Vitamin B12 deficiency is also known as hypocobalaminemia, refers to low blood levels of vitamin
B12. A
wide variety of signs and symptoms may occur including a decreased ability to
think and changes in personality such as depression, irritability, and psychosis.Abnormal sensations,
changes in reflexes, and poor muscle function can also occur as may inflammation of the tongue, decreased
taste, low
red blood cells, reduced
heart function, and decreased fertility. In young
children symptoms include poor
growth, poor
development, and difficulties
with movement.
B12. A
wide variety of signs and symptoms may occur including a decreased ability to
think and changes in personality such as depression, irritability, and psychosis.Abnormal sensations,
changes in reflexes, and poor muscle function can also occur as may inflammation of the tongue, decreased
taste, low
red blood cells, reduced
heart function, and decreased fertility. In young
children symptoms include poor
growth, poor
development, and difficulties
with movement.
Without early treatment some of the
changes may be permanent( Hunt et al.,2014).
Read Also: Types and Consequences of Lack of Vitamins
SIGNS AND SYMPTOMS
Vitamin B12 deficiency can lead to vitamin B12 deficiency anemia and neurologic
dysfunction. A mild deficiency may not cause any discernible symptoms, but as
the deficiency becomes more significant symptoms of anemia may result, such as
weakness, fatigue, light-headedness, rapid heartbeat, rapid breathing and pale
color to the skin. It may also cause easy bruising or bleeding, including
bleeding gums. GI side effects including sore tongue, stomach upset, weight
loss, and diarrhea or constipation. If the deficiency is not corrected, nerve
cell damage can result. If this happens, vitamin B12 deficiency may result in tingling or
numbness to the fingers and toes, difficulty walking, mood changes, depression,
memory loss, disorientation and, in severe cases, dementia.
dysfunction. A mild deficiency may not cause any discernible symptoms, but as
the deficiency becomes more significant symptoms of anemia may result, such as
weakness, fatigue, light-headedness, rapid heartbeat, rapid breathing and pale
color to the skin. It may also cause easy bruising or bleeding, including
bleeding gums. GI side effects including sore tongue, stomach upset, weight
loss, and diarrhea or constipation. If the deficiency is not corrected, nerve
cell damage can result. If this happens, vitamin B12 deficiency may result in tingling or
numbness to the fingers and toes, difficulty walking, mood changes, depression,
memory loss, disorientation and, in severe cases, dementia.
The main
syndrome of vitamin B12 deficiency
is pernicious anemia. It is
characterized by a triad of symptoms:
syndrome of vitamin B12 deficiency
is pernicious anemia. It is
characterized by a triad of symptoms:
1. Anemia with bone marrow promegaloblastosis
(megaloblastic anemia). This is due to the inhibition of DNA synthesis
(specifically purines and thymidine)
(megaloblastic anemia). This is due to the inhibition of DNA synthesis
(specifically purines and thymidine)
2. Gastrointestinal
symptoms: alteration in bowel motility, such as mild diarrhea or constipation,
and loss of bladder or bowel control (Briani et
al.,2013).These are thought to be due to defective DNA synthesis
inhibiting replication in a site with a high turnover of cells. This may also
be due to the autoimmune attack on the parietal cells of the stomach in
pernicious anemia.
symptoms: alteration in bowel motility, such as mild diarrhea or constipation,
and loss of bladder or bowel control (Briani et
al.,2013).These are thought to be due to defective DNA synthesis
inhibiting replication in a site with a high turnover of cells. This may also
be due to the autoimmune attack on the parietal cells of the stomach in
pernicious anemia.
3. Neurological
symptoms: Sensory or motor deficiencies (absent reflexes, diminished vibration
or soft touch sensation), subacute
combined degeneration of spinal cord, seizures (Yavuz
2008), or even symptoms of dementia and or other psychiatric symptoms may
be present. The presence of peripheral sensory-motor symptoms or subacute
combined degeneration of spinal cord strongly suggests the presence of a B12 deficiency instead of folate deficiency.
Methylmalonic acid, if not properly handled by B12, remains in the
myelin sheath, causing fragility. Dementia and depression have been associated
with this deficiency as well, possibly from the under-production of methionine because of the inability to convert
homocysteine into this product. Methionine is a necessary cofactor in the
production of several neurotransmitters.
symptoms: Sensory or motor deficiencies (absent reflexes, diminished vibration
or soft touch sensation), subacute
combined degeneration of spinal cord, seizures (Yavuz
2008), or even symptoms of dementia and or other psychiatric symptoms may
be present. The presence of peripheral sensory-motor symptoms or subacute
combined degeneration of spinal cord strongly suggests the presence of a B12 deficiency instead of folate deficiency.
Methylmalonic acid, if not properly handled by B12, remains in the
myelin sheath, causing fragility. Dementia and depression have been associated
with this deficiency as well, possibly from the under-production of methionine because of the inability to convert
homocysteine into this product. Methionine is a necessary cofactor in the
production of several neurotransmitters.
TREATMENT
B12 can be supplemented by pill or injection
and appear to be equally effective in those with low levels due to absorption
problems. When large doses are given by mouth its absorption does not rely on
the presence of intrinsic factor or an intact ileum. Generally 1 to 2 mg
daily is required as a large dose. Even
pernicious anemia can be treated entirely by the oral route (Kuzminski et al.,1998).These supplements carry
such large doses of the vitamin that 1% to 5% of high oral doses of free
crystalline B12 is
absorbed along the entire intestine by passive diffusion.
and appear to be equally effective in those with low levels due to absorption
problems. When large doses are given by mouth its absorption does not rely on
the presence of intrinsic factor or an intact ileum. Generally 1 to 2 mg
daily is required as a large dose. Even
pernicious anemia can be treated entirely by the oral route (Kuzminski et al.,1998).These supplements carry
such large doses of the vitamin that 1% to 5% of high oral doses of free
crystalline B12 is
absorbed along the entire intestine by passive diffusion.
Food sources of Vitamin B12
can only be found only in foods of animal origin such as meats, liver, kidney,
fish, eggs, milk and milk products, oysters, shellfish. Some fortified foods
may contain vitamin B12.
can only be found only in foods of animal origin such as meats, liver, kidney,
fish, eggs, milk and milk products, oysters, shellfish. Some fortified foods
may contain vitamin B12.
