Nutritional information for People with Parkinson’s (PwP)
Vitamin B-12: Another problem for PwP to deal with.
Vitamin B-12 (cobalamin) is a water soluble vitamin essential for our nervous system which stirs up some disagreement in the world of nutrition between meat eaters and vegetarians. In fact, it is the odd one out among B vitamins as all the rest are found in fruits and vegetables as well as meat. B-12 is almost exclusively found in animal sources of food and meat eaters insist that vegetarians are probably deficient in B-12. Many veggies also eat eggs, cheese and milk and some say they are vegetarian and eat fish. ‘Pure’ veggies that eat no animal foods at all (vegans) definitely struggle to get enough B-12 unless they use supplements. B-12 does exist in some forms of algae but it is not the same and does not correct B-12 deficiency.
So far in this series we have found among PwP that low levels of D3 are commonplace and that B3 (and maybe a new form of B3) may also be beneficial in greater amounts. So, are you surprised when I say that B-12 is yet another vitamin that often appears to be deficient in PwP and some people take doses of it far in excess of the nonsensical recommended daily intakes (RDIs) ?
The trouble with RDIs is that they recommend the same amount of vitamins and minerals for everyone – according to them a little old lady who sits down all day should take in the same as a 110 kg bodybuilder who trains with heavy weights 2 or 3 hours a day! Obviously these 2 examples require radically different nutrition to function effectively. I suggest forgetting RDIs and treating yourself as the unique individual that you undoubtedly are.
Unlike other B vitamins we cannot digest and absorb B-12 unless our stomachs can secrete a substance called ‘Intrinsic Factor,’ and our production of this inevitably goes downhill with age, which is why many old people are B-12 deficient and are given injections of B-12 as eating more food does not help when you cannot absorb it.
If you are older or a PwP, it would be a good idea to get a blood test done to check your levels – ask your doctor for an MMA test (Methyl Malonic Acid) to find out what your B-12 count is. Symptoms of deficiency include: Diarrhea or constipation; excessive fatigue; low energy; loss of appetite; pale skin; shortness of breath when exerting yourself; going dizzy when standing up, problems concentrating and a swollen red tongue. As if that is not enough already prolonged low levels of B-12 can see neurological problems get worse – for example, depression, loss of balance, numbness and/or tingling in hands and feet and even mental confusion and dementia.
Of real concern to women is the fact that low B-12 levels can fool the pap smear test for cancer, leading to a false positive suggesting cancer of the cervix when in fact the test is wrong and there is no cancer.
My study of research papers and trials show this is another substance which has much in common between PwP and Diabetics (and quite a few other drugs used by diabetics are looking promising in drug repurposing trials around the world). Many entries on blogs and online forums talk about very high intakes of B-12 to get blood levels up into the ‘normal range’ followed by lower doses to maintain that level. At least part of the need for such large doses is down to the fact that even in a best-case scenario we are still not very good at absorbing B-12 so we have to allow for waste that is not absorbed.
Okay, what and how much is right for you? Obviously I cannot tell you how much you need, you need to liaise with your doctor and have blood tests taken to monitor your needs. I can suggest what you should look for in a supplement. There are several types of B-12 used in supplements, for example: Hydroxycobalamin, Dibencozide, and Cyanocobalamin. The active form in our bodies is Methylcobalamin and some quality supplements provide this form. The bad news? It is very expensive. The good news? Even large doses relatively speaking are very small so the actual cost of taking supplements of B-12 is not that high.
That’s it this time, good luck with it and if you feel like it please reply and let me know your story or tell me what I am getting wrong if your experience indicates other things we need to know about B-12. I have kept this text reasonably jargon-free so hopefully it will make sense to everyone.