Evidence supporting the use of: Vitamin B12 (various)
For the health condition: Multiple Sclerosis

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Vitamin B12 (cobalamin) is sometimes used as a supportive therapy in patients with Multiple Sclerosis (MS), largely due to its essential role in nerve function and myelin synthesis. There is scientific rationale for ensuring B12 sufficiency in MS, as B12 deficiency can mimic or worsen neurological symptoms similar to those seen in MS, such as neuropathy, fatigue, and cognitive impairment. Several observational studies have reported lower serum B12 levels in some MS patients compared to controls, but this finding is not universal, and most MS patients do not have clinical B12 deficiency. Some small studies suggest B12 supplementation may improve subjective well-being or reduce fatigue in MS patients with low or borderline B12 levels, but there is no strong evidence that B12 supplementation alters the course of MS, reduces relapse rates, or prevents progression in patients with normal B12 levels. Randomized controlled trials are lacking or of low quality. Current clinical guidelines recommend checking B12 levels in people with MS to rule out deficiency, but do not support routine high-dose supplementation in the absence of deficiency. Thus, while the use of B12 is scientifically justified in cases of deficiency, its use as a general treatment or disease-modifying therapy in MS is not well supported by strong evidence.

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