A Table – Nutrients depleted by psych meds and risk factors for schizophrenia.

My latest work is on SubStack but I am going to start copying it here too. This post is about a series I have been working on regarding underlying risk factors about schizophrenia.

  • This post is the beginning of the series about my proposed clinical trial: Schizophrenia risk factors may also be Alzheimer’s risk factors; Experimental design and variables. (substack.1).
  • This prior post discusses the issue of harm from psychiatric and other medications and has some resources. Another oversite: #21 – psych med use (substack.3).
  • And this one is related: #22 – Psychosomatic symptoms, Childhood ACE score (adverse factors). (substack.2) – The nutshell – psychosomatic symptoms may also be a problem but the overlap with schizophrenia is not significant, suggesting there is a biological basis to schizophrenia.

The second two were later in the series and are pertinent to the Table discussed below:

Since imagining a Table is not as easy as viewing a Table – a link. /*I didn’t imagine that the link wouldn’t work on my phone. (pdf in my Dropbox link)/ Verbal synopsis – a dozen medications commonly used in psychiatric care are listed with nutrients that may become depleted with ongoing use of the medication. The list of nutrients includes 23 items and there was a significant overlap with the potential causal factors I had identified regarding schizophrenia (this series: substack.1) – so I added another column to the medication Table.

The list of schizophrenia risk factors also had matched the previous list I had made for mitochondrial support. Comparing datasets can help show overlap or lack – these are different topics. Sadly, the list of nutrients depleted by psychiatric medications, the list of schizophrenia risk factors, and the list of mitochondrial support nutrients all match. That is some unhealthy math. Mitochondrial dysfunction and quantum biology disruption are likely leading people with less severe mental health problems into more severe schizophrenia and later Alzheimer’s could be the risk if the chronic nutrient deficiencies remain a problem.

Tables help us see patterns in a large amount of data and can help compare similar data sets.

  • The medication data is from the book; Antidepressants, Antipsychotics and Stimulants, by Dr. David W. Tanton, Ph.D. (2006), and is as accurate as his work was at the time.

It makes it clear though, why people who are put on psychiatric medications tend to worsen more than people who aren’t started on meds for mild depression or anxiety. It also makes it clear why quality of life for patients with schizophrenia is now worse than it was 100 years ago. The focus of care at that time was simply stabilizing healthy diet and life routines, in a care facility setting perhaps, but just care, not medications.

A healthy diet can restore physical and mental health in many cases, but it may take work to figure out what individually is healthy versus adding to inflammatory problems.

Good health is visible:

Health shows up in healthy skin and hair. Good hair day selfie, Oct. 2, 2022

And an Excerpt from my really not finished draft, about one of the other Tables viewable at the link. The paper still needs a lot of work and removing opinion excet from the Discussion section.

Excerpt:

Pain is a signal from our body that we are doing something wrong. Pain medications to block or desensitize pain is leaving the body vulnerable to ongoing damage. Identifying the causes of pain and removing them, reduces both the pain and risk of chronic damage from inflammation. Table 10 is a snapshot of a much larger database that physicians and patients need to have created, to more easily identify triggers of inflammation in both diet and lifestyle.

Table 10 has a focus on TRP channel activators for this article about nociceptive pain, as TRP channels are so closely involved with pain signaling and the topic is new from a therapeutic diet perspective.

Hot pepper, black pepper, horseradish, ginger, turmeric, mustard, cinnamon, cloves, nutmeg, mint, and vanilla are TRP activators. Good in moderation, painful in excess. Migraine inducing or colitis flaring for hypersensitive patients.

Vanilla is calming. The TRPV1 channels can do anti-inflammatory things or send pain signals depending on the agonist. Trials with antagonists led to negative side effects from the peripheral functions of TRPV1 channels. Avoiding the activators avoids the pain or colitis flare-up.

Many types of TRP channels exist with varying agonists and those details are not included –it is a snapshot to get an idea of the size of the problem of identifying possible food triggers. From Table 10: TRP activating chemicals include: Histamine, Dopamine, Leptin, Arachidonic acid, Glutamate, cytokines, Substance P, and many others (See: Table 1, Kumar, et al, 2013) 1, 25, dihydroxy cholecalciferol-vit D. “…estrogen, androgen, testosterone, cortisol and many other steroids (Table 1)” (Kumar, et al, 2013)”

*and therefore possibly estrogen mimetic chemicals are also adding to chronic pain. 

