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]]>The post Letter sent to Secretary Kennedy & Congressman John James (July 2025): How pediatric B12 deficiency is being misdiagnosed as autism. appeared first on B12 Awareness!.
]]>Dear Mr. Secretary,
We have vital information that is instrumental to your commitment in understanding the incidence of autism spectrum disorders. We are compelled to share our knowledge and life’s work about cobalamin (vitamin B12) deficiency and how it’s being misdiagnosed as autism. Untreated vitamin B12 deficiency is an unrecognized public health care crisis costing state and federal agencies billions of dollars and costing millions of people their health. It can strike any age, race, religion, or socioeconomic background, but often times strikes infants and young children the hardest. We are requesting to discuss this urgent matter with you. We also reached out to Congressman John James in our district.
We are from Macomb County, Michigan and are practicing clinicians in the emergency department (ER nurse and emergency medicine physician) both for over 30 years. We are also the authors of Could It Be B12? An Epidemic of Misdiagnoses, Quill Driver Books (2005), 2nd Ed. (2011), which includes a chapter on pediatric B12 deficiency. Ten years later, we devoted an entire book to exposing the continued misdiagnosis and mismanagement of pediatric B12 deficiency, Could It Be B12? Pediatric Edition, Quill Driver Books (2015).
Lack of vitamin B12 during the rapid growth and wiring of the brain in fetuses, infants and young children can cause permanent injuries or lifelong disabilities. Vitamin B12 is critical for various brain development processes (myelination, synaptogenesis, and neurotransmitter synthesis). A deficiency impairs these processes, leading to structural brain abnormalities, developmental delays (motor, sensory, speech, language) and cognitive impairments. The signs and symptoms of autism are virtually identical to the symptoms that stem from neurologic damage due to pediatric B12 deficiency. Clinicians are not screening women in pregnancy, during breastfeeding, nor in symptomatic infants or young children. In the 21st century, there is no excuse for a child to acquire a brain injury from B12 deficiency and have it mistaken or misdiagnosed as “autism.” Just as in stroke, “time is brain,” this too applies to pediatric B12 deficiency.
B12 deficiency has several causes and is both preventable and treatable, yet most clinicians do not screen high-risk groups or patients who are symptomatic. Besides children, many adults with untreated B12 deficiency go undiagnosed and suffer needlessly from mental illness, dementia, anemia, neuropathy, fall-related trauma, and vascular occlusions. Diagnosis is generally late, and the disease can progress to a debilitating condition causing injury, often times requiring long-term care. Billions of healthcare dollars are squandered by failing to properly screen and treat B12 deficiency and using other medications and treatments in its place.
I (S.P.) started the fight for this cause back in 1998. We have published four books* (one of which has been translated into several other languages), created B12awareness.org, have lectured in the US and in Europe, and have appeared in a documentary. Additionally, an 87-minute feature film was made about my life story by E.L. Productions. Sally Pacholok won best feature film at the 2015 D.C. Independent Film Festival. The film’s tagline was, “This nurse could save your life.” It debuted at the U.S. Naval Heritage Center Base in Washington, D.C. and actress Annet Mahendru, well-known for her role in The Americans, played me.
Despite our minor accomplishments and dedicated work in exposing this epidemic, past healthcare leaders and governmental officials we previously contacted have all turned a blind eye. Untreated B12 deficiency has unnecessarily turned into a chronic disease over the past four decades, silently attacking Americans of all ages. We can help Make America Healthy Again. Addressing B12 deficiency is common sense. A comprehensive list of possibilities is well beyond the scope of this letter. Please allow us the opportunity to brief you on this critical matter injuring our children and unknowingly contributing to the incidence of “autism.” We are available upon your request.
Sincerely,
Sally M. Pacholok, R.N., BSN
Jeffrey J. Stuart, D.O.
Pacholok, SM, Stuart JJ. Could It Be B12? An Epidemic of Misdiagnoses. Quill Driver Books; 2005.
Pacholok, SM, Stuart JJ. Could It Be B12? An Epidemic of Misdiagnoses, (2nd Ed.) Quill Driver Books; 2011.
Pacholok, SM, Stuart JJ. Could it Be B12? Pediatric Edition: What Every Parent Needs to Know About Vitamin B12 Deficiency. Quill Driver Books; 2015.
Pacholok, SM. B-12 Sally! Ingram Sparks; 2024, Kindle Direct Publishing; 2024.
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]]>The post Undiagnosed B12 Deficiency Crisis in the US. Letter to President Trump and HHS Secretary Kennedy. appeared first on B12 Awareness!.
