By Dr. med. Ludwig Jacob
As a medical doctor, Ph.D. and specialist in vegetarian and vegan diets, (I wrote a 500-page medical book quoting over 1400 scientific studies on this), my research and personal experience with the health problems of senior devotees have shown clearly that we urgently need to improve and re-think our eating and health habits. The world-wide devotee community has already a large percentage of cardiovascular diseases and of neuro-degenerative diseases such as dementia and Parkinson with the high probability of developing an epidemic. One of the easier ways to revert these causes is to increased vitamin B12, which lacking causes high levels of homocysteine in the blood.
The lack of vitamin B12 and too high homocysteine can cause dementia, Alzheimers disease, heart disease, nerve damage, brain shrinkage, stroke, fatigue, memory loss, miscarriage, mental illness, and many more. People who already have Parkinson or dementia urgently need to supplement B12.
The insidious problem with a chronic lack of B12 is that in the early stage there are no or little symptoms and is, therefore, often not treated on time. Once it has done serious damage, it cannot be cured. Please allow me to share some important information about it with you.
How do we get vitamin B12?
Vitamin B12 is a water-soluble vitamin that your body does not produce itself, which means you must get it via your diet or supplements. Milk products contain little B12 and require a lot of B12 for their digestion. After the age of 50, dairy products no longer meet our needs for B12, and supplementation is a must. Vitamin B12 deficiency is more common in the elderly. This is because stomach acid decreases as you get older, and stomach acid is essential for your body to absorb vitamin B12.
Vitamin B12 deficiency is prevalent not only among the known risk groups of elderly persons, vegetarians, vegans, pregnant women, and patients with kidney disease or intestinal disorders.
In general, those most at risk of vitamin B12 deficiency include:
• Vegetarians and vegans
• People over 50
• People who regularly use proton pump inhibitors (PPIs) or taking metformin
• People with Crohn’s disease, colitis, celiac disease or irritable bowel syndrome (IBS)
• Women with a history of infertility or miscarriage
The NIH, the highest US health authority, recommend that EVERYBODY above 50 should supplement B12 in their diet, as the absorption from food after that age is often insufficient, since it is dependent on intrinsic factors and stomach acid concentration.
How do we test it?
It is a simple blood test. The cheapest way is to test homocysteine, as it shows a lack of active B12. Homocysteine should not be below 12 μmol/L.
If you test B12, the values that are considered normal are often already too low and you may suffer from a lack of active B12! Experts suggest a B12 level of no less than 450 pg/mL.
Oral Vitamin B12 Supplements or injections?
Many people, including the elderly, those with intestinal disorders, vegetarians and vegans, benefit greatly from Vitamin B12 supplements. There is, however, one problem with supplementation, which is the poor absorption rate of oral vitamin B12. Vitamin B12 is the largest vitamin molecule known. Because of its large size, it is not easily absorbed. Therefore, oral B12 supplements are often grossly ineffective. This is why vitamin B12 is often given via injection, especially for people with absorption issues. Sublingual (under your tongue) sprays are also effective. You need 500-1000 mcg of B12 orally if you do not absorb it well. For younger, healthy people who absorb well 5-10 mcg of vitamin B12 daily is usually sufficient.
In summary: blood tests show how well you absorb B12 and whether you need B12 orally or intramuscular (a little injection into the muscle, make sure the dose is high enough, e.g.500-1000 mcg).
What can we change to stay healthy?
As confirmed with Dr.Pradyumna at the Vedic Village Clinic, who treat many devotees with neuro-generative diseases, these diseases are connected with the high consumption of paneer and cheese. He is an expert Ayurvedic doctor and named the high dairy consumption, like paneer, as the number one cause for the high rate of neuro-generative diseases in Western devotees. It is a well-established scientific fact that all neuro-degenerative diseases start with these protein deposits in the brain.
Some B12 is found in paneer, but it contains too much methionine which causes high homocysteine. It is proven that high homocysteine increases the risk of Alzheimer 5-fold. In normal population this is often due to high meat consumption, but we can also reach this by a high cheese and milk intake, as usually found in a devotee diet.
Studies show that not only homocysteine is produced by the metabolisation of methionine, but also other methionine metabolites increase damages to the cardiovascular and nervous system.
Cheese and other dairy sources also increase homocysteine in the elderly. In addition, they are loaded with a lot of saturated fatty acids that are known to increase Alzheimer risk.
Unhealthy diet and too little sleep.
