Vitamin B12 deficiency is often overlooked when patients visit their GPs suffering from crippling exhaustion, muscle weakness and problems with memory and concentration. After all, these symptoms are common to many different conditions but can cause misery to their many millions of sufferers. It is vital that a correct diagnosis is made in order for the right course of action or treatment to be initiated.
So what do we need vitamin B12 for?
Vitamin B12 is vital for the way the body works as it is involved in the formation of red blood cells that carry oxygen around the body. It is also important for the proper functioning and health of nerve tissue. A lack of vitamin B12 can lead to anaemia, as well as nerve and brain damage, which may eventually become irreversible. People with B12 deficiency may eventually develop pernicious anaemia, a type of blood disorder in which the body cannot absorb vitamin B12. Vitamin B12 also helps our bodies absorb folic acid which aids the release of energy.
Approximately 6% of people aged over 60 are vitamin B12 deficient in the UK and the US according to the American Journal of Clinical Nutrition.
What are the symptoms of vitamin B12 deficiency?
- Extreme tiredness or fatigue
- Lethargy or a lack of energy
- Panting or shortness of breath
- Palpitations or heavy beating of the heart
- Lack of appetite
- Feeling faint
- Tinnitus or a ringing in the ears
- Tingling or numbness in the fingers or toes
- Irritability, confusion or forgetfulness
- Difficulty walking properly leading to staggering
The Importance Of Vitamin B12
Vitamin B12 is vital for the way the body works as it is involved in the formation of red blood cells that carry oxygen around the body. It is also important for the proper functioning and health of nerve tissue.
What causes the deficiency?
The most common cause of vitamin B12 deficiency is pernicious anaemia. The immune system of patients with pernicious anaemia creates antibodies which attack the lining of the stomach. This damages the cells that produce a protein called intrinsic factor. Intrinsic factor is needed to absorb vitamin B12 from food into the body from the gastro intestinal tract. This condition is more common in women, in people over 60 years of age, if you have a family history of pernicious anaemia and in people with other autoimmune conditions such as Addison’s disease and vitiligo.
Some people who follow a strict vegan diet may be at risk of being deficient as they don’t eat the major food sources of B12 – meat, eggs and dairy products. Patients with Crohn’s disease or coeliac disease, as well as people who have had surgery to remove part of their stomach or small intestine, may also have problems absorbing vitamin B12 into their bloodstream.
Other causes of deficiency include chronic alcoholism, stomach ulcers and medication such as proton pump inhibitors used to treat indigestion.
How is the deficiency diagnosed?
Blood tests can be carried out to determine whether the red blood cell count is low. The size and shape of the blood cells are also checked under a microscope. The doctor may also want to check your blood intrinsic factor antibody levels to determine whether you have pernicious anaemia.
What are the treatment options?
Treatment will depend on what doctors find is causing your deficiency. If a lack of B12 in the diet is found to be the likely cause, advice on eating more vitamin B12 rich food will be given. Good food sources include meat, shellfish, salmon, milk, eggs, some fortified breakfast cereals and some soy products.
Vitamin B12 supplement tablets may also be prescribed
If pernicious anaemia is diagnosed, regular vitamin B12 injections of hydroxycobalamin may be recommended. This is a form of B12 which is injected into the muscle and patients usually require booster injections every 3 months for the rest of their lives. Further blood tests are needed to monitor the success of the treatment. A new option of an oral treatment which involves a larger dose of B12 than is currently prescribed, is being considered by the Department of Health. For more information on this, you can click on the link to the UK Pernicious Anaemia Society
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