See: Table 10. Foods Ranked by Potentially Inflammatory Categories, NF-kB promoting if sensitive; and Nrf2 promoting status otherwise* – healthy if not individually sensitized and the product was grown organically.

The TRP pain chain of events: emotional or physical stress degranulates mast cells, releasing histamine and cytokines, which activate TRP channels that send pain signals via an increase in intracellular calcium or sodium. The influx of calcium can lead to overactivity of the cell and lead to cell damage and add up to fibrotic damage over time.

ME/CFS, fibromyalgia, MCAS, Ehlers-Danlos Syndrome (EDS), Dysautonia or POTS, can all be chronic problems with little help available regarding reversing the symptoms rather than treating symptoms and coping with pain and other symptoms.

Disrupt the pain: self-calming techniques and pacing activity, avoiding TRP and histamine food triggers and vitamin A/carotenoids if Retinoid Toxicity is a problem, and wearing layered clothing to easily adjust to temperature changes, and avoiding excess EMF, etcetera; can help prevent degranulation of mast cells. Taking pomegranate products could also help inhibit mast cells and prevent more histamine from activating more TRP pain channels. Preventing the pain in the first place would be more efficient.

Doctor, it hurts when I bang my thumb with a hammer!” The doctor can give pain medication and ideally would also suggest more practice using a hammer. Knowing what is causing the pain and knowing how to stop it has more value to patients than simply treating pain. We know over-activation of TRP channels can cause pain signals. We know less about why some people seem to have more activation, or more expression of TRP channels. Childhood or chronic trauma can be causal of Irritable bowel syndrome (IBS) or Inflammatory bowel disease (IBD), in addition to gene alleles possibly being an individual factor. Increased expression of TRPV1 channels was observed and correlated with the level of hypersensitivity inflammatory bowel disease (IBD) and in patients with rectal hypersensitivity. (Hicks, 2006) (González-Ramírez , et al, 2017)

brown hammer on focus photography
Photo by Moritz Mentges on Unsplash

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.

(González-Ramírez , et al, 2017) González-Ramírez R, Chen Y, Liedtke WB, and Morales-Lázaro SL. Chapter 8: TRP Channels and Pain, Emir TLR, editor. Neurobiology of TRP Channels, Boca Raton (FL): CRC Press/Taylor & Francis; 2017. https://www.ncbi.nlm.nih.gov/books/NBK476120/

(Hicks, 2006) Hicks, G.A. 2006. TRP channels as therapeutic targets: Hot property, or time to cool down? Neurogastroenterol Motil, 18(8): 590–594. doi:10.1111/j.1365-2982.2006.00823.x. https://pubmed.ncbi.nlm.nih.gov/16918723/

David W Tanton, Antidepressants, Antipsychotics, And Stimulants – Dangerous Drugs on Trial. Soaring Heights, 2006, https://www.amazon.com/Antidepressants-Antipsychotics-Stimulants-Dangerous-Soaring/dp/0977270327

Distractions from nutrition – a timeline

Goals for the chronically ill often are different than for those who enjoy typical health – avoiding a cold is less difficult than avoiding increased inflammation that can lead to an inability to digest food, or to heal small wounds, or to grow skin in areas where skin cells are replaced on a weekly basis such as in mucous membranes of the nose or mouth or in the ear canal. Those rapidly growing areas represent all of the lining of the intestinal tract. If your skin isn’t healing well from minor scrapes and you have frequent nose bleeds then likely your entire digestive tract isn’t in good shape either. Cells are replaced throughout the body on a regular basis but some areas have a longer life cycle for the replacement than other areas.

