Bone Fractures, Lung Most cancers, and Vitamin B12 Dietary supplements? 

What do randomized managed trials of high-dose each day vitamin B12 supplementation present about its results on most cancers threat, dying, and longevity? 

In 2019, “Affiliation of Excessive Intakes of Nutritional vitamins B6 and B12 from Meals and Dietary supplements with Threat of Hip Fracture Amongst Postmenopausal Ladies within the [Harvard] Nurses’ Well being Research” was revealed. Word, although, that solely the mixed excessive consumption of nutritional vitamins B6 (≥35 mg/day) and B12 (≥20 mcg/day) was related to an elevated hip fracture threat. We all know that remedy with excessive doses of vitamin B6 could enhance hip fracture threat by itself. After a decade or so, those that had been taking high-dose (40 mg) B6 dietary supplements had a few 40 p.c greater hip fracture threat, however not these taking B12, as you may see beneath and at 0:35 in my video Do Vitamin B12 Dietary supplements Trigger Bone Fractures and Lung Most cancers?.  

That’s what the Harvard examine discovered, too. Excessive consumption of vitamin B12 alone was not related to elevated threat. In reality, some observational research counsel a barely decrease fracture threat at excessive B12 blood ranges. What we care about most, although, are interventional research, the place individuals are randomized to B12 so we are able to see what occurs, and once we have a look at these, we discover there isn’t a elevated fracture threat amongst these given B12. In conclusion, based mostly on randomized managed trials, excessive doses of vitamin B12 haven’t been proven to be related to the danger of fractures.

Okay, however what about this? In 2017, a examine discovered that males taking vitamin B12 dietary supplements appeared to have elevated lung most cancers threat. Now, the researchers didn’t discover any such affiliation in girls, and the elevated threat was largely amongst males who smoked. May it’s that B12 was feeding budding tumors? It’s arduous sufficient imagining a vitamin being carcinogenic by itself, particularly if it one way or the other solely impacts males and never additionally girls. “Replication of those findings in further potential research with cautious measurement of B vitamin complement use is warranted.” And, certainly, once you put collectively all of the observational research, there is no significant correlation between lung most cancers and ranges of B12 within the blood, whether or not you’ve smoked or not. If something, most research appeared to pattern in direction of greater B12 ranges being protecting, as you may see beneath and at 2:03 in my video. 

Then, in 2018, a brand new examine discovered an affiliation between total lung most cancers threat and better circulating ranges of B12, once more showing to be extra of a priority with people who smoke, as seen right here and at 2:16 in my video. 

Now, this was one other observational examine. These with greater B12 ranges had been simply noticed to have greater most cancers ranges. These of you who’ve been following my work know the drill: There are two potential points that come up in observational research that stop us from ascribing cause-and-effect: confounding components, also called “lurker variables,” and reverse causation.

What could be a lurker variable on this case? What could be a 3rd issue related to each greater B12 ranges and most cancers which may be the true trigger? Properly, who has greater ranges of B12 circulating of their blood? Those that eat a variety of meat and dairy, that are, the truth is, “crucial contributors to serum vitamin B-12,” that’s, B12 in our blood. And people who eat extra meat do are inclined to have extra lung most cancers: “Dose-response evaluation confirmed that consumption of crimson meat for 120 g per day would possibly enhance the danger of lung most cancers by 35%, and consumption of processed meat for 50 g per day would possibly enhance the danger of lung most cancers by 20%.” So, we’re usually speaking about 35 p.c extra threat for each quarter-pound burger eaten every day and about 20 p.c elevated threat for each breakfast sausage hyperlink. It’s no surprise these with greater B12 ranges of their blood may have extra lung most cancers. The B12 may simply be a marker for meat consumption.

And, when you keep in mind, reverse causation is when X could not result in Y, however, as an alternative, Y could result in X. So, as an alternative of excessive B12 blood ranges resulting in most cancers, possibly most cancers results in excessive blood ranges of B12. And, certainly, practically 75 p.c of sufferers recognized with most cancers exhibit elevated B12 ranges. So, elevated B12 ranges could merely be a marker for most cancers. In addition to taking additional B12, there are all kinds of causes your ranges can rise, reminiscent of liver issues, kidney issues, bone marrow issues, and most cancers, as you may see beneath and at 3:50 in my video. So, excessive B12 ranges may be a marker of brewing, however not but recognized, most cancers. 

What about observational research particularly linking B12 complement use to lung most cancers, although? These may additionally be reverse causation: “The consequence of being in danger for most cancers is that sufferers will have interaction in more healthy behaviors, together with taking multivitamins (reverse causality). The well-established causes, reminiscent of smoking, power obstructive pulmonary illness, and former cancers, are the actual lung most cancers dangers.” So, we’re left with this “rooster or the egg causality dilemma,” which is why, ideally, we’d like randomized managed trials to see if there’s any trigger and impact.

This grew to become much more pressing with genetic proof suggesting that these born with greater lifelong ranges could also be at elevated threat. Fortunately, as you may see beneath and at 4:47 in my video, we do have randomized managed trials—greater than a dozen randomized managed trials randomizing hundreds of individuals as much as 2,000 micrograms of B12 each single day for years, the truth is. 

The findings? “Vitamin B supplementation doesn’t impact most cancers incidence, dying attributable to most cancers, or whole mortality.” And this consists of particularly taking a look at lung most cancers, as seen beneath and at 5:02 in my video. In reality, if something, vitamin B dietary supplements may very well decrease the danger of essentially the most harmful type of pores and skin most cancers. 

When you missed my earlier video, take a look at Do Vitamin B12 Dietary supplements Trigger Zits?.

For my different B12 updates, see associated posts beneath. All of those movies might be present in one digital obtain: Newest Vitamin B12 Suggestions.

I’ve additionally explored vitamin B12’s position in stroke threat. See the associated posts beneath. That collection is offered for digital obtain, too: Why Do Vegetarians Have Larger Stroke Threat?.