Vitamin B12- who needs it and are pills okay?

Vitamin B12 is an important vitamin mostly obtained from dairy products and meat.  It is a critical ingredient your body needs to make red blood cells and also helps your nervous system work correctly.  If you have low B12 levels, you might have anemia, depression, dementia or neuropathy (pain, burning or tingling sensation).  Some people with low B12 also have high levels of homocysteine which may increase your risk of heart disease and stroke.  Your doctor can run a simple blood test to see if your B12 level is low.

The most common reasons for low B12 are 1) not taking in enough in your diet or 2) a problem with your stomach or intestines that prevents you from being able to absorb the vitamin.  This includes Pernicious Anemia (where you do not have the cells needed in your stomach to absorb B12) or long standing heartburn or ulcers or having had surgery on your stomach or intestines.

In the past, everyone who needed B12 supplementation was given shots- initially given several times a week for a couple weeks and then once a month. Now we know that unless you have a problem absorbing B12, it is just as effective to take a daily pill instead of getting a shot.  Over the counter Vitamin B12 pills do not have enough B12 to increase your levels- you need to take at least 1000 mcg of B12 everyday.  You can get a prescription for this high dose from your doctor if you levels are low.

Even if you’ve been getting Vitamin B12 shots for years, you can switch to the pill and it will be just as effective unless you have a problem absorbing B12 from your digestive tract.

Where do you spend most of your time in the grocery store?

Here’s one thing I have noticed about the grocery store.  The healthiest foods are located around the periphery of the store.  That’s where the dairy, meats, fruits and vegetables are found.  The aisles are typically filled with pre-packaged, processed carbohydrates and bad fats.  Think about your trips to the grocery store- do you find most of the items on your list around the periphery in the produce and refrigerated sections or do you spend most of your time weaving your way through the aisles?  More “aisle time” probably reflects the amount of unhealthy food you are stocking your pantry with which almost certainly reflects what you are eating.  Except for an occasional trip to an aisle for a specific item like beans or legumes for example, try spending your next trip to the grocery store only around the periphery and notice the difference in what’s in your refrigerator when you get home.

Makeover your kitchen

Wanting to make over your body?  The best place to start is your kitchen.  Good nutrition is in part about knowing which foods are good to eat but it may be more about altering lifestyle habits.  Even if you know what’s good to eat, if those foods are not around, you won’t eat them!  So how do you start establishing a lifetime of good nutrition?  Well, start at home!  Your dietary willpower and discipline will be frequently challenged at potluck dinners, social events, lunch meetings at work, etc.  But, what matters more than an occasional non-nutritious meal is the other meals you are eating the majority of the time.  Start by making your home a “safe place.”

Here are some excerpts from Gourmet Nutrition by John Berardi, PhD, founder of Precision Nutrition.

“If a food is in your possession or located in your residence, you will eventually eat it.   That’s right, if you wish to be healthy and lean; you must remove all foods not conducive to your goals from your residence and replace them with a variety of better, healthier choices.  Now, before you go thinking that this is just a suggestion- one way to improve your body- we want to make it clear.  This is the only way to improve your body….We assure you that once you makeover your kitchen, your body will follow.”

Take a look in your fridge and pantry- is it filled with soft drinks, fruit juices, processed foods wrapped in colorful wrappers, boxes and containers?  If so, it may be time for a kitchen makeover.

Tanning to get more Vitamin D???

You may have heard in the news or from your doctor that there have been studies done that associate a low blood level of Vitamin D with some types of cancers, neurologic disease, autoimmune disease and cardiovascular disease.  Let me emphasize- the studies show an association, not that a low level of Vitamin D causes these diseases.  However, based on these studies there was an emphasis placed on educating patients to have their Vitamin D levels checked or talk with their doctor about getting more Vitamin D.

The two sources of Vitamin D are through the sun’s UV rays or through our diet by either food or supplements.  Some doctors had recommended that people spend more time in the sun without sunscreen to increase their levels of Vitamin D.  The American Academy of Dermatology has recently ammended their position on Vitamin D.  It is NOT recommended that people increase their unprotected UV exposure from the sun or tanning beds in order to increase Vitamin D.  Sun exposure and tanning are known causes of skin cancer.  Since there is another method of increasing Vitamin D in our systems through our diet, this is clearly the better choice.

There are currently ongong studies to determine if the current recommended adequate intake levels should be revised but for now we are using the levels shown in Table 2 of this link from The National Academy of Sciences Institute of Medicine (IOM) guidelines for vitamin D.

Some people with higher risk of having Vitamin D insufficiency are “dark skin individuals, elderly persons, photosensitive individuals, people with limited sun exposure, obese individuals or those with fat malabsorption.”

See the official statement here for further details: American Academy of Dermatology Position Statement on Vitamin D.