Vitamin B12 Deficiency
Vitamin B12 deficiency happens when your body is either not getting enough or not absorbing enough vitamin B12 from the food that you eat that it needs to function properly.
What is Vitamin B12?
Vitamin B12 is an important nutrient that helps your body make red blood cells and DNA, the genetic material in all of your cells.There are two things that need to happen in order for your body to absorb vitamin B12 from the food you eat. First, hydrochloric acid in your stomach removes vitamin B12 from the food it was in. Next, vitamin B12 combines with something called intrinsic factor, a protein made by your stomach. Vitamin B12 is then able to be absorbed by your digestive system.
Requirement of Vitamin B12
The average recommended daily amounts, measured in micrograms (mcg), vary by age –
• Infants up to age 6 months: 0.4 mcg
• Babies ages 7-12 months: 0.5 mcg
• Children ages 1-3 years: 0.9 mcg
• Kids ages 4-8 years: 1.2 mcg
• Children ages 9-13 years: 1.8 mcg
• Teens ages 14-18: 2.4 mcg (2.6 mcg per day if pregnant and 2.8 mcg per day if breastfeeding)
• Adults: 2.4 mcg (2.6 mcg per day if pregnant and 2.8 mcg per day if breastfeeding)
Symptoms –
• Fatigue
A deficiency in B12 or folate can cause megaloblastic anemia. This condition leads to the formation of large, abnormal, and immature red blood cells and impaired DNA synthesis. When your body doesn’t have enough healthy red blood cells to carry oxygen to tissues, you’ll likely feel weak and tired.
• Pale or Yellow skin
Like the condition called iron deficiency anemia, anemia related to B12 deficiency may make your skin pale due to a lack of fully-matured, healthy red blood cells in the body. B12 deficiency can also cause a condition called jaundice, which makes your skin and the whites of your eyes take on a yellowish color.
• Headaches
B12 insufficiency and deficiency can lead to neurological side effects, including headaches. In fact, headaches are amongst the most commonly reported symptoms related to B12 deficiency in both adults and kids.
• Depression
B12 is essential to the proper functioning of your central nervous system, and a deficiency in this nutrient can impact your mental health. Specifically, B12 deficiency is associated with a greater risk of developing depression.
• Glossitis with Stomatitis
Glossitis is a medical term that refers to an inflamed, red, and painful tongue. It can be caused by a B12 deficiency.
In people with this deficiency, glossitis can appear alongside stomatitis, which is characterized by sores and inflammation in the mouth.
• Paresthesia
Paresthesia is a medical term that refers to a burning or pins-and-needles sensation in certain areas of the body, like the hands and feet. Many adults and kids who have B12 deficiency report experiencing paresthesia.
• Muscle cramps and muscle weakness
B12 deficiency negatively impacts motor and sensory nerve function, which can cause muscle cramps and weakness
• Impaired coordination
Ataxia, or impaired balance and coordination, is a neurological symptom that can be caused by B12 deficiency. As such, a person with B12 deficiency may have difficulty walking and balancing .
• Erectile dysfunction
Men with B12 deficiency may experience erectile dysfunction as a result of increased levels of homocysteine in the body
• Vision disturbances
B12 deficiency may cause vision disturbances, possibly due to damage to the optic nerve
• Gastrointestinal problems
A B12 deficiency may also cause diarrhea, nausea, constipation, bloating, gas, and other gastrointestinal symptoms. These issues can affect both adults and children.
Causes –
Situations or conditions that can cause vitamin B12 deficiency include:
• Lack of vitamin B12 in your diet: People who don’t eat enough foods that naturally have vitamin B12 or don’t eat foods fortified with vitamin B12 can develop vitamin B12 deficiency.
• Gastritis: Gastritis is inflammation of the stomach lining, and it’s a common cause of vitamin B12 deficiency. It can cause vitamin B12 deficiency due to a lack of hydrochloric acid in your stomach, which is needed for vitamin B12 absorption.
• Pernicious anemia: People who have pernicious anemia, a rare medical condition, are not able to make intrinsic factor, a protein made by your stomach. You need intrinsic factor so that your body can absorb B12 vitamin. People with pernicious anemia have a B12 vitamin deficiency.
• Digestive diseases: Diseases that affect the digestive system, like Crohn’s disease and celiac disease, can prevent your body from fully absorbing vitamin B12.
• Surgery: People who have gastrointestinal surgery, such as a gastric bypass (weight loss surgery), can have difficulty absorbing vitamin B12.
• Alcohol use disorder: This condition can damage your digestive system and cause vitamin B12 deficiency.
• Transcobalamin II deficiency: This is a rare genetic disorder that impairs the transport of vitamin B12 (also known as cobalamin) within the body.
Risk Factors –
• Being older than 75 years
• Having a digestive system disorder such as celiac disease and Crohn’s disease
• Following a strict vegan or vegetarian diet: Vitamin B12 is only naturally found in animal products such as meat and dairy. Because of this, people who eat a vegan or vegetarian diet are more likely to have a vitamin B12 deficiency if they aren’t eating enough fortified foods with vitamin B12.
• Taking certain medications, including metformin, proton pump inhibitors (PPIs are used to treat GERD and peptic ulcers), histamine H2 blockers and oral birth control pills (oral contraceptives).
• Having Sjögren’s syndrome
• Drinking excessive amounts of alcohol
Diagnosis –
To assess for a vitamin B12 deficiency, a doctor will likely:
• ask about symptoms
• carry out a physical examination
• do a blood test to measure B12 levels and check for anemia
• do other tests to rule out other conditions and check for pernicious anemia, if necessary
Treatment –
Vitamin B12 deficiency can be treated with vitamin B12. It is often treated with cyanocobalamin, a man-made form of vitamin B12. Depending on the cause of the deficiency, the person may only have to be treated until their vitamin B12 levels are back to normal, or they may have to take vitamin B12 therapy for the rest of their life.
Food Sources
• Fish such as shellfish
• Liver
• Red meat
• Eggs Poultry
• Dairy products such as milk, cheese, and yogurt
• Fortified nutritional yeast
• Fortified breakfast cereals
• Enriched soy or rice milk
• Nuts such as almonds
Options for vitamin B12 treatment include:
• Vitamin B12 oral medication.
• Vitamin B12 intramuscular injections (a shot that goes into the muscle).
• Vitamin B12 nasal gel.
• Vitamin B12 nasal spray.
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