Vitamin B12 commonly known as Cobalamin is vital for the formation of red blood cells, as well as for the proper functioning of the nervous system. Vitamin B12 is a water soluble vitamin. Lack of sufficient amount of vitamin B12 in the body cause vitamin B12 deficiency which results in anaemia (pernicious anaemia) and irreversible nerve and brain damage.

Causes:

• Decreased dietary intake. Especially in vegans.
• Less absorption of vitamin B12
• Diabetes medications also interfere with less absorption of vitamin B12.

Sources:

Vitamin B12 is found naturally in a wide variety of animal foods and is added to some fortified foods. Plant foods have no vitamin B12 unless they are fortified. You can get recommended amounts of vitamin B12 by eating a variety of foods including the following:

• Beef liver is the best source of vit B12.
• Fish, meat, poultry, eggs, milk, and other dairy products, which also contain vitamin B12.
• Some breakfast cereals, nutritional yeasts and other food products that are fortified with vitamin B12.

Dietary requirement:

The amount of vitamin B12 you need each day depends on your age. Average daily recommended amounts for different ages are listed below in micrograms (mcg):

Life Stage                                           Recommended Amount

Birth to 6 months                                           0.4 mcg

Infants 7–12 months                                     0.5 mcg

Children 1–3 years                                          0.9 mcg

Children 4–8 years                                         1.2 mcg

Children 9–13 years                                       1.8 mcg

Teens 14–18 years                                         2.4 mcg

Adults                                                                 2.4 mcg

Pregnant teens and women                          2.6 mcg

Breastfeeding teens and women                 2.8 mcg

Symptoms:

• Fatigue
• Headache
• Dizziness
• Nausea
• Vomiting
• Constipation
• Diarrhea
• Confusion
• Irritability
• Menstrual cycle disturbance
• Weight loss
• Palpitation
• Heartburn
• Numbness and tingling of the fingers of hands/feet.
• Muscular weakness
• Chest pain
• Shortness of breath
• Pale skin

Investigations:

• Blood test with red blood cell count
• RBC morphology
• Bone intrinsic factor antibody levels
• Bone marrow biopsy.

Deficiency:

• Pernicious anaemia, which makes it hard for your body to absorb vitamin B12.
• Hair loss.
• Vitamin B12 and your nervous system
  Vitamin B12 is one of the most important nutrients for your nerve cells– it plays an instrumental role in protecting and maintaining your nervous system impulses.
  Each nerve cell is protected by a fatty layer called myelin that insulates and allows for quick and efficient communication throughout the many other neurones of your brain and spinal cord.
  Demyelinating diseases such as pernicious (megaloblastic) anaemia and multiple sclerosis destroy the myelin of your nervous system, wearing it down to a thin layer, causing nervous reactions to slow down and malfunction.
  Physical damage caused by vitamin B12 deficiency
  Neuropathy, nerve cell impairment, is one of the first symptoms of vitamin B12 deficiency and unless treated, worsens with time, causing severe and permanent nerve damage affecting your physical health.
• Physical impairments caused by vitamin B12 deficiency include:

• Slower reflexes
• Impaired perception of vibrations
• Altered taste perception
• Ataxia- difficulty controlling posture and movement.
• Gait impairment- difficulty walking smoothly without stumbling
• Muscular weakness
• Poor bladder control
• Burning mouth syndrome- tingling and painful burning sensations in your mouth tongue and lips.
• Impaired vision
• Eye twitching
• Impotence
• Increased risk of miscarriage and stillborn births

• Conditions that affect your small intestines, such as Crohn’s disease, celiac disease, bacterial growth, or a parasite
• Immune system disorders, such as Graves’ disease or lupus

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