Anxiety Archives – A Healthy State of Mind

In this article I want to help you to get to know your heart. Knowing more about your heart (specifically your heart rate variability) can improve your awareness of how stressors impact your mind and body. To evaluate the health of your heart and nervous system, you just need a heart rate variability monitor (typically […]

Chocolate can nurture and nourishes. It is derived from the cacao tree (Theobroma cacoa). The word Theobroma means ‘food of the gods’. Americans consume, on average, 11 pounds of chocolate per person per year and we are ranked as the 5th major consumer of chocolate worldwide. Research on the health benefits of chocolate shows it […]

Micronutrients in Mental Health Series II Vitamin B12 is nutrient is critical in proper mental functioning and overall health.  If intake or absorption of vitamin B12 is insufficient, a wide array of psychiatric (anxiety, depression, psychosis to name a few), cognitive (memory loss and confusion) and gastrointestinal (constipation and low stomach acid) can result. Vegetarians and […]

Sleep is something so many take for granted and yet sleep problems or insomnia affects a large proportion of the population, 22.1% by recent estimates .  Untreated insomnia can lead to psychiatric disorders such as anxiety and depression and insomnia commonly occurs in those with psychiatric disorders. Treating the underlying psychiatric disorder will generally improve […]

Recent evidence suggests that the status of our gastrointestinal (gut) flora may affect mood and behavior. This evidence, derived from a study conducted by Bravo et al. and published in the Proceedings of the National Academy of Sciences, suggests that bacteria in the gut can communicate with the brain and vice-versa via the vagus nerve1. […]

Well it is hard to not notice the collective stir around love & relationship in February and it prompted me to reflect on the power of relationship to heal. This power is undoubtedly important in any healing dynamic (doctor-patient relationship), but as Dr. Heron so aptly states, perhaps even more so when one suffers from […]

‘Sensitivity’ can be a loaded term in our culture and has a number of connotations, many not very positive. Elaine Aron, Ph.D., author of The Highly Sensitive Person book, defines a sensitive person as one who is aware of subtleties in their surroundings, more readily overwhelmed after being in a stimulating environment for too long […]

The holidays are a time of increased stress for many and as year-end tasks pile up, it can make it challenging to get the support and perspective one needs to re-prioritize. As stress can be cumulative, and is also hard to objectify, I think that introducing a scale to assess the burden of stress in […]

May is National Physical Fitness and Sports month, and with the warmer days and more sun, it hopefully is easier for people to get motivated to move! Doctors have a tendency to overlook or understate the value of exercise in being busy to find the best treatment(s) for a patient’s ills, but the effects of […]

Depression Archives – A Healthy State of Mind

In this article I want to help you to get to know your heart. Knowing more about your heart (specifically your heart rate variability) can improve your awareness of how stressors impact your mind and body. To evaluate the health of your heart and nervous system, you just need a heart rate variability monitor (typically […]

Chocolate can nurture and nourishes. It is derived from the cacao tree (Theobroma cacoa). The word Theobroma means ‘food of the gods’. Americans consume, on average, 11 pounds of chocolate per person per year and we are ranked as the 5th major consumer of chocolate worldwide. Research on the health benefits of chocolate shows it […]

Micronutrients in Mental Health Series II Vitamin B12 is nutrient is critical in proper mental functioning and overall health.  If intake or absorption of vitamin B12 is insufficient, a wide array of psychiatric (anxiety, depression, psychosis to name a few), cognitive (memory loss and confusion) and gastrointestinal (constipation and low stomach acid) can result. Vegetarians and […]

Micronutrients in Mental Health Series I The role of optimal nutrition in depression, and a number of other mental health conditions, is often overlooked, but plays a critical role in health and well-being. Iron deficiency, even without being diagnosed with anemia, can lead to low energy, fatigue and depression.  Many of my patients who have […]

The Centers for Disease Control and Prevention (CDC) Data Brief, (in which they report that the rate of antidepressant use among all ages) reports a nearly 400% increase in medicine for depression since 1988-1994. Some salient features of this report are: Females are more likely to be on antidepressant pills than males Greater than 60% of Americans […]

