Could It Be B12?: An Epidemic of Misdiagnoses [Paperback]

Sally M. Pacholok RN (Author), Jeffrey J. Stuart DO (Author)

Book Description

Publication Date: June 1, 2005

A silent crippler stalks millions of North Americans. It afflicts one person with tremors, makes another depressed or psychotic, and causes agonizing leg pains or paralysis in still another. It can mimic Alzheimer’s disease, multiple sclerosis, early Parkinson’s disease, diabetic neuropathy, or chronic fatigue syndrome. It can make men or women infertile or cause development disabilities in their children. The disorder is vitamin B12 deficiency. This isn’t a new or fad disease. You’ll find it listed in the textbooks of any first-year medical student. Yet it may be the most misdiagnosed disease and, when this occurs, the consequences can be tragic.

Editorial Reviews

Review

"I defy you to read this book then not get yourself or a loved one tested for B12 deficiency." -- Dr. Eric Norman, developer of the UMMA test for B12 deficiency and founder of the first commercial laboratory to provide UMMA testing

"I have gained a distinct sense that we physicans, neurologists and psychiatrists have been miserly with our B12 diagnosis and treatments." -- John Dommise, M.D.

"Sally Pacholok, R.N. and Jeffrey Stuart, D.O. are to be congratulated for calling attention to this common disorder. The number of conditions and illnesses that can be attributed to deficiency of vitamin B12 is impressive. It is often under-diagnosed and under-treated by the medical profession. I recommend this book to professionals and patients alike who are interested in finding the underlying cause and cure of many common diseases and conditions." -- Kilmer McCully, M.D., author of The Homocysteine Revolution and The Heart Revolution

"As a practicing physician I can only hope that malpractice attorneys don’t read this book." -- Richard Nimbach, D.O.

"Exposes a major health-care scandal: the failure to identify and treat hundreds of thousands suffering from vitamin B12 deficiency." -- Bernard Rimland, Ph.D.
Director, Autism Research Institute

"I defy you to read this book then not get yourself or a loved one tested for B12 deficiency." -- Dr. Eric Norman, developer of the UMMA test for B12 deficiency and founder of the first
commercial laboratory to provide UMMA testing.

"What makes misdiagnoses' so probable is that this vitamin deficiency masquerades itself in so many symptoms...an eye-opening survey comes from the author." -- The Bookwatch, Midwest Book Reviews, January 2006

"What makes misdiagnoses’ so probable is that this vitamin deficiency masquerades itself in so many symptoms...an eye-opening survey comes." -- The Bookwatch, Midwest Book Reviews, January 2006

From the Inside Flap

A silent crippler stalks millions of North Americans--and any of us may be its next victim.
This crippler is a master of masquerade, striking different people in different ways. It afflicts one person with tremors, makes another depressed or psychotic, and causes agonizing leg and arm pains or paralysis in still another. It can mimic Alzheimer's disease, multiple sclerosis, early Parkinson's disease, diabetic neuropathy, or chronic fatigue syndrome. It can make men or women infertile or cause developmental disabilities in their children. Other times it lurks silently, stealthily increasing its victim's risk of deadly diseases ranging from stroke and heart attacks to cancer.
This medical disorder stems from a vitamin deficiency, but your standard multivitamin pill won't prevent it in many cases, and even high-dose oral formulas of this vitamin may not help. It's considered an "old people's disease" by doctors, but it can strike any person at any age, and it sometimes hits children the hardest.
The disorder is vitamin B12 deficiency. If you develop this deficiency it's easy to spot, easy to treat, and easy to cure--but only if your doctor diagnoses you before it's too late. Unfortunately, that frequently doesn't happen.
This isn't a new or fad disease. In fact, you'll find it listed in the textbooks of any first-year medical student. It's not a rare disease, either: If you're over forty, you're at an elevated risk for dangerous B12 deficiency, and if you're over sixty, you have up to a 40 percent chance of having dangerously low B12 levels.

See all Editorial Reviews

Product Details

• Paperback: 232 pages
• Publisher: Linden Publishing; 1 edition (June 1, 2005)
• Language: English
• ISBN-10: 1884956467
• ISBN-13: 978-1884956461
• Product Dimensions: 9.4 x 6.3 x 0.8 inches
• Shipping Weight: 10.4 ounces
• Average Customer Review: 4.8 out of 5 stars  See all reviews (69 customer reviews)
• Amazon Best Sellers Rank: #466,302 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

184 of 185 people found the following review helpful:

5.0 out of 5 stars This book accurately chronicles the devastation caused by B12 deficiency, September 7, 2006

By 

John V. Dommisse MD "NutrnlMtblc" (Tucson, AZ United States) - See all my reviews
(REAL NAME)   

This review is from: Could It Be B12?: An Epidemic of Misdiagnoses (Paperback)

I am an MD, a nutritional physician, and a psychiatrist (Canadian-board-certified) who has been studying vitamin B12 extensively since 1976, and applying that knowledge in my private nutritional, metabolic and psychiatric practice in Tucson AZ since 1994 (and Portsmouth VA before that).