It was recently proven that protein deposits in the brain are eliminated during sleep. So a high diet of milk products and little sleep are a fatal combination – a rather typical situation for many devotees. In addition to sufficient intakes of folic acid, Vitamin B6, and mainly B12, omega-3-fatty acids like flax seed oil, freshly ground organic flax seeds, chia seeds or rape seed oil, choline or betaine are also needed. Betain is found in quinoa whilst cholin is found in soya products. It is essential to reduce and normalise the amount of milk protein, especially rich paneer and the combination of dairy and sugar in the diet. Our high consumption of cheese and sugar also add to the cancer burden with strong evidence especially in regard to prostate cancer and breast cancer.
It is not the daily small cup of milk Srila Prabhupada recommended that makes us ill – it is the daily cheese, milk, fat and sugar products that does (such as paneer, cheese srikand, burfi, fried milk sweets etc).
Rates of brain shrinkage may depend on omega-3 fatty acids and B vitamins
A new study reveals that the long-chain omega-3 fatty acids DHA and EPA (the kind found in fatty fish like salmon) may determine whether Vitamin B treatment can slow down brain shrinkage. Higher blood levels of omega-3 fatty acids has previously been linked to larger brain volume in older adults. Researchers from University of Oxford, led by Dr. David Smith, examined data from the VITACOG trial, a 2-year randomised, placebo-controlled trial, examining the effects of Vitamin B treatment on brain shrinkage and memory loss in older adults with mild cognitive impairment. People with high levels of omega-3 fatty acids (EPA and DHA combined above 590 μmol/L or 186 mg/l).) have up to 40% less brain shrinkage if treated with B Vitamins. But in people with low blood levels of omega-3s ((EPA and DHA combined below 390 μmol/L or 123 mg/l)), B Vitamin treatment had no effect on brain atrophy. As noted by the authors, “There was a significant interaction between B vitamin treatment and plasma combined omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) on brain atrophy rates.”
As in old age the conversion of plant omega-3 to long chain omega-3 fatty acids DHA and EPA (essential for brain health), you may consider taking a supplement with DHA and EPA from algae.
If homocysteine is already high, B12 alone may not suffice but needs to be combined with choline, good amounts of omega-3-fatty acids, folic acid, and Vitamin B6. For prevention B12 supplementation is usually sufficient and the lack of it is the main reason for increased homocysteine.
Vegetarians can be very healthy, if they get it right!
The Adventist vegetarians are proven in very large and excellent health studies that have run now for decades to be the healthiest and longest living people on the planet. They are a Christian faith group for whom wholesome living expresses their religious conviction that the body must be honoured as God’s temple. The Adventist’s nutritional council recommends a vegetarian diet with plenty of whole grains, vegetables, fruit, and moderate quantities of legumes, nuts, and low-fat milk products. Among Adventists it is generally recommended that foods containing sugar, saturated fats, cholesterol, and salt should be eaten on only rare occasions. The consumption of soft drinks, alcohol, coffee, tea, and any other caffeine-containing beverages are not accepted by Adventists. Even the vegetarian Adventists eat very little milk products (an average of 150 ml of milk) and quite a bit of soya. Healthy vegetarian men lived by average more than 13 years longer than other Californian men of the same age group!
The body as a temple of God! Let us take care of it properly, it is part of our service of the Lord.
Final advice off topic: After getting up in the morning drink at least half a liter of warm water. It can save your life. We lose at least 0,5 liter of liquid during the night by breathing and sweating, even more in hot climates. So our circulation dehydrates and our blood thickens. This is the main reason why the risk of stroke and heart attack is three time higher after getting up in the morning.
Dr. med. Ludwig Jacob
If you want to know more scientific facts and details:
B12 deficiency, high homocysteine, the upcoming dementia epidemic
Science and pure observation show that many members of the worldwide devotee community are complicit in this epidemic of neuro-degenerative and cardiovascular diseases. I am a emdical doctor, Ph.D. and specialist in vegetarian and vegan diets. My 500-page book on nutrition and lifestyle has become a bestseller amongst M.D.s, nutritional scientists and naturopaths in Germany. It was edited and lauded by the world-wide leading expert on vegetarian diet, Prof. Claus Leitzmann, an officially elected “living legend” amongst the world-wide elite of nutritional scientists. My book is not based on personal opinion or hearsay but on sound science, over 1400 cited studies and with excellent reviews from experts.
My research and personal experience with devotees disturbingly shows me that we urgently need to improve our eating and health habits. In Mayapur I talked to approx. 30 elderly devotees who were blissfully unaware of the essential need of B12, (including three devotees with Parkinson), the lack of B12 and high homocysteine.
Pathogenesis of Alzheimer and Parkinson are very similar, just in different parts of the brain. So Parkinson presents earlier. Both have the same specific protein deposits. It is clear that all neuro-degenerative diseases start with these protein deposits in the brain.
