Neurological symptoms of B12 deficiency may include:
numbness and tingling of the arms and legs; problems walking; disorientation; memory loss; mood changes that may resemble schizophrenia; and dementia. Damage may occur to the myelin sheath which surrounds and insulates nerves like the plastic coating around an extension cord. Nerve damage and mental health symptoms may become permanent with long term deficiency of vitamin B12.
Digestive symptoms may include:
loss of appetite, a painful tongue, and constipation. The reason for there to be digestive symptoms associated with B12 deficiency is not well understood. One theory suggests that undiagnosed digestive problems might have been an initial cause of the B12 deficiency.
Symptoms of vitamin B12 deficiency may also include:
pernicious anemia and megaloblastic anemia which are hemoglobin deficiencies that have symptoms of tiredness. Folate deficiency symptoms are also possible because B12 is necessary in folate metabolism. Increased heart disease risk from elevated homocysteine levels may result from B6, B12, or folate deficiency.
People who may be more at risk for vitamin B12 deficiency include:
Those with malabsorption problems, or people with chronic use of antacids and those who are over age 60. A specific protein cofactor called the intrinsic factor and normal stomach acidity levels are necessary for B12 absorption to be able to occur. Some individuals receive monthly injections of B12 after reaching older age and some people need to receive them monthly throughout life due to having chronically low vitamin B12 for other reasons than normal aging such as a genetic issue with their production of the intrinsic factor protein.
Sublingual tablets of the supplement are also available which are absorbed in the mouth, bypassing any problems with the rest of the digestive system.
A genetic difference may exist that causes some individuals to require the methylated active form of B12 rather than being able to benefit from the more commonly available supplement which is an unmethylated and therefore inactive form. [More about methylcobalamin.] A genetic screening test would need to be ordered to find out if there were any differences in the gene that might cause an inability to methylate vitamin B12 or folate/(folic acid is the commonly used supplement which is also in the unmethylated form, and therefore inactive for someone with a genetic inability to perform the methylation reaction – meaning an enzyme is malfunctioning somewhere in the complex chemical chain of events.)
A problem with lower digestive acidity in the stomach could also be managed simply by adding a side dish or condiment to meals that contains vinegar or acidic ingredients. Examples from around the world include chutneys, pickles, lime or lemon juice/fresh wedges, vinegary salad dressing, salsa or Tabasco Sauce, and Worcestershire sauce.
What is Worcestershire Sauce? (thespruce) (and how do you spell it?)- It is an interesting story – featuring the chemists Lea and Perrins. (Lea & Perrins is still the best selling brand of Worcestershire Sauce). Who knew chemistry could be so delicious?
Low stomach acid may be an underlying issue with symptoms of schizophrenia and in other mental health disorders. The balance and variety of microbes living within the gastrointestinal tract also may be involved in symptoms resembling mental illness. (Digestion & schizophrenia /PMC4437570/)
Pickles that are made fresh and need to be refrigerated can be a source of healthy intestinal microbes, in a similar way to the healthy bacteria found in yogurt with active probiotics or Kefir drinks. A variety of traditional products with live cultures are listed here – and a new one, probiotics are being added to chocolate in some products: (health.com/probiotics & chocolate) Scientists studying the microbiome tend to recommend the live culture foods rather than supplements of probiotics – based on my overview impression of multiple sources. An overview regarding the current recommendations about probiotic supplements is available here: (washingtonpost/people-love-probiotics-but-do-they-really-help/2017/05/19)
Probiotics refers to products that contain actual good guy bacteria, while prebiotics refers to foods that contain fiber or other nutrients which the good guy bacteria need to eat in order to survive and flourish – in competition with the more negative strains of bacteria or with yeasts or other microbes which might be found within our gastro-intestinal tract.
