Value of Vitamin B12 for Multiple Sclerosis
Vitamin B12 deficiency is a problem frequently associated with the elderly, a form of anemia, Crohn’s disease, and vegans. Another group that should be conscious of the value of vitamin B12 are those who live with multiple sclerosis.
People with multiple sclerosis are more likely to have a deficiency of vitamin B12 (cobalamin) than are individuals without this disease. Vitamin B12 is an important nutrient in MS because it plays a critical role in maintaining the integrity of myelin. Therefore, a vitamin B12 deficiency can contribute to the destruction of this protective coating and the symptoms associated with multiple sclerosis.
In fact, vitamin B12 and multiple sclerosis have a special relationship. Not only can a deficiency of the vitamin make MS symptoms worse, but symptoms of the disease may aggravate symptoms of vitamin B12 deficiency.
Since the symptoms list for a vitamin B12 deficiency reads much like that for MS, it seems like a good idea to have your levels checked. Some of those vitamin deficiency symptoms include fatigue, breathlessness, headache, balance issues, vision problems, mood changes, and changes in sense of touch.
What is a vitamin B12 deficiency?
A simple blood test can reveal your levels of vitamin B12. According to the National Institutes of Health, normal values of vitamin B12 in the blood can range from 200 to 900 picograms per milliliter (pg/mL).
Yes, that is a wide range, and they can vary from one lab to another. Therefore it’s important to ask your doctor about what your results mean for you. Generally, however, if your vitamin B12 values are less than 200 pg/mL, you are deficient.
Getting enough vitamin B12
If you have a vitamin B12 deficiency, your doctor will recommend a supplement program. You may be asked to take B12 orally at a dose of 1,000 to 2,000 micrograms (mcg) per day for a period of time followed by 1,000 mcg daily. The more common vitamin B12 supplement is cyanocobalamin, which is converted to methylcobalamin, one of the active forms of the vitamin.
Another option is to get intramuscular injections daily or every other day for a short period, followed by an injection every one to three months. You can discuss these and other choices with your healthcare provider.
Natural sources of vitamin B12 include clams and other shellfish, liver, meat, eggs, cheese and other dairy foods, and crustaceans (e.g., crab, shrimp). Fortunately for those who have chosen to avoid animal products, some foods are fortified with vitamin B12, including cereals, nondairy beverages, soy foods, breakfast bars, and some types of nutritional yeast. Always check labels before buying these foods for the amount of fortification.
Another factor to consider when taking vitamin B12 are medications and other substances that can reduce the ability of your body to properly absorb the nutrient. These include H2-blockers (e.g., cimetidine, famotidine, and ranitidine), nicotine, alcohol (excessive use), anticonvulsants, colchicine, metformin, proton pump inhibitors (e.g., esomeprazole, omeprazole, lansprazole), and long-term use of antibiotics. At one time experts speculated that taking excessive vitamin C may cause destruction of vitamin B12, but that idea has been put to rest.
As always, you should consult with a medical professional before starting any supplementation program. The status of your vitamin B12 level if you have multiple sclerosis should be an item on you “to do” list.
Miller A et al. Vitamin B12, demyelination, remyelination and repair in multiple sclerosis. Journal of the Neurological Sciences 2005 Jun 15; 233(1-2): 93-97
National Institutes of Health
University of Maryland Medical Center