Vitamin B12 deficiency may lead to major neurological problemsREAD MORE ON » Vitamin B12 | depression"B12 deficiency causes subacute combined degeneration of the spinal cord, which leads to destruction and can present as paralysis," Dr Sheela Chakravarthy said. Harini, a 39-year-old mother of two and a foodie, had been having a strange problem over the past few months. She would be waiting for her husband and kids to step out of the house so that she could get back to bed and rest. There was a constant feeling of depression and hopelessness. There seemed nothing interesting around her to make her spring back to normal life. Her husband, who noticed the changes, tried a few peptalk sessions, but nothing worked. An appointment with the family physician followed. The doctor had some questions for Harini: "Do you have any tingling sensation anywhere? How are your appetite and bowel movements?" Indeed, she had some numbness and tingling in her left arm and leg. She had lost her love for food and was definitely not eating like earlier.
Her bowel movements had also become erratic. The doctor asked for a few tests, which included one for her Vitamin B12 levels. When the reports came, he said: "What I had suspected... it is Vitamin B12 deficiency." He put her on a course of an oral supplement and advised her to return for a follow-up. Yes, Vitamin B12 deficiency, which can cause a host of symptoms or be completely asymptomatic, is more common among us than we think. And being deficient in it can be dangerous. "Vitamin B12 deficiency causes anaemia and subacute combined degeneration of the spinal cord, which leads to destruction and can present as paralysis. Deficiency may manifest with no symptoms to devastating paralysis and confusion, and memory defects, which may be prevented if diagnosed early," said Dr Sheela Chakravarthy, director-internal medicine, Fortis Hospital, Bengaluru. What should set the alarm bells ringing? "Early symptoms can include fatigue, depression and loss of memory, " said Dr P Vijayaraghavan, professor of medicine, Madras Medical College, and senior consultant physician, St Isabel's Hospital, Chennai.
The nervous system may also be trying to tell something. Added Dr Manohar KN, consultant physician & diabetologist, Manipal Hospital, Bengaluru: "The symptoms range from affecting the general condition of the body (malaise, fatigue, listlessness, oral ulcers), involvement of the nervous system (pins and needles feeling, altered sensations like numbness, dizziness, diminished vision, depression and rarely psychosis) and also anaemia." While almost anybody can develop Vitamin B12 deficiency, vegetarians, and more so vegans, are at particular risk. "The deficiency is commonly found in vegetarians because the source of the vitamin is mainly animal origin," said Chakravarthy. Plants do not make Vitamin B12. For some individuals, absorption could be an issue. "Pernicious anaemia is an autoimmune condition where B12 absorption is absent. Taking long-term metformin for diabetes and anti-ulcer drugs like omeprazole can result in B12 deficiency," said Vijayaraghavan. "Oral or injection preparations can effectively treat such conditions."
According to Manohar, "Another important cause (for deficiency) is defective absorption, as seen in atrophic gastritis". "Gastrectomy or removal of stomach for whatever reason may affect patients. Such people need longterm treatment. Absorption of the vitamin at the ileum (the terminal portion of the small intestine) can be blocked due to diseases of the ileum like tuberculosis or Crohn's disease," said Chakravarthy. Once we wake up to the problem of Vitamin B12 deficiency, the solution is only an arm's length away. "Avoid being a vegan. At least milk and milk products should be taken. Taking B12 supplement can prevent symptoms," said Vijayaraghavan. "Taking adequate milk and milk products is enough for vegetarians." "Intramuscular or intravenous injection is the best method to initiate treatment. If there is no absorption defect, even oral supplements should be good enough to replenish the deficiency. Care should be taken to advise (the patient) on the diet and treatment of other underlying causes, including diseases of the gastrointestinal tract and worm infestations or bacterial overgrowth in some cases," said Manohar.
"Vitamin B12 is found in most animal-derived foods, including fish, meat (especially liver), poultry, eggs, milk and milk products. Food fortification could be a very good suggestion in countries like ours where we have a significant number of vegetarians. Avoiding alcohol is an important step to improve blood levels," he added. Want stories like this in your inbox? Sign up for the weekly ET Panache newsletter. You can also follow us on Facebook and Twitter.As the Global Leader in Prescription Drug Savings, Canada Drugs believes in going the extra mile to provide even better value to our customers when they order discount Vitamin B12 Injection from our online pharmacy. A key to providing Canada Drugs customers with the greatest discounts on their online prescription Vitamin B12 Injection orders is our policy of free Standard Shipping worldwide. Not only do we stand by all of our products like Vitamin B12 Injection with an unmatched No-Risk Guarantee, but unlike our competitors we don't promise low cost prescription medication online and than add in a variety of hidden shipping and delivery fees.
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Vitamin A (Retinol palmitate) Vitamin B Complex (multiple ingredients) Vitamin C (Ascorbic acid) Vitamin B6 ampoule 50 mg/ml 2 ml # 10132 PB(10,20) Vitamin B6 filmtabl 25 mg x 20 # 10133 PB(10,20) Код АТХ: A11HA 2 One ampoule of 2 ml contains 100 mg pyridoxine hydrochloride (50 mg/ml). One filmtablet contains 25 mg pyridoxine hydrochloride. Vitamin B6 deficiency in: sideroblastic anemia, drug-induced seborrheic dermatitis; in complex therapy of malabsorption syndrome, renal hemodialysis and after gastrectomy, chronic alcoholism, burns, metabolic dysfunctions, hyperthyroidism, glutenic enteropathy and regional enteritis. Ampoules are used intramuscularly or intravenously. In adults: at doses of 50-200 mg daily; in children: at doses of 10 to 100 mg daily. In vitamin B6 deficiency: i.m. and i.v. at doses of 50-200 mg daily, the course of treatment being 3- 4 weeks. Tablets are taken orally and the adult dose is 50-100 mg daily, and the dose in children is 25–50 mg daily.