Easing the pain of Fibromyalgia
Fibromyalgia is a chronic condition of the fibrous tissues of the body such as tendons and ligaments (“fibro”) and the muscles (“my”) causing pain (“algia”). The widespread pain experienced by people with fibromyalgia can also be associated with fatigue as well as headaches, problems sleeping, irritable bowel, cognitive disturbances, dizziness and allergies.
Historically, fibromyalgia has been difficult to differentiate from other chronic conditions, but the now widely established criteria for diagnosing fibromyalgia is as follows:
- Pain in all four quadrants of the body for at least three months.
- Together with pain in at least 11 out of 18 point sites when they are pressed. These “tender points” are rarely noticed by patients until pressure is placed on them.
Fibromyalgia often develops after some sort of trauma but there isn’t always a trigger to the onset of the condition. According to Fibromyalgia Action UK, research has identified a deficiency in serotonin, a neurotransmitter in the central nervous system, coupled with an increase in the neurotransmitter substance P, which transmits pain signals. This means that pain signals might be processed differently in people with fibromyalgia, causing them to feel more pain than others might feel under a similar stimulus.
Treatments for fibromyalgia include over-the-counter painkillers, drugs for neuropathic pain such as pregabalin, and tricyclic drugs used to treat depression. These don’t work for everyone, however, so it’s important to find other ways for people to manage their symptoms.
Current guidelines for this include practising rest and relaxation techniques; having cognitive behavioural therapy or other talking therapies; using heat packs or a hydrotherapy pool for painful, stiff areas of the body; and doing paced, progressive exercise or activities. A healthy diet is also important, as is following advice on how to improve sleeping habits. Many people find that joining a support group assists them in developing a more positive outlook.
As people living with fibromyalgia know all too well, there is no quick fix to the condition but there is evidence that a multi-disciplinary approach is best. Here at Physiologic, we offer a number of therapies that may be of help to you, or someone you know, to manage the symptoms of this often debilitating condition.
Physiotherapists can guide you through a tailored progressive exercise programme to improve your aerobic fitness and endurance. They will also advise on muscular strength training to reduce the strain on tendons and ligaments and improve your overall conditioning. Improving the strength of major muscle groups can in turn make it easier to take part in aerobic exercises.
Bioenergetic medicine – practised here by Martha English using NES Health and acupuncture – addresses energy blockages which can occur as a result of unresolved traumas. Martha specialises in working with people who have chronic conditions and aims to get to the root of the problem using a variety of healing techniques and in a supportive manner.
There is anecdotal evidence that craniosacral therapy can be beneficial for people with fibromyalgia. The craniosacral system includes the brain and spinal cord as well as the cerebrospinal fluid (collectively known as the central nervous system or CNS). Craniosacral therapists such as Bruce Aitkin at Physiologic have a highly trained sense of touch (called palpation) and believe that the CNS elicits a palpable rhythmic impulse which can be felt and balanced during treatment to enable optimal function as well as give an extreme sense of relaxation.
Tanya Lawton offers one-to-one hypnosis: a gentle, effective and deeply relaxing way in which to access your subconscious and begin to change unwanted belief systems. It can help with a wide range of issues, including pain relief and sleeping difficulties.
Pilates and yoga
We offer small group pilates and yoga classes in relaxed and friendly surroundings where you can work at your own pace to improve your strength, flexibility and stamina.
Women’s Health Hub
We offer regular free health talks and workshops in an open and supportive environment at Physiologic. Call us to find out when the next event is taking place.
To find out more about all the above therapies, click on the Services or Team tabs above.
Help for people living with Parkinson’s Disease
Parkinson’s disease (PD) is a long-term degenerative condition that belongs to a group of conditions called motor system disorders, resulting from a loss of dopamine-producing brain receptors causing progressive damage to the brain and affecting the nervous system. The four primary symptoms of PD are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks.
The condition usually affects people over the age of 60, where early symptoms are often subtle and gradually increase, however for some people the condition can progresses more quickly and may also produce a number of other physical and psychological symptoms such as depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problem, anosmis (a loss of sense of smell), insomnia (sleeping difficulties) and memory problems.
