I recently had a flashback to a patient I treated when I lived in New York, whose story moved me to tears. She was a long time vegan (30 out of her 40 years), a struggling anorexic and was in her early forties. Her self esteem was very low, and she had not succeeded at building a career she had dreamed of, or meeting a partner to settle down with and have children (she also wasn't having regular periods due to her restrictive eating patterns). This lovely lady suffered greatly with anxiety attacks, paranoia and depression. She felt nervous all the time.
As our work progressed together and I succeeded in getting her to eat greater quantities of healthy food, her blood sugar levels stabilised. But even though she was more energetic, she was still very nervy and jittery. I sent her for blood work and lo and behold, she had a hideous deficiency in vitamin B12. I immediately got her on some strong supplements and blood work six months later showed a great improvement: And the lady who walked back through the door was much, much calmer and serene. I cried a lot when she left.
I didn't really cry because she was feeling so much better about life - I was, of course, delighted about that. But I cried with a kind of rage about our health systems: She had been prescribed every kind of psychiatric drug for her anxiety and depression but not once had someone simply checked her B12 levels. Though psychological symptoms are rarer in younger people (below 40ish) with deficiencies in B12, this lady had been on a vegan diet AND anorexic for most of her life. I cried for all she had missed out on because of this one idiotic mistake; I KNOW her life would have been richer in every way without this deficiency (though I didn't know how long it was there for, I suspected quite many years). Why is simple nutrition science so neglected?
Anyway, in the years since then I have treated quite a lot of people with clear neurological and psychological symptoms and never forget to check the B12 levels. Very frequently these patients are deficient - and a b complex supplement (all b vitamins are very important for our neurological health) helps to remedy it: This is especially true and common for older patients; the elderly in particular. Upon supplementation the patient returns to themselves a bit more and families feel like they get their loved one back, when they thought that their 'fading away' was just a symptom of old age: NO! It does NOT have to be that way. Just the same as the lie that is propogated that people can't help but lose muscle as they get older - it is usually lost through less activity, not as something inevitable. We are responsible for our health - each and every one of us.
Vitamin B12 deficiency becomes more common as people age because the body sometimes becomes less efficient at absorbing the vitamin. In addition, the more life we live, the more B12-absorption-interference-activities can take place, such as: Using stomach acid blocking medications (H2 inhibitors or PPI's) - use diet instead, being vegan - probably not a great idea, having a gastro disorder like crohns/colitis - use diet/lifestyle instead, long time antibiotic use - boost immunity using diet/lifestyle/probiotics/prebiotics, excess alcohol consumption - find out which emotions you're trying to shut down, metformin - make those difficult changes to turn around type 2 diabetes - you won't regret it, abnormal gut bacteria growth - hello probiotics and proper diet! The real question is how common this deficiency would be in people who ate a well balanced diet throughout their life, without medications to help deal with issues which are mainly caused by eating the wrong foods/drinks in the first place...but that's another blog entry.
Ok - so to the practical stuff: How's YOUR B12? Are you at risk for a deficiency? If so, sort it out asap.
Symptoms of a deficiency in younger people: Numbness/tingling in hands, legs and feet, difficulty concentrating/thinking/reasoning, paranoia, hallucinations, weakness, fatigue, inflamed tongue.
In people above 40: The symptoms above AND diseases of the spinal cord, neuropathy, sensory disturbances, gait abnormalities, dementia like symptoms (delusions, hallucinations, memory decline, depression, anxiety).
Best sources: Animal foods - fish, eggs, meat. Sorry vegans!
The best way to take a supplement (if necessary) is a spray and add in a general B complex supplement to let those wonderful B vitamins work in harmony together. If the deficiency is severe, or if the supplements are not working (some people have a lack of an intrinsic factor in the stomach which allows aborption of B12), you may need injections. Do not just neglect this because it won't turn into something remotely enjoyable in the long term!
Bottom line: If you or someone you love is acting strangely, and especially if they're vegan or elderly, get a blood test to check - don't just jump on the medication band wagon - unfortunately doctors don't know enough about nutrition; empower yourself.