3044: Pernicious Anemia and Shots vs Supplements - The Importance of the B12 Vitamin

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[00:00:30] Have you ever noticed how a calm mind can really set the stage for a good night's sleep? That's the idea behind our new podcast, Good Sleep. Greg, our host from Optimal Relationships Daily, is here to help ease you into a peaceful night's rest with some positive affirmations. And these affirmations aren't just comforting, they can help ease anxiety and nurture positive thoughts, setting you up for true good sleep.

[00:00:54] So, press play on good sleep tonight, because a good tomorrow starts with a good night's sleep. Just search for Good Sleep in your podcast app and be sure to pick the one from Optimal Living Daily. It's another Q&A edition of Optimal Health Daily, and I'm Dr. Neil Malek. Hey there, happy Friday, and welcome to another Q&A edition of Optimal Health Daily, where I answer your health questions related to fitness, diet and nutrition, and lots more.

[00:01:23] You send in the questions, and I answer them for you. Oh, and if you do send in a question and you're in the U.S., we'll mail you a copy of our hardcover workbook. If you're outside of the U.S., we'll email you a PDF version. Now, what's the easiest way to send me a question? Just email it to health at oldpodcast.com. Alright, and with that, let's hear today's question as we optimize your life.

[00:01:53] Today's question came via email. Charlene writes, Hello, I have a question about pernicious anemia. I have had pernicious anemia for several years. I get a B12 shot once a month. During COVID, I took a B12 supplement instead of going to get the shot at my doctor's office. I'm wondering if the supplement is as effective as the B12 shot. Thank you so much for taking the time to send in your question, Charlene. I'm so sorry to hear about your pernicious anemia diagnosis.

[00:02:22] So, I'm going to start by talking about what pernicious anemia is, and then get into the specifics about vitamin B12. Now, if someone is listening to this and is like, I don't have pernicious anemia, I don't know what it is, so I'm just going to stop listening, I promise you'll still get a lot out of this, because I'm going to talk about B12 and its importance in other terms too. But again, let me start with what pernicious anemia actually is. This is a type of autoimmune condition.

[00:02:50] Now, an autoimmune condition means that, for some reason, the body attacks its own healthy cells. In those with pernicious anemia, the body's attacking cells that help create a specific substance in the stomach. That substance is called intrinsic factor. Intrinsic factor helps the body absorb vitamin B12. Okay, so let's summarize. If the body is not able to make a substance that helps absorb vitamin B12,

[00:03:19] which again is intrinsic factor, then the body doesn't get enough of this vitamin. And it turns out, vitamin B12 is really important, because it helps the body create healthy red blood cells, and protects the health of our nervous system. So, why does vitamin B12 lead to anemia? We may have heard that anemia is all about not getting iron in the diet, or anemia happening after we lose a lot of blood. Yes, those are types of anemia too.

[00:03:47] But there are other kinds of anemia that don't directly relate to iron. Pernicious anemia, the type we're talking about here, is a kind of anemia because it prevents the body from creating healthy red blood cells. And again, that's all because vitamin B12 helps with this process. So, how would someone know whether they have pernicious anemia? Blood tests are the best way to know for sure. A medical doctor will run a series of blood tests looking at vitamin B12 levels in the blood,

[00:04:17] and they'll look at the shape and size of red blood cells, and so on. Now, it can take some time for a pernicious anemia diagnosis, because often, the symptoms are subtle at first. The symptoms may vary from diarrhea, to constipation, or fatigue, shortness of breath, loss of appetite, and lightheadedness. When we think about these symptoms, we probably will think we've come down with a mild version of the flu, before we're thinking we have pernicious anemia.

[00:04:46] But as time goes on, the symptoms will start to get worse. And without enough vitamin B12, the body won't have enough healthy red blood cells, and there may be some more permanent damage to the nervous system. Over the longer term, without B12, symptoms like confusion, numbness or tingling in the hands and feet, and problems with thinking and memory may start to happen. And unfortunately, there is no cure for pernicious anemia, but the good news is,

[00:05:15] it can be well managed with B12 supplements. More on that in a second. Now, besides pernicious anemia, are there other reasons why someone might be low in vitamin B12? Yes. As we age, for example, we're more likely to experience a vitamin B12 deficiency. Those that are vegetarian or vegan are also at risk. Having a digestive disorder, and being on certain medications, can also increase the risk of deficiency. Okay.

[00:05:44] So, if someone has pernicious anemia or is low on vitamin B12 for any other reason, what are the options? Well, the most active form of vitamin B12 comes from animal products in our diets. So, you may have heard that maybe some sea vegetables, like algae, contain vitamin B12. This is true, but the B12 found in these plant-based sources is not a form the body can use. Some foods have vitamin B12 added,

[00:06:13] like vegetarian burgers or other soy-based products. But when it comes to pernicious anemia specifically, since the body has trouble absorbing vitamin B12 from foods, it's recommended to start with B12 injections. And that's something, again, you have to go to your doctor for. So, Charlene, when it comes to your question about whether B12 injections are better than, say, an oral B12 supplement, most studies do find that injections are more effective. So, most doctors

[00:06:42] recommend B12 injections, especially if someone is experiencing symptoms of a B12 deficiency. Now, there are some newer studies that have found that high-dose oral vitamin B12 supplements can be helpful if there's no deficiency and blood tests start to look normal. Now, how high do these oral vitamin doses need to be? Probably between 1,000 to 2,000 micrograms of B12 per day. So, this is something you can ask your doctor about.

[00:07:12] So, to put this number in perspective, for most otherwise healthy adults, they only need about 2.4 micrograms per day of B12. Now, for those that don't have pernicious anemia but are still concerned about getting enough vitamin B12 in their diet, consuming animal products regularly is the safest bet. Everything from seafood to eggs to yogurt contain a good amount of vitamin B12 per serving. For example, 3 ounces of salmon has 2.6 micrograms

[00:07:42] of vitamin B12, which is more than the 2.4 micrograms most adults need each day. So, for those with pernicious anemia or even older adults or those with digestive disorders or those that follow a vegetarian or vegan diet, they may need more and may actually need a B12 supplement. And again, that's where talking to a medical doctor or a registered dietitian can be helpful. Oikos presents

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[00:09:11] Thank you again for taking the time to send in your question, Charlene. Now if you want to send in a question to be answered right here on the show and get a copy of our workbook, you can email your question to health at oldpodcast.com or if you want to hear your own voice on the podcast, come by oldpodcast.com slash ask. Right on that page, you can record your voice straight from your computer's microphone. It's really easy. You can even play back your message and delete

[00:09:40] and do retakes before officially sending it in. Or you can do it the old-fashioned way and call in your question. The number is 161-ILOVE-OHD. That's 1-614-568-3643. Thank you so much for asking me your questions. This is my favorite part of the show. But that'll do it for another Q&A edition of Optimal Health Daily. Thank you so much for listening every day and all the way through and I hope you have a great start

[00:10:10] to your weekend and of course I'll see you back here tomorrow where optimal life awaits. I'll see you back here. I'll see you back here. I'll see you back here. I'll see you back here.