Take your Vitamin B12
Vegetarians prone to debilitating effects
SAMANTHA Nash had seemingly endless supplies of energy. As well as working as a midwife, the mother of two would run several kilometres a week, walk her dog daily and enjoy weekend hiking with her husband, John.
These days Nash, 42, often barely has the energy to make a cup of tea.
As well as suffering crippling fatigue, her legs can feel so leaden she can hardly lift them; her concentration can be poor and she’s had to quit the job she loved and no longer feels safe to drive.
Yet Nash’s problems were not caused by some terrible disease but by an easily treatable yet frequently overlooked health problem: vitamin B12 deficiency.
Vitamin B12 plays an important role in health – for example, it helps brain and nervous system function, and is important for the formation of blood cells. It is also needed for the manufacture of myelin, the material that surrounds certain nerve cells.
A lack of vitamin B12 causes extreme fatigue, muscle weakness and problems with memory and concentration. It can lead to temporary infertility in women, while a lack of it during pregnancy can result in foetal abnormalities.
The nutrient is found in red meat, fish and dairy products and most people can get enough from diet. However, up to 18 percent of the population are deficient in it, 80 percent of these are women, according to anecdotal evidence from retired GP Dr Joseph Chandy, president of the B12 Deficiency Support Group.
Deficiency is linked to ageing and in the elderly may be linked to dementia, adds David Smith, a professor emeritus of pharmacology at Oxford University. Once levels fall below 500 picograms per millilitre – the normal range being 500 to 1 000, the brain starts to deteriorate at twice the usual rate, making memory loss six times more likely.
Yet if diagnosed early, a deficiency can be easily treated with injections of the vitamin.
The problem is that treatment can be delayed because the symptoms of B12 deficiency are so diverse, clinicians may overlook the problem, or confuse it with other conditions, including depression and even multiple sclerosis, says Professor Smith.
Left untreated, a vitamin B12 deficiency can cause serious and sometimes permanent neurological damage.
Nash experienced pins and needles and numbness in her right hand for several months before she finally went to see her GP in 2014, when one morning she had no feeling at all in her right hand for two hours.
Her GP initially said she had carpal tunnel syndrome, caused by compression of the nerves in the hand, but also decided to do some blood tests to rule out other causes such as thyroid problems.
It was by chance the laboratory added a check of her vitamin B12 levels to the list of tests. Her levels were extremely low. Her doctor immediately put her on a course of injections – six over a course of two weeks and then a further injection three months later.
Diet is rarely a cause of a deficiency, explains Dr Premini Mahendra, a consultant haematologist at the Queen Elizabeth Hospital in Birmingham.
That’s because the vitamin can be easily obtained from food sources – for instance 85g of canned tuna provides around 2.4mcg. Since it is found in red meat and dairy products, it tends to be vegetarians and vegans who are prone to dietary deficiency.”
More common is for a deficiency to arise from an inability to absorb the vitamin correctly. Simply getting older increases this risk, because as we age, the stomach shrinks and produces less of the acid needed for B12 to be absorbed.
It can also result from pernicious anaemia, where the immune system attacks cells in the stomach that produce a protein called instrinsic factor – the body needs this to help it absorb B12.
Early diagnosis and treatment is critical.
Smith says diagnosis can be delayed as blood tests are not a foolproof way to detect a deficiency. – Daily Mail