'Brain fog' sufferers to be tested for lack of B12
By Henry Bodkin
OLDER people experiencing "brain fog" should be tested for vitamin B12 doctors with the aim of improving the ing B12 as we age. deficiency, the health watchdog has rate of diagnosis. said.
Experts say as many as one in 20 people over 60 and one in 10 over 75 could be suffering from the deficiency, with dietary changes, the organisation said. overall numbers increasing because of the rise in veganism. The vitamin is found in meat, fish, eggs and dairy, but very little is contained in plants.
Common symptoms include fatigue, confusion, blurry vision and mental health problems such as anxiety and depression, which can make the deficiency hard to diagnose.
The Daily Telegraph - Front page - Wednesday 12th July 2023
Written by
helvella
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That is good news but if the “acceptable “ range is kept as low as it is then many will be told “ everything is fine, no need for further action”…. So nothing will change. Thank you for sharing though.
Thank you for sharing helvella. I just noticed my reply missed you name.
Agreed, and they will only test serum so will miss many people anyway. Doubt they will even ask about multivitamin/B complex/fortified food intake, all potentially affecting accuracy of even serum.
Indeed! It’s always the same pointless scenario with the NHS…. Making the right noise but only in words not following by well thought-out action. They started mentioning prevention in general BUT still stick to their old ways of waiting for something serious to happen (eg: admission to A&E) to do anything at all. Totally pointless. So, here we go again…
I hope that the “heath watchdog” has teeth and that something really does happen about this . It is known that as we age the production of stomach acid diminishes . Also many older people take medications like Proton Pump Inhibitors, ( and other medications) which have a terrible effect on stomach acid production.
This lack of stomach acid results in zpoor absorption of all vitamins and minerals, but especially B12 which is the most difficult vitamin to break down and absorb.
Have to take issue with “ Very little ( vitamin B12) is found in plants “ That should read “ No useable , active Vitamin B12 is found in plants “
Totally agree with you! I have been taking PPI for decades… Prevention has never been of prime importance within the NHS unfortunately. It would save money and time in the long run.
Again I totally agree with your experience and comments. I am struggling now because I am losing my mobility and independence (38 years of RA are finally catching up with me… plus other problems). It’s most frustrating. Pleased you’re keeping well. We, patients, need to be in charge of our health. It’s most important but stressful when one is not feeling well.
Hi Wedgewood, I share your hopes and have a question about your comment that no useable B12 ...., I believe B12 in useable form is on unwashed vegetables but perhaps you know better?
Yes, Helvella, I agree, what about it? It has been suggested that allergies may be a consequence of over-cleanliness, however, I do not know about these thing. Interestingly, one of my daughters who has little time to eat some days, does not worry about cleaning fruit or vegetables and has always been very healthy. I'm not promoting anything, just think it's important to be as informed as we can and share knowledge because there may be others like my daughter who would be glad to know that and who don't worry about washing their food before eating.
Useable B12 can possibly be on unwashed organic vegetables which have been fertilised with animal faeces . If this is eaten with the vegs , then that would be usable B12.! But the vegetables themselves do not contain any B12,at all. But most people wash their vegetables I think !
Also, please continue to wash your vegetables (unless you buy a prewashed pack).
It would make no sense to put yourself at risk of a serious food borne illness for the outside, unproven chance that you might get some usable B12 that way.
"Shiga toxin–producing Escherichia coli (STEC) cause substantial and costly illnesses. Leafy greens are the second most common source of foodborne STEC O157 outbreaks. We examined STEC outbreaks linked to leafy greens during 2009–2018 in the United States and Canada. We identified 40 outbreaks, 1,212 illnesses, 77 cases of hemolytic uremic syndrome, and 8 deaths. More outbreaks were linked to romaine lettuce (54%) than to any other type of leafy green."
Finally, there is B12 in some plant foods but most of it is not human usable or is not reliable or tested. Duckweed shows some promise but viability and proper testing still lie in the future. Someone also posted some interesting research about getting B12 into plants a little while back. Very interesting stuff but nothing that really changes B12 supplementation guidelines for vegans today.
Thank you Technoid, very, very much for the article especially. This has been a most interesting and very edifying 'conversation' you have shared. I now feel much better informed after around 20 years of being vegan!
Thank you Wedgewood and Technoid, this has been a most interesting and very edifying 'conversation' you have shared. I now feel much better informed after around 20 years of being vegan!
The "rise in veganism" text is linked to a glowing review of that terrible book from Jayne Buxton, "The Great Plant-Based Con".
Gives me pause about their statement:
"Experts have warned that as many as one in 20 people over 60 and one in 10 over 75 could be suffering from the vitamin deficiency, with overall numbers increasing because of the rise in veganism."
