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Vitamin B12 Deficiency

Vitamin B12 Deficiency
Understand the importance of Vitamin B12 and the problems caused due to its deficiency through this article.
Nilesh Parekh
Last Updated: May 31, 2018
Vitamin B12 plays an important role in balancing the neurological functioning and for DNA Synthesis. Its deficiency can lead to neuropsychiatric and hematologic disorders, macrocytic anemia (also known as Megaloblastic anemia), hyperhomocysteinemia, atherosclerosis, pancytopenia, peripheral neuropathy, paresthesias, psychiatric problems such as irritability, change in personality, memory impairment, depression, psychosis, dementia, and sub-acute Combined Systems Disease, etc. Vitamin B12 deficiency is also said to be linked with cardiovascular problems, such as stroke, myocardial infarction, etc. Possible involvement of this deficiency in other diseases is still a subject of deep medical study.

Causes

The number of cases diagnosed for the above deficiency has risen exponentially, in the US alone, for the last couple of years.
  • Other than aging, use of medical substances (agents used for acid suppression therapy), proton pump inhibitors (used for ulcer diseases), and histamine H2-receptor blockers etc. may cause damage to the level of this vitamin in the body.
  • Problems in absorption (malabsorption syndrome - pernicious anemia that cause destruction of gastric parietal cells, which in turn hinders production of intrinsic factor important for Vitamin B12 absorption), absence of rich dietary supplement of this vitamin (meat, animal products, fish (salmon), eggs, and dairy products), and problems related to gastro-intestine also can cause this deficiency.
  • There are many other possible medical conditions responsible for this deficiency as well, which your doctor may explain in detail.
Role in the Human Body

It is required for the production of red blood cells. It also plays an important role as a cofactor in the conversion of methylmalonic acid into succinyl-CoA (this is one of the two known enzyme reactions that need this vitamin) and conversion of homocysteine into methionine (along with folic acid). The deficiency in this case, can lead to increase in methylmalonic acid and homocystein level in body.

Symptoms

As the level of oxygen in body decreases, because of anemia caused by this deficiency, the patient may experience:
  • Rapid and shorter breathing
  • Very weak pulse rate and irregular heartbeats
  • Frequent headache
  • Lethargy
  • Dizziness
  • Sore tongue, mouth, and throat
  • Loss of appetite
  • Diarrhea
Diagnosis

Increased level of methylmalonic acid and homocyhstein in blood along with decreased level of serum vitamin B12 can be considered as early symptoms of its deficiency. Other indicative conditions such as hematologic problems also point towards this deficiency. Schilling Test that helps in revealing pernicious anemia, has been proved to be of great help in uncovering the deficiency of this vitamin for a long time.

Treatment

The treatment involves oral (parenteral) therapy & intramuscular injection therapy. Both the methods have proven to be similarly efficient. A study revealed that a small quantity of Vitamin B12 (taken orally) is directly absorbed by the system, which is then bonded to Transcobalamin II, and circulated through the body. This is what takes place in oral therapy. Intramuscular injection therapy is in use for as long as the study of this subject. In this method, the supplement is injected to patient's body. The number of injections and treatment period is decided after studying patient's condition.

Important Tips

Once a person is diagnosed for this deficiency, a proper treatment plan is very important. Once the treatment is initiated, the patient should visit the doctor regularly after treatment, and find out if there is any need to change the course. Patient should also consult the doctor regarding dietary supplement that should be followed (or substances that should be avoided) during the treatment.

Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.