Sleep is something so many take for granted and yet sleep problems or insomnia affects a large proportion of the population, 22.1% by recent estimates .  Untreated insomnia can lead to psychiatric disorders such as anxiety and depression and insomnia commonly occurs in those with psychiatric disorders. Treating the underlying psychiatric disorder will generally improve […]

Recent evidence suggests that the status of our gastrointestinal (gut) flora may affect mood and behavior. This evidence, derived from a study conducted by Bravo et al. and published in the Proceedings of the National Academy of Sciences, suggests that bacteria in the gut can communicate with the brain and vice-versa via the vagus nerve1. […]

Well it is hard to not notice the collective stir around love & relationship in February and it prompted me to reflect on the power of relationship to heal. This power is undoubtedly important in any healing dynamic (doctor-patient relationship), but as Dr. Heron so aptly states, perhaps even more so when one suffers from […]

The holidays are a time of increased stress for many and as year-end tasks pile up, it can make it challenging to get the support and perspective one needs to re-prioritize. As stress can be cumulative, and is also hard to objectify, I think that introducing a scale to assess the burden of stress in […]

Seasonal changes are known to affect those suffering from a number of psychiatric complaints. Seasonal affective disorder (S.A.D.) is the most common diagnosis for those suffering from seasonal changes. S.A.D. affects about 6% of the U.S. population. A milder form of S.A.D., known as the Winter Blues or Subsyndromal S.A.D.,  affects approximately 14 % of […]

Vitamin B12, Psychiatry & Physical Health | A Healthy State of Mind

Posted by Mary R. Fry, N.D. on Friday, July 26, 2013

In last month’s blog post on iron’s role in mental (and physical) health, we covered one of a trio of ferromagnetic metals found in nature. Cobalt is another such metal that has a prominent role in our mental (and physical) health. Cobalt is seldom found in its free form, needing to exist in compounds with other element(s) to be stable.  Cyanocobalamin is one such compound, which is also known as Vitamin B12.  This nutrient is critical in proper mental functioning and overall health.  Here is one  woman’s experience of how this nutrient affected her health:

When I started B12 injections in 2009—-I know this sounds dramatic—my vision became clearer-brighter, my mind clearer, my well-being calmer.   I’d been living with a low-grade anxiety all of my life assuming that feeling was normal.  I am no longer anxious! With B12 injections every two weeks, I have more energy and joie de vivre.”

To understand how common signs and symptoms relate to this nutrient, I will briefly describe the biochemistry of B12. (Please bear with me- it should all make sense soon!)

Functions of B12

One of the functions of B12 is to be involved in transferring methyl groups (3 hydrogen molecules with a carbon) in the body. This type of reaction is a key step in a myriad of biochemical reactions in the body, one of which involves the formation of SAMe (S-Adenosyl methionine), an intermediate in the synthesis of neurotransmitters.

Another key function of Vitamin B12 is DNA synthesis; this explains why red blood cells are enlarged in deficiency (the insufficient DNA synthesis keeps them from dividing sooner). This effect also helps one diagnose a vitamin B12 deficiency. The term for anemia due to vitamin B12 deficiency is ‘megaloblastic anemia’, i.e. the cells are larger (recall if you read last month’s blog on iron-deficiency, that the cells are smaller (microcytic) when iron deficient.) Folate (vitamin B9), also causes megaloblastic anemia – we will discuss this further in the next blog post.

Finally, the third key function of vitamin B12 to discuss is its role in synthesizing myelin – a protective sheath on nerves. This is responsible for a number of the signs and symptoms of B12 deficiency .

Signs & Symptoms of Deficiency

Vitamin B12 deficiency can manifest with a number of different signs & symptoms due, at least in part, to its aforementioned roles in methyl transfer reactions, in DNA and myelin synthesis:

-Anxiety -Depression -Agitation -Psychosis, often with paranoia -Delusions, Hallucinations -Poor memory -Mental confusion -Mental ‘slowness’ -Weakness, Fatigue -Shortness of breath -Vision loss (partial- certain fields of view are diminished) -Numbness & tingling in the hands and feet -Loss of vibration and position sense -Poor muscle coordination -Tongue soreness -Decreased stomach acid -Constipation -Suboptimal intestinal absorption/malabsorption -Elevated homocysteine (a marker that signals increased risk of cardiovascular disease)

-Abnormal liver function tests

Causes of deficiency

-Malabsorption, Celiac disease, Inflammatory Bowel Disease (Crohns and Ulcerative colitis) -Low stomach acid, gastrectomy -Tapeworms, Gastrointestinal floral imbalance?

