Feeling dizzy? Forgetting things too often? Experts warn that the often overlooked Vitamin B12 deficiency has major consequences.Other Signs -Blurry vision-Forgetfulness-Wobbly or dizzy feeling-Sadness or anxiety-Tongue is smooth and red-Pale skin.
When the two bothers Aftab and Ansari (names changed) walked into Dr Nupur Krishnan's clinic at Cuffe Parade with a view to finding a weight loss solution,little did they know that their wobbly gait had to do with the fact that they were Vitamin B12 deficient.A simple lab test confirmed the doctor's suspicion.Hitherto, the family had always blamed it on their weight.Aftab,a 36 year old business man and his 32 year old sibling Anas reported that all their meals included either fish,meat,poultry or egg.since B12 is adequately found in these foods,it was hard to connect the dots.
"There were other signs too,"explains Dr Krishnan,listing,"Lethargy,lack of energy,shortness of breath,and a feeling of nervousness,"as some."We usually associate these with weight gain,however,it is important to investigate the root cause," she says.
According to a case report from Harvard-affiliated Massachusetts General Hospital published in The New England Journel of Medicine,a severe Vitamin B12 deficiency can lead to deep depression,paranoia and delusions,memory loss,incontinence,diminished taste and smell and a host of other problems.Senior consultant physician Dr.Sharat Kolke explains, "Vitamin B12 also known as Cobalamin is an essential ingredient for DNA synthesis,and hence any rapidly growing cell in the body,such as the red blood cells,the nerve cells,the cells lining the intestines or the cells of our skin need B12 for regeneration and growth.It is also required for the proper functioning of our immune system.Although Vitamin B12 is not manufactured in the body,there are sufficient stores in the liver,these would last for about five years,so when deficiency occurs,it is insidious and not noticed easily."
Spot the Signs
Dr Kolke tells us about a 35 year old patient who had "generalised weakness and dark discoloration of the hands,especially over the knuckles,this was so obvious,she tried to cover her hands most of the times."Tests confirmed that her B12 levels were alarmingly low.Since B12 is necessary for the production of red blood cells and for nerves and skin regeneration,its deficiency manifests as anaemia.This is characterised by fatigue, tiredness and lethargy and a spectrum of neurological manifestations ranging from personality changes to peripheral nerve involvement (this can give rise to tingling and numbness in the feet and hands).Skin changes like dryness and hyperpigmentation is also not uncommon.Even the oral mucosal hyperpigmentation is seen as a part of B12 deficiency,"he explains.
In the long run,it can lead to a host of neurological manifestations ranging from behavioural changes changes like forgetfulness,mood disorders,depression and gait abnormalities,leading to repeated falls.
Studies from various parts of India conducted by medical institutions like Apollo Hospital over the past several years have shown that a large percentage of the population suffer from Vitamin B12 deficiency,and that it's most prevalent in pure vegetarians."In fact Vitamin B12 deficiency is also associated with the use of drugs like antibiotics,antidiabetics like metformin and antacids.Smoking and alcohol consumption combined with poor nutritional intake also contributes to the condition.That should explain why many non-vegetarians too fall in to the 'deficient' bracket.Also,with age,the body's ability to absorb Vitamin B12 from food slows down.
B12 and Pregnancy
It is imperative to diagnose Vitamin B12 deficiency in pregnancy and treat it accordingly as it can have an adverse effect on the growing foetus."It can lead to neurological abnormalities and low birth weight for babies,which can have serious implications for the newborn in the long term,"warns Dr Kolke.
Vegan woes
While non-vegetarian fare includes many sources of the vitamin (seafood,eggs,meat,liver and kidney),for those who eat only vegetarian food,there no pure plant-based source of B12 ."Milk,cheese,and some forms of yeast are the only source,if they can be termed 'Pure Vegetarian'.For vegans,who do not even consume milk,a solution is not as simple.They would need to consume vitamin B12 fortified foods,or they may make up for their deficiency in this essential nutrient by taking additional nutritional supplements," suggests Dr.Kolke
Dr Krishnan recommends adding soybean,hydroponic lettuce,mushrooms,whey powder and seaweed (nori) to your diet."While these don't contain high amount of vitamin B12,It's better than nothing.And once you cross the age of 45,you must have vitamin B12 supplements and/or fortified foods,because absorption gets impaired with aging".
According to Dr Nupur Krishnan -A wobbly gait,lethargy,shortness of breath,and a feeling of nervousness are all signs of a B12 deficiency.