Functional B12 deficiency in Chronic Fatigue Syndrome, 2022, Russell-Jones

Functional Vitamin B12 deficiency in Chronic Fatigue Syndrome International Journal of Psychiatry - Gregory Russell-Jones.(2022). Int J Psychiatry 7(3): 153-158.
See
https://www.researchgate.net/public...Fp-PQDRD6aWewa5PyWhRVkLl1U3oTH7Kakm5IQ_oFqa-8

Abstract:

Chronic Fatigue Syndrome/Myalgic encephalomyelitis (CFS/ME) is a complex chronic condition, characterized by periods of extreme fatigue, for which an underlying medical condition has previously not been identified. Many of the symptoms of CFS/ME, are, though, similar to those with vitamin B12 deficiency. In contrast to nutritional vitamin B12 deficiency, the majority of individuals with CFS have been shown to have functional vitamin B12 deficiency as well as functional vitamin B2 deficiency. This functional B12 deficiency occurred despite elevated serum B12 being found, and hence presents as Paradoxical vitamin B12 deficiency. As such, CFS due to functional B2 deficiency presents as Paradoxical B12 deficiency. Maintenance of vitamin B12 functional activity is critically dependent upon functional B2 sufficiency, and hence resolution of CFS there must first be resolution of functional B2 deficiency before treatment with vitamin B12 can be effective.

 

This looks like complete garbage from someone who is trying to sell B12 oil.

 

Why is it garbage?

 

About the author Gregory Russel-Jones:

https://au.linkedin.com/in/gregrusselljones

 

I'm not trying to sell anything. I have functional B12 deficiency. I developed eczema aged 9 or 10 and spots/zits when I was about 11 or 12. I was assured by my mother (and doctors) that I would grow out of the spots and possibly even the eczema by the time I aged out of my teens. It never happened. I still had both conditions in my late 40s and early 50s. It's embarrassing having "teenage" spots at that age. I started taking methylcobalamin at a fairly high dose as well as methylfolate. And, although it took several weeks, I eventually found that my spots and eczema vanished. If I run out of either the methyl-B12 or the methyl-folate my spots and eczema start to make a reappearance.

I'm not suggesting that functional B12 deficiency affects everyone the same way that it does me.

My folate levels have a tendency to drop rapidly if I stop taking the methylfolate. But my B12 levels (both serum and active) are always extremely high. I have copies of B12 test results going back 10 years and they have only dropped back into range once during that time. It is common for my level to be > 2000 ng/L.

One other factor is that I very much doubt I had taken methylcobalamin and methylfolate before about 2012 or so. Before that I would only have taken cyanocobalamin and folic acid.

 

Discussion

Measurement of many metabolic markers in OAT revealed reduced metabolism of glucose (elevated lactic acid and pyruvic acid), fatty acids (elevated adipic acid and suberic acid), and proteins (elevated glycolic acid, glyceric and oxalic acid) as well as reduced metabolism of citric acid in individuals with CFS. In this regard, elevation of these Organic acids reflects energy loss into urine. The metabolism of each of the above is linked to mild functional vitamin B2 deficiency, and is supported by the elevated glutaric acid marker – representative of functional B2 deficiency. In addition, levels of citric acid were raised, which is characteristic of a block in the iron-sulphur enzyme aconitase. We have shown previously that such a block is due to uncoupling of the enzyme aconitase when levels of ferritin in serum drop below 60 ug.

 

So, does that mean that someone with this problem who eats, say, a bar of chocolate, will end up with higher than desirable levels of glucose in the blood? And what does the body do with it? Convert it to fat?

I've had problems with iron all my life, as do almost all of the females, and even a few males, on my mother's side of the family. I think my ferritin would have been below 60 ug/L most of my life. It isn't that low now. But then I started testing and treating my own iron and ferritin levels a few years ago.

 

My ferritin levels started to drop when I developed M.E., but I no longer have low levels since menopause.

My B12 drops too. I haven't been tested in a few years so I take oral methylcobalamin.

 

Senior Consultant
B12 OIls Pty Ltd
Jul 2016 - Present6 years 2 months

Senior Biochemist
Studying the Biochemistry of Autism, Chronic Fatigue Syndrome (CFS/FM/ME) and Dementia

Director, Consultant
Mentor Pharmaceutical Consultants
2007 - Present15 years

Biochemical consultant specializing in the Biochemistry of diseases such as Chronic Fatigue/Fibromyalgia/ME, Autism and Dementia.

