Since then, there have been numerous related threads.
We are sometimes told to ignore epidemiological studies. After all, association does not prove causation. At the same time, absence of proof does not prove absence of causation. One can't ignore the plausibility factor.
The vitamin B12 situation is one in which deficiency is protective. But there is a price to pay for long-term deficiency. I began to have balance issues 3 years ago. Eventually, I decided to take an occassional sublingual B12 supplement. There was a marked improvement. I discussed this with my integrative medicine doc. Normally, he likes to see homocysteine below 10, but thought I should perhaps aim for 20. That's my plan - insufficiency rather than deficiency.
-Patrick
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Meat, eggs, and dairy are primary sources of Vitamin B12. Since I avoid those, it seems prudent to supplement with B12, but that poses a risk for prostate cancer patients. It’s easy to find Vitamin B12 tablets in dosages of 1000 mcg and higher, but that seems too aggressive for me. I’ve found four brands of Vitamin B12 that come in 100 mcg tablets: Nature’s Blend, Solgar, Puritan Pride, and Mason Natural.
You didn't mention seafood... if you regularly eat a variety of that, and are not fully vegan, it would be hard to become deficient in B12, I do believe. (Clams and mussels are especially rich in B12, but virtually all seafood has some.)
Clams and mussels are high in B12, but are also high in (heme) iron, which feeds PC. I tried to raise my B12 using shellfish, but could not do it without increasing PSA. Stopped the shell fish and PSA went back to a slow decline on my vegan + little (wild caught) seafood diet. I then went to a B12 supplement METHYL B-12 (methylcobalamin) at about 1000 MCG/week to get to mid-range B12 values (500-600). I have been doing this B12 supplement for three years and my PSA is well under control.
Possibly. I don't know. I checked Consumer Lab, which suggested that the various forms of cobalamin are virtually interchangeable, with rare exceptions. CL says that cyanocobalamin is cheaper, more stable and perhaps marginally more effective than other forms. CL said that the cyanide content is less than one one thousandths of a toxic dose. Most of the studies CL cites use methyl cobalamin for a wide range of medical conditions, for what that's worth.
This is an interesting post for me. I too was having balance problems for the past few months. My PCP knew that I have been treated for prostate cancer. She ordered a lumbar MRI since the symptoms are numbness in my feet, ankles, and calves. It showed nothing unusual. No sign of cancer in the lumbar. Then she did a blood test. My B12 was low, 190 and she recommended four weekly B12 injections. I had my last one last week. This has definitely helped me. I recently read "If left untreated, the symptoms of vitamin B12 deficiency tend to worsen and irreversible problems involving the nerves and brain may develop." Irreversible scares the hell out of me. Be very careful.
Dwight's wife here. It's like you are damned if you do and damned if you don't. Before being diagnosed with aggressive prostate cancer my husband was taking a multi with a high amount of methyl folate in it for years. He actually kept taking it until I recently when I read about the connection between folate and prostate cancer. I now have to wonder if the vitamins caused him to have the aggressive form of prostate cancer.
You do not know. You likely will never know. Its in the past and there is nothing that can de done about it. Its like when you lock your keys in the car. As soon as the door clicks shut it doesnt matter when you realize it
The silver lining is that you discovered the risk and Dwight stopped taking the multi vitamin. That can only help. My research suggests that ONLY folate from supplements carries a risk for promoting prostate cancer; folate from vegetable carries no such risk. I'm not expert, so you may want to do your own research.
So what about fortified foods? Rates for some cancers rose in countries that followed the FDA lead. The FDA mandate affected grains (including rice) & foods containing such (read the small print on the labels.)
Agreed. Dwight likes cereal in the morning. We now buy an unfortified cereal for him. I was shocked looking at the amount of iron in the cereal he was eating. I will start looking at labels on rice, etc now. I'm so appreciative of everyone here and what I have been able to learn.
Agreed, studies have shown that some fortified foods carry some risk of promoting various cancers, including prostate cancer. When I said "folate from vegetable(s) carries no such risk", I was referring to fresh vegetables. Thanks for clarifying.
