Tag Archives: Vitamin B

Anything from the B complex of vitamins

2822 PubMed hits say the medical establishment is not “ignoring” B12

According to a callout in the January 2015 story punting Vitamin B12 as a miracle cure for all ills (and bigging up Brave Maverick Doctor Joseph Chandy),

The Medical Establishment has chosen to ignore the evidence on B12 as an inexpensive and promising answer to depression

If only there was a quick and easy way to check that claim for accuracy.

Wait! There is! A PubMed search. 2822 results. OK, not all will necessarily be relevant, but this is hardly “ignoring” it.

That said, there is a very substantial difference between the cautious claims of scientists and the bold and striking claims of Dr. Chandy.

Several nutritional and physiological factors have been linked to depression in adults including low folate and vitamin B-12 and elevated total homocysteine (tHcy) levels. (source)

These symptoms are common in undiagnosed coeliacs, where they are effects of an underlying disease, markers, not necessarily causes. B12 and folate deficiency are very often the result of malabsorption in patients with autoimmune disorders such as coeliac and Crohn’s, where the gut wall is compromised.

Conclusions: Future interventions aiming at improving mental health outcomes among US adults should take into account dietary and other factors that would increase levels of serum folate.

Damn, they missed the ball. They could have sold vitamin B12 pills to self-diagnosing worried-well patients. These scientists, they are so off message it’s untrue.

 

Ditch dairy and wheat

WDDTY loves nothing more than a bandwagon, and if one bogus treatment won’t do there’s bound to be another along any minute.

If your vitamin levels check out but you are still depressed, think twice about dairy and wheat. Nutritionists have discovered morphine-like substances called ‘exorphins’ -derived from the incomplete digestion of proteins in cereal grains and dairy products-which may be a possible cause of depression.

Stop right there. Nutritionists have discovered nothing, other than how to fleece the credulous.

Scientists and dieticians, however, have indeed discovered this, but the devil is in the detail, as we shall see in a moment.

The evidence reveals five distinct exorphins in the pepsin digests of gluten, and eight other exorphins in the pepsin digests of milk.

J Biol Chem, 1979; 254: 2446-9, cutting edge research form the bottom of WDDTY’s clipping drawer there.

Peptides with opioid activity are found in pepsin hydrolysates of wheat gluten and alpha-casein. The opioid activity of these peptides was demonstrated by use of the following bioassays: 1) naloxone-reversible inhibition of adenylate cyclase in homogenates of neuroblastoma X-glioma hybrid cells; 2) naloxone-reversible inhibition of electrically stimulated contractions of the mouse vas deferens; 3) displacement of [3H]dihydromorphine and [3H-Tyr, dAla2]met-enkephalin amide from rat brain membranes. Substances which stimulate adenylate cyclase and increase the contractions of the mouse vas deferens but do not bind to opiate receptors are also isolated from gluten hydrolysates. It is suggested that peptides derived from some food proteins may be of physiological importance.

This paper is by now mainly quoted in the alternative journals, it seems, but the finding is unsurprising.

These foods can also inhibit the takeup of nutrients like B12. Exorphins act like depressants, and it’s now thought that the immune reactions that arise from eating these foods include a number of psychiatric symptoms, even simple ‘brain fog’.

Well done, linking both stories to try to provide support for the Brave Maverick Doctor, Joseph Chandy.

Depression has also been linked to allergies and coeliac disease, where the inner lining of the small intestine (the mucosa) is damaged after eating gluten-containing grains like wheat, rye, oats and barley.”‘ According to a recent review, as many one-third of adult coeliacs suffers from various vitamin deficiencies and neurological changes, including depression.

AmJ Gastroenterol, 1999; 94: 839–43:

Untreated celiac disease can lead to serious behavioral disorders. We describe three adult patients with undiagnosed or untreated celiac disease without particular intestinal signs, causing persistent depressive symptoms in three of the parents of our pediatric patients.

See the important bit? These are coeliac patients.

lranJ Neurol,2012; 11: 59–64:

Celiac disease or gluten sensitivity may initially present as one or more neurological signs and/or symptoms. On the other hand, it may be associated with or complicated by neurological manifestations. Neurological presentations are rare in children but as many as 36% of adult patients present with neurological changes. With severe malnutrition after progression of celiac disease, different vitamin deficiencies may develop. Such problems can in turn overlap with previous neurological abnormalities including ataxia, epilepsy, neuropathy, dementia, and cognitive disorders. In this study, we aimed to review the neurological aspects of celiac disease. Early diagnosis and treatment could prevent related disability in patients with celiac disease.

So, not only does this undermine your proposed causal link between vitamin B12 and depression (vitamin deficiencies are very common in coeliac patients due to malabsorption), but they fail to establish any link outside of coeliac disease.

The correct advice is not to arbitrarily cut out gluten, but to see your doctor and find out if you an undiagnosed coeliac. Adult diagnosis is now very common and estimates range from under half a percent to around one percent of the population. Get a TTGA test, not a quack diet, because non-coeliac gluten sensitivity may well not exist.

