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About 25% of people in the US have vitamin B12 deficiency anemia without even knowing it. Pernicious anemia, a debilitating condition that occurs when vitamin B12 levels dip to a dangerous low, can result from underlying health problems that many doctors don’t pick up.
Anemia is a condition that happens when your body doesn’t have enough red blood cells or hemoglobin. Vitamin B12 is necessary for producing plenty of normal-sized red blood cells, so when vitamin B12 levels dip low, you experience symptoms of pernicious anemia, which is a type of megaloblastic anemia.
Early signs of pernicious anemia such as dizziness, tiredness, and difficulty remembering things occur because your brain is not getting enough oxygen, due to fewer red blood cells.
Symptoms of pernicious anemia include:
Painful numbness and tingling sensations
B12- why you’re not getting it
People often ask, “What’s the big deal about vitamin B12 deficiency anemia? If you’re not feeling well, then can’t you just eat more foods with vitamin B12?”
Most people do eat enough foods containing vitamin B12. Unless you follow a vegan diet, then you probably ingest enough vitamin B12 from beef, chicken, and seafood to last a lifetime.
The problem lies with vitamin B12 malabsorption; there are so many risk factors that interfere with your ability to digest vitamin B12 from the foods you eat.
Medications, autoimmune disorders, weight-loss surgeries, and gastrointestinal disorders- these all affect vitamin B12 absorption.
Vitamin B12: It takes two
Vitamin B12 cannot be digested by itself- it requires a co-factor, a “partner” in digestion. To absorb vitamin B12, you need specific digestive enzymes, such as intrinsic factor, which is manufactured in your gut, or stomach acids that help to break down vitamin B12 molecules.
You risks for developing vitamin B12 deficiency- pernicious anemia are high if:
You don’t have intrinsic factor in your gut
Your autoimmune system destroys the intrinsic factor you make
You are a senior citizen who doesn’t produce enough stomach acids to digest vitamin B12
You have had gastrointestinal surgery, such as bariatric surgery
If you fall into any of those categories, then it’s essential to get your vitamin B12 from supplementation, preferably in a non-dietary form, so that you may bypass the need for digestion in the stomach.
How much vitamin B12 should I take?
To test for vitamin B12 deficiency, ask your doctor for a simple blood test. You may need to continue checking your vitamin B12 levels regularly.
To prevent vitamin B12 deficiency anemia and restore healthy vitamin B12 levels, doctors recommend at least 1,000mcg of vitamin B12 supplements weekly, or more often, as needed.
Pernicious anemia (PA) and multiple sclerosis (MS) are both autoimmune disorders that cause fatigue, chronic pain, and physical handicaps, but that is where their similarities end. If that’s the case, why are so many doctors quick to diagnose multiple sclerosis before testing for simple vitamin B12 deficiency from pernicious anemia?
Diagnosing multiple sclerosis (MS)
There is single test to determine multiple sclerosis; if you suffer from symptoms indicating MS, then you may need to visit a neurologist, who will run a series of tests in order to determine if you are indeed suffering from multiple sclerosis, and not another condition with similar disorders, such as pernicious anemia, which often mimic the symptoms of multiple sclerosis.
Criteria used to diagnose multiple sclerosis include:
Symptoms of fatigue, dizziness, muscle pain, and vision problems
Symptoms that began between the ages of 20-50
Signs of neurological disorder
Two or more brain lesions that are evident from MRI scans
Debilitating symptoms that occur in phases at least one month apart
Vitamin B12 levels are normal
No other underlying diseases are detected
Tests and procedures that confirm multiple sclerosis include:
MRI brain scan
Evoked potential tests
Diagnosing pernicious anemia (PA)
The main indicator of pernicious anemia is severe depletion of vitamin B12 levels in the blood. However, pernicious anemia is not the only cause of vitamin B12 deficiency. (Other causes of vitamin B12 deficiency include vegan dieting, bariatric surgery, autoimmune disorder, GERD or diabetes medications, alcoholism, and old age.)
In order to determine that vitamin B12 deficiency is from pernicious anemia, your doctor will need to run some tests and look for specific criteria that indicate pernicious anemia.
Criteria used to diagnose pernicious anemia include:
Family history for pernicious anemia or autoimmune disorders
Underlying immune system malfunctioning
Lack of intrinsic factor, a digestive enzyme needed to absorb vitamin B12 from foods and pills
The symptoms of vitamin B12 deficiency can impair a wide range of bodily functions, including your neurological, metabolic, and emotional health. Vitamin B12 deficiency symptoms may vary for each individual, but the most common symptoms are consistent with the level of vitamin B12 (cobalamin) depletion. Here are some warning signs that may indicate the earliest or most advanced stages of vitamin B12 deficiency, including pernicious anemia.
