Could It Be B-12? An Epidemic of Misdiagnoses

by Sally M. Pacholok

About the Book: Could It Be B-12? An Epidemic of Misdiagnoses The Underground Classic That Has Saved Lives Do you suffer from Fatigue, Anaemia, Depression, Forgetfulness or Frequent Falls? Is your child diagnosed with a developmental delay or autism? Has your love done been diagnosed with dementia, Alzheimers or MS? Your symptoms may have an underlying cause-vitamin B12 deficiency. B12 deficiency is a public health crisis that even most doctors dont know exists. Millions suffer from B12 deficiency, but few patients are diagnosed. The symptom of B12 deficiency can look exactly like Alzheimers disease, depression, dementia, multiple sclerosis, and other serious diseases, so its routinely misdiagnosed. B12 deficiency can cause permanent, crippling never damager- and many patients dont get treatment until its too late. Vitamin B12 deficiency can be cured with inexpensive vitamin treatment, if you are tested and diagnosed in time. A modern classic that has literally saved lives, Could It Be B12? is the only complete and authoritative guide to B12 deficiency. Newly revised, updated and expanded with the latest scientific findings, Could It Be B12 ? Second Edition reveals how standard medical practice has for decades misdiagnosed and under-treated B12 deficiency? and shows what you can do to protect ourself and your family from this crippling disorder.

Genres: Health, Nonfiction, Nutrition, Medical, Medicine, Self Help, Reference

352 pages, Paperback

First published June 1, 2005

Reviews

[Margo Kelly · Rating 3 out of 5]

I'm glad I read this, and I read the whole thing. And while I learned a lot from the book, I can't give it more than three stars simply because the writing was so over-the-top fanatical. Surely not every ailment on the face of the earth can be caused by a B12 deficiency ... okay, maybe the authors didn't say that exactly, but close.

I was also surprised to read on page 4, "B12 is produced in the gut of animals, it's also the only vitamin that you can't obtain from plants or sunlight. Plants don't need B12, so they don't produce or store it. To obtain B12 from your diet, you need to eat meat, poultry, fish, eggs, dairy products, or food fortified with B12..."

So, I'm still researching that concept. According to veganforum.com, "Vitamin B12 is found in algae, peas, clover, alfalfa, mustard..." and "Foods fortified with vitamin B12 (as cyanocobalamin) may be a potential problem if cooked."

But Pacholok writes, "...several plants that some supplement manufacturers claim are high in B12, such as spirulina and tempeh, actually contain "pseudo-B12" analogues that block the uptake of the real vitamin, sometimes causing dangerous deficiencies" (page 4).

I also really take issue with any person that places blame (of any sort) with mothers who are well intentioned doing the best they can to care for the well-being of their children. Maybe I misread or misunderstood, but Pacholok writes, "Vegetarian and vegan mothers also are the most likely to breastfeed for long periods of time, which puts nursing children at high risk of B12 deficiency if the mothers don't supplement their diets correctly. Children can be severely crippled by B12 deficiency..." (page 95).

The extremist language used in the book was certainly a turn-off, but I can't deny the potentially useful and life-changing information in this book. If you are suffering from any physical ailment, it might be worth your time to consider whether or not you are deficient in vitamin B12 and give this book a read.

Also, be aware that the authors really beat it into the reader’s head that getting a “typical” blood test for B12 deficiency is not good enough. They go on and on and on about the reasons, but just so you know, if you’re going to be tested, you need the other tests recommended by the authors.

And, if you want to supplement your diet with B12 … I’ve done the research for you (well, I did it for me, but I’ll share the info with you).

A supplement needs to be a SUBLINGUAL B12 tablet that has 1000-2000 mcg of B12 in it and it needs to be made from either hydroxocobalamin or methylcobalamin. Many vitamins that are mass produced use the less expensive form of B12 made from cyanocobalamin which uses Cyanide. Why put that in your body?

If you're not getting B12 shots, then you need to take a sublingual B12. A sublingual is placed under your tongue and you let it dissolve there. The blood vessels under your tongue absorb the vitamin directly into your blood stream, so the vitamin doesn’t have to go through your digestive system before “maybe” being absorbed.

