Greater need for vitamin B-12

February 1, 2006

Middle-aged and elderly women’s need for Vitamin B-12 is with great certainty 2,5 times higher than previously believed. A daily vitamin tablet is often not enough.

How is the need for a vitamin determined? Earlier it was determined based on how much is necessary to avoid acute deficiencies. This is sometimes still the case. For example, the current recommendations for vitamin C are still based on a World War II study on 20 English military objectors. Half of them came down with scurvy and two were close to death. But this study found that scurvy can be avoided with 12 mg vitamin C per day.

This kind of research is brutal by today’s standards. But it is also antiquated because it does not take other deficiency symptoms into account, including those which arise after longer periods and are not coupled with bruising of the skin, brittle bones, paralyses, and other acute symptoms. Today, instead of merely recording with a study participant becomes deathly ill, we follow the processes that the vitamins in question are involved in and determine whether or not they function as they should. This methodology was used by the American, Mark Levine when he proved that our need for vitamin C is closed to 200 mg per day than the normally recommended 60 mg. If one makes due with 60 mg it is believed that the vitamin C dependant reactions become slow and that there is an significantly increased risk of cardiovascular disease and cancer.

Of current interest, there is news regarding the need for vitamin B12. The current recommendation in England has been set to 1 microgram per day. A Danish study has recently shown that the need for vitamin B12 is six times as much (6 micrograms). This was determined in a study of 98 Danish women with an average age of 60. Such a large need meanwhile created a problem; the women typically only received 4.6 micrograms via their diet.

Even though they supplemented their intake with a normal vitamin pill (1 microgram B12), half of them received too little vitamin B12. Stronger pills are needed.

Increasing recommendations
For the last 50 years B12 status has been determined by measuring the blood’s B12 content. Findings in recent years have shown that a “normal” B12 value does not necessarily mean that there is enough. Even with a normal B12 value, build op of metabolism products which B12 normally removes can occur (these include homocysteine and MMA, otherwise known as methylmalonic acid). Therefore the amount of these substances present is measured when trying to determine whether or not there is a deficiency.

Recently a third indirect measure for B12 deficiency has been put into focus: holotranscobalamin, a B12 containing protein, seems to be able to replace the above-mentioned method and may even be more sensitive to B12 deficiency. It is very important to get enough of this protein. It is responsible for delivering B12 to the cells, almost like the paperboy who delivers the paper to your door. Without the paperboy, there is no paper.

The Danish study showed that the values for Holotranscobalamin, MMA, and homocysteine no longer indicated deficiency only when a B12 intake of over 6 micrograms per day was achieved. If B12 intake is less than 6 micrograms, there is sand in the B12-works.

The researchers conclude with conviction:
”…our results, together with those of others, strongly suggest that the RDA of 2.4 micrograms/day should be increased.”
This can also been said about many other vitamins. Experience from recent years indicates that the recommendations for not only vitamin B12, but also vitamins C and E and the minerals selenium, chromium, and magnesium, should also be increased, and in some cases greatly increased. Increased intake of many of the other B vitamins as well as iodine should also be considered.

This is especially true about vitamin D, on which we at the Danish Vitality Counsel have focused. The recommended daily dosage of vitamin D should be doubled for those of us who live in northern climes.

The official recommendations have as a whole not followed developments in research, even though there are strong arguments for new recommendations. According to some, there is need for more evidence. But this is contrary to the supposition that new recommendations could prevent serious chronic disease.

The dilemma is strengthened by the fact that it is difficult or impossible to get higher doses of vitamins and minerals though our modern diet. Some suggest that it might be possible with a Stone Age diet, but we surely will not have another Stone Age.

By: Vitality Council

References:
1. Mustafa Vakar Bor et al. A daily intake of approximately 6 {micro}g vitamin B-12 appears to saturate all the vitamin B-12-related variables in Danish postmenopausal women. Am J Clin Nutr. 2006 Jan;83(1):52-8.
2. Zouë Lloyd-Wright et al. Holotranscobalamin as an Indicator of Dietary Vitamin B12 Deficiency. Clinical Chemistry 49: 2076-2078, 2003;10.1373/clinchem.2003.020743.

www.ajcn.org
www.clinchem.org
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Vitamin B12, Research references

