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The risk for pernicious anemia from vitamin B12 deficiency is highest among the elderly, but a significant number of people begin to notice the first symptoms in their 30s, contrary to popular belief. Listed below are some common symptoms of pernicious anemia and explanations regarding your risk for developing pernicious anemia in middle age.
What is pernicious anemia?
Pernicious anemia is the final stage of vitamin B12 deficiency. Pernicious anemia used to be fatal until scientists figured out that death could be easily prevented by feeding patients high concentrations of Vitamin B12.
Vitamin B12 deficiency causes many debilitating health problems, including chronic fatigue, lethargy, weakness, memory loss and neurological and psychiatric problems – long before pernicious anemia sets in. These symptoms can be quite misleading, leading to incorrect diagnoses.
Autoimmune disease and immune dysregulation (unregulated immune response)
Male and female infertility
These diseases produce signs and symptoms that also occur with vitamin B12 deficiency – but are rarely diagnosed as such!
Pernicious anemia risk categories
The following groups are at greatest risk for vitamin B12 deficiency-pernicious anemia:
Anybody with a family history for autoimmune disorders or pernicious anemia
Vegetarians and vegans
People aged 60 or over
GERD patients using PPIs or acid suppressing drugs
Diabetics using drugs like metformin
Patients of Crohn’s disease, ulcerative colitis, celiac or IBS
Women with a history of infertility and miscarriage
Vegetarians and Vegans take note: Vitamin B12 is found ONLY in animal products! To prevent pernicious anemia, it is absolutely essential that you supplement with high doses of vitamin B12.
Treating pernicious anemia
If you think you might have a vitamin B12 deficiency or pernicious anemia, you should pursue blood testing immediately. If you are vitamin B12 deficient, then the next step would be to identify the source of the deficiency.
Once the source of vitamin B12 deficiency is identified, you can then begin vitamin B12 supplementation. The many, long-term or permanent vitamin B12 supplementation is required in order to prevent a relapse of symptoms.
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If you feel tired all the time, then join the club- the vitamin B12 deficiency club, which is becoming the top cause of chronic fatigue allover. Vitamin B12 is crucial for brainhealth, and if you don’t get enough, you run the risk of suffering the red blood cell disease pernicious anemia- one of many vitamin B12 deficiency symptoms.
Why am I so tired all the time?
Fatigue causes you to feel sluggish, slow, confused, and constantly in a “brain fog.” You’re exhausted before you even step out of bed, and all day at work. On the drive home, you catch yourself several times nodding off at the wheel. By the time you’re ready to pack it up and call it a day, you’re almost too tired to change into your pajamas, sorely tempted to climb into bed, clothes, shoes, and all.
Why are you so tired all the time? Many conditions can cause chronic fatigue, and most of them begin with vitamin B12 deficiency.
What is vitamin B12?
Vitamin B12 is of the vitamin B complex vitamins, and occurs in foods like beef, poultry, fish, eggs, and milk. Some of the best sources of vitamin B12 are organ meat, lean turkey, crabmeat, halibut, and yogurt. Normally, sufficient amounts of B12 are stored in your liver, unless you are prone to vitamin B12 deficiency.
Tiredness is at the core of the most common symptoms of B12 deficiency: depression, chronic fatigue, anxiety, short-term memory loss, disorientation, trouble concentrating or remembering words, painful numbness or tingling in hands and feet, loss of balance while walking, muscular feebleness, and insomnia.
Here are some illnesses and chronic conditions linked to vitamin B12 deficiency:
Sometimes, pernicious anemia is the cause of vitamin B12 deficiency.
Vitamin B12 helps your body produce healthy red blood cells needed to carry oxygen. With pernicious anemia, you have a shortage of vitamin B12, which leads to a shortage of red blood cells, which in turn causes a severe reduction in oxygen throughout your body, including the brain.
The resulting effect is overwhelming tiredness, lightheadedness, and an inability to concentrate.
Scientists found that a high correlation exists between vitamin B12 deficiency and sufferers of fibromyalgia, an autoimmune disease that causes symptoms such as severe pain, skin sensitivity, sleep problems, and chronic fatigue.
People with gastrointestinal disorders such as IBD- Crohn’s disease and ulcerative colitis- have extreme difficulty absorbing vitamin B12. Symptoms such as sluggishness, diarrhea, and unexplainable exhaustion might be confused with IBD symptoms; in fact, vitamin B12 deficiency is a likely culprit that often is overlooked.