Before reading this book, I had been taking oral B12 tablets made from the cyanocobalamin with minimal results. So now I’ve purchased new B12 vitamins – sublingual hydroxocobalamin 2000mcg. And, I’ll let you know if they make a difference for me.

[Jodi · Rating 4 out of 5]

Buy this book! Even if you think B12 deficiency is very unlikely to be the cause of your symptoms - buy this book. You may well be surprised.

B12 deficiency is far more common than many doctors are aware of. That includes nutritional doctors and authors of books on vitamins too.

It can be the sole cause of symptoms or a person can develop a B12 deficiency after years of being ill with something else. Many diseases which affect the gut or have an autoimmune component can put you at an increased risk of B12 deficiency even if you eat a very good diet.

This book explains:

* B12 deficiency is very common but often not diagnosed early or at all, and is often poorly treated.

* B12 deficiency is very response to treeatment and easy to treat but only if treatment is begun early. Time is of the essence in treating B12 deficiency.

* Patients may become wheelchair- or bedbound, incontinent and suffer many serious cognitive issues if B12 deficiency is left untreated. It can also become fatal if untreated. The book includes many case studies, both of patients that were diagnosed too late and those that were diagnosed early and so saved from being made far more ill.

* Why many patients need regular B12 injections and sublingual B12 may not work for them although can be useful to boost B12 levels between injections for many people.

* B12 deficiency can cause very different symptoms in different people. Some may just have balance and memory issues, others may have burning arm and leg pain and incontinence issues, or may seem to be very mentally ill and depressed. This book provides the most comprehensive symptom list for B12 deficiency I've seen. It's very helpful. Many symptom lists for B12 deficiency symptoms are very basic and unhelpful.

There are a few things in the book that could maybe be improved somewhat in the next edition.

* I'd love to see a brief section on the start-up reactions that some of us can have when starting B12 treatment. (Mine are huge!) This includes severe fatigue and feeling like you've taken knockout drops, bad detoxification reactions and also huge sleep-wake cycle changes and reduced sleep. This is a huge issue because when B12 is listed only as being 'harmless' it can give a wrong impression that these symptoms indicate that B12 is not being tolerated well or is being taken at too high a dose when in fact the opposite may well be true. While B12 is not toxic, it can actually cause harm to some patients. This harm is likely only short term and will be tiny when compared to the horrific neurological effects of an untreated B12 deficiency but it is still harm. The symptoms are made worse by the patient not being aware that they may occur and so not being able to prepare for them too.

* Some of the cutting-edge MTHFR websites (recomended reading!) explain that ideally it's best to take both some methylcobalamin (or hydroxycobalamin, which can be converted in the body to methylcobalamin in most people) as well as some adenosylcobalamin. These two forms do different things in the body and not everyone may convert between different types well. It seems like a person can be deficient in one or both forms of B12, and so all B12 is not necessarily B12. For this reason it'd be a great move if all sources of B12 information gave clear information about the benefits of taking both active B12 types and not just one of them.

* Higher doses of sublinguals could be talked about. Many people take more than the 2-5 mg of methylcobalamin sublinguals daily that this book mentions.

But overall this book is pretty great. I'm so glad I was able to buy this book, and to get it so quick because it was digital as well! The authors of the book are very passionate about B12 deficiency and have done a great job with this book.

I have had Myalgic Encephalomyelitis (M.E.) since 1995 when I was 19. I developed symptoms of B12 deficiency (on top of my primary neurological disease) in early 2012. I was not aware that these new symptoms were B12 deficiency for around 18 months. 18 months after these new symptoms started I began high dose B12 treatment - to pretty wonderful effect. The change I've seen in just 2 weeks of treatment is amazing!

I took an extra 1 mg methylcobalamin sublingual when I was a few pages into the book and worked on it as I read. I finished the book that night and the next day I started working my dosage up - aiming to get it as high as I could without getting severe start-up effects. By day 3 when I was up around the 10 mg mark I knew for absolute certain that finally I had found the cause of my strange new symptoms as they had already improved so much. It was a very happy day!

(BTW M.E. is not at all the same thing as Chronic Fatigue Syndrome (CFS) as most B12 deficiency resources incorrectly state, along with almost everyone else, sadly. It is also not true to say that B12 deficiency can cause all the symptoms of M.E. It cannot, although it can cause all the symptoms which are included in CFS definitions.)