Eating vegetables and other foods that are good sources of some types of fiber also helps support healthier intestinal microbes, a few foods that provide the types of fiber that our intestinal microbes need to eat in order to flourish and protect us from more negative types of microbes, are listed here: (pcrm.org/seven-foods-to-supercharge-your-gut-bacteria)
It is a very good idea to get adequate fiber in the daily diet – because starving microbes will start breaking down and consuming edible portions of the intestinal cells for nourishment – if forced, and it may leave the body more at risk for infection (labblog.uofmhealth.org/gut-bacteria-eat-colon-lining-when-starved-for-fiber) – but why starve your good guy microbes? Our intestinal microbes may also help prevent anxiety. (neuroscienceresearch.wustl.edu.pdf)
Food Sources of Vitamin B12 include:
shellfish, fish, meat, poultry, eggs, milk, cheese, dairy products, Nutritional or Brewer’s yeast. Vegetarians who don’t eat dairy, eggs, fish or other meat products may need a supplement or nutritional yeast, a vegan food source of vitamin B12. (nutritional yeast/pubmed/11146329)
See the post on Vitamin B6 for more information about how the group of B vitamins work together in energy metabolism and cell growth.
Reference for more information:
An Evidence-based Approach to Vitamins and Minerals: Health Benefits and Intake Recommendations, 2nd Ed., by J. Higdon & V. Drake, (Thieme, Stuttgart / New York, 2012)
A description and source for purchasing the text: (thieme.com)
The text is produced in cooperation with the Linus Pauling Institute. He is a researcher who used large doses of vitamin C to cure cancer tumors. His work was met with skepticism. More recently research supports his work in that a specific type of cancer cells is very susceptible to vitamin C – while to the rest of the body it is water soluble and non-toxic at the level that was toxic to the cancer cells. (sciencedirect.com/science/article/pii/S2213231716302634)
Last reviewed and revised on 9/30/2017.
Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.
The Academy of Nutrition and Dietetics has a service for locating a nutrition counselor near you at the website eatright.org: (eatright.org/find-an-expert)
Vitamin B6 (pyridoxal, pyridoxal-5-phosphate (P5P), pyridoxine, and pyridoxamine, ):
Food Sources of Vitamin B6 include:
fortified cereal, barley, buckwheat;
avocados, baked potato with the skin;
beef, poultry, salmon;
bananas;
green leafy vegetables;
beans;
nuts; sunflower and pumpkin seed kernels.
Symptoms of a B6 deficiency may include:
A severe deficiency of vitamin B6 may cause seizures;
other neurological (nervous system or brain) symptoms affecting mental health may include irritability, confusion, and/or depression;
the earliest signs of a B6 deficiency might be observed first in the mouth where the tongue may be swollen and painful and become smooth looking and have a bright magenta color; mouth ulcers and cracks or fissures at the corners of the mouth may also occur;
and a weakened immune system may occur with a deficiency of vitamin B6.
Three B vitamins, B6, B12 and folate, are all necessary for the breakdown of homocysteine, which at elevated levels may increase risk of heart disease. So deficiency of any one of the three B vitamins, B6, B12 and folate, may be involved with symptoms or a diagnosis of heart disease.
Symptoms of PMS (Pre-menstrual Syndrome) and symptoms of prenatal nausea and vomiting may be helped by supplemental B6 intake. This suggests a deficiency may be involved in the underlying cause of the symptoms or that an increased need for the nutrient occurs before menstruation and during pregnancy. All B vitamins are important during pregnancy as they are involved in the growth of new cells and are needed for converting sugar into usable energy.
The skin & GI tract have a rapid cell growth rate which requires energy.
B vitamins are involved in both cell growth & energy metabolism.
B vitamins work together as a group to help breakdown the sugar glucose into a usable form of energy.
Areas of the body that have a short life cycle for cells are the first areas affected by deficiency of B vitamins because new cells need energy to grow and the B vitamin group are also involved in other chemical reactions that are necessary for the growth of new cells. The lining of the intestinal tract can have a cell turnover rate of just one week and the tongue is part of the gastro-intestinal (GI) tract and has a similar quick rate of cell growth.
The skin at the corners of the mouth and the lips in general may also have a slightly quicker rate of cell turnover than other areas of the surface skin. Our outer skin and the lining of the GI-tract are similar and considered part of the same organ system.