Vitamin B12 supports cognitive functioning- low B12 levels are common among people suffering from severe psychological disorders, including schizophrenia, clinical depression, and obsessive-compulsive disorders (OCD). Tiredness is one of many complaints of people suffering from depression and anxiety.
Vitamin B12 helps your body regulate the amount of homocysteine in your blood. High levels of plasma homocysteine are strongly associated with heart disease and stroke. By breaking down homocysteine, and thus reducing the risk for heart disease or stroke, vitamin B12 promotes cardiovascular health.
Treatment for B12 deficiency
A blood test is necessary in order to diagnose vitamin B12 deficiency. Not all doctors screen for low B12, so you will need to request a plasma vitamin B12 test. If necessary, your doctor will prescribe B12 injections or sublingual B12.
The elderly need to increase their intake of vitamin B12, in order to avoid memory loss from vitamin B12 deficiency. Brain loss caused by Alzheimer’s disease and other forms of dementia is sometimes a part of the aging process, but by getting enough vitamin B12 in your blood, you can prevent suffering the symptoms of vitamin B12 deficiency.
Chicago study links low levels of vitamin B12 with memory loss
A 2011 study that focused on 121 community-dwelling participants of the Chicago Health and Aging Project found a strong correlation between vitamin B12 deficiency and memory loss. Scientists measured methylmalonate levels to determine vitamin B12 deficiency.
They found a direct relationship between low levels of vitamin B12, reduced brain volume, and decreased cognitive skills, such as loss of short-term memory.
Scientists noted poorer memory skills, slower thinking processes, and impaired comprehension skills as attributes associated with elevated methylmalonate levels- an indicator of vitamin B12 deficiency.
Also considered were plasma homocysteine levels, which scientists also connected with loss of brain mass. High levels of homocysteine are common in vitamin B12 deficiency.
Scientists concluded that methylmalonate, an indicator of vitamin B12 deficiency, has a direct impact on brain volume, and that vitamin B12 has multiple benefits on brain chemistry beyond just memory skills.
In 2008, a UK study conducted by the University of Oxford produced similar results; namely, that vitamin B12 deficiency is a likely cause of brain atrophy, dementia, and short-term memory loss among the elderly.
For the elderly, eating foods with vitamin B12 isn’t enough
Eating plenty of foods rich in vitamin B12 is always a good idea; such foods include protein sources like beef, chicken, fish, eggs, milk, and cheese. But for the elderly, the problem isn’t really eating enough sources of vitamin B12, but rather digesting them. Part of the aging process involves making less stomach acids that are necessary for absorbing vitamin B12 from foods. As a result, many elderly individuals who include meat in their diet still run a high risk for getting B12 deficiency.
Unless blood tests indicate healthy levels of vitamin B12, senior citizens must supplement with vitamin B-12 (cobalamin) with a routine prescribed B12 shot in order to avoid the symptoms of vitamin B12 deficiency.
Memory loss in B12 deficiency for the young and old
It isn’t just the elderly who should be concerned with memory loss- short-term memory loss is one of many symptoms of vitamin B12 deficiency, regardless of age.
Being tired all the time is a symptom of B12 deficiency, but it can also signal hypothyroidism (low thyroid), a thyroid disease that occurs with lowB12 levels. Because hypothyroid symptoms are similar, vitamin B12 deficiency often goes undetected.
B12 deficiency causes fatigue, depression, and other mood disorders often associated with an underactive thyroid. If you’ve been diagnosed with thyroiditis, then it’s also important also to recognize the symptoms of B12 deficiency, and know whether you might require more vitamin B12 (cobalamin).
What is hypothyroidism?
Hypothyroidism is an autoimmune thyroid disease (AITD) that occurs in the thyroid gland, causing inflammation, and reducing its ability to produce sufficient amounts of thyroid hormones. Hashimoto’s disease is one example of thyroiditis that causes low thyroid levels.
Sometimes, thyroid treatment for hyperthyroidism (overactive thyroid), such as radioactive iodine or surgery, can backfire, causing underactive thyroid symptoms.
