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Vitamin B12 deficiency is on the rise in the US and many other developed countries. Why? Because modern dietary restrictions, bariatric surgery, and autoimmune disorders increase your chances of developing vitamin B12 deficiency anemia before you reach your senior years.
Where’s the B12?
Vitamin B12 is a water-soluble nutrient that only exists in animal-based foods such as meat, poultry, fish, milk, and eggs. The richest sources of vitamin B12 are shellfish and organ meats.
Unlike other vitamins, B12 requires a cofactor for absorption; digestive enzymes that help your body break down and utilize the benefits of the vitamin. Without intrinsic factor or stomach acids, you cannot process the vitamin B12 you ingest from the foods you eat.
Without vitamin B12, your body can’t function properly. Vitamin B12 is crucial for building healthy red blood cells containing hemoglobin, which move oxygen to your brain, muscles, and organs.
Untreated, you may develop pernicious anemia, which causes symptoms such as extreme fatigue, depression, memory loss, disorientation, and painful numbness and tingling in the extremities. Pernicious anemia can result from autoimmune disorders, or it can be caused by gastritis, damage to the stomach cells.
Vitamin B12 is also important for protecting the nervous system, boosting energy, sustaining a speedy metabolism, and delaying the effects of age-related dementia.
Vitamin B12 deficiency symptoms can creep up slowly, as your vitamin B12 levels decline over the course of years.
Vegans and vegetarians
Among young healthy individuals, vegans and vegetarians are the highest risk categories for vitamin B12 deficiency. Usually, after about two years of strict vegan dieting, vitamin B12 levels will begin to decline. For vegetarians that number may be larger, as cheese and eggs have small amounts of vitamin B12, although not enough to prevent vitamin B12 deficiency.
Most people start noticing the first signs of vitamin B12 deficiency around their 40s. This is because as you age, your ability to digest vitamin B12 from food sources declines, as your body begins to slow down in producing stomach acids. By the time you reach middle age, you should receive regular blood test screenings for vitamin B12 deficiency.
By the time you reach the age of 60, you should be extra vigilant in monitoring your vitamin B12 levels, as vitamin B12 deficiency may increase your chances of experiencing signs of Alzheimer’s disease dementia earlier than senior citizens who supplement with vitamin B12. Also read Vitamin B12, a Must for Senior Citizens
If you have autoimmune disorders, then you should get your vitamin B12 levels checked routinely, as your risk for developing autoimmune pernicious anemia is that much higher. Also, many of the symptoms of vitamin B12 deficiency can mimic those of fibromyalgia, chronic fatigue syndrome, celiac disease, and other autoimmune system disorders. So, to catch vitamin B12 deficiency early and prevent neurological ailments, it’s important to take regular blood screenings for vitamin B12 deficiency.
Certain medications interfere with your ability to absorb vitamin B12; these include metformin for diabetes, protein pump inhibitors (PPIs) for GERD or heartburn, and various other popular prescription and over-the-counter drugs.
Modern gastro surgeries that were previously unheard of have contributed to the rising rate of vitamin B12 deficiency. Patients of weight-loss surgeries (gastric bypass) and ilium removal or resectioning for Crohn’s disease are required to supplement with non-dietary vitamin B12 for life.
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People often mix up irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in speech, but really they are quite different. Although IBS and IBD both cause similar symptoms- stomachaches, nausea- only one is a gastrointestinal disease that can be severely debilitating and life-threatening.
Irritable bowel syndrome (IBS)
Other terms include spastic colon, irritable colon, mucous colitis, or spastic colitis.
About one out of every six people experience irritable bowel syndrome (IBS), a condition that causes abdominal pain and cramping, in addition to abnormal bowel movements.
IBS may occur as a result of an infection in the intestines, or it may be caused by stress. There are no tests to diagnose IBS, rather several diagnostic procedures to rule out IBD, colon cancer, or celiac disease.
People with irritable bowel syndrome suffer from the following symptoms at least three times per month, for at least three months:
Loss of appetite
Inflammatory bowel disease (IBD)
Inflammatory Bowel Diseases (IBD) refers to a set of gastrointestinal illnesses that are chronic or very frequent, and occur because of an autoimmune disorder that causes damage to the stomach and intestines.
Ulcerative colitis and Crohn’s disease are the two most common types of IBD, and both can result in ulcers, inflammation, and other types of stomach damage.
Crohn’s disease causes inflammation, sores, and ulcers all along the gastrointestinal tract, including the esophagus, but most often occurs in parts of the small and large intestines.
Ulcerative colitis causes similar damage and ailments in the large intestines and rectum.
Chronic symptoms of Crohn’s disease or ulcerative colitis may include:
Intense stomach pains, cramps
Uncontrollable frequent diarrhea
Unexplainable weight loss
There are no complications involved with IBS, which is more of a functional condition of the stomach that causes no perceivable damage.
With IBD, flare-ups, a worsening of symptoms or long-time illness may cause several comorbid conditions or complications, including:
Infected fistula caused by deep ulcers
Colon rupture caused by toxic megacolon
Anemia caused by low iron or vitamin B12 deficiency, resulting in too few red blood cells.
IBS is distressing and uncomfortable, but it causes no actual damage to the gastrointestinal tract, and is not life-threatening. To treat, avoid foods that irritate the stomach, and eat small frequent meals, in order to prevent overstuffing.
With IBD, portions of the intestines and stomach are diseased and vulnerable to rupture, which can be deadly. Diagnosis may require colonoscopy, X-ray, barium enema, blood tests, MRI, and CT scan.
Depending on the severity of IBD symptoms, treatments may include medications, restrictive diet, vitamins, including vitamin B12 supplements, and possibly, surgery.
