In today’s time, almost everyone is turning towards a plant-based diet. Although it is healthy, it has a few downfalls if you do not take supplements for certain nutrients missing in a plant-based diet. One of these important nutrients is vitamin B12. Falling short of vitamin B12 can have a serious impact on your health

What is vitamin B12?

Vitamin B12 is an essential vitamin for the human body. It is a micronutrient which means your body requires it in small amounts. It is naturally found in animal foods. Vitamin B12 is required for red blood cell formation, optimal functioning of brain and nerve cells, and maintenance of a healthy immune system.

It is also known as cobalamin and is a water-soluble vitamin. This means it can dissolve in water and travel into the bloodstream. Any excess vitamin B12 is excreted in the urine.

Your body can store vitamin B12 for several years in the liver, so a deficiency of this vitamin is usually rare. However, if you are a vegetarian, you might become deficient because plant foods do not contain vitamin B12. To prevent that, you need to take vitamin B12 from supplements.

Where can you get vitamin B12 from?

Vitamin B12 is naturally found in animal foods. Good dietary sources of vitamin B12 include:

  • Poultry
  • Red meat
  • Eggs
  • Dairy products like milk, cheese, yogurt
  • Fish
  • Fortified breakfast cereals
  • Fortified nutritional yeast
  • Enriched soy milk

How much vitamin B12 do you need?

According to the National Institute of Health, the Recommended Dietary Allowance for men and women aged 14 years and above is 2.4 micrograms (mcg) daily.

For pregnant and lactating women, it is 2.6 mcg and 2.8 mcg daily, respectively.

Want to get your vitamin B12 level checked? Check here

What happens when you do not take an adequate amount of vitamin B12?

This leads to various deficiencies such as:

1. Anemia

When you do not take an adequate amount of vitamin B12, it leads to a type of anemia known as megaloblastic anemia. In this condition, the size of the red blood cells increases. As a result of this, the red blood cells are unable to move from bone marrow to the bloodstream. Consequently, you might face fatigue, weakness, pale skin, and shortness of breath.

2. Tingling sensation in hands and legs

Vitamin B12 plays a vital role in maintaining the covering of nerve cells, called the myelin sheath. It is the fatty material that surrounds and protects your nerves. When you are vitamin B12 deficient, your nerve cells cannot function properly. This eventually might alter the way you move. It can affect your body balance and make you more likely to fall.

3. Brain fog

Your memory can become hazy. You can find it difficult to concentrate.

4. Osteoporosis

Osteoporosis is a bone disease in which the bones become weak and may break from a fall. Vitamin B12 plays an important role in maintaining good bone health. Low levels might lead to low bone mineral density. This makes the bones delicate and fragile over time, leading to osteoporosis.

Some of the other symptoms of vitamin B12 deficiency are confusion, depressive symptoms, and vision loss. Some of the studies had stated that vitamin B12 deficiency could pose a risk of COVID-19 in older patients. However, these studies still remain to be peer-reviewed. Further validation research is required to claim the association of vitamin B12 deficiency and COVID-19.

Who can be at a risk of vitamin B12 deficiency?

  • People avoiding animal products

People who follow a strict plant-based diet are at risk of becoming deficient in vitamin B12 since it is found naturally in animal products.

  • Elderly people

Gastritis is a condition that affects elderly people the most. In this condition, the body becomes unable to absorb vitamin B12 that is naturally present in food.

  • People with certain digestive disorders

Certain digestive disorders like inflammatory bowel disease, Celiac, and Crohn’s disease reduces the body’s potential to absorb vitamin B12. Thus causing deficiency of vitamin B12.

  • People who had undergone gastrointestinal surgery

Weight loss surgeries or surgery to remove part of the stomach often interferes in the proper absorption of vitamin B 12 from the diet.

  • Pregnant and lactating women

Vitamin B12 can pass from mother to baby via breast milk. Mothers who exclusively breastfeed their baby and follow a plant-based diet might make their baby deficient of vitamin B12. Without enough vitamin B12, the baby might have growth and developmental delays.

  • People with chronic alcoholism

In this condition, the body becomes unable to absorb vitamin B12 efficiently from the diet.

How to overcome vitamin B12 deficiency?

You can take animal-based food and if you are a vegetarian you can take vitamin B12 fortified cereals. You can also take vitamin B12 supplements with doctor’s advice.

Are there any side-effects of vitamin B12?

Vitamin B12 is a water-soluble vitamin. After the body utilises the required amount of vitamin B12, leftover amount will pass through urine. Generally, there are no side-effects seen with excess vitamin B12 intake from food. However, it is always advisable to consult your doctor before starting a high dose of vitamin B12 supplements.

When do you need a vitamin B12 test?

