Wednesday, April 22, 2015

Vitamins, Anxiety, and Depression, Oh My!

Second only by a hair in my top vitamin line-up is vitamin B12 which is vital to proper functioning of the brain and nervous system. B12 helps with fatigue, weakness, memory loss, and depression to name just a few. Once again, chemo played the introductory role for me, in that after my final treatment, I found it difficult to walk or to even hold a coffee cup due to the pain in my hands and feet. My internist suggested drawing a B12 level, and while my lab values indicated a low normal, she suggested treatment with an oral tablet. My symptoms went away and my anxiety decreased.

This low normal level is not unusual. The Tufts Framingham Offspring Study found that approximately 40% of patients (age range 26-83) had a low normal and that patients could still have neurological symptoms at a low normal. Interestingly enough, the lab standard used in Japan and Europe doubles the threshold for normal (U.S low is less than 258 picomoles per liter, and European standard is 500-550). Scary. Even levels of 500 have been associated with memory loss.

It is not necessary to hasten to get a B12 level drawn. It can be expensive. Just know that decreased B12 absorption is part of the aging process and there are few of us who get enough in our diets. I suggest supplementing with 1000 mcg B12 along with a B complex vitamin. All the B vitamins help with the nervous system, but B12 is quickly metabolized by the liver when given orally so greater amounts must be taken. The B vitamins are water soluble, so the body eliminates what it does not use. Also, eat fortified breakfast cereal. These are inexpensive and easy fixes. Other dosage options are the sublingual and injectable forms.

Next week, we are going to discuss the role of B12 and another vitamin, L-5 methylfolate, in depression so stay tuned!

Healthy living with John Hollis Pharmacy!

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