What is vitamin B12 deficiency?
A vitamin deficiency is what occurs anytime your body doesn’t have enough of a nutrient that it needs in order to fulfill your basic needs. Vitamin B12 deficiency is one such type of malnourishment that is sometimes caused by diet, but can also result from other factors, such as autoimmune disorder, medications, illness, or surgical procedures. Of all forms of malnourishment, vitamin B12 deficiency symptoms are the most common in the US.
Vitamin B12 occurs naturally in all animal-based foods. If you regularly include plenty of meat, poultry, fish, eggs, and milk in your diet, then you probably won’t develop symptoms of vitamin B12 deficiency, as your body is able to store several years’ worth of vitamin B12 in the liver at one time. If you are a vegan, then you must supplement with vitamin B12 regularly, in order to prevent vitamin B12 deficiency symptoms.
Even if you are a meat-eater, you may still be at risk for suffering a slow depletion of vitamin B12. People with a family history for pernicious anemia, a condition sometimes caused by autoimmune disorders, should check their vitamin B12 levels regularly, in addition to looking out for symptoms indicating vitamin B12 deficiency.
Also, if you regularly suffer gastrointestinal problems, such as diarrhea, vomiting, acid reflux, or stomach ulcers, then you may need to replenish your vitamin B12 levels. Illnesses such as Crohn’s disease, migraines, celiac disease, fibromyalgia, and chronic fatigue syndrome are all high risk factors for vitamin B12 deficiency symptoms.
Patients of gastric bypass surgery or ileostomy should also be on the alert for warning symptoms of vitamin B12 deficiency, as removal of the ileum interferes with vitamin B12 absorption.
Walk into a convenience store, and you can’t even see the sugary sodas for all the energy drinks cluttering up the aisles, touting vitamin B12 among their many other energy-boosting ingredients. Why are more Americans turning to vitamin-infused 5-hour energy shots for instant get-up-and-go, and do these products work?
Energy drinks- is it all bull?
The label on the can promises extra vitamin B12 -cobalamin- for “maximum energy,” athletic endurance, and increased mental focus, without causing nasty side effects associated with most energy drinks (nervousness, paranoia, and insomnia). At least, that’s the claim. But how healthy are vitamin B12 drinks, and does the “energy blend” of vitamins and nutrients really have that much impact on your energy level?
Let’s look at the most common ingredients in a 2-ounce bottle:
Niacin- 30mg (150% RDA)
Vitamin B6- 40mg (2000% RDA)
Folic acid- 400mcg (100% RDA)
Vitamin B12- 500mcg (8333% RDA)
“Energy Blend”- 1870mg
Oh, and don’t forget the caffeine
Yes- all energy drinks contain loads of caffeine, in addition to all the healthy nutrients. That “energy blend” referred to on the label includes about 138mg of caffeine- ounce for ounce, the same amount of caffeine as in a cup of brewed coffee, and twice as much caffeine as you’ll find in a cup of instant coffee.
Vitamin B12 has gained a lot of popularity these days as the “energy vitamin,” and for good reason. Vitamin B12 helps your body convert carbs into energy. Vitamin B12 also helps produce amino acids, promotes a healthy metabolism, builds red blood cells, supports healthy cognitive functioning, protects your nervous system by sustaining myelin, and regulates homocysteine, a hormone linked with heart attacks and strokes. (See B Vitamins prevent Cardiovascular Disease- B6, B12 and Folate)
Some side effects of having low vitamin B12 in your system include
Over a long period, low vitamin B12 levels could lead to pernicious anemia, early onset dementia like Alzheimer’s disease, neurological damage, osteoporosis, stroke, heart attack…even death.
Why you’re better off getting your B12 elsewhere
Nobody’s disputing that it’s important to get your daily fix of vitamin and minerals. But it’s important to make sure you get a potent, fully digestible form of vitamin B12. The problem with many energy drinks is that they only work if your body is able to absorb vitamin B12. And most people who suffer severe fatigue and loss of concentration because of low vitamin B12 levels lack the necessary chemicals for vitamin B12 absorption from dietary sources and distributing it to the blood supply.
