides 100% absorption as compared to a tablet where you get 1.2% absorption.

2. Higher Retention

Taken in ordinary tablet form, a B12 pill goes through your digestive system and through the entire digestive process.  On the way, it loses its strength because of alteration to its original form by various digestive acids. Sublingual b12, because it will not come into contact with any acids whatsoever, will get absorbed into the body in its original form and give the highest nutritional value.

3. Instant Effect

Because of faster absorption and better optimization, the effects are instant. If you were taking it for energy, for instance, you will feel energized much faster than if you took it through a tablet. It is definitely recommended when lack of B12 has led to a condition or disease because the healing will be faster.

4. Works Great for Appetite and Sleep Control

Lack of B12 can lead to loss of appetite and poor sleeping patterns. When trying to deal with these, you want a solution that will work as fast as possible. If its determined that B12 deficiency is the one causing you to lack appetite and sleep, the best way to get over this quickly is to have a sublingual B12.

5. Its Inexpensive

Compared to a B12 tablet which may come at the same price, you get more value with sublingual B12. You will need to take much less of it and for shorter periods for your body to have enough. Shots are expensive too, especially if you think of doctors fees and if you need a series of them.

Remember that B12 is essential for good health. Your body needs it for energy, sleep, appetite and even a healthy central nervous system. If you’re not already including it as a part of your diet, you should consider it. If you are and haven’t yet tried sublingual B12, you should – it’s the fastest and most effective.

Sources:

1.    The Vegetarian Society of the United Kingdom

Parkdale, Dunham Road, Altrincham, Cheshire, England WA14 4QG

2.    www.vitab12.com

3.    An Essential Part of a Healthy Plant Based Diet : http://www.ivu.org/congress/2002/texts/b12pres.html – B12:

4.    Dietary Fact Sheet: Vitamin B12:http://ods.od.nih.gov/factsheets/vitaminB12.asp -

More and more, vitamin B12 shots are becoming a health fad. Not too long ago, they came recommended by the doctor and then only for serious B12 deficiencies. Now, with the discovery of the multiple benefits of B12 for the body and overall health, people are opting them into their wellness routine. High energy people, politicians, stars and anyone who is constantly in the public eye and has to look energetic all the time has probably tried them.

Why are vitamin B12 shots getting so popular?

Picture of B12 shots

B12 is a great energy boosters. It works through the red blood cells, by enabling them to carry oxygen more efficiently. An oxygenated cell is a cell that is at its optimum, full of energy and won’t tire easily. B12 is also great for the skin. These are just some of the benefits – overall, it’s an essential vitamin that the body must have to stay in balance. The only problem is that it is not that easily found in food – very few foods are B12 rich and these are essentially meat and eggs. This leaves especially vegans to look for sources elsewhere, in fortified foods, supplements or vitamin B12 shots. Shots are a preferred option because of their direct and immediate absorption into the bloodstream.

So what are the benefits of B12 shots?

1. B12 increases metabolism, the side effect of which can be weight loss. With regular B12 shots and a combination of other weight loss regimens, people have reported to lose weight much faster and they attribute it to the shot.
2. B12, as we said earlier is a great energy booster. What better way to deliver an energy booster than directly into the bloodstream? The other option would be to take a supplement, which would take many hours in the digestive process and would lose much value along the way.
3. Speaking of value, with a B12 shot, you retain almost all the B12 – none of it gets lost in the digestive process. For comparisons sake, a B12 tablet leaves you with only 1.2% of B12 in the tablet. A shot will lose very little, if any.
4. b12 Shots are highly recommended mood boosters as well. B12 is essential for a properly functioning central nervous system – we know that dysfunction can lead to depression. If you suffer from mild depression once in a while, you can try a B12 shot as a mood booster – some people have reported feeling happily giddy afterwards, but not for long. In a few hours, it settles and you are just happy!
5. B12 is essential for a properly functioning cardiovascular system. It thins the blood and prevents blood stickiness. Blood cells sticking together is what leads to a blood clot which can cause a stroke.

If you are getting vitamin B12 shots regularly, you’re probably already feeling the tremendous changes it can have on your body. If you’re not yet taking in B12 to boost your diet, or are taking supplements, you should consider the shot. It’s quick, painless and has multiple benefits.

1. An Essential Part of a Healthy Plant Based Diet : http://www.ivu.org/congress/2002/texts/b12pres.html
2. Dietary Fact Sheet: Vitamin B12:http://ods.od.nih.gov/factsheets/vitaminB12.asp

Biochemical indicators of vitamin B12 and folate insufficiency and cognitive decline

Tangney, C.C., Tang, Y., Evans, D.A., and Morris,

M.C.Neurology – 27-JAN-2009; 72(4): 361-7

Objectives: The goal of the study was to determine which parameters—serum concentrations of Vitamin B₁₂ or B₁₂ metabolites were most closely correlated with cognitive decline.

