Vitiligo and B12
Because vitiligo patients have low levels of vitamin B12, some experts believe the skin pigmentation disorder is caused by nutritional imbalance. Read on to find out if vitamin B12 can indeed reverse depigmentation and "cure" vitiligo.
Vitamin B12 is a water-soluble vitamin used by every cell of the body for metabolism. It is also known as cobalamin and it is the vitamin with the most complex structure.
There are 4 vitamers of cobalamin. These are cyanocobalamin, which is the synthetic form found in affordable vitamin supplements; and the bioactive forms, hydroxocobalamin, methylcobalamin and adenosylcobalamin.
The last two bioactive forms of vitamin B12 are made in the liver. About 2 – 5 mg of the vitamin is normally stored in the body. Half of this store is found in the liver, and this organ is very efficient in holding on to vitamin B12.
Hydroxocobalamin is synthesized by bacteria while cyanocobalamin is produced hydroxocobalamin is purified with activated charcoal (thus picking up cyanide). Cyanocobalamin is preferred for use in supplements and as food additives because it is stable against air oxidation and it forms crystals easily.
Hydroxocobalamin is more expensive than cyanocobalamin but it stays for longer in the body. Therefore, it is used when vitamin B12 supplementation becomes even more important and in cases where cyanocobalamin cannot be used due to its cyanine content.
Therefore, only adenosylcobalamin and methylcobalamin are solely produced in humans. These are also the most abundant forms of the vitamin in the body. Most of the store of vitamin B12 in the liver is in the adenosylcobalamin form.
Although humans may obtain their vitamin B12 from animal and plant sources, the vitamin is only produced by bacteria. For this reason, dietary sources of the vitamin are plants and animals with vitamin B12-producing bacteria living on them.
Plant sources of vitamin B12 are not reliable because the bacteria synthesizing the vitamin are only found in the soils and roots of the plant. The process of washing and cooking the plant actual removes most of the vitamin B12 present.
Animals are especially excellent sources of vitamin B12. Livers are rich sources of this vitamin but eggs, poultry, milk, dairy products, meat, shellfish and fish are also good sources of vitamin B12.
Dietary vitamin B12 can also be obtained from fortified foods including breakfast cereals, energy bars and energy drinks.
The recommended dietary intake of vitamin B12 is 2 – 3 micrograms per day.
Vitamin B12 deficiency may result from low consumption of vitamin B12-rich foods or improper absorption of the vitamin.
Vitamin B12 deficiency causes 2 major changes in the biochemistry of cells. The deficiency leads to an increase in the production of homocysteine and methylmalonic acid. Because folic acid deficiency can also increase homocysteine levels, the level of methylmalonic acid is a more accurate marker for vitamin B12 deficiency.
The conversion of homocysteine to methionine requires vitamin B12 as a cofactor. The methionine produced is needed in a number of essential biochemical reactions including syntheses of proteins, fatty acids, phospholipids and neurotransmitters.
Therefore, vitamin B12 deficiency leads to low production of methionine and a number of disease conditions.
The symptoms of vitamin B12 include anemia, impaired sensory perception, fatigue, depression, memory impairment and other damages to the brain and nervous system.
Vitiligo is a skin pigmentation disorder. It is the hypopigmentation of parts of the skin due to the destruction of melanocytes.
Melanocytes are the specialized skin cells found at the bottom of the epidermis and responsible for producing the skin pigment, melanin. Melanocytes are activated when sunlight penetrates the skin. To protect the skin from damage, they secrete melanin which absorbs most of the harmful ultraviolet radiation in sunlight.
However, if melanocytes are increasingly destroyed, the amount of melanin produced in the skin gets reduced dramatically. This causes a color change and white vitiligo spots appear on the skin.
Vitiligo affects about 1% of the population. It is usually first diagnosed between the ages of 20 and 40.
This skin disorder affects people of both sexes equally. It also affects people of all races although it is most visible in dark-skinned people due to the sharp contrast between those white spots and the normal, pigmented skin surrounding them.
Although everyone agrees that it is the increased destruction of melanocytes that cause vitiligo, there are various theories regarding its cause. The most popular theories regarding the cause of vitiligo are listed in the table below.
