EP.342/ can low b12 affect endo related nerve pain and period pain?
Today we’re continuing with our theme of micronutrients and their impact on endo pain and period pain. Today, we’re talking about B12.
Research on the use of B12 for pain suggests that B12 can reduce chronic pain (and menstrual pain) through various methods.
Firstly, B12 can inhibit the production of the inflammatory prostaglandins which are responsible for pain and inflammation, and are found to be especially high in people with endometriosis and dysmenorrhea (which is the medical term for period pain).
Additionally, B12 plays a role in supporting nerve health and pain signally pathways, which can influence pain perception. If nerves or pain signalling pathways are comprised, this could increase pain levels. This is particularly relevant to those of us with endo who are suffering with nerve related pain due to endo on the nerves, nerve damage from surgery, leg pain, etc.
So, what about endo and B12 specifically?
Research from 2023, on a study of 156 people, found that people with endo had a lower dietary intake of B12, and another study from 2022 found significantly lower levels of B12 in those with endo, with 20% being deficient. This 2022 study, like many others, also found elevated levels of oxidative stress in endo patients, which we know contributes to endometriosis progression and pain, and the researchers theorised that the low B12 levels may be in part contributing to the higher oxidative stress.
However, in contrast, a recently published study, that analysed data from 1999 - 2006, of 3351 participants, did not find a significant association between B12 intake and endometriosis risk, but did report that B12 may improve period pain with endo.
So, that leads me on to what we know about B12 and dysmenorrhea.
Recent research has found an association between a lower intake of dietary B12 and severity of menstrual pain, so in essence, a low intake of B12 was linked with more period pain.
Research on treatment for period pain showed that B12 supplementation, alongside fish oil, reduced period pain due to its inhibiting effects on prostaglandin production. Clinically, I also see good outcomes with B12 and/or a B complex in my endo clients for pain relief.
So what about food? The study that I mentioned earlier which observed deficiency in 20% of participants with endo, improved B12 levels with the application of the Mediterranean diet for three months, and this also reduced oxidative stress levels.
Sources of B12 include:
Eggs
Meat - especially beef and organ meats
Fish - especially oysters, clams, sardines, salmon and tuna
Dairy
Tempeh
Spirulina
Yes, I know - there’s not many plant sources here, and that’s because B12 is made from a bacteria which accumulates in animals, and can be found in tempeh due to the fermentation process, which develops the specific bacteria required to make B12. Spirulina also has small amounts and you can also buy products like nutritional yeast, which has B12 added to them.
Now, if you don’t eat these foods, or many of them, for example, you’re vegan or are veggie but don’t tolerate dairy, you really do need to supplement with B12, because it’s such an important nutrient and deficiencies can actually lead to long term nerve damage and mental health issues - and I’ve linked to an episode on this in the show notes.
B12 is generally safe and most supplements will average at about 1000 to 2000 mcg, with the NHS advising that 2000 mcg should be about the upper limit. However, if you are deficient, you may need more and may even need B12 injections, so work with your GP or health practitioner.
The other thing to consider, is that if you have an MTHFR gene mutation, you may be better off having methylated B12 supplement, which is an active form of B12 that the body does not have to convert and so you can use it more readily. However, some people find active B12 too stimulating and may struggle with nervousness, anxiety, palpitations, etc. so it’s best to start on a low dose and test your tolerance, and if you don’t do well on them, opt for the non-active forms. I’ve listed some examples in the show notes, but these are not affiliated or sponsored.
Lastly, giving the benefits of various B vitamins for pain and endo, it may be worth investing in a B complex rather than a B12 supplement alone.
Okay, that’s it for this week! Happy Easter to those of you who celebrate, and I’ll see you next week.
Show notes
B12 pain benefits and endo/prostaglandin link
https://pmc.ncbi.nlm.nih.gov/articles/PMC7468922
https://pubmed.ncbi.nlm.nih.gov/30700078/
https://pmc.ncbi.nlm.nih.gov/articles/PMC10178419/
https://pubmed.ncbi.nlm.nih.gov/20511671/
B12 and endo
https://www.mdpi.com/2227-9059/11/2/450
https://pmc.ncbi.nlm.nih.gov/articles/PMC10227355
https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-024-01895-x
https://pmc.ncbi.nlm.nih.gov/articles/PMC5625949/
B12 and period pain
https://pmc.ncbi.nlm.nih.gov/articles/PMC10178419
https://www.researchgate.net/publication/385143175_STRESS_PHYSICAL_ACTIVITY_AND_DIETARY_INTAKE_ARE_ASSOCIATED_WITH_DYSMENORRHEA_AMONG_FEMALE_STUDENTS
B12 and period pain relief
https://pubmed.ncbi.nlm.nih.gov/30700078/
https://www.sciencedirect.com/science/article/abs/pii/S0271531700001524
https://www.researchgate.net/publication/385143175_STRESS_PHYSICAL_ACTIVITY_AND_DIETARY_INTAKE_ARE_ASSOCIATED_WITH_DYSMENORRHEA_AMONG_FEMALE_STUDENTS
Supplementation
https://www.theendobellycoach.com/podcast/low-b12-and-endo
https://www.seekinghealth.com/blogs/education/methyl-free-vs-methylated-do-you-need-a-non-methylated-supplement
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This episode is sponsored by BeYou Cramp Relief Patches. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches. Click here to find out more and to shop: https://beyouonline.co.uk/pages/how-it-works
Produced by Chris Robson