I think its certainly a possibility that veganism could be making a contribution if new vegans are not supplementing B12 adequately, or get confused about dosage (as I did).
But I'd like to see some data 😁
Does anyone have the NICE document showing where they say overall numbers are increasing because of the rise in veganism? I hesitate to take this article at face value given their clear biases.
I somehow doubt that the older generation is turning to veganism as indicated in the article . More likely their B12 deficiency is caused by a lack of stomach acid , coupled with a lack of money to buy meat and fish .
I think veganism is likely a real issue - but there is much more discussion of B12 among vegans than (so far as I have seen) among vegetarians.
And there is little or no certainty that any vegetarian diet will have enough B12-containing content to provide the necessary B12. They don't all consume eggs and dairy non-stop!
Veganism will be an issue, but like wedgewood , doubt that this has much to do with lifestyle choices of the older generation.
Poverty (cooking and meat/fish both expensive) , increasing lack of appetite, lack of senses of taste and/or smell , lack of stomach acid for digestion - none of this sounding much like trending lifestyle options.
Vegetarians only seem to get mentioned in research as "strict vegetarians" - by which I suspect they actually mean vegans - but no real definition given. How unsciencey ! What is the need for the word "strict" in this sense - as opposed to what other type ?
I have been a vegetarian for over 40 years. Glad that NICE mentioned that vegetarians are not immune to having B12 deficiency for other reasons as well as/ instead of dietary deficiency. I sincerely hope that vegans are more clued up re B12 than we veggies were back then, although no-one seems to ever mention B12 deficiency risks when talking about vegan food on TV.
As for Health Ministers extolling the virtues of the B12-packed broccoli ...... so unhelpful.
I had never heard of B12 when I was told, seven years ago, that I was deficient in it. I thought the 6 injections were all there was to it - right up until the 5th one when the nurse put me right !
My GP luckily did not expect me to sort it out myself with vitamin tablets. I think, by now, if being a vegetarian was my only problem, I would not have need to still self-inject every fourth day.
The difference with veganism being that someone who is vegan follows such a diet for ethical reasons and there is more to veganism than just diet - it encompasses avoiding purchasing any items containing animal products, where practical, not buying animals from a breeder, not supporting animal testing etc etc.
In practice, I sometimes see people describe themselves as following a vegan diet when they exclude animal products from their diet for health reasons. But strictly speaking, being vegan is not something confined to diet, but rather an ethical stance and lifestyle against causing unnecessary suffering to non-human animals, so such a diet is better described as strict vegetarian. But mostly I don't care too much to argue this as I don't think its worth the hair-splitting.
Older books on veganism such as "Becoming Vegan" by Davis & Melina (2000), and "The Vegan Sourcebook" by Joanne Stepaniak (2000), do prominently feature B12 and explicitly describe the need for B12 supplementation and the consequences of deficiency. I read both books before becoming vegan. The problem is, (at least in these older editions), the RDA is described as being tiny (2.4mcg), which is true, but how the absorption mechanisms affect dosage quantity and frequency are not discussed. Recommended amounts that are safe to take 3x daily, once daily or weekly are not mentioned, none of which are intuitive. This is critical information which fortunately is now more available, from the vegan society site, from veganhealth.org and many other good sources. Lucky millenials!
But the low quality of information available back then made it very easy to make a dosing mistake, especially if intrinsic factor saturation and passive absorption are not understood. Things are better today and better quality information is out there, just needs to find its audience and be followed!
I just saw "strict vegetarian" as someone who is scrupulous to avoid meat and fish including even trace ingredients. They read labels. They won't reuse a frying pan with any fat in it (or at all). They never slip and have a bacon sarnie or a midnight kebab!
LOL. I can see why that would make sense. Some people have said to me "oh so you're a strict vegan?" which is a meaningless term to me. Intentionally eating animal foods or foods containing animal products to me is just not something a vegan does. I mean, its in the definition 😋
......which is exactly the point I was making about vegetarians: the "strict" is just unnecessary. You are/aren't.
The hair-splitting is more to do with researchers being stricter about definitions.
This may seem trivial now, but might not if we get to the stage where all who follow vegetarian diets are dismissed early on by GPs as having dietary B12 deficiencies. It stands to reason that, statistically, some of us will also have pernicious anaemia and other causes for B12 deficiency.
And that some of us, even the strict ones, will have sufficient daily B12 in their diet.
Hello Technoid, I am pretty sure that there are three categories of vegan now, ethical which you describe, but also environmental vegans and a third which I've forgotten, ah yes, those who are vegan for health reasons. I believe these three categories have been made because of legal implications, I think an ethical vegan has some legal protection in the same way someone following a Hallal diet for religious reasons does, although as I write this, it seems to me that those who practice for their health or for the environment also deserve legal protection.
