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.
-
Nov 4, 2026, 18:57Connecting Haemophilia Centres, Certifying Treaters, and Improving National Data in Romania – EHC
-
Nov 4, 2026, 18:45Smitirupa Mishra: A Practical Guide to Coagulation Pathway Assessment and Laboratory Interpretation
-
Nov 4, 2026, 15:59Alessandra Bosch: A Successful Patient Day for the Bleeding Disorders Community in Zürich
-
Nov 4, 2026, 15:47Wolfgang Miesbach: Targeting Hepatic Endothelial Cells for Lentiviral Gene Therapy in Haemophilia A
-
Nov 4, 2026, 15:20Augustina Isioma Ikusemoro: Before You Transfuse, Think PBM
-
Nov 4, 2026, 14:23Advancing Hemophilia Care Through Global Research – WFH
-
Nov 4, 2026, 14:12Jean-Jacques Kiladjian: From JAK Inhibitor-Associated Skin Cancers to Laboratory Discovery
-
Nov 4, 2026, 13:59Rita Li: ASH 2026 Abstract Achievement Award for Gut Microbiome Research
-
Nov 4, 2026, 13:38Omid Seidizadeh: Improving Access to von Willebrand Disease Diagnosis and Treatment Across Europe