Vitamin B12 deficiency

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VITAMIN

B12 DEFICIENCY

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If you have any unusual

undiagnosed symptoms, perhaps you should consider whether you

have a vitamin B12 deficiency. Chances are you don't,

but many sufferers of the symptoms of hypothyroidism do.

Could my symptoms be

caused by B12

deficiency even if my blood tests have shown a normal range?

Possibly. A blood test may

reveal that your B12 level is in or near the normal range. However, it may be

just below or in the lower end of that range, otherwise sometimes known as

borderline, or near borderline. Your serum B12 levels should be at the TOP of

the reference range.

If I have B12

deficiency, wouldn't my doctor have diagnosed it already?

Not necessarily. B12

deficiency is sometimes overlooked by the medical profession even when you've

had a blood test (actually two different tests are required to nail the

deficiency down to B12).

Borderline B12 deficiency can

sometimes cause symptoms so dramatic that B12 deficiency may be rejected as a

possible cause because it may be thought that such symptoms wouldn't be caused

by a mere borderline deficiency. B12 deficiency sometimes goes undiagnosed

until the symptoms become moderate to severe, although this is not necessarily

the fault of the medical profession. The symptoms often come on so slowly that

a B12-deficient individual may become accustomed to them and not complain until

the symptoms become severe.

Is there an alternative

to taking B12 shots for deficiency?

Yes, if the deficiency is

stabilized and not too severe. There are now available sublingual tablets,

which will be discussed at the end of this article.

What are some of the

symptoms of B12 deficiency?

First, bear in mind that each

of these symptoms can be caused by something else, often something serious. It

is probably safe to say that if you have a wide range of these symptoms, the

cause is much more likely to be B12 deficiency than if you have a just a couple

of similar symptoms. If you have any of these symptoms, you might actually consider

yourself fortunate if the cause turns out to be B12 deficiency because it is

easily treatable, at least if not so far advanced that it has done permanent

damage.

An effort was made to put the

following symptoms more or less in order, beginning with those perhaps most

likely to be indicative of B12 deficiency.

1. Itchy or tingling tongue. The tongue

suddenly itches from time to time without warning. This occurs on the edge of

the tongue, along one side or the other or at the tip. There is an irresistible

urge to scratch the tongue on the teeth to stop the itching. Some individuals

experience stinging, pain, or tingling instead of itching.

2. White spots in the skin, resulting

from melatonin

becoming absent in the area. These often occur on the outside of the forearm,

but may occur in other places. The longer these spots are there, the whiter

they get. As time goes by, the spots become very dry and flaky to the extent

that small raw spots of skin may be exposed.

3. Sharp stabbing, tingling pain in the

palm of one or both hands. This occurs suddenly and for no apparent reason in a

spot directly below the ring finger, approximately where the first palm crease

is. If B12 deficiency is not treated, a tingling pain may begin to occur along

the outside edge of the hand, starting from the wrist. This pain occurs when

the wrist is flexed backward.

4. Sores at the corners of the mouth,

sometimes extending along the edge of the lip. These are raw spots, not

blisters, and they tend to come and go.

5. Nerve shock in the side of the body.

It can be felt coming on a few seconds before it hits, and then it hits almost

like a mild but deep electric shock and quickly subsides. It can occur at the

side of either hip or on either side of the upper body, along the ribs. Worse

yet, it can occur consecutively in at least two or three locations, one right

after the other.

6. Shortness of breath, but without chest

pain. This can occur when walking just a few yards.

7. Eye twitch, usually in one eye or the

other. It can occur on the eyelid or just below the eye. This is not usually

painful, just annoying.

8. Facial pain, usually on only one side

of the face at a time. This pain varies so much that it would be difficult to

describe all the possibilities. It can be a dull pain in the cheek bone right

underneath an eye. It can also be a sharp shooting pain across the forehead,

sometimes coming downward from the scalp

to the edge of the nose by the eye. This pain can be excruciating but is

usually fleeting.

9. Tingling along the back of one or both

thighs, staring at the hips and shooting downward. This starts out as more an

annoyance than pain, but can develop into pain if not treated.

10. Memory loss and/or disorientation. For

borderline deficiency, these should be mild if they occur at all. They can be

severe with extreme deficiency.

11. Migraine headaches. These may be

preceded by a temporary blind spot in the centre of the field of vision,

usually lasting about ten minutes, and sometimes followed by facial pain under

the eyes. After the blind spot vanishes, there may be zigzag streaks through

the vision that may last up to hours. Even in the same person, there may be

extreme variations in the headaches themselves. They may be quite severe with

nausea or they may be virtually nonexistent. How can it be a migraine if

there's virtually no pain? Doctors say it's a migraine if the described visual

problems occur, whether there is significant pain or not. (Migraines of most

individuals have causes other than B12 deficiency, but migraines of certain

individuals diminish or stop completely after they are treated for B12

deficiency.

