Vitamin B12, in our body; It is an essential vitamin that is also involved in processes such as DNA synthesis, energy production, and central nervous system function. Vitamin B12 is a water-soluble vitamin found naturally in a variety of foods. Although the vitamin is found in many foods, vitamin B12 deficiency is common. This condition is usually caused by restricted diets, malabsorption, certain medical conditions, or the use of drugs that inhibit B12 absorption.
How to Diagnose B12 (Vitamin B12) Deficiency
For reference, 300 pg/mL B12 levels above ≥ 200 are considered normal, levels of 200-300 pg/mL are borderline, and levels below 200 pg/mL are considered vitamin B12 deficiency.
The body's need for vitamin B12 is 2-3 mcg daily. Pregnant and lactating women need more vitamin B12 per day. Since vitamin B12 is involved in very important biochemical reactions in the human body, the B12 value should be kept in the clinical range of 500-800 pg/ml. Values of 800 pg/ml and above indicate high vitamin B12 values. As vitamin B12 decreases with age, deficiency is more common in the elderly. This does not mean that children and young adults, including pregnant and lactating women, cannot develop B12 deficiency.
Who Should Have a Vitamin B-12 Test?
Our bodies do not naturally produce vitamin B-12 . It is derived from animal products such as fish, meat and dairy products. Individuals at risk for vitamin B-12 deficiency include:
- The Elderly,
- Children,
- Vegans,
- Strict Vegetarians,
- Individuals with Diabetes,
- People who have had gastric surgery,
- People with Gastrointestinal Disorders such as Crohn's or Celiac Disease
- Proton Pump for Chronic Heartburn Those Who Use Inhibitors
What Causes Vitamin B12 Deficiency? What are the Causes?
- Pernicious anemia: Vitamin B12; It is absorbed from the small intestine by combining with the intrinsic factor secreted from the stomach. Pernicious anemia is an autoimmune disease and is among the causes of B12 deficiency.
- In autoimmune diseases; The immune system fights against the body's own cells instead of harmful microorganisms. As a result, damage occurs in the tissues that are the target of the immune system. In pernicious anemia; immune The digestive system attacks the cells that secrete intrinsic factor from the stomach. In this case, the secretion of intrinsic factor decreases. Since the intrinsic factor is reduced, it cannot sufficiently complex with B12. As a result, B12 absorption decreases and serum B12 concentration decreases. Although the exact cause of pernicious anemia is not known, it is known that it is common in the 60s. It is more likely to occur in people with another autoimmune disease such as vitiligo.
- Diet: Insufficient B12 intake also leads to vitamin deficiency. Foods such as meat, fish, milk and dairy products are rich in B12. People who do not consume enough of these nutrients in the diet may experience a deficiency. The effect of malnutrition may not appear immediately. B12 stores are sufficient for about 2 to 4 years.
- Stomach problems: Vitamin deficiency can be seen in people who have had stomach surgery. Surgical procedures that reduce the inner surface area of the stomach, such as gastrectomy, may reduce B12 absorption. It can reduce the absorption of B12 from the intestine in conditions such as celiac, Crohn's disease.
- Functional B12 deficiency: People with this condition have symptoms of deficiency, although the serum B12 concentration is at normal levels. The problem in these people is the intercellular transport of B12.
What Causes B12 Deficiency?
Vitamin B12; Since it takes part in many reactions necessary for the body, symptoms involving many different organs can be seen in its deficiency. For example, B12 deficiency may present with a headache symptom or with weight loss. One of the most important symptoms of B12 deficiency is anemia. Anemia is the lack of red blood cells that circulate in the blood and are responsible for carrying oxygen to the tissues, or problems in the production of the hemoglobin molecule, which is responsible for carrying oxygen. As a result of this event, the blood cannot carry enough oxygen to the tissues.
Symptoms of B12 deficiency anemia:
- Fatigue,
- Weakness,
- Breathing,
- Feeling like fainting,
- Headache,
- Paleness,
- Heart palpitations,
- Anorexia,
- Weight loss.
- Pale yellow color of the skin,
- Painful and reddened tongue,
- Tingling,
- Change in the way of walking and moving
- It can be counted as impaired vision.
- Irritability,
- Depression,
- Changes in thinking and behavior
- It is in the form of a decrease in cognitive abilities such as memory, understanding and judgment.
How is B12 Deficiency Treatment?
There are different methods in the treatment of vitamin B12 deficiency. When choosing the appropriate treatment method, it is important to determine the condition causing the deficiency. After determining the underlying cause, this cause should also be treated. For example, people on a vegan diet may have insufficient dietary B12 intake. Vitamin supplementation may be recommended to prevent recurrence of the disease after B12 deficiency treatment in these people.
B12 deficiency treatment can be administered orally (by mouth) and parenterally (by injection).
- Oral therapy; 250-1000 mcg (micrograms) per day, every day for 1 week, then 2 days a week for 2 weeks, then once a week for 1-2 weeks. When this treatment method is used, it should be checked whether the patient continues his treatment regularly. B12 level can be measured at regular intervals for control. It can be preferred in the elderly with mild or moderate B12 deficiency. It can be used in children as it provides ease of use.
- Parenteral therapy, also known as B12 deficiency injection; 100-1000 mcg per day, intramuscularly or subcutaneously, every day for 1 week, then 2 days a week for 2 weeks, then once a week for 1-2 weeks. B12 absorption is impaired in diseases related to the stomach and intestines. Giving oral therapy to these patients does not benefit because absorption is impaired. Maintenance therapy can be continued for a longer period of time in patients with neurological symptoms.
What is Good for B12 Deficiency?
One of the most important factors to be considered in order not to be exposed to B12 deficiency. one of them is diet.
The amount of B12 that should be taken daily with diet; 0.5 mcg in infants up to 1 year old; 1-2 mcg for ages 1-13; 2.4 mcg is recommended for people over 14 years of age. Ha This amount increases as 2.6 mcg in mileage and 2.8 mcg in breastfeeding women. You can add B12-rich foods such as salmon, red meat, tuna, oysters, milk and dairy products to your diet so that you never suffer from B12 deficiency.
What are Foods Rich in Vitamin B12?
Consuming foods containing B12 regularly is the most important step in preventing the development of deficiency. Foods rich in B12 are generally animal foods.
- Offals such as liver and spleen,
- Shellfish such as mussels, oysters, shrimps,
- Trout, herring, mackerel and tuna,
- Milk, yogurt, cheese,
- Eggs are the leading sources.
B12 Deficiency Results What are they?
B12 deficiency can cause anemia. Oxygen transport capacity to tissues is reduced in patients whose deficiency is not treated and who have severe anemia. The heart works faster to compensate for this decrease and the pulse increases. If this continues for a long time, the heart loses its ability to contract strongly and heart failure may develop.
Neurological changes can be seen in the patient. Visual problems, memory loss, loss of coordination in movements and tingling are among the effects of B12 deficiency. Neurological changes are usually irreversible.
B12 deficiency can lead to temporary infertility. This condition usually resolves when the deficiency is corrected.
The risk for gastric cancer is increased in patients when the underlying cause of B12 deficiency is pernicious anemia.
B12 deficiency in pregnancy has very serious consequences known as neural tube defect (disorder). Among these disorders, conditions such as the lack of development of the baby's spinal cord, the skull and some parts of the brain can be seen.
B12 levels should be closely monitored in pregnant women and B12 levels should be kept within the normal range with the help of supplements when necessary.
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