More stress; more b12?

[megan17]

Hi

Does anyone here believe, like me, they need more b12 if the body is stressed eg. from infection, vigorous exercise, lack of sleep etc. and if so, does anyone know of any research on this so I can go armed and prepared when I see GP?

megan

[Gambit62 Administrator]

Definitely notice that I have problems with B12 levels if I get an infection - earlier this year had several episodes of getting a cold just after a shot and immediately felt as if I hadn't had a shot.

Also notice that I cope a lot better with stress if my B12 levels are high - which they always are these days as I supplement heavily.

I wouldn't say I do strenuous exercise but I am pretty active - job 0.6-2.5miles twice a day and tend to cycle about 8 miles most days which may be one reason why I seem to need a lot of B12 (>1mg a day). symptoms don't return as quickly if I'm not taking B12 but not doing exercise (eg because of a bad migraine confining me to bed.

Sorry but I am not aware of any research on the issue.

Would make sense that stress increases the demand for B12 as coping with stress - either physical or mental involves a lot of nerve activity etc.

[Hidden]

Hi ,

Some info here you may like to read up on, but if it will help you is a matter of luck it seems:

bmj.com/rapid-response/2011...

B12 deficiency may be more difficult to detect in people who exercise regularly

Martin J Turner, Honorary Principal Research Fellow

School of Public Health, University of Sydney, NSW 2006, Australia

Herrmann and colleagues[1] found that the correlation between methylmalonic acid (MMA) and serum B12 was -0.38 in sedentary subjects but -0.01 in recreational athletes, suggesting that B12 metabolism in people who exercise regularly differs from that in sedentary people. The same group suggested that regular endurance training is associated with an increase in B12 and folate requirements.[2] Herrmann and colleagues suggest that people who exercise regularly can be functionally deficient in B12 with normal or even high B12 levels.[1] In their study most of the healthy recreational athletes they studied had elevated MMA levels, suggesting critical intracellular B12 supply.[1] Possibly the best method for detecting B12 deficiency is change in serum MMA after B12 supplementation.[3]

In the early stages of my small fibre sensory neuropathy in 2005 my lower extremity parasthesia was apparent 24-48 hours after a high intensity 2 hour bicycle ride, lasted less than 12 hours and recurred only after the next bike ride. At that time my B12 and folate levels were 460 pmol/L and 1624 nmol/L respectively (Roche method). When my neuropathy started I was 53 and had a four-year history of proton pump inhibitor and ant-acid use, but the neurologists I consulted did not consider B12 supplementation and advised that B12 deficiency was very unlikely. Gastroscopy revealed mild chronic gastritis and helicobacter pylori infection. A test for intrinsic factor anti-bodies was normal but was within 10% of the cut-off value. The temporal relationship between my early neuropathy symptoms and exercise might have been explained by the prolonged recovery of acute exercise-induced elevation of homocysteine observed in some endurance athletes.[2] Plasma concentration of MMA is also acutely increased by strenuous exercise.[1] Both homocysteine and MMA are implicated in neuronal injury.[4]

After much reading prompted by an anaesthetist colleague who had seen neuropathy develop in a patient exposed to nitrous oxide on multiple occasions, I started oral B12 supplementation at 3 mg of methylcobalamin/day. My neuropathy stopped progressing and partially resolved over the following few years. It is important to start B12 supplements early because delay may contribute to residual neurological damage,[5] and the consequences of prolonged B12 deficiency can be devastating.[6] No toxic or adverse effects have been associated with large intakes of B12, so the threshold for prescribing B12 supplements should be very much lower than it appears to be at present. Further research is needed in B12 metabolism and measurement, particularly in older people who exercise regularly.

1. Herrmann M, Obeid R, Scharhag J, Kindermann W, Herrmann W. Altered vitamin B12 status in recreational endurance athletes. Int J Sport Nutr Exerc Metab. Aug 2005;15(4):433-441.

2. Herrmann M, Schorr H, Obeid R, Scharhag J, Urhausen A, Kindermann W, et al. Homocysteine increases during endurance exercise. Clin Chem Lab Med. Nov 2003;41(11):1518-1524.

3. Bolann BJ, Solli JD, Schneede J, Grottum KA, Loraas A, Stokkeland M, et al. Evaluation of indicators of cobalamin deficiency defined as cobalamin-induced reduction in increased serum methylmalonic acid. Clin Chem. Nov 2000;46(11):1744-1750.

4. Dharmarajan TS, Adiga GU, Norkus EP. Vitamin B12 deficiency. Recognizing subtle symptoms in older adults. Geriatrics. Mar 2003;58(3):30 -34, 37-38.

5. Larner AJ. Missed diagnosis of vitamin B12 deficiency presenting with paraesthetic symptoms. Int J Clin Pract. Jun 2002;56(5):377-378.

6. Dharmarajan TS, Norkus EP. Approaches to vitamin B12 deficiency. Early treatment may prevent devastating complications. Postgrad Med. Jul 2001;110(1):99-105;.

[megan17 in reply to Hidden]

Many thanks for your replies. I'm currently on 8 weekly injections and supplement with patches. The frequency of patches seemed haphazard until I realised I was needing more following exercise, or being unwell etc. and it's quite a relief to know I'm not imagining it!

Hoping to get GP to prescribe 4 weekly. Whether this happens or not I will try self injecting to compare with patches and see which is most effective.

Interesting to see that the research in the BMJ backs this up.

Thanks again

megan