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In a recent study on vitamin B12 deficiency and antacid medications, doctors from Kaiser Permanente found further evidence proving that people who take stomach acid-inhibiting drugs for GERD (acid reflux) and heartburn are more likely than others to develop significant vitamin B12 anemia over time. Side effects include memory loss, fatigue, and nerve damage.
If you suffer from gastro-esophageal reflux disease (GERD), chronic heartburn, or peptic ulcers, then you’re chances of developing vitamin B12 deficiency (aka pernicious anemia) are higher than normal, according to a California study published in JAMA.
Vitamin B12 and the stomach
In order to digest vitamin B12 from the foods you eat, your body uses digestive enzymes produced in the stomach; without these essential stomach acids, you would not be able to absorb vitamin B12- it would just pass through the digestive system untouched.
And such is the case with patients using certain antacid medications to treat chronic acid reflux, stomach ulcers, painful heartburn, and esophageal strictures. By inhibiting the production of peptic acids, you also inhibit digestion of vitamin B12, resulting in vitamin B12 malabsorption- a widespread cause of vitamin B12 deficiency, or pernicious anemia.
Likewise, elderly individuals who stop producing sufficient stomach acids as a result of old age are also at risk for vitamin B12 deficiency.
Quick note: A deficiency in stomach acids is equal to a deficiency in vitamin B12.
Which antacid medications cause B12 deficiency?
In the Kaiser study, doctors examined patients using proton-pump inhibitors (PPIs) and histamine 2 receptor antagonists (H2RAs) who also had vitamin B12 deficiency.
This doesn’t mean that you should stop taking these medications; rather, it’s important to check your vitamin B12 levels regularly if you use any of the following antacid medications long-term:
Quick note: If you use PPIs or H2RAs, then check your B12 levels yearly, at least.
Is vitamin B12 deficiency serious?
Untreated, vitamin B12 deficiency can lead to severe nerve damage, dementia, and increased risk for heart attack and stroke. (Remember, pernicious anemia used to be a fatal disease until scientists learned to treat it with vitamin B12.)
However, even the earliest and middle stages of vitamin B12 deficiency can be extremely debilitating- enough to make daily functioning difficult and tiring.
Symptoms of vitamin B12 deficiency:
Listed are common signs of vitamin B12 deficiency which are often overlooked or misdiagnosed:
Painful numbness and tingling in the hands and feet
Once you start noticing even the earliest symptoms of vitamin B12 deficiency, that’s a sign that your vitamin B12 levels have already dropped to a dangerous low. So, it’s important to start treating immediately.
A simple blood test may indicate if you have vitamin B12 deficiency, but it’s best not to wait for diagnosis to begin supplementing. Vitamin B12 is safe to use in any amount, so there’s no harm in taking “too much,” but there can be negative ramifications if you wait too long to begin restoring your vitamin B12 levels.
Also, the median used to determine vitamin B12 levels is too low to catch the earliest signs of vitamin B12 deficiency.
Quick note: Symptoms are a better indicator of vitamin B12 deficiency than lab tests.
Which types of vitamin B12 are best?
With vitamin B12 malabsorption, vitamin B12 pills are useless, as they pass through the stomach undigested. Instead, your doctor may prescribe vitamin B12 injections which must be inserted directly into the muscular tissue of the thigh, arm, abdomen, or buttocks. Depending on the level of anemia, you may be required to take vitamin B12 shots monthly or bi-monthly.
You may find that monthly sessions of vitamin B12 shots are not enough to make you feel “normal” again. If that’s the case, then it’s helpful to take extra doses of vitamin B12 between injections. Just make sure to use types of vitamin B12 that pass directly through the skin’s layer into the blood.
Quick note: If you can’t digest vitamin B12 in the stomach, then you have to manually insert it into your blood stream through the skin.
Dizziness and lightheadedness can make you feel faint, like you need to pass out. Causes of dizziness, including vertigo- that whirling sensation you may experience while sitting still- may include anemia from vitamin B12 deficiency or low iron, heart disease, or one of several other conditions that share symptoms of nausea, fatigue, and loss of balance.
Is it dizziness or vertigo
Many people confuse vertigo with standard dizziness. This is an important distinction, because actual symptoms of vertigo may indicate a serious underlying health risk, such as tumor or stroke.
With dizziness, you may feel faint, unsteady, and slightly nauseas while walking around. Usually, lying down will relieve dizziness and lightheadedness, but not always.
