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Is Vitamin B12 Causing Your Chronic Cough?

Sick Man CoughingVitamin B-12 deficiency is a known cause of central and peripheral nervous system damage. It has been implicated in sensory neuropathy and autonomic nervous system dysfunction -- which can in turn have a role in chronic, unexplained coughs.

A recent study showed that vitamin B-12 deficiency patients had a higher prevalence of laryngeal hyperresponsiveness. After being given B-12 supplements, their symptoms and laryngeal, bronchial, and cough thresholds significantly improved.

According to the study in the American Journal of Clinical Nutrition:

"This study suggests that [vitamin B-12 deficiency] may contribute to chronic cough by favoring sensory neuropathy as indicated by laryngeal hyperresponsiveness and increased NGF expression in pharyngeal biopsies of [vitamin B-12 deficiency] patients. [Vitamin B-12 deficiency] should be considered among factors that sustain chronic cough, particularly when cough triggers cannot be identified."

Dr. Mercola's Comments:

There's nothing worse than having a "mystery cough" that lingers and has no apparent cause.  Your doctor will tell you it might be a sign of bronchitis or asthma and try to get you to inhale anti-inflammatory steroidal medications, some of which have a very dubious safety history.

If this approach fails this new study suggests it would be worthwhile to consider a trial of of optimizing your vitamin B12 levels.  But doing this may be trickier than you think, more about this in a moment.

If you eat an all vegetarian or vegan diet, vitamin B12 is one of the nutrients your body is most likely deficient in. Vitamin B12 is one of the eight B complex vitamins and is naturally present in foods that come from animals, including meat, fish, eggs, milk and milk products.  Please note that vegetarian supplements of B12 are notoriously ineffective in raising B12 levels.

You might know that I recommend eating your egg or milk products raw or not at all, and this applies as well in the case of getting your B12.  Cooking the eggs and pasteurizing the milk denatures the fragile proteins in these amazing foods and may interfere with B12 absorption as well.

Another possible cause of your mystery cough could be either ulcers or asthma related GERD, which I will discuss below.  Optimizing your B12 levels also helps with both of these chronic conditions.

Ulcers as a Cause of your "Mystery Cough"

H. pylori bacteria, the actual cause of most cases of peptic ulcers and GERD in America, may be associated with vitamin B12 deficiency and could be the underlying cause for your cough in the first place.

Studies have shown that removal of the H. pylori bacteria from the stomach increases absorption of B12.  This bacteria appears to interfere with your stomach's parietal cell's production of intrinsic factor, which is essential to getting the B12 your body needs out of the foods you eat.

In fact, without intrinsic factor, which diminishes as you age, it's virtually impossible to get B12 from your diet.  This also means the older you get, the more likely you will need to supplement B12.

In one study, 56 percent of patients suffering from pernicious anemia (extreme B12 deficiency) had H. pylori bacterial infections in their stomachs.  Of these people, 40 percent saw their B12 levels improve with the removal of the H. pylori bacteria.

So if you suffer from a mystery cough, you may actually be suffering from a bacterial infection in your stomach that is causing both chronic deficient B12 levels (the stomach needs normal levels of hydrochloric acid to absorb B12 and H. pylori restricts stomach acid production) and possibly GERD related asthma symptoms. 

The first step to removing this cough from your life will be to remove the underlying causes of both GERD and poor B12 absorption: You need to get rid of your H. pylori infection.

How to Treat H. Pylori Infections and GERD

Contrary to what the pharmaceutical industry wants you to believe, the class of drugs including H2-receptor antagonists like Zantac and Tagamet, and proton pump inhibitors like Nexium and Prilosec, are the last thing you want to put into your body to deal with GERD and poor digestion.

These drugs will further shut down your stomach's production of stomach acid, which will further inhibit your ability to process nutrients like B12 from your food that your body needs.

Besides, the cause of GERD is not caused by excess production stomach acid, it's caused by not enough production of stomach acid

We know this because 20 year olds rarely suffer from GERD.  This is because when your body is young it produces plenty of stomach acid.  GERD begins to show up in your 30's and early 40's, when production of stomach acid naturally begins to diminish with age.

So don't believe the myth the drug companies want you to believe about the source of your stomach ailments, it's not an overproduction of stomach acid!  Most likely it's the H. pylori bacteria, which is treated with probiotics.

That's right, not antibiotics.  Probiotics, which naturally compete for space with the infectious bacteria and drive it right out of your stomach once healthy levels return to your intestinal flora.  Be sure when purchasing a source of probiotics to insist on only the highest quality available.