(Non-healing sores may be more common in autoimmune condition Lupus, patient forum, may also occur with vasculitis – migraines may involve vasculitis. Patient forums for people with odd diseases can be comforting if only to let them know they aren’t alone. Sunlight exposure can make Lupus worse or be a trigger for some types of vasculitis sores.  The patient forum tips also included a warning not to use petroleum jelly (Vasoline TM) within the nasal passages as it can increase risk for a type of lung infection. Coconut oil was recommended by another forum comment and is the active ingredient in a product that I’ve found helpful for moistening the dry scabby tissue – pain is the common complaint along with bleeding or seeping plasma from the sore tissue. Applying tiny amount within the nasal passage or ear area is not easy but pain is unpleasant. /(After reading the patient forum tips I’ve switched to plain coconut oil as was suggested and it does seem more healing than the thicker chapstick which likely contains some waxes in addition to coconut oil. While a humid, moist air quality is helpful I’ve also found that clean air is important, smoke or smog like air made the skin condition worse whether there was a humidifier or not.)/

I’ve also found relief after a magnesium sulfate/Epsom salt bath and the dryness is reduced with adequate humidity in the air. A damp towel hung near a heating vent can help add humidity to a closed small room if a commercial humidifier isn’t available or seems inadequate. Commercial humidifiers should be cleaned with bleach water or another sanitizing agent occasionally or they may be adding mold or other infectious pathogens to the air – the damp towel dries each night and needs to be remoistened and simply washed occasionally as it doesn’t really get dirty or mold because it doesn’t stay damp. Mold and pathogens can grow on the commercial humidifiers because they tend to always retain some moisture in portions of the machinery. )

Not having a severe headache, migraine pain, and being able to breathe through both nostrils at the same time due to frequent congestion problems are also part of my good days versus bad days. Severe exhaustion and just having the energy to get dressed can be a limiting factor for a day’s goals to get anything else accomplished. Chronic illness is becoming more common rather than less common and how to help prevent or manage it is something that nutrition can help in ways that a bottle of medication can’t because the cell repair throughout the body needs many trace nutrients, vitamins and minerals, and an adequate amount and variety of protein and essential fats and carbohydrates – every day, throughout the day.

Strolling through the distractions used to suggest my concerns about nutrition are unfounded simply reveal the accuracy. (More on the “Weaponization of Social Media” by the U.S. and others) My providing free information is simply in the hope that it might be helpful to someone. I will be fine because I’ve found the research and am using it for my own benefit. Living in a desert is not something that my health can handle however and has never been my goal. The advantage of a virtual world is that if twenty readers find my information valuable then they can benefit from it wherever they are sitting and don’t need me to be present or to be living in a desert area.

Do your own research or find a health care practitioner that is trained in nutrition to help guide you if you are interested in taking better care of yourself now rather than waiting for worse chronic illness or brain degeneration. You could be one of the twenty readers who are interested or not, life is full of choice but consider whether you are choosing for yourself or whether you are accepting society’s Darwin Award of chronic illness via modern lifestyle. The United States is becoming one of the most unhealthy countries on average. Qatar is leading the group too but only since the decades since switching to a modern lifestyle and dietary habits.  (20% diabetes rate in Qatar)(Magnesium deficiency causes insulin resistance)

Supporting big business profit goals is noble but so is survival of the ecosystem over the next thousand years – if we make it through the next one hundred I have hope that we will have figured out more sustainable ways to produce energy and use renewable agricultural methods and that we will survive the next thousand – we are at a turning point where pretending the status quo is working is no longer helpful and is harmful even over the short term.

