An “Undiscovered” Vitamin, Now Vitamin B12

 

       Vitamin B12 was in the process of being discovered when I was in medical school from 1943 to 1946.   The Dean of the University of Rochester (NY) School of Medicine and Dentistry had received the Nobel Prize for discovering that eating very large amounts of liver cured pernicious anemia .  It is still called pernicious anemia (PA) even though it is not pernicious any more because it is curable by the modern version of George H. Whipple’s discovery.

        When I arrived on the scene as a student, the active ingredient of liver that cured the anemia had not been isolated, but concentrated extracts of liver had been devised controlling PA with one injection of a few milliliters per month of this extract (a milliliter is about ¼ teaspoon).  A crucial part of unraveling the cause of PA was that something was missing from the stomach secretions of these patients necessary for the normal absorption of an undiscovered dietary constituent and eating the enormous portions (pounds per day) of liver overcame the defect.

         Ultimately, when vitamin B12 was isolated from liver extract, amazingly only one microgram per day turned out to be needed for continued health.  Such a tiny quantity is invisible---even ten times as much would still be invisible---small wonder it took so long to obtain it in pure form.  One twentieth (5%) of the vitamin B12 molecule is the trace element cobalt.  Cobalt was not known to be essential in human nutrition prior to the isolation of vitamin B12, and cobalt has not been found to be essential other than as a part of the vitamin B12 molecule. 

         It is interesting that even partial removal of the stomach for treatment of peptic ulcers may interfere with the absorption of vitamin B12.  Surgical treatment of these ulcers , although effective, is obsolete because of modern medications which totally shut down acid production in the stomach.  Survivors of ulcer surgery need monthly shots of vitamin B12 just like PA patients.

          Now we know that many elderly people do not absorb vitamin B12 entirely normally.  For them it is usually sufficient to take about 1000 times the normal requirement daily by mouth.  This “large” dose is still only 1 mg. (1/1000 of ¼ teaspoon). Vitamin B12 is present only in foods of animal origin including yeast as an animal, but the tiny amounts of yeast in bread is not enough.  So total vegetarians, sometimes called vegans, need vitamin B12 supplements.  Vegetarians who eat dairy products, for example most Hindus, do not need supplements.  A blood vitamin B12 level will tell whether you are deficient, but if you are a vegan, you need extra---don’t bother with the blood test.

         No more new vitamins have been discovered in the last 50 years.  I have stopped telling people to eat a balanced diet in order to get the vitamins yet to be discovered and therefore not present in multivitamin pills.  Now I say, “Eat more vegetables because vegetables contain substances which enhance health even though you don’t die without them---vitamins that ‘didn’t make the team’ if you will.”  Bioflavonoids are examples.

John A. Frantz, MD

City Health Officer of Monroe

May 21, 2005

     Genius is no more than childhood recaptured at will, childhood equipped now with man’s physical means to express itself, and with the analytical mind that enables it to bring order into the sum of experience, involuntarily amassed.          Charles Beaudelaire, French poet – 1821-1867