Vitamin B12 Deficiency

• Vitamin B12 deficiency is a treatable condition that occurs if you are not consuming enough vitamin B12 in your diet or if your body is not absorbing it properly. Vitamin B12 deficiency can begin with physical, neurological, and psychological symptoms. It can be managed with vitamin B12 medications.

What is vitamin B12 deficiency?

• Vitamin B12 deficiency occurs when your body is either not getting enough or not absorbing enough vitamin B12 from the food that you eat that it requires to function properly. Vitamin B12 is an important nutrient that assists your body make red blood cells and DNA, the genetic material in all of your cells.
• Vitamin B12 deficiency can cause physical, neurological, and psychological problems if it is not managed.

What is vitamin B12?

• Vitamin B12 is an important nutrient that assists your body keep your nerve cells and blood cells healthy. It also assists your body make DNA, the genetic material in all of your cells. Your body does not create vitamin B12 on its own, so you have to consume food and drinks that have vitamin B12 in order to acquire it.
• Vitamin B12 has come from animal products you eat and drink such as meat, dairy, and eggs. It can be built into fortified foods (foods that have some vitamins and nutrients added to them) such as certain cereals, bread, and nutritional yeast.
• Adults require surround 2.4 micrograms (mcg) of vitamin B12 a day, and people who are pregnant or breastfeeding require more. The amount of vitamin B12 babies and children require varies based on age.

How does my body absorb vitamin B12?

• There are 2 things that require to happen in order for your body to absorb vitamin B12 from the food you eat. First, hydrochloric acid in your stomach takes off vitamin B12 from the food it was in. Next, vitamin B12 combines with something known as an intrinsic factor, a protein made by your stomach. Vitamin B12 is then able to be soaked by your digestive system.
• Some people have a rare condition known as pernicious anemia, which means their stomach does not make an intrinsic factor. Because of this, their body cannot properly soak vitamin B12, which causes a vitamin B12 deficiency.

What is vitamin B12 deficiency anemia?

• Vitamin B12 deficiency anemia occurs when your body does not have adequate healthy red blood cells (RBCs) because your body has a vitamin B12 deficiency. Vitamin B12 is required to create red blood cells (RBCs). Because of this, a decrease in vitamin B12 can cause anemia. People can have vitamin B12 insufficiency without having anemia.

What does vitamin B12 deficiency affect?

• Any person can create vitamin B12 deficiency at any age. People who are 60 years old or older are more such as to have vitamin B12 deficiency compared to other age groups.

How common is vitamin B12 deficiency?

Around 1.5% to 15% of people have vitamin B12 efficiency. Here are the percentages of people who have vitamin B12 efficiency rest on age ranges:

• At most 3% of people aged 20 to 39 years old,
• At most 4% of people aged 40 to 59 years old,
• At most 6% of people are 60 years or over.

What causes vitamin B12 deficiency?

• Vitamin B12 deficiency is seen in you if you are not taking enough vitamin B12 through Diet or your body is not absorbing the vitamin B12 you swallow properly.

Situations or conditions that can cause vitamin B12 deficiency involve:

• Lack of vitamin B12 in your diet: People who do not eat enough foods that naturally have vitamin B12 or do not eat foods fortified with vitamin B12 can develop vitamin B12 deficiency.
• Gastritis: Gastritis is inflammation of the stomach lining, and it is a common cause of vitamin B12 deficiency. It can cause vitamin B12 deficiency due to a decrease in hydrochloric acid in your stomach, which is needed for vitamin B12 absorption.
• Pernicious anemia: People who have pernicious anemia, an infrequent medical condition, are not able to make intrinsic factors, a protein made by your stomach. You require intrinsic factors so that your body can absorb the B12 vitamin. The person with pernicious anemia has a B12 vitamin efficiency.
• Digestive diseases: Diseases that harm the digestive system, such as Crohn’s disease and celiac disease, can prevent your body from fully absorbing vitamin B12.
• Surgery: People who have gastrointestinal surgery, such as a gastric bypass (weight loss surgery), can have hard absorbing vitamin B12.
• Alcohol use disorder: This condition can harm your digestive system and cause vitamin B12 deficiency.
• Transcobalamin II deficiency: This is an infrequent genetic disorder that impairs the transport of vitamin B12 (also known as cobalamin) within the body.

