Vitamin B12 deficiency, Addison-Biermer’s anemia- Pernicious anemia (PA) has been called many things.  Though we have a cure in vitamin B12 supplements, symptoms of pernicious anemia remain similar to historical descriptions of this once fatal disease.

“Starvation in the midst of plenty”

In 1849, if a doctor diagnosed you with pernicious anemia, he would have told you to say your prayers.  That’s because back then, the survival rate was 1-3 years.  Many scientists tried various experiments to find out what caused this fatal disease, which was as dreaded as leukemia or cancer is today, causing symptoms like tiredness, painful tingling in the arms and legs, muscular weakness, and finally, death.

Pernicious Anemia: Your 13 Most Frequently Asked Questions, Answered!

Anybody care for a shot of liver juice?

Finally, Dr. William B. Castle made an important scientific breakthrough.  He conducted an experiment that involved feeding regurgitated raw hamburger meat to patients of pernicious anemia, and discovered the presence of intrinsic factor, an essential chemical found in gastric juices that is lacking in pernicious anemia patients.  Like many medical discoveries, the next one that occurred somewhat by accident.  In trying to find a cure for anemia resulting from blood loss, Dr. George Whipple produced the first cure for pernicious anemia- raw liver. Later, in 1926, scientists developed a more concentrated antidote based on the same therapy- raw liver juice, to be swallowed or injected.

Juvenile Vitamin B12 Deficiency- the Dinosaur of all Disorders, say Scientists

Vitamin B12 is born

It wasn’t until two decades later that scientists finally discovered the potent ingredient in raw liver juice. In 1948, two chemists from the US and Britain isolated cobalamin as the health-giving nutrient, and named it vitamin B12.  For patients of pernicious anemia, dosages of 1000 to 4000 mcg, prescribed daily, were given orally as vitamin B12 pills or through intramuscular injection, as a vitamin B12 shot. Other methods of supplementing vitamin B12 are sublingual B12 tablets and behind-the-ear vitamin B12 patches.

Painful Tingling in Hands and Feet- What’s Up with That?

Pernicious anemia symptoms

Scientists today understand that pernicious anemia is a form of megaloblastic anemia, resulting from weakened DNA synthesis in red blood cells.  People with pernicious anemia suffer from an autoimmune condition that inhibits your body’s ability to produce intrinsic factor, thus resulting in vitamin B12 deficiency.  Rarely does pernicious anemia ever result in death, since doctors today know how to diagnose the symptoms early on, and confirm diagnosis with a vitamin B12 blood test. Still, many of the symptoms of pernicious anemia are disabling, and often confused with other conditions like clinical depression, thyroid disorder, and diabetes.

Typical symptoms of pernicious anemia are:

• Diarrhea
• Chronic fatigue
• Pale complexion
• Decreased appetite
• Dizziness
• Loss of concentration
• Shortness of breath while exercising
• Painful tingling or numbness in the hands and feet
• Sore, red swollen tongue
• Bleeding gums
• Altered taste perception
• Depression
• Short-term memory loss
• Frequent stumbling
• Clumsiness

Read more about pernicious anemia and B12:

Vitamin B12 Deficiency- 4 Causes, 1 Solution

Top Ten Signs of a Vitamin B12 Deficiency

What is vitamin B12, and why is it so important?

Sources:

William B. Castle

Pernicious anemia

Images, from top:

HikingArtist.com, Frank Muckenheim, Mario Caruso, genericlook

Vitamin B12 deficiency is one of the fastest growing forms of malnutrition, inflicting at least 40% of all adults with symptoms like fatigue, memory loss, painful tingling sensations, and psychosis.  But what researchers know about the effect of B12 deficiency in children is even more troubling…

Infants with B12 deficiency

Scientists have conducted many studies focusing on neurodevelopment issues in infants diagnosed with low cobalamin- severe vitamin B12 deficiency.  One such study conducted by UC Davis noted symptoms of neurological disorders in breast-fed infants born to women with undiagnosed pernicious anemia, including:

• Irritability
• Failure to thrive
• Low growth rate
• Lethargy
• Anorexia
• Refusal of solid foods
• Developmental regression
• Involuntary movements
• Alterations in skin pigmentation
• Megaloblastic anemia

Babies, B12, and Fertility- B12 Deficiency during Pregnancy

How early can infants develop B12 deficiency?