I knew late-stage B12 deficiency caused neurological damage that could be permanent but I had no idea it could affect your bladder and kidneys and cause all sorts of vein, breathing, lymph and cardiac issues. My awareness of the B12 deficiency facts was poorer than I'd thought it was. (I've put my symptom list and treatment reactions up on my health site FWIW.)

B12 deficiency wasn't mentioned at all in many of my otherwise excellent health books that went into such details about the benefits and deficiency symptoms of so many vitamins, minerals and other nutrients. Often when it was mentioned it was listed as very rare or just not an issue at all. The doctors that wrote those books need serious re-educating on this issue!

I saw the 'Could it be B12?' book so many times in my 'recommended books' list on Amazon and elsewhere but I thought buying it would be a frivolous purchase. I really wanted to though as I love health books and am a big huge B vitamin fan. Several times in the last 2 years I added it to my cart then deleted it again. I was sure it'd be only a health-trivia read and not affect me at all personally. Huge mistake as it turns out! I should have bought that book in 2011, not 2013. If only!

If you have any new onset neurological issues, nerve or vein pain, oedema, bladder or kidney weirdness such as pain or recurrent UTI-like symptoms etc. make sure you investigate B12 deficiency! Get the three tests done and then start your B12 trial. It is very simple to treat but early diagnosis and treatment is vital.

This book is a must-read if you have a B12 deficiency or any new and unexplained symptoms. I give it 4.5 stars.

Jodi Bassett, The Hummingbirds' Foundation for M.E. (HFME) and Health, Healing & Hummingbirds (HHH)

[Sharice · Rating 5 out of 5]

This book is a complete lifesaver and that's no lie. I'm so glad I read this, it's like my Bible now. Really gave me some food for thought and has given me hope that one day I might start to feel well again. I was diagnosed with a severe B12 deficiency in October 2010 after feeling ill since the December 2007/January 2008. I am so grateful to the authors of this incredible book.

[Guillaume Belanger · Rating 3 out of 5]

Essential information; way too long and repetitive
I think this book is an important read in order to grasp the importance of B12, the devastating consequences of B12 deficiency, and the generalised ignorance about this in the health care field. However, it should be a quarter of the size. There is a lot of things that are repeated several times in slightly different ways, and there are way too many reported case histories. I have written a concise article about B12 based on the book that I think captures the essence of it in far fewer words here: B12: Your Life Depends on It

The authors of this book, a registered nurse and an osteopathic doctor,  work and have worked for a long time as health care practitioners, and have seen a lot of things. Clearly the most remarkable of these is the universality of both misdiagnosis and missed diagnosis of B12 deficiency. They have seen time and time again the devastating toll that this deficiency has brought to hundreds of people, from the youngest infants to oldest elders, and have also seen, very unfortunately, almost as often the sad truth that the doctors treating these people failed to recognise that their problems were are stemming from B12 deficiency.

Therefore, they wrote this book to inform as many individuals as possible, and at the same time give themselves the necessary backing in the form of a written document for what has been since then their mission to bring to the medical community as a whole the direly needed attention this issue deserves.

In that sense, the book is very convincing, and hence serves its purpose well. It is, however, very long to get through, and contains surprisingly little biochemistry and physiology even if the main subject, B12 or cobalamin deficiency, is wholly biochemical and physiological in form and in action. There are a very large number of examples and reported cases of victims of B12 deficiency, what their symptoms were, how their story unfolded over weeks, months and years, how they recovered sometimes fully, sometimes partly, and sometimes not significantly from being unable to remediate to the permanent neurological damage incurred.

Furthermore, as with most of the health books I have read and listed in this bibliography, there is a lot of repetition throughout the book. It is clearly a book written for the masses (even though there are some sections, including a whole chapter dedicated to health practitioners, with more technical details and specific advice). As such, the authors are primarily concerned with getting their main message across, which is: do not allow yourself or your doctor to be ignorant to the devastation that B12 deficiency can cause, and everyone's B12 levels should be kept above 600 pg/ml throughout life.

