The Pernicious Anaemia: The Forgotten Disease: The Causes and Consequences of Vitamin B12 Deficiency book. But buy the book listed first, first! Click here to read my review of this book.
New Views On Folic Acid by Karlis Ullis, M.D. and Cristiana Paul, M.S. Nutrition
Is the mainstream still cheating you out of the best health possible—with folic acid?! by Dr. Jonathan V. Wright, MD
Good Fats and Vitamin B12, Imperative Brain Fuel by Becky Plotner
The Meat of B12 Deficiency: Interview with Sally M. Pacholok, R.N., B.S.N.
The Vitamin You Need for a Sharp Brain as You Age - Yet 1 in 4 are Deficient and Vitamin B-12 Deficiency Might be Causing Your Chronic Cough and Why Most Vitamin B12 Supplements Do Nothing by Mercola
The effects of B12 deficiency (brain image comparison) by Nora Gedgaudas
Methyl Life dosing article on folate dosage
More B12 links still:
I understand that it is very important for B12 deficiency advocates to make clear that B12 is a non-toxic treatment and can cause no harm.
BUT I think for many patients this creates a lot of confusion and misunderstanding because when they start to take even a little bit of B12 it makes them experience all sorts of start-up symptoms. Feeling extreme fatigue and tiredness after taking B12 seems to be the most common effect although headaches are also common. It can be very disabling and scary and leave a patient in a semi-conscious state for hours each day or liable to pass-out unexpectedly and possibly dangerously (i.e. in the bath!). The symptoms are made worse by the patient not being aware that they may occur and so not being able to prepare for them.
Methyl B12 in higher doses can also change the sleep-wake cycle. Patients can end up sleeping for fewer hours each night due to unavoidable early morning waking etc. This can cause significant problems for many people and severe problems and relapse for patients that are already very ill. Some ill people need 8 or 9 or more hours of sleep to function at all or to have any quality of life. Lack of sleep may cause some diseases to deteriorate.
So while B12 is not toxic, it can actually cause harm to some patients. This harm is likely only short term and will be tiny when compared to the horrific neurological effects of an untreated B12 deficiency but it is still harm.
Many with very severe B12 deficiency don't have negative symptoms even with the initial loading doses of several injections a week. They feel great right away or at least don't have any real issues with it. These patients are described well in the B12 literature.
But a significant number of people do have very big reactions and most importantly to some extent this can indicate that actually a patient has a big huge need for B12! (Perhaps these people have detoxification system issues along with their B12 deficiency, needs more potassium, has another serious deficiency, or are more ill or just more sensitive in some other way, it's not clear.)
These B12 start-up symptoms do seem to pass over time. But it can and does take weeks or months for this to happen sometimes. Until then B12 treatment can be quite hard going and difficult - even when at the same time the B12 may be doing a wonderful and noticeable job healing damaged nerves. Start-up symptoms and positive signs of B12 treatment can occur at the same time.
It should also be noted that many good MTHFR websites warn that B12 and folate startup symptoms are very common and to be expected, especially in patients that are significantly ill. They strongly warn against ever starting at a high dose of sublingual B12 right away and explain that will often make you very ill. No such warnings are given by many B12 deficiency resources (aside from advice to take lots of extra potassium as this is depleted by B12 therapy at first) while at the same time beginning B12 treatment at an extremely high dosage such as daily injections is recommended very often.
I think more clarification on how common B12 start-effects are in some people is urgently needed by B12 experts. It is a tragedy that some people read up about B12 and read nothing about negative effects and so assume when they experience them that this means B12 will cause issues for them forever or that continuing the B12 probably wouldn't help them much. Patients need to be told that mild-severe start-up symptoms may occur and that these effects do NOT indicate an intolerance to B12 or an overdose of B12 but only a need in some cases to perhaps go a bit slower with building the dose up.
There is also a big chance that feeling these start-up symptoms means your body is in desperate need of B12 and will do wonderful things for your health with it once you give it enough!
There are two forms of activated B12 - methylcobalamin and adenosylcobalamin. A lot of the information given about B12 does not make it clear that taking a reasonable amount of just one of these forms could still leave you with a B12 deficiency. Some of the cutting-edge MTHFR websites explain that ideally it's best to take both some methylcobalamin (or hydroxycobalamin, which can be converted in the body to methylcobalamin in most people) as well as some adenosylcobalamin. These two forms do different things in the body and not everyone may convert between different types well. It seems like a person can be deficient in one or both forms of B12, and so all B12 is not necessarily B12.
For this reason it'd be a great move if all sources of B12 information gave clear information about the benefits of taking both active B12 types and not just one of them.
This issue is particularly important when considered together with the issue of severe start-up reactions caused by high-dose methylcobalamin and/or hydroxycobalamin supplementation. Patients experiencing these reactions may well switch to the adenosylcobalamin B12 form which does not cause the same issues precisely because it is not doing the same job as methylcobalamin. The problem is that just taking this form of B12 alone is likely still leaving a serious B12 deficiency mostly untreated, while at the same time the patient may feel their risk of B12 deficiency has been entirely averted.
If it weren't already taken by orotic acid, perhaps we could start referring to adenosylcobalamin as B13? I'm kidding of course, but the differences between B12 types do need to become more well known generally.
I'd be great if the information on B12 deficiency recovery percentages could be more complete. Information about whether or not patients were taking other myelin rebuilding nutrients along with the B12 or were just taking B12 (and maybe folate and B6) would be so interesting to know. If only B12 research could be as well funded as it deserves to be!
Note that the aim of this site is to provide a starting point for health and healing research for ill people; especially very overwhelmed and disabled ill people. This site provides recommendations, summaries and reviews of books but is not meant to be a replacement for actually reading some of these wonderful health books if the reader is at all well enough to do so. (Plus getting individualised advice from a doctor that is also an orthomolecular medicine expert if possible). There is no substitute for reading as many of these books as you can. The HHH site can only really hint at their full brilliance. The amount of insight, scientific references, logic, intelligence, compassion and experience in the recommended books will most likely amaze you. HHH aims to encourage people to do their own reading and learning, and to always make up their own minds. All content copyright Jodi Bassett 2006 - 2014.