The condition can be difficult to diagnose accurately as there are no blood or laboratory tests that are proven to help determine this. Usually a diagnosis is based on a patient’s medical history and a neurological examination (for some patients a brain scan may be required).
Although there is currently no cure for Parkinson’s, treatments are available on the NHS to help alleviate the main symptoms and maintain quality of life for as long as possible, which include:
- Brain surgery (in some cases)
- Supportive treatments (such as physiotherapy and other occupational therapies).
Not everyone with the condition needs treatment during it’s early stages, however regular appointments with a medical specialist is highly recommended to monitor the condition.
As most people know, conventional medicine focuses on understanding and correcting the problems that are causing symptoms, whereas complementary therapies (therapies that can be used alongside medical treatment) take a more holistic approach, aiming to treat the whole person including mind, body and spirit, rather than just the symptoms.
Although no treatments or therapies have been scientifically proven to slow, stop or reverse the development of Parkinson’s, there are several complimentary therapies that can make living with Parkinson’s disease easier and have been said to have helped many people living with the condition on a day-to-day basis.
Some of the most popular therapies chosen by people with Parkinson’s and their carers include:
Meditation and relaxation techniques
The best advice to anyone diagnosed with this condition is to start exercising as soon as possible. It is known that Physicians rarely refer their patients to health and fitness programs at diagnosis because medications are very effective early on at alleviating most of the symptoms and patients experience little change in function. Yet, research shows that it is at the time of diagnosis that patients often begin to consider lifestyle changes and seek education about conventional and complementary/alternative treatment options. This makes it the ideal time for referrals to exercise, wellness programs and physical/occupational therapy, when it may have the most impact on quality of life.
At Physiologic we provide an array of therapy treatments from the recommended list above and can offer a specially dedicated exercise treatment programme called LSVT BIG® for people with Parkinson’s disease. This is based on the principle that the brain can learn and change (neuroplasticity).
Formulated from an existing programme called the Lee Silverman Voice Treatment (LSVT) which was started in the United States and has been developed and scientifically researched over the past 25 years, with funding from the National Institutes for Health and LSVT LOUD® which is the effective treatment created to help patients with their speech, that improves vocal loudness by stimulating the muscles of the voice box (larynx) and speech mechanism through exercises, improving respiratory, laryngeal and articulatory function to increase speech clarity.
LSVT BIG® is an intensive amplitude focused, physical and occupational therapy approach applied to limb movement that has been documented to be effective in the short term, increasing amplitude of limb and body movement (bigness), trunk rotation/gait), improved speed (upper/lower limbs), balance and enhancing the quality of life for people with Parkinson disease. In addition, people were able to maintain these improvements when challenged with a dual task. It is a standardized treatment practice that is customised to the individual goals of each patient
This unique therapy programme consists of 16 treatment sessions over a single month (4 X 60 minute sessions per week) with daily homework practice and exercises. The programme can only be delivered by certified physical or occupational therapists.
At Physiologic we are proud to welcome Cary Morin who recently immigrated from the US where he was born and raised. He studied in North Carolina, receiving a Doctorate in Physical Therapy in 2016. He trained and worked in Acute Care and Outpatient Care and worked at Walter Reed National Military Medical Center in Bethesda Maryland, the United States’ largest and most renowned military medical centre. Cary specialises in treating musculoskeletal needs and is well educated on Parkinson’s disease. He is one of only three therapists based in the Kent region, certified to deliver LSVT BIG® treatment programmes and he hopes to expand the awareness and accessibility of this treatment here in the UK.
For many women that arrive at the menopause, whether earlier than expected or right on schedule, it can be a minefield of change, sometimes difficult to recognise, and often hard to live with.
Some women struggle during the perimenopause stage, when change occurs to the reproductive system and activity ceases, usually after 12 months without a period. Generally this starts for woman in their mid to late 40’s or as late as their 50’s but for some this can happen as early as the mid 30’s and can cause dramatic hormonal imbalances from fluctuations in oestrogen, progesterone and testosterone the. Some women may suffer the worst at this stage but for others the later stages of the full menopause can be when they experience their symptoms.
