Do You Get Your Vitamin B12 Checked?

By Dr Harold Gunatillake - Health Writer

Recently, a doctor friend of mine was relating an experience he had one morning, and from time to time. He was finding it difficult to walk and quite unsteady on his legs on waking up in the morning.

My wife had a similar experience about a year ago, when she got up in the morning she was very unsteady on her legs, and complained that she was cramping, did not know what was happening, and felt  as if she was dying.

I was writing an article on the side effects of statins that morning, and her complaint fitted well into the picture what I was writing about the side effects of statins.

I was quite confident that it was due to the side effects of statins, as her cardiologist had put her on 40 mg of Crestor, quite a large dose to be taken each night.

I said, no Crestor from tonight, and next morning she was bright as ever, and could walk steadily with no cramps.

My doctor friend did not have muscle cramps but only weakness. He took an injection of vitamin B12 (cyna-cobolamine), and next day felt much relieved. Since then, he has been taking a capsule of Vitamin B12 daily.

Less dramatic symptoms of a Vit B12 deficiency may include muscle weakness as mentioned by the doctor, fatigue, shakiness, unsteady gait, incontinence, low blood pressure, depression, other mood disorders and cognitive problems like poor memory.

Vitamin B12 test measures the amount of vitamin B12 in the blood. The body needs this vitamin to make blood cells and to maintain a healthy nervous system.

Vitamin B12 is mainly present in animal products such as meat, shellfish, milk, cheese and eggs. Those who eat such products are not likely to get vitamin B12 deficiency.

Strict vegetarians and babies of mothers who are strict vegetarians seem to develop anemia due to B12 deficiency, and should take a supplement containing vit B12. Vitamin B12 seems to get stored in the liver for about 12 months.

Vitamin B12 is also measured as a folic acid test, because lack of either one, can get anemia called magaloblastic anemia where red cells seem to be larger and abnormal than the normal size .Lack of Vitamin B12 specifically affects the nervous system.

Those people, who undergo bowel surgery, may not absorb sufficient folic acid and vit B12 and may lead to this type of anemia.

The symptoms of affecting the nervous system may appear as dementia or other nervous system symptoms like tingling or numbness or weakness of muscles. We call this peripheral neuropathy, quite common among the poorly controlled diabetics.

    Vitamin B12 – Early symptoms of lacking
    Difficulty speaking (stammering)
    Slow reflexes
    Limbs being jerky
    Problem with memory
    Soreness in legs or arms
    Severe deficiency can lead to brain damage
    For the test of Vit B12 in your blood you need to be on empty stomach for 12 hours. Normally more than 200-835 pictograms per milliliter are found in the blood.

  • •         Higher levels are found in liver disease, such as cirrhosis or any form of hepatitis. Also higher values are found in leukemia, diabetes and in obesity.
    •         Low levels are found in pernicious anemia due to poor absorption of the vitamin and also due to the lack of a substance called intrinsic factor.
    •         Low levels can be found in after partial removal of the stomach for growths, or in gastric bypass surgery, or gastric stapling for obesity.
    •         Children having tapeworm infestation of the gut may suffer from vit B12 deficiency.
    •         Low levels could be linked with hyper active thyroid or folic acid deficiency.
    •         Certain medicines may affect your vit B12 blood results. Some antibiotics like tetracycline may make B12 less likely to absorb in the human body.
  • Diabetic patients who take metformin may suffer from vitamin B12 deficiency.
    •         Pregnancy and breast feeding can lower vit B12 level in the blood.
    •         Taking too much of vitamin C daily can lower the B12 level.
    •         Chronic alcoholism is another cause of vit B12 deficiency.

It appears that Folic acid level can be high in people who lack vitamin B12. It is recommended that both folic acid level and vitamin B12 are done on blood simultaneously.

B12 is an essential vitamin for many functions in the body. It is needed for the development and maintenance of a healthy nervous system as mentioned before, also for the production of DNA and formation of red blood cells.

Vitamin B12 has the ability to boost ones energy level, and speed up your metabolism. People who suffer from lethargy and inability to do your normal day to day work should be on a trial of vitamin B12. Patients who suffer with Chronic Fatigue Syndrome can make excellent use of B12 by taking therapeutic amount. The therapeutic amount is 1000 micrograms.

B12 has helped individuals feel less tired, and worn down. The most effective form is B12 capsules or lozenges. Vitamin B12 is also available in a vegetarian form. It also comes in other supplements as in multivitamin preparations.

Without vitamin B12 present in your body iron is incapable of functioning at its full potential. Nutrients in our body work together in a corporate effort to keep us healthy.

For example vitamin B12 helps the body to absorb carotene, and it plays a role in vitamin A being converted.

So, Vitamin B12 in addition being an energy booster, helps promote weight loss, and promotes emotional wellbeing and stables the nervous system. Elderly people are more susceptible to B12 deficiency.

Natural Sources of B12
Beef Liver
Organic eggs
Milk products
Tongue (if you have the stomach for it)
Nuts-rich in complete B complex

When you purchase your vitamin supplements look for “cobalamin and cyanocobalamin” the generic names given to vitamin B12. If you have bowel problems in absorbing B12, your doctor will suggest the injections. They also come in soft gel tablets, liquid drops for children, lozenges and traditional capsules.

As people age, there is a lack of stomach acids in the human body that makes absorbing vitamin B12 difficult. People who take medications to aid and suppress stomach acids due to heartburn issues are also at risk. Such medications are Prilosec, Prevacid, Mylanta and Nexium, as well as ulcer medications like Pepcid, Tagamet, Zantac and others. Recognizing Vitamin B12 deficiency symptoms are crucial.

Intrinsic factor
This important factor has been mentioned above. This factor secreted in the stomach diminishes with age, and also lacking in people with an autoimmune disorder called pernicious anemia mentioned earlier; affects the gastric mucosa and results in gastric atrophy. This leads to the destruction of parietal cells secreting acid juice, (achlorhydria), and failure to produce intrinsic factor, resulting in vitamin B12 malabsorption.
If pernicious anemia is left untreated, it causes vitamin B12 deficiency, leading to megaloblastic anemia and neurological disorders. The resulting vitamin deficiency is commonly treated with monthly injections (cytemin) of B12.

Most often, a daily supplement of 2,000 micrograms is recommended for about a month, then lowered to 1,000 micrograms daily for another month, then lowered again to 1,000 micrograms weekly. Sublingual B12 or B12 patches, or even B12 lollipops, can be helpful for people who require a supplement but cannot swallow pills.

Alzheimer’s disease and dementia patients having high levels of homocysteine levels do not seem to benefit with B12 supplements
Evidence from the Framingham Offspring Study suggests that the prevalence of vitamin B12 deficiency in young adults might be greater than previously assumed. This study found that the percentage of participants in three age groups (26–49 years, 50–64 years, and 65 years and older) with deficient blood levels of vitamin B12 was similar. The study also found that individuals who took a supplement containing vitamin B12 or consumed fortified cereal more than four times per week were much less likely to have a vitamin B12 deficiency.

Individuals who have trouble absorbing vitamin B12 from foods, as well as vegetarians who consume no animal foods, might benefit from vitamin B12-fortified foods, oral vitamin B12 supplements, or vitamin B12 injections.

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