Deficiency of several of the B vitamin group can cause changes in the appearance and surface texture of the tongue. Other B vitamins that can cause changes in the tongue are mentioned in the following excerpt and include “niacin (B3), riboflavin (B2), pyridoxine (B6), folic acid (folate/B9), and vitamin B12”:
“Deficiencies of niacin, riboflavin, pyridoxine, folic acid, or vitamin B12, resulting from poor diet or from the administration of antagonists, may cause a sore, beefy-red tongue without a coat. In the chronic vitamin deficiency state, the tongue may become atrophic and smooth.” – “The Tongue – Clinical Methods – NCBI bookshelf https://www.ncbi.nlm.nih.gov/books/NBK236/
Pyroluria:
Pyroluria may be a genetic problem that causes increased urinary loss of B6 and zinc for some people. For patients with the condition adequate amounts of the nutrient cannot be readily obtained from food sources and large dose supplements are needed on a daily basis of both vitamin B6 and the mineral zinc. The condition is generally not assessed for or treated by the current medical system as it is not easy to diagnose. Anxiety is a primary symptom, migraine headaches and reduced tolerance for stress may also be symptoms. This post of mine has links and sources for more information: https://transcendingsquare.com/2014/09/22/pyroluria-anxiety-and-deficiency-of-b6-and-zinc/
This post by a medical doctor discusses the mental health and other symptoms in more detail. Emily Dickinson and Charles Darwin had similar symptoms. Daily supplements of zinc and B6 and/or the more bioactive form, pyridoxal-5-phosphate, (P5P), can quickly restore more normal health: http://www.judytsafrirmd.com/pyroluria-mental-health-and-the-immune-system/
Lack of dreaming at night is a symptom of pyroluria likely due to a long term deficiency of vitamin B6. Once treatment with the large dose supplements has been underway for a while it is common for patients to report remembering dreaming at night again. Whether the deficiency of B6 is causing less time to be spent at night in the stage of sleep when dreaming is more likely to occur, or whether it interferes with the ability to remember dreams the next morning, is not known.
Reference used for food sources & symptoms of Vitamin B6 deficiency:
An Evidence-based Approach to Vitamins and Minerals: Health Benefits and Intake Recommendations, 2nd Ed., by J. Higdon & V. Drake, (Thieme, Stuttgart / New York, 2012) [Amazon]
The text is produced in cooperation with the Linus Pauling Institute. He is a researcher who used large doses of vitamin C to cure cancer tumors. His work was met with skepticism. More recently research supports his work in that a specific type of cancer cells is very susceptible to vitamin C – while to the rest of the body it is water soluble and non-toxic at the level that was toxic to the cancer cells. http://www.sciencedirect.com/science/article/pii/S2213231716302634
Other References used for the food sources of Vitamin B6:
Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.
Both is the answer or kind-of is the answer to the question in the title. I realize I never answered it directly in the post or may not have explained it clearly. We may have the RDA, the Recommended Daily Allowance, of iodine in a supplement or fortified products each day — but if the environment and diet are also providing the chemically similar minerals bromide, perchlorate (chloride), and fluoride then the body may be making thyroid hormone with the atoms of bromide, chloride and fluoride instead of with atoms of iodine and a lab test might show the presence of thyroid hormone but that lab test wouldn’t be testing specifically for the presence of iodine.
Thyroid hormone might be present that contained bromide, chloride, or fluoride, or a combination, but it wouldn’t actually function within the energy pathways in the body and symptoms of tiredness and other symptoms of hypothyroidism. A very large dose of iodine taken for one month can help the body replace the wrong atoms in the thyroid hormone with atoms of iodine. The presence of bromide, chloride and fluoride may be involved in risk for autoimmune thyroid disease and cancer of the thyroid or other endocrine glands. More is included on these topics later in this post. It can also help resolve the pain of fibrocystic breast disease, that topic isn’t included in this post but I did find it helpful for resolving that condition for me, and it hasn’t returned. I had symptoms of it for years and the standard answer is along the lines of “we don’t know,” – well I know that for me my condition resolved after taking a large dose of iodine for one month and then a smaller but still larger than RDA dose for several years — but I didn’t know about or forgot the selenium and ran into hyperthyroid problems, more on that –>
*This updated post is not about being fat or thin, or “body-shaming,” inner beauty has nothing to do with size, however good health can have to do with size. Mood and skill in social settings can also be affected by size. Information about cancer is included in this post because a problem with iodine deficiency can increase risk for cancer.
