Vitamin B12 Deficiency Often Missed in Primary Care

Vitamin B12 deficiency is present in 5% to 20% of the elderly population and may begin in middle age. One common cause, malabsorption, is affected by many factors often seen in the primary care setting, including prolonged use of proton pump inhibitors or metformin, or as a result of gastric bypass surgery. 

The traditional sign of B12 deficiency, macrocytic anemia, can be masked by the folic acid supplementation in all enriched cereals/grains mandated by the US Food and Drug Administration since 1998. Vitamin B12 deficiency often causes neurologic deficits such as numbness and tingling in the arms, dizziness, loss of memory, burning mouth and fatigue etc. 

B12 is vital for optimal function of the immune system. B12 is stored in the liver, but it can take 5 to 10 years for a person to become B12 deficient due to malabsorption; however, demand for B12 markedly increases during times of physical stress, which depletes stores as well. B12 deficiency is common with celiac's disease and crohn's disease. Homecysteine levels are often high with Vitamin B12 deficiency. B12 levels should be checked if any of the above symptoms are present.

Vitamin D effects Testerosterone Levels in Men

Currently, there is great interest in vitamin D because poor vitamin D status is common and has been associated with an increased risk of various chronic diseases including cancer, diabetes, hypertension, autoimmune diseases, musculoskeletal diseases, depression and cardiovascular diseases as well as all-cause mortality. This study of 2299 men from Clin Endocrinol (2010) shows that low vitamin D levels are associated with decreased sperm count and motility and histological abnormalities of the testis in mice. Low vitamin D levels are also associated with low testerosterone levels.

Men who are having issues with sperm count or moitilt issues should get their vitamin D levels checked. And older men with low testerosterone levels should get their vitamin D levels checked.

The Time Spent Sitting is Independently Associated with Total Mortality

A study done in the American Journal of Epidemiology (2010) shows that reducing time spent sitting, regardless of activity, may improve the metabolic consequences of obesity. The US obesity epidemic is attributed to reduced overall physical activity expenditure. And reduced physical acitivity increases our risk for many chronic diseases, including cardiovascular disease, diabetes, stroke, and various types of cancer including colon and postmenopausal breast cancer.
Numerous studies support an association with sitting time and obesity, type 2 diabetes, cardiovascular disease, and unhealthy dietary patterns in children and adults. Men and women who spent the least leisure time sitting were leaner, more likely to have never smoked cigarettes, more likely to be employed, and had lower total energy intake. In this large prospective cohort, women who reported sitting for more than 6 hours during their leisure time versus less than 3 hours a day had an approximately 40% higher all-cause death rate, and men had an approximately 20% higher death rate. Mortality rates were approximately 25% lower among men and women who reported the most versus the least daily physical activity.

B12 May Lower Your Risk For Alzheimer's Disease

A Finnish study showed a group of elderly subjects followed up for 7 years with elevated baseline serum homocysteine levels were independently associated with an increased risk of developing Alzheimer's disease. Several studies linked elevated homocysteine levels with an increased risk for stroke, cognitive decline, and dementia, including Alzheimer's. Homocysteine can directly promote cerebrovascular disease and neuronal injury through a variety of mechanisms. Many individuals with high homocysteine levels also have low B12 levels. Therefore, B12 may also play a role in Alzheimer's disease.

Anger Has Been Associated With Increase Pain

Two studies published in Arthritis Care & Research reported that anger amplifies clinical pain in women with and without fibromyalgia. Women with fibromyalgia not only experienced negative emotions more frequently and with a larger intensity, but also processed and dealt with their emotions in less healthy ways. The women with fibromyalgia had more difficulty identifying and describing their emotions and suppressed their emotions more, which are related to worse functioning, including more pain. The study found that negative emotions as experienced in daily life are able to increase pain above the already high pain levels in women with fibromyalgia. Because women with fibromyalgia experience negative emotions more frequently than women without fibromyalgia and already have heightened pain levels, the increase in pain due to negative emotions is especially relevant in this patient group. The study strongly suggests that negative emotions may cause an increase of the pain.

Medications for Insomnia & Anxiety Increase Mortality

According to the Canadain Journal of Psychology seditive drug use has been associated with 36% increase in Mortality. Although the mechanisms by which sedatives contributed to increased mortality risk were undetermined, these drugs can impair reaction time, alertness, and coordination, thereby increasing the risk for falls and other accidents. Respiratory inhibition may aggravate sleep-disordered breathing, and central nervous system inhibition may impair judgment and increase the risk for suicide. Where possible, physicians should consider possibilities for nonpharmacological treatment of sleep disturbances and anxiety.