For adults, vitamin B12 deficiency symptoms may take years to surface. That’s because the liver stores vast amounts of B12, and unless you lack intrinsic factor, your body constantly replenishes its supply of B12 whenever you eat foods like beef, chicken, fish, eggs, and milk.  However, if you follow a vegan diet, or if you are unable to produce intrinsic factor in your stomach, then your vitamin B12 levels will eventually become depleted.

Newborn infants are not born with large stores of vitamin B12, especially if their mothers have pernicious anemia or refrained from eating foods with B12 during pregnancy or while nursing. Even though they are born neurologically healthy and of a normal birth weight and size, symptoms of B12 deficiency usually manifest between four to ten months of age, but can occur as early as the second month.

Brainy People are high on B12, according to Brain Health Study

Vitamin B12 supplements as treatment

After receiving vitamin B12 supplements, infants began recovering rapidly from neurological illness, and eventually experienced a reversal of symptoms, confirming scientists’ beliefs that B12 deficiency causes nerve damage, brain atrophy, and chemical imbalances in the brain.

Find out if you or your infant has B12 deficiency by taking a simple blood test. If diagnosed, your doctor may recommend sublingual vitamin B12 pills, intramuscular B12 shots, or a vitamin B12 patch.

Symptoms of Vitamin B12 deficiency

Many other neurological and emotional ailments are attributed to low B12 levels:

• Memory loss
• Depression
• “Brain fog”
• Fatigue
• Difficulty concentrating
• Anxiety
• Hallucinations
• Clumsiness
• Poor motor control
• Frequent stumbling
• Painful tingling in hands and feet
• Arms and legs going numb
• Sore, red tongue
• Altered sense of taste

Read more about B12 deficiency symptoms:

Juvenile Vitamin B12 Deficiency- the Dinosaur of all Disorders, say Scientists

Brain Drain Medications- Drugs that Drain the B12 out of you

Pernicious Anemia: Your 13 Most Frequently Asked Questions, Answered!

Sources:

Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms

Image credits, from top:

**ShutterGirl**, Insight Imaging: John A Ryan Photography, christopherallisonphotography.com

Recent study on brain health proves that people who eat a diet rich in B vitamins, including vitamin B12, have healthier brains, and are least likely to suffer from Alzheimer’s disease.  Here are the results of the study that focused on senior brain health in relation to diet and nutrition.

Eat this to avoid brain shrinkage…

According to a study published by Neurology, senior citizens in their 80’s who eat a combination of foods high in vitamins and nutrients have better cognitive skills and more brain volume than seniors who fail to meet the requirement.  Blood tests indicated which senior citizens had the highest levels of vitamins like B12 and B6, and which elderly individuals had vitamin deficiency.

The study found that the following vitamins are conducive to good brain health:

• Vitamin B1 (Thiamine)
• Vitamin B2 (Riboflavin)
• Vitamin B6 (Pyridoxine)
• Vitamin B9 (Folate, Folic acid)
• Vitamin B12 (Cobalamin)
• Vitamin C (Ascorbic acid)
• Vitamin E
• Vitamin D

Scientists also noted that foods rich in Omega-3 fatty acids are also beneficial for optimal brain health.

…and avoid eating this

Scientists also noted decreased cognitive functioning and less brain volume in senior citizens who ate foods high in trans fats, including fried foods, pizza, margarine, and high-fat packaged goods.

Which foods are highest in vitamin B12?

Here is a list of foods that contain brain-healthy vitamins such as B12, taken from Medline Plus:

• Vitamin B1, Thiamine: yeast, cereal grains, beans, nuts, and meat
• Vitamin B2, Riboflavin: milk, meat, eggs, nuts, enriched flour, and green vegetables
• Vitamin B6, Pyridoxine: cereals, beans, vegetables, liver, meat, and eggs
• Vitamin B9, Folate: leafy green vegetables, fruits, dried beans, peas and nuts
• Vitamin B12, Cobalamin: meat, fish, and dairy products
• Vitamin C, Ascorbic acid: fruits and vegetables, especially citrus, red and green peppers, tomatoes, broccoli, and greens
• Vitamin E: vegetable oils, margarine, nuts, seeds, and leafy greens
• Vitamin D: egg yolks, saltwater fish, and liver

How do I know I’m getting enough vitamin B12?