There are two Vitamins ( D and B12) which should be supplemented after checking their blood levels.Excessive intake or supplements (tabs/sublingual /IVetc) can take B12 levels very high a. nd make Prostate cancer grow aggressively.
Meat eaters generally have sufficient B12. Normal blood level of B12 is between 200 to 900 picogm/L. The ideal level of B12 in men with prostate cancer should be in low normal range. That is between 200 to 400 pg/L This level does not promote PCa and at the same time, does not lead to anemia and neurological problems. I am a vegetarian and my recent B12 level came 310 pg/L and I have no anemia (Hb13.2) or any neuro issues.
As for folate, Vegetarians get enough folate from fruits, beans, green leafy vegetables and there is never a need to take Folate supplements.
American Cardiologists recommend Homocystine level below 10 in order to prevent heart attacks. Remember what is good for heart is good for prostate..
While it is true that elevated homocysteine is associated with cardiovascular disease, none of the intervention studies that lowered homocysteine (via B vitamins, e.g.) lowered the risk of a CVD event.
Weird coincidence..I started to develop low b12 levels which I presume is emergent from one of my two T busters. Dropped to the mid double digits but recovered a little this month to the low hundreds…Is this ‘body wisdom’ adapting to my cancer’s vaguery. The downside is somewhat daunting in developing deficiency disorders especially my persistent low hemoglobin…I’ll keep on doing nothing in the meantime.
A number of years ago I noticed that when I took Metformin my homocysteine level went up. A search through the literature dealing with diabetes reveals that Metformin interferes with the absorption of B-12. However, since my homocysteine levels are high, my MO measured my B-12 level a few months ago. The test results revealed that my B-12 was more than adequate. I think that circulating levels of B-12 (free B-12may not really reflect just how much B-12 is in or system, i.e., in our organs or wherever else it lives.--K.
This is too complicated. My regular blood test showed very low B12 so my GP prescribed IM shots of B12. I have taken four once weekly. I mentioned the link of methyl folate but not B12.
Should I discontinue the B12 or how do I determine if I should? The dose is 1000 mcg or 1 mg
Be cautious with B12. You only need to achieve low-normal levels. A blood test before committing to the next shot will maybe indicate how high your dose should be - or if you should put off the shot.
I agree. I like the --if one hasn't been proved then that doesn't make the other disproved either take. Indeed--plausible!
I believe that Dr. Ruth Heidrich, a famous cancer survivor, who attributes much of the reason for her astounding recovery by becoming a vegan only supplements with B12. Obviously, she doesn't have a prostate.
A vegan would use a vegan B12 supplement and have their blood work done to monitor their B12 levels. Would a B12 supplement from plants make a difference? Has there ever been a study between B12 supplements sourced from plants and animals for the effect on men with prostate cancer?
You have done much research on this subject. The info about the B12 added to our bread products, the flour, was an important post. I had forgotten about that it was so long ago when I first read it.
Thanks. In terms of bureaucratic fortification of food, it was the folic acid mandate that did a lot of people in. These men & women had indolent undiagnosed cancer (often colorectal). They also had a dietary methyl shortage that, ironically, might have caused their cancers, due to DNA instability. Suddenly, their cancers had enough methyl to silence the tumor suppressor genes that were keeping things under control.
With B12, unless one is vegan, B12 insufficiency is probably due to an uptake problem. The stomach produces "intrinsic factor" (such a vague term) which allows B12 to be taken up in the ileum (why not call it the gastric ileum factor?). Fortification of food with B12 will not help those whose parietal cells are shot.
{My integrative medicine doc, who prefers otc solutions if possible, is not keen on sublingual B12, & prefers belly fat injections.}
Some of the people running vegan sites insist that food alone is sufficient to meet all needs, while others accept that the only reliable way of getting B12 is via fortified food. A sly way of getting around the supplement issue.
If vegans had to forgo fortified food entirely, I wonder what the effects would be in that population?
