Dr Ramavtar Sharma
Vitamin B12 is one amongst many ingredients of the B group of vitamins and it is vital for making DNA and RBCs ( Red Blood Cells). It also supports the nervous system which includes central, visceral and peripheral nervous system. Central nervous system is the brain and spinal cord while the visceral nervous system is an extensive web of nerves across various soft organs of the body which as a group are called viscera. Peripheral nervous system is the widespread network of nerves covering the periphery of our body. Vitamin B12 is crucial for proper functioning of these highly important body systems. This vitamin must be an important ingredient of our food as the human body can not synthesize it hence, it has to be sourced entirely via food.
In the case of vitamin B12 deficiency our RBCs are imperfectly made. These imperfect red blood cells are unable to carry adequate oxygen to our cells hence our body systems would not work properly. As a result of this, various troubling symptoms of deficiency start appearing . Imperfect RBCs are rapidly destroyed by spleen leading to anemia. Rapid destruction of RBCs releases higher amounts of bilirubin pigment which leads to pale skin with yellowish hue. As less oxygen is available to cells, people with severe B12 deficiency would be extremely tired and fatigued. As the heart has to pump more frequently to fulfill oxygen demand, these people would have faster heart rate. The combination of rapid heartbeat and low hemoglobin are responsible for shortness of breath in people with serious and prolonged vitamin B12 deficiency. The tongue of these people would be swollen, smooth and red and this type of tongue leads to bad taste and burning sensation in the mouth.
The symptoms in the nervous system include tingling sensation in hands and feet because of nerve damage or nerve conduction issues. People might feel muscle weakness and diminished reflexes and there may be trouble in walking as a result of numb nerves. B12 deficiency significantly affects thinking and reasoning and is frequently responsible for irritable and irresponsible behavior. The chances of such people developing Alzheimer's, Parkinson disease and dementia are significantly higher as are depression and anxiety. Visceral nervous system malfunctioning may cause nausea, vomiting and diarrhea along with loss of appetite and body weight.
The most common cause of vitamin B12 deficiency is diet as plant based diet doesn't contain significant amounts of this vitamin. Diseases like ulcerative colitis, Crohn's disease, type 1 diabetes mellitus and pancreatic diseases cause problems with absorption of B12. Some people are genetically predisposed to B12 deficiency. Elderly people, vegetarians and vegans are also more prone to deficiency. Metformin, a drug frequently used in type 2 diabetes treatment, may cause vitamin B12 deficiency and so may be any significant surgery on the stomach.
Major food sources of B12 are animal based ( non-vegetarian ) foods like red meat, poultry, eggs, dairy and fish. Plant based sources are fortified cereals, plant milk, natural yeast and fortified bread. Looking at the overall scenario, it would be prudent to include vitamin B12 supplement in food of vegetarian and vegan people as food sources are not reliable in these categories.
The author is Practicing physician at Jaipur and freelance writer
ramawatarf132@gmail.com
