What is Vitamin B12 deficiency, and why is it important?

Vitamin B12 deficiency can be potentially dangerous, both for us and for our future children. This is why it’s very important to understand about this entity, so that we can recognise and prevent it.

Where does Vitamin B12 come from?

Vitamin B12 is created by microorganisms, and microorganisms only. In order for us to get this vitamin we need to eat it from meat, fish and/or dairy products. The only way that vegetables and fruits can contain vitamin B12 is if they are contaminated by bacteria. A normal western diet contains between 5-30 micro-grams of vitamin B12 daily, and a normal adult loses 1-3 micro-grams, which comes out to about 0.1% of our body’s stores (2-3mg). This means that if you have appropriate amounts in your body of vitamin B12 and you stopped the intake all together, cutting off the source, you have a supply of 3-4 years.

Our body absorbs vitamin B12 in a very inefficient manner. One of the mechanisms for this, through our cheeks and part of the intestines manages to absorb less than 1% of our daily intake. However our small intestines are a bit more efficient with their active absorption, managing to trap a bit of what we eat, and 6 hrs later a portion of that can be detected in our blood stream.

Why is Vitamin B12 important? 

Although the mechanism is not completely understood, we do know that Vitamin B12 plays a very important role in DNA synthesis. This is important for every cell in our body that needs to divide and replicate itself. Every system in our body renews itself every so often, the most often would probably be the blood, and the least often would be the nervous system. However the replication and ability to create DNA for the new cells is absolutely critical our body’s continual normal function.

Anemia from Vitamin B12 deficiency:

Although there are some people with minor deficiencies who do not develop anemia, the first sign of this deficiency is usually a low hemoglobin count. It comes in a form known as megaloblastic anemia, meaning that the average size of the red blood cells is larger than normal. However this is just the beginning. As the deficiency progresses, a number of other manifestations can be seen as well. Inflammation of the tongue or the corners of the mouth can be seen, along with hyper-pigmentation of the skin, and jaundice as well. Due to the fact that vitamin B12 is crucial for the building blocks of new cells, platelet counts may be diminished leading to bruising, and white blood cells can also be low leading to infections especially of the respiratory and urinary tracts.

How does Vitamin B12 deficiency effect pregnancy?

Infertility is one of the most common manifestations of vitamin B12 deficiency in both men and women. For women who do manage to become pregnant, vitamin B12 deficiency has been shown to cause fetal loss and neural tube defects. Although this has been more commonly linked to folic acid deficiency, vitamin B12 and folic acid are heavily connected and so both can cause these clinical situations. Interestingly enough folic acid supplements taken by the mother have shown to be extremely beneficial in lowering the risk of neural tube defects in their children, though vitamin B12 supplements have not been studied enough to make the same claim.

What about the nervous system?

As mentioned earlier, cells of our nervous system are some of the slowest to divide and multiply, doing so only once per year in some cases. Nevertheless vitamin B12 deficiency has been shown to have some direct effects on the nervous system due to other reasons which are poorly understood. Some of these manifestations include psychiatric disorders, dementia, muscle weakness which can lead to difficulty walking. Vision impairment has also been noted in some cases.

Why are there people with vitamin B12 deficiencies?

The most common reason is poor dietary intake, which is usually vegans or vegetarians who do not take supplements. Accordingly certain people with eating disorders are also at risk for developing vitamin B12 deficiency. There are a number of diseases as well which cause this situation, most having to do with decreased absorption along the intestinal tract. An example of this is Pernicious Anemia. This is when an enzyme which plays a key role in vitamin B12 absorption, called Intrinsic Factor is under-secreted due to atrophy of part of the stomach. Most patients are around 60 years old, and has correlation with other autoimmune diseases like thyroid disease, hypoparathyroidism and Addison’s. Lastly infants under 6 months old can also develop vitamin B12 deficiency, and this is usually if their mother is deficient as well. These infants are usually breast fed, and they don’t receive the amount of vitamin that they require, developing anemia. This can be very dangerous, as it leads to growth retardation, slows down their development both physical and mental.

How do you treat vitamin B12 deficiency?

After establishing that you have a vitamin B12 deficiency which can be done a number of ways, it’s important to get yourself treated properly. If the problem is lack of intake, there are vitamin B12 injections that can be taken. In the UK the injection is called hydroxocobalamin, and in the US it’s called cyanocobalamin. If the problem is a different disease causing the deficiency there are sometimes treatments, for example surgery to remove fish tapeworms, tropical sprue or other rare reasons of the sort. If someone has a borderline level of vitamin B12 without any symptoms, they can be followed to make sure that the deficiency does not progress, but should change their diet and try to incorporate more meat, fish or dairy into their lives. The bodily stores are usually completely replenished within 6 injections which can be given at different intervals depending on the severity of the symptoms. Once the stores are replenished, an injection once every 3 months is appropriate for maintenance.

Vitamin B12 is an incredibly important vitamin which should be on the radar of anyone who is either vegan or vegetarian, especially women when they are considering becoming mothers. Keep an eye out for yourself and your friends to prevent some of these tragedies which don’t have to occur if you prepare responsibly.


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