Conversely, vertigo makes you feel dizzy while standing still. If you’ve ever spun around in a circle and stopped abruptly, you’ll recognize the feeling of vertigo that occurs, that sensation of your surroundings tilting and whirling around you, making it hard to stand still, or walk without falling down.
If you experience constant wooziness, fatigue, nausea, or vertigo, then it’s important to see your doctor immediately, so that he can rule out rare life-threatening causes of dizziness and lightheadedness.
Below are 25 causes of dizziness, including chronic conditions and rare illnesses.
1- Vitamin B12 deficiency anemia
Dizziness and fatigue are some of the earliest symptoms of vitamin B12 deficiency, or pernicious anemia. Lightheadedness due to low vitamin B12 levels may result from peripheral neuropathy (nerve damage), low red blood cell count, hypoxia (decreased oxygen), and cognitive mood disorders.
Symptoms include loss of balance (ataxia), brain fog, dizziness, disorientation, memory loss, fatigue, muscle weakness, difficulty holding an upright position, and numbness or tingling sensations in the arms and legs.
In addition to vitamin B12 deficiency, other forms of anemia, including low iron may be causing frequent dizziness and lightheadedness.
3- Chronic subjective dizziness
Chronic dizziness is a term that doctors use when they are unable to find the exact cause for faintness, fatigue, nausea, and vertigo. People with chronic subjective dizziness may be hypersensitive to bright lights, movies, and dizzying images.
4- Low blood sugar (hypoglycemia)
Low blood sugar may cause a shock to the system that results in fatigue, dizziness, and weakness.
5- Multiple sclerosis (MS)
A demyelinating illness, multiple sclerosis damages the nervous system, causing impaired muscle control, instability, and many other severe handicaps.
It’s mortifying when you can’t remember people’s names, especially when other people always seem to remember yours. “Brain fog” caused by chronic fatigue, vitamin B12 deficiency, fibromyalgia, or other chronic illnesses makes it difficult to remember people’s names.
Name forgetfulness can be socially awkward, especially if that person works in your office, or goes to the same daily aerobics class as you. Here are some helpful tips for remember names and boosting your memory, even when you’re in the middle of a brain drain.
Use it or lose it
As soon as somebody introduces himself, make a concentrated effort to remember his name the first time. Turn your attention to the person, repeat his name back, and make sure that you heard correctly. Repeat the name (quietly) to yourself several times. Take every opportunity to introduce your new friend to other people, and use her name while conversing. Your earliest attempts to remember a name are always the most successful.
Look for distinguishing characteristics in every person you meet, and link them with the person’s name. It’s okay to let your imagination run wild this this one- Lenny from Human Resources need never know that you think he looks like a lion cub. Another good association is connecting names with hobbies or occupations, like Arthur the Attorney, or Daphne who likes dolphins.
Put it in the dictionary
Sometimes, it’s easier to remember somebody’s name if you associate it with a real word that’s in the dictionary. For example, Justin’s name will be easier to remember if you think of justice, or “just in time.”
Play the spelling bee
Some people are visual learners- they need to see something in their mind in order to absorb its meaning. When you are introduced to somebody new, spell her name out (to yourself). This will further establish her name in your memory.
Rhymes have been used for centuries to remember things like instructions, moral codes, and historical facts. Today, they’re effective for remembering names, which is helpful if your job requires you to meet new people every day. Some good rhymes are “Tracy shops at Macy’s,” or “Ellen eats melon.” It doesn’t have to be a perfect rhyme, just as long as it sticks in your memory.
Have you ever written a “cheat sheet” before a test in high school, only to find out during class that you didn’t even need it? Writing down important details cements them in your mind. So, why not follow a scaled-down version of that practice? Keep a small notepad in your purse or messenger bag, and jot down people’s names before you can forget them. Not only will you be more likely to remember their names the next time your meet, but you’ll have a handy book of names to refer to later.
Despite your best efforts to seal somebody’s name in your memory, you will still have moments when you just can’t remember somebody’s name. Instead of calling them “Hey you” or “What’s-your-name,” just come out and ask. People would rather be asked to repeat their names- it tells them that they are important and worthy of your attention.
“Oh no, here she comes, and I don’t remember her name!” Don’t panic. If you’re standing next to somebody you know, casually initiate an introduction. “Hey Dan, have you two met?” More often than not, she will probably pipe up with her name in introduction, and you’re home free.
This isn’t just a good pick-up line; it’s also a great way to remember somebody’s name. Sometimes, we associate names of people with places. You may not recall Shawn’s name, but you probably remember that you spent three hours with him while waiting in line at the DMV.
