Vitamin B12 deficiency: Treatment, symptoms, advice and help
About vitamin B12 deficiency
Vitamin B 12 deficiency is a condition causing anemia with neurological disease in up to 40% of cases.
Signs & symptoms of B12 deficiency: Diagnosis
B12 deficiency produces megaloblastic anaemia.There are no distinct symptoms. Common symptoms are tiredness, a decreased mental work capacity, weakened concentration and memory, and irritability and depression. Sleep disturbances may occur. Neurological signs of B12 deficiency, which can occur with or without anemia, include sensory disturbances such as numbness and/or tingling of the extremities, impaired sense of smell, loss of appetite, disturbed coordination and, if not treated in time, an ataxic gait especially in the dark.
Causes and prevention of vitamin B12 deficiency
Dietary deficiency occurs in strict vegans but the onset of clinical features can occur at any age between 10 and 80 years.
Gastric factors Normal gastric acid and enzyme secretion is required for the release of vitamin B12 from the food. Hypochlorhydria in elderly patients or following gastric surgery can impair the release of vitamin B12.
Pernicious anemia is an autoimmune disorder in which the gastric mucosa is atrophic with loss of pareietal cells causing intrinsic factor deficiency. In the absence of intrins9ic factor less than 1% of dietary vitamin B12 is absorbed.
Small bowel factors such as motility disorders or hypogammaglobulinaemia can result in bacterial overgrowth.Fish, tapeworm.inflammatory disease of the terminal ileum, such as Crohn’s disease may result in vitamin B12 malabsorption.
For prevention,older adults especially strict vegetarians, must obtain their per day dose of vitamin B12 by consuming a vitamin supplement or eating a fortified cereal product.
Vitamin B12 deficiency: Complications
In extreme cases, B12 deficiency can lead to a syndrome known as subacute combined degeneration of spinal cord.B12 deficiency can also cause symptoms of mania, psychosis, fatigue, memory impairment, irritability, depression and personality changes.
Vitamin B12 deficiency: Treatment
Vitamin B12 deficiency is treated with hydroxycobalamin 1000µg i.m. in five doses 2 or 3 days apart followed by maintenance therapy of 1000µg every 3 months for life.