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In today’s environment of supplemental confusion, as a rule we don't generally recommend vitamins for the fit and healthy. Some people see it as a way of perhaps overcoming the partial guilt of not always eating right. There are some exceptions and the use of vitamin B12 is one of them.
Vitamins are trace elements that we do not require to be continually replenishing. They help our body function by enabling certain chemical reactions to occur, mostly in the manufacture and replenishment of tissue.
Vitamin B12 is also known as cobalamin, and some of us tend to slowly get deficient over time for a variety of reasons. Chiefly, it is because all of our cobalamin must come from food. We do not possess the ability to manufacture any of our own, and generally obtain our supplies by eating red meat.Cobalamin is fundamental to DNA synthesis, the blueprint of our existence, by catalyzing a reaction which produces a DNA building block called methionine from homocysteine. When there is a deficiency of cobalamin and methionine cannot be produced, there is a back-up of homocysteine and cell division in our bone marrow is prevented, resulting in large looking immature blood cells. The decrease in total red blood cells is a term called anemia.
Methionine is also a critical part of our nervous system functioning properly. Cobalamin is also involved in the production of a coenzyme.
The most common symptom of cobalamin or B12 deficiency is fatigue. In more severe states, a glossy red tongue is seen along with unusual nerve problems. At times the nerve damage can be permanent. To diagnose a deficiency in cobalamin, we start with taking a good dietary history, examining the patient for features and then performing routine blood work. Sometimes a more specialized test called a Schillings Test is required. It is a little more labor intensive and requires special booking. It measures how well our body can absorb B12 into the system.
The time tested treatment has been to use injection of B12 given every few weeks. Cobalamin requires an intrinsic factor produced by special cells in our stomachs for proper absorption into our system through the intestines.
Additionally, another secretory factor found in saliva is also needed. It binds to the B12 to prevent normal gastric degradation. In certain gastric conditions, there is little intrinsic factor produced in the stomach cells, and over time, little B12 is absorbed.
Many patients hate attending the clinic for injections on a regular basis. Others elect to be taught self-injection. There have been some reports of greater success by using large doses of B12 pills on a daily basis. With the large dose, some of the B12 is simply pushed across the intestinal wall. There is some promise in this method, but it requires regular use of the pills, and there is no substitute for the natural B12 found in our diets.
The manufactured pills are slightly different. I caution all readers against self-diagnosis and self-treatment of fatigue symptoms. It may delay the diagnosis of a more serious condition.
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