Tag Archives: vitamin B12

TMJ: a total PIA

I have never been officially diagnosed with TMJ. I’m just assuming that the term applies to the condition I experience every few years or so wherein sitting in one place longer than 20 minutes makes want to rip my jaw out and stomp on it. I keep moving it around, trying to get it to fit together in a way that will stop the dull pain that spreads into my cheeks and face.

After the last miserable episode of this during a layover at the airport, which found me contemplating how one goes about locating strangers willing to share their prescription opiates, I looked TMJ up online. The TMJ page on Sandy Simmons’ Connective Tissue Disorder site mentioned magnesium, so I added that to my daily regimen. I also began doing this yoga stretch, but holding a yoga block between my hands and pressing into it. I think I also took vitamin B12. It stopped bothering me after a week or so.

In the meantime, thinking that my less-than-movie-star-quality teeth alignment was one of the contributing factors, I visited an orthodontist who specialized in adult braces. He took X-rays of my jaws and spent an hour with me discussing them and different treatment options.

His explanation of why teeth misalignment happens made a lot more sense to me than the “it’s genetic” line everyone else throws at you. He said that breathing with your mouth open, as people with allergies are wont to do, puts your tongue in a different place than when the mouth is closed. Tongue placement influences the way your teeth grow and shift. Mine definitely lean in a bit, although in a very tidy and straight way thanks to two years of orthodontia. When my teeth bite down they’re not actually crown to crown but bottom-outside-edge to top-outside-edge. Which causes shocks to the enamel, which travel upward and cause damage that results in my gums receding, among other things.

He described a process whereby a digital model of my mouth would be taken, some sort of device would be fitted, I’d occasionally come in to have the device adjusted, and after a year my teeth would be aligned more optimally.

I don’t actually remember what he said about the TMJ connection. I don’t remember much of anything that happened after I heard the $4,200 price tag, which was not covered by insurance and was not even remotely a possibility for me. But at least the appointment was free and the information interesting.

Conditions to consider if you’ve been mysteriously sub-par for a long time

Updated August 14, 2017.

Here’s a list of conditions I’ve investigated over the years as I tried to solve my health problems. You’ve no doubt heard of some of them but might think the symptoms don’t apply to you, or might have been given the wrong test or had your test results evaluated with the wrong lab ranges. All but two of the items listed (Lyme disease and mold / biotoxin poisoning) have the benefit of being easy (if not cheap) to test for or at least rule out.

You cannot trust your doctor to know the right lab ranges, so if you do have tests taken, make sure you arrange to have copies of the test results sent to you. I can’t be the only person who had a ferritin so low I couldn’t even sit up straight, and yet was told repeatedly over the years that my iron levels were fine.

B12 deficiency. This requires two or ideally three tests: the usual one, plus two you’ll have to specifically ask your doctor for and which your insurance company might not cover. If you are already taking B12 supplements, the tests will not be accurate, a fact your doctor might not be aware of. The book Could It Be B12 has up-to-date info, or if your brain fog isn’t too bad you can look at the intro docs at the Vitamin B12 Deficiency is Commonly Misdiagnosed forum.

Bromide poisoning. This substance is everywhere in our environment and food supply, and because of its link to breast cancer, sites about that topic have the most info. Here’s a short intro on the subject. This condition tends to go hand in hand with iodine deficiency (see below).

Food reactions. This seems really obvious, but it might be that you are reacting to a certain category of food but haven’t tried enough types of foods in that category to make the connection. If you’re lucky, it might be a category connected to a deficiency you can correct. For example, oxalates lower zinc levels, salicylates lower vitamin K, and goitrogens can lower iodine.

Histamine: the Low (histapenia), the High (histadelia), and the Intolerant. People think of histamine in terms of allergies, but your histamine can go awry for non-allergy related reasons and cause all sorts of wackiness, many involving your mental state. (“Histamine intolerance” refers to having a body that wanders into histadelia territory too easily.)

