Repetitive or Continual Fatigue Linked to Low Vitamin B12

Discussion in 'Fibromyalgia Main Forum' started by JLH, Jul 8, 2006.

  1. JLH

    JLH New Member

    New Study Links Repetitive or Continual Fatigue to Low Vitamin B12 and High Homocyteine in Cerebrospinal Fluid

    Studies regarding the correlation between unhealthy cardiovascular function and abnormally high blood levels of the amino acid homocysteine have been appearing with increasing regularity. Relatively overlooked among the research articles is a recently published Swedish study, the results of which demonstrate consistently high homocysteine levels and low concentrations of vitamin B12 in the cerebrospinal fluid (CSF) of individuals who report repetitive or continual fatigue at levels that interfere with normal life functioning.

    In the Swedish study by Regland M.D., Ph.D., et al., published in the Scandinavian Journal of Rheumatology, twelve female trial subjects that met criteria for repetitive or continuing fatigue that interfered with normal life functioning were studied along with a control group of eighteen healthy women. Subjects were also evaluated using a subset of items from the Comprehensive Psychopathological Rating Scale. The aim of the study was to determine factors present in cerebrospinal fluid related to homocysteine metabolism that correlate with the occurrence of repetitive or prolonged fatigue.

    The mean value of cerebrospinal fluid homocysteine in the fatigued trial group was over three times the mean level in the control group, a highly significant difference. Cerebrospinal fluid vitamin B12 levels measured below normal in the majority (7/12) of the fatigued subjects.

    On the other hand, blood Serum levels of homocysteine, folate, and vitamin B12 did not significantly deviate from normal ranges in the fatigued subjects. The authors interpret their findings to mean that biochemical events leading to high homocysteine levels in their patient group occur predominantly, if not exclusively, within the brain itself. Low vitamin B12 levels in the cerebrospinal fluid may reflect disruption of the mechanism of transport across the blood brain barrier. Incidentally, according to health practitioners who have used vitamin B12 in complimentary nutritional programs, high doses are often required to achieve measurable effects.

    Homocysteine is a sulfur-containing amino acid involved in several important methyl and sulfur transfer reactions. Excessive accumulation of homocysteine in the body fluid compartments is normally prevented by degradation through two enzymatic reactions called transsulfuration and remethylation. Importantly, these enzyme reactions depend on folate, vitamin B 6 (pyridoxal 5- phosphate), and vitamin B12 (cobalamin) as cofactors.

    When functioning properly, the enzymatic break-down of homocysteine forms methionine, which can then be converted to S-adenosyl-methionine (SAM). SAM is an important cofactor in the metabolism of central nervous system monoamine neurotransmitters, including dopamine, norepinephrine and serotonin. It has also been used successfully to treat both on-going fatigue and mood balance. Unfortunately, SAM was not measured in the Swedish study.

    Another explanation for high cerebrospinal fluid homocysteine levels was considered by the Swedish authors. Nitric oxide, which is an inhibitor of the enzyme that converts homocysteine to methionine, is produced as a result of inflammatory reactions. Most of the fatigued trial subjects in the study, in addition to their on-going fatigue, had accompanying symptoms of viral or bacterial infections. Theoretically, the inflammation caused by these infections increased nitric oxide levels, which in turn increased homocysteine levels.

    In conclusion, this study provides convincing preliminary evidence that high homocysteine levels in cerebrospinal fluid is an underlying factor in patients suffering from recurrent or continuing fatigue. Low vitamin B12 levels in cerebrospinal fluid and possibly low SAM levels are implicated as contributing factors. Additional evidence from other studies further support the idea that deficiencies in enzymatic pathways in the brain involving vitamin B12 , homocysteine, and folic acid underlie a range of neurological function issues. Deficiencies in these essential biochemical pathways in the brain should be considered by health practitioners in the evaluation of successful interventions for nutritional support in overcoming recurrent or continuing fatigue.

  2. I wonder do supplements of b12 help, my doctor won't give me the shots.
  3. Pianowoman

    Pianowoman New Member

    This is more evidence that high dose B12 supplements can realy help. There have been other recent posts about people, including myslf, who have been helped by B12 injections.

  4. razorqueen

    razorqueen Member

    I am Canadian too, and I've had my B12 tested which is in the low normal range. My ferritin levels are low too, but I am not taking my iron tablets,as I am over constipated as it is.
    I do have the B12 suglingual tablets at home, but I forget to take them. I want to talk to my doctor about getting B12 shots and see if he will do them now.
    So, you drs won't even give you a blood test to check your levels? That is odd.
    I'm in Manitoba

  5. NyroFan

    NyroFan New Member


    I also use sublingual B-12. After I have two I seem to get a great amount of energy.
    Nice study jlh.

  6. Pianowoman

    Pianowoman New Member

    I did have my B12 tested. Initially, it was low but has come back up. My doctor recommends the injections to increase energy. I think they increase the RBC production and hence the O2 carrying capacity of the blood.

    I give myself the injections. For a while I was getting 1000mcg/ml twice a week. I stopped for a while and noticed a drop in energy. Then she decided to try the high dose stuff. I have now 25,000 mcg/wk in 2 doses. That helped a lot. I am sort of playing with the doses a bit now to see if I can get by with a smaller dose. The high dose serum is pretty expensive.

    My doctor is Dr Bested and I guess you could say she is an Integrative physician.

  7. Pianowoman

    Pianowoman New Member

    You should know fairly soon if it is helping. I felt a boost right away but not everyone does. Give it a few weeks and see.

  8. I have asked my dr. to give me b12 shots but she nods no. how can you get them to give them to you? grrr! Maybe I'll copy this and give it to her?

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