Vitamin B12, also called cobalamin, is an essential dietary micronutrient...
...that plays an important role in the normal functioning of the brain and nervous system and the production of red blood cells. It is involved in the metabolism of every cell of the human body, affecting DNA synthesis and regulation, fatty acid synthesis and energy production.
Like most vitamins, Vitamin B12 is not produced by the body but comes from nutrients in the foods we eat or from supplements. The main food sources are animal foods, including meats, fish, poultry, eggs and dairy. It can also be found in seaweed and in products fortified with B12, such as some varieties of bread and plant-based milk.
To keep the body’s various systems functioning well the average adult needs to take in around 2.4 micrograms of B12 a day. But some people don’t consume enough vitamin B12 to meet their body’s needs whilst others, due to a variety of physical conditions, don’t absorb enough. It is rare for young people to be deficient in vitamin B12, but it is not uncommon for older people to be mildly deficient. It is estimated that up to 20% of adults over age 50 may have a borderline vitamin B12 deficiency, and 3.2% have seriously low B12 level.
The causes of vitamin B12 deficiency include:
- Diet - people who do not eat animal products (or seaweed) run the risk of becoming deficient in B12. Those who exclude meat from their diet but do eat fish and dairy will be much less at risk of developing a deficiency because dairy products make B12 ‘more bioavailable’
- Intrinsic factor deficiency - Intrinsic factor is a protein that helps your intestines absorb vitamin B12. It is made by cells in the stomach lining. Some people don’t make enough intrinsic factor or have a condition that destroys it. If your body does not make enough intrinsic factor, you can develop a type of vitamin B12 deficiency called pernicious anaemia.
- (see Gastric Atrophy below for further detail)
- Conditions that affect the small intestine - which can interfere with B12 absorption – for example Crohn's disease, coeliac disease, and an imbalance in gut bacteria
- Medications - some medications, for example proton pump inhibitors used to control acid indigestion, can worsen vitamin B12 deficiency. This is because stomach acid is needed to release vitamin B12 bound to proteins in food. Some antibiotics can lead to B12 deficiency.
- Weight loss surgery
Vitamin B12 deficiency - which can be slow to develop - causing symptoms to appear gradually and intensify over time – but can also happen relatively quickly - can lead to a variety of health conditions, some serious, if untreated.
- Loss of physical co-ordination -difficulty walking (staggering, balance problems)
- Pins and needles (especially in your hands and feet)/numbness
- Peripheral Neuropathy
- Difficulty thinking and reasoning (cognitive difficulties), or memory loss
- Swollen and sore tongue (glossitis)/mouth ulcers
- Shortness of breath
- Blurred vision
Anaemia is where you have fewer red blood cells than normal or you have an abnormally low amount of a substance called haemoglobin in each red blood cell.
General symptoms of anaemia may include:
- Feeling faint
- Pale skin
- Loss of appetite and weight loss
Some of these symptoms can also present in people who have a vitamin B12 deficiency but have not developed anaemia.
Gastric Atrophy (Atrophic Gastritis)
Atrophy is the medical word used to describe ‘wasting away’. Gastric Atrophy is the result of chronic inflammation of the stomach lining which means it cannot produce hydrochloric acid (needed to break down food), pepsin (that helps speed up the break-up of food) or Intrinsic Factor which is necessary to help extract B12 from food. Atrophic Gastritis can be caused by advancing age, by Helicobacter Pylori or by Autoimmune Gastritis where the patient produces antibodies that destroy either the Parietal Cells or Intrinsic Factor or both. Patients who produce antibodies that destroy their Intrinsic Factor will be diagnosed as having Pernicious Anaemia.
The most common underlying cause of vitamin B12 deficiency is Pernicious Anaemia - an autoimmune disorder indicated by the absence of intrinsic factor (IF). An autoimmune condition means your immune system, the body's natural defence system that protects against illness and infection, attacks your body's healthy cells. In the case of Pernicious Anaemia, the body produces an antibody that attacks the protein (IF) responsible for extracting vitamin B12 from food.
A lack of B12 can damage the myelin sheath that surrounds and protects nerves. Without this protection, nerves cease to function properly and conditions such as Peripheral Neuropathy (PN) occur. PN indicates a problem with the functionality of the peripheral nerves responsible for the transmission of signals from the central nervous system to the rest of the body and from the body back to the brain. Depending on which type of peripheral nerve is affected, PN may produce a wide variety of symptoms with varying degrees of severity. In a lot of cases, other health conditions perpetuate PN, and thus, it can be both a symptom and disease unto itself.
Vitamin B12 Shots
BioMed offers in house diagnostic tests and blood tests (sent away) to screen for vitamin B12 deficiency and any other underlying imbalances.
Using the data provided BioMed may recommend Vitamin B12 supplements or regular injections. More frequent shots may be required initially to treat the deficiency but an injection is usually then given every three months to treat/prevent B12 deficiency.
Vitamin B12 injections are now available at our clinics. BOOK NOW