Category Archives: B12 Deficiency Neuropathy

B12 Deficiency Neuropathy

Dr. Rutherford:  OK so we’re going to talk about B12 induced neuropathy. We’re going to try and keep this relatively short. B12 has been … a lot of times patients come in Doc Gates and I do a lot of neuropathy it’s a pretty significant part of our chronic pain practice. So there’s a lot of different things that can cause neuropathy according to the research or within that research serious put out by the medical profession. The

Neurology Research Series. What about the black book that we beat up.

Dr. Gates:   Oh, OK the Contemporary Neurology Series.

Dr. Rutherford:   Okay so according to this Contemporary Neurology Series which is kind of the bible for the medical neurology field. They list approximately 80 difference reasons that a person can get neuropathy. So a lot of folks come in and have done their research and have come up well if I take Alapha Lipoic Acid or if I take B12 or if I take this and I took it and it didn’t work or I took it and it work. So we’re going to discuss that one mechanism of how that could potentially be involved or not be involved relative to who you are in neuropathy. With that I’m actually going to refer over to Dr. Gates on this. He’s done most of the research he works most directly with our neuropathy patients and I’m going to let him share his findings with you.

Dr. Gates:  And so I’m just going to say it anyways I’m a Board Certified Chiropractic Neurologist. Dr. Rutherford is a Certified Functional Medicine Practitioner. We look at nutrition heavily in our trim base and peripheral nerve cases. Now that being said, almost every patient of neuropathy come in invariabley taking B12. Now you need to know B12 deficiency neuropathy the prevalence or the agreed upon statistics on how may neuropathy patients have B12 deficient neuropathy varies. Some say 3% some say 7% but it’s pretty low overall. And so first of all you need to know that. Now let’s say you do actually have a B12 deficient neuropathy. We have to ask the question why do you have a B1 deficiency. Are you a vegetarian, are you a vegan. We have seen those cases, we have seen those cases and the critical factor was taking B12 and lots of time they may not absorb this. So they’ve had to get injections. We had to refer the patient for an injection.

Dr. Rutherford : And odds because.

Dr. Gates:  And that’s where I’m going next. And so commonly B12 can be deficient term initial pernema which is where the amount system attacks the factor that finds the B12. So let’s say you eat a big steak, that steak has B12 in it. That steak goes into your stomach. You stomach has to be acidic to break down the steak to get the B12 out. If your stomach is not acidic because you’re aging, because you’re on Prilosec. Prilosec the favorite purple pill.

Dr,. Rutherford: If you had acid indigestion which most of the time folks is caused by a lack of hydrochloric acid and you’re taking the purple
pill to destroy what little acid you have left which will then not break things down so that you can absorb your B12.

Dr. Gates:   Exactly. And so now…

Dr. Rutherford:  You could be having B12 prophylactic.

Dr. Gates:  Right. And so now if you’re not breaking down the B12 out of the fluids that you’re eating. You’re not going to be able to get it out of those foods and that’s one circumstance. Where I was going before relative to promisioin anemia is that the immune system can actually start to kill the factor that is secreted further down in our def intestinal track in terms of trim factor that finds the B12 and gets it into your blood stream. Also ,other confounding variables can be hypothyroidism which will not allow you to make enough hydrochloric acid in your stomach. So you can see immediately that it gets pretty complex, pretty quickly. And so any clinician looking at a case of B12 deficient neuropathy has to consider all those other factors int terms of why the person is not getting B12 from their dietary needs. And then figure out a strategy to get that B12 into the system. The studies are pretty good in showing that if someone has a B12 deficient neuropathy and they haven’t had it for a while and if you give them B12 in conjunction with some other techniques. They can start to feel a little bit better. Now B12 deficiency neuropathy can also go hand in hand with something termed sub acute combined degeneration of the spinal cord. Which is where because the body lacks B12 the spinal cords actually starts to degenerate as well. And it can be confusing for a neurologist to
really figure out is that going on with neuropathy or it just the spinal cord problem or just the neuropathy. There is some overlay there as well. So that’s what I would say relative to B12.

Dr. Rutherford:   And what symptoms might they look for in B12-neuropathy deficiency?

Dr. Gates:  B12 deficiency neuropathy patients commonly will have numbness in their feet commonly they’ll have some unsteadiness with their balance. Reason being is that the B12 tends to affect the pathways and the peripheral nerves as well as the spinal cord that involve things like sensing where your toes are at, which are critically important in balance. And commonly when we exam these patients they can’t feel vibration in their feet. They can’t tell which direction we’re taking their toe up or down so on and so forth. Now, the interesting thing we see clinically relative to working with  B12 deficient patients who have neuropathy is that if we figure out the underlying cause as to why they lack the B12 and fix that and then.

Dr. Rutherford:   Detect the B12.

Dr. Gates:  Maybe we need to take the B12, maybe you’re just a vegetarian you’re not getting B12. And then we couple that with some rehabilitation exercises that we use in our office to basically shock the nerves back into life. We’ve seen just some striking and dramatic improvements in B12 deficiency neuropathy cases. And it’s really gratifying because a lot of those who are suffer B12 as a mentioned, B12 deficiency, have problems with balance. And balance can be a major factor in leading to someone falling and fracturing a hip and it can be a disastrous event, let’s just say it that way.

Dr. Rutherford:    So if you have B12 deficiency OK. It’s a small percentage of neuropathy patients who have it. But 4 to 7% that’ significant, you know. And if it’s somehow determined that B12 deficiency just understand you need to check these other things out. You’re taking Prilosec and now you’re taking B12 and it isn’t working guess what, that might be the reason. OK, if you have hypothyroid you’re taking B12 it’s not working it may not be that you have a B12 deficiency it maybe that your thyroid needs to fixed. And I think that’s really the take away point for this because that’s generally what I hear when patients come in. Well, you know I took B12 it didn’t work. And then it turns out they have B12 deficiency but their trans fat is bad, their thyroids bad, their gut it bad so on and so forth. I think that’s a pretty good suppose. And think those are the important points for those of you who are researching or investigating of you have a B12 deficiency should …. I think those are the take away points. And it think that should be very helpful. Thank you for watching and if there are any other questions you can go to

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