Are you suffering with fatigue and low energy? Do you struggle to get through your day? Are you no longer motivated to hit the gym? While there are many causes of fatigue, we’re going to dig a little deeper and look at how the deficiency of one nutrient in particular, vitamin B12, can lead to fatigue and low vitality.
What Does Vitamin B12 Do?
Vitamin B12, or cobalamin, is one of eight essential B-vitamins, and essential for maintaining your energy levels via the production of your red blood cells, the oxygen- and nutrient-carrying “taxis” traveling through your bloodstream. However, you may be surprised to learn just how many other key processes are regulated by this essential vitamin.
Vitamin B12’s role goes right down to your DNA and RNA production, the genetic material that lays the blueprint for your health and performance. B12 works together as a team with other B-vitamins to convert your food to energy (crucial for fighting winter fatigue) and also keeps your heart healthy by controlling pro-inflammatory homocysteine levels, a reliable marker associated with heart disease. (1)
If your B12 levels are low, you may suffer from increased fatigue, poor memory, lack of concentration, anemia, muscle weakness, low vitality and poor sleep. (2) Let’s take a closer look at why your B12 may be low and how you can top it up.
Why Is My B12 Too Low?
Common causes of low B12 that you may have already read about are vegan/vegetarian diets, inability to absorb B12 (e.g. due to inflammatory bowel disease like Crohn’s disease or weight loss surgery), bacterial infection (e.g. h. pylori infection) and aging.
However, if we dig a little deeper and do some more detective work, we find a few more very commonly seen causes that go unnoticed by many doctors.
1. Your Stomach Acid Is Too Low
Your stomach plays a key role in supporting the absorption of B12 via the production of a protein called intrinsic factor (IF), which is needed to effectively take up B12 into your cells.(3) If your stomach acid levels are too low – due to stress, vegan/vegetarian diet, heartburn drugs, aging, etc – then your stomach can’t produce adequate IF, leading to B12 deficiency. A gentle fix for supporting optimal stomach acidity is to take apple cider vinegar before your meals.
2. Genetic SNiPs
Your DNA may be holding you back from achieving optimal B12 levels. Genetic single nucleotide polymorphisms (SNiPs, pronounced “snips”) are small genetic variants or blips that occur in your DNA can lead to inadequate production of key enzymes needed to absorb certain vitamins.
New research shows the genetic SNiP FUT-2 gene may strongly contribute to low levels of B12. (4) However, it’s important to remember that even if you test positive for a SNiP on a genetic test, it doesn’t mean you’ll have lifelong deficiency. It simply means you’ll need to take extra steps to ensure your diet is rich in B12 foods.
It’s not just the classic proton-pump inhibitor drugs and H2 blockers (i.e. drugs like omeprazole or ending with the suffix “–azole,” or ranitidine or drugs ending in “-tidine”), designed to treat heartburn by reducing stomach acid that can lower your B12 levels. There is a whole host of other drugs that can lead to low B12 levels and fatigue; metformin (to treat diabetes), antibiotics, methotrexate (used in chemotherapy), colchicine (used to treat gout) and a group of cholesterol-lowering drugs (e.g. cholestyramine). If you’re on one of these medications, talk to your doctor about getting your B12 levels assessed.
How Do I Get Tested?
The classic method for assessing vitamin B12 status is to perform a blood draw. A frank deficiency is typically classified as blood levels below approximately 150-200pg/mL (depending on the lab). However, this level falls short of the ideal “functional range,” a term used to describe the amount needed to support good health (not just prevent disease). Most functional medicine doctors aim for about 800-1,000pg/mL; anything less is considered insufficient. A dietary insufficiency reflects a level too low to promote and support your best health, and while not a frank deficiency, can still lead to many of the adverse symptoms associate with B12 deficiency.
Another key test to perform if you suspect low B12 is methylmalonic acid (MMA). If you have deficient or insufficient B12, you’ll begin to produce significant amounts of MMA, which may occur despite a “normal” finding of your blood B12 levels. This can be measured via blood draw along with B12. Genetic testing can also be useful to identify any SNiPs in your DNA that may predispose you to insufficiency or deficiency.
What Are The Best Foods To Increase My B12 Levels?
The best way to boost your B12 levels is to follow a dietary approach that provides a robust source of dietary B12. A Paleo approach to eating is the perfect foundation for correcting low B12 for good, because animal protein is hands down the best dietary source of B12.
Boost your levels by including more of the following foods regularly in your diet; shellfish (which has 85g per 3oz. serving), organ meats, cold-water fatty fish (e.g. salmon, mackerel, herring, sardines), beef and wild game meats, and pasture-raised eggs. Aim for 1-4 servings (3oz) per day of these nutrient-dense foods, depending on your level of deficiency.
What About B12 Shots, Are They A Good Option?
If find you have insufficient or deficient B12 levels and need to restore your levels quickly to fight off fatigue and low energy, then B12 shots can be a great option. The injection is given intra-muscularly (IM), normally in the back of your shoulder, bypassing your digestive system (an area that may be compromising your ability to absorb B12) and dramatically increasing the bioavailability or your capacity to absorb it. In short, B12 shots are a great way to increase your levels acutely, while you ramp up your dietary intake.
It’s important to note that the typical form of B12 used in doctors offices is cyanocobalamin, an older form of B12 that is not actually found in nature. While some of it does get converted to the active form in the body, those with conversion problems (i.e. digestive issue) or SNiPs will likely not absorb this form very well.
Instead, choose the methylcobalamin form, the “active” form of vitamin B12, that requires no conversion in the body and will give you the most benefit. B12 shots are typically given in 1,000mcg doses, weekly for 4-8 weeks depending on your levels and clinical picture. (Ask your doctor for more information.)
Low energy, fatigue and brain fog are no fun anytime of year, but they’re especially difficult in the winter months when colder, darker days and the hectic nature of the holidays can easily leave you rundown. If you need a quick boost, a series of B12 shots can help restore ideal levels and provide a nice energy boost. But remember, your diet is the foundation for good health and performance, so be sure to include B12-rich animal protein to keep your levels topped up throughout the year.
For more information on our therapies including B12 therapy and appointments, please contact Clinic Director Charlie Blaisdell at CBlaisdell@CoreNewEngland.com
BTP/CORE New England