Thread by @KetoCounselor

Microcytic anemias, which affect all cell lines, can have adverse effects on brain and nervous system health. Iron deficiency #anemia, the most common type of microcytic anemia, can cause #cognitive impairment. 🧵(1/18)

Iron is crucial for #brain function, and its #deficiency can reduce #oxygen delivery to the brain, affecting #cognitive processes like #attention, #memory, and learning. (2/18)

#B12 deficiency, another common cause of microcytic anemia, can also damage the nervous system. (3/18)

B12 deficiency can cause #neurological symptoms like numbness, tingling, and balance problems, and if left untreated, can cause irreversible damage to the #brain and nervous system. (4/18) #neurotwitter

Vegetarian and vegan diets, which are deficient in #B12, place people at high risk for B12 deficiency. #Alcohol consumption is another common cause of microcytic anemias, affecting red blood cells and potentially contributing to #neurodegeneration. (5/18)

Proton pump inhibitors can cause B12 deficiency. PPIs affect the acid in the stomach and are associated with reduced B12 absorption, leading to potential health complications. (6/18)

The exact mechanism by which #metformin causes B12 deficiency is not entirely clear. Theories include it may interview with absorption or use. Regardless, its long-term use is associated with B12 deficiency. (7/18)

Early detection and treatment of microcytic anemias, particularly iron deficiency anemia and B12 deficiency, can prevent or reverse neurological damage and improve cognitive function. (8/18)

But unfortunately, there's no consensus on how to confirm Vitamin B12 deficiency with standard testing, which varies widely across countries. Most cutoff values lack sensitivity to detect early deficiency, so serum B12 is not a good test to rely on. (9/18)

Supplementation can make it look like B12 levels are higher, but it does not reflect cellular stores of B12. This is where the Active B12 test comes in - it provides a more accurate assessment of B12 status but still has limitations. (10/18)

Homocysteine is another test that can provide a functional assessment of B12 status. However, it's not specific to B12, and there's no consensus on what threshold should be used for a diagnosis. (11/18)

Elevated homocysteine can also be caused by other factors, including riboflavin deficiency. Common mutations in the MTHFR gene may cause elevated homocysteine, but supplementing with riboflavin can restore the ability of the MTHFR enzyme to produce tetrahydrofolate. (12/18)

The best test for B12 deficiency is Methylmalonic acid (MMA), which measures the level of methylmalonic acid in the blood. If you suspect a B12 deficiency, MMA testing is a good idea. (13/18)

Oral B12 supplementation is generally safe and effective. If neurological symptoms are present, injections may be recommended for the first few weeks, followed by oral supplementation. (14/18)

My favorite forms of B12 include hydroxocobalamin, methylcobalamin, and adenosylcobalamin. I avoid cyanocobalamin because nobody wants to deal with cyanide when they are trying to heal, and it's just not as well absorbed. (15/18)

When I help people learn supplementation in my online program, they know to never just supplement one B vitamin alone. They learn to do it as part of a complex. B vitamins like to work their magic together. (16/18)

Monitoring clinical symptoms and repeating blood tests can confirm normalization of B12 levels and related parameters. Remember that early detection is important, as neurological symptoms can become permanent and irreversible. (17/18)

I want you to know all the ways you can feel better. And for some of you, B12 is definitely one of them. (18/18) #nutrition #brainhealthmatters