January 1999

1. Allen, LH, Casterline J. Vitamin Bl2 deficiency in elderly individuals. diagnosis and requirements. Am J Clin Nutr 60: 12-14, 1994.
2. Baker H et al. Plasma vitamin B12 titres as indicators of disease severity and mortality of patients with alcoholic hepatitis. Alcohol Alcoholism 22; (1):15, 1987.
3. Brinton LA, Gridley G, Hrubec A et al. Cancer risk following pernicious anemia. Br J Cancer 59: 810-813, 1989.
4. Campbell RE, Pruitt FW. Vitamin B12 in the treatment of viral hepatitis. Am J Med Sci 224:252, 1952.
5. Campbell RE, Pruitt FW. The effect of vitamin B12 and folic acid in the treatment of viral hepatitis. Am J Med Sci 229:8-15, 1955.
6. Carethers M. Diagnosing vitamin Bl2 deficiency, a common geriatric disorder. Geriatrics 43: 89-112, 1988.
7. Chu RC, Hall CA. The total serum homocysteine as an indicator of vitamin Bl2 and folate status. Am J Clin Pathol 90: 446-449, 1988.
8. Dalery K et al. Homocysteine and coronary artery disease in French Canadian subjects: Relation with vitamins B12, B6, pyridoxal phosphate and folate. Am J Cardiol 75:1107-11, 1995.
9. Davidson S. The Use of Vitamin B12 in the Treatment of Diabetic Neuropathy. J Flor Med Assoc 15: 717-20, 1954.
10. Doscherholmen A, Swaim WR. Impaired assimilation of egg 57 Co vitamin Bl2 in patients with hypochlorhydria and achlorhydria and after gastric resection. Gastroenterol 1973; 64: 913-919.
11. Ellis FR, Nasser S. A pilot study of vitamin B12 in the treatment of Tiredness. Br J Nutr 30: 277-83, 1973.
12. Gaby SK, Bendich A. Vitamin intake and health: A scientific review. New York: Marcel Dekker. p 193-197, 1991.
13. Gaby AR. The story of vitamin B12: Is vitamin B12 a panacea or placebo? Nutrition & Healing 2; 7, July, 1995.
14. Goodman KI, Salt WB 2nd. Vitamin B12 deficiency. Important new concepts in recognition. Postgrad Med 88; 3: 147-50, 153-8, 1990.
15. Gupta AK, Mital H.S. Cyanocobalamin (vitamin B12) in the management of Herpes Zoster. Indian Pract 20; (7):457-9, 1967.
16. Harriman GR et al. Vitamin B12 malabsorption in patients with acquired immunodeficiency syndrome. Arch Intern Med 149; (9):2039-41, 1989.
17. Heyblon R. Vitamin B12 in herpes zoster. Abstract. JAMA 146:1338, 1951.
18. Herbert, V. Vitamin B-l2. In: Present knowledge in nutrition. 7th edn. Washington DC: International Life Sciences Press. 1996: p 191-205.
19. Heimburger DC, Alexander CB, Birch R, Bailey WC, Krumdieck CL. Improvement in bronchial squamous metaplasia in smokers treated with folate and vitamin Bl2. J Am Mcd Assoc 259: 1525-1530, 1988.
20. Herbert V. B12 deficiency and AIDS. Letter. JAMA 260; (19):2837, 1988.
21. Herzlich BC et al. Synergy of inhibition of DNA synthesis in human bone marrow by azidothymidine plus deficiency of folate and/or vitamin B12? Am J Hematology 33:177-83, 1990.
22. Hjelt K, Krasilnikoff PA. The impact of gluten on haematolgical status, dietary intakes of haemopoietic nutrients and vitamin B12 and folic acid absorption in children with coeliac disease. Acta Paediatr Scand 79; (10):911-19, 1990.
23. Inada M, Toyoshima M, Kameyama M. Brain content of cobalamin and its binders in elderly subjects. J Nutr Sci Vitaminol 28: 351-357, 1982.
24. Kokkonen J, Similä S. Gastric function and absorption of vitamin B12 in children with celiac disease. Eur J Pediatr 132; (2):71-5, 1979.
25. Lederle FA. Oral cobalamin for pernicious anemia. Medicine’s best kept secret? JAMA. 265: 94-95, 1991.
26. Nilsson-Ehle H, Landahl S, Lindstealt G et al. Low serum cobalamin levels in population study of 70- and 75-year-old subjects. Dig Dis Sci 34: 716-723, 1989.
27. Olszewski AJ, Szostak WB, McCully KS. Plasma glucosamine and galactosamine in ischemic heart disease. Atherosclerosis 75:1-6, 1989.
28. Omaye ST. Nutritional and toxicological aspects of food safety. New York: Plenum Press. p 169-203, 1984.
29. Richardson LR, Brock R. Studies of reproduction in rats using large doses of vitamin Bl2 and highly purified soybean proteins. J Nutr 1956; 58: 135-145.
30. Robertson KR et al. Vitamin B12 Deficiency and Nervous System Disease in HIV Infection, Arch Neurol 50:807-11, 1993.
31. Rule SAJ et al. Serum vitamin B12 and Transcobalamin levels in early HIV Disease. Am J Hematol 47:167-71, 1994.
32. Shemesh Z et al. Vitamin B12 deficiency in patients with chronic tinnitus and noise-induced hearing loss. Am J Otolaryngol 14; (2):94-9, 1993.
33. Shils ME, Young VR. Modem Nutrition in Health and Disease. 7th edn. Lea and Febiger. p 401-404, 1988.
34. Tang AM, Graham NM, Chandra RK, Saah AJ. Low Serum Vitamin B-12 concentrations are associated with Faster Human Immunodeficiency Virus type 1 (HIV-1) disease progression. J Nutr 127:345-51, 1997.
35. Ubbink JB, Vermaak WJH, van der Merwe A, Becker PJ. Vitamin B-12, vitamin B-6, and folate nutritional status in men with hyperhomocysteinemia. Am J Clin Nutr 57: 47-53, 1993.
36. Uchizyama M et al. Effects of vitamin B12 on human circadian body temperature rhythm. Neurosci Lett 192: 1-4, 1995.
37. Verhoef P, Stampfer MJ, Buring JE, et al. Homocysteine metabolism and risk of myocardial infarction: Relation with vitamin B6, B12, and folate. Am J Epidemiol 143:9:845-59, 1996.
38. Wright J.V. Treatment of childhood asthma with parenteral vitamin B12, gastric reacidification, and attention to food allergy, magnesium and pyridoxine: Three case reports with background and an integrated hypothesis. J Nutr Med 1: 277-82, 1990.

 

Sources
Joseph E. Pizzorno Jr., Michael T. Murrey & Melvyn R. Werbach.