Vitamin B12 Deficiency Information Including Symptoms, Diagnosis
Vitamin B12 deficiency is seen as a megaloblastic anemia, fatigue, weakness, constipation, loss of appetite, and weight loss. Neurological changes, for example numbness and tingling in the possession of and feet, can also occur. Additional symptoms of vitamin B12 deficiency include difficulty maintaining balance, depression, confusion, dementia, difficulty in remembering things, and soreness of the mouth or tongue. The neurological symptoms of vitamin B12 deficiency can happen without anemia, so early diagnosis and intervention is essential to avoid irreversible damage. During infancy, signs and symptoms of a vitamin B12 deficiency include failure to thrive, movement disorders, developmental delays, and megaloblastic anemia. A number of these symptoms are general and migh result from a variety of health conditions other than vitamin B12 deficiency.
Typically, vitamin B12 deficiency is given vitamin B12 injections, because this method bypasses potential barriers to absorption. However, high doses of oral vitamin B12 can also be effective. The authors of the review of randomized controlled trials comparing oral with intramuscular vitamin B12 figured 2,000 mcg of oral vitamin B12 daily, then a decreased daily dose of just 1,000 mcg and then 1,000 mcg weekly and finally, monthly may be as effective as intramuscular administration. Overall, a person patient’s ability to absorb vitamin B12 is an essential factor in determining whether vitamin B12 ought to be administered orally or via injection. In many countries, the practice of using intramuscular vitamin B12 to deal with vitamin B12 deficiency has always been unchanged.
Folic acid and vitamin B12
Considerable amounts of folic acid can mask the harmful effects of vitamin B12 deficiency by correcting the megaloblastic anemia brought on by vitamin B12 deficiency without correcting the neurological damage which occurs. Moreover, preliminary evidence shows that high serum folate levels may not only mask vitamin B12 deficiency, but tend to also exacerbate the anemia and worsen the cognitive symptoms related to vitamin B12 deficiency. Permanent nerve damage can happen if vitamin B12 deficiency isn’t treated. For these reasons, folate intake from fortified food and supplements shouldn’t exceed 1,000 mcg daily in healthy adults.
Groups vulnerable to Vitamin B12 Deficiency
The primary causes of vitamin B12 deficiency include vitamin B12 malabsorption from food, pernicious anemia, postsurgical malabsorption, and dietary deficiency. However, in lots of cases, the cause of vitamin B12 deficiency is unknown. The next groups are the type of most likely to be vitamin B12 deficient.
Atrophic gastritis, a condition affecting 10%-30% of seniors, decreases secretion of hydrochloric acid within the stomach, resulting in decreased absorption of vitamin B12. Decreased hydrochloric acid levels may also increase the growth of normal intestinal bacteria which use vitamin B12, further lowering the amount of vitamin B12 open to the body.
Individuals with atrophic gastritis cannot absorb the vitamin B12 that’s naturally present in food. Most, however, can absorb the synthetic vitamin B12 put into fortified foods and dietary supplements. Consequently, the IOM recommends that adults over the age of 50 years obtain the majority of their vitamin B12 from vitamin supplements or fortified foods. However, some elderly patients with atrophic gastritis require doses higher than the RDA to avoid sub-clinical deficiency.
People with pernicious anemia
Pernicious anemia, a condition that affects 1%-2% of seniors, is characterized by deficiencies in intrinsic factor. People with pernicious anemia cannot properly absorb vitamin B12 within the gastrointestinal tract. Pernicious anemia is generally treated with intramuscular vitamin B12. However, approximately 1% of oral vitamin B12 could be absorbed passively in the absence of intrinsic factor, suggesting that high oral doses of vitamin B12 may also be an effective treatment.
People with gastrointestinal disorders
People with stomach and small intestine disorders, for example celiac disease and Crohn’s disease, might be unable to absorb enough vitamin B12 from food to keep healthy body stores. Subtly reduced cognitive function caused by early vitamin B12 deficiency may be the only initial characteristic of these intestinal disorders, then megaloblastic anemia and dementia.
Individuals who have had gastrointestinal surgery
Surgical treatments in the gastrointestinal tract, for example weight loss surgery or surgery to get rid of all or part of the stomach, often create a loss of cells that secrete hydrochloric acid and intrinsic factor. This cuts down on the amount of vitamin B12, particularly food-bound vitamin B12, the body releases and absorbs. Surgery of the distal ileum also can increase the risk for inability to absorb vitamin B12. Individuals undergoing these surgical treatments should be monitored preoperatively and postoperatively for several nutrient deficiencies, including vitamin B12 deficiency.
Strict vegetarians and vegans are in greater risk than lacto-ovo vegetarians and nonvegetarians of developing vitamin B12 deficiency because natural food causes of vitamin B12 are restricted to animal foods. Fortified cereals are one of the few causes of vitamin B12 from plants and may be used as a dietary fiber supply of vitamin B12 for strict vegetarians and vegans.
Pregnant and lactating ladies who follow strict vegetarian diets and their infants
Vitamin B12 crosses the placenta while pregnant and is present in breast milk. Exclusively breastfed infants of ladies who consume no animal products might have very limited reserves of vitamin B12 and can be cultivated vitamin B12 deficiency within months of birth. Undetected and untreated vitamin B12 deficiency in infants can lead to severe and permanent neurological damage.
The Ada recommends supplemental vitamin B12 for vegans and lacto-ovo vegetarians during both pregnancy and lactation to make sure that enough vitamin B12 is used in the fetus and infant. Pregnant and lactating ladies who follow strict vegetarian or vegan diets should meet with a pediatrician regarding vitamin B12 supplements for their infants and children.