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At Integrated Nutrition of Mount Kisco, PLLC and Blood Logic, Inc. we work in close partnership with you towards developing your natural healing plan. What you do not need is a generalized “one size fits all approach.”  Our approach for clarifying your health issues, finding hidden causes of your health problem(s) and developing natural solutions has been woven into our carefully designed longevity approach that we call The Blood Detective’s Longevity Plan. We believe that developing a Metabolic Map of your entire body by performing specialized health tests (e.g., biomarkers) is a truly holistic way of viewing, appreciating and managing your health concerns. As a concierge practice, we make ourselves truly available to you.  As a paperless office we are concerned about the world environment as it affects our “internal environment”…namely, your health.

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Weight loss, poor memory, intestinal issues, hormone problems, pain, fatigue, muscle aches and pains…whatever your health concerns(s), Dr. Michael Wald, The BloodDDetective has the answers…naturally. The Blooddetective blog is filled with dozens of radio shows on just about every health topic that you can think of. “Ask The Blooddetective is Dr. Wald’s weekly radio show covering nutrition and naturopatic, dietary and exercise, disease and health topics.

Filtering by Tag: New York Times

VITAMIN B12 – Everything you need to know!


Dr. Michael Wald Vitamin B12,  also called cobalamin, is a water-soluble vitamin with a key role in the normal functioning of the brain and nervous system, and for the formation of blood. It is one of the eight B vitamins. It is normally involved in the metabolism of every cell of the human body, especially affecting DNA synthesis  (our genetic material) and regulation, but also fatty acid synthesis and energy production. It is the largest and most structurally complicated vitamin and can be produced industrially only through bacterial fermentation-synthesis.

As important as vitamin B12 obviously is there are several important facts about this nutrient you should know that the New York Times article did not mention. Here are some of the most important points:

1.    NEVER take vitamin B12 alone as it can cause imbalances including deficiencies of many other nutrients that can cause or worsen other health issues.

2.    THERE ARE SEVERAL TYPES (FORMS) of vitamin B12.  The best form is methylcobalamin.  Other types of B12 include hydroxycobalamine adenosylcobalamin and cyanocobalamin; each has its unique and common properties and should be carefully chosen based on the health condition one is using it for. Methylcobalamine is, overall, the best type of B12 because it is “methylated” or activated.  Taking the non-activated form causes more stress on the body to activate it. However, there are times when taking another form of vitamin B12 may be more appropriate. For example, if someone has a cyanide toxicity then the best form of vitamin B12 is definitely the hydroxycobalamin; if a person is suffering from nerve pain (neuropathy) then the methyl-B12 form is usually best.

3.    IT IS A MISTAKE to take B12, no matter the form, without the appropriate nutritional synergists such as B1, B2, B3, B5, and B6 and folic acid. Too much B12, and this is a relative term, can cause imbalances or outright deficiencies of these B-vitamins; resulting in neurological problems.  Also if a person has a malabsorption disease or a certain type of bacterial stomach infection B12 deficiency will often result – the problem must be fixed otherwise supplementing with any form of vitamin B12 is virtually useless.

4.    YOU MIGHT NEED B12 EVEN IF YOUR BLOOD TEST IS NORMAL! A blood test will only tell you if you have had low intake of B12 for a few days and cannot distinguish if B12 intake has been low for months or years.  A look under the microscope by a trained nutritional practitioner is one of the very best ways to tell if vitamin  B12 is needed and when the deficiency is fixed. Large cells known as macrocytes will appear when a vitamin B12 deficiency is longstanding and will resolve once the deficiency is resolved.

5.    IMPORTANT tests that tell us whether or not we use vitamin B12 and it’s important nutritional partners include: homocysteine, methylmalonic acid, serum folic acid, red blood cell folic acid, serum B1, microscopy and a few others.  These tests should be performed along with whatever tests are determined as important by us. If these are done alone they are just reflecting a small “slice of the pie” of nutritional problems.

6.    CAUSES OF VITAMIN B12 deficiency must be found!  Deficiency or improper use of B12 can be caused by malabsorption syndromes (celiac disease, intrinsic factor antibodies, parietal cell antibodies, parasites, eating disorders, cancers, many autoimmune disease and even by medications .


8.    THE BEST WAY TO GET B12 LEVELS BACK TO NORMAL – is to find out the cause of vitamin B12 deficiency in the first place. Is your diet deficient in it? Do you have a stomach acid deficiency (stomach acid is required to separate B12 from proteins in foods)? Do you have an immune disease as B12 problems are often a result of autoimmune diseases? Do you have a parasite? There are many other causes of deficiency.

9.    VITAMIN B12 TAKEN UNDER THE TONGUE, otherwise known as sublingual administration, is not necessarily the best way to fix a deficient vitamin B12 level.  The quality of the vitamin B12 supplement matters in terms of absorption (how it is manufactured), the type of vitamin B12 matters (i.e., methylcobalamin vs. cyanocobalamin, etc) and the extent of the deficiency and its cause(s).   Just because you place vitamin B12 under the tongue does not mean it will correct a deficiency. Laboratory tests are important to check results (see above). If you have been deficient in this vitamin for many years shots of vitamin B12 AND SEVERAL OF ITS NUTRITIONAL SYNERGISTS) should all be given at once.