Unbelievably 72% of women say they do not know what the menopause is, while at least a quarter of us are lucky enough to have no symptoms at all. For the unfortunate 25 % of us that do suffer with severe symptoms of the menopause, it can be one hell of a ride that can on average last for up to 4 years!
At this natural cross roads in a woman’s life it can feel taboo to talk about what is happening and we know from research that a third of women don’t even speak to their GP’s but for those women who do confide in their Doctor around half will be prescribed antidepressants, while only 20% will go onto HRT in the hope of treating some of the following symptoms:
- Irregular periods
- Hot flushes
- Poor sleep
- Night sweats
- Poor concentration
- Stiff joints
- Vaginal dryness
- (Low libido)? Sex
- (Difficulty with) intimacy/ Issues?
- Dry hair
- Dry skin
- Loss of confidence
- Loss of self
- Inability to function
- Mental health problems
- Weight gain
- Being overwhelmed
- Heart disease
It’s not surprising, considering the list above, that half of menopausal women say that their mental health has suffered and 7 out of 10 women choose not to tell their employers, while a quarter of women say they would rather stay at home.
Most people reading this would agree that any sane person that suddenly started experiencing memory loss, anxiety, poor concentration, irritability, loss of confidence, anger, an inability to function and a general sense of feeling overwhelmed would struggle to carry out the simplest of tasks let alone be able to maintain healthy relationships and a balanced work and home life. This only fuels the fire and increases frustration, which can make it almost impossible to live a normal life. Partners are ill equipped to cope with the rollercoaster of emotions, work colleagues no longer trust your judgement or ability and friends don’t even recognise you. It can be a very lonely and scary place and one that we are in no way prepared for.
There needs to be a better education on what to expect and how women can help themselves. Guidance should also be provided for those living and working with women struggling with the menopause, at least to try and understand what is happening but also so that we can learn how to support our loved ones, friends and colleagues through this natural but sometimes impossible transition in their lives. For the 23% of women that say that their life lacks enjoyment, hopefully we can begin to help them feel alive again.
Rather surprisingly and in contrast to what we are lead to believe I am pleased to report that 90 % of women still want to have sex, which may please some if not all of our readers.
So now that we’ve covered the worst parts lets look at how we can help ourselves and enable menopausal women the world over to embrace this natural evolution.
There are many tried and tested ways to ease the symptoms of the menopause, one most obviously being Hormone Replacement Therapy as prescribed by your GP or women’s health consultant. This can be a welcome antidote to much of the suffering for some but not all women.
So many of us are unaware of the natural remedies and alternative treatments such as acupuncture, CBT, meditation, yoga, breathing, exercise, masturbation, vaginal oestrogen, Replens, yes and KY jelly lubricants, magnets, dietary changes such as removal of gluten, soy, alcohol, pork, dairy and supplements such as vitamin D, calcium, Homeopathy, Aromatherapy oils such as basil, lavender, anise, licorice, lemon, myrtle, clary sage, geranium, Chinese herbs, black cohosh, red clover, sage, star flower oil, evening primrose, wild yam, St johns wort, woman’s kind,
Of course it’s easy to forget that how we live can affect how we feel and vice versa. Lets not forget the very powerful medicine of talking, sharing and laughing with friends, colleagues and indeed loved ones, as this can do wonders for our self worth and help all us to remember that outside of our bodies there is a big wide world full of hope and wonder.
02 February 2018
Low back pain is the single leading cause of disability worldwide (Global Burden of Disease, 2010). It is one of the most common reasons for time off work and most people you meet will have suffered with low back pain at some stage in their life.
Current evidence moves away from long periods of rest and immobility and encourages exercises and regular movement as the key to a healthy back and healthy lifestyle. We see this daily in our Physiotherapy clinics, and whether the cause of the pain is stress, spinal muscles, ligaments, tendons, intervertebral discs or spinal nerves, the majority of people find reduction in their pain and a return to normal activities and life with simple, graded low back exercises.
So here they are for you to try. And you don’t have to be recovering from an injury to do these exercises – they will be beneficial to anyone who has a sedentary job, does a lot of driving or just can’t get out and exercise as much as they’d like to. We recommend you spend five to ten minutes a day working through the exercise slowly and with control. You can try them either on the floor or in bed.
