In the last few weeks, I had a patient question me about B12 deficiency. This vital vitamin, if deficient in our bodies, can cause many changes including mood changes, numbness and tingling, muscle weakness and other symptoms.
- What is B12 ?
- How does B12 Play a Role in Our body?
- What are the symptoms associated with a deficiency of B12?
- What Foods are rich in B12?
- What are the treatment options for B12 deficiency?
What is B12 ?
B12 is a vitamin, also known as cobalamin.
In order for B12 to be absorbed by the body (which happens in the small intestine), the stomach secretes intrinsic factor which is a special digestive secretion that increases the absorption of vitamin. Low levels of stomach acid or an inadequate amount of intrinsic factor (both of these things can occur with age), can lead to deficiency in B12. Because the body as reserves, it can take 5-6 years for a deficiency to develop.
This vitamin is stored in the liver, kidney and other body tissues.
It has been found that with age, B12 decreases in the body, and this deficiency is noted in 3 to 42 % of persons over age 65. It is easily treatable if the deficiency is caught early. If left untreated, it can lead to impaired neurological and cognitive function.
Who is more at risk? Patients with ulcers, crohns disease, other gastrointestinal disorders, those taking prescription medication for seizures, chronic heartburn, and gout. Too much consumption of alcohol can also hinder vitamin b12.
Vitamin B12 is necessary in small quantities: the RDA is 2 micrograms.
How does B12 Play a Role in Our body?
Vitamin B12 works with folic acid in many body processes such as:
- Making DNA and RNA
- Making red blood cells
- Making the insulation sheath aka myelin sheath that surrounds nerve cells and speeds up the conduction of nerve cells.
- Assists in converting food to energy
What are the symptoms associated with a B12 Deficiency?
A deficiency of Vitamin B12 can take up to 5-6 years to show up, because the body does have large reserves for it. The classic deficiency symptom is pernicious anemia. However, the first area to be affected with B12 deficiency is the brain and nervous system. As a result it can result in fatigue, muscle weakness, numbness, pins and needles sensations, or a burning type of sensation. It can also cause impaired mental function including memory loss and confusion. Finally, it can be the cause of depression.
What Foods are rich in B12?
Vitamin B12 is found in large quantities in animal foods ( beef, pork, halibut, hamburger, lamb, salmon, and veal). The richest sources are liver and kidney, followed by eggs, fish, cheese and meat. Eggs, Milk and milk products are high in B12. Oysters, sardines, brewers yeast are also rich in b12. Some breakfast cereals are fortified with B12 vitamin as well.
What are the treatment options for B12 deficiency?
A general dose of 1000 micrograms of B12/ day is useful for heart disease prevention, pernicious anemia, numbness and tingling, tinnitus, multiple sclerosis and rosacea. **
Correction of B12 deficiency improves mental function and quality of life in patients significantly.
Fortunately, B12 vitamin is available in a few forms:
- Methycobalamin, available in tablet form
- B12 shots
- Prescription nasal spray
** it is beneficial to take B12 along with 400 mcg of folic acid.
Ways to determine B12 deficiency:
- Measure the level in the blood (serum cobalamine)
- Measure the level in methylmalonic acid in the urine *** This is the best test because it is sensitive, non invasive and convenient for the patient.
- Measure the level of plasma homocysteine (looks at both B12 and folate)
- Schilling Test : measures whether there is a proper secretion of intrinsic factor. Intrinsic factor is needed for B12 to be absorbed by the body.
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