Even if you eat plenty of foods high in B12- lean beef, chicken, seafood, eggs, and cheese-, you are not immune from vitamin B12 deficiency.  People who lack intrinsic factor, a protein produced by the stomach to absorb B12 from food, cannot digest vitamin B12 and are at risk for developing pernicious anemia.

The following individuals must have their vitamin B12 levels checked regularly through blood testing:

• Senior citizens
• Patients of gastrointestinal disorders like Crohn’s disease or Celiac disease
• Anybody who has had a gastric bypass, or any other surgery involving the removal of the ileum
• Diabetics on metformin
• Acid reflux sufferers taking medication for chronic heartburn

Read more about vitamin B12 and brain health:

Here’s Your Brain on B12 Deficiency- Memory Loss and Aging

How to keep Vitamin B12 Deficiency from Shrinking your Brain

Vitamin B12- How much do you need?

12 Ways to Avoid Alzheimer’s Disease

Feed your Brain Something You’ll never Forget

Sources:

Diet Patterns Linked With Brain Health

Vitamins, Omega-3s May Keep Brain From Shrinking: Study

Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging

Image credits, from top:

mtsofan, jalb, moogs, primerano

What is pernicious anemia, and how is it different from vitamin B12 deficiency or megaloblastic anemia? That is one of many questions that people have about pernicious anemia- questions that are answered here.

1. What’s the difference between pernicious anemia and megaloblastic anemia?

Pernicious anemia is a form of megaloblastic anemia, a disease of the red blood cells.  Pernicious anemia results from vitamin B12 deficiency; for that reason, it is also called vitamin B12 malabsorption anemia.  (It is worth mentioning that pernicious anemia is only one of many conditions caused by B12 deficiency.)  Other names for pernicious anemia are Biermer’s anemia, Addison’s anemia, and combined systems disease (a disorder of the nervous system).

2. What is the relationship between intrinsic factor and pernicious anemia?

Whenever you eat foods that contain vitamin B12- protein foods like beef, chicken, seafood, cheese, and eggs- your digestive system produces a chemical called intrinsic factor that grabs the B12 from your stomach, carries it through the small intestine, and delivers it to the ileum, where the vitamin B12 is then absorbed and dispersed into your bloodstream. That is how most people digest vitamin B12.

People who suffer from pernicious anemia, a deficiency in vitamin B12, are usually not able to manufacture intrinsic factor.  Even if they eat a strict high-protein diet rich in vitamin B12, the B12 will pass through the intestines without ever reaching the bloodstream, causing symptoms of vitamin B12 deficiency.

3. What are the symptoms of B12 deficiency- pernicious anemia?

The most common pernicious anemia symptoms are:

• Extreme fatigue
• Depression
• Trouble concentrating
• Memory loss
• Irritability
• Painful tingling sensations in hands and feet
• Hands and feet often “falling asleep” or going numb
• Sore, red tongue
• Altered taste perception
• Constant stumbling while walking
• Clumsiness
• Muscular feebleness
• Pale complexion
• Diarrhea
• Stomach pains
• Trouble sleeping

Untreated, vitamin B12 deficiency causes low red blood cell production, dementia, severe nerve damage, increased risk for heart attack and stroke, cancer, and osteoporosis.

4. What natural remedies work best for pernicious anemia?

Since pernicious anemia results from vitamin B12 deficiency, the only remedy you need is…more B12!  The real question is: Can your body absorb vitamin B12 naturally from food sources- beef, chicken, fish, milk, and cheese- or not?  Only your doctor can answer that by taking blood tests, and determining if your body makes intrinsic factor.  If it is determined that you lack intrinsic factor, then you will need to take vitamin B12 supplements, most likely for the rest of your life, in order to avoid getting pernicious anemia.