Note that you should not experience severe pain at any point during these exercises – if you do, you should consult you GP or come and see us in the clinic where we are on hand to offer advice and help.
Exercise 1 – Knee Hug
This exercise focuses on stretching out the low back, relieving stiffness and tension.
Lie on your back and hug both knees to your chest.
Hold for 20 to 30 seconds three times and feel the gentle stretch in the low back and buttocks.
If you find this too hard, try hugging just one knee at a time.
Exercise 2 – Knee Rolls
This exercise also focuses on stretching out the low back and relieving stiffness.
Keeping your back flat to the floor, allow you knees to roll to the left and right.
Rest in each position for 10 to 20 seconds 3 times each way.
You should feel a gentle pull through the hips and lower spine.
The following three exercises are for strength and lower back stability, “The Core”. As you strengthen your lower back muscles, you reduce fatigue and train the muscles in your pelvis, lower back, abdomen and hips to work in unity.
Exercise 3 – Bridge
Start with knees bent and your back flat on the floor. Slowly lift your hips up off the floor making sure you keep your arms at your sides for balance.
Hold this position for approximately 5 seconds and then relax back down.
You should feel a slight pull/effort in you low back and legs.
Repeat this 10 times.
Exercise 4 – Scissors
Keep your back flat on the floor with your arms at your sides for support.
Lift your legs to 90 degrees and hold this position for a count of 5 to 8 seconds.
If this is easy, try a cycle/scissors motion forward and backward with your legs.
Try to repeat this 8 times
Exercise 5 – Superman
In a four-point kneeling position (hands below shoulders and knees below hips) lift one arm and the opposite leg. This exercise challenges your balance so take it slowly.
Hold this position for 5 to 10 seconds, and repeat 5 times on each side
You should feel the effort and work in the low back. If you find this easy, bring your hands together, below your head to reduce you base of support and challenge your core stability further.
The Office of National Statistics doesn’t have figures on how many people in the UK have desk-based jobs, but our guess is many millions. Despite progress being made in terms of flexible working hours, it’s probably fair to assume that most office workers still spend 7 to 7.5 daylight hours a day at their desks. It’s no wonder that people present to physiotherapists complaining of neck pain, shoulder tension, headaches, repetitive strain injury and more.
So what can you do to stay healthy in the office?
First and foremost, sit up tall in your chair with your legs uncrossed and breathe, remembering to take some deeper breaths throughout the day to stretch through your diaphragm, ribs and intercostal muscles.
Avoid hunching your upper back when looking down at mobile devices as this can lead to ‘text neck’. And if you’re sitting hunched and looking up at a computer screen this can lead to a ‘chin poke’ posture. Both of these positions put strain through the base of your neck.
Don’t wedge the telephone between your ear and your shoulder as this places strain on the muscles of the neck, upper back and shoulder.
Adjust the height of your chair and computer screen so that your hips are slightly higher than your knees. Place your forearms in a roughly horizontal position when using your mouse and keyboard, and your eyes should be about level with the top of your screen.
Adjust the backrest of your chair so you can lean against it comfortably. Ensure your lower back is well supported and your feet are flat on the floor or on a footrest.
The Chartered Society of Physiotherapy recommends the following easy exercises that can be done at your desk regularly throughout the day:
Keep using all the muscles in your arms and legs. You can do simple biceps curls holding a bottle of water, and you can march with your legs under the desk.
Rotate your upper body in your chair to the right and reach for the backrest with your left hand, hold for 5 seconds. Repeat to the other side.
Interlock your fingers, pushing your palms away from your body, stretching your arms, shoulder blades and fingers – hold for 5 seconds.
Reach over your head, bending to the side at the waist and straighten up. Swap sides and repeat 10 times.
Take regular breaks
Here are some good reasons why stepping away from the screen is so important:
It gives a chance for your eyes to relax from the close-up work and the glare of the computer screen.
Walking around will often immediately relieve aches and pains. Do a task that takes you to another floor of the building and, if you can, take the stairs not the lift.
