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The B12 factor

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How to overcome vitamin B12 deficiency.

Vitamins are essential and important constituents in our diet, as they perform a variety of critical roles to maintain one’s health and keep the body functioning optimally. Among the various vitamins, one of the essentials is Vitamin B12. In recent times, doctors have noted that a sizeable percentage of the population is deficient in this vitamin.

“It is one of the commonest deficiencies that I see,” says Dr. Kousalya Nathan, Lifestyle management and Anti-ageing consultant, Nova Speciality Hospitals, Chennai. “Vitamin B12 cyanocobalamin is an important water-soluble vitamin from the B-complex family. It has a vital role to play in pregnancy/lactation, infancy/childhood, menopause/old age. Its key functions are the manufacture of red blood cells, supporting the normal function of nerve cells, and specifically to manufacture myelin, a nerve covering that speeds up neural transmission. It assists in maintaining the health of the DNA and helps in normal biochemical metabolism on a daily basis.”

So what are the causes for the deficiency? Dr. S. Ramesh, Consultant Physician and Pulmonologist, Department of Internal Medicine, Manipal Hospital, Bangalore, says, “Vitamin B12 deficiency is especially common in exclusively breast-fed infants with no access to supplemental nutrients and whose mothers might already be B12 deficient. It is estimated that over 70 per cent of adults in India and 80 per cent of pre-school children have some form of B12 deficiency. As a result many suffer from anaemia, fatigue, infertility and neurological illnesses. Growth retardation, mental anomalies, failure to thrive, feeding difficulties, and early infant mortality are other possible problems.”

The deficiency is, to an extent, attributed to limited sources of B12, which occurs mainly in animal products such as meat (mainly liver), dairy and fish. Thus people who are exclusively vegetarian/vegan are more susceptible to developing this deficiency. B12 also has a complicated method of absorption in the ileum requiring the presence of stomach acid and intrinsic factor, a substance secreted by the stomach that enables the body to absorb the vitamin. Patients who are on acid-reducing therapies and diabetics on metformin are particularly at risk.

Dr. Nathan adds, “Poor gut health is another factor. More than 40 per cent of individuals have improper digestion and poor gut health due to multi factoral reasons. Unmanaged stress, poor eating habits, genetic factors, people suffering from digestive disorders like Crohn’s disease have problems in absorbing B12. Many people over 50 lose the ability to absorb it from foods. Insufficient intake of water can also affect B12 absorption as it is a water-soluble vitamin.”

So how does one make good the deficiency? Dr. Ramesh says, “Traditionally, Vitamin B12 supplements have been in the form of injections to be taken regularly. However, more recently, high-dose oral supplements have become available and have been shown to be as effective as the injections. Improvements in dietary habits are also necessary. Treatment should be initiated without waiting for lab tests or even clinical signs like anaemia. The earlier the treatment is started, the better the overall prognosis.”

Dr. Nathan concludes, “Given that symptoms range from generalised weakness to inability to carry out daily work/activities to mood swings, irritability, numbness or tingling in the arms and legs, shortness of breath, palpitations and mouth ulcers, swelling and thickening of the tongue, poor vision, depression, increased risk of infertility and even problems with the normal functioning of the heart over a period of time (if the deficiency is left untreated) and the fact that it is 100 per cent reversible”, there is absolutely no reason why anyone who is B12 deficient should put themselves at risk.

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Printable version | Jan 16, 2018 6:58:11 PM | http://www.thehindu.com/features/magazine/vitamin-b12-deficiency/article6710861.ece