Know the Symptoms and Causes of Vitamin B12 Deficiency

2024-10-18 00:00:00

Vitamin B12 deficiency occurs when the levels of vitamin B12 in the body are insufficient. This essential vitamin is required for the erythropoiesis (production of red blood cells), which carries oxygen to all parts of the body. It is also required for healthy functioning of the nervous system, brain and synthesis of hemoglobin. Vitamin B12 is water soluble and enters the bloodstream, where it can be stored in the body for almost four years and excess vitamin B12 is excreted out.

 

Stages of Vitamin B12 Deficiency

Vitamin B12 deficiency occurs in four stages-

Stage 1- Declining blood levels of the vitamin.

Stage 2- Progressing to low cellular vitamin concentrations.

Stage 3- Increased blood homocysteine levels and decreased DNA synthesis rate.

Stage 4- Macrocytic anemia (a type of anemia that causes abnormally large red blood cells).

 

Symptoms of Vitamin B12 Deficiency

Symptoms may include-

• Weak muscles.
• Tingling or numbness in the hands and feet.
• Confusion and memory related problems
• Nausea
• Weight loss.
• Irritability
• Decreased appetite.
• Trouble walking.
• Chronic diarrhea.
• Erectile dysfunction.
• Shortness of breath.
• Palpitations (accelerated heart rate).
• Dizziness 
• Skin darkening.
• Swollen, red and painful feet.
• Fatigue
• Depression
• Lack of balance.

 

Causes of Vitamin B12 Deficiency

It is caused by one of the following causes:

Lack of intrinsic factor-

Intrinsic factor is a protein produced in the stomach. It is important for the absorption of vitamin B12. This type of vitamin B12 deficiency is called pernicious anemia.

The inability to produce intrinsic factor can have different causes, such as-

• Chronic gastritis (a condition that occurs when the lining of the stomach becomes inflamed).
• Surgery to remove all or part of the stomach (gastrectomy).
• Autoimmune disease in which the body attacks its own tissues.

Surgery to remove or cut the end of the small intestine-

Vitamin B12 deficiency can develop in people who have had surgery to remove part of the abdomen.

Medications-

The use of medicines such as antibiotics, metformin, and medicines to treat gastritis or peptic ulcers (such as pantoprazole) can cause decreased absorption of vitamin B12 in the intestine.

 

Risk Factors of Vitamin B12 Deficiency

In general, the following groups are most at risk for deficiency-

• Vegetarians
• Family history of the disease.
• People over 60 years old.
• People who regularly take PPIs or acid-suppressing drugs.
• Those taking diabetes medications such as metformin.
• Those with Crohn's disease, ulcerative colitis, celiac disease or IBS.
• Women with a history of infertility and miscarriage.

 

How is Vitamin B12 Deficiency diagnosed?

Your doctor may suspect your medical history and symptoms to check for deficiency. He or she will examine you and arrange for laboratory tests to confirm the diagnosis. Laboratory tests include-

Blood test to measure the level of red blood cells and check their appearance-

In cases of vitamin B12 deficiency, the red blood cells are large and look abnormal.

Blood test to measure B12 levels-

Iron and folic acid levels may also be measured to check for deficiency.

Blood test to measure methylmalonic acid levels-

Blood methylmalonic acid levels increase when a person is deficient in vitamin B12.

Blood test for intrinsic factor antibodies-

Your doctor may take blood tests for antibody levels to determine if you have pernicious anemia. Most people who do not have an intrinsic factor in their stomach have these antibodies in their blood.

Bone marrow biopsy-

Sometimes a bone marrow biopsy is done to confirm the diagnosis. In this procedure, a small sample of bone marrow is obtained by inserting a needle into the pelvic bone just below the waist on either side of the spine. The bone marrow sample is tested in a laboratory to look for other causes of anemia and red blood cell abnormalities.

 

 

Prevention for Vitamin B12 Deficiency

To prevent vitamin B12 deficiency, vegans should take adequate amounts of vitamin B12 supplements to complete the shortage in their diet.

In people who cannot absorb B12, this condition cannot be prevented. However, once diagnosed, regular vitamin B12 injections will prevent symptoms from returning.

 

Treatment for Vitamin B12 Deficiency

Yogurt-

Yogurt is one of the best sources of vitamin B12. One cup of plain yogurt can provide almost 28% of vitamin B12. Plain yogurt works best for many patients to relieve symptoms of vitamin B12 deficiency.

Milk and other dairy products-

Milk is rich in vitamin B12, as well as protein, calcium, and minerals. Dairy products like cheese, paneer are also good sources of vitamin B12. Milk can be absorbed more quickly and easily in the stomach than other sources.

Bran and Whole wheat oats-

Bran and whole grain oatmeal are rich in vitamin B12, as well as folic acid, iron and vitamin A. Consuming these regularly helps increase vitamin B12 levels in the body.

Soy or almond milk-

Consuming daily a glass of soy or almond milk reduces the signs of deficiency as it contains 2.1 mcg of vitamin B12.

Nutritional yeast-

Nutritional or fortified yeast is high in vitamin B12. A small amount of this yeast can add a nutty flavor to food. One tablespoon of fully fortified yeast contains 2.4 mcg of vitamin B12. You can add this fortified yeast to sauces or curries for better taste.

Nori-

Nori is an edible dried seaweed that contains a good amount of vitamin B12. Only 4 grams of dried Nori is sufficient for daily requirements, you can have it as a simple snack or use it in sushi.

Eggs-

Eggs are also rich in vitamin B12, protein and calcium. Egg yolks have a higher vitamin B12 value than egg whites. Therefore, it is recommended to eat whole eggs. You can eat boiled eggs for breakfast or add them to soups.

Tempeh-

Tempeh is a fermented soybean cake that is a delicacy in Indonesian cuisine. It resembles tofu and is very rich in vitamin B12.

Red meat-

Red meat such as beef and pork are excellent sources of vitamin B12. About 2.42 mcg of vitamin B12 is found.

When to see a doctor?

If a person develops any of the symptoms, he or she must consult a doctor for further medical examination.