Deficiency of vitamin B12 Anemia is a disorder in which the body’s supply of healthy red blood cells is insufficient due to a deficiency of vitamin B12. If B12 is deficient, the body may not be able to make enough red blood cells to supply the body with enough oxygen.
Vitamin B12, also known as cobalamin, is a B vitamin that is essential for a variety of bodily activities, including red blood cell synthesis (RBCs). A person who is deficient in vitamin B12 may develop anemia, which is caused by a decrease in the amount of healthy circulating RBCs. This might happen as a result of malabsorption, an underlying ailment, or a particular diet. Vitamin B12 supplementation is commonly used as a treatment.
In this post, we’ll go over the many types of B12 deficiency anemia, as well as their causes and therapies.
When to consult a doctor
Symptoms of B12 deficiency anemia can be confused with those of a variety of different illnesses, and long-term insufficiency can worsen symptoms. A person who is having any symptoms should consult a doctor to determine the origin of their symptoms and begin treatment as soon as possible.
What is it?
Vitamin B12, often known as cobalamin, is a water-soluble vitamin that contains the mineral cobalt. It can be found in a variety of meals, including fish, meat, and dairy products. Vitamin B12 is required by the body for the following functions:
- brain and neurological function
- fat and protein metabolism
- creating new RBCs
- DNA synthesis
The recommended daily requirement for vitamin B12 varies by individual due to a variety of circumstances, but for most adults, it is around 2.4 micrograms.
B12 deficiency is a condition in which the body lacks the vitamin B12. When a person’s B12 levels are too low, the body is unable to manufacture enough healthy RBCs, resulting in anemia. When this happens, the body may not be able to manufacture enough RBCs to appropriately provide the body with oxygen. The body cannot function properly without enough oxygen, resulting in weariness, weakness, and other problems.
Megaloblastic anemia is a kind of megaloblastic anemia caused by a lack of vitamin B12. When RBCs do not mature regularly, this is referred to as this condition. Instead, they are much larger and more oval in shape than mature RBCs. Another type of megaloblastic anemia is folate deficiency, which is caused by a lack of another B vitamin.
Causes and risk factors
The following are some of the most common causes of vitamin B12 deficient anemia:
Pernicious anemia is an autoimmune disease that damages the stomach lining and hinders the generation of an intrinsic factor protein. The immune system produces antibodies that assault the parietal cells that lining the stomach and manufacture this protein. Intrinsic factor aids vitamin B12 absorption in the small intestine. Vitamin B12 deficiency can occur if a person does not consume enough of this protein.
Pernicious anemia is frequently linked to autoimmune diseases such type 1 diabetes, vitiligo, and thyroid problems. Pernicious anemia is a rare disorder, although research suggests that it is more common in adults of Northern European ancestry who are over 60 years old.
Chronic gastritis, or inflammation of the stomach lining, can impede the secretion of intrinsic factor and stomach acids, both of which aid in the absorption of vitamin B12.
The gastrointestinal system may be rearranged or removed in some procedures, such as gastric bypass or small bowel resection. A person’s ability to absorb vitamin B12 may be hampered as a result of certain anatomical alterations.
Vitamin B12 shortage is frequent after this sort of surgery, according to research, with 13–60 percent of individuals developing a shortfall.
Long-term use of certain drugs might make it difficult for the body to absorb vitamin B12, resulting in a deficiency. The following drugs have been linked to inadequate vitamin B12 absorption:
- Metformin: A medication that can help treat type 2 diabetes.
- Proton pump inhibitors: A type of medication that suppresses stomach acid. A person may use this to treat conditions such as gastroesophageal reflux and peptic ulcers.
- Colchicine: A medication people may use to treat gout and Mediterranean fever.
Only animal-based foods contain vitamin B12. People who eat low-fat, low-carbohydrate diets, such as vegan and vegetarian diets, may be deficient in vitamin B12.