]]>Dear Mr. President,
As dedicated medical professionals we share HHS’s commitment to improving the health, safety, and well-being of Americans. Accordingly, we are compelled to call your attention to a long-standing failure in basic preventive services in the United States that poses a profound threat to Americans of every age and patient demographic. We refer, specifically, to the potentially injurious and fatal consequences of undiagnosed vitamin B12 (cobalamin) deficiency, a commonly overlooked condition that, left untreated, can cause irreversible damage to virtually any organ system in the human body.
For over 25 years, we’ve campaigned to raise widespread awareness among our colleagues as well as governmental officials at local, state, and national levels of the need for updated screening protocols to detect B12 deficiencies early. Incredibly, our call for simple, common-sense, data-driven updates to standards of care in the US have been largely ineffective. Thus, we appeal herein to you, Mr. President, and separately to HHS Secretary Robert F. Kennedy Jr., who has the authority and requisite resources we lack to improve outcomes in this setting and, in the process, save the health of millions of Americans.
With over 30 years’ experience as board-certified, front-line practitioners in emergency medicine and emergency nursing—supported by a wealth of data in the professional literature—we bring first-hand knowledge to the compelling argument in favor of improving screening criteria, testing, and treatment. Undiagnosed, thus untreated, B12 deficiency constitutes a public-health threat that costs state and federal agencies billions of dollars and imposes an avoidable burden on Americans in terms of morbidity and mortality, as well as financial hardship. When one compares the benefits and minimal cost of B12 replacement therapy versus the aggregate consequences of misdiagnosis and failure to treat—the current status quo—the analysis points to ongoing fiscal and medical malpractice.
The importance of this essential vitamin is widely underestimated. Indeed, it’s fair to say we are in the midst of a silent epidemic of ignorance—or, worse, indifference—among healthcare professionals when it comes to the detection and treatment of vitamin B12 deficiency. Consumers who view B12 as “optional” are likely unaware of the vital role it plays in sustaining life itself, which can be problematic.
Vitamin B12 deficiency causes weakness, fatigue, mental illness, dementia, neuropathy, anemia, balance and gait disorders, tremors, fall-related trauma, vascular occlusions, and developmental disabilities. Often times it’s diagnosed late, and the disease has progressed to a debilitating condition causing neurologic injury. Billions of health-care dollars are squandered by failing to screen symptomatic and at-risk patients and using other medications and treatments in its place. Repeated ER visits and hospital admissions result, contributing to overcrowded facilities.
Sources of B12 include liver, seafood, meat, dairy products, and eggs. Vitamin B12 deficiency can occur from poor dietary intake, impaired absorption, medications, maternal factors, or from an autoimmune condition known as pernicious anemia. A variety of gastrointestinal disorders such as Crohn’s or celiac disease, atrophic gastritis, and gastrointestinal surgeries (e.g., bariatric, ileectomy) can cause B12 deficiency. Vegan or vegetarian diet, eating disorders, alcohol abuse, liver disease, chemotherapy, radiation therapy, Helicobacter pylori, and genetic mutations are yet other causes. Certain medications (proton-pump inhibitors, metformin) as well as nitrous oxide (aka “laughing gas,” an anesthetic used in medical and dental procedures, and increasingly abused recreationally by teens and young adults) interfere with B12 metabolism.
The damage caused by vitamin B12 deficiency progresses in a slow, insidious manner. Early clinical studies recognized that B12 deficiency caused severe neuropathy leading to paralysis and death, while post-mortem analysis demonstrated spinal cord demyelination. The signs and symptoms are similar to other neurological disorders (e.g., dementia, Parkinson’s, multiple sclerosis, Guillain-Barré syndrome). It is a great mimic and seldom suspected when pursuing more “common” diagnoses. Thus, the opportunity to rule out a B12 deficiency early, when it is often reversible with supplementation, is lost. For example, signs of Alzheimer’s and other forms of dementia can mirror signs of B12 deficiency. Unlike Alzheimer’s, a B12 deficiency can be reversed—but only if caught in time. Yet, proper screening and treatment by all practitioners is not universal, despite how devastating a B12 deficiency can be. We wonder whether former President Joe Biden received proper testing.
The same can be said about autism spectrum disorders. Unlike autism, pediatric B12 deficiency can be reversed—but only if diagnosed early. Lack of B12 during pregnancy, infancy, or early childhood can injure the brain causing lifelong disabilities. Pediatric B12 deficiency causes demyelination and atrophy of the brain and nerves. During the third trimester of pregnancy and during infancy the brain rapidly develops, forming neural connections and myelination which is critical for motor, language, and communication skills, as well as sensory processing. The signs and symptoms of autism are virtually identical to those of pediatric B12 deficiency. Therefore, infants and young children with developmental delay or ‘autistic-like’ symptoms must have B12 deficiency ruled out. In the 21st century, there is no excuse for a child to have a brain injury due to B12 deficiency and later have it labeled or misdiagnosed as “autism.” Just as in stroke, “time is brain,” the same applies to pediatric B12 deficiency.
