What is Vitamin B12’s Relationship with Shoulder Injuries?

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What is Vitamin B12’s Relationship with Shoulder Injuries?


In this prospective study, researchers followed 87 people to determine if their vitamin B12 levels correlated to a higher risk of a rotator cuff tear.  The rotator cuff are muscles and tendons that stabilize the shoulder and maintain joint integrity, and this is one of the first studies to look at this specific injury and its relation to B12.

To begin the study, levels of vitamin B12 were measured as well as other nutrients including vitamin D, zinc, calcium, magnesium, and folate.  In addition, homocysteine and blood sugar biomarkers – both associated with B12 metabolism – were measured.  Homocysteine is a metabolite that builds up in the blood when certain nutrients (B12, folate, or B6) are deficient since its detoxification requires these vitamins as cofactors.  Elevated levels of homocysteine can be harmful, causing damage to blood vessels and brain tissue when it is not detoxified properly.   Interestingly, the homocysteine levels did not differ between patient groups, but vitamin B12 levels differed significantly.

In all, 47 patients were included in the healthy group, meaning they did not have any rotator cuff injury during the course of the study.  The second group contained 40 people, all of which experienced a rotator cuff tear that required surgery during the course of the study.

Of the six nutrients measured, only vitamin B12 and vitamin D showed a measurable difference, meaning B12 and D were lower in the group that ended up having a shoulder injury.  

Specifically, the B12 level in the healthy group was 627 pg/mL compared to 528 pg/mL in the injured group, which is about a 16% decrease. 

Rotator cuff injuries involve dysfunctional connective tissue such as impaired collagen synthesis. The role B12 plays in collagen formation is not fully known but its role in inflammation is well understood.  Low vitamin B12 status is directly linked to pro-inflammatory cytokines – meaning poor B12 function increases inflammation.  Research cited by the authors confirms this notion – linking low B12 status to the expression of genes that increase inflammation, which would compromise collagen integrity.

Another noteworthy observation is that a person can remain free of musculoskeletal symptoms for a long time, but “these subclinical levels can induce long-term damage to macromolecules (e.g. nucleic acids, proteins, and lipids)” which may ultimately manifest with an injury – in this case, rotator cuff tear.

SpectraCell has long emphasized the importance of correcting subclinical nutrient deficiencies, before an overt event, whether it is injury or worse, happens.  Subclinical deficiencies are usually missed with traditional serum testing which is why functional nutritional testing is clinically more relevant. 

SpectraCell measures vitamin B12 + over 30 nutrients that play a role in muscular health and inflammation. 

Source:  (BMC Musculoskeletal Disorders, April 2021)

LINK to FREE FULL TEXT Low Serum vitamin B12 levels are associated with degenerative rotator cuff tear.

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