-Intrinsic factor deficiency (a factor required for proper absorption of B12)

-Strict vegetarian/vegan diet (without adequate supplementation) -Chronic alcoholism

-Medications, including anticonvulsants & antibiotics and possibly oral contraceptives, (interfere with B12  absorption)

-Liver disease (affects storage of B12)
-Hyperthyroidism (increases B12 needs)
-Pregnancy (increased demands for B12 )
-Megadoses of vitamin C (may destroy B12 )
-And a number of other medications, diseases & conditions (methotrexate (medication), pancreatic disease, HIV/AIDS, GI cancers,….)

Diagnosing deficiency

Laboratory tests, which may include all or some of the following: Complete Blood Count (CBC), serum B12, Homocysteine and Methyl Malonic Acid are often used to determine if you have a vitamin B12  deficiency. Genetic testing to determine enzyme aberrations that may predispose to B12  deficiency may also be performed (MTHFR (Methylenetetrahydrofolate Reductase) polymorphisms are one such aberration).  It is imperative to be properly evaluated by a trained physician before supplementing with vitamin B12 as it is possible to mask deficiencies of other nutrients, or to induce additional vitamin imbalances with self-medication.

The following questionnaire, produced by Mark Hyman, MD is a helpful tool to determine if your methylation pathways (which involve vitamins B12, B & B ) are impaired due to a deficiency of one or more of these nutrients. You will assign a ‘1’ beside each of those questions which you answer ‘yes’ to.

 Methylation Quiz1

Scoring the test:

0-8; generally indicates a low-level problem with methylation

≥9; may indicate a severe problem with methylation. A visit to a skilled medical provider who works with nutrient supplementation and diet is advised.

Treatment for deficiency

Depending on the cause and severity of deficiency, vitamin B12 may be administered by injection, (intramuscularly), sublingually, in capsule form or via a nasal spray. Adding rich sources of vitamin B12 to the diet, wherever possible, is highly recommended.

Food Sources

Vitamin B12 is produced in nature from microorganisms and is thus not found in plant foods, unless they are contaminated with microorganisms, (which occurs with seaweed). It can also be obtained from organ meats and other animal products (vitamin B12 is stored in some of the organs and is present in other tissues). Rich sources of this nutrient include organ meats (liver, kidney and heart in particular), clams and oysters. Moderately rich sources include fish and seafood (salmon, sardines and crab) and egg yolks. Moderate sources include dairy products.

Addressing Mental Health Concerns with Vitamin B12

It is recommended that those suffering from anxiety, depression, or psychosis, especially if accompanied by other signs and symptoms outlined in this blog post, have screening blood work to rule out nutrient deficiency/deficiencies. If a nutrient deficiency is present, supplementation and some dietary changes can often make a world of difference!

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References:

  1. Hyman, M. (2009). The UltraMind Solution Companion Guide. Retrieved from http://drhyman.com/wp-content/uploads/2012/03/UltraMindCompanionGuidewithCover1.pdf – page 10
  2.  Herbert, V. & Kshitish, C.D. (1994). In Shils, M.E. , Olson, J.A. & Shike, M. S. (Eds.), Modern Nutrition in Health and Disease. (8th ed.). (pp. 402-422). Philadelphia, PA: Lea & Febiger.
  3. Marz, R.B. (1999). Medical Nutrition from Marz. (2nd ed.). Portland, OR: Omin-Press.

Categories: Anxiety Disorders, Depression, Diet & Nutrition, Schizophrenia & Psychosis, Supplements Tags: celiac disease, Cyanocobalamin, memory, nutrient deficiencies, vegan, vegetarian, Vitamin B12, vitamins