If I have this right, two main culprits are behind high histamine – wonky methylation and/or? low DAO enzyme levels. This article on histamine intolerance describes it in terms of low DAO. This article on the effect of brain histamine levels focuses on methylation. Ignore the fact that histamine is spelled wrong for a third of the article. Also be warned that the author is behind the times in her belief that folic acid and vitamin B12 should not be used for histadelia. There are now methylated versions of each on the market that are used to treat methylation issues.

Iodine deficiency. This deficiency is getting more and more common but misconceptions abound. For one thing, what doctors assume are hyperthyroid reactions to iodine are in fact usually bromide detox symptoms. Drs. Guy E. Abraham and David Brownstein have books on the subject. A primer is at Breast Cancer Choices. The Yahoo Iodine Group also has intro documents. (Be sure to read the bit about how they tracked down the source of the oft-repeated warning about iodine causing heart failure.)

Iron deficiency. This requires four lab tests to evaluate correctly. Stop the Thyroid Madness has a page on recommended tests and lab ranges and how to take iron supplements. If you’ve lost hair due to low iron, you’ve probably read in your internet research that your ferritin level has to be in the 70s for three months before your hair will grow back.

Long-term effects of prescription drugs or supplements. Some prescription drugs will affect your biochemistry for 15 years, but your doctor will tell you they are out of your system in a few months. Xanax, for example, can disastrously affect your levels of the neurotransmitter GABA, which is involved in sleep. Also see the books Drug Muggers by Suzy Cohen, Supplement Your Prescription by Hyla Kass, and The Nutritional Cost of Prescription Drugs by Ross Pelton and James LaValle. Blogger Monica Cassani at Beyond Meds also covers this subject a lot.

The same can be said of any supplement. If you ever took anything in large amounts for a long period of time, it might have affected levels of its cofactors. Vitamin D, for example, can lower vitamin K levels, among others. L-glutamine, often used in huge amounts by body builders, can deplete vitamin B6. Nitrous oxide, aka laughing gas — you know who you are — can deplete folate.

Lyme disease. This is significantly under-diagnosed. Mainstream doctors rely on an unreliable blood test for diagnosis and often won’t order the test if you don’t remember getting the stereotypical bullseye rash, which half of patients don’t get anyway. Unfortunately the far more accurate test (about 75%, said one alterna-doc) by the company Igenex is upwards of $750. The good new is you don’t need a prescription.

Mold or biotoxin poisoning. One of the first doctors to bring this to the public’s attention was Ritchie Shoemaker. His books are a good place to start. I also recommend the pdfs put out by a citizen science group made up of a group of his former followers, who are making many new discoveries about effective treatment and about mold behavior. Some of their findings about recovering from mold and other biotoxin poisoning, borne out of personal experience, differ significantly from Shoemaker’s opinions. For one thing, the group has found that mold remediation of a home rarely works when someone has reached a certain level of illness, because it cannot eliminate the toxins themselves, only the mold spores. A significant percentage of “moldies” have also been diagnosed with Lyme.

Pyroluria. In pyroluria, the body can’t process sufficient vitamin B6. You can be born with it, in which case your life probably sucks, or it can develop from a long-term deficiency. Convincing your doctor to test for it might not be easy, but you can arrange it yourself for about $129. I used The Bio-Center Laboratory in Wichita, Kansas. The test does not require a prescription or blood draw but it does require careful handling — refrigeration, close timing, etc. Here is a list of symptoms.

Thyroid wonkiness. Most doctors only test TSH and not the other hormones, and use the wrong lab ranges to evaluate results. Stop the Thyroid Madness has lists of recommended lab work and optimal lab values.

Please let me know if you have any other suggestions for this list.

Hunting the mysterious origins of geographic tongue

by Kara

My experiences with geographic tongue (GT) started about ten years ago. GT is an unpleasant condition where patches of papillae are missing from the surface of the tongue and appear as smooth, red areas with slightly raised borders. The patterns of the lesions can change daily or hourly. It’s considered benign, but it can be painful, especially when eating acidic or abrasive foods, and is very unattractive. Because my GT makes me feel like my mouth is dirty all the time and that I have bad breath, I generally open my mouth less, am always covering my mouth or restricting myself when I laugh, and feel embarrassed to kiss my husband.

