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What About Deficiency of Vitamin B12 in Pregnancy?
What about Vitamin B12 in Pregnancy? Thanks to public health campaigns, it seems like everyone is aware that sufficient Folic Acid Prevents Neural Tube Defects. As such, most governments have made folic acid supplementation of many foods mandatory to prevent these permanent birth defects. A lesser known fact, however, is that sufficient Vitamin B 12 is just as important as folic acid in the fetal development of the brain and spinal cord- yet a handful of researchers seem to be the only ones concerned about the equally important public health issue of Vitamin B12 in Pregnancy.
Is Folic Acid More Important than B12 in Pregnancy
Supplementation of the food supply with nutrients not found naturally in those foods is so commonplace that most of us would point to milk as a good source of Vitamin D, yet in nature there is no vitamin D in milk whatsoever. Most recently, governments in several western countries have chosen to fortify bakery products with folic acid in order to prevent the spinal cord malformations that occur in infants during development when this vitamin is lacking. Fortunately, supplementation and education has worked to reduce the incidence of the spinal cord defects known as Neural Tube Defects- or NTD’s.
Yet the same research that led to the conclusion that lack of Folic Acid caused neural tube defects ALSO led to the conclusion that insufficient Vitamin B12 in pregnancy, a condition known medically as Cobalamin Deficiency, is a separate and independent risk factor for neural tube defects. But astoundingly, this information was ignored when the decision was made to begin widespread folic acid fortification!
“We found a 3-fold increase in the risk of NTDs in mothers
who had vitamin B-12 status in the lower quartile, regardless
of FA [folic acid] fortification.”
Vitamin B-12 and neural tube defects: the Canadian experience
Obviously, those responsible for this fortification did not read the science about the relationship between folic acid and vitamin B12 in pregnancy because it is well-known that supplementation with folic acid alone can actually PREVENT the only clinical sign of vitamin B12 deficiency that doctors look for. This condition, called Macrocytic Anemia, is easily detected on routine blood tests, but folate Effectively Prevents this sign without preventing the ACTUAL B12 deficiency.
“Folic acid fortification of the diet in North America
and elsewhere is giving rise to the potential risk of
undetected cobalamin deficiency, through “masking” by folate.”
Ralph Green, MD, PhD- University of California Davis
Is Deficiency of Vitamin B12 in Pregnancy Rare?
There are two other aspects of this problem that are important to note. First of all, the ‘official’ stance of most medical groups is that Vitamin B12 deficiency is ‘rare’, but studies have shown that it is actually quite common. Since vitamin B12 is found almost exclusively in animal products, those in the lowest socioeconomic classes who are unable to afford higher priced animal products are at an increased risk. And women who have chosen, for religious or health reasons, to eat fewer meat and meat products often unknowingly put themselves at risk as well. With huge numbers of women that fit into these categories, research points to the fact that Vitamin B12 Deficiency in women of childbearing age is hardly the rare phenomenon that medical groups have made it out to be. Interestingly, this is virtually the same problem with Vitamin D in Pregnancy as well.
The second aspect of this problem that is less understood is that the levels of Vitamin B12 in pregnancy found in the mothers of children with NTD’s were low, but would NOT have been low enough to be considered a true deficiency. Therefore, even if their doctors had been on alert for this problem and had actually done Testing for Vitamin B12 Deficiency, it still would not have been likely to be found anyway. These unique circumstances have led research groups, including teams from The University Medical Center of Nijmegen in The Netherlands and The Institute of Nutrition and Food Technology at the University of Chile in Santiago to urge consideration of vitamin B12 fortification of foods. In addition, American researchers Victor Herbert and Jean Bigaouette unsuccessfully petitioned the US Food and Drug Administration in 1997 for the vitamin B12 fortification of foods already fortified with folic acid.
That governments chose to fortify foods with folic acid without the consideration that it may very well mask deficiency of Vitamin B12 in Pregnancy that ALSO contributes to neural tube defects is obviously not based on science. In true governmental fashion, the decision was likely based more on outcries from bakery groups that Vitamin B12 would discolor their pure white products than it was based on the welfare of unborn children. Vitamin B12, however, plays just as important a role in the brain and spinal cord health of the next generation as folic acid does. But without public health campaigns teaching us of its importance, it is up to concerned individuals to get this information about Vitamin B12 in Pregnancy out to as many women as possible in order to decrease the incidence of these devastating yet entirely preventable birth defects.
Now, find out what you need to know about Magnesium in Pregnancy, another overlooked nutrient that pregnant women need in abundance.