[Peggy · Rating 5 out of 5]

Everyone should read this book! Some say that it is simplistic to suggest that a B12 deficiency could be at the root of so many diseases, but as the author explains, B12 is more than just a vitamin, it is involved in digestion, cell reproduction and many more functions. I think the day will come when doctors will routinely check for this as they are now starting to check vitamin D levels. A vitamin B12 deficiency may cause different symptoms in different people. Some people are not able to convert the B12 from supplements into a form that their bodies can use. Also if a person has too much folic acid it may mask a B12 deficiency.

[Kris · Rating 3 out of 5]

I began reading "Could it be B12" because I was researching possible problems related to my son's anti-seizure medications, and was reading about the fact that Lamictal (an anti-seizure med) can leech folate out of the system, thereby making it difficult to process vitamin B12. That, and the fact that my son is on the autism spectrum, and vitamin B12 shots are one of many possibly therapies tossed around to "improve" the symptoms of autism, made this book worth a read.

There is no doubt that the information within the book is well-researched. I am sure that, when an individual has a true B12 deficiency, this book is extremely valuable. I also agree whole-heartedly that there are doctors out there who would dispute the necessity of having people tested for B12 deficiency as a matter of course, and that drives me as crazy as it does the authors of this book. It would be so easy to provide a few tests and at the very least rule out that B12 deficiency is a cause for some of society's most difficult and perplexing medical issues.

In our situation, though, after reading this book, I get the distinct impression that my son does not have a B12 deficiency (based on the books list of symptoms) -- that his autism diagnosis was legit. I still think that B12 supplementation should be tried, and if it improves ones energy levels, cognition, etc, then it's worthwhile -- and if not, there's no harm done at all.

I agree with others, though, that there is an implication that B12 deficiency causes all sorts of medical problems, and this may be true -- but after reading this book, you get the impression that the authors almost think that B12 deficiency has it's tentacles in EVERY medical issue. Maybe I over-interpreted this, but it sure felt like this was the case as one lumbers toward the end of the book. By the 12th chapter, I was just skipping through the information, because much of it was getting repetitive.

If B12 deficiency is indeed your problem, then this book is a godsend. It's definitely worth a read, but read it with a grain of salt and a level head.

[coffeedog]

Excellent lay-person's guide to the importance of B-12 metabolism and the problems that may result in the absence of absorption of B-12 vitamin.

[kim manzari · Rating 1 out of 5]

I found reading this book has helped me need not to be on certain meds like lycera and tramadol.too.

[Amanda]

Read pertinent chapters, good information. Go get your B12 checked! I've already found B12 defiency in a couple of my patients.

[Nicole · Rating 3 out of 5]

I was recently diagnosed with a B12 deficiency and immediately started scouring for books that could help me understand a) what are the symptoms of a B12 deficiency, b) why someone would have a B12 deficiency and c) the best treatment options. I think Sally Pacholok has achieved the first (a) objective well and partially on the second (b) objective but I was still underwhelmed overall. As others have noted, the tone throughout the book is off-putting as you can tell Sally has a huge chip on her shoulder (she mentions early in the book that at one job she was asked to sign a paper saying she wouldn’t talk about B12 anymore or she’d be fired). It does feel as though she’s taken her “advocacy” a bit too far into defensiveness.

On that note, it’s difficult to tell who the book was written for. If it’s for physicians/providers, there may not be enough detail into the biological mechanics of how the body processes B12 (the summary on page 5 is about the extent of explaining how B12 is processed). If this is intended for a layperson/patient, then there are far too many studies and citations used to explain all the links of a B12 deficiency to many health ailments. The many chapters explaining how B12 deficiencies can manifest as seemingly other diseases just felt repetitive and almost as though the author was trying to convince everyone how important testing for B12 is.

As a patient, I wanted to know — what steps can/should I do to rectify a B12 deficiency? Sally pretty much limits the next steps to — get B12 injections (methyl-B12 or hydroxyl-B12 preferably). Fine, that information is easy to find now through many different sites and discussion forums about B12. What is missing is any information about what else may be needed for the body to properly use those B12 injections - while she references other vitamins/minerals, there’s no clear mention in a summary form of recommendations for other vitamin deficiencies to test along side B12 or supplements to take when taking such high doses of B12. From other reading, that appears to be quite a misstep as very high injections of B12 (due to a deficiency) can create large depletions of other key vitamins and minerals.

