I realise this is an old post, but things have moved on over the last 8 years & I would hope, so has the understanding of B12 & it’s role in MS (although I very much doubt it).
B12 plays a huge role in the support & maintenance of nerve & myelin. It is no surprise that a deficiency can seriously impact nerve function anywhere in the body - although the periphery is often the first to indicate an issue.
The biggest problem with B12 comes from a misunderstanding of how the deficiency is diagnosed. There are at least 3 ways it can be missed.
Firstly, many doctors still only test for Pernicious Anaemia. However, depending on Folate levels, which can change the blood cell structure, it is still possible to have B12 deficiency without the anaemia. In which case the B12 deficiency may be completely missed.
Secondly, even if the B12 is independently checked, most doctors assume that as long as B12 is ‘within range’ it is acceptable. But that runs on the assumption that everyone’s tipping point into deficiency is exactly the same, which is obviously not true. Many things can determine how much B12 an individual needs in order to not be deficient, including diet, lifestyle, what drugs they are on, how well they can absorb or utilise B12, etc, etc., and of course, ‘adequate’ is nothing like ‘optimum’.
Thirdly, in those that can absorb B12, the ability to convert it to its active forms Methyl-cobalamin & Adenosyl-cobalamin for use at cellular level may be impaired. In that case, the serum B12 may appear normal or even high (in fact high B12 may be a red flag that it isn’t being utilised very well). Having plenty of B12 floating around the bloodstream tells nothing about what is - or isn’t - going on at cellular level.
Whilst an ‘active’ B12 test may give a better picture, Homocysteine & Methylmalonic Acid (MMA) tests are also very useful, as high levels would indicate the B12 is not being utilised very well to bring them down. High B6 may also potentially suggest a poor B12 conversion. As the symptoms of B6 ‘toxicity’ are identical to those of B12 deficiency, it is possible that occult (hidden) cellular B12 deficiency is the real culprit.
Dr. (removed by moderator) who had had experience of acute B12 deficiency amongst vegan Hindus, discovered that a high percentage of his patients in his Durham practice, were B12 deficient. And amongst them were some diagnosed with MS who turned out to be very B12 deficient. Giving IV B12 was like flipping a switch for them. Although now sadly retired, he wrote a book ‘B12 deficiency in Clinical Practice’ available free for distribution to Health Professionals from his website I believe. Www.B12d.org
There’s a little video about him & some of his patients on YouTube.
It is likely that if this was picked up early, the damage may be reversible, but because the Medical Profession is so blind to the devastation & havoc that undiagnosed B12 deficiency can wreak, it is rarely, if ever even on their radar. And if it is ever detected, it is just assumed to be a ‘result’ of the MS rather than a potential cause. So sad.
All B vitamins are involved in the nervous system in various ways. Thiamine (B1) can also be implicated in ANS & CNS dysfunction. The different forms of BeriBeri are very much alive & kicking (our butts) in this modern high-calorie malnutrition lifestyle. Due to things like antibiotics devastating the gut biome, many of us no longer have the plethora of B vitamin-producing & metabolising microbes in our guts, so find it very hard to utilise B vitamins. Stomach & gut issues, surgery, PPI/antacid use, certain drugs, ageing, etc, can all inhibit B vitamin absorption &/or utilisation. I wonder how many have had various gut & digestive issues prior to their diagnoses……?
