I’ve written many times about vitamin B12’s crucial role in detoxifying homocysteine, a compound linked to an increased risk of heart disease, cancer, and Alzheimer’s disease. Vitamin B12 is so important in clearing homocysteine from the body that elevated serum homocysteine is now recognized as a reliable indicator of a vitamin B12 deficiency.

However, vitamin B12 is no one-shot wonder. This nutrient is a key player in the burning of fats and carbohydrates for energy, the formation of healthy red blood cells, and the maintenance of the myelin sheaths that protect nerves. Because of these diverse roles, a deficiency of vitamin B12 can cause fatigue, memory loss, and depression. Sadly, physicians often chalk these symptoms up to the inevitable effects of aging, not recognizing that their patients suffer from a treatable nutritional deficiency.

At the Whitaker Wellness Institute, we treat patients with fatigue with B12 on a regular basis. Conventional doctors may order blood tests looking for the obvious causes and suggest their patients get more sleep, perhaps even offering addictive sleeping pills. But they generally overlook this simple solution that can dramatically improve energy and quality of life.

Sleep apnea occurs when the fleshy tissues at the back of the throat relax and block the airway, causing you to stop breathing. The brain, sensing oxygen deprivation, sends signals that wake you up just enough to take a breath. This not only makes getting a good night’s sleep impossible, but also leads to a number of very serious problems. Sleep apnea causes significant drops in blood oxygen levels and wreaks havoc with normal metabolism. It triples risk of hypertension, more than doubles risk of stroke, and quadruples risk of arrhythmia. It is also closely linked with obesity and insulin resistance, and a five-fold increased risk of diabetes.

Fortunately, sleep apnea is easy to treat. I used to snore like a freight train until I discovered I had sleep apnea. Now, I use an automatic positive airway pressure (APAP) machine. This device gently blows a stream of air through a small mask worn over the nose that prevents the tissues in the throat from collapsing and ensures that oxygen levels remain in the optimal range throughout the night. It has changed my life. I sleep like a baby and wake up rested and invigorated. My wife loves it too—no more snoring or worrisome episodes when I would literally stop breathing.

At the clinic, we screen patients we suspect of having sleep apnea with an inexpensive overnight test that records pulse, blood oxygen levels, and oxygen flow. It doesn’t require a visit to a special sleep lab, where you’re hooked up to all manner of sensors and monitors and observed all night long. It can be done in your own bed or, for out-of-towners, in your hotel room. If a test is positive for sleep apnea, the patient is prescribed an APAP or CPAP (continuous positive airway pressure) machine and instructed in its use by our sleep specialist.

Most insurance plans, including Medicare, reimburse for APAP/CPAP, as this therapy has been shown in numerous scientific studies to improve sleep, energy, memory, mood, and reduce risk of serious disease.

When it is diagnosed, most doctors write a prescription for Synthroid (levothyroxin). This, in my opinion, is bad medicine. Although the thyroid produces a number of hormones, Synthroid is a synthetic version of just one of them (T4). At Whitaker Wellness, we use only natural hormone replacement, and that includes natural thyroid, which contains the full spectrum of thyroid hormones. Although some people do well on Synthroid, most of my patients note dramatic improvements after switching to natural hormone replacement.

If you’re already using natural thyroid, I’m sure you’re aware that availability has been spotty for some time now. Prescriptions for popular brands such as Armour Thyroid, Nature-Throid, and Westhroid have been on backorder for months. Raw materials shortages may be part of the issue, but other factors are also involved. The FDA has declared that natural thyroid is an unapproved drug and, to distribute it, pharmaceutical companies must go through a lengthy and expensive new drug approval process.

This has nothing to do with the safety or efficacy of natural thyroid, which has been included in the U.S. Pharmacopeia—the official authority for prescription and over-the-counter drugs manufactured or sold in the United States—for more than a century. It’s simply another of the FDA’s attempts to put the kibosh on all forms of natural hormone replacement.

It appears that the shortage of natural thyroid is finally beginning to ease up and limited quantities are being released. If Armour, Nature-Throid, or Westhroid are not available in your pharmacy, contact a compounding pharmacy to see if they can formulate a similar product.