B12/Folic Acid and D3/K2 Supplementation

I have joined a Facebook group called Understanding B12 deficiency where members are recommended to get iodine, selenium and molybdenum up to a good level, one by one, only then add B2, and only then add B12 (injections or in oil that is absorbed through skin...) All very gradually. Don't know yet if it works, but the message in that group is that if you take B12 too soon, and the wrong type, will get nasty side effects... My daughter now at the stage where (after several months) we have ordered the B12... She has EDS and suspected POTS and Mcas, and paediatrician has said she has all the symptoms of ME. Just posting in case it helps someone - we don't know yet if it works ourselves...

 

Just to say that - although most doctors don't know about it - functional B12 deficiency (B12 deficiency despite normal or even high levels in blood) is in fact recognised by the NHS: 'Functional vitamin B12 deficiency Some people can experience problems related to a vitamin B12 deficiency, despite appearing to have normal levels of vitamin B12 in their blood. This can happen as the result of a problem known as functional vitamin B12 deficiency, where there's a problem with the proteins that help transport vitamin B12 between cells. This results in neurological complications involving the spinal cord.' (https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/causes/). Am I right that the only way you can tell if you have Functional B12 deficiency is by trying B12 injections and seeing if they help?

 

Anyone interested in vitamin B12 might find this paper of interest :

Title : The pathophysiology of elevated vitamin B12 in clinical practice

Link : https://www.researchgate.net/public..._of_elevated_vitamin_B12_in_clinical_practice

People can download and save a copy of the full paper as a PDF if they want.

 

And urine

 

Sue Jacksons blog carrys a lot of info presented in an easy to understand way.
B12 is a NO scavenger and this may be why it has an effect for some.

https://livewithcfs.blogspot.com/2014/04/vitamin-b12-and-mecfs.html?m=1

Certain genetic expressions also control the rate of B12 use / need for b12
You could have high blood serum but low cellular use - a kind of functional deficiency.
Tagging @Midnattsol who may be able to better explain this.

 

There might be one nevertherless.

Obviously actions in the body take place in a range of degrees.
These actions will be boosted or slowed down by molecules to be released, or even atoms.
Furthermore, there are different influences on an action (directly and indirectly),
it´s a web (which must stay stable enough).

If now a certain action has been slowed down,
and is itself in a single cell nevertheless within a normal range,
though an aggregation of this kind of action is too small (and this would be not normal)
one might want to boost cells of this action, although everything behaves as normal,
and there is no deficiency.

In this logic it would be important not to counteract the wanted influence
(which easily will happen, as the body is a web of different influences).
Here it would be crucial to do the molecule or atom without other stuff to the body.
It could even be important to do it in small dose to the body,
otherwise other actions might start (or maybe the reception will get close for such a too high influence).

 

Merged thread

Association of Plasma Concentration of Vitamin B12 With All-Cause Mortality in the General Population in the Netherlands, 2020, Flores-Guerrero et al.

In a January 2020 issue of JAMA (Journal of the American Medical Association) a paper about the dangers of having a high level of vitamin B12 was published.

1) I've linked the paper, then followed it up with

2) another link showing how this was reported in the media, then linked

3) a very good debunking of the paper. The statistical shenanigans in the paper in JAMA are very clearly described for a non-medical and non-scientific reader.

----------

1)
Title : Association of Plasma Concentration of Vitamin B12 With All-Cause Mortality in the General Population in the Netherlands

Link : https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2758742

----------

2)
Title : High levels of B12 were associated with an increased risk of early death in a new study

Link : https://www.insider.com/b12-supplements-could-be-lethal-in-high-doses-study-finds-2020-2

Notice the difference in the title and the actual web page link - apparently B12 supplements could be lethal in high doses! Shock, horror!

----------

3)
Title : Guest post by GP David Morris - Unravelling the alarming misinformation in a recent study on vitamin-b12

Link : https://www.b12deficiency.info/blog...information-in-a-recent-study-on-vitamin-b12/

The website that the article comes from is very annoying and has had copying of anything disabled, so I can't quote any of it on here in the normal way - I've had to use the snipping tool instead.

 

I am not qualified to give an opinion but it occurs to me that possibly the people taking very high doses of B12 might have been doing so for a reason, and that it may not have been taking high doses of B12 that killed them, even indirectly.

It might, just possibly, have been whatever the reason they were taking B12 for that did, even indirectly.

The quick scan that I have done would suggest that this is like concluding that chicken sandwiches are lethal simply because they were found in the stomachs of people who died by being shot, or who died in a traffic accident, or an avalanche.

It all appears, from a cursory glance, by someone with no medical training or experience, to be the height of stupidity to assume that correlation equals causation.

Of course B12 may actually be lethal, I have no clue, but the 'argument' given doesn't appear to show this.

 

This is one of the absurdities of the paper I linked from JAMA. The researchers had no idea who was supplementing.