I don't understand Technoid, I was not putting forward my views or opinions, I was stating the most up to date information I have about vegan categorisation but if you know of more recent changes I'd be very interested to hear about them.
I'm not aware of any recent recategorizations of veganism. Do you have a reference? Since veganism started with the Vegan Society they seem a reasonably good source for a definition and that has not changed in quite some time.
"Veganism is a philosophy and way of living which seeks to exclude—as far as is possible and practicable—all forms of exploitation of, and cruelty to, animals for food, clothing or any other purpose; and by extension, promotes the development and use of animal-free alternatives for the benefit of animals, humans and the environment. In dietary terms it denotes the practice of dispensing with all products derived wholly or partly from animals."
Some people begin excluding animals from their diet for health reasons and over time, come to agree with the ethical aspects of veganism as well, which entails further lifestyle changes. Which is great! Simon Hill is a good example of this.
If someone is following a vegan/strict vegetarian diet, whatever their reasons, thats a great thing IMHO. But it is a different thing to say that a person IS vegan, since this is something that goes beyond diet, as per the Vegan Society definition.
Hi Technoid, I'm afraid I don't have a reference, all I recall is that it was a legal issue that started this off - I think to do with someone being served something non-vegan in a restaurant, or, possibly, the other way round, that ethical vegans must be catered for, that it's not enough to provide a salad, if vegan food is offered then it must be a nutritionally balanced meal. It's not something I put into my memory and I don't want an argument. As a family our veganism extends to using only positive reinforcement in training and handling animals, which, since one of my daughter's is an equine vet is not easy. The other daughter is an animal behaviourist, so, as an example, our own animals do not have to be sedated or mechanically restricted for x-rays/gastroscope etc, they will on request stand completely still and reasonably relaxed. How humans, including vegans, treat animals, especially pets, is something that we find distressing. That's where our focus is and I'm afraid it's not on definitions of veganism but on opening people's eyes to the subtle cruelty to pets/horses etc. Apologies to all for the long post off-topic.
"As many as" - all too often weasel words - especially when followed by "could be".
Some years ago there was a trial of methylcobalamin, methylfolate and pyridoxal 5’-phosphate. Ah - I think this night be it:
Metanx Alleviates Diabetes-Induced Large and Small Fiber Neuropathies and Promotes Small Sensory Nerve Fiber Regeneration
IRINA G. OBROSOVA, PIERRE WATCHO, HANNA SHEVALYE, Baton Rouge, LA
Metanx (PamLab L.L.C.) is a prescription combination medicine containing L-methylfolate, pyridoxal 5’-phosphate, and methylcobalamin. Metanx increases production of tetrahydrobiopterin, a cofactor of endothelial nitric oxide synthase (eNOS), which, theoretically, should counteract eNOS uncoupling, generation of superoxide, superoxide-induced upregulation of inducible nitric oxide synthase (iNOS), and peroxynitrite formation. We, therefore, evaluated Metanx on diabetic peripheral neuropathy (DPN) using Zucker diabetic fatty (ZDF) rat, a model of Type 2 diabetes. Metanx was administered to 15 week old ZDF and ZDF lean rats at either 4.87 mgkg -1d -1 (the dose used in clinical practice) or 24.35 mgkg -1d -1, 2 times a day, for 4 weeks. Neuropathy was evaluated by sciatic motor (MNCV) and hind-limb digital sensory (SNCV) nerve conduction velocities, thermal response latency (Hargreaves method), mechanical withdrawal threshold (Randall-Selitto test), tactile response threshold (flexible von Frey filament test) and intraepidermal nerve fiber density (fluorescent immunohistochemistry with confocal microscopy). Sciatic nerves were used for nitrite/nitrate and nitrotyrosine assays (ELISA). 15 week old ZDF rats displayed hyperglycemia, MNCV and SNCV deficits, thermal and mechanical hypoalgesia, tactile allodynia, and ∼26% loss of intraepidermal nerve fibers. Both doses of Metanx alleviated SNCV deficit and thermal and mechanical hypoalgesia, in the absence of any reduction of hyperglycemia. Low dose Metanx treatment induced small sensory nerve fiber regeneration and increased intraepidermal nerve fiber density in ZDF rats. At the end of the study, sciatic nerve nitrotyrosine and nitrite/nitrate concentrations were lower in the Metanx- treated ZDF rats compared with the untreated group. In conclusion, Metanx, at the dose currently employed in clinical practice, alleviates sensory large and small fiber DPN and induces small sensory nerve fiber regeneration, by mechanisms that are likely to involve inhibition of oxidative-nitrosative stress. Evaluation of Metanx on eNOS uncoupling and iNOS expression are in progress.
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