9. Vitamin B12 deficiency

Question 1

Causes

Answer 1

Atrophic gastritis
Pernicious anemia
Surgical removed part of your stomach or small intestine, incl. weight loss surgery
Conditions affecting the small intestine: E.g. Crohn’s disease, celiac disease, bacterial growth, or a parasite
Heavy drinking
Immune system disorders: E.g. Graves’ disease or lupus
Long-term use of acid-reducing drugs

Question 2

Signs and symptoms

Answer 2

Weak., tiredness
Heart palpitations and shortness of breath
Pale skin
A smooth tongue
Constipation, diarrhea, a loss of appetite, or gas
Nerve problems: E.g. numbness or tingling, mus. weak., and problems walking
Vision loss
Mental problems: E.g. depression, memory loss, or behavioral changes

Question 3

Treatment

Answer 3

Pernicious anemia or a problem w/its abs.

• Replace vit. B12 by injection initially and then continued injections
• High doses of an oral replacement
• Nasal therapy for life

Don’t eat animal products

• Change diet, incl. vit. B12-fortified grains
• A supplement of B12 injections
• High-dose oral vitamin B12

Elderly

• Daily B12 supplement
• Multivitamin that contains B12

Any nerve damage that happened due to the def. could be permanent

Question 4

Diagnosis

Answer 4

Blood test:
- Number and appearance of red blood cells: Macrocytic anemia
- Check vit. B12, C & folate b/c of similar symptoms
Antibodies test: Pernicious anemia
Methylmalonic acid test: High
Schilling test: Lack of abs.