Article #19: Well! You Wanted to Know! by V.V. Vetrano, B.S., D.C

What is vitamin B-12?

Vitamin B-12 is known as the anti-pernicious anemia factor. It is also called the extrinsic factor of Castle. It was first isolated in 1948 from liver as a red crystalline compound which contains cobalt and phosphorus. It is a water soluble vitamin and functions as a coenzyme in metabolism.

It is called cobalamin because it contains cobalt. The central structure, which contains cobalt, is referred to as a "corrin" ring system. One type of cobalamin contains cyanide, but in the latest edition of The Review of Physiological Chemistry, (p. 180) by Harper, Rodwell, Mayes and Lange, they say that the "cyanide group as a component of vitamin B-12 is an artifact introduced in the procedure used to isolate the crystalline compound from natural sources. It (cyanide) does not occur in the vitamin molecule as it exists in natural materials."

Cyanide is very toxic and the addition of cyanide to a vitamin does not seem to me to be desirable. It is known that this particular form of the vitamin is eliminated more rapidly than other forms and is not as effective as the other cobalamins, such as hydroxocobalamin. Some scientists think cyanocobalamin should be withdrawn from the market because it is not as effective as other cobalamins. ("Why Has Cobalamin Not Been Withdrawn," Freeman, A. G., et al, Lancet 1 (8067) p. 777-8, Apr. 1978). This simply stresses the view that Dr. Shelton and I have held for many years. We have always said that the mere extraction of vitamins from natural foods changes their character and renders them unfit for use, in as much as they are no longer combined with natural substances as they were in the natural food and are therefore digested and metabolized differently. The extraction of cobalamin from natural sources actually adds a toxic substance, cyanide, to the structure.

By reacting cyanocobalamin with other substances, it can be made into other derivatives of cobalamin. "Substitution of the cyanide group with a hydroxy group forms 'hydroxocobalamin'; with a nitro group, 'nitrocobalamin'; and with a methyl group, 'methylcobalamin'. The biologic action of these derivatives appears to be similar to that of cobalamin, although hydroxocobalamin (B-12A) is more active in enzyme systems requiring B-12 in experimental studies in vitro. Furthermore, although hydroxocobalamin given orally in large doses is absorbed as well as cyanocobalamin in similar doses, hydroxocobalamin is retained longer in the body; this suggests that hydroxocobalamin may be more useful for therapeutic administration of vitamin B-12 by mouth." The fact that it is eliminated more slowly than cyanocobalamin from the body could mean two things; either that it is hard to eliminate or that cyanocobalamin is more toxic. Synthetic substances do not function in metabolism exactly like the natural substance. Synthetic vitamins may be used as substitutions and fool people temporarily by masking symptoms, but they never metabolize or function exactly like the natural substance and taking the so-called "natural" vitamins never produces health.

The B-12 coenzymes, called cobamides, have been isolated not only from "several bacterial cultures but also from the liver of various animals (mainly dimethylbenzimidazole cobamide). The best source is a culture of Propionibacterium shermanii (ATCC 9614). The coenzymes are inactivated and converted to the vitamin form by visible light or by cyanide ion, the adenine nucleoside being removed or replaced by the cyano group. The methods originally used to extract the vitamin included heating in weak acid, addition of cyanide ion, and exposure to light. As a result it is likely that the coenzymes were converted to the vitamin and thus overlooked." (page 181, Review of Physiological Chemistry.) This brings to my minds a question. Perhaps they are not finding vitamin B12 in fruits and vegetables because it is in the coenzyme form or in another form or perhaps they are destroying it by their methods of finding it. The following quote brings out the fact that all the B vitamins are found together in nature.

The Nutrition Almanac, on page 18, warns that, "The most important thing to remember is that all the B vitamins should be taken together. They are so interrelated in function that large doses of any of them may be therapeutically valueless or may cause a deficiency of others. For example, if extra B6 is taken in 50-milligram potencies, it is important that a complete B complex accompany it. In nature, we find the B-complex vitamins in yeast, green vegetables, etc., but nowhere do we find a single B vitamin isolated from the rest. Natural forms of the B vitamins are preferable to the synthetic forms since the natural forms have all of the B factors, even those not yet known, plus valuable enzymes. Most preparations of single B vitamins are synthetic or, at least, no longer in their natural form. These synthetic B vitamins are used primarily to overcome severe deficiencies or serious physical conditions in which rapid results are needed. When taking supplements, it is very important to remember that the B vitamins exert many different effects upon each other; therefore, excesses and insufficiencies may be harmful."

