Beware of B12 functions and Deficiencies Lola Lurch Kaplan University August 4, 2015

Objectives Vitamin B12 benefits and deficiencies will be explored. Define Vitamin B12 Discuss the functions of Vitamin B12 Discuss the causes of Vitamin B12 deficiencies Identify the at risk populations for B12 deficiencies Discuss the Recommended Dietary Allowance of B12 Identify the best natural sources of B12 Determine the dosage and Safety of B12 supplements The purpose of this presentation is to explore the biological and psychological functions of Vitamin B12; discuss the causes, symptoms, and effects of Vitamin B12 deficiencies; identify those populations at risk for B12 deficiencies; discuss the recommended dietary allowance (RDA); determine the dosage and safety factors of B12 supplemental usage; and identify the best natural sources of Vitamin B12.  

What is Vitamin B12? Vitamin B12 is one of 13 essential vitamins that is needed for the body to function. Properties of B12, also known as Cyanocobalamin, include: Water Soluble (dissolves in water) Only produced microorganisms (etc. bacteria) Body can store in the liver Found naturally in animal foods Animals and plants cannot produce Synthetically added to plant foods (fortified) Essential vitamins are organic compounds (containing carbon) that are necessary for body functions; however, the body can not produce them, so these vitamins must be obtained from food sources, naturally in animal products, and synthetically added to plant food sources. Although Vitamin B12 can be stored in the liver for years, it is water soluble and unused amounts can be eliminated through the urine (Medline Plus, 2015). Only one-celled microorganism (etc. bacteria) can synthesize Vitamin B12. (Oregon State University, 2015).

Vitamin B12 functions Vitamin B12 is necessary for certain body function. Development red blood cells Maintenance of the Central Nervous System Preserves DNA integrity Essential roll in folate metabolism Aids in production of neurotransmitters The importance of an adequate intake of Vitamin B12 should not be underestimated or underrated. This micronutrient, although needed in small amounts) is essential to biological and psychological functioning of the body’s command center (the brain). The central nervous system consists of the brain and spinal cord; and the delivery of oxygen to all parts of the body is dependent upon a sufficient supply of health red blood cells. Neurotransmitters are those little messengers that transport signal to and from the brain; they are essential for mobility and cognition; without DNA integrity, the cells would not know how to reproduce; and B12 serves as a cofactor in the metabolizing of (another B vitamin) folate (OSU, 2015).  

Symptoms of Vitamin B12 Deficiencies Deficiencies in Vitamin B12 are evidence by certain biological and psychological conditions. Muscle weakness Spasticity (stiff or rigid muscles) Hypotension (low blood pressure) Mood disturbances Megaloblastic anemia (larger than normal red blood cells) Vison problems Dementia Research studies have shown that deficiencies in Vitamin B12 can lead to muscle weakness, low blood pressure, abnormal mental disorders, vision problems, rigid and stiff muscles, dementia, abnormally large red blood cells, and may even be connected to a lack of bladder and bowel control (May Clinic, 2013).

At Risk Populations Some people are more susceptible to Vitamin B12 deficiencies than others: Older Adults Vegans Those infected with HIV Those who had gastrointestinal surgery People who have Celiac disease People who have Crohn’s disease Some people are at increased risk for Vitamin B12 deficiencies. Older adults lose the ability to absorb vitamin B12 from foods; those who follow a vegetarian or vegan diet need to eat vitamin B12-fortified foods or consult their healthcare professional about taking B12 supplements; those who have had gastrointestinal surgery (etc. weight loss surgery), and those who have digestive disorders (etc. celiac or Crohn’s disease may not absorb enough Vitamin B12 (Medline Plus, 2015).

