Marco Lombardozzi
Medicine is undergoing a very fast process of evolution and updating, so fast that doctors cannot keep up with all the information that is arriving. One of the purposes of this newsletter is to focus and filter some information related to the world of phytotherapy and nutraceuticals and propose them summarized to the professionals of the healthcare world.
One such case is represented by vitamin B12, about which it was believed that everything had been said and that there was nothing else to know, instead recent studies have highlighted new aspects and new functions.
Vitamin B12 generally refers to a group of cobalt-containing compounds called corrinoids, or more narrowly to a member of the vitamin B group. The major cobalamins are cyanocobalamin (the most studied, stable, and most widely used form in supplements), hydroxocobalamin, and the two coenzyme forms (methylcobalamin and adenosylcobalamin).
An insufficient supply of vitamin B12 can occur mainly due to a supply deficit or inadequate absorption. In this case, the categories that are most at risk of developing a vitamin B12 deficiency are: subjects with decreased gastric acidity, those who regularly and for prolonged periods take certain types of drugs (antibiotics, antacids and antidiabetics), patients with inflammatory bowel diseases (Crohn's disease)
subjects who have undergone gastrointestinal surgery or bariatric surgery, those suffering from celiac disease or pancreatic diseases.
In general, vitamin B12 is involved in the fundamental metabolic pathways that affect neurological and hematological functions. It is also a very important coenzyme factor for methylmalonyl-CoA mutase that converts methylmalonyl-CoA to succinyl-CoA.
New lines of research are also bringing to light the role of vitamin B12 as a possible aid in the therapy for viral infections (in the treatment and persistence of symptoms, revealing both the effect of modulating immune responses and the relationship of B12 with the muscle-gut-brain axis. Other studies finally seem to demonstrate the involvement of vitamin B12 also in some of the main neurological diseases, other than neuropathy from B12 deficiency, such as Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis and Alzheimer's disease.
Scientific and clinical studies regarding oral cyanocobalamin supplementation have widely demonstrated its efficacy and tolerability even at high doses, the efficiency of vitamin B12 absorption in liquid formulations and in particular in the case of sublingual administration has also been validated. Therefore, up to 1000 mcg/day can be administered without adverse effects being observed.
