Many doctors mistakenly rely on blood serum B12 levels to screen for vitamin B12 deficiency.
There it was two cases of young, strictly vegetarian subjects without known vascular risk factors. One had a stroke and the other had multiple strokes. Why? Probably because they weren’t taking vitamin B12 supplements, which leads to high levels of homocysteine, which can attack our arteries.
So that’s it eating plant-based foods that fail to supplement with B12 may increase the risk of heart disease and stroke. However, as you can see in the chart below and at 0:47 in my video How to test for functional vitamin B12 deficiencyvegetarians have so many heart disease risk factors benefits that they are still at lower risk overall, but this may explain why vegetarians were found to have more stroke. This difference would probably disappear with adequate B12 supplementation, and the benefit of lower heart disease risk would be even greater.
In comparison with non-vegetarians, vegetarians enjoy a myriad of other advantages, including better cholesterol, blood pressure, blood sugars, and obesity rates. But, what about this stroke study? Even among the studies that have shown benefits, “the effect was not as pronounced as expected, which may be a result of poor vitamin B12 status due to a vegetarian diet. Vitamin B12 deficiency may negate the cardiovascular disease prevention benefits of a vegetarian diet. To further reduce the risk of cardiovascular disease, vegetarians should be advised to use vitamin B12 supplements.”
How can you determine your B12 status? By the time you are symptomatic with B12 deficiency, it is too late. And, at first, the symptoms can be so subtle that you might even miss them. In addition, you develop metabolic vitamin B12 deficiency long before you develop clinical deficiency, so there is a “missed opportunity to prevent dementia and stroke” when you have enough B12 to avoid deficiency symptoms, but not enough to keep your homocysteine in check. “The underdiagnosis of this condition is largely due to a failure to understand normal saline [blood level] B12 may not reflect an adequate functional B12 status.” Our blood B12 levels are not always represent the levels of B12 in our cells. We may have a severe functional deficiency of B12, even though our blood levels are normal or even high.
“Most doctors tend to assume that if the serum B12 is “normal,” there is no problem,” but, within the lower range of normal, 30 percent of patients could be metabolically deficient in B12, with high homocysteine levels.
Directly count Methylmalonic acid (MMA) or homocysteine levels are a “more accurate reflection of vitamin B12 functional states.” Methylmalonic acid can be squared with a simple urine test; you’re looking for less than 4 micrograms per milligram of creatinine. “Elevated MMA it is a specific indicator of vitamin B12 deficiency while Hcy [homocysteine] increases both vitamin B12 and folate deficiencies.” Thus, “metabolic B12 deficiency is strictly is defined by increasing MMA levels or by increasing Hcy in people with folate,” that is, those who get enough folate. Even without eating beans and greens, which are full of folate, folic acid is added for the law’s flour supply, so these days, high homocysteine levels can be primarily a B12 problem. Ideally, you are looking for a homocysteine level in your blood down into the single digits.
Measured in this way, “the prevalence of subclinical functional vitamin B12 deficiency it is dramatically higher than previously assumed…” We are speech about 10 to 40 percent of the general population, more than 40 percent of vegetarians and the majority of vegans who are not meticulous about their B12 intake. Some suggest that those following plant-based diets should control Their vitamin B12 status every year, but you shouldn’t have to if you’re getting adequate supplements.
There hectare rare cases of vitamin B12 deficiency that can’t be detected in any test, so it’s best to make sure you’re getting enough.
If you get your homocysteine tested and it’s still very high, in the double digits despite taking B12 supplements and eating beans and greens, I have a suggestion for you in the final videos of this series, which we’ll cover next with: Should vegetarians take creatine to normalize homocysteine? and The efficacy and safety of creatine for high homocysteine.
How did we end up here? To watch the entire series, if you haven’t seen it yet, check out the related posts below.
