Are you Vitamin B12 deficient? Read this before you nod your head!

When the two brothers Alan and Ansel Adam (names changed) walked into Dr Neil’s with a view to finding a weight loss solution, little did they know that their wobbly gait had to do with the fact that they were Vitamin B12-deficient. A simple lab test confirmed the doctor’s suspicion. Hitherto, the family had always blamed it on their weight.

Ala, a 36-year-old businessman and his 32-year-old sibling Ansel reported that all their meals included either fish, meat, poultry or eggs. Since B12 is adequately found in these foods, it was hard to connect the dots.

“There were other signs too,” explains Dr Neil, listing, “Lethargy, lack of energy, shortness of breath, and a feeling of nervousness,” as some. “We usually associate these with weight gain, however, it is important to investigate the root cause,” she says.

According to a case report from Harvard-affiliated Massachusetts General Hospital published in The New England Journal of Medicine, a severe Vitamin B12 deficiency can lead to deep depression, paranoia and delusions, memory loss, incontinence, diminished taste and smell, and a host of other problems.

Senior consultant physician Dr Sam, “Vitamin B12 also known as Cobalamin is a an essential ingredient for DNA synthesis, and hence any rapidly growing cell in the body, such as the red blood cells, the nerve cells, the cells lining the intestines or the cells of our skin need B12 for regeneration and growth.

It is also required for the proper functioning of our immune system.Although Vitamin B12 is not manufactured in the body, there are sufficient stores in the liver -these would last for about five years, so when deficiency occurs, it is insidious and not noticed easily.”

Spot the signs

Dr Sam tells us about a 35-year old patient who had “generalised weakness and dark discoloration of the hands, especially over the knuckles -this was so obvious, she tried to cover her hands most of the times.” Tests confirmed that her B12 levels were alarmingly low.

“Since B12 is necessary for the production of red blood cells and for nerves and skin regeneration, its deficiency manifests as anaemia.

This is characterised by fatigue, tiredness and lethargy and a spectrum of neurological manifestations ranging from personality changes to peripheral nerve involvement (this can give rise to tingling and numbness in the feet and hands).

Skin changes like dryness and hyperpigmentation is also not uncommon. Even the oral mucosal hyperpigmentation is seen as a part of B12 deficiency,” he explains.

In the long run, it can lead to a host of neurological manifestations ranging from behavioural changes like forgetfulness, mood disorders, depression and gait abnormalities, leading to repeated falls.

Studies from various parts of India conducted by medical institutions like Apollo Hospital over the past several years have shown that a large percentag eof the population suffer from Vitamin B12 deficiency, and that it’s most prevalent in pure vegetarians.

“In fact Vitamin B12 deficiency is also associated with the use of drugs like antibiotics, anti diabetics like metformin and antacids.

Smoking and alcohol consumption combined with poor nutritional intake also contributes to the condition. That should explain why many non-vegetarians too fall into the `deficient’ bracket. Also, with age, the body’s ability to absorb Vitamin B12 from food slows down.

B12 and pregnancy

It is imperative to diagnose Vit B12 deficiency in pregnancy and treat it accordingly as it can have an adverse effect on the growing foetus. “It can lead to neurological abnormalities and low birth weight for babies, which can have serious implications for the newborn in the long term,” warns Dr Sam.

Vegan woes

While non-vegetarian fare includes many sources of the vitamin (seafood, eggs, meat, liver and kidney), for those who eat only vegetarian food, there is no pure plant-based source of B12.

“Milk, cheese, and some forms of yeast are the only sources, if they can be termed `pure vegetarian.’ For vegans, who do not even consume milk, a solution is not as simple. They would need to consume Vitamin B12-fortified foods, or they may make up for their deficiency in this essential nutrient by taking additional nutritional supplements,” suggests Dr Sam.

Dr Neil recommends adding soybean, hydroponic lettuce, mushrooms, whey powder and seaweed (nori) to your diet. “While these do not contain high amounts of Vitamin B12, it’s better than nothing. And, once you cross the age of 45, you must have Vitamin B12 supplements andor fortified foods, because absorption gets impaired with aging.”

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