Vitamin B12, cobalamin, is one of the most important vitamins when it comes to depression and overall mental health.
B12 is well-known for its role in red blood cell production and protecting us from pernicious anemia, heart disease, stroke, osteoporosis, and even infertility. It’s even called the “energy” vitamin because of its ability to reduce fatigue.
But it also has a vital role in psychiatric symptoms such as depression, anxiety, confusion, memory loss and even psychosis.
Deficiency is widespread. In fact, 2/5 of the population may be deficient in Vitamin B12 according to a recent study in Framingham, Mass.
Vitamin B12 works with B6 and folic acid to make serotonin and dopamine, two important mood neurotransmitters as well as SAMe. Both B6 and folic acid/folate are in short supply in our society as well.
Testing for B12 Deficiency
You can check your levels of this important vitamin with a simple blood test. Blood levels of 200-600 pg/mL are considered normal. Below 200 is considered deficient.
But did you know that even slightly lower than ‘normal’ levels of Vitamin B12 may be linked to depression, fatigue and poor memory?
Studies have shown that even levels in the 300-400 pg/mL range can result in insomnia, fatigue, depression and dementia, reports Dr. Kelly Brogan, psychiatrist.
Dr. James M. Greenblatt, psychiatrist, finds that levels of 800-900 pg/mL give his patients more optimal energy levels.
In addition to simply looking at the levels of B12, blood and urine levels of methylmalonic acid or homocysteine are also used to gauge whether B12 is optimal. Because B12 is a primary player in methylation and homocysteine recycling, we can tell if B12 is ‘on the job’ by testing methylmalonic acid and homocysteine.
What Causes B12 Deficiencies?
B12 cannot be made by our bodies. For that reason, we have to obtain it from our food or supplements. It is absorbed in the small intestine. Therefore anything that impairs digestion can affect B12 absorption.
The body actually stores vitamin B12 so any deficiencies may take several years to develop. It is stored in the liver, heart, kidney, pancreas, brain, testes, blood and bone marrow.
The most common causes of deficiency are:
- Low stomach acid (hypochlorhydria) caused by antacids, proton pump inhibitors, laxatives, or other acid-blocking medications.
- Lack of intrinsic factor–an enzyme produced by the stomach that allows B12 to be absorbed.
- Age–as we get older, it is more likely that we become deficient due to lower stomach acid and intrinsic factor production.
- Vegetarianism/Veganism–Vitamin B12 is not found in the vegetable kingdom, with the possible exception of nori seaweed and tempeh.
- Diabetes medications–Metformin and other blood sugar medications deplete B12.
- Birth control pills
If you have had bariatric surgery, Crohn’s disease or Celiac disease, you are particularly at risk for B12 deficiency.
If you become deficient in B12 and digestive function is also impaired, you will likely develop symptoms that will earn you a prescription for an antidepressant and then other prescriptions may pile up because they are not addressing the root of the problem.
Boosting Your B12
Vitamin B12 sources come from food or supplements. Our primary food sources of Vitamin B12 are found in:
- Meat, particularly organ meats like liver
- Most fish, crab, scallops, shrimp, and oysters
- Egg yolks
- Dairy products (especially live-active yogurt)
Supplementing with Vitamin B12
The vitamin comes in a few different forms. Cyanocobalamin is the synthetic version and probably the most common. It is bound with cyanide (yes, the poison, although in levels that would never be enough to be fatal). Hydroxocobalamin, adenosylcobalamin and methylcobalamin are other forms. These are best taken sublingually, under the tongue.
The most desirable form is methylcobalamin, which is the form produced by our gut bacteria. Contact me for dosages and brands of Vitamin B12 supplements. Quality matters when it comes to supplements.
Many psychiatrists prefer administering B12 by a series of injections. With injections, B12 does not have to go through the digestive system and can effect change more rapidly. For many patients, it’s the last antidepressant they will ever need.
Here is your simple change for the day: Check your Vitamin B12 levels and lift depression and energy levels with the right foods or supplements.
A Mind of Your Own, Dr. Kelly Brogan, 2016
Breakthrough Depression Solution, Dr. James M. Greenblatt, 2016
Staying Healthy With Nutrition, Dr. Elson M. Hass, 2006
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Joli Tripp and Simple Changes Healthy Results are not medical doctors nor licensed medical professionals. No comment or recommendation should be construed as being a medical diagnosis. If you suffer from a medical or pathological condition, you should consult an appropriate healthcare provider.
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