This book is an outstanding compilation of anecdotes, references and experiences on the "underground devastator" of our society. The reason why this is not common knowledge in the medical profession in the US is because the laboratory "normal range" is way too low. In Japan the range is 2.5 times higher at its low end - and Japan has very little "Alzheimer's Dementia", and less depression and bipolar disorders, than we do in the US.

In the 26 years that I have been investigating B12, memory disorders and depressive/ bipolar illnesses, NO patient who came to me with a memory problem (early Alzheimer's) has gone on to Alzheimer's dementia, and I have a near-perfect track record in helping people overcome depression and bipolar disorders. These outcomes are largely due to my permanent optimization of every patient's serum B12 level.

Congratulations to Ms Sally Pacholok RN on an outstanding recording of most of the important facts and treatments for this serious condition. I believe it to be the best book out there for a combination of both medical and lay readers on this condition.

[To anyone reading this review: Please do not simply go and buy B12 tablets or lozenges and start taking them, before getting an accurate serum level measured.]

John V Dommisse MD, MBChB, FRCP(C)
Tucson, AZ, USA

143 of 145 people found the following review helpful:

5.0 out of 5 stars The Definitive Book on B12 Deficiency, Diagnosis and Treatment, December 23, 2007

By 

Jeffrey Dach MD "Jeffrey Dach MD" (Hollywood, FL USA) - See all my reviews

Amazon Verified Purchase

This review is from: Could It Be B12?: An Epidemic of Misdiagnoses (Paperback)

Could it Be B12, An Epidemic of MisDiagnoses by Sally M. Pacholok R.N. and Jeffrey J Stuart D.O.

A good friend of ours had a sudden unrelenting pain in her leg which baffled her doctors. After many months of suffering, and many failed treatments and medications, she tried inexpensive vitamin B12 injections which immediately worked, providing complete relief. Occasionally the pain returns and reminds her it's time for another B12 injection. The injections are easy with a small syringe and tiny needle, and the B12 is injected under the skin twice a week.

There are many more stories of B12 misdiagnosis in Pacholok's book. Nurse Pacholok first describes her own ordeal with pernicious anemia and B12 deficiency which motivated her to become an expert on the topic. Working within the health care system, she was appalled at the numbers of patients with obvious signs and symptoms of B12 deficiency who were misdiagnosed.

Finding the medical system apathetic and unresponsive to her advice about B12 deficiency, Pacholok wrote this book to empower medical consumers and to educate their physicians. Pacholok is on a crusade to change medical practice to routinely screen for B12 deficiency, and her book is one giant step in that direction.

Vitamin B12 deficiency is estimated to affect 10%-15% of individuals over the age of 60 years. 40% of elderly hospitalized patients have low or borderline serum B12 levels, and 50% of long term vegetarians have B12 deficiency.

B12 absorption depends on many cofactors, so it is possible to take adequate amounts of B12 in the diet, and still have a B12 deficiency. Absorption of B12 requires gastric acid, so anything which reduces gastric acid production such as gastric surgery, atrophic gastritis, or antacid drugs could produce B12 deficiency. The very popular antacid drug Prilosec (omeprazole) has been clearly shown to decrease B12 absorption. Other antacid pills such as Prevacid, Protonix, antac, Nexium, Aciphex, Zantec, Tagamet, Pepcid, Maalox, mylanta, reduce gastric acid, inhibit B12 absorption and may produce B12 deficiency. Drugs such as Metformin and other diabetes drugs can cause B12 deficiency. The anesthetic agent, Nitrous Oxide, or "laughing gas", used in dental or surgical procedures causes B12 deficiency

Pernicious anemia is the second most common cause of B12 deficiency. This is an autoimmune disease with loss of Intrinsic Factor, in which antibodies damage the stomach lining interrupting the B12 absorption mechanism.

Other people at risk for B12 deficiency include vegetarians, people with eating disorders such as bulemia and anorexia, inflammatory bowel disease with malabsorption (ie. crohn's).

Auto-immune diseases such as Hashimoto's thyroiditis may be associated with B12 deficiency(pernicious anemia).

Vitamin B12 deficiency can cause unusual neurological symptoms such as tremor, gait disturbance, severe pain, and can mimic MS (multiple sclerosis) or even Parkinson's Syndrome. The physical signs and symptoms can often mimic other diseases and the diagnosis is frequently missed.

