Vitamin B12

Vitamin B12

By Arunima Verma  on: 12 October 2017
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Many of you, who might have had a look at health check-up packages, might have seen that almost all such packages have tests for Vitamin D and Vitamin B12. I already written about vitamin D in a previous article. Here I am going to focus on Vitamin B12.

What is Vitamin B12

It is a water- soluble vitamin, also known as cobalamin or cyanocobalamin, and is very important for normal functioning of brain and the central nervous system. It works closely with folic acid and helps in the formation of red blood cells. Folic acid and B12 also work together to form a compound which is involved in immune function and mood. It also helps in the production of DNA and RNA, body's genetic material. Vitamin B12 along with Folic acid and vitamin B6, control the levels of homocysteine, which in high levels can cause heart diseases. Therefore it is a vital nutrient, the deficiency of which will invite a lot of diseases.

Since Vitamin B12 also assists in the metabolism of protein and fat, it has been found to be important for body building. Bodybuilding requires the amino acids resulting from protein metabolism to repair and build muscles, and fat for energy. But if the person is not deficient in Vitamin B12, then taking extra doses than recommended will not improve the energy levels or the workouts.

Deficiency

Vitamin B12 deficiency is a fairly common condition but is usually undiagnosed due to lack of enough classic symptoms but yet there are some signs and symptoms which one can look out for.

  1. Depression, Psychosis, Dementia, Obsessive Compulsive Disorder (OCD), memory loss, tremors, shaky movements, unsteady gait. As mentioned above, it is involved in the functioning of the brain and Central Nervous System, therefore its deficiency can lead to the above symptoms.
  2. Pernicious Anemia, Fatigue, Shortness of breath. Anemia is a classic symptom of B12 deficiency. Severe anemia can lead to fatigue and shortness of breath. These symptoms are also related to congestive heart failure, along with ankle edema, breathing difficulty and frequent urination at night.
  3. Loss of balance, tingling in the arms and legs are some other signs of deficiency.

Reasons of Deficiency

  • In India, one of the main reasons is thought to be dietary habits. Due to religious, spiritual, and socioeconomic conditions, our country is largely vegetarian and since B12 is mainly found in animal food sources, it may contribute to deficiency of this vitamin. Also, there is a high prevalence of Helicobacter pylori infection. H.pylori  is a bacteria which causes stomach infection which then leads to low secretion of stomach acids and something called an intrinsic factor which helps in the absorption of vitamin B12.
  • People with Celiac disease, Crohn's Disease may not absorb Vitamin b12 well.
  • People over 50 lose the ability to absorb Vitamin B12 from food.
  • If an individual has undergone any gastrointestinal surgery or weight loss surgery, he or she may not be able to absorb vitamin B12.
  • Some others who are at risk are individuals with diabetes and HIV.
  • Consistent intake of antacid.
  • Heavy drinking

Food Sources of Vitamin B12

Image courtesy of (Lamb: James Barker; Fish: Dan; Eggs: amenic181; Museli and fruit: joephotostudio; Milk: John Kasawa) at freedigitalphotos.net

  • Organ meat particularly liver and kidney
  • Fish
  • Shellfish
  • Meat
  • Poultry
  • Eggs
  • Dairy
  • Fortified breakfast cereals

In case one is detected with deficiency, supplementation will be required along with food sources. For certain cases which are not diet related deficiency, vitamin B12 injections may be given. Please follow the doctor's advice for supplementation. Do not self-diagnose or self-medicate.

Side Effects

Recent research from Ohio State University, suggests that long term use of high doses of vitamin B6 and B12 is related to higher risk of lung cancer in men relative to non-users. This risk was higher in male smokers than non- smokers. More research is underway to see if the results can be replicated. https://cancer.osu.edu/news-and-media/news/long-term-high-dose-vitamin-b6-b12-use-associated-with-increased-lung-cancer-risk-among-men

Remember that this is only for high doses and long-term use. Do not panic the moment you are given this supplement by your physician. Because deficiency will require supplementation along with the right kind of food.