10.    BIG MISTAKE that many of our patients make is that once we recommend vitamin shots (containing B12 as one of perhaps ten other supplements all together) they go to their regular doctors and ask for a B12 shot. WE NEVER GIVE VITAMIN B12 ALONE BECAUSE IT MAKES NO BIOCHEMICAL AND NUTRITIONAL SENSE?  Other nutritional imbalances will occur with this practice.

Please forward your questions about vitamin B12 to the Blood Detective, Dr. Michael Wald at or call 914-242-8844.

You can also read this New York Times article on Vitamin B12 by going to:

Dangerous Decisions - Why Doctors Order So Many Tests


Commentary by Dr. Michael Wald

Contact: 914-242-8844

An article occurring in the New York Times, Sunday October 2, 2011 edition, discussed this important issue.  Dr. Wald’s comments in black below.

The article goes on to say that doctors admit performing tests because some patients seem to insist on testing when they have chronic symptoms.  Other causes include:

Staying out of trouble and surviving in medical practice  – doctors are performing tests to help offset malpractice cases.

Financial reasons – Most doctors did not report that this was a motivation.  This of course does not mean that money making was not part of their decision to perform tests. In my opinion however financial gain is actually not a prominent reason by the individual health care provider, but might be on the part of their employer (i.e., the hospital and/or HMO/PPO who drives testing criteria).  It is my believe that many practitioners are actually ignorant to the harm that many procedures/practitioners can inflict upon their patients (such as too many x-rays, mammograms and CT scans, or medication prescriptions).  I believe that most medical physicians actually believe that they are doing the right thing for their patients in terms of medications and medical tests even and have not thoroughly thought out for themselves the negatives.  They are simply “doing what they are told” or doing what they were taught in residency or medical school and do not often think creatively or “out of the box”.

It should be noted, according to the New York Times article, that some studies have estimated that up to 30% of the care delivered to patients in the United States is unnecessary, and sometimes even harmful.

Patients are receiving too much care.  This believe, according to many doctors themselves, underscores the issue of too much care, increased chances of complications including unnecessary deaths, side-effects and other issues associated with unnecessary interventions (i.e., x-rays and CT scans that may contribute to cancer incidence).

Surveys show that doctors feel pressure to overtreat patients based on inadequate time allowed to consult with their patients, fear of being sued or being perceived as not doing enough and ordering tests for minor issuesThe problem here in my opinion is that patients insist on more attention within a disease care system (and not a health care system) – this philosophical and practical difference often leads to trouble.

A survey of doctors said that they, “believe that the current quality measures and clinical guidelines endorsed by healthcare experts and insurers has a way to reign in excesses, where, in fact, has the opposite affect.  The guidelines might, for example, require patients with high blood pressure and diabetes to have specific blood tests every three months…”  What this statement is saying is that the insurance companies often dictate practice guidelines for doctors that may lead to overtreatment, medical complications and unnecessary medical care.  One must also keep in mind that the medical treatments for these and other conditions that are tested, due to medical policy, on a regular basis, may lead for many people only to the “standard medical management” (which may be dangerous) when so many safe and natural alternatives are available.

“Guidelines in general set a bar for not enough care” – Some doctors claim that more testing should be done, but studies have shown that the more medical care delivered the greater the number of complications. Also, according to the New England Journal of Medicine, 80% of procedures and practices in medicine are wrong!  According to other studies, most diagnoses are wrong; if this is true than 100% of the medications prescribed for these wrong diagnoses are incorrect!

 “Moreover, a majority of doctors surveyed acknowledge being curious about how their colleagues practice; and well over half ask to see a report and the researchers offered on how practices in their own communities differed from others”.  I find this statement unbelievable because doctors should know something about other areas of medicine.  This is a problem I believe in the basic medical education that is compartmentalized meaning that different doctors studying different types of medical care are often undereducated in other areas of medicine.  This underscores a major criticism of holistic doctors and practitioners that have knowledge in medicine, natural medicine and all areas of the body.  Remember the old saying, “One can be too close to the tree so as not to see the forest”; this statement I believe is true of medicine and is a major limiting factor preventing wellness care delivery to the public.

What this article completely ignores is the fact there is almost a total absence of tests and procedures which are meant to prevent the major causes of death and disability in this country.  Furthermore, these tests, otherwise known as bio-markers and nutritional tests, when considered in a holistic fashion, can go a long way towards prevention saving literally billion so of dollars and millions of lives; and improving quality of life. 

 No one is claiming that holistic care, when done right is inexpensive, but in the long run people undoubtedly live higher quality lives and may even be living longer as a result of a reduction in chronic degenerative incidence.