Do you wake up each morning fatigued, even after sleeping 8 hours? Boost energy with these 9 chronic fatigue-fighting tips on healthy living.
Wake up, sleepyhead!
Getting up in the morning can be the most challenging time of the day, even if you don’t suffer from chronic fatigue or fibromyalgia. Developing a good morning routine is the only way to conquer morning sleepiness, wake up without feeling sluggish, and keep that energy going the rest of the day.
Stop feeling lethargic in the afternoons by avoiding unhealthy energy-zapping foods, developing a consistent sleep schedule, and staying active.
Here are 8 tips for keeping your energy up, all day:
1) You Snooze, You Lose.
Resist the urge to press the snooze button. The longer you lay around in bed, the more tired you’ll feel, and the less energy you’ll have the rest of the day. Give yourself a maximum of ten minutes to loll around under the covers, and stick to your sleep schedule.
Set your alarm clock to a loud beeping sound, or to music that you don’t like, and don’t leave your clock by the bedside table. This way, you’ll find yourself jolting out of bed to turn off the alarm pronto.
Now that you’ve tricked yourself into getting up, go ahead and make up your bed quickly, or else you might be tempted to slip back under the covers.
2) Let there be Light.
Your body needs to sleep in the dark; your brain can’t function without quality, nighttime slumber, and the darker, the better. Likewise, we can’t become fully awake without the presence of light.
Immediately upon waking up, switch on the bedside lamp, or open the curtains. Even if you wake slowly, the added burst of sunlight will give you more energy.
3) Break your Fast.
Studies prove that eating a healthy, balanced breakfast in the morning is the best way to increase energy, lose weight, and prevent illness. Foods to avoid are fried, fatty foods and sugary, high carbohydrate snacks that only slow you down, and make you feel sluggish.
Instead of bacon and toasted white bread with butter, opt for healthyfoods for energy, such as bananas, oatmeal, whole grain crackers, and low-fat yogurt.
Ditching caffeine is often preferable, but if you have to have your morning java, then keep it down to a one or two cups per day. Any more than that and you’re setting yourself up for an afternoon caffeine crash and burn.
Swap caffeinated beverages for healthier pick-me-ups, such as iced herbal tea, fruit juice smoothies, or sugarless lemonade.
Drink some cool water upon waking each morning, and keep drinking throughout the day. This is sound advice, not only because it prevents dehydration, but also because it keeps your metabolism running, providing long-lasting energy.
Purchase a metal sports water bottle- it stays icy cold longer, and it’s better for the environment!
Background music keeps you on your toes- it keeps your brain active and alert, and keeps you from feeling drowsy. If your work doesn’t allow music, then tune in on your iPod during lunch breaks.
Choose a radio station that you like, such as jazz, rock, rhythm and blues- whatever lifts your spirits. Another good alternative is thought-provoking talk radio.
8) Keep Moving!
If you have a desk job, then take breather s every two hours, at least. Get upand stretch your legs for five minutes. Not only does brief exercise boost energy, but it also aids in productiveness and creativity!
If you’re one of those, who prefer to plough right through your workload, then set a timer to remind you to take a small, five-minute break. Even if you can’t leave your workstation, you can always stand up, raise your arms, breathe deeply, and enjoy a nice long stretch.
If you frequently feel fatigued, zapped of energy, then you might benefit from a new exercise program, a new hobby, or a vitamin regimen! Sometimes, chronic fatigue symptoms are related to diet.
Vitamin B12 deficiency makes you feel sluggish, confused and depressed. Often, you feel like you are in a fog, or fibro fog, as it’s called when you also have fibromyalgia, an illness that sometimes correlates with vitamin B12 deficiency.
Don’t let fatigue get in the way of work, school or your social life. More importantly, don’t fall into the habit of jolting yourself awake with caffeine, energy drinks or sugary snacks. You might get a quick high, a temporary one at that, but the resulting drop in energy will leave you more tired than you were before.
Below is a list of suggestions which have been compiled from Leo Babauta’s popular blog Zen Habits, along with a few other tidbits from other health-related sites:
1 Sing, sing a song… Don’t be shy about belting it out, whether in the car, in the break room or while washing the dishes!
3 Let the sun shine in. Our bodies are attuned to sunlight, as well as the absence of it. Dark lighting tells our brain that it’s time to rest and leaves us feeling sluggish. Indoor lighting, sunshine and even bright colors wake up our senses and keep us energized.
