What Is Hepatitis C? Vitamin B12 Deficiency Anemia - Topic Overview What is vitamin B12 deficiency anemia? Having vitamin B12 deficiency means that your body does not have enough of this vitamin. You need B12 to make red blood cells , which carry oxygen through your body. Not having enough B12 can lead to anemia, which means your body does not have enough red blood cells to do the job. This can make you feel weak and tired. Vitamin B12 deficiency can cause damage to your nerves and can affect memory and thinking. What causes vitamin B12 deficiency anemia? Most people get more than enough B12 from eating meat, eggs, milk, and cheese. Normally, the vitamin is absorbed by your digestive system-your stomach and intestines. Vitamin B12 deficiency anemia usually happens when the digestive system is not able to absorb the vitamin. This can happen if: You have pernicious anemia. In this anemia, your body destroys the cells in your stomach that help you absorb vitamin B12.
You have had surgery to remove part of the stomach or the last part of your small intestine, called the ileum . This includes some types of surgery used to help very overweight people lose weight. You have problems with the way your body digests food, such as sprue (also called celiac disease), Crohn's disease, bacteria growth in the small intestine, or a parasite. This anemia can also happen if you don't eat enough foods with B12, but this is rare. People who eat a vegan diet and older adults who don't eat a variety of foods may need to take a daily vitamin pill to get enough B12. Other causes include drinking alcohol and taking some prescription and nonprescription medicines. What is the recommended daily amount of vitamin B12? The amount of vitamin B12 you need depends on your age. Daily amount of B12 (micrograms) What foods contain B12? Vitamin B12 is found in foods from animals, such as meat, seafood, milk products, poultry, and eggs. It is not in foods from plants unless it has been added to the food (fortified).
Some foods, like cereals, are fortified with vitamin B12. Supplements containing only B12, or B12 along with other B vitamins and/or folate, are readily available. Also, B12 is usually in multivitamins. Check the label to find out how much B12 is in a supplement. Estimates of B12 in certain foods Cereal fortified with 100% daily value for B12 What are the symptoms? If your vitamin B12 deficiency is mild, you may not have symptoms or you may not notice them. Some people may think they are just the result of growing older. As the anemia gets worse, you may: Feel weak, tired, and lightheaded. Have a sore, red tongue or bleeding gums. Feel sick to your stomach and lose weight. Have diarrhea or constipation. If the level of vitamin B12 stays low for a long time, it can damage your nerve cells. If this happens, you may have: Numbness or tingling in your fingers and toes. A poor sense of balance. Dementia, a loss of mental abilities.
How is vitamin B12 deficiency anemia diagnosed? Your doctor will examine you and ask questions about your past health and how you are feeling now. You will also have blood tests to check the number of red blood cells and to see if your body has enough vitamin B12. The level of folic acid, another B vitamin, will be checked too. Some people whose vitamin B12 levels are too low also have low levels of folic acid. The two problems can cause similar symptoms. But they are treated differently. How is it treated? Vitamin B12 deficiency anemia is treated with supplements of vitamin B12. Taking supplements brings your level of vitamin B12 back to normal, so you do not have symptoms. To keep your level of vitamin B12 normal, you will probably need to take supplements for the rest of your life. If you stop taking them, you'll get anemia again. Your vitamin B12 supplements might be pills or shots. If you use shots, you can learn to give them to yourself at home. For many people, pills work just as well as shots.
They also cost less and are easier to take. If you have been getting shots, ask your doctor if you can switch to pills. Another form of treatment is a vitamin B12 nasal spray (such as Nascobal). You can take steps at home to improve your health by eating a varied diet that includes meat, milk, cheese, and eggs, which are good sources of vitamin B12. Also, eat plenty of foods that contain folic acid, another type of B vitamin. These include leafy green vegetables, citrus fruits, and fortified breads and cereals. Can vitamin B12 deficiency anemia be prevented? Most people can prevent this anemia by including animal products like milk, cheese, and eggs in their diets. People who follow a vegan diet can prevent it by taking a daily vitamin pill or by eating foods that have been fortified with B12. Babies born to women who eat a vegan diet should be checked by a doctor to see whether they need extra vitamin B12. If you have a high risk of getting this type of anemia, your doctor can give you vitamin B12 shots or pills to prevent it.
Vitamin B12 deficiency anemia Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia.Vitamin B12 deficiency anemia is a low red blood cell count due to a lack (deficiency) of vitamin B12.Your body needs vitamin B12 to make red blood cells. In order to provide vitamin B12 to your cells:You must eat plenty of foods that contain vitamin B12, such as meat, poultry, shellfish, eggs, and dairy products.Your body must absorb enough vitamin B12. A special protein, called intrinsic factor, helps your body do this. This protein is released by cells in the stomach. A lack of vitamin B12 may be due to dietary factors, including:Eating a poorly planned vegetarian dietPoor diet in infantsPoor nutrition during pregnancy Certain health conditions can make it difficult for your body to absorb enough vitamin B12. They include:Chronic alcoholismCrohn disease, celiac disease, infection with the fish tapeworm, or other problems that make it difficult for your body to digest foodsPernicious anemia, a type of vitamin B12 anemia that occurs when your body destroys cells that make intrinsic factorSurgery that removes certain parts of your stomach or small intestine, such as some weight-loss surgeriesTaking antacids and other heartburn medicines for a long period of time You may not have symptoms.
Symptoms may be mild. Diarrhea or constipationFatigue, lack of energy, or lightheadedness when standing up or with exertionLoss of appetitePale skinProblems concentratingShortness of breath, mostly during exerciseSwollen, red tongue or bleeding gums If you have low vitamin B12 level for a long time, you can have nerve damage. Symptoms of nerve damage include: Confusion or change in mental status (dementia) in severe casesDepressionLoss of balanceNumbness and tingling of hands and feet The health care provider will perform a physical exam. This may reveal problems with your reflexes. Tests that may be done include: Complete blood count (CBC)Reticulocyte countLactate dehydrogenase (LDH) levelVitamin B12 levelMethylmalonic acid (MMA) levelOther procedures that may be done include:Esophagogastroduodenoscopy (EGD) to examine the stomachEnteroscopy to examine the small intestineBone marrow biopsy if the diagnosis is not clearTreatment depends on the cause of B12 deficiency anemia. The goal of treatment is to increase your vitamin B12 level.
Treatment may include a shot of vitamin B12 once a month. If you have a very low level of B12, you may need more shots in the beginning. It is possible you may need shots every month for the rest of your life. Some people may also need to take vitamin B12 supplements by mouth.Treatment may no longer be needed after Crohn disease, celiac disease, or alcohol use is properly treated.Your provider will also recommend that you eat a variety of foods.People with this type of anemia often do well with treatment.Long-term vitamin B12 deficiency can cause nerve damage. This may be permanent if you do not start treatment within 6 months of when your symptoms begin.A woman with a low B12 level may have a false positive Pap smear. This is because vitamin B12 deficiency affects the way certain cells (epithelial cells) in the cervix look.Call your provider if you have any of the symptoms of anemia.You can prevent anemia caused by a lack of vitamin B12 by eating a well-balanced diet.Shots of vitamin B12 can prevent anemia after surgeries known to cause vitamin B12 deficiency.