Vitamin B12 is found only in foods that are animal based with the exception of seaweed. Consequently, those who do not consume animal products run the major risk of becoming deficient in B12. Those who exclude meat from their diet but do eat fish and dairy will be much less at risk of developing a deficiency as dairy products make B12 ‘more bioavailable’. Diet is not the only cause for one to be deficient. Those suffering with gastric atrophy which is a result of chronic inflammation of the stomach lining, having parasites within the body, taking certain medicines including contraceptive pill, ibuprofen, or metformin, gastric bypass surgery or anyone using nitrous oxide could make a person deficient. Another cause is a condition known as pernicious anaemia, which affects a person’s absorption of B12 from food.
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Pernicious anaemia may cause neurological problems if left untreated.
The condition is the most common cause of vitamin B12 deficiency in the UK.
It’s an autoimmune condition that affects the stomach.
The NHS added: “An autoimmune condition means your immune system, the body’s natural defence system that protects against illness and infection, attacks your body’s healthy cells.
Vitamin B12 is combined with a protein called intrinsic factor in a person’s stomach.
This mix of vitamin B12 and intrinsic factor is then absorbed into the body in part of the gut called the distal ileum.
Pernicious anaemia causes your immune system to attack the cells in your stomach that produce the intrinsic factor, which means your body is unable to absorb vitamin B12.”
If your skin turns a certain colour you could be at risk of pernicious anaemia.
Having a lemon tinged skin could mean you have pernicious anaemia. JAMA Internal Medicine said: “The lemon yellow colour of the skin in pernicious anaemia has always been closely associated with the idea of jaundice and is often referred to as an icteroid hue.
“But the almost invariable absence of bile from the urine has stood in the way of our calling pernicious anaemia patients definitely jaundiced.
“The frequent appearance of urobilin in the urine has suggested an explanation for the colour of the skin and we frequently see the term ‘urobilin icterus’ in this connection.”
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Other signs of pernicious anaemia include a sore, red tongue, mouth ulcers, pins and needles, changes to mood or mental function and having disturbed vision.
Pernicious anaemia usually is easy to treat with vitamin B12 shots or pills.
If a person has severe pernicious anaemia, their GP may recommend shots first.
Shots are usually given in a muscle every day or every week until the level of vitamin B12 in the blood increases.
After the vitamin B12 blood levels returns to normal, a person may get a shot only once a month.
For less severe pernicious anaemia, a GP may recommend large doses of vitamin B12 pills. A vitamin B12 nasal gel and spray also are available.
These products may be useful for people who have trouble swallowing pills, such as older people who have had strokes.
A GP will diagnose pernicious anaemia based on a person’s medical and family histories, a physical exam, and test results.
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