12. General feeling of fatigue. Although

listed last, this may be the most common symptom, but it is also a symptom of

many, many other ailments.

Are there any other

possible symptoms?

This list is certainly not

all-inclusive. There are other possible symptoms deliberately omitted here

because they're relatively rare and/or debatable as to the actual cause. The

symptoms listed here are for a borderline to mild deficiency. Extreme B12

deficiency can cause very extreme symptoms, including mental dullness, coma,

and even death.

If I have some of these

symptoms what should I do about it?

First of all, discuss your

symptoms with your doctor or other health care provider if you haven't already.

Don't try to make your own diagnosis because you may have an entirely different

problem that needs to be treated. If no satisfactory diagnosis is reached, you

may want to broach the subject of a possible B12 deficiency with your doctor.

If you've been given blood tests, find out whether your B12 level is near

borderline or lower. Bear in mind, that even a near borderline B12 level can

cause symptoms.

Keep in mind that even if you

have another long term physical problem, if you acquire new symptoms they may

be caused by a new problem. In other words, if you have another ailment, actual

symptoms of B12 deficiency might erroneously be blamed on that other ailment.

What could cause me to

be B12 deficient?

There are several possible

reasons. If you're in your fifties or older your stomach may have lost its

ability to process B12 from the food you eat. This could also happen at a

younger age, but it is not likely unless you have a genetic defect. In either

case, a needed protein called gastric intrinsic factor would be lacking in the

stomach. In this situation, a dangerous condition called pernicious anaemia can

develop if B12 deficiency is not treated.

Another possible reason for

B12 deficiency is that you simply may not be eating enough meat or animal

products, or not any if you're a vegetarian. If this is the case, you must take

B12 supplements

or injections.

There is an additional less

widely known reason for B12 deficiency for those who have multiple sclerosis

(or MS). MS causes nerve myelin to be destroyed and B12 is used in the

manufacture of myelin as the body struggles to replace the lost myelin. MS can

contribute toward B12 deficiency if the body uses up B12 in manufacturing

myelin.

If I'm found to be

deficient in vitamin B12, what should I do about it?

Your doctor will probably

prescribe a series of B12 injections, likely starting daily, then going to

weekly and then monthly. You may be told that you'll have to take B12 shots

regularly for the rest of your life. B12 tablets exist, but they don't help all

who are B12 deficient. If your stomach has little, or no ability to process B12

from food, then it won't be able to process B12 from swallowed tablets either.

If I start receiving

B12 injections for deficiency, how soon can I see an improvement?

You may feel a difference in

as little as 12 hours. If you start out with daily shots, your milder symptoms

may disappear completely within a few days. Some may take a few months or

longer to completely clear up, especially white spots. On the other hand, some

symptoms, such as nerve shock or eye twitch, may quickly vanish temporarily but

then try to emerge again at times. Extra B12 taken when this happens may

eliminate the emerging symptoms.

Is there a way I can

avoid taking B12 shots for the rest of my life?

There is now available a

sublingual B12 tablet, or nugget, with as high as 5000 mcg of B12. You hold

these under your tongue or in the side of your mouth until they dissolve and

are absorbed into your bloodstream. As they dissolve, they turn into a

pleasant-tasting bright red liquid (cobalamin) which looks the same as the B12

used in injections. In a study, these nuggets have been shown to be effective

in some people in overcoming B12 deficiency and maintaining a sufficient level

of B12 in the body.

Anecdotal evidence suggests

that if taken daily, sublingual nuggets can maintain a constant level of B12 in

the body and constantly hold off symptoms, whereas with B12 injections, the

symptoms sometimes creep back between injections. Periodic injections keep some

people on a rollercoaster but nuggets, when taken daily, tend to create a

steady condition of B12 adequacy.

You should consult your

doctor before taking B12 nuggets, especially substituting them for B12

injections. There may be a reason why you should not in your particular case.

Another possibility is that you may be given injections until you recover from

your deficiency and then permitted to take nuggets to maintain a normal B12

level. Your doctor may or may not recommend that you take certain other oral

supplements along with B12 nuggets. This is one reason why you should ask your

doctor before switching from shots to nuggets.

Where can I get B12

sublingual nuggets?

They are available on the

internet, but still very difficult to find in stores, especially outside of

metropolitan areas. Even in metropolitan areas, they don't seem to be widely

distributed. (Solgar make an excellent sublingual B12 nugget 1000mgs)

Are B12 nuggets more

expensive than shots?

At the usual dosage of one nugget

per day, they are generally much less expensive then one injection per month

given in a clinic.

Should I worry about

taking too much B12?

Apparently not. Unlike

certain other vitamins, B12 reportedly has no known side

effects even when taken in large quantities. It is water

soluble and doesn't accumulate in the body over a long period of time.