In the United States, as in most parts of the world, fortification of food was initiated as a systematic approach to correct identified nutrient deficiencies in the population. In 1924 iodine was first added to salt on a voluntary basis in an attempt to address the prevalent health problem of goiter in the United States. This program was begun only after a number of prominent national health organizations of the time, the American Public Health Association, the Council on Foods and Nutrition of the American Medical Association (AMA), and the Committee on Food and Nutrition of the National Academy of Sciences, recommended this step based on new research demonstrating that sodium iodide prevented goiter (Quick and Murphy, 1982). This initial fortification effort was followed in 1933 by the fortification of milk with vitamin D based on recommendations from similar groups. The addition of vitamin D to milk was originally accomplished by irradiating milk or by feeding the cows irradiated yeast. This technique was replaced in the 1940s by the simpler and more effective method of adding vitamin D concentrate to milk, as is currently practiced today (Quick and Murphy, 1982).
In the 1930s and 1940s specific deficiency disease syndromes were first identified and documented in the United States (Foltz et al., 1944; McLester, 1939; Williams et al., 1943). Based on this new science, in 1940 the Committee on Food and Nutrition (now the Food and Nutrition Board [FNB]) recommended the addition of thiamin, niacin, riboflavin, and iron to flour (NRC, 1974). About that time FDA first established a standard of identity for enriched flour that identified specific nutrients and amounts required for addition to any flour labeled as “enriched” in order to improve the nutritional status of the population (FDA, 1941). The approach of using a standard of identity, which establishes the specific type and level of fortification required for particular staple food to be labeled as enriched, has remained a key aspect of fortification regulations and policy in the United States. These standards have been amended over the years, but they continue as the basis for the addition of thiamin, niacin, riboflavin, folic acid, and iron to enriched flour, with the addition of calcium as optional.
Concurrent with these activities, the nutritional status of Americans was being questioned as a result of the poor nutritional status of young men enlisting for service during World War II. These concerns led to the National Nutrition Conference for Defense in May 1941, convened by President Roosevelt. An outcome of this conference was the recommendation for flour and bread enrichment using the existing standards developed by FDA (Quick and Murphy, 1982).
Although the original FDA standard was not amended to include bread for several years, the enrichment of bread began in 1941 as a result of discussions among FNB, AMA, FDA, and the American Bakers Association. The voluntary cooperation of bakery-associated industries led to 75 percent of the white bread in the United States being fortified by the middle of 1942 (Quick and Murphy 1982). The first War Food Order, enacted in 1943, stated that all flour sold for interstate commerce would be enriched according to FDA standards. This order was later repealed in 1946, but was followed in 1952 with official standards of identity for enriched bread (FDA, 1952a, 1952b). Under this new regulation, fortification of flour and bread products was not mandatory, but if a product was labeled as “enriched” it was required to meet the standards of identity described in the regulation.
FDA made a decision in the 1940s that it would not require mandatory fortification for any food product; this policy is still in place. For every standard of identity for which there is an enriched version of a food, there is a corresponding standard of identify for an unenriched version. Prior to 1990 individual states could enact laws that addressed fortification of products sold within their boundaries. For example, by the time the enriched bread standard was finally promulgated by FDA in 1952, the enrichment of flour and bread was mandatory in 26 states (Hutt, 1984). The National Labeling Education Act of 1990 provided for federal preemption of standards of identity, however, thus nullifying these state laws.
Since the 1950s standards of identify have been issued for the fortification of food, such as oleomargarine and rice and other cereal grains, and have been proposed for formulated meal replacements. The most recent standard of identity change for these products was the regulation, effective in January 1998, regarding folate. To meet the standard of identify for most breads, flours, corn meals, rice, noodles, macaroni, and other grain products labeled as enriched, folic acid is to be added at the level of 0.43 mg to 1.4 mg/lb of product.
I should mention that my B12 levels probably suffer from a high intake of Metformin:
"Reduced serum levels of vitamin B12 occur in up to 30% of people taking long-term anti-diabetic metformin. Deficiency does not develop if dietary intake of vitamin B12 is adequate or prophylactic B12 supplementation is given. If the deficiency is detected, metformin can be continued while the deficiency is corrected with B12 supplements."
Incidentally, long-term use of proton-pump inhibitors will reduce uptake.
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