When we talk about treating vitamin B12 deficiency we should make sure that we get enough vitamin B12 in order to stay healthy.
Vitamin B12 deficiency is a serious problem, which if not treated can lead to severe neurological symptoms.
The ideal way for treating vitamin B12 deficiency and managing the problem is with an interdisciplinary team professionally that includes a primary clinician, gastroenterologist, neurologist, surgeon, pharmacist, dietitian, and a nurse.
Etiology of vitamin B12 deficiency
Vitamin B12 deficiency has 3 primary causes:
Autoimmune
Pernicious anemia is an autoimmune condition in which antibodies to intrinsic factors are produced which bind to and inhibit the effects of intrinsic factors and resulting in an inability of vitamin B12 absorption by the terminal ileum as well as an effect in treating vitamin B12 deficiency.
Malabsorption
Parietal cells in the stomach produce intrinsic factors; so, there may be a risk of developing vitamin B12 deficiency because their new alimentary pathway bypasses the intrinsic factor production site in any patient with gastric bypass surgery.
Patients with normal intrinsic factor production suffer from impairment at the absorption of vitamin B12 which affect treating vitamin B12 deficiency and lead to a deficiency, when any damage happens to the terminal ileum, such as surgical resection due to Crohn's disease.
Also, inflammation from celiac disease or infection with the tapeworm Diphyllobothrium latum may also damage the small intestine resulting in vitamin B12 deficiency.
Dietary Insufficiency
Vitamin B12 is stored in the liver; for this, patients may develop vitamin B12 deficiency from this lack of dietary intake when they have followed a very strict vegan diet for approximately three years which affects treating vitamin B12 deficiency.
Symptoms of vitamin B12 deficiency
Vitamin B12 or folate deficiency anemia can cause a wide range of symptoms that develop gradually but can worsen in treating vitamin B12 deficiency in case of untreatment as well as most symptoms are the same whether the causes are by either folate deficiency or vitamin B12 deficiency.
Symptoms of vitamin B12 and folate deficiency anemia include
- Rapid breathing or shortness of breath
- Headaches
- Indigestion
- Loss of appetite
- Palpitations
- Problems with your vision
- Feeling weak or tired
- Diarrhoea
- Red tongue or sometimes with mouth ulcers
- Cognitive changes such as memory problems, understanding or judgment
Vitamin B12 deficiency can also cause neurological symptoms which may affect the brain and nervous system including
- Numbness
- Muscle weakness
- Psychological problems can range from mild depression or anxiety to confusion and dementia
- Problems with balance and coordination
- Pins and needles
- Incontinence
Complications of vitamin B12 deficiency
Although they are not common, vitamin B12 or folate deficiency either with or without anemia may lead to complications, particularly if there is a deficiency in vitamin B12 or folate for some time.
Potential complications can include
- Problems with the nervous system
- Temporary infertility
- Heart conditions
- Pregnancy complications and birth defects
- Adults with severe anemia are also at risk of developing heart failure.
Diagnosis of vitamin B12 deficiency
It can be difficult to diagnose vitamin B12 deficiency as its symptoms are not always present or they can be similar to other nutritional deficiencies.
So healthcare providers will usually do routine blood tests in people at high risk for developing it for treating vitamin B12 deficiency to check for vitamin B12 deficiency.
The most common tests that are used to diagnose vitamin B12 deficiency are a complete blood count (CBC) and a vitamin B12 blood test level and the patient is diagnosed with vitamin B12 deficiency when the amount of vitamin B12 in their blood is less than 150 per mL.
Treatment of vitamin B12 deficiency
Vitamin B12 deficiency can be resolved with vitamin B12. Often treating vitamin B12 deficiency with cyanocobalamin, a man-made form of vitamin B12.
Depending on the cause of the deficiency, the patient may only have to be treated until their vitamin B12 levels are back to normal, or they may have to take vitamin B12 medications for the rest of their life.
Vitamin B12 deficiency is a serious problem, which if not treated can lead to severe neurological symptoms.
The ideal way for treating vitamin B12 deficiency and managing the problem is with an interdisciplinary team professionally that includes a primary clinician, gastroenterologist, neurologist, surgeon, pharmacist, dietitian, and a nurse.
Options for treating vitamin B12 deficiency are:
- Vitamin B12 oral medication.
- Vitamin B12 intramuscular injections.
- Vitamin B12 nasal gel.
- Vitamin B12 nasal spray.
Prevention of vitamin B12 deficiency
Most people are treating vitamin B12 deficiency by using foods and drinks that have vitamin B12.
Options for consuming vitamin B12 include:
Animal food products
Red meat, fish, poultry, eggs, and milk all contain vitamin B12.
Fortified foods
They are foods that have certain vitamins and nutrients added to them that they don’t naturally have which include certain breakfast cereals, nutritional yeast, plant milk, and certain bread but be sure to check the food label (nutritional facts) to see if the food has been fortified with vitamin B12.
Vitamin B12 dietary supplements
Many multivitamins include vitamin B12. Also, there are supplements that only have vitamin B12. Healthcare providers or pharmacists could be asked to help choose the best supplement.
Other methods for treating vitamin b12 deficiency:
Avoid alcohol consumption
As the frequent usage of alcohol can damage the digestive system and make it difficult for the human body to vitamin B12 absorption.
Manage any digestive disease
If patients have a digestive disease such as Crohn’s disease or celiac disease, be sure to follow the healthcare provider’s instructions to stay healthy.
Conclusion
Vitamin B12 deficiency in adults is common because of poor nutrition, dementia, rigid vegetarian diet or lack of access to care.
These people should be proactively screened for vitamin B12 deficiency and once treated, they should be followed by a visiting home care nurse to make sure of improvement of the neurological symptoms.
The nurse, dietitian, and pharmacist can help educate the patient that there is a high risk among family members, who should be screened for the problem.
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