all things vitamin b12

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jimmylegs
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Re: all things vitamin b12

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Vitamin B12 Deficiency and Multiple Sclerosis; Is there Any Association? (2012)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354399/
Background: Vitamin B12 (Cobalamin) deficiency can result in some clinical and paraclinical characteristics similar to what is seen in multiple sclerosis (MS) patients. This study aimed to evaluate the controversial association between vitamin B12 deficiency and MS.

Methods: We measured serum vitamin B12 in 60 patients with MS and 38 healthy controls. Clinical disability was evaluated according to the Extended Disability Status Scale (EDSS). Serum B12 concentration was measured with Radioimmunoassay Dual Isotope method. The cutoff value for low serum vitamin B12 concentrations was 75 pg/mL. [jl edit: interesting - my lab must have used this assay too; my cleanest b12 test from '06 came back with the result "less than 75"] Patients were in remission at the time of blood draw.

Results: There were 13 (21.6%) MS patients and 10 (26.3%) controls with low serum B12 concentration with no significant difference between the groups; P>0.05. The mean serum vitamin B12 concentration in MS patients (108.9±45.3 pg/mL) was not significantly different compared with controls (98.9±44.4 pg/mL); P=0.284. Likewise, there was no correlation between the concentration of serum vitamin B12 and disease’ age of onset, duration, subtypes, or disability status.

Conclusions: In contrast to some previous reports, our findings did not support any association between B12 deficiency and MS.
first, let's play 'spot the methodological flaws'. in the abstract, one stands out to me. any thoughts?

here's the study data, showing patients with higher levels than controls: http://www.ncbi.nlm.nih.gov/pmc/article ... /table/T1/
http://www.sciencedirect.com/science/ar ... 6808002622

they're all pretty bad though, across the board.

if i had been in this study in 2005, i would have been in the control group with low b12 and no ms. by 2006, i would be in the patient group with low b12 and ms. there *is* a b12 - ms connection. it's just not as simple as b12 alone.

another study:

Serum vitamin B12, folate, and homocysteine levels and their association with clinical and electrophysiological parameters in multiple sclerosis
http://www.sciencedirect.com/science/ar ... 6808002622
We aimed to evaluate serum vitamin B12, folate, homocysteine, mean corpuscular volume (MCV), hemoglobin (Hb), and hematocrit (Hct) levels in patients with MS. ... These parameters were evaluated in 35 patients during an acute attack and compared to data collected from 30 healthy individuals (control subjects).
Table 2
Vitamin B12, folate, homocysteine, Hb, and Hct levels and MCV in patients with
multiple sclerosis and healthy control subjects
.............................Patients with MS..............Control group
Vitamin B12 (pg/mL)....221.26 ± 72.75...........257.43 ± 105.67
No statistically significant differences (mean ± SD) were observed for vitamin B12, folate, or homocysteine levels
but
Subjects who exhibited prolonged (>116 ms) VEP latencies had lower vitamin B12 levels compared to normal subjects (212.22 ± 66.72 pg/mL vs. 251.75 ± 88.30 pg/mL, respectively). Patients who exhibited posterior tibial SEP P1 latencies longer than 42.1 ms also had lower vitamin B12 levels compared to normal subjects (221.95 ± 69.92 pg/mL vs. 244.57 ± 97.84 pg/mL). Similarly, subjects who exhibited prolonged (> 63 ms) posterior tibial SEP P2 latencies had lower vitamin B12 levels compared to normal subjects (214.67 ± 63.76 pg/mL vs. 246.87 ± 98.06 pg/mL)
We found a significant association between MS and vitamin B12 deficiency, and therefore suggest that all patients with MS should be screened for vitamin B12 deficiency.
grr using what standard :S moving on..

just looking for general healthy controls serum levels now... found this which sidetracked me neatly:

Folate, vitamin B12, and neuropsychiatric disorders.
http://www.lef.org/protocols/abstracts/ ... ote]Folate and vitamin B12 are required both in the methylation of homocysteine to methionine and in the synthesis of S-adenosylmethionine. S-adenosylmethionine is involved in numerous methylation reactions involving proteins, phospholipids, DNA, and neurotransmitter metabolism. Both folate and vitamin B12 deficiency may cause similar neurologic and psychiatric disturbances including depression, dementia, and a demyelinating myelopathy. A current theory proposes that a defect in methylation processes is central to the biochemical basis of the neuropsychiatry of these vitamin deficiencies.[/quote]
i'm on board with the methylation defect.. went looking for other players

