Vitamin B-12 Supplementation for Nerve Pain and Stress

I find Vitamin B-12 supplementation for Nerve Pain and Stress to be a very valuable adjunct to treatment with acupuncture, Ayuveda, and Chinese herbal medicine.

Vitamin B-12 for Nerve Pain and Other Neurological Disorders

I find Vitamin B-12 particularly useful in the treatment of neurological disorders when they are aggravated by stress. Its often the case that even nerve pain due to a frank injury, like sciatic pain, improves somewhat with sublingual Vitamin B-12.

I also use Vitamin B-12 with patients who have poorly understood neurological type disorders that are associated with high stress levels, such as tingling and numbness in the arms or legs that is not associated with any kind of nerve entrapment syndrome, and also vertigo and dizziness or tinnitus, in the absence of neurological or MRI findings, and in the absence of sensorineural hearing loss.

Vitamin B-12 with Acupuncture for Peripheral Neuropathy

I have one patient who I treat with acupuncture and Chinese Herbal Medicine for his peripheral neuropathy which is arose after  multiple back surgeries for herniated discs. His surgeries did halp his sciatic nerve pain, but, sadly left him with electrical type shooting pain, pins, needle, numbness and what's called allydynia--numbness with hypersensitivity on the sole of his foot.

This patient noticed early on that under emotional and work stress his neuropathy worsened no matter what herbal medicines he was taking. We added sublingual Vitamin B-12 to the mix, and he has been pain free for one year.

Before that, he would periodically spend a whole night struggling with excruciating shooting, burning, stabbing, electrical pains in his left foot.

I also recommend B-12 to some of my patients who are "stress cases" with high anxiety levels, especially if they like to deal with their anxiety and/or stress by drinking to excess.

Vitamin B-12 Deficiency--Who Is At Risk?

Its hard to imagine, but some people actually are deficient in Vitamin B-12. According to Harvard University Medical School,

"Vegans are at risk of this syndrome, as are alcoholics or heavy drinkers who don't consider themselves alcoholics.  So are people with Chron's and celiac disease. 
Even more importantly the use of commonly prescribed heartburn drugs like Prilosec, which reduce acid production in the stomach, can be a possible cause of Vitamin B-12 Deficiency."
If you are:

  • over 50
  • on Metforman to regulate your blood sugar
  • PPI's, or H2 blockers, like Nexium, Zantac, Prevacid, or Pepcid
then you should have your blood checked for Vitamin B-12 deficiency.

From the Harvard Health Letter letter:

What harm can having too little of a vitamin do? Consider this: Over the course of two months, a 62-year-old man developed numbness and a “pins and needles” sensation in his hands, had trouble walking, experienced severe joint pain, began turning yellow, and became progressively short of breath. The cause was lack of vitamin B12 in his bloodstream, according to a case reportfrom Harvard-affiliated Massachusetts General Hospital published in The New England Journal of Medicine.

Who is at risk for developing Vitamin B-12 vacuity?

According to the article

There are many causes for vitamin B12 deficiency... two of them are practices often undertaken to improve health: a vegetarian diet and weight-loss surgery.
Plants don’t make vitamin B12. The only foods that deliver it are meat, eggs, poultry, dairy products, and other foods from animals. 
1)Strict vegetarians and vegans are at high risk for developing a B12 deficiency if they don’t eat grains that have been fortified with the vitamin or take a vitamin supplement.
2) People who have stomach stapling or other form of weight-loss surgery are also more likely to be low in vitamin B12 because the operation interferes with the body’s ability to extract vitamin B12 from food.
3) Conditions that interfere with food absorption, such celiac or Crohn’s disease, can cause B12trouble. 
4) So can the use of 
commonly prescribed heartburn drugs, which reduce acid production in the stomach
(acid is needed to absorb vitamin B12). The condition is more likely to occur in older people due to the cutback in stomach acid production that often occurs with aging.

How to Supplement? Sublingual Vitamin B-12

The good news is its so easy to supplement B-12. You can get inexpensive sublingual B-12 at Trader Joe's, any health food store, or online from Amazon or Take them daily, at a high dose. 

Chinese and Ayurvedic Alternatives to PPI and H2 Blockers

Its a simple blood test to confirm if you are deficient in B-12. Even if you are not a vegan, if you are over 50, or on either Metforman to regulate your blood sugar. or PPI's, or H2 blockers, like Nexium, Zantac, Prevacid, or Pepcid,  which half the country is, then get your blood checked.

Do you HAVE to take PPI's or H2 Blockers?

People over 50 tend to have poorer absorption of nutrients from food. According to Chinese Medicine everyone's digestion weakends after round about age 36. This is why we tend to gain weight. We don't require as much food, but we keep eating it anyway.

 But this is what Ayurveda and Chinese Medicine are all about--living with the aging process by adjusting our diet to acomodate the weaking of our Agni digestive fire (Spleen and Stomach Hun Hua in Chinese Medicine) that is a natural function of the aging process.

Ayurveda and Chinese medicine are rich in the use of churna spice mixtures, and also digestives "candies" made from dried Hawthorne fruit with orange peel, or dried Amla fruit with cumin, salt, and long pepper, to improve absorption and digestive fire.
While severe B-12 deficiency can cause  symptoms like jaundice and paranoia, less severe symptoms such as 
  • fatigue
  • difficulty thinking
  • memory loss
  • weakness
  • balance issues, difficulty walking
  • strange sensations like numbness and tingling in your hands, feet, or legs
can also be due to Vitamin B-12 deficiency. 

Vitamin B-12 Injections

If you have the money you can try B-12 injections which bypass the gut. I have met patients who claim to feel much better with these injections. Frankly I am not positive whether its not sometimes placebo affect when they are reporting improved "energy." As for injections of B-12 for nerve pain, I have had so much success with oral and sublingual B, that I have not needed to investigate further

Sub-lingual B-12 is typically well absorbed, and both safe and easy to take at high doses, and seems a great adjunct therapy for nerve pain and other functional neurological disorders that may be due to stress.

copyright Eyton J. Shalom, M.S., L.Ac. San Diego, CA, August 2017, All Rights Reserved, Use With Permission Ayurveda, Acupuncture, and Chinese Medicine in San Diego