VITAMIN B12 – An essential micronutrient! Causes and symptoms of its deficiency!
Food is the key to our physical and mental health! The foods that are beneficial to our body are further classified based on their macro and micro nutrient profiles. While macro nutrients require higher intake in terms of proportion and quantity as compared to micro nutrients; the significance of micro nutrients for our health cannot be ignored. In fact, each and every one of them is impertinent for our survival! Let us look at one of the most important micronutrients Vitamin B12 and how its presence in our body is essential for our well-being.
Vitamin B12 – A gatekeeper of the health of our physical and mental systems!
Vitamin B12 or cobalamine is one of the 8 primary Vitamins. It an essential micronutrient required by our body for the normal functioning of the brain and the nervous system. It is also required for the production of red blood cells, fatty acid and amino acid metabolism and for DNA synthesis.
In a recent study in Journal of Clinical Biochemistry and Nutrition, it was found that adequate folic acid and vitamin B12 intake could also help decrease the risk of vascular disease. Vitamin B12 decreases plaque formation that blocks arteries and hence it reduces the risk for cardiovascular stroke and peripheral vascular disease like deep vein thrombosis.
Required Daily Intake and source of Vitamin B12
Since the vitamin is water soluble, it is easily lost from the body and has to replenished daily. The current Estimated Average Requirement (EAR) for vitamin B12 for women and men (aged 14 and above) is 2.0 μg/day. For women during pregnancy requirement is 2.6 μg/day and during lactation, the requirement is 2.8 μg/day.
It is mainly found in animal products such as fish, egg, meat, poultry, milk* and milk products.
*It is important to note that boiling milk destroys the vitamin and yogurt lose it during fermentation.
Vitamin B12 Deficiency – Vegans and Vegetarians are at higher risk!
As B12 is generally not present in plant food, vegetarians and vegans are not able to get it from their dietary intake and hence run the risk of B12 deficiency.
“Yes, Indians who are pure vegetarians or vegans (who don’t eat any animal products, including meat, milk, cheese, and eggs) are highly prone to be vitamin B12 deficient,” says Anil Arora, Unit Head and Senior Consultant (orthopedics) at Max Super Speciality Hospital in Patparganj.
In Hong Kong and as well as India, vitamin B12 deficiency has been found in roughly 80% of the vegan population. Indian cosmetologists, hairstylists and orthopedics claim 80% of their clients suffer from a B12 deficiency. The problem is so serious that The Department of Biotechnology, Government of India, is working with experts in the public health field to create a road map for understanding and preventing vitamin B12 deficiency disease.
Multiple other causes of B12 Deficiency
Apart from the dietary deficiency, other causes of vitamin B12 deficiency include:
- Surgical removal of the small intestine
- Celiac disease
- Chronic alcoholism
- Infection with tapeworm
- Medications like metformin, ranitidine
- Blind loop syndrome
- Nitrous oxide abuse
- Transcobalamin deficiency
- Severe MTHFR deficiency
- Roux-en-Y gastric bypass surgery
Symptoms of Vitamin B12 Deficiency
Vitamin B12 major deficiency symptom comes from pernicious anemia characterized by the triad of:
- Megaloblastic anemia
- Gastrointestinal disturbances including diarrhea
- Constipation, loss of bladder/bowel control and neurological symptoms.
There can be severe and irreversible damage to the brain and nervous system as well.
Other Symptoms include fatigue, headaches, lethargy, breathlessness, ‘watermelon stomach’, decreased ability to think, emotional and behavioral changes, depression, poor memory and pale skin etc. Neuropathy involving Dementia, psychosis may develop later.
Vitamin B12 and/or folate deficiency is generally associated with hyperhomocysteinemia, which has been linked with pregnancy complications like pre-eclampsia, recurrent pregnancy loss, and intrauterine growth restriction.
Vitamin B-12 in blood is elevated (above about 600 pmol/L) in several liver diseases like metastatic liver, hepatocellular carcinoma acute hepatitis, cirrhosis, and thus is also used as a disease marker.
Treatment of vit B12 deficiency depends upon treating the cause. If it’s simply due to low level of dietary intake then food fortified with vit B12, or capsules of Vitamin B12 are enough to manage the case.