There seems to be no definitive understanding of what causes GT. When I ask doctors about it they don’t seem to take it seriously, so I’ve been doing research on my own. I’ve gathered bits and pieces of information from the internet and conversations with others and from monitoring my own condition. I have three theories as to the cause: 1) allergies, 2) vitamin B12 and/or zinc deficiency, or 3) post-nasal drip in general, either allergy related or caused by colds.

I developed GT in my early 30s, around the time I started developing my first allergies. We were living in an apartment in New York City that was situated right next to a garbage chute and had a bad roach problem. My husband was able to fill a small snack-bag with the roaches he had sprayed and killed. (He brought the bag down to the super, demanding they bring in an exterminator). Interestingly, my youngest daughter, who was about two, developed GT at the same exact time that I did. She also had dry patches of skin behind her knees and the inside of her elbows. I vaguely recall her doctor saying it was a form of eczema and that it was allergy related, but I can’t recall for sure. I once read somewhere that GT is similar to eczema in the way it manifests itself in changing patterns.

The coincidental timing of my GT and allergy onset and that of my daughter’s led me to believe that GT is an allergy symptom -– specifically, allergies which cause sinus congestion and post-nasal drip. I became further convinced of this when I came down with a bad sinus infection and my doctor prescribed antibiotics and Zyrtec. After taking these medications for a couple of days, I felt complete relief from my GT symptoms for the first time.

As the years progressed, however, my allergies worsened, and the Zyrtec did not seem to have the same effect. I eventually developed allergy-induced asthma and went to an allergist who told me that I have allergies to dust, roaches, cats and mold. I started going to her on a weekly basis and have been going to her for the past three years or so. My asthma is now under control, and I generally suffer less from my allergies. The geographic tongue improved noticeably with the allergy treatments, but did not resolve completely.

Because another woman I know with GT is also a vegetarian like me, I started wondering if the cause could be a vitamin B12 and/or zinc deficiency, developed as a result of my vegetarianism. My thinking was that the deficiencies were causing an imbalance in my immune system, but I’m not sure. I take B12 regularly now, but I don’t see any clear improvement. My next experiment will be to try taking zinc lozenges in addition to the B12, to test whether zinc might play a part in this.

When I get a sinus infection or regular cold that results in post-nasal drip, the GT comes back with a vengeance. This makes me wonder if it’s related not to allergies but to sinus issues in general. I don’t know. Do bacteria drip down my throat from my sinuses and trigger the GT?

My daughter’s GT seems to have gone almost completely away. Her tongue is as smooth and healthy as a baby’s, which I am thrilled about. She still does have occasional flare-ups of eczema, but I haven’t been taking note of whether her GT comes back during these times or not.

Kara is the post author, but in the comments below Marjorie’s avatar describes her as the post author. This is not correct but I don’t know how to change it. Apologies for the confusion. Kara is not actually responding to comments herself anymore because I don’t know something about raising two children while working full-time and studying for a PhD. Whatevah.

A list of supplements that don’t work very well in the versions sold in the US

This past year I’ve learned that some of the nutrient supplements on the shelves in the US don’t work very well, either because a significant part of the population can’t process them, or because the version used is poorly absorbed by the body, or because they are so cheaply formulated that the filler would make you sick before you could get enough of the active ingredient to resolve your deficiency.

Here’s everything I know so far. Needless to say, the better versions are more expensive and harder to find.

Folic acid: Processing this synthetic vitamin into its active form requires methyl groups and those of us who are methyl-challenged (low methylators) need to use the methylfolate version. Some sources say that the folic acid formulation is pointlessly inefficient for anyone. Using methylfolate instead certainly can’t hurt.

Calcium carbonate. Calcium carbonate requires stomach acid to work, and is hard on the stomach for some people. Calcium citrate absorption doesn’t require stomach acid. (This issue isn’t as big a concern as the others listed here.)

Magnesium oxide: This is not as bioavailable as other options, such as magnesium citrate. According to the National Institutes of Health’s Office of Dietary Supplements, magnesium lactate and magnesium chloride are even better options, but they are harder to find in pill form. You can also absorb magnesium through the skin in the form of epsom salts (magnesium sulfate) and magnesium chloride, which can be found in a spray oil.

