Numbness and tingling in hands and feet, fatigue, weakness, constipation,
loss of appetite, and weight loss. What this all have in common?
All of these are symptoms of Vitamin B12 deficiency.
Older adults, people with gastrointestinal diseases who are unable to absorb vitamin B12,
vegetarians, pregnant and lactating women
are more susceptible to deficiency of vitamin B12, or cobalamins.
So, let’s talk about Vitamin B12 today
Our body does not produce our own Vitamin B12 (cobalamins), and they are essential to form
red blood cells, neurological function and to regulate the synthesis of DNA.
How to detect deficiency?
When we suspect of vitamin B12 deficiency, we order a blood test that measures it in the plasma.
The normal values are 170 to 250 pg/ml or 120-180 picomol/Litre.
Because vitamin B12 is also important to form red blood cells, we usually detect anemia,
a special type of anemia called megaloblastic anemia, in the blood
of people who have deficiency of Vitamin B12. Megaloblastic anemia means that the red blood
cells are bigger than normal, but they do not contain enough hemoglobin inside of them.
On the other hand, if the person also has deficiency of other vitamins or minerals,
that cause red blood cells to decrease in size, we call this microcytic anemia,
then it will be complicated to make the diagnosis only looking at the hemogram,
which assess the size of the red blood cells. Because one deficiency makes them larger,
and the other makes the red blood cells smaller, so they hide each other.
There is a blood test that is better to detect Vitamin B12 deficiency, it is called homocysteine,
and it can indicate problems of deficiency of vitamin B12 or B9 (also known as Folate),
but these are usually very expensive tests.
Recommended daily intake
Health Canada, and the Institute of Medicine in the US
recommend that for people over 14 years of age the ideal intake of Vitamin B12 is 2.4 mcg per day.
What are some sources of Vitamin B12?
Fish, meat, poultry, eggs, milk and milk products are rich in Vitamin B12.
Vitamin B12 is generally not present in plant foods, but there are fortified cereals and
yeast products that contain cobalamins. Beef liver contains the highest amount
of Vitamin B12. I love beef liver, and it is enough to eat once a week.
However, some people have a gastrointestinal problem that does not let them absorb the Vitamin
B12 they eat. And because Vitamin B12 is important to form red blood cells,
the person will develop a type of anemia called pernicious anemia, which is caused by the
gastrointestinal malabsorption of Vitamin B12. In this case we have two options.
They may use sublingual supplements of vitamin B12, that is absorbed in the mouth,
or intramuscular injections. But if the person has deficiency of Vitamin B12,
but has a normal absorption in the stomach and intestines, then the deficiency can be
corrected with a diet rich in Vitamin B12, or by taking supplements and ingesting them by mouth.
You need to talk to your doctor of pharmacist to get the right dose of supplements for you.
However, it is important to remember that the deficiency of Vitamin B12 can be corrected,
that is, the blood levels can return to normal, however, the damage that the
deficiency caused in the neurological system is sometimes irreversible, including pain.
So, we still recommend supplementation at least the diseases will not get worse.
There is some new evidence suggesting that vitamin B12 can be used in the treatment of
neuropathic pain and low back pain, but we need more studies to demonstrate these benefits.
In severe cases of prolonged Vitamin B12 deficiencies,
we can also see depression, visual disturbances, psychoses, dementia, glossitis (a red
beefy tongue), restless leg syndrome, paraplegia and even incontinence of bowels or bladder.
If you need to take supplements of Vitamin B12, talk to your pharmacist,
as they interact with some other medications like proton pump inhibitors,
H2 receptor antagonists like those used to treat stomach ulcers, and a commonly prescribed
medication to treat diabetes, metformin. If you have another supplement that you
would like me to review in a video, just write down your suggestion in the comment box below.
I already have other videos about Vitamin D, Magnesium, glucosamine, chondroitin, and Omega-3.
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