You can do some full body standing stretches or bend and stretch towards a wall. Stand about a metre away from a wall, bend at the pelvis so your upper body is perpendicular to the floor and stretch out your hands to the wall. You should feel a good stretch through the whole of the length of the spine.
Get outdoors during your lunch hour for some fresh air and sunlight or to meet up with friends. You could even do a short exercise class to really invigorate you for the afternoon.
Stepping away from the work environment can also help diffuse stress. We can all face challenging tasks, situations or behaviours in the workplace, but these don’t have to dominate the entire working day. Step away, breathe, and raise any concerns early with your employer.
Take short breaks for drinks and healthy snacks. Try not to have your lunch at your desk, but if you do, at least take a break from work. Flick through a newspaper or magazine, talk to a colleague, or simply look out a window.
Try not to take work home with you. Use your spare time to do exercise and the other activities you enjoy.
And absolutely, definitely, take your entire holiday allowance every year.
Many of us readily admit we don’t eat enough fruit and veg. The ‘5 A DAY’ mantra is ingrained in our psyche (if not necessarily adhered to in reality) but more recent research actually suggests that up to 10 portions of fruit and veg per day is best, and could lower the risk of chronic illness such as heart disease. We can hear the groans of despair as we write this, but it doesn’t have to mean eating meat and 5 veg, a salad for lunch, plus 3 fruit snacks per day; juicing can be a great way of getting additional healthy nutrients in one tasty drink.
The first thing you’ll need is a juicer. There are two main options for those starting out:
Centrifugal – the fruit and veg goes into a feed tube and has direct contact with the blades. The pulp and juice are separated. They’re fast, noisy, and quick to clean. The juice doesn’t store as well as from masticating juicers (see below) because more oxidation takes place during the juicing process, but this isn’t a problem if you’re drinking it straight away.
Masticating – these juicers masticate, or chew, the fruit and veg so they extract more juice and the pulp comes out drier. There is less oxidation during the process so more nutrients are preserved. They are slower and less noisy, but there are more parts to clean after use. Also, in most cases the feed tube is smaller than the centrifugal juicers so the fruit and veg needs to be cut into smaller pieces, adding to the preparation time.
Some tips for a long and healthy relationship with your juicer:
- Don’t be overwhelmed by all the juicing resources out there. Find half a dozen combinations of ingredients you like (there’s no end of suggestions on the web) and be creative depending on what you’ve got in the fridge.
- Add ginger, lemon or lime to give depth to the flavour and boost your immune system.
- You can stir in powdered ingredients such as spirulina and wheatgrass, or add a spoonful of chia seeds to boost the nutritional content. Large packets of these ‘superfoods’ will last you months.
- Don’t overdo the fruit content if you’re watching your sugar intake or your weight. You can add sweetness to a vegetable juice with one ripe banana or a few strawberries.
- Add kale or other green leafy vegetables to benefit from the amazing nutrients they offer.
- Wash up the equipment straight away before anything sticks to the plastic!
And don’t be hard on yourself if you don’t use your juicer as often as you’d hoped. Try to find a way to make it part of your daily routine. If at first you don’t succeed, perhaps try a different type of juicer or you could even use your kitchen blender to make delicious smoothies. It’s amazing what you can whizz up using a ripe avocado, a cup of green tea, a handful of rocket, a ripe banana, some red fruit and a few chia seeds!
One of the types of therapy on offer at Physiologic is Bioenergetic Medicine. It’s a tricky concept to grasp because it’s based on quantum theory and biophysics, mind-boggling stuff which, let’s face it, most of us know nothing about. This type of medicine moves away from the molecular and biochemical (pharmaceuticals) and ‘wet’ matter options (such as surgery) we are all familiar with, to those based on fields, forces and the quantum nature of the body.
Advocates of the quantum-field view of the human body include Rupert Shelldrake, Deepak Chopra, Andrew Weil, James Oschman, Peter Marcer, who have all written extensively on the subject.
Bioenergetic Medicine therapies trace the root cause of the loss of health to distortions, blocks or other impairments to the human ‘biofield’ and this can be corrected using a system called NES Health.
