Dr. Jonathan Collin, MD

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Letter to Patients
February 2011

The Need for Vitamin B12

Dear Patient,

There are few treatments in my medical practice that I appreciate more than Vitamin B12. While medicine recognizes that B12 also known as cobolamin is important for maintaining health, physicians commonly fail to diagnose B12 as a medical problem The reason for this is that most doctors only acknowledge the problem of Vitamin B12 deficiency not Vitamin B12 need. Optimal levels of Vitamin B12 are rarely met by simply having minimal levels sufficient to prevent deficiency. When a doctor suspects that a neuropathy, a nerve pain disorder, is being caused by Vitamin B12 deficiency, laboratory testing is ordered for Vitamin B12 levels. Unfortunately, many patients will have a level of Vitamin B12 that meets the criteria for a normal level and the doctor will dismiss the diagnosis of Vitamin B12 deficiency as the cause of the neuropathy. However, research has demonstrated that the level of Vitamin B12 in the cerebrospinal fluid, the brain and central nervous system circulation, is frequently low when the blood Vitamin B12 level is normal. Furthermore, research has demonstrated that when patients are administered Vitamin B12 by injection and not by mouth, that symptomatic improvement in nerve pain is noted. The administration of Vitamin B12 by injection raises the Vitamin B12 level in the blood beyond what the laboratory calls "normal range." Additionally the level of Vitamin B12 in the cerebrospinal fluid also increases from deficient to normal. However, most doctors will not treat patients with Vitamin B12 if the blood Vitamin B12 level is normal. What this means is that the treatment for many painful nerve conditions, such as neuropathy, will remain painful because B12 injections are not administered. A review of the research on Vitamin B12, including understanding laboratory testing and treatment, has been published in the Townsend Letter, February/March 2011 issue which I edit. The article is "Understanding the Serum Vitamin B12 Level and Its Implications for Treating Neuropsychiatric Conditions: An Orhomolecular Perspective," by Jonathan Prousky, ND. The article is available in the printed edition of the Townsend Letter, which is available from the Townsend Letter office at 360.385.6021, or online at TownsendLetter.com.

Is Vitamin B12 by injection only helpful for neuropathy? No, Vitamin B12 by injection has been very helpful in treating many other medical disorders and psychiatric conditions. It has been helpful in treating depression, anxiety disorder, insomnia, memory problems, cognitive disorders, fatigue, mood swings, numbness, balance disorders, and other neurologic disorders. What are the reasons why Vitamin B12 is helpful in treating such disorders? Vitamin B12 absorbs poorly through the diet especially as we age and digestive factors in our stomach and intestines impede its absorption and utilization. Vitamin B12 is needed for important biochemical reactions including the production of SAM (s-adenosylmethionine) which is critical to the formation of normal nerve tissue myelin. Vitamin B12 is also critical to control buildup of a toxic material known as homocysteine. Excess homocysteine has been found to weaken the heart and cardiovascular system and interfere with normal enzyme activities in the body. Does sublingual or other forms of oral B12 work as well injection? Unfortunately, the only means to significantly increase Vitamin B12 in the body and cerebrospinal fluid is through injection.

For an evaluation of your medical condition and Vitamin B12 status, please contact Dr. Jonathan Collin's office.

Best to you,

Jonathan Collin, MD

Office Addresses and Phone Numbers

Jonathan Collin, MD
911 Tyler St.
Port Townsend, WA 98368

12911 120th Ave. NE #A-50
PO Box 8099
Kirkland, WA 98034

Visit the Townsend Letter online.

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