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Vitamin  B12 is a water soluble vitamin, this is why it’s reserves in body lasts only a few days in the body; we have to get it adequately from diet or supplement to avoid vitamin B12 deficiency and thereby its ill effects.

Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Vitamin B12 also helps prevent a type of anemia called megaloblastic anemia that makes people tired and weak.

But B12 is NOT FOUND IN PLANT FOODS AT ALL, so the only source for vegetarians is milk, yoghurt, almonds, and certain fermented foods. Therefore, its deficiency is common in India, especially among the vegetarians, the elderly and pregnant women. Reports from all parts of the country show that vitamin B12 deficiency could be present in more than 50% of vegetarians. Today however 90% of the Vitamin B 12 supplements are fed to the animals as they are mostly removed from the natural environment and therefore do not have the required amount of Vitamins.

Vitamin B12 is produced by microorganisms found in the soil and in the guts of animals, which is how they end up in their flesh. Because in modern society we sterilize our produce and do not tend to get our water from natural untainted sources like streams and creeks, we need to be mindful on a vegan diet to supplement with this crucial nutrient.

Often, B12 deficiency doesn’t show up until it is too late and there is already irreversible neurological damage.

Fortified foods and B12 analogues found in fermented foods, sea vegetables, and algae are unreliable at best, harmful at worst because they may block the absorption of active B12.

The simplest, most cost-effective, safest, and most reliable way to avoid deficiency is to supplement.

Symptoms of Vitamin B12 Deficiency

If you have vitamin B12 deficiency, you could become anaemic. A mild deficiency may cause no symptoms. But if untreated, it may lead to symptoms such as:

  • Weakness, fatigue, tiredness, or light headedness as body is not able to generate Red blood corposules.

  • Sexual problems / Infertility.

  • Muscle pain

  • Heart palpitations and shortness of breath

  • Pale skin

  • Constipation, diarrhoea, loss of appetite, or gas 

  • Nerve problems like numbness or tingling, muscle weakness, and problems walking

  • Hearing and Vision problem

  • Mental problems like depression, memory loss, or behavioural changes.

  • Dementia / Alzheimer’s disease.

  • Learning Disorder in children.

  • Autoimmune disease.

  • Cardiovascular disease.

  • Cancer.

The Warning Signs

  • If you don’t have enough red blood cells, then the proper amount of oxygen will not get to the rest of the cells in the body.
  • Lack of RBCs due to Vitamin B12 deficiency include diarrhoea or constipation, shortness of breath, loss of appetite, or gums/tongue that are swollen, irritated or even bleeding.
  • Over a long period of time, it can even cause brain or nerve damage manifested by dementia, numbness in the limbs, balance issues or mental confusion.
  • If tests indicate that you are B12 deficient, your doctor may prescribe injections right away to get your vitamin levels back up and either an oral supplement or a list of fortified foods to keep it up. Supplements should be 10 micrograms per day.

Other Issues Causing Deficiency

  • People with certain medical conditions or taking certain medications may be taking in enough vitamin B12, but their body is not absorbing enough of it. Certain intestinal disorders or anaemia can cause inefficient absorption as well as some antibiotics, diabetes medications and pump inhibitors. In these cases, (along with several others), your healthcare provider may prescribe injections instead of supplements to get the vitamin directly into your blood stream and not absorbed through the intestinal wall.
  • Age can be a factor too, regardless if on a plant-based diet or not. Most doctors recommend everyone over the age of 50 to either take additional B12 by supplement or though fortified food. Because only a little B12 is stored in the liver and the rest unused amount excreted through urination, it is important to get the proper dose each day to keep from becoming deficient in the first place.

Medicines that contain the following ingredient causes vitamin B12 deficiency in body.

  1. Cholestyramine – used to lower high cholesterol levels in the blood.

  2. Cimetidine – used to treat and prevent stomach ulcers.

  3. Clofibrate – impairs absorption of vitamin B12 –

  4. Colchicine – used to prevent or treat attacks of gout (also called gouty arthritis)

  5. Co-trimoxazole– It reduces bacteria that cause infections of the urinary tract, lungs (pneumonia), ears, and intestines.

  6. Demeclocycline– an antibiotic used to treat bacterial infections.

  7. Famotidine– a histamine blocker used to treat and prevent ulcers.

  8. Fluoroquinolones– antimicrobials used to kill bacteria in pneumonia, urinary tract infections, and diarrhea.

  9. Lansoprazole– used to prevent stomach ulcers and to treat other conditions in which the stomach produces too much acid.

  10. Macrolides– antibiotics used to treat a wide range of bacterial infections.

  11. Metformin– type 2 diabetes drug, known to cause vitamin B12 deficiency.

  12. Methyldopa  – reduces vitamin B12 levels, leading to a vitamin B12 deficiency.

  13. Minocycline– antibiotic used to help treat periodontal disease, acne, and inflammatory arthritis.

  14. Neomycin– antibiotic, antibacterial used topically to treat skin infections, wounds, and burns. Neomycin impairs vitamin B12 absorption and has been shown to decrease vitamin B12 levels.

  15. Nizatidine– used to treat and prevent stomach ulcers, intestinal ulcers, and acid reflux.

  16. Omeprazole  -used for gastroesophageal reflux disease (GERD).

  17. Oral contraceptives– oral contraceptives with high estrogen content leads to decreased levels of vitamin B12.

  18. Phenobarbital -barbiturate, anticonvulsant that results in decreased levels of vitamin B6 and vitamin B12, in addition to elevated homocysteine levels. (Vitamin B12, Homocysteine, and your Heart)

  19. Phenytoin– an antiepileptic drug.

  20. Potassium chloride– used for dehydration, can be deadly in its concentrated form.

  21. Ranitidine – H2-receptor, heartburn medication used to suppress production of stomach acids that are necessary for digesting vitamin B12.

  22. Sulfonamides– antibiotics used to treat a wide range of bacterial infections.

  23. Tetracyclines – antibiotics prescribed for acne.

  24. Trimethoprim– (TMP/SMX) is used to treat urinary tract infections, pneumonia, and “travelers’ diarrhea.”

  25. Valproic Acid – anticonvulsant used for migraine headache prevention.


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