How Much Vitamin B12 Do you Need? Recommended Dietary Allowance (RDA) for Vitamin B12 Life Stage Age Males (mcg/day) Females (mcg/day) Infants  0-6 months  0.4 (AI) 0.4 (AI)  7-12 months  0.5 (AI)  Children  1-3 years  0.9  Children 4-8 years  1.2  9-13 years  1.8  Adolescents  14-18 years  2.4  Adults  19-50 years  51 years and older  2.4*  Pregnancy  all ages  -  2.6  Breast-feeding  2.8 The Recommended Dietary Allowance (RDA ) for vitamin B12 was revised by the Food and Nutrition Board (FNB) of the US Institute of Medicine in 1998 (OSU, 2015).

Some food sources of vitamin B12 Serving Vitamin B12 (mcg) Clams (steamed) 3 ounces 84.1 Mussels (steamed) 20.4 Mackerel (Atlantic, cooked, dry-heat) 3 ounces* 16.1 Crab (Alaska king, steamed) 9.8 Beef (lean, plate steak, cooked, grilled) 6.9 Salmon (chinook, cooked, dry-heat) 2.4 “Animal-derived foods are the best food sources of vitamin B12, including dairy products, eggs, meat, fish, poultry, and shellfish” (Weil, 2012). A serving is about the size of a deck of playing cards.  

Some food sources of vitamin B12..continued Serving Vitamin B12 (mcg) Milk (skim) 8 ounces 0.9 Turkey (cooked, roasted) 3 ounces 0.8 Brie (cheese) 1 ounce 0.5 Egg (poached) 1 large 0.4 Chicken (light meat, cooked, roasted) 0.3 Most healthy individuals do not have a problem meeting their daily their B12 needs. Eating a balanced diet that includes a variety animal products the best way to meet your RDA for Vitamin B12.

Vitamin B12 Dosage, safety, side effects Older adults and vegans may need Vitamin B12 supplements. Caution should be exercised when taking Vitamin B12 supplements if the following conditions exist: Skin disorders (rash, itching, redness) Genitourinary concerns (urine discoloration) Gastrointestinal disorders Cancer Hypertension (high blood pressure) Pregnant or breastfeeding Drug interactions (with pharmaceutical and alcohol) Gout Heart concerns Blood disorders Vitamin dosage for deficiencies and therapy should be treated the same as pharmaceuticals; consult with a qualified healthcare provider before starting a treatment plan. Caution should be taken when there is a skin disorder; people with gastrointestinal concerns may experience nausea, difficulty swallowing, and diarrhea. Caution should also be taken if there is a history of cancer, hypertension, gout, heart concerns, or blood disorders. There can be drug interactions with people who are taking “ACE inhibitors, acetylsalicylic acid (aspirin), alcohol, antibiotics, anti-seizure agents, bile acid sequestrants, chloramphenicol, colchicine, H2 blockers, metformin, neomycin, nicotine, nitrous oxide, oral contraceptives, para-aminosalicylic acid, potassium chloride, proton pump inhibitors (PPIs), tobacco, vitamin C, and zidovudine (AZT, Combivir®, Retrovir®). (May Clinic, 2013).

summary Vitamin B12 is essential to biological and psychological body function. Animals and plants cannot produce Vitamin B12. Only single-cell microorganisms (etc. bacteria) can produce Vitamin B12. The best natural source of Vitamin B12 is animal products. . The Food and Nutrition Board (FNB) of the US Institute of Medicine has posted the recommended dietary allowance for Vitamin B12 for each age population. Certain populations are at increased risk for Vitamin B12 deficiencies (older adults, vegans, HIV infected, and certain gastrointestinal disorders). Consult a qualified healthcare professional before taking vitamin supplements.

references Mayo Clinic. (2013). Evidence based. Retrieved from http://www.mayoclinic.org/drugs-supplements/vitamin-b12/ evidence/hrb-20060243 Medline Plus. (2015). Vitamin B12. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/002403.htm#top Oregon State University. (2015). Micronutrient information center: Vitamin B12. Retrieved from http://lpi.oregonstate.edu/mic/vitamins/vitamin-B12 Weil, A. (2012). Facts about vitamin B12. Retrieved from http://www.drweil.com/drw/u/ART02810/facts-about-vitamin- b?_ga=1.48364710.1241562207.1437006689