The following are some factors that may increase a person’s risk of vitamin B12 deficiency anemia:
- having a family member who suffers from the disease
- thyroid disease, diabetes, and vitiligo are all autoimmune conditions linked to vitamin D deficiency
- as you become older, your chance of B12 malabsorption rises
Symptoms of vitamin B12 deficiency anemia can appear gradually and differ from one person to another. Among the signs and symptoms are:
- pale skin
- sore and tender tongue
- fast heart rate
- difficulty walking
- tingling or numbness in the hands and feet
- decreased appetite
- weight loss
While complications are uncommon, people with severe anemia are more likely to have heart and lung problems as a result of issues giving oxygen to important organs. In addition, patients with vitamin B12 deficient anemia may have the following symptoms:
- stomach cancer
- neural tube birth defects if the B12 deficient person is pregnant
- neurological changes, such as vision and memory problems
Vitamin B12 deficiency anemia is difficult to detect because of its wide range of symptoms and frequent comorbidity with other illnesses. During a medical exam, a doctor may use a routine blood test to diagnose the illness.
A doctor may enquire about a person’s medical history, perform a physical exam, and order blood tests to detect vitamin B12 deficiency anemia. A complete blood count will detect any anomalies in RBCs and hemoglobin concentration, as well as a person’s serum vitamin B12 levels.
If the blood test reveals symptoms of anemia, more testing may be required to determine the cause. The following are examples of such tests:
- a blood test for intrinsic factor antibodies associated with pernicious anemia
- a blood test to see a person’s reticulocyte count and measure the number of young RBCs
- bone marrow tests to see if a person’s bone marrow is making RBCs properly
Vitamin B12 supplementation is usually used to restore a person’s levels to a healthy level. Depending on the source of a person’s B12 deficiency, the length and type of treatment may differ.
A doctor may give oral B12 supplements to ease symptoms in persons who are deficient owing to dietary reasons. A person might also work with a dietitian to increase their intake of vitamin B12. Vitamin B12-rich foods include:
- dairy products
Foods fortified with vitamin B12, such as yeast extracts, cereals, and some plant milks, can be consumed if a person chooses to include vitamin B12 in their diet without consuming animal products.
Treatment for malabsorption usually entails a doctor injecting B12 into the patient. By injecting the vitamin into a muscle, the body may absorb it without having to go via the digestive system. cyanocobalamin and hydroxocobalamin are two examples of these injections.
Before transitioning to monthly injections, a person may receive these injections regularly at the start of treatment to refill their stockpiles. For some people, this treatment may be required for the rest of their lives in order to maintain adequate vitamin B12 levels.
B12 insufficiency is a condition in which the body lacks the vitamin B12. Anemia is a condition in which the generation of healthy red blood cells is hampered due to a shortage of vitamin B12. People with anemia may feel symptoms such as weakness, exhaustion, and shortness of breath as a result of a smaller amount of healthy red blood cells.
Other underlying medical issues, specific medications, or surgery can all cause this illness. A doctor may recommend taking B12 supplements and eating B12-rich or fortified foods to help manage a deficiency.
Types and normal ranges of kidney function tests
Kidney function tests are basic procedures that use blood or urine to diagnose kidney abnormalities. A variety of kidney function tests are available to assess various aspects of renal health.
A kidney function test can detect sluggish waste filtering. Another test may detect protein leakage from the kidneys.
In cases where a doctor suspects a kidney disease, routine testing can help all individuals.
According to the National Kidney Foundation, 1 in 3 adults in the US is at risk for kidney disease, and many early cases show no symptoms. It’s important to detect and treat this condition early to avoid permanent damage.
In this article, you’ll learn about kidney function tests and their results.
What is it?
Kidney function tests use blood or urine to assess many elements of kidney health.
Doctors frequently request multiple tests to provide a comprehensive picture of kidney health.
The kidneys are vital to the body’s wellbeing. Their major function is to filter waste from the blood and excrete it in the urine.
Kidney disease can hinder the kidneys from filtering waste effectively, causing hazardous symptoms.
Regular testing may help detect disorders like kidney disease early on, halting its disease.
Doctors may also arrange imaging or a biopsy to learn more about the kidney.
Continue reading to learn about kidney function testing.
Pee tests may demand a little sample or all of a person’s urine in 24 hours.
Urinalysis helps doctors uncover underlying disorders or decide which test to employ next. Urinalysis can discover unwanted particles in urine such as:
A positive test for one or more of these particles means:
The microalbuminuria or albumin-to-creatine ratio
Both tests require a little urine sample. Both aid in detecting albumin in urine.
Albumin is an important protein in the blood. Not doing your job properly if your kidneys excrete too much albumin.
30 mg/g or less urine albumin is normal. Any higher may indicate renal disease.
As a result, microalbuminuria can detect even minute levels of protein in the urine.
Even if other urine protein tests are negative, people at increased risk of renal disease may need a microalbuminuria test.
A creatine clearance test involves both blood and urine. It entails taking a 24-hour urine sample and a blood sample.
Creatine is a naturally occurring waste product in the body from muscular use.
Doctors compare creatine levels in urine to blood levels. This chart compares the amount of waste the kidneys filter out, which may indicate their general health.
An arm blood test requires a doctor or nurse to extract a little amount of blood from the patient. The person may need to fast or take the test early in the morning.
Serum creatine test
Serum creatine levels that are excessively high could indicate that the kidneys aren’t doing their job properly. As part of the creatine clearance test, doctors will also prescribe a serum creatine test.
Serum creatine levels exceeding 1.2 for women and 1.4 for men, according to the National Kidney Foundation, may be an early warning that the kidneys aren’t working properly. As renal disease advances, these figures may grow even higher.
This test can also be used to calculate a person’s glomerular filtration rate (GFR) to confirm a diagnosis or to order additional tests to double-check the results.
The GFR test adjusts the findings of a serum creatine test for a variety of parameters, including age, gender, and race. A GFR of 60 or higher is considered normal. A GFR of 60 or less is indicative of renal disease.
Blood urea nitrogen test
The blood urea nitrogen (BUN) test looks for urea nitrogen and other waste products in the blood.
When proteins in food break down, urea nitrogen is produced, and high amounts may indicate that the kidneys are not filtering these waste products adequately.
BUN levels typically range from 7 to 20 milligrammes per deciliter. Higher levels could indicate a kidney-related underlying condition.
However, numerous other factors, such as drugs or antibiotics, might impact BUN levels. A diet high in protein may also have an impact on levels.
To acquire a better picture of how successfully the kidney filters this waste, doctors would often compare these results to the results of a creatine test.
Imaging scans may aid in the detection of any physical abnormalities to the kidneys, such as injuries or kidney stones.
To take photos, ultrasound exams use innocuous sound waves. An ultrasound may be ordered by a doctor to check for changes in the shape or position of the kidneys. An ultrasound may also be requested to screen for tumours or obstructions, such as kidney stones.
A CT scan is a procedure that employs a sequence of X-ray images to build a 3D image of the kidneys. It could aid in the detection of any structural alterations or deformations in the kidney.
A dye injection is sometimes required for the scan, which might be problematic for people who have kidney disease.
Doctors may recommend a kidney biopsy in some instances. This is a procedure in which a tiny needle is inserted into the kidney to remove renal tissue. The tissue will be sent to a lab for testing by the doctor.
When doctors need to diagnose a specific disease and determine how well it might react to treatment, they may perform a biopsy. A biopsy may also be used to assess the progression of renal disease.
Multiple positive test findings indicate that there is a problem with the kidneys.
Each of these tests provides doctors with a more complete view of a person’s overall kidney health. The scans can also detect renal disease signs, allowing for the ordering of additional tests.
Doctors will strive to completely identify the condition and design a treatment strategy once they have determined that there is a problem with the kidneys.
Kidney failure can be caused by a variety of underlying diseases. In order to discover the best treatment for each instance, a comprehensive diagnosis is required.
Renal function tests are an important element in diagnosing and treating kidney problems. Even if there are no symptoms, some people may need to be tested on a regular basis.
People at increased risk for kidney problems should get frequent kidney function testing, according to the National Institute of Diabetes and Digestive and Kidney DiseasesTrusted Source. Those with the following people are at a high risk:
Regular renal function testing can help detect kidney abnormalities early on, when the outlook is the best.
People can assist prevent the condition from progressing by sticking to a treatment plan. The best method to evaluate and manage any indicators of kidney damage or underlying issues is to work directly with a doctor.
Uses of vitamin B-12 level test: Normal ranges, and results
The amount of vitamin B-12 in the blood or urine is measured in a vitamin B-12 level test to determine the body’s overall vitamin B-12 reserves.
Vitamin B-12 is required for a variety of body functions, including neuron function, DNA and red blood cell formation.
Treatment is required if a person’s vitamin B-12 levels fall outside of the usual range. Vitamin B12 deficiency can cause neurological symptoms as well as fatigue, constipation, and weight loss. B-12 levels that are too high could indicate liver disease, diabetes, or another condition.
Continue reading to learn more about B-12 testing and what the results indicate.
Purpose of a vitamin B-12 level test
The vitamin B-12 level test determines the amount of vitamin B-12 in your body. Doctors can use the data to see if low vitamin B-12 levels are causing symptoms.
If a person exhibits any of the following symptoms, a doctor may recommend a vitamin B-12 level test:
Vitamin B-12 insufficiency
Vitamin B-12 deficiency is thought to affect up to 15% of people in the United States, according to research. The following are signs and symptoms of a deficiency:
- fast heartbeat
- numbness and tingling in the hands and feet
- poor memory
- a sore mouth or tongue
- difficulty maintaining balance
Vitamin B-12 deficiency in infants can cause them to underachieve. They may have mobility issues in addition to developmental delays.
A vitamin B-12 level test may be required for people who have signs of low iron. Pernicious anaemia is caused by a lack of vitamin B-12 absorption, resulting in poor red blood cell causes.
It usually affects the elderly or people who are deficient in intrinsic factor. Intrinsic factor is a gastric material that binds to vitamin B-12 and allows it to be absorbed by the body.
The following are signs and symptoms of pernicious anaemia:
- pale skin
- weight loss
- loss of appetite
High levels of folate in the blood
They can also make you more susceptible to anaemia.
Symptoms of other illnesses
Vitamin B-12 levels that are unusually high can be a symptom of liver disease, diabetes, or certain types of leukaemia. The findings of a vitamin B-12 test may be used by a doctor to help them make a diagnosis.
Vitamin B-12 deficiency is more common in some people than in others, especially those with low stomach acid or other digestive problems. Stomach acid helps the body absorb vitamin B-12 more effectively by separating it from meals.
Low vitamin B-12 levels are more common in the following groups of people than in others:
- people with conditions that reduce vitamin B-12 absorption, including celiac disease and Crohn’s disease
- people who have had gastric bypass surgery
- those who are breast-feeding
- people who are taking medicines such as chloramphenicol, proton pump inhibitors, or H2 blockers
- older adults
- vegans and vegetarians
- people with diabetes
How does the B-12 vitamin level test work?
Vitamin B-12 status is normally determined by a blood test, but home urine tests are now available. Vitamin B-12 levels can be checked as part of a routine blood test by a doctor.
Although fasting is not required before a B-12 test, it may be necessary if the doctor is utilising the test to check at other blood components.
It is important that patients inform their doctors about any medications or supplements they are taking, as some may have an impact on the outcome.
Acknowledging the results
The following are possible results:
- Low. Vitamin B-12 levels below 200 pg/mL are considered low. This indicates that you may have a vitamin B-12 deficiency, pernicious anaemia, or an overactive thyroid. Neurological symptoms are common in people who have low vitamin B-12 levels.
- High. Anything over 900 pg/mL is considered excessively high vitamin B-12 status. This result could indicate problems with the liver or kidneys, diabetes, or certain types of leukaemia.
Because the ranges of results differ from one laboratory to the next, it’s important to talk to a doctor about the results and what they signify.
To rule out vitamin B-12 deficiency, the doctor may measure levels of methylmalonic acid (MMA) and other chemicals. These lab results aid in the early detection of vitamin B-12 deficiency.
Vitamin B-12 deficiency treatment
Vitamin B-12 injections are frequently required by people who have low amounts of the vitamin. These shots are more successful at boosting vitamin B-12 levels than supplements, especially when people have medical issues that make supplements difficult to absorb.
High doses of vitamin B-12 supplements may help some people improve their B-12 status. Supplements are sold in the form of capsules or liquids in pharmacies, supermarkets, health food stores. It may also be beneficial to consume extra vitamin B-12-rich foods.
Treatment for high vitamin B-12 levels
There is no upper limit on vitamin B-12 consumption because high amounts do not cause problems. Having naturally high levels of vitamin B-12 in the body, on the other hand, could be cause for alarm, since it could indicate a serious underlying condition. Doctors will focus on treating the underlying medical condition rather than the vitamin B-12 levels.
Vitamin B-12 foods.
Although low vitamin B-12 levels are frequently caused by absorption problems and other medical conditions, some people may be deficient because they do not acquire enough vitamin B-12 through their food. This is especially true for vegans and vegetarians who have been vegetarian for a long time.
Vitamin B-12-rich foods include:
- fortified plant-based dairy alternatives
- fortified breakfast cereals
- fortified nutritional yeast
- fish and seafood
- dairy products
Vitamin supplements can help vegans and strict vegetarians make up for dietary deficiencies. Older persons should seek to achieve their vitamin B-12 needs through fortified meals and vitamin supplements, as supplements are simpler for their bodies to absorb than naturally occurring vitamin B-12.
Vitamin B-12 dietary recommendations
Vitamin B-12 is required in 2.4 micrograms (mcg) per day for adults and adolescents over the age of 14. During pregnancy, this rises to 2.6 mcg, and breast-feeding raises it to 2.8 mcg.
Vitamin B-12 is an essential nutrient that is necessary for good health. The status of a person’s vitamin B-12 is determined by a vitamin B-12 level test. This test may be recommended by a doctor to people who have symptoms of a deficiency or who are at risk of having low vitamin B-12 levels in their bodies.
Vitamin B-12 deficiency can be avoided by eating a well-balanced diet that includes many sources of the vitamin on a daily basis, or by taking supplements. If they have trouble absorbing vitamin B-12 from food, oral supplements or injections can help them avoid symptoms and consequences.
Iron deficiency anemia and aging: What to know
Due to a lack of iron, iron deficiency anemia is a condition in which the body does not produce enough healthy red blood cells. Nutritional deficits, blood loss, the use of certain drugs, and impaired absorption are all possible causes in older people.
Iron is used by the body to make red blood cells (RBCs), which transport oxygen throughout the body. A person may not be able to manufacture enough healthy RBCs to meet the body’s needs if they do not have enough iron. As a result, iron deficiency anemia can be caused as a result, causing symptoms such as weariness, weakness, and shortness of breath.
A person’s food is usually the source of iron. Iron deficiency anemia is caused by a nutritional deficiency or the body’s inability to utilise iron properly. Due to various contributory factors that might influence how the body receives or uses dietary iron, this condition is frequent among older persons.
The prevalence of iron deficiency anemia in older people is discussed in this article, as is how to treat and manage the condition.
When to consult a doctor
Anyone over the age of 50 who is having symptoms that could indicate iron deficiency anemia, such as fatigue and shortness of breath, should seek medical advice.
Individuals who have underlying disorders that can limit iron absorption should talk to their doctor about how to lower their risk of iron insufficiency.
According to other studies, anemia is most common in older people, affecting roughly 17% of the population over the age of 65. Iron deficiency anemia, in particular, is thought to account for around one-third of anemia cases in older persons, according to research.
Despite the fact that some cases of iron deficiency anemia are mild, anemia in older persons can lead to a variety of negative consequences, including extended hospital admissions and even death. As a result, even minor cases of anemia will be diagnosed and treated by doctors.
Iron deficiency anemia can be caused by a variety of underlying reasons, with more than one contributing to a person’s diagnosis. These can include the following:
If the body does not get enough iron to replenish healthy RBCs, low dietary iron intake may cause symptoms. Anemia may be more common in people who follow certain diets, such as vegans, or who do not consciously consume enough iron-rich foods.
Other vitamin deficiencies
Even with a high-iron diet, a person who is deficient in other vitamins is at risk of developing iron deficiency anemia. B vitamin deficiencies, such as vitamin B12 or vitamin B9, also known as folic acid or folate, are also common and can affect iron absorption.
Even a high iron intake may not be enough to balance iron levels if the body cannot use iron efficiently, such as owing to a gastrointestinal condition. As a result of health problems that affect iron absorption, iron deficiency anemia can cause as a side effect.
The hormone erythropoietin (EPO) is produced by the kidneys. EPO aids in the formation and repair of red blood cells. Iron deficiency anemia can be caused by conditions that alter EPO levels. Kidney diseases and hormone-related disorders are examples of these problems.
Anemia can develop if a person loses enough healthy RBCs as a result of bleeding. As the skin ages and thins, external bleeding is more frequent, making cuts and scratches more likely. It’s also possible that these wounds and scrapes will take longer to heal.
Internal bleeding, such as ulcers or stomach or intestine problems, can lower the quantity of healthy RBCs in the body and cause iron deficiency anemia. Internal bleeding can cause as a result of trauma or injury, resulting in blood loss.
Internal bleeding is a risk with some drugs or combinations of medications, especially when used for a long time. People in medical care who require regular testing may be subjected to a high number of blood draws, which could exacerbate the problem.
In many people, bleeding may be a contributing reason to RBC depletion and anemia. According to a 2018 study, the most common cause of iron deficiency anemia in elderly people is bleeding from drugs and underlying diseases.
The RBC count can be affected by a variety of drugs. Medications that impact the kidneys or hormones can cause the formation of RBCs by causing chemical imbalances.
Medications that disrupt digestion might make it difficult for the body to metabolize iron and other important vitamins like B vitamins. Chemotherapy medications, for example, can harm the bone marrow, which is crucial for producing healthy RBCs. Some drug combinations may have unknown side effects that affect how the body creates or uses RBCs.
It is recommended that people review the probable side effects of a drug and speak with a doctor about the probability of a drug creating signs of iron deficiency anemia.
H. pylori infection
Some infections might cause the body’s ability to utilise iron. According to a 2019 study, Helicobacter pylori infections are widespread in the elderly, affecting up to 50% of people over the age of 60. Anemia is one of the complications of H. pylori infections.
Chronic illnesses can cause a variety of problems in the body, including problems with RBCs and other systems involved in the production or usage of RBCs. Here are a few examples:
- liver disease
- kidney disease
- conditions in the intestines or stomach
When rendering a diagnosis, doctors will take into account any underlying disorders.
Chronic inflammation in the body can be caused by a variety of factors. Inflammation can interfere with basic activities like RBC production, depending on the nature and location of the inflammation. Anyone with a chronic inflammatory condition or another issue that causes long-term inflammation should talk to their doctor about their risk.
Anemia symptoms differ from person to person, but here are a few frequent ones:
- shortness of breath
- rapid heartbeat
- chest pain
Light-skinned people may notice that their complexion becomes paler or slightly yellow.
Blood tests will be used to determine anemia.
A complete blood count (CBC) test can assist determine the different types of blood cells and other blood components, such as hemoglobin, an oxygen-carrying protein. A low hemoglobin count can imply anemia and a low RBC count.
A packed cell volume (PCV) test may also be used to determine hematocrit levels. The percentage of RBCs in the blood is measured by the hematocrit level. A PCV test can reveal whether a person has too few RBCs, indicating anemia.
Doctors may employ follow-up testing in addition to blood tests to look for other important anemia-related issues. A C-reactive protein test to search for inflammatory indicators or a reticulocyte count to assess bone marrow production may be performed. They may also look for the following things:
- abnormalities in the gastrointestinal tract
- blood in the urine or stool
- H. pylori infection
- sufficient levels of B vitamins
- kidney function
Depending on the underlying cause and degree of anemia, doctors may offer several treatment options. Because various causes may be contributing to the condition, treatment will differ from case to case.
To raise the person’s iron levels, a doctor may prescribe supplemental iron in the form of medications, dietary iron, or intravenous iron.
If anemia is caused by an underlying condition, the doctor will seek condition for it. This may help them uncover other underlying causes of anemia or resolve the anemia.
If a doctor feels a prescription or a combination of medications is causing anemia, they may suggest alternate treatments if they are available. Alternatively, they may offer alternative methods of managing anemia until the person is able to stop using the medicine.
Management and suggestions
A person with iron deficiency anemia must ensure that their diet contains enough iron and other essential minerals.
The following are some suggestions for doing so:
- consuming more iron-rich meals such as dark leafy greens, meat, and beans
- Iron absorption can be improved by eating foods high in vitamin C, B9, and B12
- avoiding foods that may interfere with iron absorption, such as dairy and meals high in phytic acid
- taking iron supplements with food can help to alleviate the burning sensation in the stomach
Iron deficiency anemia is frequent in elderly people, and it can be caused by a variety of reasons. Blood loss, nutritional deficiencies, medicines, underlying diseases, and malabsorption are all possible causes of iron deficiency anemia in this age range.
Individuals who are having iron deficiency anemia symptoms should consult a doctor for a diagnosis. The doctor should be able to advise you on how to boost your dietary iron intake or address any underlying issues that are preventing you from absorbing iron.