It is well established that B12 deficiency causes psychiatric illness. It is surprising that most doctors fail to routinely consider low B12 as a cause of their psychiatric patients’ symptoms. Patients who present with mental illness symptoms (e.g., depression, suicidal or homicidal ideations, psychosis, hallucinations, mania, OCD), need proper B12 screening. This is not currently happening.
Ignoring B12 deficiency in America—unknowingly or by design—results in lucrative profits when misdiagnosis leads to inappropriate use of costly prescription drugs, treatments, therapies, hospitalizations, and avoidable long-term nursing care. The unnecessary costs associated with failure to screen contribute significantly to our rising national debt, which is entirely avoidable given an inexpensive treatment has been available for nearly 80 years. Its landmark discovery proved life-saving to countless patients. Moreover, it was, and remains, highly affordable. Imagine the financial savings that could be realized by treating B12 deficiency in mental illness alone.
I (S.P.) started the fight for this cause back in 1998. I am an ER nurse from Macomb County, Michigan and have been practicing for over 30 years. I currently work at the same hospital that gave me a gag order in 2000, prohibiting me from educating staff and patients about B12 deficiency or else I would be terminated. I would not, however, be silenced. Since then, I have published four books (one of which has been translated into several other languages*), created B12awareness.org, have lectured in the US and in Europe, and appeared in a documentary. Additionally, an 87-minute feature film was made about my life story. Sally Pacholok won best feature film at the 2015 D.C. Independent Film Festival. The film’s tagline was, “This nurse could save your life.” “Registered Nurse Sally Pacholok takes on the medical establishment’s epidemic of misdiagnosis and writes her influential book about vitamin B12 deficiency (based on true events).” It debuted at the US Naval Heritage Center’s Burke Theater, in Washington, DC, and actress Annet Mahendru, well-known for her role in The Americans, played me.
Recently you stated, “Something is wrong,” about the rising incidence of autism, and “We’re gonna figure something out.” Well, something is definitely wrong and we can help you decrease the numbers by educating you and your team about pediatric B12 deficiency and how it is being misdiagnosed as autism. We continue to “Fight, fight, fight!”, because this atrocity has been lurking behind closed doors in our healthcare system for decades and it must stop. Identifying and treating B12 deficiency in all ages is common sense and we’re confident you would agree!
Despite our minor accomplishments and dedicated work exposing this epidemic, our healthcare leaders and governmental officials have all turned a blind eye. Untreated B12 deficiency has turned into a chronic disease over the past four decades, injuring Americans, ruining lives and wasting billions of healthcare dollars. It would be our great honor to update, educate, and work with you and your team in any capacity. We believe we can help you Make America Healthy Again and end this silent epidemic. A comprehensive list of possibilities is well beyond the scope of this letter, but we would be pleased to provide additional information and assist in any way possible. Please do not hesitate to contact us for further information.
Sincerely,
Sally M. Pacholok, RN, BSN
Jeffrey J. Stuart, DO
Pacholok, SM, Stuart JJ. Could It Be B12? An Epidemic of Misdiagnoses. Quill Driver Books; 2005.
*Pacholok, SM, Stuart JJ. Could It Be B12? An Epidemic of Misdiagnoses, (2nd Ed.) Quill Driver Books; 2011.
Pacholok, SM, Stuart JJ. Could it Be B12? Pediatric Edition: What Every Parent Needs to Know About Vitamin B12 Deficiency. Quill Driver Books; 2016. Pacholok, SM. B-12 Sally! Ingram Sparks; 2024, Kindle Direct Publishing; 2024.
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B-12 Sally! for ages 3 years and up, takes the reader on a journey of understanding B-12 deficiency in a simple and fun format. Adults reading this book along with their child will learn factual information about a forgotten medical disorder that can strike all age groups. This book introduces B-12 Sally, and is the first in a planned series. The sequels to B-12 Sally! will feature the pair traveling the world spreading B-12 awareness and learning about other health topics. They make new friends, visit new places, and taste new foods. Other characters join this duo teaching them about friendship, teamwork, and geography. This series gently blends math and science in an entertaining storyline making learning fun.
B-12 Sally and Piggles are best friends. After Sally got sick from vitamin B-12 deficiency, she learned all she could about it to get better. Now, she and Piggles are on the lookout to help others who may also suffer from it.
