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Vitamin B12- what does it do for you?-by Dr Harold Gunatillake

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“Meat supplies a variety of nutrients – among them iron, zinc, and Vitamin B12 – that are not readily found in plants. We can survive without it; millions of vegetarians choose to do so, and billions of others have that choice imposed upon them by poverty”. – Author: Michael Specter

Sri Lankans are by and large meat-eaters a part of the staple diet, and the incidence of vitamin B12 deficiency is very low, other than among the vegetarians.

Furthermore, your body can store vitamin B12 for years, which is an advantage.

Vegans and vegetarians should add some processed grains like fortified breads, and cereals.

How can one tell or suspect that you lack vitamin B12?

You may develop pins and needle sensations in your hands, and lower extremities, unsteady walking disability.

Shortage of B12 can damage the protective sheath that covers your nerves and cause these neurological issues.

Diseases like Crohn’s or other gut illnesses may make it harder for your body to absorb vitamin B12.

Taking heartburn tablets too will affect this vitamin absorption.

Those diabetics on metformin tablets reduce vitamin B12 concentration and cause a deficiency. Vegans having diabetes and on metformin need to worry about their vitamin B12 levels and need to take supplements with fortified cereals and other foods.

If you feel unusually colder, this could be an early sign that you have vitamin B12 deficiency. Without enough B12, you might not have enough healthy red blood cells to move oxygen around through the blood vessels and keep your body warm.

Headaches, pale skin or being breathless and fatigued for no reason. Then, think that you may be suffering from Vitamin B12 deficiency. Fatigue may be common in other illnesses or just due to lack of exercise, but fatigue or tiredness with vitamin B12 deficiency is accompanied with other symptoms mentioned. With further time with no diagnosis made, you may get confused; have cognitive impairment, paranoia, delusions, mania, psychosis, memory loss, incontinence when passing urine and loss of taste and smell.

Lack of B12 may lead to these symptoms of depression due to brain fog. You are recommended by your doctor 2.4 micrograms of B12 day. If you take too much the rest passes in your urine.

Higher doses of B12 can have side effects like dizziness, headache, nausea, and vomiting.

So, always stick to the recommended dose by your doctor.

If you feel that your muscles, feel weak and lack strength you need to suspect it could be due to B12 deficiency.

If you feel that your tongue is smooth and glossy when you brush your teeth in the morning, that could be a sign of early B12 deficiency. Certain medications too can give a smooth glossy tongue.

You may get mouth ulcers on your gums or tongue. You may not be able to enjoy your spiced meals. Be aware this could be due to vitamin B12 deficiency.

Some drugs can drop your vitamin B12 level in your blood, such as chloramphenicol, proton pump inhibitors given for heart burn, Cimetidine given for stomach ulcers, and metformin as mentioned earlier.

In vitamin B12 deficiency your heart rate may become rapid or feel having skip beats.

Vitamin B12, also known as cobalamin, is a water-soluble vitamin involved in metabolism.

It is required by animals, which use it as a cofactor in DNA synthesis, in both fatty acid and amino acid metabolism.

Vitamin B-12 (cobalamin) plays an essential role in red blood cell formation, cell metabolism, nerve function and the production of DNA, the molecules inside cells that carry genetic information. Food sources of vitamin B-12 include poultry, meat, fish, oysters, mackerel, salmon, and dairy products. Beef liver is one of the best sources of vitamin B12. Chicken, eggs and fish are the other best sources. It is also

added to some foods, such as fortified breakfast cereals, and is available as an oral supplement.

Further, deficiency in vitamin B12 can cause Megaloblastic macrocytic anaemia. In this situation the red blood cells are larger than usual and irregular in shape. This deficiency can cause, damage to the white matter of the spinal cord and brain and peripheral neuropathy, resulting in symptoms already mentioned.

This deficiency can be seen among vegans due to inadequate intake of Vitamin B12.

Foods bound vitamin B12 is released in the stomach’s acid environment, binds with the intrinsic factor secreted in the stomach lining cells and get absorbed in the terminal small gut.

Inadequate vitamin B12 absorption is most seen in the elderly due to inadequate absorption as a result from decreased acid secretion in the stomach which produces the intrinsic factor.

Older people are advised to take vitamin B12 supplements to avoid anemia, nerve damage, moodiness, and other serious problems.

Inadequate absorption may occur in a combination illness called blind loop syndrome with overgrowth of bacteria or tape worm infestation. They ingest the vitamin B12 so less is available for absorption.

Vitamin B12 absorption may be inadequate in inflammatory diseases of the bowel, or when the gut is surgically removed.

Inflammatory bowel diseases include Crohn disease and ulcerative colitis.

Pernicious anemia is a type of anaemia resulting from vitamin B12 deficiency. Here too there is atrophy of gastric inner lining with loss of the intrinsic factor. Patients with classic pernicious anaemia, most common among young adults are at increased risk of stomach and other gastro-intestinal cancers.

If you lose your appetite and as a result lose weight and have constipation, may be due to vitamin B12 deficiency.

It takes time for B12 deficiency to show early symptoms as they are slow to appear at the onset. In some the symptoms may come on relatively quickly. So the doctors find it difficult to suspect during the early stages other than from a blood test. It is sensible for elderly people to request for the specific blood test on their annual routine medical check-ups.

Today, most breads, grains, pasta, egg noodles, rice, cereals, orange drinks and tomato juice are fortified with B12. Standard multivitamin tablets too have B12 incorporated.

Lentils being a cheap popular legume cooked as a curry with rice and bread in Sri Lanka don’t seem to have B12.

So, people who eat red meat, seafood and dairy products do get sufficient vitamin B12, but for older people it is advisable to take a supplement.

Annual blood levels for B12, need to be checked up on your routine blood tests is advisable.

Hope this video talk was useful Stay safe and goodbye for now.



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