VITAMIN B12: WHAT IS IT
Vitamin B12, sometimes referred to as cobalamin, is used by our bodies in the production of DNA which is the genetic material found in all of our cells. It is also essential for healthy nerves and red blood cells.
We get vitamin B12 from animal products that we eat. Some of the more common sources are fish, eggs, poultry, meat and milk products. For vegetarians fortified breakfast cereals are an excellent source. B12 is bound to the proteins in the foods that we eat and is released by hydrochloric acid during the digestive process. Once released it will now combine with a substance called intrinsic factor (IF) which is easily absorbed in our intestinal tract.
WHO MAY BE B12 DEFICIENT
Most people in the United States get their recommended daily requirement of B12 from the foods that they consume. The body normally stores several years of supply. In a person that has an absorption problem and those who follow a strict vegetarian diet and do not eat any meat products B12 deficiencies may develop. The majority of people with this deficiency are those with underlying stomach or intestinal problems. Symptoms can be very subtle and start with reduced cognitive function followed by anemia and dementia. These symptoms are very general in nature and can be the result of many other medical conditions. If you or someone you know are having these symptoms it is important to be evaluated by a medical professional who can prescribe the proper treatment plan.
PREGNANCY AND VITAMIN B12
Nutrients are transferred from the mother to the fetus through the placenta during pregnancy. Vitamin B12 is one of these nutrients that are transferred at this time. This is also one of the nutrients infants receive from their mothers during breast feeding. Deficiencies of this vitamin are rare in infants but can occur when the mother herself is deficient and does not have the proper reserves. One example of this is when the mother is a strict vegetarian and has an inadequate supply of B12 to pass on to their infant. In cases like this a deficiency of B12 can develop in a matter of months after birth. This is something to be concerned about because if a deficiency goes undetected and untreated in an infant it can lead to neurological damage. Unfortunately this damage is often severe and irreversible. In light of this it is suggested that mothers who follow a strict vegetarian diet consult with their pediatricians about B12 supplementation for their infants and children. They may also want to speak with their own primary care provider about their own B12 requirements.
WHO ELSE MAY BE AT RISK OF B12 DEFICIENCY?
Hemoglobin in red blood cells carries oxygen to our tissues and cells. Anemia is a condition in which or red blood cells have an insufficient amount of hemoglobin to do this. Symptoms of an anemia can be weakness and fatigue. Anemia can cause a variety of medical problems such as deficiencies in vitamin B12, vitamin B6, folate and iron. Pernicious anemia is a name given more than a century ago to a then fatal form of anemia caused by gastric atrophy. This condition prevents gastric cells from secreting intrinsic factor (IF). As we know B12 must combine with IF to be absorbed into the system. The solution to this problem is usually an injection of B12 to get levels to where they should be followed by supplementation to maintain them. Your doctor should always monitor this treatment.
If you have gastrointestinal disorders you could be B12 deficient due to reduced ability to absorb nutrients. Some common conditions that may cause this are Cohn’s Disease and celiac disease. Also people that have undergone gastrointestinal surgery such as removal of part of the stomach may result in the loss of cells responsible for the manufacture of IF.
Atrophic gastritis is a condition in which one has increased intestinal bacteria. It is estimated that about 30% of people over 50 years of age have this. There are two effects from this, first it decreases the amount of gastric juices produced and secondly this increased bacteria actually compete for the available amount of B12. This causes the normal absorption process to be hindered. People with this condition are able to absorb synthetic B12 such as those found in fortified foods and supplements. These two sources of B12 are believed to be the best for people over 50 years of age.