Hello Crohnies! Sorry for the lack of posting recently. Apparently I’m not the most consistent blogger… But to be fair I have had a lot on my plate. And more than just SCD food!
About a month ago I started experiencing some weird sensations. Tingling and numbness on patches of my body, but primarily my arms and legs and the side of my face. Naturally I became very worried and started doing some immediate research.
Many different conditions can cause peripheral neuropathy, but one of them is severe, prolonged B12 vitamin deficiency. As many of you are already aware, vitamin deficiency is very common in Crohn’s disease or any disease that results in malabsorption or small intestinal bacterial overgrowth (SIBO).
I immediate started taking 4 mg of B12 sublingually daily. I did this for about a week prior to getting blood testing for B12 deficiency. My results actually came back high but I have to wonder if these were skewed by my high dose intake in the previous days. It is also possible that my symptoms are not due to B12 deficiency, but I will say I felt almost 100% better a few days after receiving a 1 mg B12 injection intramuscularly. Begs the question!
Another interesting tidbit regarding B12 levels: even though the reference interval in North America is 200-900 pg/ml symptoms of neuropathy can be seen when levels are lower than 500 pg/ml. In Japan the low end of the B12 reference interval is 500-550 pg/ml. Supplementation is done if levels are lower.
Furthermore, since tissue B12 concentrations don’t always correlate with serum levels, other tests to determine B12 deficiency are needed. These are methylmalonic acid (MMA) and Homocysteine (Hcy). B12 vitamin is needed for the pathway that metabolizes these chemicals in the body so one or both should be elevated in a B12 deficient individual. Although we also have to take into account that normal levels may not rule out B12 deficiency, since we develop reference intervals based on a “healthy” population of people. It is becoming increasingly apparent that our North American population is largely B12 deficient. Most of us just don’t have obvious symptoms.
It is my feeling that my symptoms are due to B12 deficiency. Knowing B12 is absorbed in the terminal ileum, it makes sense that Crohnies will have problems maintaining healthy levels of this vitamin. Add to this issue strictures and SIBO, and you have a recipe for dangerously low B12 levels.
I sign off here fellow IBDers! Keep your nerve fibers intact. Supplement B12 under the guidance of your physician!