5. Why is a pernicious anemia patient unable to take vitamin B12 orally?

Without intrinsic factor, your body cannot digest dietary sources of vitamin B12- and that includes vitamin B12 pills.  As a rule of thumb, if vitamin B12 passes through a digestive system that does not produce intrinsic factor, then the B12 will pass through without being broken down or digested.  In order to get vitamin B12 into your blood supply, you have to insert it there directly- usually through B12 shots or transdermal means.

6. How long does it take before you start to feel the benefits of vitamin B12 supplements?

Assuming you are getting the correct dose of vitamin B12, and are taking an efficient method of B12 supplements…most patients start to feel notably better within 24 hours of vitamin B12 supplementation.

7. Is Pernicious anemia genetic?

Family history is one of many causes of pernicious anemia.  If your family has a history of suffering from pernicious anemia, then you should take routine blood tests for vitamin B12 deficiency throughout your life.

What are the Symptoms of Pernicious Anemia- B12 deficiency?

8. If I have one autoimmune disease like pernicious anemia, am I more likely to have another autoimmune disease?

Scientists have noted a high correlation between pernicious anemia and many other autoimmune disorders. When other diseases are a factor, pernicious anemia often occurs from drug interactions, comorbid symptoms, or a cyclical relationship with that disease.  Below are some conditions that may accompany pernicious anemia:

• Fibromyalgia
• Chronic fatigue
• Crohn’s disease
• Ulcerative colitis
• Diabetes
• Leaky Gut Syndrome
• Celiac disease
• Gastritis
• Chronic heartburn
• Hypothyroidism

Leaky Gut Syndrome Symptoms and Causes

9. I’m only 20 years old.  Could someone my age have pernicious anemia?

Pernicious anemia can happen to somebody of any age group.  Because your body stores vitamin B12 in the liver for several years, you may not know that your body has stopped absorbing it until you start to feel the symptoms, by which time your B12 levels will have dropped severely.  If you suspect you have any of the symptoms of pernicious anemia, then do not hesitate to get a blood test.

10. Can pernicious anemia cause gastritis?

Gastritis- painful inflammation of the stomach lining- has many possible causes.  The most common are alcohol abuse, chronic vomiting, and overusing drugs such as aspirin. Untreated, chronic gastritis can cause blood loss, and may lead to stomach cancer.  Other causes of gastritis are:

• Pernicious anemia
• Stomach infection
• Bile reflux
• Viruses

11. Can pernicious anemia shorten your life?

When scientists first discovered vitamin B12 deficiency anemia, they deemed it a fatal disease, and thus named it “pernicious (malicious) anemia.”  Without B12, your body is unable to make sufficiency red blood cells.  Today, doctors are easily able to diagnose vitamin B12 deficiency through blood tests, administer treatment in the form of pure vitamin B12, and prevent further escalation of pernicious anemia.  Untreated, pernicious anemia can lead to life-threatening illnesses, such as heart attack, stroke, and cancer.

12. Can pernicious anemia cause stomach cancer?

Pernicious anemia may cause gastric polyps, increasing one’s risk for getting stomach cancer or gastric carcinoid tumors.

13. Are there any support groups for others with pernicious anemia?

There are many advocacy groups for pernicious anemia, and most of them are on Facebook.  Here are a few:

Pernicious Anaemia Society

Vitamin B12 Deficiency on Facebook

Pernicious Anemia Awareness on Facebook

Pernicious Anaemia – What do you know?…And what they don’t tell you! on Facebook

Last, but not least- Vitamin B12 Patch on Facebook

Read more about pernicious anemia and vitamin B12:

Painful Tingling in Hands and Feet- What’s Up with That?

Lupus and Vitamin B12 Deficiency- What’s the Connection?

Babies, B12, and Fertility- B12 Deficiency during Pregnancy

Sources:

Vitamin B12 (cobalamin)- University of Maryland Medical Center

Gastritis: Symptoms, Causes, Treatments, and More

Pernicious Anemia- Medscape

Pernicious Anemia Symptoms, Causes, Diagnosis, Treatment, and Prevention on MedicineNet.com

Image credits, from top:

Danilo Rizzuti, digitalart, Salvatore Vuono

Are you at risk for developing vitamin B12 deficiency, one of the leading, fastest growing forms of malnourishment today?  Most people with B12 deficiency don’t even know it.  Find out why B12 is important for healthy living, and whether you are getting enough.

