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B12

What is B12

B12 is a B vitamin!

Symptoms of deficiency

At first...

Later stages

Causes of deficiency

  • Poor diet - especially vegans, since its found in eggs, meat and milk.
  • Coeliac disease, or Crohn's disease, since these inflammatory bowel disorders irritate the end of the ileum, where B12 is absorbed.
  • Terminal ileum resection (since this is where most of the absoprtion happens).
  • Autoimmune atrophic gastritis - this is one cause of pernicious anaemia, where the parietal cells in the stomach are killed off by the immune system. More common in Northern Europe. Leads to no intrinsic factor being released.
  • Taking the diabetes medication metformin can inhibit absorbtion of B12.
  • Parastitic infestation.

Management

Sort out the cause.

Give them some B12 tablets, or B12 injections. If you give 1mg of B12 orally a day, as opposed to normal diet intake of 5μg (about 500 times more), it doesn't matter if there's no intrinsic factor or ileum, enough still goes in.