 

I have only read the abstract of the paper but it seems perfectly fair to me. There is an association between high B12 levels and death. That proves no causal relation, as they say, but it raises a distinct possibility that having a high B12 level is bad for you. It is then very logical to assume that B12 supplementation might be harmful. As with all adverse effects, like damage from GET or suicides on psychiatric drugs, the level of evidence needed is very low.

I think it highly likely that anyone criticising this paper on the net has a very substantial axe to grind of their own. Since there is no evidence as far as I know that supplementing with B12 other than in proven deficiency is useful I think the original paper is a pretty good reason to be wary of supplementing over and above that.

 

I think that the problem with the issue of high levels of B12 is that people don't take into account or know the direction of causation/correlation. So, if someone who has never supplemented has high levels of B12 then this could indicate a problem with some type of solid tumour, or a serious liver problem. It is a known consequence of some types of cancer, and some forms of liver disease e.g. cirrhosis that levels of B12 may become very high.

But if someone has been supplementing B12 then the high level they have tells you nothing. It isn't possible to say whether the person taking the B12 has cancer or liver disease on the basis of the B12 alone. And there is no evidence that taking high doses of B12 causes cancer. The abstract of the paper I first linked in post 1 really is an appalling paper. I think the axes being ground belong to whoever paid for the "research" in link 1.

This paper is mentioned in the debunking paper and it mentions other conditions apart from supplementing, some cancers, and liver disease that can cause high B12 and it is well worth reading :

Title : The pathophysiology of elevated vitamin B12 in clinical practice

Link : https://academic.oup.com/qjmed/article/106/6/505/1538806

This is a very good link on the uses and effects of high doses of B12 from a Dutch deficiency group (it's in English) :

https://stichtingb12tekort.nl/weten...been-shown-to-be-safe-for-more-than-50-years/

It mentions, amongst other info, that smoke inhalation is treated with vitamin B12 injections as follows :

"
The safety of vitamin B12 treatment is further illustrated by the decennia long use of hydroxocobalamin as an antidote for cyanide poisoning, often caused by smoke inhalation. In the Netherlands ambulances, fire departments and emergency rooms have the Cyanokit at their disposal. In life threatening situations 5 g hydroxocobalamin is given intravenously within 15 minutes, an amount that corresponds with 5 000 injections of 1 mg B12.10 Hydroxocobalamin reacts in the body with cyanide, and forms cyanocobalamin, which is excreted in urine.
The serum value of B12 can rise to an average of 560 000 000 pmol/L within 50 minutes.11 If necessary this treatment is repeated within several hours, making the total dose 10 grams. The side effects that occur, like reddening of the skin and urine and changes in heart rate and blood pressure are temporary and harmless. In short: 10 000 injections a day are still not enough for an overdose of vitamin B12."

 

The authors of the original paper seem to be quite open about that and, as I indicated, it if you are worried about harm the question is whether there might be a causal relation

But as far as I am aware this is a pretty rare situation. I never came across it in my practice. The paper looks at a wide population with no particular link to cancer.

It tells you that there is a high level, and that might be a bad thing.

What makes you say that?

 

I think the paper article in link 3 debunking the paper in link 1 gives me plenty of reasons for thinking it is appalling.

 

I realise you think that but what reasons?
Not sure which paper in link 3 you are referring to.

The paper by Andres looks to me to be pushing a line, with a number of inconsistencies. I doubt a high B12 level is a useful route to diagnosis of any particular disease.

 

In post #1 in this thread I gave three links and gave a superficial description of what each of the three links was. I should have said "article in link 3" rather than "paper in link 3".

One of the problems that was discussed in link 3 was dividing the subjects into four quartiles and the way it was done. Before the end of the research, quartiles 2 and 3 were combined, and the results of quartile 2 and quartile 3 were not given separately, presumably because the combined group gave them the result they wanted of an increase in mortality as B12 increased. For all we know quartile 3 may have had lower mortality than quartile 2 - but the information needed is not given. The fourth quartile was open-ended. It included all patients with B12 levels above a certain level. The quartiles were set up as follows :



The other thing that is strange about the splitting up of the subjects is that 455.41 pg/mL is not even a high level of serum vitamin B12. It is well within the reference ranges of any test of serum vitamin B12 I've seen used in the UK. The last NHS test of serum vitamin B12 that I had (5 years ago) had a reference range of 197 - 866 pg/mL.

Although I haven't got any proof, I have frequently seen it mentioned that in Japan a level of serum B12 below 500 is considered to be deficient and the top of the range is around 1300.

But if we accept (and I do) that a high level of B12 indicates the possibility of a problem (which may well not have been diagnosed) it means that quartile 4, which apparently had the highest levels of mortality, included people with levels which were well within any normal range, people with levels which were really, really high, and also included people who must already have been sick. And another thing - the differences between the quartiles was really very small.

It looks as if the researchers went out of their way to set up their quartiles to show the results they wanted.

Oh, and another thing - the subjects in the study were not healthy members of the general population.




Also, the researchers had no information on whether the subjects were supplementing B12.