Vitamin B12 is a water-soluble nutrient that is responsible for making red blood cells, controlling DNA synthesis, regulating the nervous system, and improving cognitive functioning. Without proper levels of vitamin B12, you may suffer neurological damage, dementia, or heart attack resulting from elevated homocysteine levels.
In a study conducted in Sapir Medical Center, Kfar Saba, Israel, patients with autoimmune thyroid disease received blood screening for vitamin B12 deficiency. Researchers noted a significantly high percentage of people with AITD who also had vitamin B12 deficiency caused by pernicious anemia, a disease that inhibits proper absorption of vitamin B12.
Another study conducted in Pakistan by Aga Khan University produced similar results; namely, a 40% prevalence of vitamin B12 deficiency among patients with hypothyroidism.
If you are a patient of hypothyroidism, then physicians strongly recommend routine blood testing for vitamin B12 deficiency, regardless of thyroid hormone levels.
If you’re having trouble finding balance, B12 deficiency might be the culprit. Symptoms of vitamin B-12 deficiency- dizziness and nerve damage like ataxia (unsteady gait, difficulty keeping balance), and numbness or tingling in hands and feet require B12 supplements.
Vitamin B12 deficiency symptoms
Vitamin B12 occurs naturally in all meat, cheese, and egg products, but if you are one of millions of people who cannot absorb B12 efficiently, then you will start feeling symptoms of vitamin B12 deficiency. Some common emotional and cognitive signs of B12 deficiency are:
Chronic fatigue, sleepiness
Nerve damage caused by B12 deficiency
In addition to psychiatric symptoms, vitamin B12 deficiency causes severe damage to your nerves, notably subacute combined degeneration (SCD)of the spinal cord- a severe neurological disorder caused by B-12 deficiency. SCD causes damage in your spinal cord, brain, and peripheral nerves, beginning with the myelin sheathe.
1- The myelin sheathe- your nervous system’s “ozone layer”
The myelin sheath is a protective covering that surrounds many of your nerves, providing a shield from potential danger. The myelin sheathe also accelerates communication between your nerves and your many bodily sensors (hands, feet, tongue, nose, eyes). Vitamin B12 aids your body in maintaining this essential protective mechanism, and low levels of B12 often result in a breakdown of the myelin sheathe.
2- Communication breakdown
The nerves of your spinal cord rely on a steady inflow of information from your nerve sensors throughout your body. Messages from the nerves in your legs, for example, flow along the spinal cord and to the brain, thus controlling movements like running, walking, skipping, and tapping your feet. Nerve damage causes these signals to become misinterpreted, resulting in poor coordination, or gait ataxia.
3- Gait ataxia- taking the spring out of your step
A typical sign of abnormal neurological behavior resulting from B12 deficiency is gait ataxia, which is difficulty walking. Gait ataxia is also one of the symptoms of perniciousanemia, red blood cell disease associated with prolonged vitamin B-12 deficiency. Symptoms of gait ataxia are:
Unsteady gait, difficulty walking without stumbling
Difficulty staying balanced on one leg
Trembling awkward movements, clumsiness
Muscular weakness in the legs and arms
Hypotension (low blood pressure)
Vision problems, blurriness
4- Paresthesias- “pins and needles” and numbness sensations
An early sign of nerve damage related to vitamin B12 cobalamin deficiency is paresthesias, resulting in numbness and tingling in the hands and feet. Paresthesias is a kind of peripheral neuropathy that affects the peripheral nerves that run along your spinal cord and to your extremities, thus causing that pins and needles sensation that you often feel in your hands and feet.
Do you have vitamin B12 deficiency? Go ask a hematologist.
The only way to determine if you are indeed suffering from vitamin B12 deficiency is by getting a blood test. If a physician diagnoses you with dangerously low levels of B12, then he may recommend B12 injections, which will require a prescription.
Do you know how much vitamin B12 you need in order to avoid vitamin B12 deficiency? Unless you supplement, you could wind up with dangerously low vitamin B12 levels. Find out if your B12 blood levels are normal and how much you need to meet the FDA’s RDA for vitamin B12.
What are the symptoms of vitamin B12 deficiency?