If you think you might be vitamin B12 deficient, it is advisable to consult your doctor and get a blood test done. Vitamin B12 is like a regular blood test and you can get it done from any trustworthy laboratory.

The normal range is 211 – 911 pg/mL irrespective of sex and age.

Bottom line

Vitamin B12 is a water-soluble and essential vitamin. It is responsible for various health benefits like preventing anemia, supporting the nervous system, improving and maintaining healthy bones. You can get the required amount of vitamin B12 from your diet (animal food). However, if you follow a plant-based diet or have a condition that affects absorption, supplements are a simple way to increase your B12 intake.

Take care, stay healthy!

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Do you feel fatigued and energy draining out of you all the time. Does your child have difficulty concentrating? Or does she feel dizzy? Do you have leg cramps? Can’t fall asleep even if you are tired?

These are not symptoms of exhaustion or a long day at work/school but indicate a probable cause of Anaemia! Did you know that Anaemia is the most common condition that affects Indian women? Research done by Metropolis Healthcare indicates that 1 in 2 women in India are anaemic and that puts a large number of us under risk.

Also you would be surprised to know that there are over 400 different types of Anaemia. So adding a lot of spinach to your daily food may not help at all. While the most common reason for Anaemia is Iron Deficinecy, there are many other types of Anaemia and it is important to find out the exact cause.

Symptoms of anemia will vary depending on the type and cause, but include:

  • Fatigue and loss of energy
  • Unusually rapid heartbeat, particularly with exercise
  • Shortness of breath and headache, particularly with exercise
  • Difficulty concentrating
  • Dizziness
  • Pale skin
  • Leg cramps
  • Insomnia

Now let’s look at different types of Anaemia and Symptoms pertaining to each one of them

Type of AnaemiaSymptomsManagement
Anaemia caused by iron deficiency: Craving for paper, ice, or dirt/mud/chalk (a condition called pica) Soreness of the mouth with cracks at the corners A smooth or sore tongueWith iron deficiency anaemia your doctor may recommend iron supplements that contain the ferrous form of iron, which your body can absorb easily. Always consult with your doctor before taking iron supplements. Excess iron intake can be harmful.
Anaemia caused by vitamin B12 deficiency: A tingling, “pins and needles” sensation in the hands or feet.  Loss of sense of touch. An unsteady, wobbly gait and difficulty walking For vitamin B12 and folate deficiency anaemia, the treatment depends on the cause of the deficiency. If your body stores are depleted of vitamin B12, your doctor is most likely to prescribe vitamin B12 injections
Anaemia caused by chronic lead poisoning: Blue-black line on the gums referred to as a lead lineAbdominal pain, Constipation,  Vomiting, Seizures in severe cases, especially in childrenLead poisoning is treated by discontinuing exposure to lead and administering a medicine that binds and draws lead out of the body.
Anaemia caused by red blood cell destructionJaundice (yellow skin and eyes)Brown or red urine, Leg ulcersFailure to thrive in infancySymptoms of gallstones, Seizures, Abdominal painThe treatment of haemolytic anaemia may be tailored to the underlying cause. It is important to consider altering or stopping any medication or agent that is causing the condition.
Sickle cell anaemia: Fatigue, Susceptibility to infectionDelayed growth and development in children, Episodes of severe pain, especially in the joints, abdomen and limbsDoctors usually begin treatment that includes stimulation of a different type of hemoglobin which reduces the severity of the conditions

So lets look at some of most common tests used to screen for anaemia and diagnose the root cause:

Complete Blood Count

Often, the first test used to diagnose anemia is a complete blood count (CBC). The CBC measures many parts of your blood.The test checks your hemoglobin and hematocrit levels. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of haemoglobin indicates anaemia.

The CBC also gives information on mean corpuscular volum abbreviated as MCV. MCV is a measure of the average size of your red blood cells and a clue as to the cause of your anemia. In iron-deficiency anemia, for example, red blood cells usually are smaller than normal.

Other Tests and Procedures

If the CBC results show that you have anemia, you may need other tests, such as:

Hemoglobin electrophoresis: This test looks at the different types of hemoglobin in your blood. The test can help diagnose the type of anemia you have.

A reticulocyte count: This test measures the number of young red blood cells in your blood. The test shows whether your bone marrow is making red blood cells at the correct rate.

Tests for the level of iron in your blood and body: These tests include serum iron and serum ferritin tests. Transferrin level and total iron-binding capacity tests also measure iron levels.

To find out the exact cause of Anaemia, your doctor may recommend tests for conditions such as as kidney failure, lead poisoning (in children), and vitamin deficiencies (lack of vitamins, such as B12 and folic acid). In case a case of internal bleeding is suspected, then a stool test for blood is performed may be along with an endoscopy.

In rare cases, bone marrow tests are also performed to check if bone marrow is making healthy and enough blood cells.

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