Vitamin B12 deficiency (patient information): Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
'''For the WikiDoc page for this topic, click [[Vitamin B12 deficiency|here]]''' | '''For the WikiDoc page for this topic, click [[Vitamin B12 deficiency|here]]''' | ||
{{Vitamin_B12_deficiency_(patient_information)}} | {{Vitamin_B12_deficiency_(patient_information)}} | ||
{{CMG}}; {{AE}} [[Lakshmi Gopalakrishnan]], M.B.B.S. | |||
==Overview== | ==Overview== | ||
| Line 26: | Line 12: | ||
*People with mild anemia may have no symptoms, or symptoms may be very mild. | *People with mild anemia may have no symptoms, or symptoms may be very mild. | ||
*More | *More typical symptoms of vitamin B12 deficiency anemia include: | ||
:*[[Diarrhea]] or [[constipation]] | :*[[Diarrhea]] or [[constipation]] | ||
:*[[Fatigue]], lack of energy, or [[light-headedness]] when standing up or with exertion | :*[[Fatigue]], lack of energy, or [[light-headedness]] when standing up or with exertion | ||
| Line 35: | Line 21: | ||
:*Swollen, red tongue or bleeding gums | :*Swollen, red tongue or bleeding gums | ||
*Symptoms from nerve damage caused by vitamin B12 deficiency that has been present for a | *Symptoms from nerve damage caused by vitamin B12 deficiency that has been present for a longer time include: | ||
:*Confusion or change in mental status (dementia) in severe cases | :*Confusion or change in mental status ([[dementia]]) in severe cases | ||
:*[[Depression]] | :*[[Depression]] | ||
:*Loss of balance | :*Loss of balance | ||
| Line 42: | Line 28: | ||
==What causes Vitamin B12 deficiency?== | ==What causes Vitamin B12 deficiency?== | ||
*Your body needs vitamin B12 to make red blood cells. In order to provide vitamin B12 to your cells: | *Your body needs vitamin B12 to make [[red blood cells]]. In order to provide vitamin B12 to your cells: | ||
:*You must eat enough foods that contain vitamin B12, such as meat, poultry, shellfish, eggs, and dairy products. | :*You must eat enough foods that contain vitamin B12, such as meat, poultry, shellfish, eggs, and dairy products. | ||
:*Your body must absorb enough vitamin B12. Your body uses a special protein, called intrinsic factor, released by cells in the stomach. The combination of vitamin B12 attached to intrinsic factor is absorbed in the last part of the small intestine. | :*Your body must absorb enough vitamin B12. Your body uses a special protein, called [[intrinsic factor]], released by cells in the stomach. The combination of vitamin B12 attached to intrinsic factor is absorbed in the last part of the [[small intestine]]. | ||
*A | *A lack of vitamin B12 in the diet may be due to: | ||
:*Eating a vegetarian diet | :*Eating a vegetarian diet | ||
:*Poor diet in infancy | :*Poor diet in infancy | ||
:*Poor nutrition during pregnancy | :*Poor nutrition during pregnancy | ||
*A number of problems can make it | *A number of problems can make it difficult for your body to absorb enough vitamin B12: | ||
:*Chronic alcoholism | :*Chronic [[alcoholism]] | ||
:*[[Crohn's disease]], [[celiac disease]], infection with the fish tapeworm, or other problems that make it difficult for your body to digest foods | :*[[Crohn's disease]], [[celiac disease]], infection with the fish tapeworm, or other problems that make it difficult for your body to digest foods | ||
:*[[Pernicious anemaia (patient information)|Pernicious anemia]], which occurs when your body destroys cells that make intrinsic factor. [[Intrinsic factor]] is needed to absorb vitamin B12. | :*[[Pernicious anemaia (patient information)|Pernicious anemia]], which occurs when your body destroys cells that make intrinsic factor. [[Intrinsic factor]] is needed to absorb vitamin B12. | ||
:*Surgeries that remove certain parts of your stomach or small intestine, such as some weight-loss surgeries | :*Surgeries that remove certain parts of your stomach or small intestine, such as some weight-loss surgeries | ||
:*Taking antacids and other heartburn medicines for a long period of time | :*Taking antacids and other [[heartburn]] medicines for a long period of time | ||
==Diagnosis== | ==Diagnosis== | ||
*A | *A physical exam may show problems with reflexes or a positive [[Babinski reflex]]. | ||
*The following | *The following tests may be done: | ||
:*Complete blood count | :*[[Complete blood count]] | ||
:*[[Reticulocyte count]] | :*[[Reticulocyte count]] | ||
:*Schilling test (if [[Pernicious anemia (patient information)|pernicious anemia]] is suspected) | :*[[Schilling test]] (if [[Pernicious anemia (patient information)|pernicious anemia]] is suspected) | ||