Vitamin B12 (Cobalamin) is a water-soluble nutrient that your body gets from protein sources, such as beef, chicken, liver, fish, eggs, and dairy products. Your body uses vitamin B12 for DNA synthesis, protecting your nervous system, and strengthening cognitive skills. Symptoms that indicate a low vitamin B12level include constant fatigue, difficulty concentrating, memory loss, tingling or numbness in your hands and feet, depression, agitation, altered taste perception, and red, swollen tongue.
How much B12 is in my blood right now?
By performing a blood test, your doctor can tell you if you are deficient in vitamin B12, or if you have normal B12 levels. Vitamin B12 blood screening requires a 6-8 hour fast before testing. Laboratory tests will measure how many picograms (pg) of cobalamin you have per milliliter (ml) of blood in your body.
How much B12 should I have?
Scientists agree that a normal level of vitamin B12 in your blood is 200 – 900 picograms per milliliter (200-900 pg/ml).
Test results showing less than 200 pg/ml signal vitamin B12 deficiency.
For elderly adults, the recommended vitamin B12 level is much higher- Test results showing less than 500 pg/ml indicates B12 deficiency.
In order to find the cause of a vitamin B12 deficiency, doctors may perform a Schilling test.
What is the recommended dose of vitamin B12?
The FDA’s RDA of vitamin B12 for healthy adults is approximately three mcg daily for males and females alike, including pregnant and nursing moms.
For elderly individuals, the recommended dose of vitamin B12 is 25-100 mcg per day.
Scientific study proves that the RDA for B12 is off.
According to a study conducted in the Netherlands, elderly sufferers of vitamin B12 deficiency need more than the recommended daily allowance (RDA) in order to achieve normal levels of B12.
Using methylmalonic acid (MMA) levels as a gauge, scientists established that cyanocobalamin supplementation amounting to 200 times the RDA of vitamin B12 is required in order to stabilize B12 levels in patients showing signs of vitamin B12 deficiency.
How much vitamin B12 do you really need?
Vitamin B12 shots administering a daily doseof 1,000 mcg of cobalamin are prescribed for the first 10 days following diagnosis of vitamin B12 deficiency, continuing with a weekly dose of 1,000 mcg for a consecutive 4-week period.
Sufferers of celiac disease follow a gluten free diet, but many don’t add vitamin B12. People with autoimmune disease or gluten intolerance getB12 deficiency more often than not, according to health experts. Doctors advise sufferers of digestive diseases or pernicious anemia to supplement with B12.
Celiac disease facts:
“Alternative Names: Also classified as a disease of nutrient malabsorption, celiac disease is also known as celiac sprue, nontropical sprue and gluten-sensitive enteropathy.” –DiagnoseMe.com
Celiac disease (Gluten Enteropathy) is a digestive disease that causes severe damage to the small intestine’s lining.
Celiac disease is also an autoimmune disease. When any food containing gluten enters the body, the body proceeds to attack its own digestive system, harming the inner lining of the small intestine.
Gluten is a protein that occurs primarily in wheat, rye, and barley. All baked goods, snacks, or condiments that contain gluten are hazardous to patients with celiac disease.
Celiac disease patients have difficulty digesting vitamins and minerals from food sources, particularly vitamin B12, which can lead to severe vitamin B12 deficiency.
Some symptoms of celiac disease include diarrhea, stomach cramping, nausea, flatulence, blood in the stool, pernicious anemia caused by B12 deficiency, and stunted growth.
There is no confirmed cure for celiac disease. Physicians recommend lifestyle changes, such as following a gluten-free diet and supplementing with vitamin B12.
Vitamin B12 deficiency: What’s the connection?
“Since most B12 in our diets comes from animal products, vegans are at risk for B12 deficiency. Crohn’s and celiac disease, weight loss surgery, and chronic alcoholism can all interfere with a person’s ability to absorb enough of the nutrients they need. Seniors have more problems with nutrient absorption and malnutrition as well.” –WebMD
Vitamin B12 is a water-soluble nutrient that occurs naturally in protein sources such as beef, chicken, fish, eggs, and milk products.
Your body needs vitamin B12 for the nervous system, building red blood cells, mental clarity, maintaining metabolism, and preventing dementia.
According to one study, celiac disease patients run a high risk of developing vitamin deficiencies. Out of over 400 celiac disease patients, 12% suffered folate deficiency and 5% were deficient in vitamin B12. Among men, 33% had iron deficiency, while 19% of women had low iron levels.
