Psychiatric Drugs or Vitamin B12?

A case report published in 2015 in the Indian Journal of Psychological Medicine has important implications for children (and adults) suffering from neuropsychological disorders. A 13-year-old boy following a lacto-vegetarian diet suddenly stopped talking and exhibited “rigidity, immobility, staring look, disturbed sleep, ideas of worthlessness and hopelessness, aimless wandering, guilt and suicidal ideas.” Some may recognize these symptoms as similar to those of autism.

The report noted that all blood tests, including those for anemia (and a later test for thyroid function), proved normal. The patient was diagnosed with “acute schizophrenia-like psychotic disorder” and treated with a pile of drugs including lorazepam (used to treat anxiety disorders) for three days, then olanzapine (an antipsychotic), sertraline (an antidepressant, commonly known as Zoloft) and aripiprazole (another antipsychotic) for two months.

That’s four strong drugs pumped into this little kid. “[D]espite good adherence,” he relapsed. At first, he became hyper with “suspiciousness, hearing voices, over-talkativeness, over-cheerfulness, inflated self-esteem, decreased need for sleep, increased appetite, increased pleasurable activities, and disruptive socio-education.”

His diagnosis was revised to “schizoaffective disorder, manic type,” and his physician replaced the Zoloft with divalproate sodium (used to treat seizures). Four days later, he returned with worsening of symptoms, and lithium carbonate (for treatment of bipolar disorder) and haloperidol (another antipsychotic) were added to the mix. That’s a total of six drugs in this thirteen-year-old child.

Still, his symptoms continued to worsen and two days later he was readmitted, with yet another revision to his diagnosis. He underwent more tests—including a test for vitamin B-12 levels—which the doctors found to be extremely low at 112ng/mL (the normal range is 180–914 ng/mL). The level of 180 ng/mL is associated with the most severe manifestation of B12 deficiency—pernicious anemia—and in Japan and some European countries, a level of 500–550 ng/mL is associated with psychological and behavioral manifestations such as dementia and memory loss.

And our patient’s B12 levels were very low indeed! His diagnosis was revised to “schizoaffective disorder secondary to Cobalamin [vitamin B12] deficiency.” Lo and behold—after two B12 shots, the patient recovered and then tapered off the medications. His sanity remained stable during the convalescent period.

Of course, this begs the question, why not test for B12 deficiency the moment any child or adult presents with behavior deemed schizophrenic, depressive, or in any way abnormal? B12 deficiency is associated with a wide range of psychological disorders—depression, memory loss, Alzheimer’s, anxiety, irrational or chronic anger, violent behavior, and other psychological problems. And vitamin B12 therapy has proved useful for a range of conditions deemed neurological—vision problems, loss of hearing and tinnitus, numbness and tingling in the hands and feet, alcoholism, impotence, incontinence, neuralgia, combat fatigue, and lack of balance or abnormal gait. In addition, low B12 is indicated in a range of other diseases—osteoporosis, asthma, skin conditions including psoriasis, diabetes, glaucoma, infertility, and of course anemia.

B12 is a huge molecule containing one cobalt atom, which we get only from animal products—however, even those who eat meat may become B12 deficient because it is difficult to absorb and utilize, especially as we get older. For example, B12 needs to attach to the intrinsic factor for assimilation, and the intrinsic factor is produced by the same cells in the stomach that produce hydrochloric acid. If we do not produce enough hydrochloric acid (often due to a low-salt diet) B12 assimilation will be compromised. Lack of a number of enzymes can also affect B12 assimilation.

Plant foods said to be sources of B12—such as soy, mushrooms, and spirulina—contain B12 analogs (called cobamides)—which can worsen the symptoms of B12 deficiency. Bacterial overgrowth in the small intestines is a surprising source of cobamides. The use of antibiotics, or a diet high in refined carbohydrates, can encourage the proliferation of bacterial overgrowth and lead to B12 deficiencies.

The highest sources of B12 are liver and mollusks. A serving of liver or oysters once a week is the best way to obtain B12 from the diet—if B12 levels remain low, oral and injectable supplements are available.

A word on vegetarianism in India. Although the inhabitants of southern India may not be as tall and robust as their meat-eating cousins in the north, lacto-vegetarianism has sustained the population of southern India for centuries. That’s because they had two good sources of B12 in the traditional diet. One was raw and cultured milk. Raw milk contains B12-binding protein, needed for the assimilation of B12—an essential compound destroyed by pasteurization.

The second source was insect parts and excrement in stored grains, a good source of B12. Now that India has joined the modern world—hence pasteurizing its milk and fumigating its grains—these sources are less available.

How common is B12 deficiency? A 1982 study of volunteer subjects from an American vegetarian society conference found that among those who did not take B12 supplements “92 percent of the vegans (total vegetarians), 64 percent of the lactovegetarians, 47 percent of the lacto-ovovegetarians and 20 percent of the semivegetarians had serum vitamin B12 levels less than 200.”

The authors note that similar values can be found for non-vegetarians. As one report put it:

“Vitamin B12 deficiency is a frequently ignored cause of neuropathy and psychiatric disorders. It is frequently found in older age groups, diabetes patients, and patients with a history of acid peptic disease. It can cause neuropsychiatric disorders or worsen them. Vitamin B12 therapy results in a reversal of neuropsychiatric symptoms or improvement in most patients. It is recommended to keep vitamin B12 in mind while ordering the first set of investigations in patients aged 40 years or more presenting with neuropsychiatric disorders even if there is no hematological manifestation [that is, no anemia].”

Unfortunately, most psychiatrists and doctors today don’t do this—they reach for the prescription pad rather than order a B12 test. However—you as a patient or as the caregiver of a patient—can insist that blood is drawn for B12 testing. If B12 is low—under 500 ng/mL—the doctor is obligated to treat with supplemental B12, either by injection or oral tablets. It’s a simple solution to some of the maladies that cause much suffering—autistic and schizophrenic behavior, memory loss, depression, neurological decline, and fatigue.

Reposted from: https://www.theepochtimes.com/health/psychiatric-drugs-or-vitamin-b12-5437909