Studies show that not only homocysteine, which is made by the metabolisation of methionine, but also other methionine metabolites increases damage to the cardiovascular and nervous system. In addition, it brings a lot of saturated fatty acids that are known to increase Alzheimer risk. Also milk and other protein sources can increase homocysteine in the elderly.
Vitamin B12 is a water-soluble vitamin that your body does not produce, which means you must get it via your diet or supplements. Vitamin B12 is essential for the maintenance of your central nervous system, including the conduction of nerve impulses and producing the myelin sheath, which protects and “insulates” your nerves. Vitamin B12 is among the stored vitamins, which is why specific clinical symptoms become only apparent when chronic deficiency is already manifest and pronounced. Chronic Vitamin B12 deficiency can result in irreversible neurological disorders and haematological alterations like microcytic anaemia and pernicious anaemia.
Vitamin B12 deficiency yields only non-specific symptoms which is why it is often not recognised and treated on time. To catch latent shortage persons in risk groups should have their Vitamin B12 levels tested every two to three years. Nitrosative stress is notorious in causing rapid Vitamin B12 depletion. If Vitamin B is known to be deficient it must be supplemented initially in high dosages.
Studies from the USA Framingham trial show nearly 40 percent of the USA population may have suboptimal blood levels of vitamin B12, which is a level low enough to experience neurological symptoms. Another 9 percent were considered deficient in the vitamin, while 16 percent were near deficient. Vitamin B12 deficiency is more common in the elderly. This is because stomach acid decreases as you get older, and stomach acid is essential for your body to absorb Vitamin B12. Many symptoms often attributed to ageing may actually be due to Vitamin B12 deficiency. This includes memory loss, cognitive decline, muscle weakness and more. Low levels were common in young people and the elderly alike.
Why Low Levels of Vitamin B12 Are Often Missed
Most physicians do not routinely test their patients’ Vitamin B12 levels. Levels considered “normal” in the USA may still be too low. Normal ranges of Vitamin B12 in the USA are 200 pg/mL to 1100 pg/mL, even though people at the lower end of this spectrum (between 200 pg/mL and 350 pg/mL) often have symptoms of Vitamin B12 deficiency. Various studies show that B12 levels below 308 pmol/L more than triple the risk of premature loss of brain volume (brain atrophy) compared with people with B12 levels above 386 pmol/L. In fact, if your levels are below 600 pg/mL, you might be suffering from B12 deficiency. Integrative medicine practitioner Chris Kresser explains, “In Japan and Europe the lower limit for B12 is between 500 to 550 pg/mL, the level associated with psychological and behavioural manifestations such as cognitive decline, dementia and memory loss.”
Experts who specialise in the diagnosis and treatment of B12 deficiencies suggest treating all patients who are symptomatic and have B12 levels less than 450 pg/mL. This is especially true if homocysteine is increased. Low levels can also lead to mental fogginess, memory troubles, muscle weakness, and fatigue, one of the hallmark signs.
Vitamin B12 also plays a role in:
• Proper digestion, food absorption, iron use, carbohydrate and fat metabolism
• Healthy nervous system function
• Promotion of normal nerve growth and development
• Help with regulation of the formation of red blood cells
• Cell formation and longevity
• Proper circulation
• Adrenal hormone production
• Healthy immune system function
• Support of female reproductive health and pregnancy
• Feelings of well-being and mood regulation
• Mental clarity, concentration, memory function
• Physical, emotional, and mental energy
Vitamin B12 Is Crucial for Mental and Cognitive Health
Vitamin B12’s role in brain and mental health is particularly significant and can cause a range of neurological disturbances that mimics depression, dementia and confusion, as well as serious mental illness. B-group vitamins may slow brain shrinkage by as much as seven-fold in brain regions specifically known to be most impacted by Alzheimer’s disease. Among participants taking high doses of folic acid and vitamins B6 and B12, blood levels of homocysteine were lowered, as was the associated brain shrinkage — by up to 90 percent.
Oral Vitamin B12 Supplements Are Difficult to Absorb
Many people, including the elderly, those with gut disorders and vegetarians and vegans, could benefit from adding extra vitamin B12 to their diet. There is one problem with supplements however, which is the poor absorption rate of oral Vitamin B12 supplements. Vitamin B12 is the largest vitamin molecule known. Because of its large size it is not easily absorbed passively like most other supplements, making many, if not most, oral B12 supplements grossly ineffective. This is why vitamin B12 is often given via injection, especially for people with absorption issues. Sublingual (under your tongue) sprays are also effective, as they allow the large B12 molecule to be absorbed directly into your bloodstream.