Scientists conclude that damage to the small intestine in celiac disease patients prevents them from properly absorbing nutrients, thus causing severe malnourishment.
Scientists also speculate that following a gluten-free diet might also contribute to vitamin deficiencies, adding that many gluten-free products lack sufficient B vitamins, calcium, iron, zinc, magnesium, fiber or vitamin D.
Vitamin B12 deficiency symptoms and treatment
Only a blood screening for low B12 can confirm if you have vitamin B12 deficiency.
Some symptoms of B12 deficiency include fatigue, depression, psychosis, memory loss, brain fog, tingling or numbness in the hands and/or feet, altered taste perception, and loss of balance.
In some cases, following a gluten-free diet is effective at maintaining vitamin B12 levels.
For people who exhibit celiac disease symptoms in addition to symptoms of vitamin B12 deficiency, doctors advise immediate supplementation of B12.
Vitamin B12 supplementation can include weekly B12 injections, and may follow up with sublingual vitamin B12 tablets.
For many, B12 shots cause bruising, and are extremely painful, as they require insertion into thick, muscular tissue. A popular option is to supplement with an alternative weekly over-the-counter (OTC) vitamin B12 supplement, which administers the same amount of vitamin B12 as the B12 injections, without the pain, and doesn’t require prescription.
Pernicious Anemia, Sickle Cell, and Others: Anemia is a serious blood disease resulting in low blood cell production; aside from vitamin B12 deficiency from pernicious anemia, how many other types of anemia are there?
What are the different kinds of anemia?
There are six general types of anemia. They include:
Pernicious Anemia (PA)
Pernicious anemia is an acquired disease that causes vitamin B12 deficiency. Vitamin B12 is crucial for producing healthy red blood cells, in addition to supporting your nervous system, promoting mental clarity, and optimizing your metabolism. With pernicious anemia, you are unable to absorb vitamin B12 from natural food sources, resulting in severe depletion of vitamin B12 levels in your blood.
Symptoms of vitamin B12 deficiency include:
tingling in your hands and/or feet
If diagnosed with pernicious anemia, your doctor may recommend weekly vitamin B12 injections, which are inserted in the thick thigh muscle or buttock. Vitamin B12 shots require a prescription, may cause bruising, and are usually painful.
As an alternative, patients may opt for gentle over-the-counter (OTC) vitamin B12 supplements that don’t require injection.
Hemolytic anemia occurs when red blood cells are destroyed (hemolysis) at a rate that is quicker than their reproduction in bone marrow. People who have hemolytic anemia have either inherited it as a genetic disease, or acquired it later in life. Mild hemolytic anemia does not usually require treatment, but severe anemia can be life-threatening, requiring blood transfusions, steroids, or splenectomy.
Sickle Cell Anemia (SCA)
Sickle cell anemia is an inherited blood disease. In sickle cell anemia, abnormally shaped hemoglobin cells become obstructed in small blood vessels, causing pain and possible organ damage to the anemic individual. There is no cure for sickle cell anemia, but therapies for reducing the symptoms of anemia include antibiotics, pain relievers, and blood transfusions.
Aplastic Anemia (AA)
Aplastic anemia is a blood disease that can be life threatening. In aplastic anemia, your bone marrow is unable to produce sufficient amounts of crucial blood cells, including red blood cells, white blood cells, and blood platelets. Diagnosis of anemia includes testing that indicates low blood count of any of the three blood cells types. Causes of aplastic anemia include autoimmune disease (most common) or exposure to chemotherapy and other types of radiation. Possible treatments for aplastic anemia include bone marrow transplants, blood transfusions, and restraining of the immune system. Untreated, aplastic anemia can be fatal.
Fanconi Anemia (FA)
Fanconi anemia is a rare blood disorder, and it is inherited as a genetic disease. Fanconi anemia involves bone marrow failure, and can lead to myelogenous leukemia. Even with bone marrow transplants, patients of Fanconi anemia rarely live past the age of thirty.
Bone Marrow Disease Anemia
Sometimes, bone marrow diseases, such as leukemia and myelodysplasia (pre-leukemia), create symptoms of anemia in patients, as diseased bone marrow causes inadequate production of red blood cells.
Which stars rely on vitamin B12 boost for energy? Celebrities like Madonna, Kate Perry and musical boy genius Justin Bieber get vitamin B12 injections regularly. Find out why.
