November 2017

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DIETICIAN’S VIEW VITAMIN B12 DEFICIENCY CAN LEAD TO PERNICIOUS ANEMIA by Nancy M. Ouhib, MBA, RD, LD/N Vitamin B12 is part of the water-soluble vitamin B complex. There is a total of eight B vitamins, B12 being one of them. Pernicious anemia is a vitamin B12 deficiency disease caused by the lack of a protein called intrinsic factor that is normally synthesized in the gastric mucosa. Vitamin B12 deficiency anemia can also occur if your small intestine cannot absorb B12. This may be due to a surgery to your stomach or small intestine (gastric/bypass surgery), abnormal bacterial growth, altered GI function, or an intestinal disease such as Crohn’s or Celiac disease. A severe B12 deficiency can lead to deep depression, paranoia, delusions, memory loss, loss of taste and smell, incontinence, and more. The human body needs vitamin B12 to make red blood cells, nerves, DNA, and carry out other complex functions. The body cannot make B12, it is a vitamin that we must ingest and get from our food sources. Vitamin B12, or cobalamin, is found primarily in animal tissues with liver being the most plentiful source. B12 is found mainly in meat, fish, eggs, poultry, dairy products, and milk. The vitamin itself is a dark red crystal that derives its color from the cobalt in the cobalamin molecule. Plants do not make B12, so strict vegetarians and vegans are at high risk for developing a B12 deficiency if they do not eat grains that have been fortified with B12, or take a vitamin supplement. The presence of certain commonly prescribed medications, like heartburn drugs, can cause B12 trouble because the vitamin needs stomach acid to be absorbed. The condition is more likely to occur in the elderly, where common use of these medications is seen. Vitamin B12 is a metabolic requirement for all humans. A B12 deficiency occurs as a consequence of faulty absorption of the vitamin and results in pernicious anemia, or decreased red blood cell production. The deficiency can be slow to develop and the symptoms can be overlooked or confused with something else. Symptoms may include: Strange sensations, numbness, tingling in the hands, legs, or feet Difficulty walking (staggering, balance problems) Swollen, inflamed tongue Yellow skin (or jaundice) Difficulty thinking and reasoning (cognitive difficulties), or memory loss Paranoia or hallucinations Weakness/fatigue A blood test is needed to confirm a deficiency and detection/treatment is important to prevent neurological deficiencies. B12 injections can efficiently alleviate the effects of this type of anemia. As is the case, we do not need a lot of vitamin B12 to meet our metabolic needs – 3 to 5 micrograms per day is sufficient. Nevertheless, a percentage of the population is at risk as discussed above. Have your primary care practitioner check your B12 level if you are: Over 50 years old Take a proton-pump inhibitor (Nexium, Prilosec, or Prevacid) Take an H2 blocker (Pepcid, Tagamet, or Zantac) Take metformin (oral hypoglycemic agent) Are a strict vegetarian and do not consume sources of B12 Have had weight loss surgery, Crohn’s, or Celiac disease Have a low red blood cell count A B12 deficiency can be corrected, with injections being the most effective form. A deficiency can also be prevented by eating the right food sources or foods that are fortified with the vitamin. If needed, a daily multivitamin can provide you 100 percent of the daily requirement. Remember, your health is in your hands. P 84 NOVEMBER 2017
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November 2017

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