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Polycystic Ovaries Syndrome (PCOS) is a hormonal condition that occurs in 5-10% of women between late adolescence and menopause. It is one of the most common hormonal related problems in women during their reproductive years. Not only is PCOS a leading cause of infertility it can also be a risk factor for other health problems. The diagnostic criteria of PCOS has been a topic of debate. Merely the presence of polycystic ovaries ( enlarged ovaries with small cysts on the outer edges) does not qualify for the condition to be called a syndrome. In November 2015, the American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE), and Androgen Excess and PCOS Society (AES) released new guidelines in the evaluation and treatment of PCOS and it was mentioned that the diagnostic criteria for PCOS should include two of the following three conditions: Chronic anovulation ( chronic absence of ovulation), hyperandrogenism (excess of male hormones which can be clinical/biologic), and polycystic ovaries. Signs and symptoms The major features of PCOS include menstrual dysfunction, anovulation, and signs of hyperandrogenism. Other signs and symptoms of PCOS may include the following: Hirsutism Infertility Obesity Metabolic syndrome ( a cluster of conditions such as high blood sugar, abnormal lipid levels, high blood pressure, obesity) Diabetes Obstructive sleep apnea Most PCOS patients are overweight or obese ( except a small percentage who are not markedly overweight). 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Nevertheless, there are enough studies which have shown that even a moderate weight loss of about 5-10% helps in restoring functions of the ovaries which leads to normal hormone production. This then results in improvement in symptoms of PCOS. Since PCOS is related to so many metabolic abnormalities, many studies have shown that apart from the required drug therapy, diet and lifestyle changes is the first line treatment. Diet for PCOS PCOS diet is very individualistic. Since the symptoms will vary from woman to woman. But there are a few basic guidelines 1. Foods with low GI (Glycemic index ): These are foods which release the sugar slowly to the blood stream, therefore there is a steady rise in blood sugar and insulin, as opposed to high GI foods which are broken down and absorbed quickly by the body leading to a rapid rise in blood sugar levels. Image courtesy of (Grains: rakratchada torsap; fruits and vegetables: Suat Eman; Almonds: phasinphoto) at freedigitalphotos.net List of low GI foods Whole wheat ( chapati, bread) Multigrain bread Oat bran Rolled oats Natural Museli Whole wheat pasta Brown rice Buckwheat ( kuttu ) Kidney beans (Rajmah) Black eyed kidney beans ( Rongi/ Lobia) Lentils Chickpea Almost all vegetables except beetroot which is a medium GI, potatoes, pumpkin and parsnips which are high GI. Cherries, Plums, Grapefruit, Peaches, Apples, Pears, Dried Apricots, Grapes, Coconut, Coconut Milk, Kiwi Fruit, Oranges, Strawberries, Prunes, Nuts and seeds such as walnuts, peanuts, almonds, chia seeds, ground flaxseeds.   2. Less than 30 % of the daily calories should be from fat: This should comprise of mostly unsaturated fats and only a very low amount of saturated fat (<10%). So how does one translate this to normal day to day life. The basic idea is to cook the food in very less oil. Stir fry vegetables and let them steam cook. If you are in the habit of adding a bit of ghee ( clarified butter) to your chapatis, it's completely ok since ghee is one of the good fats, but reduce the amount and the number of times you have it in a week. The amount and restrictions will also depend upon the metabolic conditions of the individual. 3. Dairy: The effect of dairy on PCOS has some conflicting views. Studies have shown that regular consumption of dairy increases insulin production. It is also believed to increase androgen production (except cheese). At the same time whole milk and whole milk products have been related to increased fertility. There are very few studies relating dairy to PCOS. So the effect of dairy will probably vary from person to person. Therefore an individual with PCOS can avoid dairy for a certain period of time and observe if there are any changes in the way they feel. 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