Finally, while this second edition was printed in 2011, there is very little mention of the MTHFR gene and its role with B12. I have a hard time recommending this book when it’s missing so many relevant components for those suffering from a B12 deficiency as the recommendations appear outdated.

If you are looking to understand how a B12 deficiency can present differently in different population groups, I think this book could be helpful. If you have been diagnosed with a B12 deficiency, I would stick to the B12_deficiency subreddit for more up to date recommendations and actually helpful information. Mike Newman’s book “Vitamin B12 Deficiency and Chronic Illness” (though at times seemingly less scientifically grounded) had better action items for someone suffering from a B12 deficiency. I continue to search for an updated B12 book that really helps patients understand how to best combat their deficiency. If that it was you are searching for, I would not read this book.

[Marie (SassyUrbanite) · Rating 5 out of 5]

"What is the cost of failing to diagnose vitamin B12 deficiency early? The answer may stun you: BILLIONS OF DOLLARS! Not only are insurance companies and the government (through Medicare and Medicaid) paying out enormous amounts of money, but so are taxpayers and society. Why? People who are injured as a result of B12 deficiency OFTEN BECOME DISABLED. The consequences of this invisible epidemic include fall-related trauma, frequent emergency room department visits, frequent medical office visits, repeated hospitalizations, cognitive decline (dementia), nursing home placements, unnecessary prescriptions, blood transfusions and/or erythropoietin use, psychiatric care, unnecessary radiologic and invasive testing, malpractice settlements and payments, need for mobility devices (wheelchairs, scooters, walking devices), rehabilitation (in and out patient), physical therapy, occupational therapy, loss of income to disability, social security payments or disability insurance, family stress as relatives become caretakers or disabled individuals."

This book is a must read for anyone who has ever been diagnosed of having low B12s. I know with experience of how hard it is to get a correct diagnosis. I was told I had a b12 deficiency many years ago and was told to take oral over-the-counter supplements when I eat a diet rich in B12s. Sadly the doctors are very incompetent about this issue. It runs in my family. My mom is currently in a wheelchair with a diagnosis of diabetic neuropathy and she has also tested for low b12s in the past. Unfortunately I have come to the conclusion that I will have to sue my doctors as they keep not addressing my neurological issues that I know deep in my heart stem from a B12 deficiency. My doctor appointments keep getting pushed farther due to the CORVID-19 pandemic but as soon as I can have my appointment I am arming myself with my wits and thanks to groups on Facebook, I am armed with documents that I will be giving my doctor to help with my lawsuit. It's so sad and unfortunate that it has to come to this. But maybe if enough people sue it can be brought to the attention that it greatly deserves.

[Xzs · Rating 4 out of 5]

This book is a must read for anyone working in the medical or health & wellness sphere. I don’t fall into either category but the book is equally valuable to the lay reader. Upon reading the first few pages, it became evident to me that my dad has been struggling with a B12 deficiency ever since undergoing cardiac bypass surgery last year. His doctor reluctantly agreed to test him, while prefacing that his B12 levels would most certainly come back normal. Low and behold his B12 came back in the gray zone and he is now supplementing. We have already noticed an improvement in his symptoms - shortness of breath, mental fog/confusion, fatigue, lack of energy, etc. This book had been sitting at the bottom of my pile of books to read for several years - I purchased the book a while back because I suspected I was vulnerable to B12 deficiency but I never got around to reading it. It was some of my own recurring symptoms that finally led me to dig this book out from under the bottom of the pile. The book provided insight into my own long standing symptoms. I didn’t anticipate that the information in the book would also help my dad regain quality of life! In short, this is an extremely valuable book, with life saving information. I plan to keep it front and center in the health & wellness section of my home library for future reference. Thank you to the authors for spreading this information and improving countless lives along the way...your crusade is making a difference.

[Simone · Rating 5 out of 5]

This book was published in 2011 so the issues with MTHFR weren’t as well known back then, though the authors DO mention genetic mutations inhibiting B12, as well as things like autism etc. so they were on the right track.

