B12 energy enhancer, endurance booster

 

Harley Street GP Dr Cristina Romete of RoC Private Clinic draws our attention to the facts about Vitamin B12.

According to the Guardian in 2003, Lady Thatcher’s high energy levels were put down to B12 shots.

So…if it was good enough for the Iron Lady…should I recommend it to my patients?

I must say, I never read that article back in 2003. The first time I came across B12 as an energy booster was when I commenced work as a private GP in Harley Street. On the NHS, B12 injections are only given when there is documented vitamin B12 deficiency from blood tests so most NHS GPs won’t be aware of it’s additional energy boosting properties.

I recall questioning in my early days as a private GP whether it was right to give patients the B12 shots they were after, in the absence of a diagnosis of B12 deficiency. Trying to lead me down the path of conviction, patients would say: ‘ I feel great straight away’, ‘it is like a boost of energy’, ‘my doctor always gives it to me when I’m run down’, ‘it always helps me during performances’ etc.

One patient that will stay in my memory for good is now a 101-year-old lady whom I came across during my private practice in 2007. I used to consult her on a weekly basis. She had a brilliant mind and was always joyous and full of life despite her disabilities and need for full-time care. I remember being amazed at the clarity of mind she possessed, the ability to carry out a daily critical analysis of the ‘News of the World’ and ‘The Times’. Two weeks after our first consultation, she popped the question ‘Did you bring my shot doctor?’. Yes, it was B12! She had been having regular B12 injections for a number of years, in the absence of a demonstrable B12 deficiency and most certainly her monthly energy boosters weren’t to stop with me. Her story always serves me as a reminder, that we, as doctors, don’t know everything. Mind you, some doctors may say that it wasn’t the B12 injections that kept her full of life but who can say otherwise for certain? She most certainly swore by the ‘magic shot’.

What is B12?

Vitamin B12 is naturally found in meat, fish and dairy products. Vegetarians and vegans are therefore most likely to have B12 deficiency. B12 is not present in plant foods but some cereals are fortified with B12. A small amount of ingested B12 will get absorbed into the blood stream.

Vitamin B12 is required for red blood cell production, neurological function and DNA synthesis.

It has been linked with the prevention of Alzheimer disease and breast cancer, heart disease prevention (lowering homocysteine levels), prevention of cervical cancer, helping with sleep disorders, depression, fatigue and shaky leg syndrome to name a few.

However, the only clear evidence that exists for the benefit of Vitamin B12 supplementation is when Vitamin B12 deficiency has been diagnosed and is being treated.

How does one recognise B12 deficiency?

The most predominant feature of B12 deficiency is tiredness and lack of energy. When treating someone for B12 deficiency, this is the first and most notable symptom to improve. Chronic fatigue, forgetfulness, emotional symptoms such as irritability, low mood or mood swings, pins and needles or numbness, mouth discomfort are some of the other symptoms that a B12 deficient person may experience.

How do we measure B12 levels?

One of the difficulties in diagnosing Vitamin B12 deficiency has been the measurement of B12 in the blood.

Commonly, the total B12 levels are measured, but those have limitations, as not all the circulating B12 is available to be used by the body. The majority of the B12 (70-90%) is bound to haptocorrin and the body cannot use this.

The active B12 is bound to transcobalamin and the cells can only take up this type.

Therefore, measuring total B12 may give a false picture as to what the real, active levels of B12 are. In addition, as most of B12 is bound to haptocorrin, and haptocorrin has a longer life than transcobalamin, it may be a long time between someone experiencing symptoms of B12 deficiency and total B12 levels dropping.

It was only until early 2013 that active B12 has become easily measurable within the private sector and RoC Private Clinic carries out such testing.

What B12 Supplementation regimes are available?

B12 comes in different forms such as injectable solution, oral tablets, sublingual lozenges and nasal sprays. It is available on its own or part of most multivitamin tablets available to be purchased over the counter.

The recommended dietary intake varies from country to country from 1mcg to 10mcg daily. It is known that, only a small proportion of the oral B12 gets absorbed, that is even if there are no abnormalities of the gut affecting absorption. Some institutions recommend that people over the age 50 have B12 fortified foods, or take supplements as 10-30% of them may develop absorption issues.

Injectable B12 (Hydroxocobalamin) regimes vary, but most often include an initial loading regime (daily or weekly) followed by a maintenance regime of 1mg injections every 1-3 months. No health risks have been identified from excessive B12 intake.

If you would like to know more about B12; be tested for vitamin deficiencies or discuss your particular case, Dr Cristina Romete will be more than happy to see you.

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