In fact, if you don’t produce “intrinsic factor,” then no amount of vitamin B12 food sources, drinks, sprays, or pills will give you the boost of energy and mental focus you need to get through the day. To get vitamin B12 into your blood, you will have to bypass the digestive system.
First, find out if you have B12 deficiency by asking your doctor for a blood test. Supplementation may include vitamin B12 supplements or b12 shots.
Did your recent lab work point to vitamin B12 deficiency? A low vitamin B12blood test is serious. Symptoms of B12 deficiency can include nerve damage, loss of red blood cells, and mood disorders.
What is vitamin B12?
Vitamin B12 is a water-soluble nutrient which your body extracts from food sources such as lean meats, dairy products, eggs and fish. Vitamin B12 is necessary for producing plenty of red blood cells, maintaining a healthy nervous system, regulating homocysteine levels and monitoring DNA synthesis. A blood test which results in low B12 levels means that some of these vital bodily functions could be malfunctioning.
What causes low B12 levels?
There are many factors which can cause your B12 levels to dip dangerously low; these include:
Lack of intrinsic factor, a protein which is necessary for proper digestion of vitamin B12 from natural food sources
Long-term use of heartburn or antacid medication
Following a vegan diet, which excludes foods which are rich in vitamin B12, such as beef, chicken, milk, cheese, yogurt, eggs and fish.
Gastrointestinal conditions, such as Crohn’s disease or gluten intolerance
Weight loss surgery, such as gastric bypass surgery.
My lab test results indicate vitamin B12 deficiency. Should I be worried?
Due to the fact that it dissolves in water, your body is not able to hold vitamin B12 in the system for long; vitamin B12 must be constantly replenished through protein-rich foods or vitamin B12 supplements, in order to avoid becoming deficient in B12.
Regular lab blood testing is crucial for catching vitamin B12 deficiency before it has a chance to create any lasting impairment. If left untreated, vitamin B12 deficiency can lead to life-threatening illness and irreversible damage. These include:
Increased risk for heart attack, due to elevating levels of homocysteine
If you are not able to utilize sufficient stores of vitamin B12 naturally, then you must supplement regularly in order to avoid B12 deficiency.
For chronically low B12 levels, doctors have often administered vitamin B12 injections until symptoms abate.
Sublingual tablets are also often prescribed as a preventative measure, but recent studies indicate that under-the-tongue B12 supplements are not the most effective sources of B12, as they are not wholly digestible.
We’ve all heard of overeaters binging themselves into a state of depression- a vicious circle which is difficult to get out of. But eating for happiness?
Vitamin B-12 deficiency is linked with depression
Vitamin B12 is essential for many aspects of brain development, such as myelination (the production of a protective layer around the brain) and the distributing of neurotransmitters to and from the brain. So it comes as no surprise that the Mayo Clinic suggests eating foods rich in vitamin B-12 as a means of preventing the onset of clinical depression.
“Eat to live, don’t live to eat.”
That’sa great motto if you happen to be an android. The fact is, eating is a sensual experience which we were meant to enjoy. (Why else would we have taste buds?) The key to good nutrition is finding foods you love that will love you right back.
Here are some yummy appetizers and entrées which are naturally high in vitamin B-12:
Fish tacos- Made popular by Rubio’s, the fish tacos is a tasty fusion of Cal-Mex and seafood cuisine. Take a soft flour tortilla, add some fiery mango salsa, a dab of sour cream and a grilled fish fillet (hint: salmon is high in B-12). It’s a wrap!
Are you a Sushi lover? Then you’re going to love this- sushi and sashimi recipes typically include such high-in-B12 ingredients as roe (fish eggs), octopus, crab, shrimp, and mackerel. Pass the soy sauce!
New England clam chowder- just the name elicits images of salty sea breezes, sailboats and clam bakes. Don’t have any recipes handy? Here is a list of variations on this classic soup recipe.
Lean cuts of lamb are high in vitamin B-12 and a popular staple of many Middle Eastern cuisines. Here is a flavorful Lamb Moussaka recipe, as featured in epicurious.
Tuna casserole is one of America’s fave comfort foods and it’s simple to make- combine canned tuna, cooked broad noodles, and a can of concentrated mushroom soup. Top it with some fried onions and pop it in the oven for 30 minutes. Tuna is high in B-12 and omega-3 fatty acids.
Hamburgers barbecued with low-fat ground beef chuck are a great source of vitamin B-12. Serve it up on whole-grain buns with a side of oven roasted root veggies for a healthy upgrade from the typical artery-clogging burgers ‘n fries.