Methods: A stratified random sampling selected 516 subjects from the Chicago Health and Aging Project. Linear mixed models were used to examine the association of homocysteine, methylmalonic acid, 2-methylcitric acid, and cystathionine to a change in cognitive scores. The time frame of the study was over 6 years. Every three years during this period, cognitive function was assessed by the East Boston tests of immediate and delayed recall, the Mini-Mental State Examination, and the Symbol Digit Modalities Test. On each test, scores were expressed as z-scores and averaged. An approximately normally distributed global measure of cognitive function was obtained. The statistical analysis reduced the “floor and ceiling effects” as well as other potential measurement errors inherent in each test. Results were expressed as the sum of the standardized scores.

Results: Vitamin B₁₂ deficiency was seen in 14.2% of the participants. Increased serum homocysteine was noted in 19.2% while increased methylmalonic (MMA) acid levels were noted in 36.4% of participants. The higher MMA values were correlated with faster cognitive decline (p = 0.004). Conversely, higher B₁₂ concentrations were associated with slower rates of cognitive decline. (p = 0.005) There was no detectable relationship between homocysteine levels and cognition.

Conclusions: The most important risk factors for cognitive decline in older populations are high serum methylmalonic acid and low vitamin B₁₂ concentrations. Supplementation with folic acid, in food or as a supplement, may be contraindicated in this population.

Effects of cyanocobalamin on immunity in patients with pernicious anemia.

Erkurt, M.A., Aydogdu, I., Dikilita,Å.Ÿ., Kuku, I., Kaya, E., Bayraktar, N., Ozhan, O., Ozkan, I.,and Sonmez, A. Med Princ Pract – 01-JAN-2008; 17(2): 131-5

Objectives: To evaluate patients with pernicious anemia regarding the role of Vitamin B₁₂ in both cellular and humoral immunity.

Methods: A prospective study was conducted. Changes in T and B lymphocyte subpopulations, Natural Killer (NK) cell number, serum C3/C4 and levels of immunoglobulins G, M and A were measured before and during treatment of Vitamin B₁₂deficient patients with cyanocobalamin.

Results: Pre-treatment, the absolute numbers of CD⁴⁺ and CD⁸⁺ lymphocytes was decreased as was NK cell activity. The CD⁴⁺/ CD⁸⁺was also decreased. After treatment with cyanocobalamin, these values were restored to normal levels. Serum levels of C3, C4 and immunoglobulins G, M and A were increased post-treatment.

Conclusions: Vitamin B₁₂ plays an important role in cellular and humoral immunity and immunoregulation. In patients with pernicious anemia, immune parameters were restored after treatment with cyanocobalamin.

Studies of biomarker responses to intervention with vitamin B-12: a systematic review of randomized controlled trials.

Hoey, L., Strain, J.J., and McNulty, H. Am J Clin Nutr – 01-JUN-2009; 89(6): 1981S-1996S

Objectives: To assess the effectiveness of various biomarkers of Vitamin B₁₂ status in randomized controlled trials of oral B₁₂ supplementation.

Methods: A systematic meta-analysis of the literature was undertaken. A structured search strategy on Ovid MEDLINE, EMBASE (Ovid), and Cochrane databases was implemented using formal inclusion/exclusion criteria, data extraction and validity assessment. Eight randomized, controlled trials were included. All trials measured serum and plasma values of B₁₂. In addition, three studies followed methylmelonic acid values and six studies followed total homocysteine levels with B₁₂ supplementation.

Results: The three biomarkers studied, Vitamin B₁₂, methylmelonic acid and total homocysteine, correlated with levels of Vitamin B₁₂ intake (P< .0001). Insufficient data was available to determine the effectiveness of holotranscobalamin as a marker.

Conclusions: The three biomarkers are effective measures of Vitamin B₁₂ intake, particularly in those patient populations with borderline or low plasma/serum B₁₂ levels. Future supplementation trials with Vitamin B₁₂ should measure the holotranscobalamin response.

Homocysteine Lowering and Cognition in CKD: The Veterans Affairs Homocysteine Study

Brady, C.B., Gaziano, J.M. Czypoliski, R.A., Guarino, P.D., Kaufman, J.S., Warren, S.R., Hartigan, P., Goldfarb, D.S. and Jamison, R.L.

Objectives: The study was designed to investigate the relationship of the high homocysteine levels associated with chronic kidney disease and decreased cognitive function. Potential treatment by supplementation with high dose Vitamin B was investigated as well.

