B12 and Hypo

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B-12 has two functions: one, methylocobalamin is used by the enzyme

methionine synthase to change homocysteine into methionine. When this enzyme

is not working, we increase the homocysteine in our system, which recent

research has associated with the increased potentiality of heart disease and

deterioration of the arteries and nerves. When the homocysteine is high, it

appears to be a nerve toxin, as well as a blood vessel toxin. The second

function of B-12 is as a coenzyme is using 5'-deoxyadenosylcobalamin in the

enzyme methyl malonyl-CoA mutase in the conversion of methyl malonyl-coA to

succinyl-CoA.

Elevated homocysteine also happens with deficiencies in B-6 or folic acid.

One of the major symptoms of B-12 or folic acid deficiency is macrocytic

anemia. Folate, also called folic acid, is needed to turn the uracil into

thymidine, an essential building block of DNA. This DNA is needed for

production of new red blood cells and for red blood cell division. B-12 is

involved because it is involved in the pathway that creates methyl cobalamin

This B-12 also produces a form of folate needed to make DNA. So, if there

is no B-12, folate can become depleted and DNA production slows down.

Another little side part of the methyl malonyl-CoA to succinyl-CoA

conversion is that when the B-12 is not available, the methyl malonyl-CoA

levels increase and are converted to methyl malonic acid, which accumulates

in the blood and urine. Since the B-12 is the only co-enzyme required in

this pathway, methyl malonic acid levels are considered the gold standard as

an indicator of B-12 deficiency. Other causes of high methyl malonic acid

(MMA) are genetic defects, kidney failure, low blood volume, dysbiosis,

pregnancy and hypothyroid. The MMA test is important because the progressive

medical community no longer considers serum B-12 levels an accurate

measurement of appropriate amounts of B-12. In other words, a normal serum

B-12 may not mean that B-12 levels are healthy. We need a urinary assay of

methyl malonic acid to really determine that.

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