The commonly used treatment for hypothyroidism within the current medical community is simply replacement of the thyroid hormone which is not addressing iodine deficiency for the thyroid gland or for the rest of the endocrine glands and the rest of the body. The thyroid organ can preferentially take up iodine when there is a limited supply, so a diagnosis of hypothyroidism suggests the rest of the body has even less iodine than the thyroid gland. Other side effects of hypothyroidism include depression, extreme tiredness, feeling cold, a tendency towards gaining weight and for constipation – everything slows down in the body when there is inadequate thyroid hormone or when it is present but not functioning correctly.
It is more comfortable to not weigh an excessive amount and it is more comfortable to have energy and not feel depressed and cold.
Showing the two pictures below is again, not about “body-shaming,” but was to give some idea of my past. Overweight women are somewhat invisible to men and to other women who care a lot about image. I have the social skills of an overweight woman, not those of a woman used to fending off unwanted attention from strangers or old acquaintances. I’ve never been to a fancy “cocktail party” if such a thing still occurs outside an episode of Mad Men (aka/the 1950’s). Or – more accurately – I have the social skills of someone with child trauma issues who may not have tried much in life and never gained experience and learned better skills.
It takes a while to learn what you don’t know and further, to learn how many layers of not-knowing-what-you-didn’t-know and that you’ll have to learn about and work through before you will really get to the core issue or issues.
A core issue revealed in the first picture is hyperthyroidism – I look thinner than typical for me. In the second picture I’m heavier but that was the weight that stubbornly stuck no matter how hard I tried to diet and exercise it off – until I took the large dose iodine supplement. My problem turned out to be the selenium. I didn’t learn about that until later after having developed hyperthyroid symptoms. Autoimmune thyroid problems can fluctuate between hypothyroid – low activity, and hyperthyroid – elevated activity. The first picture is me with hyperthyroidism and the second picture is hypothyroid.
We all do need iodine though. I have to limit how much I eat now because I still have an overactive autoimmune thyroid condition. I do eat some iodine foods but not much iodized products or any supplements and I do try to eat selenium rich foods regularly, which is about two Brazil nuts per day.
There aren’t many foods naturally rich in selenium. Coastal ocean microbes transform it from the form found in the ocean water into a form that can be carried in water droplets in the atmosphere where it is rained onto Brazil nut trees in the Amazon rain forest – isn’t our planet amazing?
We all need iodine.This is how I spent most of my years as an adult, before I took iodine supplements.
The rate of infants born with congenital hypothyroidism has been escalating, baffling many, unless you consider an older diagnostic term – cretinism or iodine deficiency. Cretinism is somewhat reversible if the infant receives adequate iodine after diagnosis, the thyroid gland would grow and begin to produce hormone naturally. If the infant is treated only with synthetic thyroid hormone, then organ development would continue to suffer and the baby will probably need the drug for the rest of its life. Weight gain, fatigue, apathy and depression are common symptoms in adults and children born hypothyroid typically are petite and can have reduced IQ. Women can’t grow babies out of synthetic hormone, but that is what they usually are given if diagnosed with hypothyroidism instead of iodine deficiency.
All of our glands need iodine not just the thyroid gland. The pineal gland, also known in more ancient terms as our Inner Eye, [crystalinks], has the second largest uptake of iodine and it is crucial for melatonin and a good night’s sleep. [5, 6] The mammary and prostate glands need iodine as well. Prostate and breast cancer also may involve an underlying iodine deficiency [2, 3] and the substitution of bromide, perchlorate and/or fluoride.