If H. plylori turns out not to be the source of your GERD, you probably need to start supplementing immediately with Betaine HCL to increase the acid in your stomach.  Consult a holistic doctor who will advise you on the appropriate dose and duration of this form of treatment.

Surprising Causes of Vitamin B12 Deficiency

Besides the causes listed above, other sources of vitamin B12 deficiency include:

  • Use of the drug metformin for Type 2 diabetes -- Use of metformin (brand names include Glucophage, Glucophage XR, Fortamet, Riomet, and Glumetza) may inhibit your B12 absorption, especially at higher doses.
  • Coffee consumption -- Four or more cups of coffee a day can reduce your B vitamin stores by as much as 15 percent.
  • Gastric bypass surgery
  • Exposure to nitrous oxide (laughing gas)
  • And the LEADING cause of vitamin B12 deficiency: food-cobalamin malabsorption syndrome -- This condition results when your stomach lining loses its ability to produce intrinsic factor, a protein that binds to vitamin B12 and allows your body to absorb it into your bloodstream at the furthest point of your small intestine.

The Role of Intrinsic Factor in B12 Absorption

The reason your body needs intrinsic factor is because vitamin B12 is a very large molecule. It is actually the largest vitamin discovered thus far, and the way it gets absorbed into your body is by far the most complex.

Intrinsic factor is a molecule protein made by your stomach. It grabs onto the B12 molecule and together they move through your stomach to your small intestine. When they reach the end of your small intestine, the intrinsic factor is absorbed first, pulling the B12 with it into the cells of your large intestine, where they are absorbed for use by the rest of your body.

Since the only way vitamin B12 can be absorbed into your system is through bonding with intrinsic factor molecules, which naturally decline as you age and also in response to an H. pylori infection, it's now easier to understand why so many people are not getting adequate B12 into their bodies.

Warning Signs and Symptoms of B12 Deficiency

Besides the above mentioned "mystery cough", there are actually a wide range of symptoms of vitamin B12 deficiency, from mild to severe, which can affect your body, mind and mood.

In general, the signs are:

  • Fatigue, lack of energy, muscle weakness, tingling in your extremities.
  • Mental fogginess or problems with your memory, trouble sleeping.
  • Mood swings, especially feelings of apathy or lack of motivation.

Even though vitamin B12 is water-soluble, it doesn't exit your body quickly like other water-soluble vitamins. B12 is stored in your liver, kidneys and other body tissues, and as a result, a deficiency may not show itself for a number of years until you finally run out of this naturally stored internal source of the vitamin.

This time lag is seeing symptoms of a B12 deficiency is a serious concern, because after about seven years of deficiency, irreversible brain damage can result.

Other symptoms of long-term, chronic B12 deficiency can include:

  • depression
  • dementia and Alzheimer's
  • anemia
  • neurological and neuropsychiatric conditions
  • female fertility and childbearing problems
  • heart disease and cancer

Sources of Vitamin B12

As I mentioned earlier, B12 is available in its natural form only in animal food sources. These include seafood, beef, chicken, pork, milk, eggs.

If you don't consume enough of these animal products to get an adequate supply of B12, or if your body's ability to absorb the vitamin from food is compromised, there's good news.

Science has recently developed a technology that can reduce the effective size of the vitamin B12 molecule and help you absorb this molecule into the fine capillaries under your tongue. The delivery system for these microscopic droplets of vitamin B12 is a fine mist you spray into your mouth.

This delivery system bypasses the intrinsic factor problem and is much easier, safer and less painful than having your doctor inject you with a vitamin B12 shot.

What to Do If You Suspect You Have a B12 Deficiency

Blood tests for vitamin B12 deficiency aren't as clear cut or helpful as they are for other nutritional deficiencies. Standard tests to assess vitamin B12 concentrations are limited because the clinical severity of vitamin B12 deficiency is unrelated to vitamin B12 concentrations.

Getting your B12 and MMA serum levels lab tested is one way to go, especially if you have a compelling reason to have "official" test results.

However, it is probably a more practical approach if you suspect or are concerned you are vitamin B12 deficient, to simply supplement your diet with B12 and see if your symptoms improve.

Vitamin B12 supplementation is completely non-toxic and inexpensive, especially when compared to the cost of laboratory testing.

If you aren't getting sufficient B12 in your diet, or you suspect your body isn't able to efficiently absorb the vitamin, I recommend you begin supplementation immediately with either an under-the-tongue fine mist spray or vitamin B12 injections.