What are the symptoms of vitamin B12 deficiency?

Vitamin B12, an essential nutrient called cobalamin, occurs naturally in meat and other protein foods such as beef, poultry, fish, eggs, and milk.  Vitamin B12 is one of the B-complex vitamins, and plays many important roles in your healthy lifestyle, and unless you get enough vitamin B12 from your diet or from vitamin B12 supplements, then you might experience the following symptoms:

• Constant tiredness, fatigue for no apparent reason
• Depression
• Anxiety
• Confusion
• Lack of appetite
• Insomnia
• Lack of concentration
• Short-term memory loss
• Irritability
• Muscular aches
• Tingling, numbness or pain in your hands and feet
• Sore, swollen red tongue
• Altered taste perception
• Hallucinations
• Difficulty walking smoothly
• Poor hand-eye coordination and motor skills

Untreated, vitamin B12 deficiency could lead to pernicious anemia, neurological damage, increased risk for heart attack and stroke, osteoporosis, early onset dementia, and misdiagnosis of psychotic illnesses.

Low B12 means Low Thyroid- Hypothyroidism and B12 Deficiency

So, who’s at risk for B12 deficiency?

Even if you eat plenty of meat and milk, you may be susceptible for vitamin B12 deficiency, as there are many other risk factors involved…

If you fit into any one of the following categories, then you are highly susceptible to vitamin B12 deficiency:

• Do you have diabetes? If you are diabetic, and you take metformin, then you are vulnerable to B12 deficiency, since metformin blocks your ability to digest vitamin B12 properly.
• Have you had weight loss surgery? If you have had any bariatric surgery such as gastric bypass, or any other gastrointestinal surgery that involves removing a piece of the small intestine called the ileum, then you need to take vitamin B12 supplements regularly.  The ileum is the bottom-most part of the small intestine, and is principally responsible for absorbing vitamin B12.
• Do you suffer from autoimmune disorders? If you suffer from any autoimmune disease that involves damage to the digestive system, then you are at risk for many forms of malnourishment, including vitamin B12 deficiency.  Examples of autoimmune disorders that correlate with vitamin B12 deficiency are Crohn’s disease, celiac disorder, ulcerative colitis, irritable bowel syndrome (IBS), and lupus.
• Are you a senior citizen? The elderly are highly susceptible to B12 deficiency.  As you age, your body produces fewer stomach acids that are necessary for digesting vitamin B12 from the foods you eat.  Also, older people tend to eat less and have sensitive stomachs, all of which can lead to malnourishment. In order to avoid B12 deficiency, it is crucial to include extra B12 supplements in your daily vitamin regimen.
• Do you take heartburn medication? If you suffer from gastroesophageal reflux disease (GERD), or if just take many antacids, then you might become deficient in vitamin B12, as stomach acids are essential for digesting vitamins such as B12 from your food.
• Are you an alcoholic? Frequent alcohol use inhibits your body’s ability to absorb nutrients like vitamin B12 properly, and causes malnourishment.
• Does vitamin B12 deficiency or pernicious anemia run in your family? Some people are unable to produce intrinsic factor, an essential chemical your stomach makes to access and digest vitamin B12 from food sources.  If you have this autoimmune disorder, then you must supplement with a form of vitamin B12 that dispenses the vitamin directly into your bloodstream.  To date, the most popular methods are vitamin B12 shots and vitamin B12 patches.

How can I find out if I have vitamin B12 deficiency?

The only way to find out if you have vitamin B12 deficiency is to visit your doctor and ask for a vitamin B12 blood test.  If you test positive, then he will likely prescribe a regimen of vitamin B12 supplements.

Read more about preventing vitamin B12 deficiency:

Brain Drain Medications- Drugs that Drain the B12 out of you

WhichTests check Absorption of Vitamin B12?

Sources:

Vitamin B12 Deficiency Risk Factors – Am I at Risk of Vitamin B12 Deficiency? – Third Age

Vitamin B12- Mayo Clinic

What Is Vitamin B12 Deficiency? What Causes Vitamin B12 Deficiency?

