Vitamin B12 Deficiency--A Devastating Disease You Can Prevent

Incredibly, many people today don't know how serious a vitamin B12 deficiency can be, assuming they've even heard about the ailment--i.e., "hypocobalaminemia." Well, not only should you know that it's a serious condition but that, more importantly, it's a lot more common than some people may think.

People who suffer from hypocobalaminemia can succumb to a number of different symptoms, at first mild but, if not caught and treated within a reasonable time, possibly escalating to very serious, irreversible damage to the brain, the nervous system, and to other parts of the body.  In fact, some of the symptoms/repercussions of a B12 deficiency include:

  • Mania
  • Psychosis
  • Memory loss
  • Fatigue
  • Irritability
  • Ataxia (impaired muscular control)
  • Depression
  • Personality changes/disorders
  • Apathy
  • Anorexia
  • Developmental regression & difficulty thriving (in infants)
  • Dizziness & lightheadedness
  • Tachycardia (rapid heart rate) & palpitations
  • Dyspnea (shortness of breath)
  • A painful, sore, reddish ("beefy" appearance) tongue
  • Poor appetite
  • Nausea
  • Weight loss
  • Diarrhea
  • Yellowish hue to the skin & the eyes
  • Walking difficulties
  • Muscle weakness
  • Dementia
  • Tinnitus (though the connection, if any, isn't yet fully understood/established)

One of the most important symptoms, however, is a tingling/numbness in the feet and hands; this symptom may be one of the symptoms first noticed and one which, unlike some of the other symptoms listed, applies to most (if not all) cases. 

Because this disease can be so devastating (especially if not caught early enough or treated appropriately), it's in your best interest to be on the lookout for it.  In fact, you may be suffering from a vitamin B12 condition and not be aware of it for a long time. 

As is the case for most other chronic conditions, your best strategy for dealing with a B12 deficiency is by preventing or taking aggressive measures to reduce the chances of ever acquiring the disease.  This is best accomplished by knowing what promotes/causes the condition--the 15 most likely scenarios being:

1.  Insufficient or inadequate consumption/absorption of B12.  People, for example, who don't eat sufficient quantities of dairy products, meats, seafood, eggs, some forms of algae, and other good sources of B12 may succumb to the condition.  This can include nutritionally-deprived individuals, children, vegans/vegetarians, children (who may need highest amounts of B12 on a more regular basis), etc. 

It should be noted, though, that even people who consume these foods on a regular basis can succumb to the ailment. 

2.  Partially-impaired B12 intake situations/conditions.  These can include chronic atrophic gastritis (often as a result of damaged gastric parietal cells), pernicious anemia, general stomach resections, and hereditary synthesis of intrinsic factor impairment. 

3.  Maldigestion/malabsorption syndrome leading to B12 absorption impairment.  This would involve any damage or surgical re-structuring of the terminal ileum, where B12 is mostly absorbed.

4.  Naturally or medically-induced forms of achlorhydria--i.e., reduced or absence of hydrochloric acid in the digestive system.  Medications such as histamine 2 receptor antagonists and proton pump inhibitors can inhibit production of hydrochloric acid, thus preventing the splitting of (and, therefore, proper absorption of) B12 from food proteins. 

Ironically, achlorhydria shouldn't interfere with nutritional supplements since the B12 therein is generally unbound. 

5.  Small bowel removal.  This can be seen in surgery-necessary cases of Crohn's disease leading to B12 absorption inability/difficulty.

6.  Extensive, uninterrupted use of ranitidine hydrochloride (Zantac).

7.  Celiac disease not treated properly or at the early stages, especially in cases involving small bowel mucosa.  It should be noted that a gluten-free diet may not, by itself, remove or ameliorate the deficiency, unless supplementation is utilized.

8.  Certain bariatric surgical procedures.  This is especially true for stomach-section-removal procedures, including gastric bypass surgeries.  Then again, "adjustable gastric band" surgeries may not affect B12 as much, if at all.

9.  Over-growth of bacteria in the small bowel.  Such imbalance of microorganisms can impair the amount of B12 the body ultimately absorbs.  This might be treated/prevented with the use of probiotics, preferably under the supervision of a physician.

10.  The medication "Metformin"--most commonly used for diabetics. 

11.  Hereditary diseases like MTHFR, transcobalamin, and homocystinuria (causing) deficiencies.

12.  Giardiasis--but this correlation is still only speculative

13.  Alcoholism-induced malnutrition.

14.  Abuse, misuse or overused of nitrous oxide.

15.  Diphyllobothrium latum tapeworm infections.


Although you shouldn't go around wondering what diseases you may be struck with at any time, you need to be aware of common ailments that you can easily prevent simply by being vigilant, responsible, proactive and well-informed.  Because vitamin B12 deficiencies are so common and so potentially devastating, it's the kind of a thing that you should at the very least be aware of.

The fact of the matter is that hypocobalaminemia is exceedingly preventable, in most cases.  By knowing the causes, you can take action to protect yourself, especially if any of the above situations/conditions apply or will apply to you.  Such "action" should include being tested periodically for a B12 deficiency. 

Even if you aren't experiencing any of these symptoms/situations, it's probably not a bad idea to be tested, especially if your are over 45 years old, have had or will have surgeries involving your digestive system, or have used (or are planning to use) any of the medications/treatments herein.

As a matter of fact, consider having micronutrient tests as part of your yearly physiological well-being assessment routine.  Vitamin B12 is only one of a long list of crucially-important nutrients many people these days may be deficient of.

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6/6/2017 7:00:00 AM
Fred Fletcher
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Fred Fletcher is a hard working Consumer Advocacy Health Reporter. Education: HT-CNA; DT-ATA; MS/PhD Post-Graduate Certificates/Certifications: • Project Management • Food Safety • HIPAA Compliance • Bio-statistical Analysis & Reporting • Regulatory Medical Writing • Life Science Programs Theses & Dis...
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Many people have been misdiagnosed with MS and other debilitating diseases when, in fact, they were really suffering from hypocobalaminemia. What a shame! Like you point out, Fred, so-called modern medicine grossly underestimates how devastating micronutrient deficiencies can be.
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