Monday, March 14, 2011

Ruling Out B12 Deficiency Memory Loss

B12 deficiency is one of the most frequently missed diagnoses when neurological problems such as memory loss begins to appear.  There are many reasons why...

  1. B12 deficiency can be present without frank anemia, yet many doctors do not know nor acknowledge this.
  2. B12 is not always absorbed properly, even when given orally in massive doses.  Injections may be necessary.
  3. B12 deficiency is frequently overlooked and not tested, even when symptoms of deficiency are present.
  4. The wrong tests are often use to detect B12 deficiency.  The best tests for detection are: Methylmalonic acid, and Homocysteine.  The B12 test is considered an unreliable indicator of B12 status in any one individual.
  5. B12 deficiency can be hidden when the patient mistakenly supplements folic acid or a multi-vitamin with folic acid as a component.
  6. When testing is done to find B12 problems, those tests will often come back without flags even though the patient is suffering deficiency serious enough to cause permanent neurologic damage.
  7. "Normal" ranges for direct B12 testing reflect the point at which anemia becomes a problem, but by the time the patient is at that low level, neurological damage has likely already occurred. 
  8. Doctors often assume that if B12 deficiency is a problem, eventually the patient will become anemic and treatment can be started at that time.  In cases of malabsorption this is not always the case, and patients can go for years suffering neurologic damage and not be aware of it.
  9. Medications frequently taken by adults such as stomach preparations can cause a depletion of B12 because they stop the excretion of a special stomach acid called Intrinsic Factor that is necessary to carry the B12 from the digestive system into the blood stream.  Doctors often don't know about this correlation, and patients often forget to tell their doctors they take these OTC meds.
B12 is vital to the nervous system.  Without enough B12, the myelin sheath that surrounds our nerves cannot heal themselves nor regenerate, and damage eventually occurs. As a result, B12 deficiency can also masquerade as Multiple Sclerosis.

B12 is integral in something called the Methylation Process in which other metabolites are formed which are necessary for our health.  If you are an Alzheimer's or Dementia Health Activist, you should be very familiar with the methylation process, how it works and what can happen when things go wrong with it, because it is intimately tied to Alzheimer's and dementias as well as our neurologic health.  Without these metabolites, our bodies become severely unbalanced and our overall health suffers. The methylation process is also one of the ways our bodies rids itself of harmful homocysteine - a dangerous inflammatory compound linked to cardiac problems and brain atrophy.

It takes years to become deficient in B12 because a great deal of it is stored within the liver and it takes a long time to deplete those stores.

Here are some interesting articles on the Methylation process and how it relates to Alzheimer's Disease:

Clinical Chemistry
Life Extension Vitamins article
Dr Ray Sahelian

My story:

I began having serious memory difficulties.  I was afraid maybe I had an early onset dementia.  I went to my doctors, but until I asked for specific testing to be done - indeed I had to insist on it - nobody knew I had a problem with my B12 status.  In fact, the neurologist I asked looked me square in the face and was angry with me, telling me "You are not deficient in anything.  I can tell just by looking at you.  If you are deficient I would know."  He agreed only to run a single test for me - the B12 test.  When it came back dismally low, I was immediately tested for the other levels  I requested, and given immediate B12 injections.  When I requested records from other doctors I'd had in the past, I found that I had been tested and diagnosed as B12 deficient for many years before anybody ever told me.

It turns out that my deficiency went on for so long that I have permanent damage to contend with every day of my life.

When I talked to my doctors about what happened to me, most shrugged their shoulders.  A couple admitted to me that they literally get almost nothing on vitamin deficiencies in medical school.  They didn't know in most cases even the tests that needed to be ordered to find them, let alone what to do if they came back bad.

I post this today as a warning to those friends of mine in the Alzheimer's Disease and Multiple Sclerosis worlds - - Get yourself and your family members tested.  Make sure your doctors use the appropriate testing methods to find a deficiency - Methylmalonic Acid and Homocysteine should always be ordered along with a B12 status test.  Check on the price of this testing as shopping around can be important.  I've paid as little as $150 for all these tests, and as much as $3000 for the very same tests.  Getting them through your doctor's office is usually the cheapest method.  The hospital lab I've found is usually the highest price.

Taking B12 injections is a very small thing.  You can get them through your doctor's office, or give them to yourself.  One of my most popular blog posts contains far more information on B12 deficiency as well as instructions and a video that tells how to give yourself injections to fix the problem.  You can find it here:  B12 Injection Basics

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