Who is at greater risk of vitamin B12 deficiency

Although Vitamin B12 deficiency is becoming increasingly common across population, be it young or old, affluent or poor, women or men, there are some groups who are more susceptible.

Vegetarians: Since vitamin B12 is mainly found in animal products strict vegetarians especially vegans (those who do not consume milk and milk products) are at greater risk of deficiency than ovo-vegetarians (consume egg but not dairy), lacto-ovo vegetarians (consume eggs, dairy but not meat) and non-vegetarians.

Pregnant and lactating women:  B12 crosses the placenta during pregnancy and is present in breast milk. Mothers who are vegetarian may provide limited amounts of B12 to the breastfed infants leading to vitamin B12 deficiency within months of birth which if undetected and untreated may result in severe and permanent neurological damage in the infant.

Age >50 years: B12 is released from its bound state in the presence of Hydrochloric acid (HCl) in the stomach thereby facilitating its absorption. In elderly, the gastric cells secreting HCl get eroded causing decreased absorption of vitamin B12. Hence in this age group, increased intake of vitamin B12 through diet or supplements is a must. Decreased bone mineral density causing brittle bones in elderly may also result from B12 deficiency.

Gastric disorder or gastric surgery: The individuals suffering from celiac disease, Chron’s disease, ulcerative colitis or those undergoing weight loss surgery have lower number of cells that secrete HCl and hence develop B12 deficiency.

Treatment

Once supplementation is initiated, patient recovers from most of the symptoms within first few weeks itself. Resolution of neurological symptoms and gradual decline in fatigue is also seen. The physician may advise intramuscular B12 injections along with or oral supplements.  The treatment may last for six to eight weeks depending on the dose required and severity of the condition. The levels once normalized need to be maintained through diet and/or supplementation and must be monitored every six months.

Timely detection and treatment can help reduce further health risks and improve quality of life among these individuals.  Don’t let vitamin B12 deficiency lower your spirits, get tested early.