Effect of zinc deficiency on methionine metabolism, methylation reactions and protein synthesis in isolated perfused rat liver.
http://europepmc.org/abstract/MED/3968590


will continue reviewing the literature, to establish an actual optimal serum cobalamin range seen in healthy controls across multiple studies.
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Re: all things vitamin b12

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continuing the quest for a reasonable approximation of healthy serum cobalamin status

Cobalamin status in sickle cell disease
http://www.ncbi.nlm.nih.gov/pubmed/22830455
We analyzed blood samples from 86 subjects in two groups: SCD (n = 29) and non-SCD (n = 57). Serum cobalamin, folate, homocysteine, methylmalonic acid (MMA), anti-intrinsic factor antibody, Helicobacter pylori antibody, and gastrin were measured and compared.
Results
The median cobalamin was 235 pM in the SCD group vs. 292 pM in the non-SCD group (P-value = 0.014).

ugh now i have to worry about units ABBREVIATIONS on top of conversions? pM = pmol/L.

Vitamin and Mineral Status in Patients With Inflammatory Bowel Disease
http://journals.lww.com/jpgn/Abstract/2 ... th.21.aspx
Results: None of the 61 patients with IBD had folate or vitamin B12 deficiency. Vitamin D deficiency was found in 62% of the patients, vitamin A deficiency in 16%, vitamin E deficiency in 5%, and zinc deficiency in 40%. The control group had vitamin D and E and zinc deficiency in 75%, 8%, and 19% patients, respectively.

boo :( i don't have full text access to this journal. anyone else out there able to get into the serum levels for this one?

interesting:
Evaluation of Indicators of Cobalamin Deficiency Defined as Cobalamin-induced Reduction in Increased Serum Methylmalonic Acid
http://www.clinchem.org/content/46/11/1744.short
........................................Nondeficient (n = 136).......Deficient (n = 51)
Variable..........Units.............Range.....Mean.....SD........Range.....Mean.....SD
Cobalamin.......pmol/L...........51–300.......181....69........24–260.......108.....44

Signs of impaired cognitive function in adolescents with marginal cobalamin status
http://ajcn.nutrition.org/content/72/3/762.full.pdf
Characteristics, biochemical variables, and dietary intake of subjects who consumed a macrobiotic diet in early life and had a low or normal cobalamin status at the time of the study and in control subjects with normal cobalamin status

..............................................................Macrobiotic subjects
...............................................Cobalamin deficient.....Normal cobalamin.....Control subjects
Characteristic .................................(n = 31).....................(n = 17).................(n = 24)
Cobalamin (pmol/L)...................177 (136, 227).................291 (239, 331)......446 (352, 568)

"We found a significant association between cobalamin status and performance on tests measuring fluid intelligence, spatial ability, and short-term memory."

Serum Cobalamin and Transcobalamin Levels in Systemic Lupus Erythematosus
http://www.sciencedirect.com/science/ar ... 439090463N
The mean cobalamin level of the control group was 556.9 +/- 320.6 pg/mL ... The cobalamin levels of the entire SLE group (328.5 +/- 182.9 pg/mL) were significantly low in comparison to the control group (p <0.0005) (Figure 1).

Cobalamin Status and Its Biochemical Markers Methylmalonic Acid and Homocysteine in Different Age Groups from 4 Days to 19 Years
http://www.clinchem.org/content/49/12/2067.short
.................................................4 days.....6 wks–6 mos.....1–10 yrs.....10.5–15 yrs.....15.5–19 years
Serum cobalamin, pmol/L
Median........................................314.................217............551.............436................369

divide by .738 to convert to pg/ml... 369 converts to exactly 500 pg/ml
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Re: all things vitamin b12

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on the flip side:

High serum cobalamin levels in the clinical setting – clinical associations and holo-transcobalamin changes
http://www.ncbi.nlm.nih.gov/pubmed/11843883
High cobalamin levels (> 664 pmol/l; > 900 ng/l) occurred in 94 of 670 consecutive clinically requested assays (14%). The only independently significant associations with a high cobalamin level were renal failure among the clinical disorders (P=0.01), elevated serum creatinine (P=0.0001) and diminished albumin (P=0.0002) levels among laboratory tests. Both holo-TC I and holo-TC II levels were increased in renal failure (P=0.0001) but the increase was relatively greater in holo-TC II. The results indicate that high cobalamin levels are more frequent than low ones in clinical practice and appear to be associated often with renal failure.
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Re: all things vitamin b12

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this tidbit is related to thx's post from last year, on the previous page, re regimen changes associated with reduction in MCV. one regimen change item listed was cessation of vit d3 supplementation. possible connection:

