William Wallace: Your Nerves Can Be Damaged Before Your Blood Shows It
William Wallace, Co-Founder and Chief Scientific Officer at Supplement Success Solutions, shared a post on LinkedIn about an article by G. Scalabrino et al. published in Progress in Neurobiology adding:
“Every nerve in your body is wrapped in myelin, a multilayered lipid sheath that insulates the axon and lets electrical signals travel fast.
B12 maintains this sheath through two separate pathways, and both fail at the same time when B12 drops.
The first pathway runs through methionine synthase.
B12 (as methylcobalamin) converts homocysteine into methionine, which becomes SAMe. SAMe provides the methyl groups needed to build phosphatidylcholine, one of myelin’s major lipid components. When B12 is low, SAMe drops and myelin lipid synthesis stalls.
The second pathway runs through methylmalonyl-CoA mutase. B12 (as adenosylcobalamin) clears methylmalonyl-CoA by converting it to succinyl-CoA. Without B12, methylmalonic acid (MMA) accumulates and abnormal fatty acids get incorporated into the myelin sheath itself, weakening its structure from the inside.
What makes this dangerous: the nerve damage can appear before anemia does. In the Lindenbaum NEJM study, 28% of patients with neuropsychiatric symptoms from B12 deficiency had completely normal blood counts. No anemia, no macrocytosis.
The myelin was already degrading with nothing on the CBC to flag it. If caught early, repletion can reverse it. If caught late, the demyelination can become permanent.”
1.Title: The multi-faceted basis of vitamin B12 (cobalamin) neurotrophism in adult central nervous system: Lessons learned from its deficiency
Autor: G. Scalabrino
2.Title: Neuropsychiatric Disorders Caused by Cobalamin Deficiency in the Absence of Anemia or Macrocytosis
Autors: John Lindenbaum, M.D., Edward B. Healton, M.D., David G.Savage, M.D., John C.M. Brust, M.D., Thomas J. Garrett, M.D., Elaine R. Podell, B.A., Paul D. Margell, B.S., Sally P.Stabler, M.D., and Robert H. Allen, M.D.
Read the Full Article on NEJM.
Find more posts featuring William Wallace on Hemostasis Today.
-
Sep 19, 2026, 14:17Abdul Mannan: What Exactly Is a Platelet?
-
Sep 19, 2026, 13:39Keisuke Goda: Decoding Platelet Phenotypes in COVID-19 With Optofluidic Imaging
-
Sep 19, 2026, 13:30Targeted Thrombolysis Beyond tPA
-
Sep 19, 2026, 13:21Paul Armstrong: From Summer Studentship to Young Researcher
-
Sep 19, 2026, 13:06Rabiya Masood: Breaking the Cycle of Thalassemia Through Screening
-
Sep 19, 2026, 10:52Consuela A. Albright: The Critical Role of Black Blood Donors in Sickle Cell Treatment
-
Sep 19, 2026, 10:47Amber Yates: Inside Agios’ Partnership with the Sickle Cell Community
-
Sep 19, 2026, 10:46Anton Farkas: Mechanical Thrombectomy for Acute PE in Early Pregnancy
-
Sep 19, 2026, 10:40Marjolein Smidt: ASH Raises Ferritin Thresholds for Iron Deficiency