Vitamin B1 – thiamine hydrochloride. This is poorly absorbed by the body. If you are only mildly deficient, it might be all you need, but I needed a fairly large dose and couldn’t stomach it at all. When I switched to the more efficient benfotiamine, I had no trouble and noticed results much faster. Another version is thiamine tetrahydrofurfuryl disulfide (TTFD), which is what I use.

Vitamin B2 – riboflavin. This is also poorly absorbed. Riboflavin phosphate AKA riboflavin-5′-phosphate AKA flavin mononucleotide (FMN) is a better formulation.

Vitamin B6 – pyridoxine. Some people have trouble converting pyridoxine to its active form, pyridoxal-5-phosphate (P5P). You can buy the active version in supplement form, usually referred to as P5P. Some experts say you just have to use a part of your dose in that form; the rest can be pyridoxine.

Vitamin B12 – cobalamin or cyanocobalamin or hydroxocobalamin (used in injections).
Like folic acid, it requires a methyl group to convert to its active form. I’ve followed a discussion group on B12 whose members are adamant that these types are pathetically inefficient and that methylcobalamin should be used. (There is also adenosylcobalamin AKA dibencozide AKA coenzyme B12, but I was never clear what the difference is.) If you are having injections, you might have to search a bit to find a compounding pharmacy that can prepare the methylcobalamin shots, which is less stable than the other versions and has to be carefully shipped and stored.

The reason B12 tablets come in doses with such large numbers — 1,000 mcg., 5,000 mcg. — is because the body can only absorb about 1% of it at a time.

Vitamin D2 – ergocalciferol. Depending on what you read, vitamin D3 (cholecalciferol) is either three or five times more bioavailable than vitamin D2.

Vitamin K1 – phylloquinone. Vitamin K2 (menaquinone) is the preferred version, but I don’t know a lot about it. Vitamin K3 (menadione) has been banned so you shouldn’t have to worry about that one.


Update December 24, 2013: See also the post on methionine.

Adventures in Nutritional TherapyMy ob/gyn has only two treatment suggestions for menorrhagia, or heavy menstrual bleeding. Or, as I call it, Niagarrhagia. The first treatment is a prescription NSAID that can reduce output by 40%. Since my body freaks out at every Rx besides antibiotics, it not an option for me.

The second treatment, ablation, was probably thought up by Torquemada and involves cauterizing the lining of the uterus. The resulting scar tissue prevents or at least severely hinders the accumulation of blood. In theory, I’d then have a pleasant, light period, instead of having to trot off to the loo every 20 minutes for three days a month.

My particular brand of Niagarrhagia started 20 years ago. It was neither painful nor prolonged but was still a PIA. Three years ago it developed a nails-on-a-chalkboard quality that sent my insomnia to near-total levels. Dr. Ob/gyn explained that if the flow gets to a certain point, you can actually feel the pressure on the cervix, which makes you want to hiss and grind your teeth. There was also an increase in pain, but I’m assuming that was just a subset of the lovely abdominal pain that started three years ago.

Once again, multiple tests say I’m perfectly healthy in the affected regions and the usual culprits have been ruled out: endometriosis, thyroid or hormone wackiness, etc.

Over the years I have found three things to help considerably and reliably. First of all, getting my calcium and magnesium levels up to what I assume is normal helped by about 30 percent for a while. But it eventually crept back.

From Sandy Simmons’ site I got the idea of increasing my vitamin K intake. She recommended lots of leafy greens, but most of them are goitrogenic (affecting the thyroid, usually by lowering iodine levels) so I went for alfalfa tablets instead. After six weeks of 9 tablets a day, (3, 3x day) I had a normal, manageable cycle and continued to as long as I took them, about 18 months. Eventually I got tired of the flipping things and quit, and after six weeks the old status reigned again.

I was about one month away from scheduling the ablation when for other reasons I decided to go crazy with the vitamin B12. I read Sally M. Pacholok’s book Could it Be B12? An Epidemic of Misdiagnoses and discovered that a newer form worked better for some people and that the old recommended dosages weren’t really very helpful for repleting deficiency.