What are the symptoms of vitamin B12 deficiency?

• Vitamin B12 deficiency can begin with physical, neurological, and psychological symptoms. The symptoms of vitamin B12 deficiency can create slowly and can get worse over time. Some people may have no symptoms despite having a decreased level of vitamin B12 in their bodies. People with vitamin B12 deficiency can have neurological symptoms and/or harm without anemia (lack of red blood cells).

Usual physical symptoms of vitamin B12 deficiency can involve:

1. Feeling very tired or weak,
2. Experiencing nausea, vomiting, or diarrhea,
3. Not feeling as hungry as usual,
4. Weight loss,
5. Having a sore mouth or tongue,
6. Having yellowish skin.

Neurological symptoms of vitamin B12 efficiency can involve:

1. Numbness and tingling in your hands and feet,
2. Vision problems,
3. Having a difficult time remembering things or getting confused easily,
4. Having a hard time walking or speaking like you usually do,
5. If neurological problems create from vitamin B12 deficiency, they may not be reversible.

Psychological symptoms of vitamin B12 deficiency can involve:

1. Feeling depressed,
2. Feeling irritable,
3. Experiencing an exchange in the way you feel and behave.

How is vitamin B12 deficiency diagnosed?

• It can be hard to diagnose vitamin B12 deficiency because symptoms are not always present and the symptoms can be similar to other nutritional deficiencies. Healthcare providers (doctors) will usually do routine blood tests to check for vitamin B12 deficiency in people who have a high risk of developing it.
• The tests utilized to diagnose vitamin B12 deficiency are a complete blood count (CBC) and a vitamin B12 blood test level. A person has diagnosed with vitamin B12 deficiency if the amount of vitamin B12 in their blood is decreased by 150 per mL.

How is vitamin B12 deficiency treated?

• Vitamin B12 efficiency can be managed vitamin B12. It is sometimes managed with cyanocobalamin, a man-made form of vitamin B12. Depending on the cause of the deficiency, the person may only have to be managed until their vitamin B12 levels are back to normal, or they may have to grab vitamin B12 therapy for the rest of their life.

Options for vitamin B12 treatment involve:

1. Vitamin B12 oral medication,
2. Vitamin B12 intramuscular injections (a gulp that goes into the muscle),
3. Vitamin B12 nasal gel,
4. Vitamin B12 nasal spray.

Physiotherapy Treatment

• An individual with a confirmed or suspected Vitamin B12 deficiency is commonly treated by a primary physician with medication that includes intramuscular injection, oral Vitamin B12 supplements, or a change in nutritional habits.
• Treating or diagnosing a patient with a vitamin deficiency commonly falls outside of the Physical Therapist’s Scope of Practice, however, physical therapists should be aware of the presenting sign and symptoms of Vitamin B12 deficiency and refer to proper medical personnel with any uncommon findings.
• Physical Therapists should be particularly familiar with the part of Vitamin B12 on the nervous system.
• If a physical therapist is suspicious that a Vitamin B12 deficiency may be present they should refer to MD.
• Early diagnosis of the deficiency is extremely important because the result of treatments is believed to be linked to the time of diagnosis.

What are the risk factors for vitamin B12 efficiency?

