Enigmatic Vitamin B12

If you are feeling fatigued, dull and low, you could well be suffering from low levels of Vitamin B12. These symptoms, often passed off as “psychological”, are increasingly finding a true organic basis in Vitamin B12 deficiency. Physicians are progressively becoming cautious not to overlook this modern-age deficit that can now be diagnosed quickly and easily by a simple blood test.

Several problems of nerves and spine, such as tingling of feet , loss of balance, alteration in gait, forgetfulness, drowsiness and dementia, especially in the elderly, are now being put down to Vitamin B12 deficiency, as are fluctuations in mood and even depression. Studies are showing that It may underlying frequent falls and fractures sustained by senior citizen.

Vitamin B12 is a water soluble vitamin that plays a crucial role in the normal functioning of the brain and nerves. Also called cobalamin, as it contains the rare element Cobalt, this water soluble vitamin is one of the 8 “B” vitamins essential for most cell functions. Due to its crucial role in formation of blood, its deficiency sets back division of red blood cells resulting in a type of anaemia characterized by larger but much fewer and less efficient red blood cells, aptly described as “megaloblastic”.

Interestingly, this vitamin is not produced by the human body butsolely by bacteria.Equally interestingly, unlike most other vitamins of the B and C groups that are present in abundance in fresh fruits and green vegetables, this vitamin is present only in animal proteins like meat, fish, milk and cheese. It is for this reason that vegans, a sect of vegetarians who do not consume animal products in any form, are often found to be B12 deficient despite the body’s low requirement of only 2-3 mcg per day.

Symptoms of Vitamin B12 deficiency are usually vague and non-specific, often overlapping with other disorders such as hypothyroidism, diabetes and Alzheimer’s disease, making it impossible for doctors to make the diagnosis on clinical grounds alone. Hence major hospitals and physicians have started testing for serum Vitamin B12 levels in patients with a wide range of symptoms and even in normal individuals coming for a health check. 

Some drugs can interfere with Vitamin B12 absorption. One common culprit is the anti-diabetic medication, metformin while another is the group of acid suppressant medications such as omeprazole and its other -zole sibs. Patients on long term therapy with these drugs should get their Vitamin B12 levels checked periodically.

Once the diagnosis is established, treatment is easy. The vitamin is best replenished by injection of 100 to 1000 mcg every 6 to 12 months. Weak and confused patients promptly brighten and spring back to life like freshly watered lilies.

And as I drag myself to work these days, grope for words when I write this column and scratch my head for the once familiar names, I know it is time for me to take the B12 test.

As published in HT City ( Hindustan Times) dated 3rd February, 2013.