Cardiovascular disease, vitiligo, vascular dementia, Alzheimer’s, autoimmune disease, fibromyalgia, pernicious anaemia, subacute combined degeneration of the spinal cord.

Cardiovascular disease

Vitamin B12, folic acid, vitamin B6 and biotin lower excessive homocysteine levels. Elevated homocysteine levels increase the risk of cardiovascular disease. Using dietary supplements containing these vitamins reduces stroke risk by 20%.

Vitiligo

Clinical research shows that many vitiligo patients (white spots on the skin) have very low concentrations of folic acid, vitamin B12 and vitamin C. These vitamins are involved in the synthesis of the skin pigment melanin. Using a combination of vitamin B12 and folic acid for 3 months stopped its spread, despite exposure to sunlight. See treatment.

Vascular dementia, Alzheimer’s

The large Framingham study has shown that people with elevated homocysteine values (over 12 μmol/L) are twice as likely to get dementia as people with normal homocysteine values. Serum homocysteine is often elevated in people with vascular dementia, but is often also elevated in Alzheimer’s patients.
It is known that folic acid has a significant influence on homocysteine levels. However, among elderly vitamin B12 is more important for homocysteine levels than folic acid. Elevated homocysteine levels are significantly and positively associated with white matter lesions, cerebral strokes and atrophy of the cerebral cortex and hippocampus, aside from cognitive limitations.
Seeing as homocysteine levels are easily lowered by supplementing B6, folic acid and vitamin B12, there is a chance these vitamins can help prevent dementia. Some studies have shown improvements in patients with dementia by supplementing vitamin B12, vitamin B6 and folic acid.
Measuring vitamin B12, folic acid and homocysteine are essential in early-stage dementia patients.
There is a relationship between Alzheimer’s and low blood values of folic acid and vitamin B12. The haematological characteristics of a vitamin B12 deficiency and/or a folic acid deficiency are often unrelated to the neurological characteristics of the deficiency. Most elderly people with a vitamin B12 shortage do not have anaemia or macrocytosis. Most symptoms are of a neuropsychiatric kind. Especially a B12 shortage is associated with depression.

Auto-immune disease

Auto-immune diseases are caused by autoantibodies of the immune system which lead to the immune system to stop functioning as it should. In endocrine conditions, as well as Parkinson’s disease and auto-immune diseases, a vitamin B12 deficiency should be ruled out.

Fibromyalgia

Many symptoms that are part of fibromyalgia can also be caused by a vitamin B12 deficiency. When blood results (serum B12) show that there is a vitamin B12 deficiency, treatment with sublingual tablets (that melt underneath the tongue) of 3000 mcg (3 mg) a day or with injections should be started. If symptoms do not abate after 2 months, the diagnosis of fibromyalgia can be made. Of course, both can exist simultaneously.
Fibromyalgia patients can benefit from vitamin B12 supplementation even without a B12 deficiency. This is because patients with fibromyalgia can suffer from elevated homocysteine levels in the spinal fluid. There is a clear relationship between these elevated homocysteine levels and exhaustion. Moreover, low B12 values in the spinal fluid are associated with exhaustion and neurasthenia. A vitamin B12 deficiency causes a deficient remethylation of homocysteine, leading to elevating homocysteine levels. Once vitamin B12 supplementation leads to a sufficient remethylation again, the homocysteine level will decrease. In conclusion, elevated homocysteine values in the central nervous system can characterise both patients with CFS and fibromyalgia.
Patients with fibromyalgia have also been shown to have abnormal red blood cells, which decreases oxygen transportation. This can also be improved by vitamin B12 supplementation. Supplementation of vitamin B12 will have to be administered using lozenges in the form of methylcobalamin (3000 mcg a day) (see treatment) or in the form of injections.

Pernicious anaemia

Wikipedia: “Pernicious anaemia is a type of macrocytic anaemia. This means red blood cells are enlarged. Vitamin B12, one of the essential parts for the synthesis of haemoglobin, is missing. Absorption of vitamin B12 takes place in the last part of the small intestine. Before this process can take place, vitamin B12 has to be attached to the intrinsic factor, which is produced by the stomach wall. Because of an autoimmune reaction against the stomach’s parietal cells, the production of intrinsic factor is disrupted and vitamin B12 cannot be absorbed by the body”. “Pernicious anaemia is a strong risk factor for stomach cancer.” (Sally M. Pacholok in the book “Could it be B12? An epidemic of misdiagnoses”.)

Subacute combined degeneration of the spinal cord

This means there is damage to the dorsal cords in the bone marrow and the pyramidal lateral cords. The damage is always bilateral and usually affects the left and right equally. Sometimes the disease is paired with affected peripheral nerves. (Polyneuropathy) This disease is caused by a vitamin B12 deficiency. B12 is necessary for maintaining the myelin sheaths, the insulating layers around the nerve bundles. Damaged myelin sheaths (sometimes permanently) cause paresthesia symptoms. These are tingling sensations, ‘pins and needles’ in the toes and the feet, and later in the fingers. Sometimes the tingling lessens during sleep, but after awakening it starts again and the patient feels as if "the body coming back to life".