Specifics of treating vitamin B12 deficiency
With gastrointestinal tract impairment (atrophic gastritis, troubled secretion of the intrinsic factor in the stomach, resection of the terminal ileum) it must be checked whether a high dosed oral supplements (e.g. 0,5 – 1 mg per day as sublingual tablets) is sufficient to correct the deficiency or whether intramuscular administration will be required. A high dose of oral substitution can in most instances achieve similar good results as an intramuscular supply. The degree of success should be monitored by laboratory analysis. If the deficit originated in the insufficient intake through food sources and was successfully remedied by high dosed Vitamin B12 administration, a daily dose of 10 μg may already be adequate to subsequently maintain proper levels.
How Hyperhomocysteinemia Leads to Dementia
In hyperhomocysteinemia, homocysteine levels can range from 14 micro-moles/litre all the way up to 100 micro-moles/litre in severe cases. Elevated homocysteine damages endothelial cells that line blood vessels and induces thrombosis that can lead to heart attacks and stroke. Homocysteine produces breaks in DNA and induces apoptosis (a programmed cell suicide) that is a major cause of neuronal death in dementia. Numerous studies offer clues as to the various ways in which high levels of homocysteine induce the vascular and neuronal damage implicated in the development of dementia. Experiments in cell cultures show that homocysteine can directly kill neurones of the hippocampus, the area of the brain associated with memory. Cell death was induced by oxidative stress, DNA damage, and apoptosis.
Homocysteine and Brain Shrinkage:
VITACOG is a two-year trial of homocysteine-lowering B-vitamins in individuals over 70 years with mild cognitive impairment. Participants were given either a high dose B-vitamins (0.8 mg folic acid, 0.5 mg vitamin B12 and 20 mg of vitamin B6) or a placebo. Their rate of brain shrinkage was measured by a series of MRI scans. Complete scans were available for 83 placebo and 85 treated individuals. Homocysteine levels fell by 22.5% in treated subjects but increased by 7.7% in those given a placebo.
As in earlier studies, higher homocysteine was associated with a faster rate of brain shrinkage. But brain shrinkage was significantly less (slowed by 30%!) in treated individuals with an initial homocysteine level >9.5 μmol/L. Remarkably, after treating with B vitamins, those with the highest initial homocysteine levels (>13 μmol/L) had a rate of brain shrinkage 53% lower than the placebo group.
In summary, VITACOG shows that a combination of high dose B12, folic acid and B6 significantly slows brain shrinkage in patients with Mild Cognitive Impairment and raised homocysteine. The team has now looked in greater detail at brain scans from 156 volunteers who took part in the VITACOG study. Rather than focusing on total brain shrinkage, as reported in 2010, they now looked at shrinkage in different regions of the brain. Of the 156 volunteers that took part in the study, 77 had homocysteine levels greater than 11.06μmol/L. Compared to participants with lower levels, those with higher homocysteine had a faster rate of shrinkage specifically in the parts of the brain known to be affected in Alzheimer’s disease. B vitamin treatment slowed the shrinkage in these particular regions by almost 9-fold (from 5.2% to 0.6%) over the two-year period. In contrast, B vitamin treatment had no effect on participants with lower levels of homocysteine.
Rates of brain atrophy may depend on omega-3 fatty acids and vitamin B
A new study reveals that the long-chain omega-3 fatty acids DHA and EPA (the kind found in fatty fish like salmon) may determine whether vitamin B treatment can slow brain shrinkage. Higher blood levels of omega-3 fatty acids had previously been linked to larger brain volume in older adults. Researchers from University of Oxford led by Dr. David Smith examined data from the VITACOG trial, a 2-year randomised, placebo-controlled trial examining the effects of vitamin B treatment on brain shrinkage and memory loss in older adults with mild cognitive impairment. People with high levels of omega-3 fatty acids had up to 40% less brain shrinkage if treated with B vitamins. But in people with low blood levels of omega-3s, B vitamin treatment had no effect on brain atrophy. As noted by the authors, “There was a significant interaction between B vitamin treatment and plasma combined omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) on brain atrophy rates. In subjects with high baseline omega-3 fatty acids (>590 μmol/L = 186 mg/l), B vitamin treatment slowed the mean atrophy rate by 40 percent compared with placebo.
B vitamin treatment had no significant effect on the rate of atrophy among subjects with low baseline omega-3 fatty acids (<390 μmol/L = 123 mg/l). High baseline omega-3 fatty acids were associated with a slower rate of brain atrophy in the B vitamin group but not in the placebo group. It is also suggested that the beneficial effect of omega-3 fatty acids on brain atrophy may be confined to subjects with good B vitamin status.”
By Nrsimha Kavaca dasa
By Deena Bandhu Das