NES Health was founded by Peter Fraser, who trained for two decades in Traditional Chinese Medicine, Homeopathy and Ayurveda. His thirst for a deeper understanding of quantum theory and biophysics led him into private research and this is where he formulated a comprehensive theory that reveals the human biofield (or body-field as Fraser named it) as a complex, structured network of fields that interpenetrates the physical body and underlies all physiology. NES practitoners, such as Physiologic’s Martha English, use a device called the NES ProVision scanner to map the body-field and identify a person’s overall physical and emotional condition. Distortions in this field can cause disharmony leading to physical problems, and these distortions are cleared using the NES miHealth Medical Device. Liquid energetic remedies called Infoceuticals are then used to re-imprint the body field back to its original blueprint. You can find out much more about the NES system at http://www.neshealth.com/
There seems to be no limit to the type of conditions or symptoms that can be addressed bioenergetically. At Physiologic, Martha has treated clients with headaches, aching limbs, extreme tiredness, chronic or undiagnosed pain, insomnia, Chronic Fatigue Syndrome, Fibromyalgia, fertility issues and more… in essence, all the kinds of conditions that can be difficult to treat using today’s conventional treatment approaches.
Look out for future blogs covering the use of NES for specific health conditions.
Physiologic’s Director Martha English runs Mummy MOT clinics in London, Reigate and Hythe. Here she explains why:
“There’s a reason I do what I do, and that is the statistics that show half of all mothers suffer from a weak pelvic floor after giving birth, and over one third of women are affected by ongoing pelvic pain or a tummy gap. It enrages me that the post-natal rehabilitation of women is not more prevalent in this country.
“We cannot let another generation of childbearing women suffer these terrible consequences when so many of the symptoms are controllable, improvable and even completely surmountable given the right treatment, exercises and advice.”
So what is a Mummy MOT?
A Mummy MOT is a specialist postnatal check for mums following delivery (vaginally or by c-section). During a consultation, the strength and function of the pelvic floor and stomach muscles will be assessed and how these are supporting the pelvic organs after childbirth. If a dysfunction is found, exercises and treatment will be provided to help recovery. In France, where Martha has worked previously, check-ups were and still are a standard part of every new mother’s postnatal rehabilitation.
It’s recommended that mums have an initial check-up 6 weeks after giving birth, but it’s possible to treat women many years later to help them regain their core strength.
If you consider the changes the body goes through during pregnancy and childbirth, it’s not surprising that nearly half of all women’s bodies do not recover from the experience without some sort of intervention. New mothers may hope everything will miraculously get back to normal but they are not in a position to assess what is and what’s not normal in their bodies after giving birth. They may think that certain consequences are expected and don’t realise they have a problem that can be fixed.
It is not normal to:
- Leak when you cough or run.
- Have pain during sex.
- Have ongoing pelvic pain or debilitating constipation.
- Have a gap in your tummy where your muscles have weakened and can’t support your core or abdominal organs effectively.
If you have any of these debilitating conditions, you can be reassured that almost all of them can be improved, alleviated and often remedied entirely through a personalised exercise and manual manipulation programme. In most cases, no drugs or surgery are required – it’s just a case of being armed with some knowledge, getting the right treatment and doing the correct exercises.
Spring is a fantastic time to revitalize your mind, body and soul. Just take a look around you at how the beauty of nature gently unfolds as the warmth of the sun touches the earth. Well our bodies love to shake off the cold and dark of the winter and burst into Spring.
Here are a few factors to consider to help to balance our bodies and our minds to feel good, naturally.
Sleep – This is a must for the body to regenerate and function correctly. Getting enough sleep allows each organ to repair itself leaving us revitalized and ready to start the day with a spring in our step.
Stress – Life can be fast paced for us all at times and it needs careful management to keep levels of stress in control. Too much stress can cause the hormone cortisol to spike and our immune system can be suppressed causing us to feel sick.
Diet – It goes without saying that a good healthy balanced diet is essential to maintain the best quality of life.
Exercise – A walk in nature or by the sea, meditation, yoga, or a trip to the gym will release essential endorphins that will leave you feeling happy and full of energy.
Gratitude – Make a list the 3 things that you are grateful for each day and you will be amazed how positive you become.