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Post-Op Risks Doctors Forget to Mention: Nearly 75% of all Crohn’s disease (IBD) patients undergo gastrointestinal surgery, but few receive warnings about post-surgery vitamin B12 deficiency symptoms.
Vitamin B12 Deficiency Stories, Post-Gastro Surgery
Crohn’s disease is an autoimmune disorder, a type of inflammatory bowel disease (IBD) that causes severe damage of the gastrointestinal tract.
In many cases, IBD patients decide to undergo gastrointestinal surgery to treat the many debilitating symptoms of Crohn’s disease.
However, in addition to relapses, which often occur within 10 years, many patients begin to suffer the effects of vitamin B12 deficiency.
Three Years Later, Things my Doctor Forgot to Mention
One patient suffers from Crohn’s disease. In her Crohn’s and Life happens blog, she relates a frustrating, unfortunate scenario that happens to the majority of Crohn’s disease patients who undergo gastrointestinal surgery- the discovery, several years post-op, that she suffers from severe vitamin B12 deficiency, and that not a single doctor had warned her about the risk factors.
Close Call with Vitamin B12 Deficiency
In his blog, My Crohn’s Disease, the author tells of suffering from vitamin B12 deficiency after having small-bowel resection surgery in order to treat fibro stenotic Crohn’s disease.
“Little did I know I was pretty close to death at this point, my body having been suffering a B-12 deficiency for many months, thanks to my not having realized I was supposed to be taking B-12following my surgery a year earlier.” (taken from blog)
B12 deficiency, left untreated, can result in severe neurological damage and cognitive problems.
Symptoms of vitamin B12 deficiency often include fatigue, depression, short-term memory loss, tingling in hands and feet, and reduced motor skills, to name just a few.
Vitamin B12 shots are painful, as they require insertion into the thickest, most muscular part of the thigh. Many IBD patients opt to administer the injection themselves on a weekly basis, resulting in a large bruise, as depicted in the Jenni’s Guts blog. Sometimes, bleeding occurs, as well.
…and Paying for it dearly
Unless you have very good health insurance coverage, vitamin B12 injections can be pricy. This excerpt is taken from Gutsy Girl:
“ …like many of my surgical Crohn’s brethren, I have to bear a monthly B12 shot for the rest of my life. The negotiated rate with my insurance carrier… is $156. One hundred and fifty-six dollars for a shot of …a vitamin. Per month.”
Self-Discovery of B12 Deficiency
Two years after having his terminal ilium and colon removed, BW continues to suffer from debilitating Crohn’s disease symptoms. Upon conducting his own research online, he learns about the high correlation between vitamin B12 deficiency and gastrointestinal surgery. As to why his surgeon and other doctors failed to warn him about the risks involved, he can only speculate.
“In retrospect, I should have started B12 injections two years ago, right after the removal of my colon and terminal ileum. But my family doctor never mentioned it to me. nor did my GI, or my surgeon. It was only because of my own research that I began to question my B12 levels.” –taken from the Colitis blog.
You already know what you can’t eat on a Crohn’s disease restrictive diet…here are some foods you can eat! Because IBD doesn’t stand for Insufferably Boring Diet…
Choosing a diet you can stomach
If you have inflammatory bowel disease (IBD), such as Crohn’sdisease or ulcerative colitis, then you know that certain foods trigger gastrointestinal flare-ups that cause diarrhea, stomach cramping, nausea, and vomiting.
Following an IBD-friendly diet is instrumental in preventing damage to the small and large intestines, and promoting digestive health.
There are no unanimous opinions when it comes to following a diet for inflammatory bowel disease. Some swear by the Specific Carbohydrate Diet (SCD), which permits most cooked and raw vegetables, including broccoli, beans, and celery, while the Low Residue dietfollows a selective list of permitted vegetables that are rarely, if ever, eaten raw.
If there is any one rule regarding following a healthy Crohn’s meal plan, it is that you should pay attention to how your body reacts to certain foods. Keeping a food diary is a great way to keep track of useful info like:
What foods you ate today
What time you ate
How much you ate
How it made you feel later
What feelings or thoughts you were experiencing at the time
The following delicious recipes are usually healthy for Crohn’s and ulcerative colitis patients who are not suffering flare-ups:
This quinoa salad recipe, taken from the Crohn’s-Sanityforum, is very adaptable. If dairy is a problem for you, then leave it out, and you’ll still have a delicious, light appetizer to serve with the salad course. Remember, quinoa requires a through rinsing through a fine sieve before cooking, in order to avoid a bitter aftertaste.
This clam chowder is one of many scrumptious recipes featured in the Creative Colitis Cookbook, which boasts 100 recipes that follow the low residue diet plan. This creamy broth gets its high vitamin B12 content from clams. Many varieties of seafood, as well as meat, poultry, and dairy items, are rich in vitamin B12, a crucial nutrient for patients with inflammatory bowel disease.
What could be more presentable than a large tray of steaming, aromatic grilled turkey with rosemary? If you don’t own a barbecue grill, you can always roast this delectable dish in the oven. Taken from Living with Crohn’s Disease.com.
As featured in Crohn’s Health Center, butternut squash is one of many light, comfort vegetables that are agreeable with individuals with ulcerative colitis and Crohn’s disease. This recipe combines sweet squash and rice with a seasoned broth. Omit the garlic if they are not on your diet.
These cupcakes come from the Ramble On blog, and are gluten-free, nut-free, and SCD-friendly. Made from very few simple ingredients, they smell heavenly fresh out of the oven. When cool, top with an icing made with powdered sugar, soy milk, lemon juice, and vanilla extract.