  1. Obsessive about vitamin D, must be crazy – no my recommendation to not take excessive vitamin D and calcium supplements as it is not a sure way to protect against bone fracture risk and may be harmful, has been since supported by research and is now the standard recommendation. My initial recommendation was in February 2011, this update is December 2017:  https://www.acsh.org/news/2017/12/27/calcium-and-vitamin-d-supplements-still-do-not-prevent-fractures-12329
  2. Some people may truly have low vitamin and hormone D levels while others may have a condition that causes the inactive vitamin D level to be low while the active hormone D level is elevated and likely causing an elevation or tendency to elevation of the body’s calcium levels through increased absorption and decreased excretion and which also leads decreased magnesium absorption and increased magnesium excretion as the minerals are kind of a team. In ancient times magnesium was very plentiful in the water and food supply while calcium is rare so our evolutionary physiology tipped towards conserving calcium and wasting magnesium. Ideally simply ask to have both your inactive vitamin D level (25-D) and your active (1-25-D) hormone D levels to be tested but the current treatment and research recommendations generally just test the less expensive measurement of 25-D. Sarcoidosis, HIV, tuberculosis, Rheumatoid Arthritis are some examples of diseases that may have altered balances of 25-D and 1-25-D. The metabolism of vitamin D is complicated and the commonly used herbicide Roundup which contains glyphosate may be inhibiting the CYP enzymes that are needed to make the active form of hormone D from the inactive form or to make the inactive form with sunshine. This is not a widely accepted theory yet (more on the topic in a previous post) but my own health is better for having reduced my intake of foods that may contain glyphosate and by adding a powdered form of the amino acid glycine to my daily routine. I added the supplemental powder when I had a genetic screening performed that revealed a double gene difference in my ability to digest larger proteins down to the individual glycine. It has active roles within the brain which can help reduce anxiety as well as performing other functions and my health has been much improved. Glyphosate is only one methyl group (-OH, one atom of oxygen and one of hydrogen) different from glycine. (more on glycine & glyphosate in this previous post) Inhibition of CYP enzymes might also increase risk of pancreas problems and diabetes and may play a role in risk of developing autism but it isn’t the only chemical that is likely involved and deficiency of vitamin D is likely not the only nutrient deficiency involved – (more on that in this post.)  By the way, I’m looking for a particular link and just haven’t found it yet – please be patient. Still looking but here is a post with some dietary guidance for prenatal or other people interested in reducing intake of foods that may contain glyphosate: (Self care for prenatal care, part one) Okay I found it, see link [page 19, 1] “Other pathogens that have been shown to reduce the activity of the Vitamin D Receptor, in addition to the pathogen that causes Tuberculosis, include the mold Aspergillus, the viruses that cause Epstein-Barr chronic fatigue syndrome and HIV/AIDS, and the autoimmune diseases sarcoidosis, Crohn’s Disease, and Rheumatoid Arthritis. Elevated levels of 1, 25(OH)2D are seen with the bacterial infections: “Elevated 1,25(OH)2D appears to be evidence of a disabled immune system’s attempt to activate the VDR to combat infection.” [page 19, 1]”  an excerpt from post: [https://transcendingsquare.com/2015/08/11/whether-to-be-compliant-or-to-be-healthy-seems-like-an-easy-question-to-answer/]” which I included in (Preventing autism perinatally – before conception) Newborn umbilical cord samples which are already collected could be tested for more chemicals in order to help identify which infants are likely to be more at risk for developing autism – I would be because of my genetic difference in my ability to digest protein down to the individual amino acid glycine. A researcher found 15 lab test biomarkers/chemicals in common and to save money organized them into three groups – if an infant has the first five, then pay for the screening of the second set of five and if the infant also has those differences then screen for the last set of three chemicals. If all fifteen or most of the fifteen are different than average than the infant may need dietary modifications to help with special methyl forms of B vitamins or supplements of glycine or methionine or help with detoxifying heavy metals for example. See (Newborn Sceening for Autism – 3 sets of 5 potential biomarkers) As an overview and update I will add a link to an article about a recent review of research on the finding that low vitamin D levels are associated with increased risk for many types of cancer – but – excess levels of vitamin D don’t help protect even more than adequate or good levels. Some nutrients and chemicals are safe at elevated levels because they are excreted easily while others are safe and helpful in a -U- shape, too little or too much can be unsafe to health. Vitamin D when activated to the hormone can help control our own immune system’s ability to make antibiotic type chemicals of our own – all day, everyday as long as the nutrient building blocks are available. Too much or too little vitamin/hormone D can increase risk of cancer or of autoimmune disease.
  3. This isn’t about “I told you so” it is about our government or some other agent actively preventing helpful information from being shared. I will keep sharing information that can be helpful because I know how much pain hurts and some chronic degeneration of body and brain function can not be reversed it can only be prevented – seeing your loved ones and having them not remember basic facts about themselves or their family members hurts emotionally – having them forget how to be able to swallow food hurts them physically unless caregivers to spoon feed them can be afforded or are available within the family. You may have to physically massage their throat to help stimulate a swallow reflex, simply putting the spoon in the mouth may not be enough to stimulate a swallow reflex in end stage Alzheimer’s Disease.
  4. Magnesium matters – and Epsom salt baths or foot-soaks (about one cup magnseium sulfate salt to a half bath for 20 minutes every 3 to 4 days or half cup in a tub of water for a 20-40 minute footsoak) can be a better absorbed method – this is now supported by research. It may also help protect against and reverse early stages of Alzheimer’s  Disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182554/
  5. Symptoms of magnesium deficiency can include mood changes such as depression, anxiety, or anger and irritability and physical symptoms such as muscle cramps, eye twitches, or dry eye. https://www.healingtheeye.com/dry_eye.html
  6. Magnesium is nature’s method for blocking calcium channels – and it doesn’t cause the potential side effects that pharmaceuticals may cause (PPIs such as Pprilosec, Nexium and Prevacid.) https://transcendingsquare.com/2015/10/18/magnesium-deficiency-can-cause-irritability-anxiety-and-chronic-degeneration/
  7. Iodine is an essential nutrient for a healthy weight and appetite for adults and infants and moderate deficiency during pregnancy may be an under lying cause of later development of autism. For some reason I can’t imagine the U.S. nutrient database for iodine content was deleted some point in time between when I first started writing about it in 2010/2011 and now. I keep checking in the hope that the information has been restored – but that day isn’t today: https://ndb.nal.usda.gov/ndb/nutrients/index
  8. Zinc, B12 and vitamin D deficiency can mimic symptoms of schizophrenia which is a mental disorder where the brain isn’t recognizing the person’s own subvocal thoughts and mutterings. Treating with psychiatric drugs or only one of the missing nutrients wouldn’t cure the person of the symptoms if multiple nutrient deficiencies were the cause.  Low thyroid levels may also be a risk factor and elevated C-reactive protein or an elevated copper to zinc ratio may also be a factor. https://transcendingsquare.com/2016/03/19/the-voices-that-people-with-schizophrenia-are-hearing-are-probably-their-own-inner-thoughts/
  9. Calcium or vitamin D deficiency can cause hyperparathyroidism which can cause disoriented thinking and may cause self injury or suicidal urges. https://transcendingsquare.com/2016/04/23/self-injurious-behavior-in-autism-patients-with-low-calcium-levels/