Creativity – Allow time for your creative juices to flow. Whatever it is that you enjoy it is important to take time to explore the world
Time for you – Take the time to treat yourself to a massage or to read a book or to watch a movie. Look after yourself and get regular health checks to prevent illness. Be the best that you can be and most of all be you!
Vitamins are vital to the body’s many functions from helping to build muscles to helping to remove toxins from the body. Some vitamins may help to protect against illness whilst others help within the body’s energy cycle – of which B12 is one of them.
We can’t make vitamins and so eating or supplementing is the only way we can provide our body with these vital pieces of the nutritional jigsaw puzzle. Some vitamins may be stored within our body fat and are there for times of need, whilst others are not stored and need to be topped up daily.
B12 is one of those vitamins that needs topping up, although some is stored in the liver. A deficiency of B12 can deplete this liver store gradually to the point that we become deficient if we are not taking more in on a regular basis.
B12 is a vitamin that most vegans know about as it is almost exclusively found within animal products as it is formed in the gut of animals. Although found in some non-animal foods it is usually fortified and not absorbed as well. Non-animal sources of B12 can be found in fortified cereals, non-dairy milks such as almond or soya, yeast extract and nutritional yeast (which is a deactivated form of yeast in the form of flakes).
However, what a lot of people don’t realise is that it isn’t just vegans or even vegetarians who may need to get their vitamin B12 levels checked. B12 follows a complicated pathway and needs to be broken down by pepsin (an enzyme found in the stomach). In some people, especially those over 50, hydrochloric acid can be low in the stomach and thus pepsin is not produced as well as it should be. This affects the amount of B12 that can be absorbed – regardless of how much is actually eaten. It should be noted that antacids and proton-pump inhibitors can also reduce stomach acid, therefore those who take these may be lower in B12 than they think. Some gastric disorders such as Crohn’s Disease can also reduce absorption of B12.
Another important player in the B12 pathway is a protein called Intrinsic Factor. Some people have an inherited disorder where they don’t produce Intrinsic Factor. Therefore, if someone in your family has been diagnosed with a B12 deficiency, it may be worth while to get your own levels checked.
So, why should you be concerned about a B12 deficiency? Well, a B12 deficiency can cause mental disorders from anxiety to depression. It can present symptoms such as dizziness, tingling in extremities, falls, dementia (which is often put down to old age, but could be due to a B12 deficiency). A B12 deficiency can also mimic symptoms of Multiple Sclerosis, Chronic Fatigue, give rise to unexplained fertility problems, a failure to thrive in infants, memory loss, personality change and many, many more.
Most routine blood tests do not cover a B12 check and so you need to ask for it to be checked in addition. Also, higher levels of other B vitamins can mask a B12 deficiency which may be missed by your GP.
The lower level for B12 varies all over the world, but more surprisingly it even varies all over the UK. In some parts of the UK the lower acceptable level for B12 is 200pg/ml however, symptoms can be seen in people from 450pg/ml and below. There is some argument amongst experts that the lower level should even be raised to 550pg/ml and with levels to be nearer 1,000pg/ml in the elderly. Dr Joseph Chandy suggests a subtle B12 deficiency may be present with levels between 300-450pg/ml, an intermediate deficiency between 200-300pg/ml, and a severe deficiency below 200pg/ml
(reference – www.B12d.org).
The signs of deficiency are vast – as well as the ones previously mentioned, B12 deficiency could result in vision changes, incontinence, DVT, heart attacks, strokes, shortness of breath, gastrointestinal problems, weakness, premature grey hair, tinnitus, pour wound healing, indigestion and abdominal pain. It must be noted that if you have one or more of these it does not mean that you necessarily have a B12 deficiency, but if your GP has tested you for various things and you still feel that you are not getting answers, then it maybe worth getting your B12 levels checked. If you do think that you may be B12 deficient then it is important that you do not supplement with B vitamins before getting your levels tested as this can give you a false positive.
It is always a good idea to consult with a Nutritional Therapist if you feel that your diet may be lacking in any vitamins or minerals. Reference:
Pacholok, S.M. And Stuart, J.J. (2011). Could It Be B12? An Epidemic of Misdiagnoses. Published by Quill Driver Books.