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Vitamin B12

An estimated 6% of the people in the US and UK suffer from vitamin B12 deficiency. The condition is recognized by the World Health Organization as a global health problem that could impact millions of lives. B12 deficiency is typically characterized by symptoms such as extreme tiredness, lack of energy, muscle weakness, and even problems with memory. Not only that, but it can cause a number of serious health problems, such as irreversible nerve damage, anxiety or depression, or disorders which affect coordination, balance and speech.

While some B12 deficiencies are caused by diet, the most common reason for low B12 levels worldwide is an Autoimmune disorder called Pernicious Anemia. This is a chronic form of low B12 that can have serious consequences on health if left untreated long-term. However, because symptoms of the condition typically look like other common conditions, it’s often misdiagnosed as depression or anxiety. Not only does the condition cause physical distress, the stigma of living with this chronic condition can also cause serious psychological harm.

Vitamin B12 – otherwise known as cobalamin – is a water soluble vitamin found in animal by-products, such as meat, fish and dairy. Other sources include fortified cereal, breads and plant milks. People who don’t regularly consume animal products are at risk of becoming deficient in B12. To reduce this risk, vegans are recommended to consume at least three micrograms of B12 daily through fortified foods, or by taking a regular B12 supplement.

However, most low B12 levels are more caused by Pernicious Anemia. The condition makes it difficult for people to process vitamin B12 because the immune system impacts on the functioning of important parietal cells within the stomach. These cells produce a protein called “intrinsic factor” which is essential for vitamin absorption. People with Pernicious Anemia will produce an antibody to Intrinsic Factor that destroys any Intrinsic Factor that has been produced. And so, without any Intrinsic Factor to bind to food, they are unable to extract any B12. Without B12, the body isn’t able to produce enough healthy red blood cells. The condition can also be caused by a weakened stomach lining. This may happen because of atrophic gastritis, chronic inflammation in the stomach that eventually weakens the lining.

B12 deficiency causes a wide range of debilitating neurological and physical symptoms. The most common symptoms of Pernicious Anemia are fatigue, memory loss and problems with concentration. However, the subtle, nonspecific nature of the condition’s initial symptoms can make it difficult to properly diagnose people. One study interviewing members of the Pernicious Anemia Society found that nearly half had been misdagnosed. A further 20% had waited two years or more for a proper diagnosis. For many, symptoms were initially attributed to a hectic lifestyle or diagnosed as anxiety or depression.

Low levels of B12 can lead to nerve damage, as the vitamin is essential to producing myelin, which protects nerve cells from damage. Symptoms of low B12 might initially feel like tingling or numbness in hands and feet, or difficulty with balance. If Pernicious Anemia is left untreated, symptoms can become debilitating and nerve damage irreversible. The term “Pernicious” was used to describe the condition as historically it resulted in death.

When Vitamin B12 deficiency is caused by poor diet, it’s treated by prescribing B12 tablets or injections of hydroxocobalamin . Once the deficiency has been corrected, levels can be managed by changing diet or regularly taking a supplement.