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heather aitken, ValetheKid, soylentgreen23, Martin Kimeldorf’s Pixel Playground

If you have vitamin B12 deficiency, then it is important to recognize the symptoms of pernicious anemia.  Low levels of B12 (cobalamin) can, over time, lead to megaloblastic (pernicious) anemia, a life-threatening blood disease.

What is pernicious anemia?

Pernicious anemia is a type of megaloblastic anemia- a blood disease of the red blood cells.  If you have vitamin B12 deficiency, then it may escalate into B12 deficiency anemia.  In pernicious anemia, your body is unable to produce enough red blood cells, due to a lack of vitamin B12.

Avoid vitamin B12 deficiency

The best way to avoid getting vitamin B12 deficiency is to include animal-based protein foods in your diet, particularly beef liver, clams, oysters, poultry, eggs, milk, and yogurt.  Still, eating meat and dairy products does not guarantee you will not become deficient in vitamin B12.

Who’s at risk?

People at risk for developing B12 deficiency are people who exclude primary sources of vitamin B12 from their diet (vegans), the elderly, people who have had bariatric surgery, diabetics taking metformin, anybody using long-term medication for acid-reflux, individuals with gastrointestinal disease (IBD, celiac) and people who cannot produce intrinsic factor, a necessary hormone for digesting vitamin B12.

Signs of megaloblastic (pernicious) anemia

The most common symptoms of pernicious anemia are:

• Muscular weakness
• Frequent tingling or numbness in your hands and feet, described as “pins and needles”
• Difficulty walking balanced
• Nausea
• Diarrhea
• Loss of appetite
• Depression
• Swollen, red tongue
• Irritability
• Chronic fatigue, constant tiredness
• Hypertension

What tests diagnose pernicious anemia?

The only way to find out if your vitamin B12 deficiency has turned into pernicious anemia is to request the following diagnostic tests:

• Complete blood count (CBC)
• Vitamin B12 blood levels
• Methylmalonic acid (MMA) levels
• Holotranscobalamin II levels
• LDH levels
• Schilling test
• Reticulocyte count
• Bone marrow examination

What is the treatment for pernicious anemia?

Patients of pernicious anemia need to get routine doses of B12 supplements, usually in the form of B12 shots.  The amount and frequency of B12 injections depend on the severity of the pernicious anemia symptoms. For extra doses of B12 between doctor visits, B12-anemia patients have the option of supplementing with oral vitamin B12 or B12 patches.

Read more about vitamin B12 deficiency symptoms:

“I’ve heard of the X Factor and Fear Factor…But what’s Intrinsic Factor?”

WhichTests check Absorption of Vitamin B12?

Cruising for a Bruising? Choose Vitamin B12 Shots or Anemia

Sources:

Pernicious anemia: MedlinePlus Medical Encyclopedia

Megaloblastic (Pernicious) Anemia

Pernicious Anemia – Symptoms, Diagnosis, Treatment of Pernicious Anemia – NY Times Health Information

Pernicious Anemia and Vitamin B-12 Deficiency

Image credits, from top:

blakespot, ssoosay, jimbrickett, James Tan Chin Choy

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 low B12 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.

Why am I always tired?  Symptoms of hypothyroidism

Symptoms of low thyroid include:

• Empty facial expressions
• Husky, gravelly voice
• Chronic fatigue, tiredness
• Sluggish, droning speech patterns
• “Brain fog,” or confusion
• Depression
• Uncontrolled weight gain
• Droopy eyelids
• Puffy, bloated face
• Constipation
• Diarrhea
• Dry skin and hair
• Sparse hair, including eyebrows
• Tingling and numbness in the hands and feet
• Muscular pain
• Feebleness
• Slow resting heart rate
• Orange-colored skin on the hands and feet
• Heavy menstrual periods in women

Vitamin B12 for Healthy Hair, Skin and Nails

Vitamin B12 deficiency 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 B12, you may suffer pernicious anemia, neurological damage, dementia, or heart attack resulting from elevated homocysteine levels.

