Anaemia – Vitamin B12 Deficiency

We all know that we need to eat a healthy diet in order to receive vitamins and minerals which are essential for our health.  What we were never taught is why certain vitamins and minerals are important and therefore what occurs when you do get enough (or if your body isn’t accessing them efficiently).  I feel that the hours of lessons on the benefits of vitamins and minerals were quite disconnected from the foods which they are abundant from and the effects that they have on the body.  I have been contacted by a lady through Twitter who enquired about Vitamin B12 so the blog this week will look at this aspect of our health and well-being today.

History:

Vitamin B12 and it’s identification as an important anti-anaemia compound were discovered in the 1920s and 30s.

Why B12 is an Essential Vitamin:

B12 has a wide variety of roles within the body and the biochemical reactions that they play a part in are all inter-related.  They have an essential role in the production of DNA (it is copied and reproduced) which explains why a deficiency of B12 can affect cell division in any part of the body where there is a high turn over of cells such as the bone marrow (leading to megaloblastic anaemia) but also the walls of the digestive system affecting out assimilation and absorption of food and their nutrients.

• It is involved in the formation of our red blood cells blood.
• It enables us to access energy as it is involved in the metabolism of every cell in the body (including fats, carbohydrates and proteins).
• It  is essential to fatty acid synthesis.
• Our nervous system doesn’t have a high turnover of cells but is dependant on B12 to be healthy.
• High Vitamin B12 levels can protect against Alzheimer’s disease and reduced mental ability, it also boosts part of our immune system.
• RNA and DNA synthesis.
• Growth factor.

B12 in the Body:

The absorption of Vitamin B12 is different to all other essential nutrients, in the stomach it is dependant on not only the stomach acid (hydrochloric acid) but also a molecule which is made up of both sugar and protein (glyco-protein) called ‘Intrinsic Factor’.  Without the intrinsic factor to bind to the B12 it cannot be absorbed in the intestines by specialised receptors designed to accept the B12.  The Intrinsic factor acts as an essential carrier to take the vitamin into the body – without it we cannot access it.  This process only occurs if the internal environment of the gastrointestinal tract is alkaline (pH 6.5 or above).  B12 is absorbed (bound to the Intrinsic Factor) in the distal ileum.  Therefore B12 deficiency is a disorder of the stomach, getting to the root cause of why the stomach is deficient can be gleamed from a herbal consultation.

Our body knows it is an essential vitamin an so it is kept within the body and re-excreted from the biliary tract (part of the digestive system) but cannot be utilised unless the Intrinsic Factor is present.  There are several other molecules within the body which act as transporters binding the vitamin to it and taking it throughout the body where it is needed – theses can be found in our blood (in plasma) in our saliva and in our milk (to be passed to our baby through breastfeeding), these other transporters are not as effective as the intrinsic factor at binding to B12 to enable absorption and utilisation.  Science has thought that a lack of one of the transporters can lead to megaloblastic anaemia and is passed through our genetics.  If you are experiencing B12 deficiency is this something which runs through your family?

When you don’t get enough B12:

Vitamin B12 deficiency can affect the cardiovascular, digestive and nervous system – symptoms include:

•  Tiredness,
• Depression,
• Anaemia,
• Reduced memory,
• Mania,
• Loss of appetite,
• Psychosis,
• Hearing loss,
• A change in the way you walk,
• Spina bifida, (deficiency whilst pregnancy can affect your unborn baby)
• Changes to your reflexes,
• Pernicious anaemia,
• Changes in your behaviour,
• Digestive issues.

Possible Causes of B12 Deficiency:

• Dietary Lack

Are you eating enough foods which are ‘high’ in Vitamin B12? B12 is found in a wide variety of animal products such as meat, fish, eggs, butter, milk and cheese.  Other food sources include: liver, kidney, yoghurt, wheat germ, yeast, spinach, lettuce, algae, alphafa, kelp and dulse.  B12 cannot be produced within our body and therefore relies on dietary intake.  Our body can store a decent amount of B12 and conserve it well so if you have a vegetarian or vegan diet you may not notice signs of deficiency for several years.  If you are already eating foods high in B12 or are a vegetarian or vegan and are experiencing signs of Vitamin B12 deficiency then it may indicate there are other issues which need to be resolved.

• Low levels of Intrinsic Factor

If there are low levels of Intrinsic Factor in the stomach it is classed as a megaloblastic anaemia such as pernicious anaemia – a lack of red blood cells due to large molecules such as iron or B12.  If your stomach isn’t producing enough stomach acid this can become an issue.  Low levels of Intrinsic factor is rarely passed on genetically although a passively acquired B12 store at birth may be quickly exhausted and lead to anaemia.  This would take roughly 2-3 years.  If you have been given the diagnosis if B12 deficiency and you are an adult it may be that the lack of Intrinsic Factor in your stomach may be linked to atrophic gastritis and a lack of gastric acidity.

Have you experienced any digestive issues in the lead up to your diagnosis? A herbal consultation would be able to determine the full history and discover the true causes of any health issues and be able to support you with natural herbs to improve your health and wellbeing and prevent complications associated with B12 deficiency.

• Issues with Absorption

There may be issues with your digestive system and its ability to absorb the B12.  There are several reasons for this including some medications, iletitis, lymphoma or tuberculosis.  If there inflammation in your gastrointestinal tract it will reduce the guts ability to absorb and assimilate nutrients.  Disorders of the terminal ileum such as Crohn’s disease may result in Vitamin B12 deficiency.

• Decreased Availability

Also if there is congestion and stagnation present in the digestive system it may be due to a lack of movement as to why the B12 in your diet isn’t available.  If the gut flora is out of balance it may also cause a reduced absorption of vitamins and nutrients.  An infestation of worms can also cause a lack of availability.  The lack of movement of the contents of the gut can be due to strictures, surgically created bypasses, fistulas and diverticular disease – each of these issues have the presence of bacterial overgrowth in common.  Bacterial infections in the guts can physically block access of the vitamin B12 and Intrinsic factor molecule from the relevant receptors.  One indicator that this could be an issue is that you will have poo which floats (steatorrhea).

If you live in the Grimsby and Cleethorpes area of North East Lincolnshire and feel that you would like to have a consultation (lasts 1 hour) and investigate all aspects of your health and wellbeing please book an appointment with either myself or The Achilles Centre.  As a herbalist there are several methods of supporting B12 deficiency naturally.  All consultations include a follow-up offering tailored dietary and lifestyle advice to suit your individual needs and herbal prescriptions are tailored to benefit you and your needs.

Erslev, A Gabuzda, T (1979) Pathophysiology of Blood USA W B Saunders Company

Rose, S (1998) Gastrointestinal and Hepatobiliary Pathophysiology USA Fence Creek Publishing