I would recommend the book to everyone as it’s likely you or someone you love is experiencing symptoms of B12 deficiency... it is so common. At the very least you will know what to look out for, and signs that are often missed or contributed to other deficiencies. Even things like Restless legs syndrome, speech delays, shortness of breaths, tingling in the hands or legs, chronic fatigue, constipation or diarrhea, ringing in the ears... the list goes on.

The authors recommend anyone with symptoms gets tested first so you have your baseline numbers, but if you’re looking to prevent deficiencies in the first place they recommend the bare minimum supplementation would be oral 1000mcg B12 daily for both adults (including during pregnancy and breastfeeding) and children.

[Mylene Van Haaften · Rating 4 out of 5]

The cover is calm, but don't let that put you off, the power is really in the content of the book!
The book immediately starts intriguing, the prefaces make me want to know more. I wanted to read this book out of personal interest, I have been getting b12 injections for years, and out of broader interest, I am a holistic lifestyle coach and always want to delve into aspects that can offer people a better life. This book does what it promises, it contains background information, facts and examples and, despite being very medical, is very readable. The most important lesson I take from this book is that b12 deficiencies are often hidden and that every individual should remain very alert to complaints. In that case, this book is highly recommended. I have already recommended it to a very sick friend and will also discuss the book with my doctor.

[Pushpa Jhawar · Rating 5 out of 5]

This book is an eye opener. So many things stemming from deficiency of B12 is astonishing. I was skeptical before I read the book about the link of B12 with so many disorders and diseases but this book explores all the very many links that a lot of small and big health issues have with B12.
The tone of the book is however a little off putting, she sounds like a zealot. But the message indeed is important.
Highly recommended read.

[Chrissy · Rating 5 out of 5]

This book could save your life - it did mine! I had no idea I was B12 deficient as my symptoms were strange - shortness of breath, fast heartbeat, dizzy, anxiety, insomnia, aches/pains, tingling in my feet, I just thought I was getting old! I was deficient. I now take Methyl B12 and feel much better. Thank you Sally Pacholok!

[Louise · Rating 5 out of 5]

This book should be read by every family

Every household should have a copy of this book. Every doctor's surgery should have it and each doctor, nurse and every other staff member should be made to read it and use it as their Bible! That is how important this book and the information it contains. A life saver!

[Linda Cole · Rating 5 out of 5]

This is fascinating reading - b12 deficiency has impacted many lives including mine

If you're looking to understand more about your b12 deficiency or that of your family or are a medical professional please read this book.

Well written,clear and seems to be grounded in evidence too.

[Jackelynf · Rating 5 out of 5]

B12 has been an immense help to me

B12 is helping me immensely and before I discovered my B12 problems I was getting very serious symptoms! Thanks ti the unfo in this book my life has probably been spared serious impairment!

[denise · Rating 5 out of 5]

Given me the invite to now question my doctor on my levels are low and need injections as have all related systems that go with b12 definitions.

Rate 100% this book as I've now got the knowledge to arm myself at the doctors thank you so much Sally. M pacholok

[TLBL · Rating 5 out of 5]

This is one of the best books on health that I have ever read, and I read a lot of them. It is not only an eye opener, but can also save your life.

[Sasha · Rating 3 out of 5]

3.5 stars

[Barbara Rodgers · Rating 5 out of 5]

Great information!

[NotreallyMe · Rating 5 out of 5]

This book explains why B12 is necessary to save your life even when the doctor has told you you’re not deficient because your “normal” blood serum is fine .
User friendly and brilliant links .

[Lynette · Rating 2 out of 5]

Good info to have

[P I · Rating 5 out of 5]

science-based revelations

If you want to know how to help yourself and others, read this informative book on s very modern epidemic.

[Delia Porter · Rating 5 out of 5]

It definitely has an effect especially those with the MTHFR gene mutation. With the SAD diet in America we are always eating things that block absorption of what we need.

[Katie Gawthrop · Rating 5 out of 5]

This book has been a life saver! Go get your B12 checked. Found out I have a severe deficiency and am on the road to recovery now. So many of my symptoms make sense now!

[Althea Armour]

Very interesting but rather repetitive.

[Victoria]

In progress - 12%