[taken from a letter written to a patient]Will you be upset if I agree "it's all in your head" and then explain why? B12 is vital for the development and maintenance of the myelin sheath around nerve axons, and there's a lot of myelin sheath around the billions of axon connections in your brain. So in the absence of trauma, the most likely cause of anxiety and depression is probably nutritional, in other words, a lack of B12. Want to put it right - take B12. The anxiety, panic attacks, even psychosis, are very real, but no amount of CBT or anti-depressants are going to put them right without solving the underlying problem, deterioration of the myelin sheath. Besides which, B12 is considerably cheaper than all of these other things, and B12 is completely safe, whereas certainly the medications aren't (I've never heard of side effects from therapy, yet).
So your GP is right to be cautious about anything that s/he isn't familiar with. But I can reassure your GP - B12 administered by injection is completely safe. If s/he has any lingering doubts, turn to the trusty BNF and check the BNF dose for "possible cyanide poisoning" (to be administered to firemen who enter a burning building without breathing apparatus, ie not as uncommon as you might think). No it isn't a mis-print, they really do get 5,000 times the dose he's about to give you. And the firemen typically don't even get the rest of the shift off, 20 minutes then back to work! Long-term effects? Pin-up photograph in a dubious calendar.
So whilst we are on the subject of BNF, does your GP think you have any signs of neuropathy? Picking from your first set of symptoms - heart palpitations, sensitivity to light. It goes on in the second set of symptoms. BNF guidelines says injections every 2 months with neuropathy. Actually BNF guidelines says the injections alternate days (from the loading dose) should continue until no further improvement, so the advice in the preface of BNF applies here - give injections whenever needed to minimise symptoms (the physician should use their knowledge and judgement and inject pretty much ad lib). Obviously your GP will want to teach you how to inject at home so you don't take up valuable surgery time (or your own time travelling), and your GP might wonder how many other people on anti-depressants or with other intractable symptoms they can give life outside the surgery, by trying B12 injections for them too.
Is it safe? Well you can point the GP at our own website and our Treatment Protocol. But they are more likely to trust BMJ and NHS sources. BMJ has a section called Best Practice which many doctors subscribe to (it's doctor only) for their CPD. There's a chapter on Vitamin B12. In summary it says "signs and symptoms - start treatment. Don't wait for confirmation, because B12 is completely safe whereas a delay to starting treatment could cause permanent damage. Oh and by the way, the blood test can be used to diagnose but not to exclude B12 deficiency". Even if the GP suspects something else, they should start B12 replacement therapy (injections) whilst carrying on further investigations, because B12 is about the safest vitamin supplement there is and doesn't interact with medication or therapy.
Is this some miracle? Not really. A (biased) reading of medical papers before 1890 suggests that around 20% of post-mortems were for symptoms that could be associated with B12 deficiency. Genetic studies suggest a propensity to B12 deficiency (ie inefficiencies in the recycling, transfer across various membranes, or utilisation within cell and/or mitochondria of B12) of 40% in Caucasian population. There's almost no B12 in the diet any more due to modern agricultural methods (farmers inject cattle with B12 to help them grow 3* as fast as they used to - if you were injecting, would you inject enough to make eaters healthy, or only enough to speed up growth?) and food processing (microwaves in the abattoir destroy B12 - hence the much longer shelf life of meat in supermarkets), so more of the 40% are likely to exhibit symptoms which can be cured by B12 replacement therapy (ie taking some as a supplement/ injection).
Does this mean that MS, ME, Hashimotos, and so on don't exist? Yes they do. They are clear descriptions of the symptoms observed. But if you want to cure them, you have to work out the root cause. And all of these (at least one or other form of them) respond to B12 replacement therapy.
The Scottish Parliament discusses Pernicious Anaemia and vitamin B12 deficiency on Wednesday 7 March 2012.
This video is over 1 hour long and represents real political change - we are at last on our way.
Frankie tells of how she suffered, the tests she had to endure until doctors worked out what was wrong, and what a difference it has made.
Donna, like so many women, wants to live a normal life. Vitamin B12 could give her that chance.
New documentary out from Elissa Leonard in North America, featuring Sally Pacholok and many other internationally renowned experts.
Julia found her eyesight going as her eyes refused to focus on the same things as each other. She's been for all sorts of tests and treatment, but now that she's on B12 replacement therapy she's starting to see an improvement.
The definitive and original guide to B12 deficiency, Dr Chandy interviewed by Chris Jackson of UK BBC Inside Out Team broadcast 31 Oct 2008.
Dr Joseph Chandy explains symptoms and shows the restorative effect on one patient (other patients' families have asked that we edit out their stories unfortunately)
The local MP (Grahame Morris MP for Easington - who was a BMS (BioMedical Scientist) in the labs at Sunderland Royal Infirmary) interviews people with B12 deficiency to hear their story (August 27 2010). Here Jane describes the symptoms, and how she can't wait for her next B12 injection (in fact, she knows that she needs injections every 2 weeks because she's keeping a diary of the symptoms). We're restricted how often the GP can give injections, which is why we want to raise awareness.
June describes her suffering when doctors didn't follow the standard protocol after any stomach or intestinal operation - to offer B12 replacement therapy
Janette first appeared in the BBC InsideOut documentary in October 2006. Since then the NHS has forced her doctor to withdraw B12 replacement therapy on a number of occasions, and she tells of her struggles with having B12 and then having it taken away.
She has bravely agreed to be filmed without her usual wig, but her memory is playing up because it is so long since her last injection.
Dr Chandy was nominated for the North East Local Heroes award. The interviewer was at first surprised - people don't get awards for doing what they are paid to do - but she persisted.