Q: What are B12 shots, and what are their benefits, anyways?
A: Vitamin B12 shots are usually given to people with vitamin B12 deficiency , but stars are also finding that the benefits of vitamin B12 shots include:
Not bad, for one water-soluble vitamin. B12 shots are painful, though, and you have to take them in the buttocks. (Ouch!)
Here are the top 10 most famous celebrities who rave about their vitamin B12 shots:
#1 & #2- Justin Biebertold Chelsea Handlerin an interview on her E! network show that he was feeling a little wiped out, but wasn’t looking forward to getting a B-12 shot, “in his butt.” The late night comedienne and former Playboy model is also a fan of B12 shots. She once even posted a pic on Twitter of herself getting a B12 shot in her bare behind.
Madonna carries B12 on the go
#3 & #4- Madonna got Justin Timberlake hooked on vitamin B12 injections. Timberlake, when he was asked to speak about Madonna’s induction into the Rock and Roll Hall of Fame, told the audience all about his first B12 experience: Madonna was visiting him in a recording studio, when she whipped a syringe out of her purse, told Justin to drop trou, and proceeded to give him a shot of B12 right on the spot! He’s been taking B12 for increased energy ever since. B12: Celebs Say it’s the New C
#6- Cher Lloyd has raised a lot of eyebrows on the UK show, The X Factor, for bullying the other reality show competitors and acting like a stressed out teenzilla. It’s no wonder that mentor Cheryl Cole advised her to go to a clinic for a vitamin B12 shot, which she explained would help her fight chronic fatigue, nervousness and low immunity. Along with giving Cher more energy, the vitamin B12 supplements have also helped her deal with her stage fright. Got PMS? Let B Vitamins Ease your Pain
#8- Lindsay Lohan- Like Cher Lloyd, Lindsay has also had her share of teen antics, including many all-night parties and club-hopping. To get her back into shape the morning after, Lindsay often demands a dose of B12 for energy, focus and mental balance. 7 Reasons You Have Brain Fog…And What to do About It
If you’re pregnant or breastfeeding, it’s important to know your vitamin B12 levels, in order to avoid vitamin B12 deficiency, which can cause harm to your baby and also make you feel severe fatigue, depression, and early symptoms of nerve damage.
What is Vitamin B12?
Vitamin B12 is a water-soluble nutrient which your body needs to maintain a healthy nervous system, produce ample amounts of red blood cells, support brain functioning and promote good metabolism.
Vitamin B12 also monitors homocysteine, an amino acid which is associated with increased risk for heart attack and stroke.
How can I include vitamin B12 in my diet?
Animal proteins are especially high in vitamin B12. For that reason, vegans are warned to get B12 supplementation regularly in order to avoid B12 deficiency. Food sources which are rich in vitamin B12 include:
Lean meats, particularly beef chuck and organ meats, such as liver, kidneys and heart
Fish, including salmon and halibut, and shellfish, such as clam, crab, mussels and oysters
Dairy products, including Swiss cheese, yogurt and milk
Vitamin B12 deficiency can only be diagnosed through a blood screening. It’s important to recognize vitamin B12 deficiency symptoms in the early stages, in order to prevent serious nerve damage, memory loss, mood disorders, and increased risk for heart attack or stroke.
Some of the symptoms of vitamin B12 deficiency are:
Are nursing mothers at risk for getting vitamin B12 deficiency?
Breast feeding mothers are more likely to suffer vitamin deficiencies than mothers who bottle-feed. This is because they share a significant amount of nutrients they consume with their baby. In order to maintain healthy levels of vitamin B12, nursing moms must make up the difference by either taking vitamin B12 supplements or increasing their consumption of B12 in their diet.
If I nurse often, is my baby still at risk for becoming deficient in vitamin B12?
Cow’s milk and baby formula are rich sources of vitamin B12, and so is the breast milk of a mother with healthy levels of vitamin B12.
The milk of a nursing mother who has vitamin B12 deficiency, however, will likewise have low levels of vitamin B12.
Furthermore, while an adult could harbor low B12 levels for a long time before showing any symptoms of depletion, a malnourished infant can use up his vitamin B12 stores much more rapidly, leaving a very small window of opportunity for treatment.
If left untreated, vitamin B12 deficiency in infants could lead to: