Causes and risk factors
The red blood cells containing hemoglobin are produced in the bone marrow and are released into the blood stream. Certain components like vitamin B12 and iron are essential for the production of these red blood cells. Lack of any of the components results in hampering the production of red blood cells. It causes decreased production of RBC. This deficiency can occur either due to improper intake of food containing vitamin B12. It is especially seen in vegetarian people or in people who do not drink enough of milk. The stomach contains some intrinsic factors which helps in absorption of vitamin B12. Lack of this intrinsic factor hampers the absorption of vitamin B12 too resulting in deficiency. Certain other causes like diseases of the stomach and intestine, (e.g., IBD), parasitic infestation, liver diseases, or gastrointestinal surgeries also contribute to the causation.
Clinical presentation:
Weakness, fatigue, difficulty in breathing, and faintness are the most common symptoms seen. The patient can also present with recurrent complaints of formation of ulcers, palpitation, loss of appetite, alteration in taste, and ringing in ears. Certain visual disturbances and nerve problems can also be seen. The patient can complain of numbness and pinpricking sensation. On examination, the patient appears pale and coldness of extremities is seen. Psychological changes like irritability, lack of concentration, confusion, lack of memory and depression is also seen.
Investigations:
Taking into consideration the patient’s complaints the doctor conducts a physical examination and certain set of investigations are advised. Complete blood test along with test for measuring the levels of vitamin B12 in blood is done. If the doctor suspects some underlying pathology, certain other investigations can also be advised.
Treatment:
Finding out the underlying cause and correcting it is the main line of treatment. Vitamin B12 supplements are started. They are either administered orally or through injections. A change in diet is must. Food rich in vitamin B12 is necessary. Meat, fish, egg, and milk are the vitamin B12 rich foods.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up the disease. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.
Recent update:
As per the Loyola University Health System, if an individual has a vitamin B12 deficiency, a vitamin B12 supplement will help; however, if a B12 deficiency is not diagnosed, there is no need to waste energy and money on B12 shots.