Dr Dulcy deals with anaemia
DEFICIENCY: VITAMIN B12 IS ESSENTIAL AS PART OF A HEALTHY, BALANCED DIET
You can get it from animal-based foods or from supplements.
Vitamin B12 deficiency anaemia occurs when a lack of vitamin B12 causes the body to produce abnormally large red blood cells that can’t function properly.
Red blood cells carry oxygen around the body using a substance called haemoglobin. Anaemia is the general term for having either fewer red blood cells than normal or having an abnormally low amount of haemoglobin in each red blood cell.
You need to make sure you get enough Vitamin B12 in your diet in order to stay healthy.
Since your body doesn’t make vitamin B12, you have to get it from animal-based foods or from supplements. And you should do that on a regular basis, because your body doesn’t store vitamin B12 for a long time.
The amount of Vitamin B12 that is adequate for you depends on your age, your eating habits and medical conditions, and what medications you take.
The human body stores several years’ worth of B12 in the liver. Since a variety of foods consumed by people generally contain B12, a dietary deficiency of this vitamin is extremely rare.
It may be seen, for example, in people with generally poor nutrition or malnutrition, in vegans who do not consume any animal products, including milk and eggs, and in breastfed infants of vegans.
In adults, dietary deficiencies do not usually cause symptoms until stores of the vitamins within the body have been depleted.
Deficiencies in children and infants, however, show up fairly quickly since they have not had time to store as much of the vitamins as adults.
Vitamin B12 performs several important functions in the body, including keeping the nervous system healthy. A deficiency can cause:
Extreme tiredness and lack of energy.
Pins and needles (paraesthesia) a sore and red tongue.
Mouth ulcers.
Muscle weakness.
Disturbed vision.
Psychological problems, which may include depression and confusion.
Problems with memory, understanding and judgement.
Constipation, diarrhea, loss of appetite, or gas.
FOOD SOURCES OF VITAMIN B12
You can get vitamin B12 in animal foods, which have it naturally, or from items that have been forti-
fied with it. Animal sources include dairy products, eggs, fish, meat, and poultry.
CAUSES OF VITAMIN B12 DEFICIENCY
You can get vitamin B12 deficiency if you follow a vegan diet (meaning you don’t eat any animal products, including meat, milk, cheese, and eggs) or you are a vegetarian who doesn’t eat enough eggs or dairy products to meet your vitamin B12 needs.
In both of those cases, you can add fortified foods to your diet or take supplements to meet this need.
Ageing. With age, it can become harder to absorb this vitamin.
Weight loss surgery. If you have had weight loss surgery or another operation that removed part of your stomach.
Alcoholism. If you drink heavily.
Certain medications. If you have been taking anticonvulsants or acid-reducing medications for a long time.
Stomach acid is necessary to separate B12 from the protein in food. This is the most common cause of B12 deficiency in the elderly and in individuals on drugs that suppress gastric acid production.
Atrophic gastritis, in which your stomach lining has thinned.
Pernicious anaemia, where your immune system attacks healthy cells in your stomach, preventing your body from absorbing vitamin B12 from the food you eat.
Conditions that affect your small intestine, such as Crohn’s disease, celiac disease, bacterial growth, or a parasite.
Immune system disorders.
ADVICE FOR PREGNANT LADIES
If you are a pregnant woman on a vegan or vegetarian diet, and plan to only breastfeed your baby, you need to talk to your doctor before you have your baby.
That way your doctor can make a plan so that you’ll get enough vitamin B12 to keep your baby healthy.
TREATMENT
If you have pernicious anaemia or have trouble absorbing vitamin B12, you’ll need shots of this vitamin at first.
You may need to keep getting these shots, take high doses of a supplement, or get it nasally after that.
If you don’t eat animal products, you have options.
You can change your diet to include vitamin B12-fortified grains, a supplement or B12 injections, or a high-dose oral vitamin B12 if you are deficient.
Older adults who have a vitamin B12 deficiency should take a daily B12 supplement or a multivitamin that contains B12.
For most people, treatment resolves the problem.
PREVENTION
Most people can prevent vitamin B12 deficiency by eating enough meat, poultry, seafood, dairy products, and eggs.
If you don’t eat animal products, or you have a medical condition that limits how well your body absorbs nutrients, you can take vitamin B12 in a multivitamin or other supplement and foods fortified with vitamin B12.
If you choose to take vitamin B12 supplements, let your doctor know, so he or she can make sure they won’t affect any medicines you’re taking.
COMPLICATIONS OF VITAMIN B12 DEFICIENCY
Vitamin B12 deficiency can lead to complications, particularly if you have been deficient in vitamin B12 for some time. These include:
Problems with the nervous system.
Temporary infertility.
Heart conditions.
Pregnancy complications and birth defects.
Adults with severe anaemia are also at risk of developing heart failure.