B12 deficiency damages the myelin sheath around the nerve fibers, this is a soft fatty insulating material which is also damaged in demyelinating diseases such as multiple sclerosis.

B12 deficiency can cause mental changes such as irritability, apathy, sleepiness, paranoia, personality changes, depression (including post-partum depression), memory loss, dementia, cognitive dysfunction or deterioration, fuzzy thinking, psychosis, dementia, hallucinations, violent behavior, in children; autistic behavior, developmental delay.

B12 deficiency can cause neurological signs and symptoms of abnormal sensations (pain, tingling, and/or numbness of legs, arms trunk or anywhere),diminished sense of touch, pain or temperature (may mimic diabetic neuropathy Charcot foot), loss of position sense, weakness, clumsiness, tremor, any symptoms which may mimic parkinson's or multiple sclerosis, spasticity of muscles, incontinence, paralysis, vision changes, damage to optic nerve (optic neuritis).

Atherosclerotic vascular disease is increased by B12 deficiency including; Coronary artery disease, TIAs, CVA, heart attack, heart failure, claudication, all associated with elevated homocysteine levels caused by B12 deficiency.

B12 deficiency causes Megaloblastic Anemia (enlarged red blood cells with anemia). In this type of anemia, the red blood cells are fewer in number, yet they are larger in diameter (this large size is called megaloblastic and is measured on the CBC with the mean corpuscular volume, MCV). The anemia can cause fatigue, and weakness.

Cervical Dysplasia and increased risk for other dysplasias and cancers are associated with B12 deficiency. B12 supplementation is cancer prevention.

Most doctors do not test for B12, and if they do a test it is the serum B12 which may be unreliable because of the wide normal range. A more accurate test, urinary methyl malonic acid was developed by Eric Norman MD, and is inexpensive and widely available (MMA). The Methyl Malonic Acid MMA is elevated in the urine and serum in patients with B12 deficiency. Pacholok makes the case that everyone presenting for medical care should be routinely screened for B12 deficiency with the MMA, serum B12 and Homocysteine tests.

Treatment is Curative:

Treatment with inexpensive B12 injections or sublingual tablets is curative. Recent work by Kuzminski showed that daily 2 mg. oral B12 serves as well as monthly 1 mg intramuscular B12 injections. Serum Homocysteine is elevated in B12 deficiency. It is important to discover B12 deficiency early, since nerve damage can be irreversible if not discovered right away.

In conclusion, this is the definitive book on B12 deficiency, diagnosis and treatment for the lay reader and for the interested physician. As a result of reading this book, I now routinely test serum B12 and Urinary MMA on ALL patients, and have been surprised to find many symptomatic B12 deficient patients completely missed by the medical system. Needles to say, it is very gratifying to see ill patients completely recover with B12 injections.

I applaud the authors on a job well done, bringing B12 deficiency to the attention of the public, and no doubt saving many lives in the process. This book will make a positive impact on the nations's health, and change medical practice for the better. The only thing I would change about the book is to give Sally a name that is easier to pronounce.

Jeffrey Dach MD

100 of 101 people found the following review helpful:

5.0 out of 5 stars Physician's Critique, March 1, 2006

By 

DOCTOR "OPTIONAL" (USA) - See all my reviews

This review is from: Could It Be B12?: An Epidemic of Misdiagnoses (Paperback)

As a primary care physician I read Ms. Pacholok's book "Could It
Be B12?" with great interest. In the early 1950's a vitamin B12 shot was a sign-off gesture by many primary care doctors at the close of a Pt's visit. It seemed as though everyone got a B12 shot for no apparent documented reason. You must understand that laboratory testing in those days was awkward, expensive, and impractical. My own mother went monthly to our family GP for her routine B12 shot. She swore by it. As progress in medicine was made it became apparent that either the United States was the world's capital of pernicious anemia or perhaps B12 shots were a doctor's way to make a fast buck. With this type of prevailing sentiment anyone who wanted to be taken seriously as an ethical physician shunned the practice of "routine" Vitamin B12 shots. I do believe this stigma prevails to this day. Just mention B12 deficiency as a possible cause for any disorder and you're likely to see a smirk come across the doctor's face as those mental neurons flash back in recollection of those charlatans of an earlier era. But now unlike then we have an easily obtainable and accurate test for Vitamin B12 deficiency. I do believe medicine's nihilistic attitude toward B12 based on the past makes for a mental block on behalf of a lot of doctors to even consider B12 deficiency on their list of differential diagnoses. This is unfortunate. My only advice to the public is as Ms. Pacholok advocates: 1. Avoid shot gun B12 therapy; 2. Insist that you and your loved ones with signs and symptoms get tested. It's the right thing to do. I enjoyed the book and give it a 5 star rating.
Dr. Anonymous