According to WHO, Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity. Health emerges from a highly complex interaction between factors intrinsic to the patient and his or her environment. Vitamin B12 deficiency causes, effects, and treatment. This article covers all essential aspects of deficiency of B12 in the human body.
Many factors within the environment influence health, including aspects of the physical environment, biological environment (bacteria, viruses), and social environment.
What Is A Vitamin B12?
Vitamin B12 is also known as cobalamin. It is a water-soluble vitamin (which means this vitamin can dissolve in water and travel through the blood to the whole body) which is required in our body as for the metabolism in every cell in our body. Vitamin B12 deficiency causes effects and treatment.
It has many functions in the body but the most important is needed for the normal functioning of the nervous system through the synthesis of the myelin sheath, another very important function of cobalamin is development and maturation of RBC (red blood cells) in the bone marrow.
Among all vitamins, it is the largest and most structurally complex vitamin.
Sources of Vitamin B12
The main source of vitamin B12 is meat products and it can be industrially produced by bacterial fermentation-synthesis. The meat products include fish, meat, eggs, and all dairy products but plant food does not contain vitamin B12.
Other dietary sources which contain vitamin B12 are:-
- Fish include tuna and haddock
- Some nutritional yeast products.
- Soya milk and cereals
To achieve good health it is advised to take a balanced diet which should contain all the required vitamins in an appropriate amount for the normal functioning of the body and to avoid the deficiency symptoms.
Vitamin B12 Absorption in Body
let’s see how the Absorption of vitamin B12 takes place. It takes place in two forms.
Protein-bound vitamin B12 food
Digestion and absorption of vitamin B12 start from the stomach and ended in the last part of the small intestine i.e., ileum. When we eat animal food than this vitamin B12 is protein bound.
This protein-bound vitamin when enters the stomach, then stomach started secreting acid and enzymes which help in detaching vitamin B12 from the protein.
In the other process, this vitamin B12 is picked up by R-protein (aka cobalophilin, haptocorrin, and transcobalamin 1) and transferred to the small intestine. This R-protein beside the stomach also found in many human secretions like saliva.
IF (intrinsic factor) secreted by stomach also travels to the small intestine. This IF then carries the cobalamine to the last part of the small intestine, the ileum where its absorption takes place.
Unbound vitamin B12 food
For those who take supplements, vitamin B12 is not bounded to protein. So there is no need for the secretion of the enzyme for the detachment from the protein. To dissolve the supplement which is in the form of tablet stomach acid is needed if the tablet is not chewed.
If supplements taken in large doses than it overcomes the defect of the Intrinsic Factor. In researches, it has been found that unbound vitamin B12, when combined with absorption enhancer gets directly absorbed through the membrane under the tongue through the passive diffusion in the digestive tract.
Vitamin B12 Storage in the Body
The average storage of vitamin B12 in a non-vegetarian is about 2000-3000 mg (2.4 mcg), in which about 3mg losing per day. The human body can store vitamin B12 for four years if intake is not present.
Vitamin B12 is stored in the liver and muscles. About 60% is stored in the liver while 40 %is stored in muscles.
Who Can Have Deficiency Of Vitamin B12?
- Those who are pure vegetarian exclude meat and animal food from their diet.
- Lactating women’s
- People who are having pernicious anemia
- Those people who have small intestine problems, or have undergone small intestine surgery. In these patients absorption of vitamin B12 does not take properly.
- Those people who have Crohn’s disease
- Other gastrointestinal diseases like- Gastritis, celiac disease, IBD (inflammatory bowel disease)
- Those who consume alcohol regularly
- Those people who are suffering from Diabetes and taking Metformin tablets to control their blood sugar. As metformin reduces the absorption of Vitamin B12
- Patients who take medicine which include- proton pump inhibitor, H2 receptor agonists for peptic ulcer diseases, antibiotics include- chloramphenicol and chloromycetin.
These are the main causes that
Vitamin B12 Deficiency Symptoms and Effects
Our body stores vitamin B12 in an adequate amount. If vitamin B12 is not taken for 3-4 years our body can manage. But if the storage depletion starts, then deficiency occurs and it is shown in the form of signs and symptoms.
Though the changes produced due to deficiency are reversible in the early stage major deficiency leads to irreversible changes which are mainly seen in the nervous system and brain.
Symptoms at an early stage lower than normal includes:-
- Memory problems
- Staggering gait (difficulty walking)
- Pale skin
Few of these symptoms are found in elderly persons more than 60-70 years of age because of decreased production of acid secretion in their stomachs.
Other symptoms include
- Loss of appetite
- Weight loss
Neurological changes include:-
- Numbness and tingling sensation in hands and feet’s (paresthesia)
- Difficulty in maintaining balance (ataxia)
- Reflexes may be diminished or increased
- Sphincter disturbances
In infants due to deficiency of vitamin B12 following symptoms is seen:-
- Unusual movements include face tremors
- Reflex problems
- Difficulty in feeding
- Mental irritability
- Retarded growth if untreated
Hematological manifestations are entirely the result of anemia although very rarely purpura may appear, due to thrombocytopenia. Symptoms of anemia may include weakness, light-headedness, vertigo, and tinnitus, as well as palpitations, angina, and the symptoms of congestive failure.
On physical examination, the patient with vitamin B12 deficiency is pale, with slightly icteric skin and eyes. Elevated bilirubin levels are related to high erythroid cell turnover in the marrow. The pulse is rapid, and the heart may be enlarged; auscultation will usually reveal a systolic flow murmur.
Vitamin B12 Deficiency Treatment
Those patients who are facing the difficulty in absorption via food source need supplements for vitamin B12. Most of the patient who has undergone intestinal surgery and those of pernicious anemia has to take vitamin B12 supplements.
Supplements can be taken orally. For those patients in which oral supplements do not help has to go with vitamin B12 intramuscular injections.
Vegetarian people, pregnant women’s and lactating women’s have to take supplements to fulfill the demand of vitamin B12 in the body. If taken in large doses side effects can be produced, but it is not toxic.
Treatable Side effects can be seen as acne. Kidney patients must avoid vitamin B12 supplements. A doctor’s guidance is important in this case.
To obtain good health adequate nutrition is a fundamental requirement for the survival of every individual. Quantity as well as the quality of food influences health.
Inappropriate diets have been linked to many diseases due to nutritional deficiencies. Today Vitamin B12 has become a major nutritional deficiency among us.
A proper understanding of nutrition with all respect is therefore essential in dealing with the needs of the individual patients.
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