What is vitamin B12?
Vitamin B12, also known as cobalamin, is a water-soluble vitamin that plays a role in red blood cell formation, nerve function, and DNA synthesis. It is an essential B vitamin, meaning the body doesn't make vitamin B12, and you have to get it from your diet. Most people are able to obtain adequate amounts of B12 through their diet. Common food sources of B12 include meat, fish, eggs, and dairy. Additionally, fortified breakfast cereals and nutritional yeast can be a good source of B12.
Who is at risk for vitamin B12 deficiency?
People who are vegan are often deficient in vitamin B12. Additionally, medical conditions affecting stomach and nutrient absorption such as Chron's and UC, gastric bypass, colon surgery are more likely to have deficiency. Similarly, people who are on medications that affect GI transit and absorption such as Proton Pump Inhibitors, colchicine (a medication prescribed for gout), and the diabetes medication, Metformin, can be at higher risk for B12 deficiency.
Low B12 levels can be related to the following symptoms:
Fatigue
Dizziness
Paresthesia (numbness and tingling)
Muscle weakness
Anemia
Mood concerns
Mood changes
How much vitamin B12 is recommended?
The recommended daily amount of vitamin B12 for both women and men is 2.4 mcg. If you are low in B12, your doctor may recommend oral or injectable supplementation. Vitamin B12 supplements are considered safe - your body absorbs what it needs and any excess is excreted in your urine.
Vitamins to take for B12 deficiency
You can supplement B12 through B Complex vitamins as well as a vitamin containing only B12. If you are unable to swallow a pill, there is a sublingual formulation (dissolves under the tongue) available as well as a nasal gel.
Populations at higher risk of B12 deficiency
Vegetarians and Vegans
Alcoholics
People with digestive diseases
People with Pernicious Anemia
People with a history of stomach or colon surgery
People with Transcobalamin II deficiency
People with gastritis or on medications for stomach acid
Common Symptoms of B12 Deficiency
Fatigue and weakness
Nausea, vomiting, diarrhea
Poor appetite
Weight loss
Oral sores
Numbness or tingling in hands and feet
Vision problems
Poor memory, confusion
Balance and gait instability
Depression
Irritability
What are the health benefits of vitamin B12?
Vitamin B12 reduces circulating blood levels of homocysteine, an amino acid in the body that has been linked to increased heart attack and stroke risk. Some studies have linked elevated B12 with high risk of certain cancers, however more data is needed at this time. B12 supplements are often advertised for boosting energy, athletic performance, and endurance. However, if you get enough through your diet, these are unlikely to have added benefit.
Foods with vitamin B12
Beef
Clams (without shells)
Nutritional yeast, fortified
Salmon
Canned Tuna
Milk
Yogurt
Fortified Breakfast cereals
Cheese
Eggs
Turkey
Tempeh
Seaweed
If you have symptoms of vitamin B12 deficiency, see your healthcare provider. Your healthcare provider might order a vitamin B12 test that measures how much vitamin B12 is in your blood.
High levels of vitamin B12
Why is my vitamin B12 level high?
The most common cause of high B12 in the blood is due to recent ingestion or injection of supplemental vitamin B12. Normally, this is no concern about overdosing on B12 supplements because excess can be excreted in your urine. A high vitamin B12 level could be from a diet high in animal products such as meat, eggs and shellfish. However, it is extremely rare to have a high blood level from too much vitamin B12 in the diet.
There are cases where an individual has an elevated vitamin B12 level that is seen as an incidental finding in someone who has not recently received a vitamin B12 injection or taken a vitamin B12 supplement. Limited observational studies have reported associations of increased vitamin B12 levels with other conditions and disease states, including:
Liver disease due to release of B12 from damaged liver cells into the bloodstream
Kidney disease due to impaired function of the kidneys to excrete excess B12
Increased levels of transcobalamin, which is a transporter of B12 in the bloodstream
Inflammatory conditions: rheumatoid arthritis, lupus
Hematologic (or blood) cancers: acute leukemia, multiple myeloma
Hematopoietic disorder: myeloproliferative neoplasm, myelodysplastic syndrome, hypereosinophilic syndrome, transient neutrophilia
Most of these medical conditions are often present with other abnormal lab findings such as impaired kidney function, liver function, anemia, low white blood cell count and also other signs and symptoms of problems.
What to do if your vitamin B12 level is high? If vitamin B12 levels continue to be high, you should see a hematologist for a follow up evaluation to receive further review of your history, family history and further laboratory testing if appropriate. Avoid supplements high in B12 for now, eat a varied healthy diet rich in fruits and vegetables and check to see if B12 is in any supplements you take.
Adapted from: SOWH
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