Vitiligo spots first appear on the face, hands and wrists. It is also commonly found around the various orifices of the body including the mouth, nostrils, navel, genitals and eyes.
These spots may stay localized or soon spread to other parts of the body especially the trunk. When spots expand, they grow out from the center and change size and shape. These spots can merge together to form large white patches all over the skin.
Vitiligo can also affect the scalp, eyes, inner ears and choroid of the eyes.
If there are only a few vitiligo spots and they do not expand to other areas of the skin, camouflaging with makeup and self-tanning lotions may be recommended. However, if the vitiligo is spreading, treatment may be required to stop further depigmentation and repigment the vitiligo lesions.
Recently, vitiligo has been studied as the product of nutritional deficiencies. This approach is supported by the low levels of certain vitamins and minerals in vitiligo.
When these nutrients are supplied through nutrients, it is possible to stop further skin depigmentation and help restore pigmentation to the white spots of vitiligo.
A study published in the journal, Clinical and Experimental Dermatology in January 2012 tested the relationship between vitamin B12, homocysteine levels and vitiligo depigmentation. This study confirmed the results of a number of similar studies that concluded that vitiligo patients do have higher homocysteine levels and lower vitamin B12 (and folic) levels.
In this new study, 69 vitiligo patients and 52 control subjects were recruited.
The vitiligo patients had higher levels of homocysteine and hemoglobin but the lower levels of vitamin B12, holotranscobalamine (a metabolite of vitamin B12) and folic acid.
The study’s author concluded that low vitamin B12 levels and high homocysteine levels should be taken as risk factors for vitiligo. They also deduced that vitamin B12 deficiency and hyperhomocysteinemia shared common genetic roots.
In another study published in Acta Dermato-Venereologica in 1997, vitamin B12 was tested as a vitiligo treatment.
The 2-year study recruited 100 vitiligo patients who were given a course of vitamin B12 and folic acid combined with exposure to sunlight or UVB lamps.
The results showed that 6 patients experienced total repigmentation; 52% of patients experienced some form of appreciable repigmentation and in 64% of patients, depigmentation of the skin was stopped.
Another study published in the Egyptian Dermatology Online Journal in 2012 further confirmed the benefits of vitamin B12 supplementation in vitiligo patients. In that study, vitiligo patients had lower serum levels of folic acid and vitamin B12 but higher levels of homocysteine.
Vitamin B12 deficiency leads to a disturbance in the oxidation-antioxidant system of the skin.
When there is not enough vitamin B12, the conversion of homocysteine to methionine does not proceed. This leads to metabolic diseases arising from low levels of methionine but, just as importantly, it causes other conditions related to the buildup of homocysteine.
The breakdown of homocysteine produces reactive oxygen species which are harmful free radicals that increase the oxidative stress on the skin. These free radicals overwhelm the antioxidants found in the skin and cause the destruction of melanocytes.
By a similar mechanism, vitamin B12 deficiency may increase oxidative stress through folic acid deficiency.
The folic acid ingested in humans is needed to supply the pterine group of tetrahydrobiopterine, an important cofactor in the production of melanin. However, when this cofactor is unavailable, there is an accumulation of a group of related compounds called pteridines.
Oxidized pteridines are responsible for the distinctive yellow-green and bluish fluoresce of vitiligo skins under special lights. They also promote the release of hydrogen peroxide which breaks down the melanocytes.
In summary, vitamin B12 is useful in the treatment of vitiligo because it reduces the oxidative stress on melanocytes. By its antioxidant protection, it increases the lifespan of melanocytes. As long as some melanocytes are still active, vitamin B12 can also stimulate the repigmentation of vitiligo spots.
Different clinical trials have established that vitamin B12 supplementation works better for vitiligo when it is combined with folic acid (and some amount of UV exposure). Therefore, when looking for a vitiligo supplement to help treat the hypopigmentation disorder, you should get a supplement that includes both vitamins.
Callumae is an excellent example of such vitiligo supplements. It not only combines folic acid and vitamin B12 but it also includes other natural vitiligo remedies.
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*Callumae is a Vitiligo Remedy designed to help get rid of white spots on your skin. Use in conjunction with light therapy (or natural sun light) to help get the most repigmentation to your skin.