After one month taking 25,000 mcg of methylcobalamin a day (that’s 5 5,000 mcg lozenges a day), I had what for most people would be a light period. Then I had another one 13 days later. The two together were still only 20 percent of the usual, but you see the problem. After three months of the B12 it started lowering my iron levels (everything lowers my iron levels), so I quit it. (The B12 also ended the headaches that niacin, iron, and B6 used to cause, and they still haven’t returned.)

Not only does Niagarrhagia cause low iron, it can also be caused by low iron. But since I couldn’t raise my iron levels if I ground up a cast-iron pan and free-based it, there is no point in speculating.

I finally learned that vitamin K comes in supplement form and that the amount in the alfalfa tablets was smaller than in a serving of kale, so I probably wasn’t repleting vitamin K so much as just barely getting by. How I missed the supplements before, I don’t know. I started experimenting with much larger dosages. At first I was confused by all the choices — K1, K2 M-4, K2 M-7 — but finally just went with whatever K2 was on the shelf at the health food store.

Anyway, I started at 500 mcg, which might be the equivalent of one large serving of kale, depending on who you ask, and saw a definite difference the next cycle. I went up to 700 and there was even more improvement. When I realized that some people take 15 mg a day to prevent osteoporosis (vitamin D needs vitamin K to move calcium into bones, I think), I became emboldened, ordered the liquid stuff, which gives you 1 mg (milligram) in a tiny drop, and started at 2 mg/day. Much better than swallowing 20 flipping capsules and all that magnesium stearate. (Update 12/24/13: I’ve found that taking 15 mg once a week is just as effective.)

My cycles since then have been like a normal person’s, finally, although I’m still sick of the whole damn thing. Those health class teachers in junior high who tell girls that menstruation is a beautiful thing and a sign of nature’s power, yada yada, can go #$@!& themselves. Or as my Ob/gyn put it, “They’re full of shit.”

(Here are two lists of the vitamin K content in foods which differ quite a bit: Linus Pauling Institute at Oregon State University and The World’s Healthiest Foods site.)

If this turns out not to resolve the issue permanently, I will seriously consider ablation. I have hesitated to resort to that because I don’t like the idea of concealing a symptom without actually solving the problem that created the symptom. The cause of this particular symptom undoubtedly has other symptoms, too, that I just haven’t connected yet. To put it another way, if wasps keep getting in the parlor, I want to know where the nest is.
Illustration: 1940s American Airlines travel poster by E. McKnight Kauffer. Remix by MRhea.

Headaches and migraines

Updated 03/12/13: P5P, a form of vitamin B6, seems to have solved a lot of this. See related link below.

My two migraine episodes were the usual tennis-ball-filled-almost-but-not-quite-to-bursting-with-boiling-oil-behind-your-right-eye kind of thing, caused by the old cliché MSG. The first culprit was a Chinese restaurant. The second, after I “got healthy,” was a package of sunflower seeds. All I’m saying is that never happened to me with Oreos.

Later I developed headaches, but not full-fledged migraines, from the amino acid L-glutamine, which I used to heal my celiac-ravaged lower intestine. Apparently this is a common reaction for people who also react to monosodium glutamate (MSG). The body can convert glutamine into the amino acid glutamate. It was still very helpful but I had to be careful how much I used.

As for run-of-the-mill headaches, I have only been bothered by them infrequently, and found them to be caused by:

  • waaaaay too much vitamin A from supplements, which for a while led to headaches whenever I ate anything with high vitamin A, such as liver
  • too much copper from ill-advised copper supplementation, also resulting in headaches when I ate copper-containing foods such as chocolate and liver
  • vitamin B6 and iron supplements, until I corrected my vitamin B12 deficiency
  • very low sodium levels, caused by dehydration on a hot day (two occasions)
  • insufficient stomach acid, causing brief headaches whenever I ate anything
  • vitamin D3 supplements, by lowering my thiamine (vitamin B1) and B6 levels too far.
  • amino acid supplements, including 5-HTP — In the case of 5-HTP, this was due to its effect on B6. See last link.