We heartily agree with The Nutrition Almanac. All our nutrients should be secured through natural sources as they all function together and have a relation one to the other, and only by eating natural foods can we get our nutrients in the proper proportions one to the other.

How Stable is Vitamin B12?

Vitamin B12 can be heated at 100 degrees centigrade for long periods under certain conditions. If vitamin B12 is placed in an acid solution in a pH ranging from 4 to 7, that is, in a solution acid up to neutral, it can be autoclaved (steam heat under pressure) with very little destruction of the vitamin. "However, destruction is rapid when the vitamin is heated at pH 9.0 or above." A pH of 9 is very alkaline. Since vegetables are alkaline, this may mean that what little vitamin B12 is contained in vegetables is rapidly destroyed while cooking. This may be why researchers are unable to find this elusive vitamin in vegetables because they destroy it with heat in trying to extract it.

What does vitamin B12 do in the body?

Vitamin B12 acts as a coenzyme in metabolism. Only three cobalamins have been isolated from mammalian tissues; and of these only two forms of vitamin B12 are known to act as specific coenzymes in mammalian systems. "The two reactions in mammalian systems that are shown to be vitamin B12 dependent are (1) the conversion of methyl-malonyl-Co A to succinyl-Co A; and (2) the methylation of homocysteine to methioninc, which also involves folate coenzymes." A disease involving these conversions in metabolism is becoming more prevalent in modern times.

We must remember that vitamin B12 is an essential nutrient for all the cells of the body. It is necessary for the growth of all cells. Vitamin B12 with folic acid derivatives, are also necessary for DNA synthesis, and there are few who have not read of the importance of DNA to the body. When there is a complete lack of vitamin B12, cells can no longer divide, because their nucleus cannot mature. Without vitamin B12 the red blood cells cannot proliferate normally. They are malformed and they die more rapidly than normal cells.

Vitamins B12 is necessary for catalyzing the conversion of methylmalonyl-Co A to succinyl-Co A. Without these chemical transformations many serious symptoms develop.

A deficiency of vitamin B12 in humans causes the development of macrocytic anemia, and/or lesions of the nervous system. Sometimes both occur together. Sometimes the neurologic symptoms supervene without the development of anemia. Structural changes of the red blood cells are very reliable indicators of vitamin B12 deficiency. In this case blood tests may be valuable to determine whether or not you are properly absorbing vitamin B12. "In general, it may be concluded that when the intake of vitamin B12 is low, the demand for this vitamin in hemopoiesis exceeds that for any other clinically recognizable physiologic function. Macrocytosis is, therefore, a sensitive indicator of vitamin B12 deficiency." (page 183, Review of Physiologic Chemistry)

How do we absorb vitamin B12?

It has been well established that vitamin B12 is absorbed from the ileum. But its absorption is dependent on a factor called the Intrinsic Factor (IF), first named by Castle. It is present in normal gastric juice. It is secreted by the parietal cells of the gastric glands and is found in the cardia and fundus of the stomach but not in the pylorus: that is, it is found in the upper part of the stomach.

The free vitamin (cobalamin) becomes bound to the intrinsic factor, which is thought to be a glycoprotein. The combination of vitamin B12 with the intrinsic factor results in the formation of a complex substance that resists intestinal digestion.

In foods, vitamin B12 comes combined with proteins, or the protein break-down byproducts, such as peptides. These must be split off by the processes of digestion before absorption can take place. The members of the vitamin B12 group are very large molecules and this is considered the reason it is necessary for them to be combined with intrinsic factor for absorption. The body must actively absorb the vitamin and the cobamides with the consequent expense of energy. They cannot be absorbed by mere diffusion across the intestinal mucous membrane, unless administered in huge doses.

"They are not lipid-soluble and, according to Wilson (1964), the molecules are too large to enter the hypothetical water-filled pores in the lipid membranes of the absorptive cells, so that any absorption by simple diffusion would appear to be precluded."

Experiments conclude that, under physiological conditions, humans can absorb only about 2 ug/day of vitamin B12. Only after the vitamin is combined with intrinsic factor, can it cross the intestinal barrier. If high doses of the pure vitamin are given, however, some can diffuse through the intestinal mucous membrane because of discontinuities. A discontinuity is a sign of a damaged mucous membrane. In health all the membranes of the intestinal tract will be intact.

