• Tissue regeneration is the process of reconstructing damaged tissues and organs in the body to heal or replace them.
• The area of regenerative medicine is still new and researchers are looking at how they can use tissue regeneration for certain diseases.
• Researchers from the Institute for Research in Biomedicine in Spain found that vitamin B12 plays an important role in tissue regeneration.
• Scientists also reported vitamin B12 supplementation accelerated tissue repair in a model of ulcerative colitis.

Tissue regeneration — also commonly referred to as regenerative medicine — is the process of reconstructing damaged tissues and organs in the body to heal or replace them.

These tissues and organs could have been injured through aging, trauma, disease, or congenital defects.

The area of regenerative medicine is still new and experimental. Researchers are looking at ways to use tissue regeneration in the treatment of diseases like heart injuries and disease, bone fractures, cartilage diseases, pancreatitis, and inflammatory bowel disease.

Now researchers from the Institute for Research in Biomedicine in Spain report evidence suggesting that vitamin B12 plays an important role in cellular reprogramming and tissue regeneration.

The findings were recently published in the journal Nature Metabolism.

Scientists tested their theory in a model of ulcerative colitis — a type of inflammatory bowel disease (IBD) — showing that intestinal cells trying to repair themselves would benefit from vitamin B12 supplementation.

Why look at vitamin B12? 

According to Dr. Manuel Serrano, a researcher at the Institute for Research in Biomedicine in Spain during the time of the study — who has recently moved to Altos Labs in the United Kingdom — and co-lead author of this study, they decided to study the impact of vitamin B12 on cellular reprogramming and tissue regeneration after an unexpected finding when they analyzed how the microbial populations of the colon change during reprogramming.

“The microbiota of mammals is in equilibrium with the host,” Dr. Serrano explained to Medical News Today. “If the host metabolism changes, it affects the microbiota and vice versa. We found that during reprogramming in mice, the microbiota presented changes indicative of a shortage of [vitamin] B12. [Vitamin] B12 is essential for mammals and also for bacteria.”

Past research shows vitamin B12 assists the body with repair, such as stimulating neurological tissues needed for restoring muscles or after nerves are damaged, such as by traumatic brain injury.

Vitamin B12 has also been shown to play a protective role in bone health.

And a study published in August 2022 found that vitamin B12 can help repair and regenerate skin damaged by radiodermatitis, a side effect of radiotherapy in cancer treatment.

Vitamin B12 and tissue regeneration

Using both mouse and cultured cell models, the researchers found that vitamin B12 supplementation increased the efficiency of cell reprogramming, which is considered to be an early stage of tissue repair.

Dr. Marta Kovatcheva, a researcher at the Institute for Research in Biomedicine in Spain and co-lead author of this study, explained to MNT how vitamin B12 assists with cellular reprogramming and tissue regeneration.

“[Vitamin] B12 is involved in just two metabolic reactions in mammals — including mice and humans — and one of these reactions is critical to [producing)] a chemical tag, more technically ‘a methyl donor’,” she told us. “This chemical group is used to ‘tag’ many regulatory proteins of the DNA and the DNA itself, and in doing so, the activity of the DNA is modified — the DNA is ‘reprogrammed’.”

“This ‘tagging’ is very complex and dynamic and, although not yet fully understood, it is key for determining the behavior of cells, including their ability to repair or regenerate tissue,” Dr. Kovatcheva detailed.

“During critical periods, such as upon injury, cells require massive amounts of the ‘methyl tag’ and therefore of B12. It is so much so that despite a normal healthy diet, mice undergoing reprogramming suffer partial B12 deficiency. Supplementation with B12 facilitates reprogramming and tissue repair — it occurs faster and more widespread.”

– Dr. Marta Kovatcheva

Treatment for ulcerative colitis and beyond

Drs. Serrano and Kovatcheva also led their team through testing their vitamin B12 theory on a mouse model of ulcerative colitis.

Researchers found that intestinal cells initiating repair undergo a process similar to cellular reprogramming, which could benefit from vitamin B12 supplementation. And they reported vitamin B12 supplementation accelerated tissue repair in the mouse model of ulcerative colitis.

Both scientists believe these findings may open new doors for regenerative medicine.

“B12 supplementation is simple, inexpensive, and safe,” Dr. Serrano commented. “I would be very curious to know how this affects, for example, the recovery of surgery patients.”

“There are diseases that could also benefit, such as colon ulcers,” Dr. Kovatcheva added. “In theory, every disease that involves an active process of injury could benefit from this. But of course, this will require proper clinical tests.”

Dr. Serrano was also part of another recently published study on vitamin B12, this one looking at the vitamin’s potential health benefits in lowering inflammation.

“In this study, led by Prof. Rosa Lamuela and Ramon Estruch from the University of Barcelona, we found that elevated levels of B12 in the blood of volunteers were associated with lower levels of inflammatory markers,” Dr. Serrano explained.

“These inflammatory markers reflect the existence of ongoing injuries and damages that may occur on a very local scale. The association between high B12 and low inflammation is in agreement with the idea that high B12 helps the body to resolve and repair tissue damage,” he added.

Shedding light on complex processes

After reviewing this study, Dr. Rosario Ligresti, chief of the Division of Gastroenterology and director of The Pancreas Center at Hackensack University Medical Center, and associate professor of medicine at Hackensack Meridian School of Medicine told MNT he found the research fascinating.

“Much is known about how cells repair themselves, but much is also unknown. This study sheds some light on the complex processes involved. When the gastrointestinal tract is injured, the body rapidly acts to repair itself. Part of the process for repair involves recruiting stem cells. These stem cells, however, have to undergo a process called reprogramming for them to be able to replace the cells that were lost or injured.”

– Dr. Rosario Ligresti

“As highlighted in this paper, in the gastrointestinal tract this depends on two functioning systems: the microbiome and adequate levels of vitamin B12,” he added. “If either of these two factors are deficient or altered, intestinal tract regeneration is not nearly as effective as it could be.”

Dr. Babak Firoozi, a board-certified gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, agreed and said this adds to our current knowledge of regenerative medicine.

“Specifically for my field, for gastroenterology, because intestinal cells need to regenerate on a very constant level, anytime there’s damage you want to repair that damage in the right way, so you need to have the right tools,” Dr. Firoozi explained to MNT. “And specifically for vitamins, you need to have the right nutrients in order to have that done effectively and in the best way.”

Dr. Firoozi said he would like to see a therapy developed using B12 for ulcerative colitis.

“The problem with ulcerative colitis is that you get a lot of inflammation, very high cell turnover,” he added. “And it would be nice to see if you can not only halt that but also reverse it so that you could end up having normal tissue again.”

What foods are highest in vitamin B12? 

According to Dr. Ligresti, vitamin B12 deficiency is found in populations that consume a largely vegan diet, in older people due to malabsorption, and in people with chronic Helicobacter pylori infection.

For those looking to up their vitamin B12 intake, Dr. Firoozi said they will mainly find it in meat — including fish and chicken.

However, dairy products and eggs also naturally contain vitamin B12. Vegan- and vegetarian-friendly B12 sources include fortified plant milks, nutritional yeasts, fortified cereals, or supplements.

“Older patients may find that visiting their doctors for a monthly B12 shot is the easiest way to supplement their intake — oral B12 replacement is largely ineffective in older patients,” Dr. Firoozi also noted.

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