Vitamin B12 deficiency

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Vitamin B12 deficiency
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Fatigue, pallor, shortness of breath, neuropathy, glossitis, jaundice
Complications	Megaloblastic anemia, neurological disorders, cognitive impairment
Onset	Gradual
Duration	Long-term
Types	N/A
Causes	Malabsorption, pernicious anemia, dietary deficiency, gastric bypass surgery
Risks	Veganism, alcoholism, Crohn's disease, celiac disease
Diagnosis	Complete blood count, serum vitamin B12 level, methylmalonic acid test, homocysteine test
Differential diagnosis	Folate deficiency, iron deficiency anemia, hypothyroidism
Prevention	Adequate dietary intake of vitamin B12, vitamin B12 supplementation
Treatment	Vitamin B12 injections, oral vitamin B12 supplements
Medication	Cyanocobalamin, hydroxocobalamin
Prognosis	N/A
Frequency	Common in older adults, rare in young people
Deaths	Rare, if untreated can lead to severe complications

Vitamin B12 deficiency is a medical condition in which the body does not have enough vitamin B12 to function properly. This deficiency can lead to a variety of health problems, including anemia, neurological disorders, and cognitive impairments.

Causes

Vitamin B12 deficiency can be caused by several factors, including:

• Dietary deficiency: A lack of vitamin B12 in the diet, which is common in individuals who follow a strict vegan or vegetarian diet, as vitamin B12 is primarily found in animal products.
• Malabsorption: Conditions such as pernicious anemia, celiac disease, and Crohn's disease can interfere with the absorption of vitamin B12 from the digestive tract.
• Medications: Certain medications, such as proton pump inhibitors and metformin, can affect the absorption of vitamin B12.
• Surgical procedures: Surgeries that remove or bypass parts of the stomach or small intestine, such as gastric bypass surgery, can lead to vitamin B12 deficiency.

Symptoms

The symptoms of vitamin B12 deficiency can vary and may include:

• Fatigue and weakness
• Pale or jaundiced skin
• Heart palpitations and shortness of breath
• Neurological symptoms: Numbness or tingling in the hands and feet, difficulty walking, memory loss, and cognitive decline
• Mouth ulcers and a swollen, inflamed tongue
• Vision problems

Diagnosis

Vitamin B12 deficiency is typically diagnosed through a combination of:

• Medical history and physical examination
• Blood tests: Measuring levels of vitamin B12, methylmalonic acid, and homocysteine in the blood
• Complete blood count (CBC): To check for anemia and other abnormalities

Treatment

Treatment for vitamin B12 deficiency depends on the underlying cause and may include:

• Dietary changes: Increasing the intake of vitamin B12-rich foods, such as meat, fish, dairy products, and fortified cereals
• Oral supplements: Vitamin B12 tablets or capsules
• Intramuscular injections: For individuals with severe deficiency or malabsorption issues
• Treating underlying conditions: Addressing any medical conditions that may be causing the deficiency

Prevention

Preventing vitamin B12 deficiency involves:

• Maintaining a balanced diet: Including sufficient amounts of vitamin B12-rich foods
• Regular monitoring: For individuals at risk, such as those with gastrointestinal disorders or those taking medications that affect vitamin B12 absorption
• Supplementation: For individuals following a vegan or vegetarian diet, or those with conditions that affect absorption

See also

• Anemia
• Pernicious anemia
• Neuropathy
• Cognitive impairment
• Veganism
• Gastric bypass surgery

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