Who is at Risk of Vitamin B12 Deficiency

WHAT IS VITAMIN B12

Vitamin B12 is essential to healthy nerve and red blood cells. It is also used in the production of DNA which is the genetic material found in all of our cells. It is also goes by the name of cobalamin because it contains the metal cobalt.
Vitamin B12 is bound to the proteins in the foods that we eat. It is found in foods that come from animals. Some common sources are meat, fish, poultry, eggs, milk and milk products. If you are a vegetarian fortified breakfast cereals can be an excellent source of B12. Hydrochloric acid releases vitamin B12 from proteins during the digestive process. It then combines with a substance called intrinsic factor (IF), it is this complex that is able to be absorbed by the intestinal tract.

B12 DEFICIENCY

The body stores several years supply of B12. It has been found that most children and adults in the United States consume the recommended daily requirement in the foods that they eat. A deficiency may develop due to an inability to absorb B12 from food or if you are a strict vegetarian that does not consume any animal products. For the most part individuals that have a B12 deficiency also have an underlining stomach or intestinal disorder that limits the absorption of the vitamin. Sometimes the symptoms of these disorders are very subtle and start with reduced cognitive function followed by anemia and dementia. These symptoms are very general in nature and can be caused by a variety of other medical conditions. You should always have a medical professional evaluate these symptoms and prescribe the appropriate medical care.

VITAMIN B12 AND PREGNANCY

During pregnancy nutrients are transferred from the mother to the fetus through the placenta. B12 is one of these nutrients that pass from mother to the fetus. Breast feed infants receive their nutrition, including vitamin B12, through breast milk. B12 deficiency is very rare in infants but can occur if the mother herself has deficient levels of the nutrient. An example of this would be a mother who is a strict vegetarian and has an inadequate reserve of B12 to pass on to the infant. In such cases a deficiency of vitamin B12 can develop in the infant in a matter of months after the child is born. This is something to be concerned about because if a deficiency in B12 is left undetected and untreated in infants it can lead to neurological damage. This damage can be both severe and irreversible. For this reason a mother who follows a strict vegetarian diet should consult with a pediatrician about B12 supplementation for their infants and children. They should also discuss with their own primary care professional about their own need for B12 supplements.

OTHERS THAT MAY BE AT RISK OF B12 DEFICIENCY

Individuals with pernicious anemia may be at increased risk. Anemia is a condition that occurs when there is insufficient hemoglobin in red blood cells to carry oxygen to the cells and tissues. Common symptoms are weakness and fatigue. Anemia can result in a variety of medical problems including a deficiency in vitamin B12, vitamin B6, folate and iron. Pernicious anemia is a name given more than a century ago to a then fatal B12 deficiency caused by gastric atrophy. This condition prevents the gastric cells from secreting intrinsic factor. B12 must bind with IF to be absorbed into the system. When an individual has this condition they are normally given an injection of B12 to get levels to where they need to be and then followed by supplementation to maintain them. A primary care professional must manage this treatment.
People with gastrointestinal disorders may be B12 deficient due to reduced ability for absorption. Some of these conditions may be celiac disease, Cohn's disease, and those who have undergone surgical procedures in the gastrointestinal tract such as removal of all or part of the stomach. This can result in the loss of cells that are responsible for producing intrinsic factor.
Up to 30 percent of people over 50 years old may have atrophic gastritis, which is an increased growth of intestinal bacteria. This has two effects, it decreases the amount of gastric juices produced and the increased bacteria may actually compete for the available supply of B12. This causes them to be unable to absorb vitamin B12 normally. They are however able to absorb synthetic B12 such as that found in fortified foods and dietary supplements. These two sources may be the best sources of B12 for people over 50.
Strict vegetarians and vegans are at risk of developing B12 deficiencies. This is because B12 comes from animal products that they do not consume. Fortified cereals are a good source of B12 for this group of people.