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Dr.rania:what is the cause of be 12 defficiency ? I had last year a test blood and diagnosed below the level so I did a b12shot.knowing that I eat protein very day.last test was 5 months ago &was good
19 أغسطس 2014
Blood is made up of a fluid called plasma which contains:Red blood cells -.White blood cells-Platelets -
A constant new supply of red blood cells is needed to replace old cells that break down.
Red blood cells contain a chemical called haemoglobin . Haemoglobin binds to oxygen and takes oxygen from the lungs to all parts of the body
>>To make red blood cells and haemoglobin constantly you need a healthy bone marrow and nutrients such as iron and certain vitamins, including vitamin B12, which we get from food.
Symptoms includes symptoms due to anaemia like tiredness, lethargy, feeling faint, becoming breathless and less common symptoms include headaches, a thumping heart (palpitations), altered taste, loss of appetite, and ringing in the ears (tinnitus).You may look pale.
>And other symptoms that may occur include a sore mouth and tongue.
If left untreated, problems with nerves and psychological problems can develop.
>Psychological problems may include depression, confusion, difficulty with memory or even dementia.
>Nerve problems may include numbness, pins and needles, vision changes and unsteadiness.
CAUSES :
Normally, when you eat foods with vitamin B12, the vitamin combines with a protein called intrinsic factor in the stomach.
The combined vitamin B12/intrinsic factor is then absorbed into the body further down the gut at the end of the small intestine.
The issue is that Intrinsic factor is made by cells in the lining of the stomach and is needed for vitamin B12 to be absorbed.
THE FIRST COMMON CAUSE IS :
Pernicious anaemia is the most common cause of B12 deficiency It is classed as an autoimmune disease. If you have pernicious anaemia, antibodies are formed against your intrinsic factor, or against the cells in your stomach which make intrinsic factor.
This stops intrinsic factor from attaching to vitamin B12, and so the vitamin cannot be absorbed into your body. It is thought that something triggers the immune system to make antibodies against intrinsic factor. The trigger is not known.
>Pernicious anaemia usually develops in :
-people over the age of 50.
-Women more than menare
-run in families
-people who have other autoimmune diseases are more suspected For example, thyroid diseases, Addison's disease and vitiligo (a condition where white patches develop on skin).
>The antibodies which cause pernicious anaemia can be detected by a blood test to confirm the diagnosis.
SECOND CAUSE ARE :
>Stomach or gut problems
Various problems of the stomach or gut can be a cause of vitamin B12 deficiency. They are all uncommon causes. They include:
-Surgery to remove the stomach or the end of the small intestine and thus intrensic factor go This will mean absorption of vitamin B12 may not be possible.
-Some diseases that affect the end of the small intestine where vitamin B12 is absorbed may affect the absorption of the vitamin. For example, Crohn's disease.
-Some conditions of the stomach may affect the production of intrinsic factor which is needed to combine with vitamin B12 to be absorbed. For example, atrophic gastritis (where the lining of the stomach is thinned).
OTHER CAUSES ARE MEDICINES AND DIET :
>Certain medicines used for other conditions may affect the absorbtion of vitamin B12.
-The most common example is metformin which is a medicine often used for diabetes.
-Other medicines include colchicine, neomycin, and some anticonvulsants used to treat epilepsy.
Note: long-term use of medicines that affect stomach acid production, such as H2 blockers and proton pump inhibitors used for heartburn or stomach ulcer , can worsen vitamin B12 deficiency. This is because stomach acid is needed to release vitamin B12 bound to proteins in food. However, such medicines are not causes of vitamin B12 deficiency.
>Dietary causes
It is unusual to lack vitamin B12 if you eat a normal balanced diet. Strict vegans who take no animal or dairy produce may not eat enough vitamin B12.
Some foods are fortified with vitamin B12 - for example, some soy products, some breakfast cereals and some breads.
DIAGNOSE is based on blood test that measure Vitamin B12 in blood to know the cause then
further tests are then needed .
These further tests include blood tests for intrinsic factor antibodies and gastric parietal cell-antibodies. These blood tests help to find out whether you have pernicious anaemia.
THEREFORE ,try to know the cause if you see everytime in blood tests a lack of the vitamin ,and increase the foods rich in it with aproper diet such as :
fish, meats, and dairy products,Mackerel,Swiss Cheese,Liver ,Sardines,Steak,Fortified Soymilk,Salmon,Caviar,Parmesan Cheese, Chicken ,Fortified whole grain cereals are a great way to start a healthy day. Three-quarters of a cup of fortified cereal,milk,Low-Fat Butter,Crab meat ,Yeast extract spread (also called marmite),Tuna,Liverwurst Sausage,Fortified Tofu,Non-Fat Yogurt.
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