Sunflower Hospital Nagpur | Dr Jay Deshmukh:-  Vitamin B 12 deficiency has become very common amongst the general population. A wide range of symptoms and signs are associated with this deficiency. This can range from behavioural to emotional to severe anaemia to fertility and cardiovascular issues. The treatment is quite simple, but the diagnosis is usually reached late because of lack of awareness.

 

What is the general epidemiology of this deficiency?

1.   In the developing world, it has become very common. This is due to a vegetarian diet and a low intake of animal products. B 12 deficiency is more common amongst the elderly as the absorption of this vitamin gets reduced in the elderly due to atrophy of the stomach.

What are the main causes of Vitamin B 12 or cyanocobalamin deficiency?

1.   Sunflower Hospital Nagpur | Dr Jay Deshmukh:- Besides vegetation diet, it is common amongst children because of poor intake of B 12. Children are at a high risk of deficiency as they have fewer vitamin stores and a relatively large vitamin need per calorie of food intake. Selective impaired absorption of this vitamin due to intrinsic factor deficiency as occurs in pernicious anaemia. After surgical excision of the terminal ileum, or in malabsorption syndromes. Chronic alcoholism, bacterial overgrowth as in blind loop syndrome and fish tapeworm infestation can cause B 12 deficiency. Some bariatric procedures can cause this deficiency.

Can certain drugs can cause this deficiency?

1. Drugs like Metformin used in diabetes, the commonly used anti-ulcer drugs like Omeprazole,   Ranitidine can cause B 12 deficiency.

Why is B 12 important for our body?

1. Sunflower Hospital Nagpur | Dr Jay Deshmukh:- B 12 helps make our DNA. It also helps our nerve cells and Red Blood cells. It is thus crucial for healthy brain and immune system. It is basically found in eggs, meat, shellfish and dairy products. Up to 15 percent, people do not have adequate vitamin B 12.

What are the main symptoms of vitamin B 12 deficiency?

1. Sunflower Hospital Nagpur | Dr Jay Deshmukh:-  Fatigue, loss of weight, poor stamina, sore tongue and mouth, chronic diarrhoea, tingling numbness of toes and fingertips, forgetfulness, dementia is commonly known. Some even feel feverish most of the times and may feel irritable or depressed at times. As the immune system gets affected due to this deficiency some may become prone to infections. Some may have diarrhoea or menstrual problems. Jaundice, paronia hallucinations, difficulty in reasoning and thinking can occur. It can lead to loss of taste and smell.

What are the skin changes?

1. Premature greying of hair, darkening of the skin on the exposed parts including the hands are very common. Some may lose pigment from their skin.

How is the deficiency diagnosed?

1. Besides the clinical symptoms, a blood test may reveal low haemoglobin, large red cells on smear and low platelets. Estimation of the level in blood confirms the deficiency. Levels below 180 pg/ ml are diagnostic. High levels of methylmalonic acid are confirmatory too.

How can it be prevented?

1. Sunflower Hospital Nagpur | Dr Jay Deshmukh:- If you are a strict vegetarian it is important to eat bread, cereals or other grains that have been fortified with this vitamin. Or take daily a multivitamin supplement. A standard multivitamin delivers 6 micrograms, more than enough to cover the body’s daily needs.

Sunflower Hospital Nagpur | Dr Jay Deshmukh:-  Vitamin B 12 is a powerhouse of our body. The symptoms of deficiency can be very subtle and unusual. A strong index of suspicion is necessary as the treatment is simple. Excessive B12 in the body is harmless. Excessive deficiency can be dangerous. It can be a cause of premature cardiovascular disorders as B 12 deficiency is associated with excess  homocysteine levels that can cause thrombosis