:*Serum LDH | :*Serum [[LDH]] | ||
:*Serum vitamin B12 level and serum folate levels | :*Serum vitamin B12 level and serum [[folate]] levels | ||
:*[[Esophagogastroduodenoscopy]] (EGD) to examine the stomach, or enteroscopy to examine the small intestine may be done. | :*[[Esophagogastroduodenoscopy]] (EGD) to examine the stomach, or [[enteroscopy]] to examine the [[small intestine]] may be done. | ||
:*[[Bone marrow biopsy]] is done only when the diagnosis is not clear. | :*[[Bone marrow biopsy]] is done only when the diagnosis is not clear. | ||
==When to seek urgent medical care?== | |||
Call your health care provider if you have any of the symptoms of [[Anemia (patient information)|anemia]]. | |||
==Treatment options== | ==Treatment options== | ||
*Treatment depends on the cause of B12 deficiency anemia. | *Treatment depends on the cause of B12 deficiency anemia. | ||
:*[[Pernicious anemia (patient information)|Pernicious anemia]] requires | :*[[Pernicious anemia (patient information)|Pernicious anemia]] requires lifelong vitamin B12 replacement, most often using injections. Some patients can get enough supplementation with high-dose tablets of oral vitamin B12. | ||
:*People with anemia due to a lack of dietary vitamin B12 may be told to take vitamin supplements and | :*People with anemia due to a lack of dietary vitamin B12 may be told to take vitamin supplements and follow a more balanced diet. Treatment may start with vitamin B12 injections. | ||
:*Anemia caused by poor digestion and absorption is treated with | :*Anemia caused by poor digestion and absorption is treated with vitamin B12 injections until the condition improves. These shots are given every day and then every week at first, and then every month. | ||
:*Many people may need these shots once a month for the rest of their life. The shots may no longer be needed after [[Crohn's disease]], [[celiac disease]], or alcoholism is properly treated. | :*Many people may need these shots once a month for the rest of their life. The shots may no longer be needed after [[Crohn's disease]], [[celiac disease]], or [[alcoholism]] is properly treated. | ||
==Where to find medical care for Vitamin B12 deficiency?== | ==Where to find medical care for Vitamin B12 deficiency?== | ||
| Line 90: | Line 76: | ||
==Prevention== | ==Prevention== | ||
*You can prevent anemia caused by a lack of vitamin B12 by following a well-balanced diet. | *You can prevent anemia caused by a lack of vitamin B12 by following a well-balanced diet. | ||
*Vitamin B12 injections can prevent anemia after surgeries known to cause vitamin B12 deficiency. | *Vitamin B12 injections can prevent [[anemia]] after surgeries known to cause vitamin B12 deficiency. | ||
*Early diagnosis and prompt treatment can limit the severity and complications of this anemia. | *Early diagnosis and prompt treatment can limit the severity and complications of this anemia. | ||
==What to expect (Outlook/Prognosis)?== | ==What to expect (Outlook/Prognosis)?== | ||
*Treatment for this form of anemia is usually effective. | *Treatment for this form of [[anemia]] is usually effective. | ||
*Any damage to nerves may be permanent, especially if treatment is not started within 6 months of when the symptoms begin. | *Any damage to the [[nerves]] may be permanent, especially if treatment is not started within 6 months of when the symptoms begin. | ||
==Possible complications== | ==Possible complications== | ||
Vitamin B12 affects cells that form the outer surface of the body and line inner passageways (epithelial cells). Therefore, | Vitamin B12 affects cells that form the outer surface of the body and line inner passageways (epithelial cells). Therefore, a lack of B12 may cause a falsely abnormal [[pap smear]]. | ||
== | ==Sources== | ||
http://www.nlm.nih.gov/medlineplus/ency/article/000574.htm | http://www.nlm.nih.gov/medlineplus/ency/article/000574.htm | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Patient information]] | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Hematology]] | |||
[[Category:Autoimmune diseases]] | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
Latest revision as of 00:41, 30 July 2020
For the WikiDoc page for this topic, click here
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Vitamin B12 deficiency |
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Vitamin B12 deficiency On the Web |
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Risk calculators and risk factors for Vitamin B12 deficiency |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Lakshmi Gopalakrishnan, M.B.B.S.
