Vitamin B12 (cobalamins) is necessary for the formation and maturation of red blood cells and the synthesis of DNA, which is the genetic material of cells.

Vitamin B12 is also necessary for normal nerve function. Since your body doesn’t make vitamin B12, you have to get it from animal-based foods or from supplements. And you should do that on a regular basis, because your body doesn’t store vitamin B12 for a long time.You can get vitamin B12 in animal foods, which have it naturally, or from items that have been fortified with it.

Animal sources include dairy products, eggs, fish, meat, and poultry. If you’re looking for a food fortified with B12, check the product’s Nutrition Facts label.

People should not take high doses of vitamin B12 as a cure-all, but otherwise the vitamin does not appear to be toxic.

The causes of Vitamin B12 deficiency

• Inadequate vitamin B12 intake is possible in vegans but is otherwise unlikely. Breastfed babies of vegan mothers may develop vitamin B12 deficiency by age 4 to 6 mo because in these babies, liver stores (which are normally extensive in other babies) are limited and their rapid growth rate results in high demand.

• Conditions that affect your small intestine, such as Crohn’s disease, Celiac disease, bacterial growth, or a parasite
• Drugs such as antacids and metformin (used to treat diabetes)
• Nitrous oxide or laughing gas  (repeated exposure)

Symptoms and signs of B12 deficiency

• Constantly feeling tired or chronic fatigue
• Weakness, tiredness, Muscle or joint pain or lightheadedness

• Heart palpitations and shortness of breath
• Pale skin
• A smooth tongue
• Constipation, diarrhea, loss of appetite, or gas
• Poor dental health, including bleeding gums and mouth sores
• Nerve problems like numbness or tingling, muscle weakness, and problems walking
• Vision loss
• Mental problems like depression, memory loss, or behavioral changes
• A more serious deficiency can also cause a form of anemia called pernicious anemia, a serious condition that can cause memory loss, confusion and even long-term dementia

 

Diagnosis of Vitamin B12

Do a CBC (simple Blood Test) and measure vitamin B12 and folate levels.

TREATMENT

The recommended doses are only for ADULTS*

Daily intaking in normal adults are as follows:

Adults: 2.4 mcg daily
Pregnancy: 2.6 mcg daily
Lactation: 2.8 mcg daily

In Vitamin B12 deficiency:
Oral: 50-150 mcg daily taken between meals

Injection (IM) or deep SubQ are preferred routes of administration : 1000 mcg repeated 10 times at intervals of 2-3 days; if improvement, then every 3-4 days for 2-3 weeks; once hematologic values have returned to normal, maintenance dosage: 1000 mcg monthly.

Intranasal (Nascobal): 500 mcg in one nostril once weekly (it is expensive)

Recommendation:

Many people may have vitamin B12 deficiency without any symptoms. So, meet your doctor if you experienced any symptoms mentioned above or if you are not eating enough vitamin B12 containing foods.

By Dr. Fatemeh Aghanasiri, M.D. (MCC) – Medicentres