That’s the short list.

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.

The voices that people with schizophrenia are hearing are probably their own inner thoughts

This is kind of breaking news — new news: A research scientist, with the aid of a powerful microphone, was able to record a patient with schizophrenia speaking to themselves in a sub-vocal voice. The patient was not aware that they were speaking at the time.

The research is very early, a first in its field perhaps, but the theory seems to suggest that the patient’s with schizophrenia symptoms may have some disconnect with the normal ability to identify internal thoughts and sub-vocal speech as being self generated and instead are interpreting the internal thoughts as coming from some external source of whatever type the person might think.

(Example of my interpretation of sub-vocal speech: the almost silent muttering under your breath that you don’t notice yourself doing, until suddenly you do notice that you’re talking to yourself, and then you stop because you don’t want anyone to notice. The brain of a someone with schizophrenia may no longer recognize the voices of self-talk, or those of voices in memories or in imagined conversations, as being internally self-generated and instead probably tend to make up some explanation for  whatever or whoever might be doing the talking that is being heard — hearing voices. Our internal chatter can get busy and sometimes pretty mean, it would be scary to not realize that it is just yourself. )

Read more, of the actual article:  [http://www.slate.com/articles/health_and_science/medical_examiner/2016/03/schizophrenia_and_subvocal_speech_why_schizophrenics_hear_the_voices_of.html]

This seems like very important news — patients with schizophrenia may be able to be gently reminded that those voices are just brain mumbles, and to try to ignore them.

People with schizophrenia are generally not associated with violence unless there is also a history of violent behavior, alcohol or drug abuse, or more persecutory fantasies. [citation missing, I don’t remember where I read that recently, but I posted it in a comment somewhere.]

Mental health symptoms sometimes may be due to underlying issues that could be easily fixed, rather than considering the patient as being ‘mentally ill’ for the rest of their life and likely being placed on medications that tend to have severe side effects. Effective health care would seek for any underlying causes that can be returned to a state of normal function with the simplest solutions possible, “Let food be thy medicine,” the first part of the quote by Hippocrates may be the most important part.