A person is more likely to create vitamin B12 deficiency if they have one or more of the following risk factors:

• Being older than 75 years: Elderly people are more at risk for developing vitamin B12 deficiency because their bodies are sometimes unable to fully absorb vitamin B12.
• Having a digestive system disorder: Digestive disorders such as celiac disease and Crohn’s disease can make it harder for your body to absorb vitamin B12.
• Following a strict vegan or vegetarian diet: Vitamin B12 is only naturally established in animal products such as meat and dairy. Because of this, people who eat a vegan or vegetarian diet are more likely to have a vitamin B12 deficiency if they are not eating enough fortified foods with vitamin B12.
• Taking certain medications: Certain medications can cause decreased levels of vitamin B12 in your body, including metformin (a drug utilized to manage diabetes), proton pump inhibitors (PPIs are utilized to treat GERD and peptic ulcers), histamine H2 blockers (a medicine utilized to reduce the amount of acid your stomach makes) and oral birth control pills (oral contraceptives).
• Having Sjögren’s syndrome: People with Sjögren’s syndrome are over 6 times more likely to have vitamin B12 deficiency.
• Drinking excessive amounts of alcohol: Chronic alcoholism can harm your digestive system and cause vitamin B12 deficiency.

How can I prevent vitamin B12 deficiency?

• Most people can cure vitamin B12 deficiency by consuming foods and drinks that have vitamin B12.

Options for consuming vitamin B12 involve:

• Animal food products: Red meat, fish, eggs, milk, and other dairy products all contain vitamin B12.
• Fortified foods: Fortified foods are foods that have certain vitamins and nutrients added to them that they do not naturally have. Fortified foods involve certain breakfast cereals, nutritional yeast, plant milk, and certain bread. Be sure to check the food label (nutritional facts) to look if the food has been fortified with vitamin B12.
• Vitamin B12 dietary supplements: So many multivitamins have vitamin B12. There are supplements that only have vitamin B12. Ask your healthcare provider (doctor) or pharmacist to help you choose which supplement is best for you.

Other things you can do to assist prevent vitamin B12 deficiency involve:

1. Avoid alcohol: Frequent alcohol consumption can harm your digestive system and make it difficult for your body to absorb vitamin B12.
2. Do your best to lead your digestive disease: If you have a digestive disease like Crohn’s disease or celiac disease, be sure to follow your healthcare provider’s (doctor’s) instructions to stay healthy.

What is the prognosis for vitamin B12 deficiency?

• The prognosis for people who have vitamin B12 deficiency turns on how early the deficiency is diagnosed and treated. If vitamin B12 deficiency is caught early, most people are able to obtain rid of their symptoms with treatment. Depending on the cause of your vitamin B12 deficiency, you may have to only grab medication for a short amount of time, or you may have to take medication for the rest of your life.
• If vitamin B12 deficiency is left untreated, it can cause lasting severe side effects that affect the nervous system and brain.

More serious side effects of vitamin B12 deficiency involve:

1. Peripheral neuropathy
2. Degeneration of the spinal cord
3. Paralysis
4. Bowel incontinence and/or urinary incontinence
5. Erectile dysfunction
6. Depression
7. Paranoia and delusions
8. Memory loss.

Can a vitamin B12 deficiency cause death?

• Untreated vitamin B12 deficiency can conduct severe neurological (nervous system) harm, which can put an individual at a higher risk of mortality. Pernicious anemia, a deficiency in the production of red blood cells (RBCs) due to a decrease in vitamin B12, can cause permanent neurological damage that can conduct to death if it is untreated.

When should I see my healthcare provider?

• If you are experiencing symptoms of vitamin B12 deficiency or are at risk for creating vitamin B12 deficiency, contact your healthcare provider (doctor) to see if you should take a blood test to measure your vitamin B12 level. If you have already been diagnosed with vitamin B12 deficiency and are experiencing the latest or most concerning symptoms, be sure to reach out to your healthcare provider (doctor).

NOTE

• Vitamin B12 is an important vitamin that your body requires to be healthy. Most people can cure vitamin B12 deficiency by taking enough of it in their diet. If you have risk factors for creating vitamin B12 deficiency or are experiencing symptoms, be sure to contact your doctor to obtain a blood test to check your levels.

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