Physiology:
Cobalamin is needed for normal nerve cell activity, DNA replication, and production of the mood-affecting substance SAMe (S-adenosyl-L-methionine). Cobalamin acts with Vitamin B6, and Folic acid to control homocysteine levels (homocysteine is a normal breakdown product of the essential amino acid, methionine). An excess of homocysteine is associated with an increased risk of heart disease, strokes, osteoporosis and Alzheimer's disease.

Similar to other B complex vitamins, cobalamine is considered an "anti-stress" vitamin because it is believed to enhance the activity of the immune system and improve the body's ability to withstand stressful conditions

Deficiency in Cobalamin may manifest in some of the following symptoms, fatigue, numbness and tingling of the extremities, confusion, memory loss, delusions, hearing problems, nausea, diarrhea, disruption of the mucus membranes of the especially the lining of the inner surface of the eye and the gums, etc. Decreased levels of Cobalamin can also result in increased levels of homocysteine, which can lead to osteoporosis, heart disease, brain toxicity.

Absorption of Cobalamin is impaired by deficiencies of folic acid, iron, Viatamin E, colchicine, corticosteroids, phenformin, oral contraceptives, cholestyramine, colestipol, clofibrate, epoetin, neomycin, methotrexate, metformin, potassium supplements, and the consumption of vitamin C just prior to taking Cobalamin. The use of nicotine and excessive alcohol can also decrease Cobalamin levels.

Individuals who have had all or part of their stomach removed are also at risk for for decreased levels of Cabalamin. In order to absorb Cobalamin an individual requires the "intrinsic factor" which is produced in the stomach, without the intrinsic factor even if an individual eats foods rich in Cobalamin you will still develop a deficiency.

Clinical Studies:
Cobalamin deficiency has been attributed to a primary cause of fatigue. Clinical studies have shown that individuals who were not even deficient in the vitamin following a B12 injection reported a significant increase in energy has compared to those individuals who received a placebo injection. Ellis FR, Nasser S. A pilot study of vitamin B12 in the treatment of tiredness. Br J Nutr 1973;30:277–83.

Modern day uses:
Today, Cobalamin is prescribed by physicians and herbal specialist for the following positive effects:

• Formation of red blood cells (deficiencies in Cobalamin can lead to anemia)
• Combined action with folic acid and B6 to reduce homocysteine levels
• Helps to metabolize food
• Prevention Osteoporosis, heart disease and brain toxicity
• Important in the action of the immune system
• Formation of Myelin sheath that lines nerves cells
• Used for the treatment of male infertility
• Treatment of atherosclerosis (hardening of the arteries secondary to plaque formation in the arteries),
• Prevention of Chrohn's disease (inflammatory bowel syndrome)
• Promes DNA synthesis, the genetic material in all cells

Precautions and/or adverse effects:
Individuals with preexisting medical conditions should consult with their physician particularly if they are taking prescription or over-the-counter-medications or supplements. Women who are pregnant or breast feeding and children should also consult with there physician prior to taking any new supplements. Adverse effects from taking Cobalamin supplementation are rare, however, individuals with a rare hereditary optic nerve atrophy, Leber's disease, should not use the Cobalamin supplementation. Extremely high doses of Cobalamin may cause acne.

Black cohosh
(Cimicufuga racemosa)