The intrinsic factor is a glycoprotein secreted by the parietal cells of the gastric mucosa and is necessary for the absorption of vitamin B12. The first stage of absorption is good digestion. The vitamin must be separated from the materials to which it is bound before it can be combined with the intrinsic factor. In food, B12 compounds are largely protein or peptide-bound and these must be separated from the vitamin by digestive juices before B12 can be combined with the intrinsic factor. Only after separation from the protein, to which it is bound, can the B12 compounds combine with the intrinsic factor. The third stage of absorption is to transport the vitamin B12 into the cells of gastrointestinal mucous membrane.

After vitamin B12 has combined with intrinsic factor it is in a complex form that fortunately resists further intestinal digestion. For normal absorption the pH must be neutral and calcium ions must be present. The vitamin has two receptor sites for absorption and one of them combines with intrinsic factor and the other with the ileal intestinal microvilli. The microvilli readily become saturated and this limits the absorption of vitamin B12 to about 1.5 ug after any one dose of the vitamin. The current thought is that the intrinsic factor is released by a "releasing enzyme" within the intestine, so that the vitamin can pass into the mucosal cell.

Absorption is limited and the maximal absorptive capacity in humans under normal conditions, is about 2.ug/day. Most sources state that humans require only 1 ug/day.

The vitamin, when given in large concentrations is thought to get into the body by passive absorption, but researchers attribute this to discontinuities of the lining of the intestines. About one percent of very large doses of vitamin B12, such as 3000 ug is absorbed passively. The intrinsic factor appears to be necessary for absorption of very small amounts, such as are found in food.

Where is vitamin B12 absorbed; Can it be absorbed from the stomach or colon?

Vitamin B12 is absorbed mainly through the ileum, although there is only evidence that some absorption might also occur in the upper small intestine. Even though research physiologists transpose ileal tissue to other areas of the intestine, it still maintains its superior capacity to absorb vitamin B12. This supports my view held all along before reading this material; i.e. that the ileum had a function and since the colon couldn't absorb vitamin B12, it was probably done in the ileum. It has long been known that bacteria produce vitamin B12 in the colon. If bacteria can do this in the colon why should they not also do so in the ileum, where the absorptive mechanisms are still in operation?

Why are some people deficient in vitamin B12?

There are many reasons why vitamin B12 may be lacking. Most of them center around failure of absorption and not because the vitamins are lacking in the diet. Articles dealing with the pathology of absorption of vitamin B12 classify defects of vitamin B12 absorption into two main groups: (1) "those due to defective gastric secretion (i.e. lack of IF) and (2) those due to defective intestinal absorption."

Naturally if most of the stomach has been excised by surgery there will be little intrinsic factor secreted and consequently little vitamin B12 absorption. "After partial gastrectomy, some IF-secreting mucosa usually remains, and severe impairment of vitamin B12 absorption does not usually occur unless the mucosa of the gastric remnant undergoes atrophy."

Gastric atrophy accounts for malabsorption of many vitamins. Atrophy occurs after many years of irritation to the stomach mucosa by wrong ways of living and especially from wrong ways of eating. The stomach is the most abused organ of the entire body. When each year we pour in chocolate, coffee, tea, alcohol, hot peppers, chemicals, mustard, salt, aspirin, garlic, onions, drugs and other irritants by the tons how can we expect our digestive tracts to remain normal? When we eat all sorts of poor food combinations, so that instead of digestion we get indigestion, how can we expect any nutrients to be left for us? Bacteria use them. The stomach and intestines naturally become irritated and inflamed from all the decomposition products of bacterial decay.

Put some salt or any one of the above condiments into an open wound and you will readily understand the word irritant. Then when on top of all the above irritants we combine our foods so poorly that instead of digestion we get indigestion and its concommitant poisonous and irritating end products, we have double trouble. Gastric irritation goes from irritation, to greater irritation and finally inflammation, (gastritis or duodenitis, or gastroenteritis, or ileitis, or colitis or all at once.) When these conditions are severe, atrophy is only one consequence. Cancer is another. Ulcers are still another. After many long years of irritation and chronic inflammation, normal functioning cells of the digestive glands die, then digestion is naturally impaired. Not only will the stomach not secrete the intrinsic factor, if it indeed exists, but it will not digest the protein off the vitamin B12 to permit it to be combined with IF for absorption.