Low B12 symptoms include:

• Depression
• Chronic fatigue, tiredness
• Anxiety
• Short-term memory loss
• “Brain fog,” or confusion
• Difficulty concentrating
• Neurosis
• Altered taste perception
• Swollen, red tongue
• Tingling and numbness in the hands and feet
• Awkward hand movements
• Loss of balance
• Clumsiness and stumbling
• Sleep problems

Balance your B12, Balance your Nerves

Thyroid disease and low B12 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 B12 deficiency, in addition to pernicious anemia symptoms, a blood disease associated with low B12 levels.

Another study conducted in Pakistan by Aga Khan University produced similar results; namely, a 40% prevalence of vitamin B12 deficiency among patients with hypothyroidism.

Hypothyroidism treatment

If you are a patient of hypothyroidism, then physicians strongly recommend routine blood testing for vitamin B12 deficiency, regardless of thyroid hormone levels.

Read more about B12 deficiency:

6 Degrees of Vitamin B12- B12 Deficiency and Autoimmune Disease

Worried about Low B12 Lab Results?

Female Rapper Missy Elliot, 15 Celebs with Thyroid Disorders

Sources:

Prevalence and evaluation of B12 deficiency in patients with autoimmune thyroid disease- PubMed NCBI

Hypothyroidism- PubMed Health

Vitamin B12 deficiency common in primary hypothyroidism- PubMed NCBI

Hypothyroidism & Vitamin B12 Deficiency- LIVESTRONG.COM

Vitamin B12 deficiency common in primary hypothyroidism

Image credits, from top:

vitasamb2001, jscreationzs, Ambro

Vitamin B-12 (Cobalamin) originates in most protein foods, but even meat-eaters can get vitamin B12 deficiency. Absorbing vitamin B12 is a tricky process, and people who lack the intrinsic factor protein are unable to digest B12 from natural sources.  Learning about B12 supplement absorption is essential for avoiding B-12 deficiency symptoms.

Vitamin B12- What is it?

Vitamin B12, a member of the B-complex family of vitamins, is a water-soluble protein.  Most of the vitamin B12 that you eat comes from meat sources, as animal microorganisms produce it. Beef, liver, chicken, fish, and shellfish are some of the richest sources of vitamin B-12, in addition to eggs, cheese, and other dairy products.  The only widely confirmed vegan form of B12 occurs in brewer’s yeast.

This is your Body on B12

The benefits of vitamin B12 for your body are expansive.

• Vitamin B12 assists in producing oxygen-spreading red blood cells.
• Vitamin B12 also protects the myelin sheathe, which protects your nervous system.
• Vitamin B12 reinforces cognitive functioning- sufficient levels of B12 help to prevent symptoms of autism, and to delay the onset of dementia.
• Supplementing with vitamin B12 renews energy, memory, mental clarity, and feelings of well-being in individuals who suffer from vitamin B12 deficiency.
• Long-term vitamin B12 deficiency causes depression, anxiety, fatigue, memory loss, numbness, and tingling.  Untreated, it can lead to pernicious anemia, stroke, heart attack, or osteoporosis. (B12 Deficiency: Don’t Ignore the Symptoms)

Most People Digest B12 like this…

Vitamin B12’s journey through your body is a complicated, tricky procedure, and many things can go wrong.

• 1. When you consume dietary vitamin B12 (from food), it immediately clings to hydrochloric acid and pepsin, a gastric enzyme that your body makes- except for when it doesn’t. (More on this later.)
• 2. In your stomach, digestive acids separate vitamin B12 (cobalamin) from its protein part.  Also in your stomach, gastric parietal cells produce a substance called intrinsic factor- a necessary glycoprotein for digesting B12.
• 3. Vitamin B12 combines with “R protein,” thus becoming B-complex.  B complex, along with intrinsic factor, travels to the small intestine.
• 4. In the small intestine, R protein and B-complex separate.  B12 then attaches itself to intrinsic factor.
• 5. The B12/intrinsic factor complex travels through the small intestine, finally arriving at the very bottom, where it reaches the terminal ileum.  The ileum then absorbs the vitamin B12 and distributes it into your bloodstream, where it is then stored in the liver.