Consultant providing consultancy services to Biotech Start up companies, Pharmaceutical and Scientific Research companies in the areas of oral protein delivery (insulin, antibodies, EGF, IGF), topical protein delivery (insulin, Growth Hormone, IGF, EGF, vitamin B12, Anti-TNF molecules, vitamin B12), transdermal protein delivery, cancer targeting (polymer…

 

It's a single author paper in a junk journal from someone who concludes with a pitch for "TransdermOil TM". He seems to have written similar papers about B12 and autism, sleep disorders in children and depression.

It has a bunch of comparisons between patients and controls with no p-values, 316 patients and just 25 controls, no data on demographics of these cohorts, the author doesn't even know how people were diagnosed ("No information was obtained on either the methods of assessment nor of the severity of the Chronic Fatigue Syndrome.").

@Arnie Pye Absolutely not accusing you of trying to sell anything! Just pointing out that this paper looks pretty bad. I'm not saying anything either way about B12, but I just don't think there is anything here in this particular paper.

 

WTF is a functional disorder? How is that different from a non-functional disorder?

 

The medical profession uses the word functional in various contexts. I think it is partly to keep patients in the dark about what they mean.

In the context of a functional vitamin deficiency the patient may have ample levels of the vitamin in a blood test but, for reasons that are rarely, if ever, investigated their body is unable to make use of the vitamin concerned in the way that it should be.

 

Rich Van Konynenburg believed that our bodies had problems using B12 even though a lot of us test high for this vitamin.

 

A more accurate test to measure B12 levels in your blood and urine is through a methylmalonic acid test. I had this test done through an integrative/functional GP. It was on the higher end indicating that my B12 levels were low. My GP had never heard of this test and dismissed my concerns and would not rx injections. My levels were on the border of <200?? She goes strictly by reference range despite my lingering symptoms. I was experiencing numbness in my lips and tips of fingers at the time so I started taking oral B12. I felt better within 3 months.

I don't think B12 oils are more effective than plain cheap oral B12.

 

The reference ranges for B12 are absurd. There is absolutely no consistency throughout the world as to what is an adequate level. The units of measurement used are not standardised either and people can see results in pg/mL and pmol/L. (Also ng/L, but ng/L is the same as pg/mL.) There are also two different tests for B12 - a serum test and an active B12 test. They tend to have different units of measurement and the reference ranges are not comparable.

https://www.biolab.co.uk/docs/vitaminB12.pdf

I should point out that I have seen the top number in the range for serum vitamin B12 being quoted at around 650 pg/mL, so the author of the above quote was being generous to UK medicine in "allowing" patients to have a higher level without a doctor declaring that the patient is toxic and must stop supplementing immediately!

I did ask on a Pernicious Anaemia forum once if anyone could come up with a source for how the current RDA for B12 was developed - and nobody knew. RDAs give the minimum amount required to keep people alive. They are not designed to keep people in optimal health.

And an article on the shenanigans involved in dementia research and B12 in the UK is also of interest :

https://healthinsightuk.org/2015/08...we-want-a-cure-just-so-long-as-its-not-cheap/

 

Normal ferritin levels in Canada:

Female 11–307 µg/L

I can't even walk when my ferritin is below 20. I feel breathless and dizzy.

 

Ditto. Several years ago my ferritin was very low but in range and my serum iron was under range. I could only get upstairs by going up on my bum one step at a time. Each step would take a substantial amount of time, and in total it could take me 20 minutes just to get upstairs in a bog-standard small UK house.

 

Traditionally medical problems were divided into structural and functional. A functional disorder was often a biochemical disorder, and there were no gross structural signs. In recent decades the term "functional" has been used as a way to disguise psychogenic claims. In other words, psychobabble.

Ignoring the psychogenic stuff, this nomenclature fails at the subcellular level. If there is structural damage with mitochondria and peroxisomes, and other cellular components, that do not show up at the tissue level, how is a doctor supposed to see them?

 

What levels do they suggest are needed for men?

 

On the thyroid forum I read they suggest that people aim for mid-range or a little bit over. You would need to know what the range for a particular test was, and they tend to vary from lab to lab.