This means that blood assays of B12 may appear normal while neurological damage due to B12 deficiency may be progressing undiscovered. Alternative practitioners such as Rudolph Ballentine, M.D., medical director of the Himalayan Institute for Yoga Science in Honesdale, Pennsylvania, are finding that unrecognized B12 deficiency in their vegetarian patients is more common than they had thought. When I was in medical school, Ballentine says, I was taught that what you get with B12 deficiency was pernicious anemia. Then, if it goes on too long, you get degeneration of the nervous system. But now we know that this is not necessarily true.
Neurological symptoms can precede hematological ones.
To find a more reliable indicator of B12 status, Ballentine scoured the literature and found that the most reliable test was one called the hypersegmentation index , a test of where you put blood samples under the microscope and count the number of hypersegmented nuclei - the more hypersegmented nuclei, the greater the B12 deficiency. We now examine people for hypersegmented nuclei and have found it in a suprising number of people, even vegetarians who eat dairy products, and even in a few people who are not vegetarian. It is alarming. William Doell, M.D. medical director of Metagenics, a San Clemente, California based formulator of dietary supplements, has had similar experience. Doell was a family practioner and nutritional consultant in Denver, Colorado, for 25 years and had many vegetarian patients.