Understanding Vitamin B12 Deficiency

Vitamin B12 deficiency is a prevalent issue affecting many individuals due to various factors.

Sources of Vitamin B12

Numerous foods are rich in vitamin B12, including meat, eggs, and dairy products. This vitamin is connected to gastric intrinsic factor in the stomach, allowing it to be absorbed into the body as a single compound.

Stages of Vitamin B12 Deficiency

Vitamin B12 deficiency progresses through several stages:

Stage 1:
During this initial phase, the body’s vitamin B12 reserves diminish, leading to a slight decrease in blood serum levels.

Stage 2:
In this stage, the vitamin becomes ineffective as levels of waste products in the serum, such as homocysteine and methylmalonic acid, rise. Here, vitamin B12 levels drop below the normal threshold.

Stage 3:
Anemia and neuropathy (demyelination) manifest in this stage, presenting typical symptoms associated with vitamin B12 deficiency.

Symptoms of Vitamin B12 Deficiency

The symptoms of vitamin B12 deficiency can be categorized into:

Common Symptoms:
The classic signs of vitamin B12 deficiency anemia include:

• Fatigue
• Weight loss
• Numbness in the feet
• Loss of sensation
• Vibration perception issues

Less Common Symptoms:
These may include:

• Memory and concentration difficulties
• Mood swings
• Depression
• Sleep disturbances
• Visual problems
• Autoimmune disorders
• Various gastrointestinal issues
• Fertility challenges

Causes and Risk Factors

Several factors contribute to vitamin B12 deficiency, such as:

• Nutritional inadequacy
• Absorption disorders in the stomach or small intestine
• Lack of intrinsic gastric factor
• Gastric mucosa atrophy
• Pernicious anemia
• Total or partial gastric removal
• Zollinger-Ellison syndrome
• Intestinal infections
• Lymphoma
• Small bowel resection
• Pancreatic diseases
• Cobalamin malabsorption and proteinuria

Complications

Vitamin B12 deficiency elevates the risk of atherosclerosis. Therefore, measuring vitamin B12 levels may soon be a standard part of routine medical exams, akin to lipid and blood sugar tests.

Diagnosis

Diagnosis involves assessing various body substances indicative of deficiency, such as:

• Antibodies against parietal cells
• Elevated blood gastrin levels
• Modified Schilling test with intrinsic factor
• Homocysteine and methylmalonic acid levels

Treatment

Treatment options for vitamin B12 deficiency include:

Injections:
Vitamin B12 can be administered through intramuscular injections to address the deficiency and restore stores. Typically, injections are given daily for two weeks or weekly for 4-6 weeks, followed by monthly doses.

Medications:
Oral medications, lozenges, sublingual tablets, or nasal ointments are also available. While these may not suffice for severe deficiencies, they can help prevent further disease progression in high-risk individuals.

Prevention

To prevent vitamin B12 deficiency, it is crucial to minimize exposure to its associated risk factors.