Things that can go wrong with vitamin B12 Absorption

Some people are unable to digest vitamin B12 properly from food, and must instead supplement with vitamin B12 injections or B12 patches, which go directly into the bloodstream, bypassing the need for digestion.

You might need a B12 patch if…

• You don’t have intrinsic factor. Lack of intrinsic factor is an autoimmune response, in which autoantibodies destroy intrinsic factor proteins produced in the stomach.  Since intrinsic factor is required in order to digest B12, the only way to avoid B12 deficiency is to bypass digestion by taking vitamin B12 supplements.
• You are among the elderly. The majority of senior citizens don’t produce the amount of stomach acids needed to break down B12 for digestion.  Even the minimum amount of vitamin B12 recommended by physicians is not enough to avoid dementia caused by B12 deficiency, so elderly individuals are a high-risk group.  To prevent early-onset Alzheimer’s disease or neurological damage, transdermal vitamin B12 is advisable.
• You take heartburn medication. As with the elderly, people who have GERD, or others who frequently take medicine for acid-reflux, including pregnant women, are susceptible to B12 deficiency.
• You have had your ileum removed. Gastric bypass patients are at high risk for developing vitamin B12 deficiency, as are other patients of gastrointestinal surgery, such as sufferers of Crohn’s disease.  Unfortunately, many surgeons neglect to warn their patients about complications regarding vitamin B12 deficiency, and many bariatric surgery patients don’t find out about it until the symptoms- depression, fatigue, brain fog- become too hard to ignore.
• You are a vegan. The vegan diet is largely devoid of B-12 sources, so unless you are a vegetarian who eats eggs, fish, or dairy, then you must take regular vitamin B12 supplements in order to avoid B12 deficiency.
• You are diabetic. Metformin, a diabetes drug, interferes with the absorption of vitamin B12.
• You have an autoimmune disease. Many autoimmune diseases such as celiac disease, fibromyalgia, and chronic fatigue syndrome are highly correlated with B12 deficiency.  Scientists are unsure as to the exact cause, but they have noted a decrease in symptoms such as fatigue, irritability, and depression with the inclusion of vitamin B12 supplements.

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Sources:

The Importance of Vitamin B12 for Your Body

Where is b12 absorbed in the body?

How Is Vitamin B12 Absorbed by the Body?

What Do You Know About Vitamin B12 Deficiency?

Low Vitamin B12 Level in Elderly May Spur Dementia

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Images: Wikimedia Commons, Free Digital Photos

Intrinsic factor is a protein produced by the cells of the stomach, parietal cells, which also produce the acid (gastric juice) for digestion. The intrinsic factor is the compound which facilitates and allows the absorption of vitamin B12 from food in the stomach and the intestines.

Once ingested the B12 becomes bound to a binding proteins present in the hydrochloric acid of the stomach. In the less acidic environment of the small intestine, these proteins separate from the vitamin, enabling it to bind to intrinsic factor and enter the bloodstream.

 The intrinsic factor is an enzyme-like unidentified substance secreted by the stomach. It is present in the gastric juice as well as in the gastric mucous membrane. The optimum pH for the action of the intrinsic factor is 7 and it is inactivated at temperatures above 45^oC.

In pernicious anemia, an autoimmune disease, autoantibodies direct themselves against the intrinsic factor and/or parietal cells themselves and lead to an intrinsic factor deficiency, which results in malabsorption of vitamin B12. Atrophic gastritis, an inflammation of the mucous membrane of the stomach, can also cause intrinsic factor deficiency and anemia through damage to the parietal cells. Pancreatic exocrine insufficiency can interfere with normal dissociation of vitamin B12 from the proteins, as well preventing its absorption via the intrinsic factor structure. Bariatric surgery is a known risk factor in the development of pernicious anemia, other risk factors include stomach tumors, gastric ulcers, and excessive consumption of alcohol.

Patients experiencing an insufficiency in their intrinsic factor levels cannot benefit from a low dose oral vitamin B-12 supplement, because it will not absorb through the wall of the small intestine. Historically, the disease was thought untreatable before the discovery that it could be managed with regular injections of vitamin B-12, thus bypassing the digestive tract. Other options are available nowadays if injections are not the desired method of supplementation.