Lab tests have become a primary diagnostic tool and if the science underlying their use was wrong then the diagnosis based on the tests may not be very reliable. Our bodies have learned how to fool the lab test’s expectations of goiter by producing thyroid hormone containing fluoride or bromide. The gland is functioning normally but the hormone it is producing won’t prevent the symptoms and malfunction of hypothyroidism.
I had all those symptoms, but my lab tests were normal and therefore I was normal, or so I was told. However, after attending a seminar by Dr. Brownstein, I started a high dose iodine supplement that is equivalent to the amount of iodine provided by the sea weed in the traditional Japanese diet. The supplement that I have taken daily for six years contains 83 times more iodine than our current RDA. Our national guideline for iodine has not been changed since it was created in the 1940’s. Salt doesn’t have that much added to it and we aren’t really using much iodized table salt anymore. Do we reach for the salt shaker when we think about any other vitamin
It is important to get adequate amounts of the trace mineral selenium when supplementing with iodine, especially when using a large dose of iodine. Selenium is essential for the enzyme that breaks down excessive amounts of the active thyroid hormone. Excessive thyroid hormone can cause hyperthyroidism which can be associated with extreme mood and physical symptoms. Selenium can be toxic when excessive amounts are consumed for months.
Approximately two Brazil nuts provide the recommended daily goal of 200 micrograms of selenium. A one-a-day or prenatal vitamin would likely include 200 mcg of selenium. “Selenium” [ods.od.nih.gov/factsheets/selenium/]
A peer reviewed article with seaweed nutrient content information suggests that there is a wide range in iodine levels between different types of seaweed and between different samples of the same type of seaweed. [10]
The case study does not mention selenium. Hyperthyroid problems induced by abrupt increased intake of iodine may be mitigated by increasing selenium intake at the same time.
Kelp supplements can contain an unreliable amount of iodine. Out of 17 supplements tested the iodine content ranged from 45 micrograms to 57,000 micrograms. [1]
The kelp supplements content as tested is unreliable and potentially dangerous due to the unknown amount that might be contained. Seaweed also may contains goiterogens that interfere with thyroid function and occasionally toxins or other contaminants can be present due to the variability in ocean waters. [healthlibrary.epnet.com/GetContent.aspx?token=af362d97-4f80-4453-a175-02cc6220a387&chunkiid=21786 ]
Excessive iodine chronically can lead to toxicity side effects that include acne, a metallic taste in the mouth, a persistent mild cough and nasal discharge. The metallic taste can be a short term side effect due to bromide stores being exchanged for iodine. The RDA has been 150 micrograms. The Iodoral supplement that I have been using for six years contains 1250 micrograms of iodine/iodide which is a mega dose but is consistent and known, breaking the tablets and using a portion for a smaller daily dose is possible.
“Those at increased risk of developing hypothyroidism include: Postpartum women, Women with family history of autoimmune thyroid disorders (AITD), Those with previous head, neck, or thyroid surgery or irradiation, Those with other autoimmune endocrine disorders (e.g., type 1 diabetes mellitus, adrenal insufficiency, or ovarian failure), Those with nonendocrine autoimmune disorders (e.g., vitiligo, multiple sclerosis), Patients with primary pulmonary hypertension, Those with Down’s or Turner’s syndromes.
The following biological activities are particularly impaired by hypothyroidism: Calorigenic modification, Oxygen consumption throughout most tissues, Protein, fat, and carbohydrate metabolism, Augmentation of calcium ATPase activity in cardiac muscle, Mitochondrial ATP production, G-protein-coupled membrane receptor activity, Organ-specific effects.
