Depression cobalamins

Chronic nitrous oxide abuse can remove a lot of vitamin B12 from the bloodstream. B12 (cobalamin) is necessary for the creation of blood cells and neurotransmitters, as well as the protective layers that cover nerves. This results in nerve damage and pain balancing, walking, and concentration difficulties mental impairment mood disturbances (such as depression) and other physical problems. Chronic nitrous oxide use may also interfere with the production in bone marrow of white blood cells and red blood cells. Treatment with intramuscular injections of B12 may reverse these symptoms. 

Regulation of homocysteine metabolism appears to be especially important in the central nervous system, presumably because of the critical role of methyl transfer reactions in the production of neurotransmitters and other methylated products. It has been known for decades that mental retardation is a feature of the genetic diseases, such as CBS deficiency, that cause severe hyperhomocysteinemia and ho-mocystinuria. Impaired cognitive function is also seen in pernicious anemia, which causes hyperhomocysteinemia due to deficiency of cobalamin (see Chapter 28). Hyperhomocysteinemia also may be linked to depression, schizophrenia, multiple sclerosis, and Alzheimer s disease. The molecular mechanisms underlying these clinical associations have not yet been delineated. 

T. T. Baldewicz, K. Goodkin, et al., Cobalamin Level Is Related to SelL Reported and Clinically-Rated Mood and to Syndromal Depression in Bereaved HIV-1+ and HIV-1- Homosexual Men. Journal of Psychosomatic Research 48, no. 2, (2000) 177-185. 

Folacin deficiency may lead to glossitis, diarrhoea, depression and confusion. Deficiency anaemia may develop especially in pregnancy and in elderly people. Symptoms of deficiency are similar to symptoms of cobalamine deficiency (known as macrocytic anaemia). Megaloblastic anaemia, the most common cause of macrocytic anaemia, is due to a deficiency of either cobalamine or folic acid (or both). Deficiency in the early stages of pregnancy can lead to developmental defects of the foetus (spinal cord defects and incomplete development of the brain). Women who are at increased risk will need increased daily intake of folic acid. 

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