 

Banning B12

WDDTY has a bit of a downer on the medical establishment, especially since they struck off Andrew Wakefield on the ridiculously flimsy basis that he conducted unapproved invasive tests on vulnerable children, concealed conflicts of influence and published fraudulent research.

So it’s not a surprise to find them championing the cause of Dr. Joseph Chandy, a GP who discovered dreamed up the idea that Vitamin B12 deficiency is the cause of anaemia, multiple sclerosis, dementia, depression, confusion, myalgic encephalomyelitis chronic fatigue syndrome, migraine, tinnitus, neuralgia and (of course!) autism.

One of the hallmarks of quackery is that it claims to cure a vast range of completely different diseases. And one of the other hallmarks of quackery is that it gets you in trouble with the GMC.

The trouble with WDDTY’s narrative here is that it depends on the idea that the medical establishment would act against someone promoting a cheap and effective cure for numerous diseases, in order to protect pharmaceutical industry profits. The alternative, that he has failed to produce credible evidence to back his treatment decisions and that he is a lone voice because he is wrong, is not considered – or if it is, it is rejected, because WDDTY wants to believe that a vitamin can cure these diseases.

Sadly, science doesn’t tend to reward wishful thinking (regardless of how assiduously Lynne tries to prove otherwise with her “intention experiment”.

Luckily for Chandy, if the Saatchi Bill passes, mavericks who promote treatments with no evidence and no support from the wider medical and scientific community will be allowed to prey on patients provided they are especially vulnerable to predation.

You might want to stop that happening.

Heartburn drugs increase risk of nerve damage, anaemia

heartburn bollocksWhat WDDTY said:

Heartburn drugs increase risk of nerve damage, anaemia

What the source said:

Previous and current gastric acid inhibitor use was significantly associated with the presence of vitamin B12 deficiency. These findings should be considered when balancing the risks and benefits of using these medications.

The source additionally shows that:

  • 12% of people with Vitamin B12 deficiency are taking PPIs (i.e. most are not)
  • 7.3% of people without Vitamin B12 deficiency are taking PPIs
  • 4.2% of people with vitamin B12 deficiency are taking H2RAs
  • 3.2% of people without vitamin B12 deficiency are taking H2RAs

Here’s how WDDTY interpreted this:

Heartburn and acid reflux medications are causing B12 deficiency, which can lead to nerve damage, anaemia and dementia. The medications, known as PPIs (protein pump inhibitors), increase the risk of vitamin deficiency by 65 per cent in those who take them longer than two years, say researchers at the Kaiser Permanente research division. Similar risks have been seen in those who take higher-strength drugs but for shorter periods. PPIs are among the most common pharmaceuticals; in the US alone, around 157 million prescriptions for the drugs are written every year. The researchers discovered the B12 deficiency risk when they analysed the records of 25,956 people with the deficiency and compared them to 184,199 people with normal levels of B12. Twelve per cent of those with a deficiency had been taken a PPI for at least two years compared to 7 per cent in the healthy group. (Source: JAMA, 2013; 310: 2435-42)

Sadly space did not permit the following quotes from the investigators:

These findings do not recommend against acid suppression for persons with clear indications for treatment, but clinicians should exercise appropriate vigilance when prescribing these medications and use the lowest possible effective dose.

At a minimum, the use of these medications identifies a population at higher risk of B12 deficiency, independent of additional risk factors. (emphasis added)

Here are some of the problems with WDDTY’s slant:

  • The study only covers courses of 2 years or more. The absence of the words “long-term” from the WDDTY headline is scaremongering.
  • The study does not show a link between PPIs and H2RAs and dementia, anaemia or nerve damage. This is a potential secondary effect of Vitamin B12 deficiency. The implied direct link is scaremongering.
  • The study results clearly show that if all PPI and H2RA mediated B12 deficiency stopped overnight, the overall effect on B12 deficiency levels would be barely noticeable.
  • As an observational study, no causal link is established (though it is entirely plausible and quite likely to be at least contributory).

So, WDDTY’s hysterical anti-medicine agenda leads it to turn “long-term use of certain classes of drugs for acid reflux may increase your risk of vitamin B12 deficiency” to “HEARTBURN MEDICINE CAUSES DEMENTIA“.

Now put yourself in the position of someone who has short-term acid reflux, perhaps as a result of pregnancy. Would the difference between these two statements be significant to you? You can see how an Ob-Gyn news journal covers the story here.

Who’s most at risk of dementia? Perhaps the following might have been considered relevant, taken from Ob Gyn News:

The association between vitamin B12 deficiency and the use of acid inhibitors was strongest among patients younger than 30 years of age and diminished with increasing age.

And why don’t doctors tell you this? Oh wait, they did. One of the researchers was part-sponsored by “big pharma”, even though the findings are clearly not to big pharma’s advantage.

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