Sally is very worried about the pigs on Kenny’s Farm. They are weak, sad, and moody, and won’t play with her anymore. Some have hoof drop, others are forgetful. Some even stumble and fall! Could they too have B-12 deficiency?
Piggles fires up his puffy polka-dotted pig pillow and flies them to Kenny’s Farm. Hand in hoof, they take off in the night’s moonlit sky with passion and purpose to save the pigs!
B-12 Sally, our new health super-hero!
Where will B-12 Sally and Piggles visit next and who will they meet? Follow us on Facebook @B-12 Sally!
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]]>Please feel free to download and share these posters!
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]]>Please feel free to download and share these posters!
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]]>The post Lyn Sharkey Interview for Alimentary! Podcast appeared first on B12 Awareness!.
]]>Lyn writes:
“Vitamin B12 Deficiency can have devastating consequences for our health and there are reasons why it might currently go undiagnosed and yet be mistaken for other conditions. I was thrilled to talk to Sally Pacholok R.N. co-author of “Could It Be B12? An epidemic of Misdiagnosis” about all things B12. Deficiency can occur due to a variety of root causes, and it can impact our lives in many ways, so we can all benefit from becoming familiar with Vitamin B12 and what our levels should be. At the beginning of the video, I chat briefly about some symptoms which I experienced and then we get into the interview with Sally – I hope that you listen because if caught in time, this is easily fixed. However, if left undiagnosed, the damage to our nervous system can be permanent. Neuropathy is a broad term which describes nerve damage or disease. It can affect autonomic, sensory or motor nerves.”
The interview can be viewed on YouTube, as well as podcasts on Spotify, Amazon, and Apple:
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]]>Please feel free to download and share these posters!
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]]>The post Methyl-B12 may inhibit enzyme activity of nsp12 protein of COVID-19 virus. appeared first on B12 Awareness!.
]]>I came across an exciting article this week on Pub Med, published by IUBMB Life, October 18, 2020, International Union of Biochemistry & Molecular Biology. The article, Vitamin B12 may inhibit RNA-dependent-RNA polymerase activity of nsp12 from the SARS-CoV-1 virus, by Deepak T. Nair & Naveen Narayanan is a must read (see below for the link). Their study suggests that methylcobalamin may inhibit RNA-dependent-RNA polymerase activity of the SCV2-nsp12 enzyme. This enzyme is critical for the replication of the COVID-19 virus. Therefore, using methyl-B12 may inhibit viral replication of the COVID-19 virus, possibly resulting in lower viral titers and reduced severity of COVID-19 disease.
I have been pushing for sublingual methylcobalamin or injectable hydroxocobalamin in patient care protocols as well as in high-risk groups such as the elderly, diabetics and those with other comorbidities, as well as hospital and other medical personnel. Unfortunately, my research, information, books, and website have fallen on deaf ears. Remember, around 20% of the public are low or deficient in B12, and it’s more prevalent in older adults. The immune systems of these patients are more vulnerable to contract COVID-19 and compromise their health. Most medical providers are not testing their patients and have no idea this silent killer (low B12) is present. Nor do they know that B12 deficiency combined with COVID-19 can prove increasingly more deadly. Hopefully this post will go viral and finally push B12 into the spot light.
I urge each hospital to develop a Cobalamin-COVID-19 protocol. Those hospitalized with COVID-19 should be receiving hydroxocobalamin injections or high dose sublingual methylcobalamin tablets. No one should receive cyanocobalamin pills or injections. Those hospitalized need to have serum B12, homocysteine, and MMA tests ordered. Cobalamin therapy should be started immediately, regardless of test results. Why test if we advocate treating anyway? Evidence is needed for further research to ascertain what percentage of COVID-19 patients demonstrate low B12 via these lab tests.
It is beyond time that medical providers, healthcare institutions, public health officials (e.g. WHO, NIH), and governmental leaders wake up and study the evidence and protect the public. It is incomprehensible that this disorder is being continually ignored and allowed to silently harm millions, especially since injectable hydroxocobalamin and sublingual methylcobalamin are readily available and cheap.
I strongly suggest hospital front line workers to begin sublingual methylcobalamin as a preventative measure. If they then contract COVID-19, this may help to lessen viral replication, preventing prolonged or more severe illness, vascular clots, and reducing the chances of hospitalization or prolonged hospitalization. Narayanan and Nair’s article further proves the value of proper cobalamin therapy. Cobalamin may be the missing link in helping to reduce viral titers and reduce the severity of COVID-19 disease.
I can be reached at B12Awareness.org for further consultation.
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