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Vitamin B12 & Breast Cancer

Dear DOCTOR Owen:

I had a gastric bypass for obesity. I was told that I need monthly Vitamin B12 injections for the rest of my life. My military insurance plan paid for my surgery, but won’t cover the B12 injections. They say that B12 is a food; the insurance company won’t pay for food. I know that B12 deficiency can cause anemia. Are there serious consequences to not taking B12?

B12 Rejected

Dear “Rejected”:

Absolutely. By all means, do not miss the Vitamin B12 injections. Not only can a deficiency cause anemia, but it can also cause your spinal cord to rot and your brain cells to wither—and perhaps even lead to certain types of cancer. B12 is a vital compound in the synthesis of DNA in the body. DNA is the genetic code that determines if a cell lives, dies, or mutates to some other type of cell—including cancer.

Vitamin B12 deficiency can be seen in a variety of conditions. The most common cause is pernicious anemiaan autoimmune disease that occurs when the defense system attacks the lining of the stomach and there isn’t enough B12 in the lining to complete the absorption. If the lining, or a part of the lining, of the stomach is attacked, removed, or bypassed (as in your case), B12 deficiency can occur. Aging is associated with a much higher chance of damage to the stomach, causing B12 deficiency.

Likewise, patients who are missing the ileum, or the part of the small intestine near the appendix—usually resulting from surgery or a consequence of Chron’s disease—also develop B12 deficiency. B12 is “prepared” for absorption by the stomach, but is absorbed in the ileum. In addition, surgical changes in the bowel can lead to an overgrowth of bacteria (called a blind loop). A Vitamin B12 injection may be necessary to correct this situation.

B12 can be found in a variety of foods. It is so common that deficiency from malnutrition is almost unheard of these days. If the stomach and intestine are intact, there is enough B12 in a good multivitamin to ensure proper absorption. The vitamin is stored in the liver. It may take up to a year to deplete those liver storages, even when absorption is cut off. Liver disease enhances the chance of B12 deficiency.

Researchers at Tufts University, in Boston, Massachusetts, reporting in Nutrition Review, Vol. 57, No. 8, 250–253, found that post-menopausal women had an increased risk of breast cancer. Those with B12 levels in the lower one-fifth of average levels had a significant increase in risk of breast cancer. These B12 levels were in the lower “normal” ranges in many women, based on the “normal” values set by testing labs. B12 injections are not usually covered by insurance unless the insureds can prove deficiency based on the normal ranges in lab tests.

Disease occurs when there is an increase in DNA strand breaks resulting from a disturbance in folate (another vitamin) metabolism. The lack of folate decreases thymidine and purine metabolism and causes uracil to be inserted in the DNA instead of thymidine. The abnormal insertion of uracil eventually leads to a break in the chromosome, which can kill or mutate the cell. When this occurs in combination with other causes of chromosome mutations, cancer often results. In the case of anemia, the red blood cells are defective because of the chromosome changes and are destroyed in the bone marrow because they are “faulty”—never make it into the bloodstream.

B12 deficiency can occur, even if the complete blood count (CBC) does not indicate the presence of anemia. Therefore, have your B12 blood levels checked periodically. While B12 can be absorbed under the tongue, I would not trust my health to taking this approach alone. Injection is the only guaranteed way to replace depleted stores.

B12 deficiency can be devastating to the nervous system, causing spinal cord damage with clumsiness, numbness, and balance problems. B12 deficiency can cause dementia that mimics Alzheimer’s disease, depression, memory loss, mood swings, and even psychosis (mental breakdown). I’m sure that your military insurance will cover the physical therapy, brain scanning, and even some long-term nursing home services you will need when diseases manifest.

Obesity surgery costs $40,000 without complications. A magnetic resonance imaging (MRI) scan of the brain costs $1,200. One vial of B12 with 1-cubic-centimeter syringes, which will last a year, costs approximately $15. If necessary, bite the bullet and buy the stuff.


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