The next few posts will be on vitamin B12 and the central role it plays in MS. Vitamin B12 is necessary for every cell in our bodies, so a deficiency could have far reaching and profound effects on our health. Vitamin B12 is made by organisms in the soil. We ingest B12 by eating animal proteins that were pastured. If an animal was not given access to soil, then the meat, eggs, milk or cheese will contain no B12. Most of our animals are raised on concrete, so this would be one reason why most Americans are low in vitamin B12.
According to a large study done at Tufts University, nearly 40% of the American population has B12 levels low enough to cause neurological damage. In addition, they tested the participants at a very low level-258pg/mL. Japan has set their B12 limits at 550pg/mL to 1200pg/mL. One of the reasons for this is that at approximately 500pg/mL you will see B12 deficiency symptoms such as dementia. On this basis, Misuyama and Kogoh proposed 550pg/mL and Tiggelen et al proposed 600pg/mL. The level we have set in the U.S. is approximately the level at which you see one of the most severe manifestations of a B12 deficiency-pernicious anemia. If you are in the normal range in the U.S., you have a severe deficiency, enough to cause pernicious anemia.
One surprising fact from the Tufts University study was that the participants in the study were eating foods rich in vitamin B12, but their bodies were not absorbing the vitamin. In the previous study I mentioned that found low B12 and high homocysteine in the cerebrospinal fluid of CFS and fibromyalgia patients, the study authors interpreted their findings to mean that low vitamin B12 levels in the cerebrospinal fluid may reflect disruption of the mechanism of transport across the blood brain barrier.
Numerous studies have found that MS patients are deficient in vitamin B12. The following study entitled, "Serum Vitamin B12, Folate, and Homocysteine Levels and their Association with Clinical and Electrophysiological Parameters in Multiple Sclerosis," found that like CFS and fibromyalgia patients, MS patients also had high homocysteine and low B12. The study states in the conclusion, "Thus, we found a significant relationship between MS and vitamin B12 deficiency..." http://www.ncbi.nlm.nih.gov/pubmed/19153046
Studies show that MS patients are also unable to properly metabolize B12.
"There is a significant association between MS and disturbed vitamin B12 metabolism," states the study entitled, "Vitamin B12 Metabolism in Multiple Sclerosis."
The study entitled, "Vitamin B12 and its Relationship to Age of Onset of Multiple Sclerosis," states, "In the present communication, we report that serum vitamin B12 levels in MS patients are related to the age of onset of the disease. These findings suggest a specific association between the timing of onset of first neurological symptoms of MS and vitamin B12 METABOLISM. In addition, since, vitamin B12 is required for the formation of myelin and for immune mechanisms, we propose that its deficiency in MS is of CRITICAL PATHOGENETIC SIGNIFICANCE."
The study entitled, "Multiple Sclerosis Associated with Vitamin B12 Deficiency," also concludes, "A vitamin B12 binding and/or transport is suspected."
Here is a quote from Julie Stachowiak, Ph.D., who has MS herself. "Studies have reported a significantly higher rate of vitamin B12 deficiency in people with MS than in people without MS, which is suspected to be due to problems with binding and transport of vitamin B12. One study found low B12 levels in the cerebrospinal fluid of people with MS, although their blood levels were normal. People with B12 deficiency have destruction of both the myelin and underlying axon."
So, what is responsible for the binding and transport of vitamin B12? The next study entitled, "Cobalamin Malabsorption Due to Nonegradation of R Proteins in the Human Intestine," states,"Pancreatic enzymes and the ionic environment in the upper gastrointestinal tract are ESSENTIAL determining factors for TRANSPORT and ABSORPTION of cobalamin (B12) in man." It concludes," Absorption of vitamin B12 is dependent on the presence of appropriate pancreatic enzymes." The specific enzymes that break down the proteins that B12 is attached to are protease.