Vitamin B12 supplementation: Preventing a domino effect of health issues

As a DC, you can probably pick out which patients will have relatively straightforward health issues that can easily be addressed.

A patient with neck or back pain will generally start to see relief from having their vertebrae shifted back into proper alignment with a series of spinal adjustments.

However, not all of your patients will be this easy to treat. You will invariably have more complicated patients at some point during your career, and none can be more frustrating than those whose health issues seem to have a cascading, or domino effect, in which one health issue can actually lead to a succession of larger and larger medical concerns.

Vitamin B12 deficiency is an excellent example of this type of domino effect. However, before we can look at how to stop this domino effect by treating vitamin B12 deficiency, we must first understand the functions that vitamin B12 performs within the body, as well as the domino effect that can occur with vitamin B12 deficiency.

What functions does vitamin B12 perform?

Vitamin B12 is involved in regulating a number of functions of the human body, including the brain and nervous system, DNA, and proper cellular metabolism. Much of this happens through its ability to help the red blood cells in the body properly form and mature.^1,2 Essentially, any bodily function that depends upon adequate red blood cell counts will also depend on adequate levels of vitamin B12.

The connection between red blood cells and vitamin B12

This connection between red blood cells and vitamin B12 starts in the digestive system. The stomach contains hydrochloric acid, which separates vitamin B12 out from the protein to which it is bound in its food source (if vitamin B12 is obtained from supplements, the first step in this process is not needed).¹

The vitamin is then combined with a protein called intrinsic factor, which the stomach also produces. Intrinsic factor allows the body to properly absorb vitamin B12. This is where the domino of health effects is most readily apparent.

The domino effect and vitamin B12

Some people’s digestive systems are not able to produce enough intrinsic factor, or may not be able to produce any at all, as the result of a condition known as pernicious anemia, in which their red blood cell count is too low.^1,2 If the body cannot produce enough intrinsic factor due to this type of anemia, there will not be anything to bind with the vitamin B12, so it will simply be eliminated as waste. In this instance, the lack of sufficient intrinsic factor is that first domino.

Furthermore, a vitamin B12 deficiency may itself be that first domino that can lead to a host of other health issues, due to its involvement in forming mature red blood cells. Some of these health issues can include:³

• sore mouth or tongue
• weight loss
• tiredness, fatigue
• pale or yellowing skin
• diarrhea
• menstrual problems
• psychosis or dementia

Improving vitamin B12 levels

The best food sources of vitamin B12 come from animal protein, such as beef, pork, chicken, and fish (especially haddock and tuna).3 Other good food sources include dairy products, such as milk, cheese, eggs, and yogurt. There are also some grain products, including cereals and breads, which are fortified with vitamin B12.³

If any of your patients are strictly vegan and do not have any animal products as part of their regular diet, it will be difficult for them to obtain enough vitamin B12 just from food sources. These patients will need to take supplements in order to maintain adequate levels of vitamin B12.³

The National Institutes of Health’s Office of Dietary Supplements recommends that adults and teens over the age 14 should get a daily intake of 2.4 micrograms (mcg) of vitamin B12. Pregnant women should take 2.6 mcg per day, and those who are nursing should take 2.8 mcg.

It would be nice if all your patients were easy to treat. Unfortunately, we all know that is never the case. The good news is that if you can stop that first domino from falling by providing patients with adequate vitamin B12 supplementation, you can prevent a whole host of other serious health issues.

References

1. Vitamin B12. National Institutes of Health: Office of Dietary Supplements. Accessed 3/15/2018.
2. Vitamin deficiency anemia. Mayo Clinic. Accessed 3/15/2016.
3. Everything you need to know about vitamin B12. Medical News Today. Accessed 3/15/2018.