Overview
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.
Vitamin B12 deficiency anemia is a low red blood cell count due to a lack of vitamin B12.
What are the symptoms of Vitamin B12 deficiency?
- People with mild anemia may have no symptoms, or symptoms may be very mild.
- More typical symptoms of vitamin B12 deficiency anemia include:
- Diarrhea or constipation
- Fatigue, lack of energy, or light-headedness when standing up or with exertion
- Loss of appetite
- Pale skin
- Problems concentrating
- Shortness of breath, mostly during exercise
- Swollen, red tongue or bleeding gums
- Symptoms from nerve damage caused by vitamin B12 deficiency that has been present for a longer time include:
- Confusion or change in mental status (dementia) in severe cases
- Depression
- Loss of balance
- Numbness and tingling of hands and feet
What causes Vitamin B12 deficiency?
- Your body needs vitamin B12 to make red blood cells. In order to provide vitamin B12 to your cells:
- You must eat enough foods that contain vitamin B12, such as meat, poultry, shellfish, eggs, and dairy products.
- Your body must absorb enough vitamin B12. Your body uses a special protein, called intrinsic factor, released by cells in the stomach. The combination of vitamin B12 attached to intrinsic factor is absorbed in the last part of the small intestine.
- A lack of vitamin B12 in the diet may be due to:
- Eating a vegetarian diet
- Poor diet in infancy
- Poor nutrition during pregnancy
- A number of problems can make it difficult for your body to absorb enough vitamin B12:
- Chronic alcoholism
- Crohn's disease, celiac disease, infection with the fish tapeworm, or other problems that make it difficult for your body to digest foods
- Pernicious anemia, which occurs when your body destroys cells that make intrinsic factor. Intrinsic factor is needed to absorb vitamin B12.
- Surgeries that remove certain parts of your stomach or small intestine, such as some weight-loss surgeries
- Taking antacids and other heartburn medicines for a long period of time
Diagnosis
- A physical exam may show problems with reflexes or a positive Babinski reflex.
- The following tests may be done:
- Complete blood count
- Reticulocyte count
- Schilling test (if pernicious anemia is suspected)
- Serum LDH
- Serum vitamin B12 level and serum folate levels
- Esophagogastroduodenoscopy (EGD) to examine the stomach, or enteroscopy to examine the small intestine may be done.
- Bone marrow biopsy is done only when the diagnosis is not clear.
When to seek urgent medical care?
Call your health care provider if you have any of the symptoms of anemia.
Treatment options
- Treatment depends on the cause of B12 deficiency anemia.
- Pernicious anemia requires lifelong vitamin B12 replacement, most often using injections. Some patients can get enough supplementation with high-dose tablets of oral vitamin B12.
- People with anemia due to a lack of dietary vitamin B12 may be told to take vitamin supplements and follow a more balanced diet. Treatment may start with vitamin B12 injections.
- Anemia caused by poor digestion and absorption is treated with vitamin B12 injections until the condition improves. These shots are given every day and then every week at first, and then every month.
- Many people may need these shots once a month for the rest of their life. The shots may no longer be needed after Crohn's disease, celiac disease, or alcoholism is properly treated.
Where to find medical care for Vitamin B12 deficiency?
Directions to Hospitals Treating Vitamin B12 deficiency
Prevention
- You can prevent anemia caused by a lack of vitamin B12 by following a well-balanced diet.
- Vitamin B12 injections can prevent anemia after surgeries known to cause vitamin B12 deficiency.
- Early diagnosis and prompt treatment can limit the severity and complications of this anemia.
What to expect (Outlook/Prognosis)?
- Treatment for this form of anemia is usually effective.
- Any damage to the nerves may be permanent, especially if treatment is not started within 6 months of when the symptoms begin.
Possible complications
Vitamin B12 affects cells that form the outer surface of the body and line inner passageways (epithelial cells). Therefore, a lack of B12 may cause a falsely abnormal pap smear.
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/000574.htm Template:WH Template:WS