Mayo Clinic Report on Low Vitamin B-12 and Parkinson’s Disease

Mayo Clinic has published a research commentary that analyzes the relationship between low levels of Vitamin B-12 and Parkinson’s Disease.

While the paper does not prove causality, it does “propose that vitamin B12 supplementation could be considered as an adjuvant approach to improve cholinergic transmission and, potentially, motor and cognitive function in patients with PD.” And it makes a case for “future clinical trials of high-dose vitamin B12 supplementation as a well-tolerated symptomatic adjunctive therapy for posture and gait instability and cognitive impairment in PD.”

Mayo Clinic Video:

The paper analyzes the potential relationship between vitamin B12 and acetylcholine metabolism. Dysfunction of the cholinergic systems in PD is thought to possibly play a contributory role in postural instability and cognitive impairment.

This paper also highlights the findings of other studies that have shown:

  • Vitamin B12 levels in patients with PD have been demonstrated to be lower than controls.
  • Lower vitamin B12 levels are associated with higher Hoehn-Yahr stage (more severe PD), cognitive impairment, and neuropathy in patients with PD.
  • Low vitamin B12 levels correlate with more rapidly worsening ambulatory capacity in patients with PD.
  • Low vitamin B12 and folate and high homocysteine concentrations have been shown to be independently associated with PD dementia compared with nondemented patients with PD.
  • Low B-12 levels in early stages of PD are a good predictor of a greater worsening of mobility as PD progresses.

Note that these “lower” vitamin B12 are still in the normal reference range for B12 tests, and even patients with “normal” vitamin B12 levels have faster motor progression if in the low-normal quartile.

This raises questions as to whether the PD disease state may have higher needs for vitamin B12.

Of additional concern, levodopa treatment increases homocysteine levels, requiring increased vitamin B12 and choline to methylate higher amounts of homocysteine. (Folate and vitamins B2 and B6 are also involved.)

I’m not a doctor and I’m not a scientist, and this is not medical advice, but Vitamin B-12 is inexpensive and relatively safe. It is worth discussing with your doctor. No one is suggesting that it will cure PD, but it could potentially lessen the severity. I hope we will see a clinical trial…but I won’t be participating in that trial, as it’s been a key part of my supplement routine for the past 5 years.

Read the original Mayo Clinic research commentary here:
Low Vitamin B12 and Parkinson Disease: Potential Link to Reduced Cholinergic Transmission and Severity of Disease
https://www.mayoclinicproceedings.org/article/S0025-6196(19)30177-6/pdf

Interestingly enough, we also discussed Vitamin B12 last month:
https://parkinson.fit/forums/topic/making-sense-of-the-latest-news-about-vitamin-b-12-and-parkinsons/