There are several different nutrient deficiencies that can cause symptoms similar to schizophrenia or may be involved in an underlying cause for the condition, this information was from an older post of mine but it was not grouped together:

Summary update written for something else, (clearly this post could use editing): The balance of cannabinoids is a problem in Schizophrenia. (2-AG ~ noneuphoric CBD is decreased in ratio to anandamide ~ euphoric THC compared to normal health, (66)) Use of CBD as a treatment has showed promise for schizophrenia, particularly during early stages of the condition. (67) The genetic difference that might make someone more susceptible to developing schizophrenia may involve a deficiency in Cannabinoid Receptor type 2. (68) (*Additional Note for anyone interested – several nutrient deficiencies can also cause symptoms similar to schizophrenia – and would need to be treated with diet or supplements – and all or some of them might be involved and need to be treated with diet or supplement changes in order for the underlying symptom causing deficiencies to be resolved.

The nutrient deficiencies may include zinc or an excess of copper in ratio to zinc level; the methyl donor B vitamins folate and vitamin B12 – so if a genetic problem existed in methylation than standard supplements of folic acid and unmethylated B12 might make it worse instead of better as the non-bioactive forms would be competing with whatever bioactive dietary folate and methylated B12 were being consumed (wrong puzzle piece blocking a spot for the right puzzle piece); hypothyroidism and elevated bromide is associated with schizophrenia so iodine may be low and goitrogens in excess; Vitamin D and/or an underlying infection with Toxoplasma gondii may be present, and a genetic difference in the Vitamin D Receptor or vitamin D metabolism may increase risk for infection with T gondii (catbox litter of a young cat is a risk factor for T gondii infection).

Soapbox moment for patient advocacy – the prognosis/quality of life for patients with schizophrenia was better a hundred years ago then it is now. Prescription medications are never going to be able to resolve one or several nutrient deficiencies or metabolic differences.

Regarding trends seen around the world in rate of schizophrenia, it has been dropping in South Korea and increasing in Japan. North Korea has the highest rate for the region: http://global-disease-burden.healthgrove.com/l/58241/Schizophrenia-in-South-Korea

Malnutrition in North Korea is more likely involved in the increased rate for the nation than cat ownership due to the many years of sanctions against the country. B12, folate, zinc and vitamin D deficiencies and excess copper may be involved in risk of developing schizophrenia like symptoms. Folate and calcium are considered to be potentially deficient for the typical Korean diet. Fortified milk products aren’t typically consumed so extra vitamin D from that source wouldn’t be available. Iodine is also a nutrient that may be deficient in the diet. http://adoptionnutrition.org/nutrition-by-country/korea/

And low iodine levels can increase risk for hypothyroidism which has been found to be more common as a comorbid condition with patients with schizophrenia. https://www.ncbi.nlm.nih.gov/pubmed/30350120

Bromine excess can compete with iodine and may increase risk of hypothyroid or schizophrenia symptoms. http://www.kumc.edu/school-of-medicine/integrative-medicine/health-topics/iodine-supplementation.html

Low thyroid levels have been associated with schizophrenia in early treatment of the disease and has been used in more recent care of patients by an alternative physician. The following link includes excerpts from many older research articles and one mentions kryptopyrroles being elevated in some patients so a genetic cause may be involved for some patients that would cause low zinc and low B6 levels (pyroluria). http://www.orthomolecular.org/library/jom/2001/articles/2001-v16n04-p205.shtml

Schizophrenia treatment and other psychiatric care in Russia does not seem to be an ideal to follow anywhere else – or there: http://www.sras.org/snezhnevsky_schizophrenia_soviet_psychiatry However Russians on average do own a lot of cats, especially in comparison to residents of South Korea: https://www.statista.com/chart/10267/which-countries-have-the-most-cat-owners/?utm_content=buffer35f5b&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer 

/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./

Vitamin B12 deficiency can cause long term nerve degeneration

Vitamin B12 (Cobalamin):

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?

Schizophrenia may also be associated with an increased risk for low levels of vitamin B12. Read more: (askdrgonzalez.com/deficiency-of-vitamin-b12-and-schizophrenia/)

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)
  • A review of the text: (ajcn.nutrition.org/content/79/5/892.full)
  • 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)