Can B12 deficiency cause brain lesions?

[kw202]

Reposting from my personal "introductions" thread, to get more eyeballs.

All right, I have my B12 result, and today I had a follow up appointment with my neuro to go over results of my newest (with contrast) MRIs. My brain MRI has a couple of lesions, including the "Dawson's fingers" he said is characteristic of MS. (This is in addition to other lesions on my cspine and tspine). My spinal tap results aren't back yet but he advised me to prepare for a MS diagnosis. And he put me on a course of oral steroids, hoping to speed up my recovery from the leg heaviness/numbness I've been experiencing.

My B12 is low. I stupidly walked out of his office without a copy of the results, but he said my B12 was around 200 (on a scale where I think 200 or 250+ is normal); he told me people with neurological symptoms shouldn't go below 600, for what that's worth.

I'm going to see my GP tomorrow, it's supposed to be for a B12 shot - but maybe first I should ask her to order more B12 tests. I asked my neurologist today if he thought my lesions could be caused by B12 but he waved me off because he said B12 deficiency "doesn't cause brain lesions." So I'm back here, asking for some advice.

IS this true? Are supplemental B12 tests just worthless at this point? If not, what other tests should I be asking for related to B12?

[NHE]

Hi KW202,
If your B12 is 200 pg/mL, then you're deficient. Yes, with neurological symptoms, you definitely want to be above 500 pg/mL and 600-1000 pg/mL is a good target range to shoot for. B12 doesn't work alone. It needs folate. Either eat uncooked leafy greens every day or take methylfolate supplements. Don't bother with folic acid, it's junk. Folic acid is synthetic and it's not easily metabolized by the body. A large percentage goes unmetabolized and then inhibits the action of real folate and also inhibits the activity of macrophage cells in the immune system. http://www.thisisms.com/forum/natural-a ... ml#p230638

The B12 shot is good. However, one shot is only a beginning. Treatment of B12 deficiency usually consists of a 1000 µg shot every day for the first week followed by weekly shots for four weeks followed by maintenance therapy of monthly shots. In addition, the hydroxocobalamin form of injectable B12 is better than the cyanocobalamin form. It's more easily metabolized to the two active forms of B12, methylcobalamin and adenosylcobalamin, and is retained longer in the body.

Yes, B12 deficiency can cause brain lesions. Please see the references cited in the following discussion topic. http://www.thisisms.com/forum/natural-a ... 24857.html

Lastly, do yourself a favor and read the book "Could it Be B12? A Epidemic of Misdiagnosis" by Sally Pacholok and Jeffrey Stuart. http://b12awareness.org/could-it-be-b12 ... a-release/

[kw202]

Hi there,

I finally have my actual number -- it's 228.

I saw my GP today and she believes my B12 drop was due to a switch a year ago to vegetarianism, not malabsorption. So she did not order additional tests. Since she believes it's not due to malabsorption, she said no shot is needed, that I should start oral dosing.

Any suggestions for how to proceed myself to get it up as quickly as I can? I'd like to have the maximum impact I can before I see my MS specialist in early January.

Many thanks.

[jimmylegs]

sublingual methylcobalamin should do the trick. and a good high quality multi for cofactors.

re lesions. yes there are a few studies out there showing brain lesions with b12 deficiency. i probably have one posted on here but years and years ago and don't recall the details except for maybe that we're talking case studies nothing with huge sample size or anything. i strongly suspect in such cases that there would be other confounding factors and that it would be much better to have more info on the total nutritional picture.

[kw202]

Thank you JL. Any suggestions for dosing? She suggested 100mcg (or maybe it was 1000mcg - i don't have my paperwork at hand). both seem laughable to me but what do I know.

Her eyes also got REALLY BIG when I told her how much I'm dosing d3. But to her credit when I told her I had no plans to stop until it got to a level I was happy with, she just ordered a d3 level test and sent me on my way.

[jimmylegs]

you'll probably find them in 1000 mcg to 2000 mcg strips

as long as you have cofactors going in with the d3 you shouldn't be doing any harm in the short term.

re the doc - what are you taking daily again?

[NHE]

Any suggestions for dosing? She suggested 100mcg (or maybe it was 1000mcg - i don't have my paperwork at hand). both seem laughable to me but what do I know.

Sally Pacholok, coauthor of the book "Could it Be B12?," recommends taking Advanced B12 by Superior Source.



It has 1,000 micrograms (µg) of both active forms of B12, methylcobalamin and adenosylcobalamin. It's a small sublingual tablet that dissolves in about 1-2 minutes. I've been taking them for several months. You can get them from Lucky Vitamin for $15 for 60 tablets. http://www.luckyvitamin.com/p-429934-su ... 0-tablet-s Since you're B12 deficient, I would recommend taking 2/day for the first couple of weeks and then one per day thereafter. You'll probably notice an energy boost after taking it so try not to take it too late in the day or it could interfere with your sleep. When I was B12 deficient, taking a good sublingual B12 felt like someone turned the lights on in my head within about 10 minutes.

[kw202]

you'll probably find them in 1000 mcg to 2000 mcg strips

as long as you have cofactors going in with the d3 you shouldn't be doing any harm in the short term.

re the doc - what are you taking daily again?