Juvenile pernicious anemia is a rare condition. The secretion of intrinsic factor is congenitally absent, but the other secretory functions of the stomach are usually normal. This is just another example of the fact that as a race, we are deteriorating. Recently I've read articles intimating that formerly humans were able to manufacture their own vitamin C. If this is true, then you can see how far the deterioration has gone. A missing enzyme here and there can make a world of difference when it comes to health and life. However, most of the pernicious anemia of childhood is acquired. In these cases it is noted that there is gastric mucosal damage. This again points to the fact that enervation, by wrong living habits, and especially poor care and feeding of children, causes toxemia with the development of diseases that impair the function of the gastrointestinal tract.

There are many reasons why vitamin B12 is not absorbed from the intestines; there are as many reasons as there are enzymes and catalytic reactions. Such diseases as idiopathic steatorrhea, coeliac disease, tropical sprue, and lesions of the small-intestinal wall, such as regional enteritis and intestinal tuberculosis, and intestinal resections—particularly when the ileum is involved, are reason enough for mal-absorption of all nutrients, not just vitamin B12. Other anatomical abnormalities such as small-intestinal diverticula, enteroanastomoses and blind loops of small intestine (blind-loop syndrome) also cause failure of absorption of vitamin B12. Experimental evidence leads researchers to believe that in some cases, especially when surgical blind loops are left in the abdomen and in cases of diverticulosis, where there are stagnating feces, that more bacteria thrive and these use up the vitamin B12 of the host. They also produce toxic factors, which interfere with the absorption of vitamin B12. Bacteria also deconjugate bile salts and impair mucosal function through the toxic effects of free bile acids. Recently cases have been reported of transport defects of vitamin B12 in children and young people. It is familial and associated with proteinuria. "It is quite distinct from juvenile pernicious anemia." People who are infested with fish tapeworm also develop anemia. One reason is that the worm takes up vitamin B12 itself and produces a factor which splits vitamin B12 from intrinsic factor and then finally gastric atrophy develops from the lack of vitamin B12 itself.

Vitamin B12 and folic acid are very important to rapidly dividing cells such as those of the bone marrow and even those cells lining the gastrointestinal tract. They need vitamin B12 for multiplying rapidly, as they are supposed to. Vitamin B12 is also necessary for the absorption of other nutrients from the intestines. A lack of B12 depresses the function of the gastric mucosa. Some cases are attributed "to the production of a defective intrinsic factor or intrinsic factor: B12 complex as well as to a defective ileal receptor for intrinsic factor: B12 complex. "

In short, most cases of pernicious anemia or a low level of vitamin B12 arise out of impaired function somewhere along the gastrointestinal tract and not because there is a lack of vitamin B12 in the diet, even in Vegans:

This brings us back to basic Hygiene. Remove the causes of disease and the body will heal itself. In these cases of impaired function, fasting, rest, exercise, and sunshine will restore the body's ability to absorb vitamin B12 in all except those who have had their stomachs and intestines surgically excised or impaired by surgical blind loops, and those who were born not secreting the intrinsic factor or with a defect in metabolism of B12, such as those born with Methylmalonic Aciduria. Even in those cases where gastric or intestinal atrophy plays a part, the improved digestive capacity after fasting, with proper combinations of food, so that there won't be so much decomposition of foods in the intestinal tract will improve absorption. Better food combinations means fewer of the types of bacteria that use vitamin B12 can exist so that the bacteria that do produce vitamin B12 can do their job properly. Less decomposition in the intestinal tract will promote the proper bacterial flora that make vitamin B12 instead of using it.

There are so many intricacies of digestion and absorption that are still unknown, that can go wrong when we are in ill health, that the only way to insure proper digestion and absorption is to maintain good health. No matter which way you look at it, it comes back td the same basic principles of right living. If you live Hygienically, eat uncooked natural foods—fruits, vegetables, nuts, and seeds—and secure all the other requisites of physiology then your body will function normally for you and it will absorb all the vitamin B12 necessary for health. Hygiene does not need to be changed. We've got to realize where the real fault lies and eliminate it. Dosing our people with vitamin B12 instead of removing causes is the same as giving drugs. If we start this, it won't be long before we are among the poisoning profession. All it takes is that first blind compromise.