Vitamin B12. Joy.

Researchers have found a possible link between lack of vitamin B12 in early life and insulin resistance later.  (Link has both video and text; video does at times assume fat is a problem, but overall explores why type 2 diabetes is not brought on by eating too much.)

I’ve written before about being deficient in Vitamin B12, so you may understand that this is a bit closer to home for me that others.  And the endocrinologist has reminded me many times that I’m insulin resistant.

So. Yeah. Interesting.

Vitamin B12 in the news

I’ve written about my vitamin B12 absorption problem before.  The NY Times recently posted a good primer on B12 deficiencies, including those at risk:

Natural plant sources are meager at best in B12, and the vitamin is poorly absorbed from them. […C]hronic users of acid-suppressing drugs like Prilosec, Prevacid and Nexium, as well as ulcer medications like Pepcid and Tagamet, are at risk of developing a B12 deficiency and often require a daily B12 supplement.

Stomach acid levels decline with age. As many as 30 percent of older people may lack sufficient stomach acid to absorb adequate amounts of B12 from natural sources. […]

Synthetic B12, found in supplements and fortified foods, does not depend on stomach acid to be absorbed. But whether natural or synthetic, only some of the B12 consumed gets into the body. Treatment to correct a B12 deficiency typically involves much larger doses than the body actually requires.

Free B12 from both natural and synthetic sources must be combined with a substance in the stomach called intrinsic factor to be absorbed through the gut. This factor is lacking in people with an autoimmune disorder called pernicious anemia; the resulting vitamin deficiency is commonly treated with injections of B12.

Although most doctors are quick to recommend injections to correct a B12 deficiency, considerable evidence indicates that, in large enough doses, sublingual (under-the-tongue) tablets or skin patches of B12 may work as well as injections for people with absorption problems, even for those with pernicious anemia.

The latter is something I make use of — I appear not to absorb much B12 from food, but the little I absorb of  “a lot” is enough.  I also like that supplements are over-the-counter and I can take them daily.  Shots would be prescription and often weekly or monthly.  :)

Note to Self

Dear Self –

Yes, if you are going to spend your weekend wandering around a warehouse helping to make a music / circus / vendor event happen, then by all means, take an extra B12 if you think it will help.  Even an extra 2500-iu, if that’s what you have handy…

But don’t be surprised if you are totally dead in following days when you drop back down.  In fact, it might be a good idea to only drop by 1000-iu at a time.

Feeling stupid for not realizing this sooner,
– Me

Meds: There’s a Reason I Take Them

It’s amazing how my morning can go from “bleah” and “moving sucks” to “this feels right pleasant” and “let’s get stuff done” just by taking my meds.

The asthma meds in particular make carrying laundry up/down the stairs and changing sheets much easier, but the vitamin B12 and D also does a lot for my general energy levels.

(This message is brought to you by Saturday “taking longer to get moving than usual” and “Argh I dislike having to take pills”.)

An “Oh!” Moment

Today I was reflecting on the history of my knee/leg problems, starting with injuring my right leg and knee when I started an exercise program in July of 07.  I attributed this to starting with a more strenuous program than I could handle.

Why did I start an exercise program in July of 07?  Because:

  • I’d started treatment for my exercise-induced asthma, which had been limiting my ability to exercise previously….
  • I’d started treatment for my vitamin B12 deficiency and was full of energy and wanted to MOVE and DO things.

Here’s where I usually add, “Unfortunately, my muscles weren’t up to handling what I was doing.”   I’d started walking a 1/2 mile a day, working up to a mile a day, and then a mile and a half  — but apparently that was too much.

I’d also recently looked up journal entries from when I’d gone on other exercise kicks, plus other vacations that involve a lot of walking.  In 06 I had noticed feeling fatigued, had mentioned it to my ARNP,* but I’d still had a several walk-heavy vacations without injury.  I wondered how my muscles had been so atrophied in a year, how I’d been so much more sedentary.  Yes, symptoms of b12 deficiency include fatigue, depression, and balance problems….

And weight loss and weakness.  That sounds like muscle loss.   What if I hadn’t lost weight, but what if I’d lost muscle?   That might explain it.  From my diary at the time, 6 days after starting b12 supplementation:

This is getting entirely too weird.

First, I’m nowhere near as interested in meat and eggs as I was. Especially for breakfast. Suddenly I’m eating a banana and yogurt for breakfast, and steaming veggies with garlic and a little chicken for lunch. I haven’t done this in years.

Second, I’m not crashing hard in the afternoon.

Third, I’m less tired in general.

And now … I’m not as interested in caffeine … ? Note, I haven’t stopped drinking it. But instead of a minimum of 7 cans/cups, today I had 2 cans of diet Pepsi and 1 cup of coffee.   I’m craving chocolate less too.

This is all within one week.

A week later:

I feel like I’m bursting with energy and want to move and dance all the time. In reality, I’m ready to sit down – or at least stretch a bit – after an hour. Sitting still and focusing on work? Er…NOT so good. Wanna play!

So…hm. Maybe it wasn’t just that I’d been a lump. By the time I was diagnosed the lab noticed my red blood cells were notably deformed and I was pretty anemic.  I was asked if I’d lost weight, and the answer was no…but that might not mean I hadn’t lost muscle.

At least I hadn’t developed dementia.

*As noted earlier, my former ARNP listened to my concerns, checked my thyroid function, and decided it could be my history of depression or that I was overweight and should consider WLS.   She also upped my Wellbutrin prescription.   The B12 deficiency wasn’t found until I changed healthcare providers.

Day in the Life: Vitamins

I posted yesterday that I finally admitted that I have asthma and began using an inhaler before exercising. Walking uphill became easier.

The second change came a few days later, when the new ARNP got the results of my blood tests. “You have a severe vitamin B12 deficiency. Do you eat eggs and meat? Or are you a vegetarian?” Yes, I eat eggs and meat – had been craving them muchly the last few years – but I was still deficient. It seems that I don’t absorb vitamin B12 very efficiently, which led to anemia.

I started taking vitamin B12 supplements. I still do, every morning.  (I absorb less than most people, but “some” of “a lot” works out to “enough”.)   At a follow-up appointment she also urged me to take Vitamin D supplements, because I’m on the low side and we live north of Toronto.

Within 1 week of starting vitamin B12 supplements, I had more energy, more endurance, and stopped craving meat and eggs all the time.  Instead of insisting on eggs and meat for breakfast, I began eating things like fruit and yogurt.

What I’ve realized since then was that my activity had been limited by the lack of B12 and the asthma. Now I’m not. Now I’m limited only by my current fitness level – and I can improve it.

The scary thing?  The B12 deficiency was only found because I changed my medical practitioner.

You see, a few years ago I noticed I was feeling run down all the time.  It’d been a gradual thing.  More sleep, dealing with sleep apnea, exercise – all would give me a small boost, but not get me back to where I used to be.

Most commonly, people with anemia report a feeling of weakness or fatigue, general malaise and sometimes poor concentration. – Wikipedia entry “Anemia”

I complained to my then-ARNP.  She checked to see if I was hypothyroid; when the TSH came back normal, and she pointed out I had a history of depression and I was, of course, morbidly obese.

Common early symptoms [of B12 deficiency] are tiredness or a decreased mental work capacity, decreased concentration and decreased memory, irritability and depression.
Wikipedia entry “B12″

She suggested upping my antidepressant dosage, that I exercise more, and perhaps look into weight loss surgery.  (Because of course having a surgery that itself can cause vitamin deficiencies is exactly what I needed!) (*pounds head on desk*) Continue reading