Thanks! I had bought some B12 not long ago, I just looked and it's 6000 mcg. Well I guess I don't do anything halfway. I'm pretty sure I also have some 2,000 mcg sublingual tabs, but I'm not sure it's the most ideal form (I think they're both cyanocobalamin).

When you say cofactors, what do you mean? Sorry, I'm really new to all this supplementation jazz. I've been healthy all my life, never thought a second about pills or oils or anything else. Guess you're never too old to learn new stuff, and maybe if I had I wouldn't be here right now. ANYWAY.

As for D, last week after learning my level (9.9), I took a megadose of about 400,000IU (that started the big eyes), and since then I've been taking 10000 IU daily (they got bigger here). I figured I'd maintain this level for maybe 3 months and get tested, but since she tested me yesterday I guess I'll know sooner!

I am also taking 400mg of magnesium, and I keep meaning to go get some K2, but haven't yet. But I will, and that'll get added in. I'm also limiting my calcium intake. Maybe that's what you mean by cofactors.

Should I be taking a b complex or a multivitamin along with b12? Do you have any recommendations that way? I'm an information sponge and a fast learner, but this is all new territory for me.

[kw202]

Any suggestions for dosing? She suggested 100mcg (or maybe it was 1000mcg - i don't have my paperwork at hand). both seem laughable to me but what do I know.

Sally Pacholok, coauthor of the book "Could it Be B12?," recommends taking Advanced B12 by Superior Source. It has 1,000 micrograms (µg) of both active forms of B12, methylcobalamin and adenosylcobalamin. It's a small sublingual tablet that dissolves in about 1-2 minutes. I've been taking them for several months. You can get them from Lucky Vitamin for $15 for 60 tablets. http://www.luckyvitamin.com/p-429934-su ... 0-tablet-s Since you're B12 deficient, I would recommend taking 2/day for the first couple of weeks and then one per day thereafter. You'll probably notice an energy boost after taking it so try not to take it too late in the day or it could interfere with your sleep. When I was B12 deficient, taking a good sublingual B12 felt like someone turned the lights on in my head within about 10 minutes.

Thank you so much for all the info! Ironically, I took my first b12 dose last night (along with the steroids I'm on...) and ended up at 5:45am, about 2 hours earlier than my normal wake-up time, and found myself reading your warning and laughing. Oh well. I definitely felt more ready to spring out of bed than usual though, that is for darn sure. And I'm no morning person.

[kw202]

Here are my latest results:

B12 drawn 12/10 192 pg/ml (range 213-816) - this is even lower than it was on Monday, when it came back at 228 pg/ml. But that was before I started supplementing. For the past 4 days I've been taking 6000 mcg sublingual B12 and also trying to make sure I eat leafy greens daily. Suggestions for dosing/additions? It needs to be up over 600.

My gp also did folic acid - the result is 9.0 ng/ml (range 7-31.4). This seems very low to me. Suggestions for what it should be/how to boost it?

She also took my vitamin D again. When it was initially tested on 11/20, my vitamin D level was 9.9 ng/ml (range 30-100). As of 12/14, it had risen to 33.3 ng/ml, but that's still way too low. My treatment so far has been: About 1.5 weeks ago I took a 400,000 IU megadose (200000 IU D2, 200000 IU D3) and since then have been taking 10000 IU daily. Should I megadose again?

thanks for your help!

[NHE]

B12 drawn 12/10 192 pg/ml (range 213-816) - this is even lower than it was on Monday, when it came back at 228 pg/ml. But that was before I started supplementing. For the past 4 days I've been taking 6000 mcg sublingual B12 and also trying to make sure I eat leafy greens daily. Suggestions for dosing/additions? It needs to be up over 600.

What exact supplement are you using? The reason I ask is that I found sublingual methylcobalamin tablets from Jarrow to be ineffective for me.

My gp also did folic acid - the result is 9.0 ng/ml (range 7-31.4). This seems very low to me. Suggestions for what it should be/how to boost it?

You could always use methylfolate supplements. Here's one that I take because my RBC folate was 403 ng/mL while the normal range is 500-1500 ng/mL.

http://www.vitacost.com/superior-source ... -tablets-1

By the way, the RBC folate test is preferred over the serum folate test because it gives a better measure of your long term folate status and is less affected by daily variations in diet.

Since both folate and vitamin B12 deficiency can cause macrocytic anemia, appropriate treatment depends on the differential diagnosis of the deficiency. Serum folate measurement provides an early index of folate status3; however, folate is much more concentrated in red blood cells than in serum so the red blood cell folate measurement more closely reflects tissue stores.5,6 Erythrocytes incorporate folate as they are formed, and levels remain constant throughout the life span of the cell. RBC folate levels are less sensitive to short-term dietary effects than are serum folate levels. Red blood cell folate concentration is considered the most reliable indicator of folate status.3

You could request additional blood tests or a referral to a hematologist to help determine if you have any problems that might be interfering with nutrient absorption.

[kw202]

What exact supplement are you using? The reason I ask is that I found sublingual methylcobalamin tablets from Jarrow to be ineffective for me.

I believe it's a Nature's Bounty brand but, both of those tests were drawn before I started supplementing, so it's probably not surprising that I continued to drop. I'll see how I'm doing in a few months now that i'm actively taking B12. I don't think it's a malabsorption issue, but we'll see with the next test.