sunflower hospital Nagpur Dr Jay Deshmukh:- Vitamin B 12 is a water-soluble vitamin, that is important in red blood cell formation, nerve cell function, cell metabolism and the production of DNA which is the basis of life. More than 40 % elderly in Asian countries suffer from Cobalamin that is Vitamin B 12 deficiency. About 10 % of young adults and children may suffer from this deficiency. Early recognition and treatment are necessary to prevent permanent nerve damage.
What are the common symptoms of B 12 deficiency?
- Excessive tiredness, easy fatigue, pins and needles like sensation over the tongue, toes and fingers are common. In fact, this numbness like symptoms can occur at any other site on the body. Soreness of the tongue and recurrent oral ulcers can occur. Breathlessness due to low haemoglobin, darkening of the skin particularly over the hands and fingers are common too. Some experience recurrent infections well.
What about brain functioning and B 12 deficiency?
- sunflower hospital Nagpur: –Loss of memory, irritability, numbness in hands and feet and poor attention to what others are communicating are common. Depression, anxiety, mood swings are common too. In extreme cases of severe and long-standing deficiency, severe dementia inability to walk without support is observed. Some may have fertility issues. Decreased sexual drive, lack of concentration is also a manifestation of Cobalamin deficiency.
What are the common causes of Vitamin B 12 deficiency?
- sunflower hospital Nagpur: –Poor intake, poor absorption and excessive demands that are not met are the main reasons. In vegetarians, the amount of B 12 vitamin in their usual diet is very low. Coupled with poor absorption which at times may be genetic, B 12 deficiency is common in India. Long term consumption of Metformin an anti-diabetes medicine, antacids like Ranitidine or excessive Vitamin C intake encourage Cobalamin deficiency. Individuals who have undergone stomach or intestinal resection surgery are susceptible to B 12 deficiency. Cobalamin deficiency is more pronounced in the very young and the elderly and those who have undergone bariatric surgery. Those who have chronic diarrhoea and alcoholism have Cobalamin deficiency.
What about anaemia and B 12 deficiency?
- As Cobalamin is necessary for red blood cells growth and maturity, deficiency results in anaemia. This is associated with tiredness, breathlessness and easy fatigue. Some may experience mild swelling on their feet. Some may have palpitations with minimal effort.
What about homocysteine and B 12 deficiency?
- Excessive homocysteine has been associated with increased risk of vascular diseases like strokes and coronary artery disease. This is due to increased levels of homocysteine due to Vitamin B 12 deficiency. Deficiency of B 12 also leads to an excess of Methylmalonic acid and methionine.
Which are the common diets or foods rich in Vitamin B 12 or Cobalamin?
- Vitamin B 12 is naturally found in animal products, including fish, meat, poultry, eggs, milk and milk products. Vitamin B 12 is generally not found in plant products.
What about B 12 in a vegetarian diet?
- An excessive amount of curds, low-fat milk, cheese, fortified cereals, nutritional yeast and some mushrooms may contain Cobalamin. However, you need a large quantity of milk, curds, mushrooms to satisfy your daily recommended need of Cobalamin.
How do you confirm Cobalamin deficiency?
- Dr Jay Deshmukh:- Low levels of B 12 in blood, high levels of homocysteine in blood and excess of methylmalonic acid in urine help to confirm the diagnosis. A simple complete blood count and examination of blood peripheral smear also help.
Is a very high level of B 12 associated with disease?
- Dr Jay Deshmukh:- During treatment with injections of Cobalamin high levels are seen. There are few diseases associated with high levels though very uncommon. This being a water-soluble vitamin, excess does not cause disease.
How is Cobalamin deficiency confirmed?
- Simple blood tests like complete blood count, estimating levels of Cobalamin in the blood is sufficient. In a selected few bone marrow examination, LDH levels are important too.
What about treatment?
- sunflower hospital Nagpur Dr Jay Deshmukh: -Injections of Cobalamin are preferred. They are well tolerated and not expensive. Some individuals may require them for life as a maintenance dose. Very high doses of oral Cobalamin may help in those who refuse injections.
Maintaining a proper level of B 12 is necessary for proper body functioning. Consuming B 12 is essential to your diet. Vitamin B 12 contributes to vital functions in your body including forming and dividing red blood cells, protecting your nervous system, synthesising your DNA and giving your body energy. Early detection of deficiency states may help to prevent permanent nerve damage.
Author: Dr Jay Deshmukh
M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD
(Internal Medicine – Bombay and New Delhi)
Chief Physician and Director, Sunflower Hospital, Nagpur