4 Walk around the block…and take your dog with you. If you don’t have time to run to the gym, then just run around the block! If you have a canine friend, grab the leash and bring him along. Caring for pets increases energy and reduces stress. Assuming you’re not allergic, of course.
5 Have a quick snooze, only avoid the bed. Rest sitting upright in a comfortable position, and you’re less likely to oversleep and wake up groggy and headache-y.
6 Chin up! Look on the bright side, and try not to focus on all the things in your life you wish were different. Even if you’re trying to lose weight, find a better job, or waiting for a test result, give yourself permission to be happy now.
7 Don’t oversleep. Set your alarm clock so that you wake up at the same time every day, regardless of whether you’re going to work or taking the day off. (Resist the urge to press the snooze button!) Irregular sleep patterns leave you feeling drowsy all day long. 8 Eat smaller meals. Heavy meals leave us feeling lethargic and full (flashback to last Thanksgiving). Instead, determine how many calories you plan on consuming in one day, and divide that number into 6 light vitamin-rich mini-meals. 9 Take a break from the rat race. Been sitting at your desk for hours? Get up, stretch your legs, and go to the water cooler for a few minutes. Another bright idea: instead of taking a one-week vacation, ask your boss about taking two or three long weekends throughout the year?
10 Drink your water. Speaking of the water cooler, bring a sports bottle with you, and fill it up when nobody’s looking. Allowing yourself to become dehydrated is one of the biggest sources of fatigue.
11 Lose weight. As if you needed another reason to worry about your weight: extra poundage is a burden on our health, energy levels and mental outlook. Next time you’re at the supermarket, pick up a 5-lb. or 10-lb. bag of flour, and imagine yourself losing…or gaining an equivalent amount of body fat. Let’s Move: Michelle Obama Moving On Up the Wal-Mart Aisles
12 Have a fruit salad…and remember the berries! Apples and berries are great sources of natural sugar that won’t weigh you down or leave you feeling exhausted later. Blue, purple and red berries also contain anthocyanins, which are antioxidants known to increase energy.
13 Take your B vitamins. B complex vitamins, and particularly vitamin B12, are known to increase energy, mental clarity and boost the immune system. Foods which contain plenty of vitamin B12 are protein foods, such as meat, dairy, eggs and fish. Vegans or vegetarians are recommended to take B12 supplements in order to avoid getting B12 deficiency. 6 Must-Eat Foods for Die-Hard Vegans
14 Nix energy drinks. Energy drinks are no better for you than any other caffeinated beverages, though their manufacturers would have you believe otherwise. Avoid using energy drinks before a workout, and opt instead for a protein smoothie or a cool drink of water.
15 Jump in the shower. Nothing refreshes your senses more than a brisk power shower. Stuck at work? Go to the restroom and slap some cold water on your face for a quick pick-me-up. 16 Trade coffee for black tea. Researchers have proven what the ancient Chinese have known for centuries: that drinking small cups of black coffee throughout the day relieves stress and rejuvenates your body and mind. 17 Keep it wholly. Cut out white flour, white sugar and white rice, along with all other processed foods; they only sit in your gut for hours and spread infection, allergic reactions and fatigue. Opt instead for whole oats, brown rice, lentils and natural sweeteners like stevia and agave nectar. Can a Gluten-Free Diet Ease Symptoms of Fibromyalgia? 18 Have a breath mint. Peppermint is used by aromatherapists to awaken the mind and boost energy. Don’t have access to a health food store that sells essential oils? Stop by a drug store and pick up a peck of peppermint gum.
19 Unload. Feeling depressed? It might help to call up a friend that you haven’t heard from in a while, send an email to a close relative or chat with a colleague. If it’s something too personal to share with close friends, then schedule an appointment with a social worker.
20 Laugh it up! It’s hard to feel tired, depressed or down-in-the-dumps when there’s a smile on your face. Think of something funny you read recently, or check out today’s comics. Even a quick you-tube search for “comedy” is likely to result in something that will lift up your spirits.
Here are some more good tips on avoiding chronic fatigue, B12 deficiency and fibromyalgia:
Loss of hearing and tinnitus
Hyperpigmentation and hypopigmentation
(dark and light patches in the skin)
Neuralgia, neuritis and bursitis
Anemia, including pernicious anemia
Spinal cord degeneration
Any emotional disorder up to and including insanity
Poor growth/failure to thrive in infants
Premature grey hair
Disturbed carbohydrate metabolism
Numbness and tingling in the hands and feet
Irrational or chronic anger
Lack of balance/abnormal gait