Dietary Magnesium Deficiency Induces Heart Rhythm Changes, Impairs Glucose Tolerance, and Decreases Serum Cholesterol in Post Menopausal Women
http://www.seekinghealth.com/media/magn ... hanges.pdf
Table 6. Effect of Magnesium Depletion and Repletion on Red Blood Cell and Iron Variables Determined the Last Five Weeks of Each Dietary Period for Each Subject
Variable.....Mg Depletion.....Mg Repletion.....Pooled SD.....p Value
MCVa(fL)......93.2................91.3.................1.0.............0.0005

that's quite the p-value... so, perhaps magnesium levels are able to increase with reduced d3 influence, and mcv drops as a result.
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THX1138
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Re: all things vitamin b12

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I found this B12 article to be good: Warning: Potentially Life Threatening Vitamin Deficiency Affects 25% of Adults
Vitamin B12 is fittingly known as the energy vitamin, and your body requires it for a number of vital functions. Among them: energy production, blood formation, DNA synthesis, and myelin formation. Myelin is insulation that protects your nerve endings and allows them to communicate with one another.

If you know or suspect you're vitamin B12 deficient, you're not alone. Recent studies from the U.S. Framingham trial show one in four adults in the United States are deficient in this vitally important nutrient, and nearly half the population has suboptimal blood levels....
http://articles.mercola.com/sites/artic ... dults.aspx
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Re: all things vitamin b12

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don't think i had quite dialed in this little tidbit:

Al-Khamis, F. A. (2016). Serum Vitamin B12 and thyroid hormone levels in Saudi patients with multiple sclerosis. Journal of Family & Community Medicine, 23(3), 151.
full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5009884/

"It is important to note that the serum Vitamin B12-plasma homocysteine concentration-response curve appears curvilinear. This means that as serum Vitamin B12 increases from the lowest detectable level to 950 pg/mL, plasma homocysteine decreases. However, as serum Vitamin B12 further increases to more than 950 pg/mL, plasma homocysteine begins to increase.[5]":

this is 5:
Werder, S. F. (2010). Cobalamin deficiency, hyperhomocysteinemia, and dementia. Neuropsychiatr Dis Treat, 6, 159-195.
full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874340/

but it's not the original source. i don't personally have time to go digging for the details but at some point i'll have to go have a look at the various consequences of excessively high vit b12.
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Re: all things vitamin b12

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Time to Abandon the Serum Cobalamin Level for Diagnosing Vitamin B12 Deficiency
http://www.bloodjournal.org/content/128/22/2447.full

don't have time to read in detail atm, not sure i agree at first glance through
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Re: all things vitamin b12

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in j neurol, no less:

Vitamin B12 and its impact on Multiple Sclerosis Type and Severity (2018)
http://n.neurology.org/content/90/15_Supplement/P2.349

Abstract
Objective: This study is conducted to assess the correlation between the level of Vitamin B12 and Multiple Sclerosis type and severity.

Background: Cyanocobalamin (vitamin B12) deficiency is considered an important multiple sclerosis (MS) mimic, this is due to the similarities clinically and pathophysiologically of both diseases, as both attack the myelin sheath of the nervous system. The study aimed to determine the association between vitamin B12 levels and MS type and severity.

Design/Methods: This is a retrospective single center study of patients seen at the specialized MS clinics. Data obtained through the MS database for a total of 350 patients. patients were divided into either relapsing remitting (RRMS) or progressive (PRMS). Vitamin B12 values were obtained at the first visit and a cutoff value of 200 pg/mL or above was considered normal. The severity of MS was evaluated using the Extended Disability Status Scale (EDSS). Fisher exact test was used to identify whether vitamin B12 levels distinguished between MS types. Local regression was used to assess the correlation between vitamin B12 levels and the EDSS.

Results: A total of 100 MS patients had vitamin B12 levels (91 RRMS and 9 PRMS) with a 1:1.5 male to female ratio. B12 levels were below normal in 30 RRMS cases and one SPMS case (p=0.27). Local regression showed an inverse relation between vitamin B12 levels and EDSS at the sub-therapeutic levels, this relation plateaued once the therapeutic levels were reached.

Conclusions: Low vitamin B12 levels were inversely correlated with MS disability measures but failed to distinguish between MS types. The small sample size of PRMS was considered a limitation in our study. Future studies looking at the effects of vitamin B12 on MS severity are needed.


thought i had full text access for this one, not working right now however
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healthy controls b12

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a side project pointed up this mean (+/- SD) serum b12 level for healthy controls

XXXXX XXXXXXXXXXXX XXX Serum XXXXXX XXX Vitamin B12 Levels in XXXX XXXXXXXXX XXXXXXXXXX and XXXXXXXXX’X XXXXXXX: A Case-Control Study (2017)
fft https://www.mdpi.com/2072-6643/9/7/725/htm

see Table 1. Demographic, clinical, and biochemical characteristics ...
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Re: healthy controls b12

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jimmylegs wrote: Thu Sep 10, 2020 6:54 am a side project pointed up this mean (+/- SD) serum b12 level for healthy controls

Plasma Homocysteine and Serum Folate and Vitamin B12 Levels in Mild Cognitive Impairment and Alzheimer’s Disease: A Case-Control Study (2017)
fft https://www.mdpi.com/2072-6643/9/7/725/htm

see Table 1. Demographic, clinical, and biochemical characteristics of the three groups
It looks like high homocysteine and low folate are the key trends in MCI and AD.
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Re: all things vitamin b12

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could well be, i've only looked at the controls b12 level.
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Re: healthy controls b12

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NHE wrote: Thu Sep 10, 2020 7:06 am
jimmylegs wrote: Thu Sep 10, 2020 6:54 am a side project pointed up this mean (+/- SD) serum b12 level for healthy controls

Plasma Homocysteine and Serum Folate and Vitamin B12 Levels in Mild Cognitive Impairment and Alzheimer’s Disease: A Case-Control Study (2017)
fft https://www.mdpi.com/2072-6643/9/7/725/htm

see Table 1. Demographic, clinical, and biochemical characteristics of the three groups
It looks like high homocysteine and low folate are the key trends in MCI and AD.
According to Sally Pacholok's book, Could It Be B12?, homocysteine should be between 4-12 µmol/L so even their control group was a little high at 13.21 µmol/L.
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Re: all things vitamin b12

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from my perspective, today's post is about reporting a cognitive control group's serum vitamin b12 level.
compare standard (non cog) serum b12 deficiency lower cutoffs.
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elevated b12

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Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study (2013)
https://academic.oup.com/jnci/article/1 ... 799/903901

"... Six percent had Cbl levels greater than the upper reference limit (≥601 pmol/L).

Cancer risk increased with higher Cbl levels and was highest during the first year of follow-up
(Cbl 601–800 pmol/L: SIR = 3.44, ... Cbl >800 pmol/L: SIR = 6.27...

The risks were particularly elevated for hematological and smoking- and alcohol-related cancers for persons with high Cbl levels. ..."

( noting that 601 pmol/l / 0.738 = 814 pg/ml

and recalling, fwiw, the healthy controls levels 573.17 ± 75.41 pg/mL from table 1 in https://www.mdpi.com/2072-6643/9/7/725/htm ) (which would be 423 pmol/l)
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Re: elevated b12

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jimmylegs wrote: Tue Aug 17, 2021 4:05 pm Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study (2013)
https://academic.oup.com/jnci/article/1 ... 799/903901

"... Six percent had Cbl levels greater than the upper reference limit (≥601 pmol/L).

Cancer risk increased with higher Cbl levels and was highest during the first year of follow-up
(Cbl 601–800 pmol/L: SIR = 3.44, ... Cbl >800 pmol/L: SIR = 6.27...

The risks were particularly elevated for hematological and smoking- and alcohol-related cancers for persons with high Cbl levels. ..."
An important caveat: this article discusses naturally occurring high B12 levels as the study excluded those taking B12 supplements.

From the full text:
  • The underlying pathogenesis leading to high Cbl levels is poorly elucidated, with a few exceptions (6,10,11). It is not thought to involve increased Cbl intake because intestinal absorption capacity is saturable (31) and high physiological consumption does not increase plasma Cbl levels substantially. Only Cbl therapy in the form of injections or extremely high oral doses can produce high circulating levels, and in this study, patients treated with Cbl were excluded. We therefore conclude that the mechanisms resulting in high Cbl levels may be related to malignant pathogenesis. Our recent study showed that levels of the circulating Cbl binding protein haptocorrin were high in patients with high plasma Cbl levels (3). Moreover, cancer was associated with high Cbl and high haptocorrin levels. This protein originates from a variety of tissues, but its physiological function remains unknown (32). It is elevated in patients with some cancer types (6,10,11) and has been suggested as a marker for disease progression (6,10). Thus, haptocorrin may be a candidate factor to include in future studies of the possible pathogenic mechanisms leading to high Cbl levels in cancer patients, in particular for the novel associations demonstrated in this study.

    In conclusion, our study showed that high plasma Cbl levels increased the risk of subsequently diagnosed cancer, mostly within the first year of follow-up. However, this association was not present for all cancer types. Although our results may have clinical implications for interpreting high Cbl levels, further studies are warranted to examine the possible diagnostic value of high plasma Cbl levels.
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