Methods: A randomized, double blind controlled study was conducted with 659 patients (mean age, 67.3 +/- 11.7 years) diagnosed with chronic kidney disease (CKD) or end-stage renal disease (ESRD) with coexisting high plasma total homocysteine levels (≥15μmol/L). Cognitive assessment by Telephone Interview of Cognitive Status-modified (TICSm) and supplemented with attention, working memory and executive function tests was initiated after implementation of Vitamin B treatment. The treatment consisted of either a daily high dose Vitamin B capsule (40 mg of folic acid, 100 mg of vitamin B₆ , and 2 mg of vitamin B₁₂) or placebo.

Results: Approximately 19% of patients had some level of cognitive impairment at the onset of the assessment, regardless of treatment assignment (vitamin or placebo) or kidney disease status. The treatment with high dose Vitamin B resulted in a decrease of tHcy levels by 26.7%. 1 year analysis (adjusted and unadjusted) showed no improvement in cognitive outcomes with treatment.

Conclusions: Cognitive outcomes were not affected significantly by treatment with high dose Vitamin B. A major limitation of this study was that cognitive assessment was begun after vitamin treatment was instituted. High dose daily Vitamin B supplementation was positively correlated with decreased tHcy levels.

Effect of L-dopa on plasma homocysteine in PD patients.Relationship to B-vitamin status

Miller, J.W., Selhub,J., Nadeau, M.R., Thomas, C.A., Feldman, R.G., and Wolf, P.A. Neurology – 8-APR-2003; 60(7): 1125-9.

Objectives: l-dopa is used in the treatment of Parkinson’s disease (PD) and is known to increase both the cellular synthesis and plasma levels of homocysteine. The objective of this study was to determine the effect of supplementation with folate, and Vitamins B₁₂ and B₆ on plasma concentrations of homocyteine in l-dopa treated and control PD patients.

Methods: 40 patients were enrolled in this study on an out-patient basis. Both men and women diagnosed with idiopathic PD who showed at least two of the three cardinal criteria were included. The cardinal criteria were rigidity, resting tremor and bradykinesia. Specific exclusion criteria included pregnancy, dietary restrictions, and a history of neurodegenerative disorders other than PD, drug or alcohol abuse, depression or other major medical disorders also correlated with a Vitamin B deficiency status. 20 of the patients were concurrently treated with the standard l-dopa/carbidopa combination (treatment group) and 20 were l-dopa-naïve (control group). Levels of plasma homocysteine, folate, Vitamins B₁₂ and B₆ were measured and correlated with the treatment and control groups.

Results: Higher plasma levels of homocysteine and lower plasma levels of the vitamin were found with the l-dopa/carbidopa group. In the control group, similar plasma levels of B vitamins were not associated with higher levels of homocysteine. (P<.001)

Conclusions: PD patients treated with l-dopa should be monitored for their homocysteine levels as these can increase with treatment. The extent of the plasma hyperhomocysteinemia is inversely related to B-vitamin status. Supplementation of PD patients on l-dopa with B-vitamins should be considered.

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A single-center, double-blinded, randomized controlled study to evaluate the relative efficacy of sublingual and oral vitamin B-complex administration in reducing total serum homocysteine levels

Yazaki, Y., Chow, G., and Mattie, M.J Altern Complement Med – 01-NOV-2006; 12(9): 881-5.

Objectives: Sublingual versus oral B-complex, each containing 1000mcg of Vitamin B₁₂, was studied in a double blinded, randomized and placebo controlled test to determine the relative efficacies in reducing serum total homocysteine levels (tHcy). The ultimate goal of the study is the clinical use of B-complex vitamins in the treatment of atherosclerosis.

Methods: 41 patients (ages 50-80 years) were randomized into a control (placebo) group, a sublingual group and an oral group. The patients were selected on the basis of serum tHcy concentrations greater than 11μmol/L. The treatment groups underwent a 6 week trial of Vitamin B complex, containing 1000mcg of B₁₂, 400 mcg folic acid, and 5 mg of Vitamin B₆. Each treatment group also received the corresponding placebo (e.g. the oral group received a placebo sublingual preparation and the sublingual group received an oral placebo).

Results: Both the sublingual and the oral groups experienced significant reduction in serum tHcy levels (P < .0001) during the treatment period. There was no statistically significant difference between the two dosing regimens.

Conclusions Sublingual b12 and oral B complex preparations containing 1000mcg of B₁₂, 400 mcg folic acid, and 5 mg of Vitamin B₆ are effective at decreasing tHcy levels. The results indicated that the use of Vitamin B complex may be indicated in the treatment of atherosclerosis