Vitamin B12 & MS…

There appear to be some potential links between the nutrient, which is so essential for proper nerve function, and this debilitating disease. For instance, vitamin B12 deficiency can mimic some of the symptoms of MS, such as numbness and tingling in the arms and legs, loss of balance and fatigue, says Donald W. Jacobsen, Ph.D., director of the Department of Cell Biology at the Cleveland Clinic.

“A severe vitamin B12 deficiency can cause breakdown of the myelin sheath, similar to what occurs in MS,” Dr. Jacobsen says. That’s why many doctors test for B12 deficiency if you have symptoms of MS. Although most people get enough B12 in their diets, absorption problems can cause a B12 shortage, especially in people ages 60 and older. If you have absorption problems, you’ll probably have to get B12 shots or possibly include daily supplements in your diet for the rest of your life, depending on your particular case.

Studies are mixed as to how many people diagnosed with MS or with MS-like symptoms have low blood levels of vitamin B12, Dr. Jacobsen says. For example, a study by British researchers found that a fairly high number of people with MS have low blood levels of B12. On the other hand, researchers at the Cleveland Clinic, using tests that measure blood levels of B12 and two B12-related compounds, homocysteine and methylmalonic acid, found fewer B12-deficient people than did the British.

“At this point, we just don’t know what to make of all of this,” Dr. Jacobsen says. “We still feel like we are missing major pieces of the puzzle. It’s still an open question whether true, functional vitamin B12 deficiency exists in MS.”

To complicate matters further, people with MS often have what’s called mild macrocytosis. They have some larger than normal but immature red blood cells in their blood that resemble a budding case of pernicious anemia, a disease that is associated with severe vitamin B12 deficiency. Most, however, never go on to develop a full-blown case of pernicious anemia.

Your doctor can determine with a few tests whether you’re having absorption problems. If it turns out that you do have an absorption problem, you’ll need to get injections of vitamin B12 from your doctor. If you don’t have absorption problems, you can safely take oral doses of up to 500 micrograms of B12 a day, Dr. Jacobsen says. (This amount is many times the Daily Value of B12, which is only 6 micrograms.)

It’s also important to have your doctor check your blood levels of the B vitamin folate (the naturally occurring form of folic acid), Dr. Jacobsen says. That’s because folate deficiency can cause symptoms similar to vitamin B12 deficiency, although its neurological consequences are much less severe. If you’re found deficient, you’ll have to take oral folic acid supplements to get your blood level back to normal. You shouldn’t take folic acid unless your doctor recommends it, says Dr. Jacobsen.

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