Could it be [a Deficiency of Vitamin] B12? An Epidemic of Misdiagnoses
by Sally Pacholok, R.N. & Jeffrey Stuart, D.O.
2005, Word Dancer Press Inc., CA

Review by Robert Sealey, BSc, CA

Sally Pacholok learned about B12 deficiency the hard way, from personal experience. While training to become a nurse, she experienced symptoms which her doctors dismissed as “insignificant”.  One specialist charted her as a “hysterical female” before any diagnostic testing.  Soon after Pacholok was tested, that hematologist called to discuss Sally’s medical reality – she had a deficiency of vitamin B12, a metabolic condition called pernicious anemia, which often gets misdiagnosed. For over twenty years, Pacholok researched B12 deficiencies and compiled cases of patients who trusted their doctors to diagnose them accurately and treat them effectively, but found themselves misdiagnosed and mistreated or left undiagnosed and untreated. Untreated B12 patients risk permanent neurological complications.

Pacholok learned that deficiencies of vitamin B12 were first identified in the early 1900s. If patients’ symptoms included apathy, memory loss, restlessness, irritability, confusion, dementia, delirium, depression, delusions, hallucinations, paranoia and mania, they were considered “mad”. If those patients also had enlarged red blood cells (macrocytosis), their diagnosis was “megaloblastic madness”. In the 1920s, doctors administered raw liver to “mad” patients, thereby supplementing B12. Some patients recovered. It turned out that a deficiency of the 12th vitamin can cause blood, brain and other health problems. For decades, medical journals have reported patients who recovered after getting vitamin B12 supplements.

Even after a hundred years of medical research has consistently connected B12 deficiency with psychiatric and other problems, in some patients, the misdiagnoses and mistreatments continue. Few patients get tested for urine MMA (methylmalonic acid /creatinine ratio) or serum homocysteine. These tests can uncover B12 deficiencies, even if serum tests look normal. Mental patients don’t usually get supplements of vitamins; most psychiatrists quickly and easily prescribe pills, often without diagnostic testing. The authors point out that medications for depression and bipolar disorder usually cost more than $1,000 per year. Two and three drug combinations and other medications for multiple sclerosis or dementia can cost thousands of dollars. B12 shots cost $ 20 for a year.

Nurse Sally Pacholok and co-author Jeffrey Stuart, a physician who has practiced emergency medicine for more than twelve years, make this longstanding medical condition fresh and new for readers. They present a selection of patients who were misdiagnosed and mistreated but recovered after B12 supplements – best by injection. Each chapter has a list of research articles, both current and decades-old. Their book teaches us that a range of symptoms can lead to mistaken diagnoses when the root cause involves a deficiency of vitamin B12. Misdiagnoses include aging problems, neurological conditions (such as multiple sclerosis), stroke, heart disease and vascular problems (linked to high homocysteine), learning and developmental problems, infertility and even mental diagnoses (depression, bipolar disorder, schizophrenia and autism). The authors encourage patients and families to ask for tests (urine MMA and serum homocysteine) and supplement B12 to restore normal levels.

The late Bernard Rimland, PhD, known for researching autism and developing restorative orthomolecular treatments, recommended this book because “the authors provide an invaluable service for medical consumers who want to protect their families and for medical care providers who care about their patients.


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