The clinical manifestations of hypothyroidism (see Symptoms) are the result of effects occurring at the molecular level because of the impact of thyroid hormone insufficiency.” Read more: [medicinalplants.us/hypothyroidism ]
December 15, 2011 addition:
“Asian countries, such as Japan, have low rates of breast cancer, while Western countries have cancer rates that are many times higher. 25,26 However, when Japanese girls are raised on westernized diets, their rate of breast cancer increases dramatically.” [cancerproject.org/survival/cancer_facts/breast.php]
www.faostat.fao.org – world food supply statistics. ***The world three year average consumption of Aquatic Plants ( aka seaweed) for 2007-2005 is zero if you remove the three out-lying values out of the 154 countries with data. The countries with Aquatic Plant consumption are China – 20.39 grams/capita/day, Japan- 4.02 gr/cap/day, and the Republic of Korea – 35.28 gr/capita/day. [faostat.fao.org/site/610/DesktopDefault.aspx?PageID=610#ancor]
The Japanese intake of 4.02 grams Aquatic Plants may provide a safe amount of iodine without an excess of goiterogens that may be provided in the Chinese 20.39 average intake or the Republic of Korea’s 35.28 grams/capita/day of Aquatic Plants.
The World’s Healthiest Foods website,”Sea Vegetables, What’s New and Beneficial about Sea Vegetables?” – recipes and health information for a variety of sea vegetables. [whfoods.com/genpage.php?tname=foodspice&dbid=135 ]
Nutrient information for Kelp lists iodine content as 415 micrograms per 20 gram serving. The U.S. Nutrient Data Base # 11445, Seaweed, Kelp Raw did not have a line for Iodine content. Based on the wide range in content found by the research team in citation #1 it would be hard to estimate how much iodine the Japanese, Chinese, and Republic of Korea citizens might be consuming on average – but it is clearly an excellent source. [whfoods.com/genpage.php?tname=nutrientprofile&dbid=51]
Plastics, pesticides, herbicides and other chemicals may be a major cause of the feminizing of our young men [13] but the lack of iodine is also at fault. The prostate and testicles need iodine in addition to the thyroid, mammary and pineal glands. Switch to stainless steel drinking bottles and filtered water if you are worried about chemicals that disrupt the endocrine system; avoid soda (metal cans are lined with plastic) it is so acidic that it is leaching magnesium from you anyway; and take a high dose iodine or tested seaweed supplement. Boys will only continue to be boys if we provide their pregnant mothers and their growing bodies with nutritious building blocks. We still can’t build a functioning body out of pharmaceuticals or synthetic hormones.
/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./
_____________________________________________________________________
Most Asian Men Have Better Prostate Cancer Survival Rates, Finding could help to govern treatment approaches, study suggests. By Steven Reinberg, HealthDay Reporter, [abcnews.go.com/Health/Healthday/story?id=4508275&page=1]
Watanabe R, Hanmori K, Kadoya H, Nishimuta M, Miyazaki H, Nutritional Intakes in community-swelling older Japanese adults: high intakes of energy and protein based on high consumption of fish, vegetable and fruits provide sufficient micronutrients, J Nutri Sci Vitaminol (Tokyo). 204 Jun: 50(3): 184-95, [ncbi.nlm.nih.gov/pubmed/15386931]
Müssig, K., Thamer, C., Bares, R., Lipp, HP., Häring, HU., Gallwitz, B., Iodine-Induced Thyrotoxicosis After Ingestion of Kelp-Containing Tea, J Gen Intern Med. 2006 June; 21(6): C11–C14. doi: 10.1111/j.1525-1497.2006.00416.x. PMCID: PMC1924637
Leung, A.M., Pearce, E.N., Braverman, L.E., Iodine Content of Prenatal Multivitamins in the United States, N Engl J Med 2009; 360:939-940, [nejm.org/doi/full/10.1056/NEJMc0807851]
Jian-Ying Zhan, Yu-Feng Qin and Zheng-Yan Zhao, Neonatal screening for congenital hypothyroidism and phenylketonuria in China, World Journal of Pediatrics Vol. 5, Number 2, 136-139, [springerlink.com/content/w7054w4550233404/]
I need to talk about iodine a bit before I get to the vitamin D and calcium story. I don’t think I would have kicked my migraine and autoimmune problems if I hadn’t conquered my undiagnosed hypothyroidism first. The body can’t do anything without energy and the thyroid hormone is our energizer. Hypothyroid bodies become super efficient at not wasting energy and people can gain weight on 600 calories a day – you can’t live on that. Extreme fatigue, depression, apathy, hair loss, infertility and miscarriages are also common symptoms.
