Lower Back Pain and B12 Deficiency

Sarah 44 had been suffering from lower back pain since her mid-twenties. The pain was usually worse after standing for long periods and physical activity such as gardening. The original onset of the pain was gradual, but Sarah could not recall any particular incident such as a fall or injury that was a trigger. Other significant symptoms included mild anxiety, fatigue, heartburn (for which she takes acid blocking medication), memory loss, vertigo, and bruising easily. During the six months leading up to the start of the pain, she had an unusually heavy workload including a lot of travel. Sarah was not on any currently prescribed medications but had been on birth control from 18 to 30. She slept well and went to yoga two times a week. Sarah had been a vegetarian since 21 years old. She had managed her back pain through regular chiropractic, massage, and yoga. When I asked why she had wanted to come and see me, she said that despite these treatments her back pain kept reoccurring and she wanted to find the root cause.
Like Sarah if you are suffering from chronic back pain you are not alone. According to research:

1. In a six-month period, 5 out of 10 Canadians will suffer from back pain. (1)
2. Up to 85% of Canadians can expect to suffer from lower back pain in their lifetime. (2)

There are many physical causes of lower back pain including:

Being overweight

Research shows that having a higher body mass index (BMI) increases the risk of suffering from lower back pain. (3) With rising rates of obesity, Canadians are increasing their odds of developing low back pain. (4)

Lack of exercise

In a study carried out by Norwegian researchers, the authors concluded that physical inactivity was associated with an increased risk of chronic pain in the low back and neck/shoulders in the general adult population. (5)

But I am not overweight and exercise regularly

If you are overweight and physically inactive, it would not be a surprise if you developed lower back pain but for Sarah, this was not the case. For her we needed to take a more holistic view of her problem. When looking at her case history, I suspected that Sarah may have a B12 deficiency. Typical symptoms of B12 deficiency include fatigue, memory loss, anxiety, vertigo and bruising easily. Another common but little-known cause of back pain is a B12 deficiency. (6)

When I asked her if she had been low in B12 in the past, she said not to her knowledge as her doctor had said that all her previous blood test results appeared normal. I asked her to bring me a copy of her last blood test showing B12. She had a level of 250 which is above the laboratory's minimum level however in my experience 500 is a much more optimal reading.

So why am I low in B12

To understand why Sarah is low in B12 we needed to look back into her medical history.

• At the age of 18, Sarah began taking the birth control pill. Research has shown that oral contraceptives lower levels of B12 in women. (7)
• At 21, she became a vegetarian. A 2013 review concluded that vegetarians develop B12 depletion or deficiency regardless of demographic characteristics, place of residency, age, or type of vegetarian diet. (8)
• Sarah currently takes an acid blocking medication. Long-term use of common heartburn and ulcer medications linked to vitamin B12 deficiency. (9)

How can you help me

To help Sarah's back pain I prescribed her B12 (Methylcobalamin) to bring her levels up to an optimal level. Once at an optimal level, I recommended a maintenance dose because, of her vegetarian diet. For better B12 absorption, I helped her come off her acid blocking medication by identifying foods that were causing her heartburn.

Disclaimer

This article in not intended to provide medical advice, diagnosis or treatment.