Vitamin B12 deficiency symptoms and therapy

What do we need vitamin B12 for and what are the consequences of a deficiency?

Vitamin B12 (cobalamin) is a vital, water-soluble vitamin that the human body can not produce by itself. So he is dependent on constant supply of food.

contents

• What do we need vitamin B12 for and what are the consequences of a deficiency?
• The three forms
• tasks
• Cell division, blood formation, DNA synthesis
• Energy metabolism
• Structure of the cell membrane
• Nitrosative stress
• homocysteine
• Synthesis of neurotransmitters
• What Cobalamin can do
• Interplay of vitamin B12 and folic acid
• The vitamin in the food
• Causes: What can upset the intake of vitamin B12
• The vitamin B12 deficiency
• Symptoms of vitamin deficiency
• Daily consumption - B12 in food
• How a defect is detected
• Summary

The three forms

Vitamin B12 has three forms in the human body:

• Methylcobalamin works in the cytoplasm,
• Adenosylcobalamin in the mitochondria (power plants of the cells),
• and hydroxocobalamin works both in the blood and in the cytoplasm.

Methylcobalamin and adenosylcobalamin are both so called "bioactive coenzymes". The body can use the vitamin B12 directly in these two forms directly. The third in the group, the hydroxocobalamin is not a coenzyme, but above all as a toxin and free radical scavengers.

Vitamin B12 plays an important role in numerous processes in our organism. Accordingly far-reaching can be the consequences of a shortage. (Photo: Mikhail Petrov / fotolia.com)

tasks

Vitamin B12 has the most varied tasks in the human organism. Cobalamin is involved in energy metabolism, blood formation, DNA synthesis, folate metabolism, homocysteine ​​breakdown, myelin sheath (nerve sheath, nerve fibers) and some neurotransmitters.

Cell division, blood formation, DNA synthesis

The best known is probably the effect of vitamin B12 on blood formation. A marked deficiency can lead to anemia. For cell division to work properly, cobalamin is just as important. Folic acid is also involved in this process. In the case of deficiency, so-called transcription errors may arise during DNA synthesis, which may eventually lead to an increased risk of cancer in the long term. Even chronic diseases are associated with it.

The formation of red blood cells, also called erythropoiesis, depends on the presence of vitamin B12. Otherwise, this may lead to a maturation disorder of the red blood cells. These are then unable to absorb the necessary amount of oxygen. Symptoms such as weakness, dizziness, shortness of breath and hypotension indicate this.

Energy metabolism

The advertisement tells us that a lack of vitamin B12 can lead to energylessness. This B vitamin has an effect on the performance and the energy level. Our organism needs energy for everything it does. Food is important for that. The resulting energy is stored and retrieved when needed. Vitamin B12 plays a major role in this complicated process.

Structure of the cell membrane

Vitamin B12 is involved in the formation of cell membrane lipids. However, this process has not been thoroughly researched yet. The membrane-forming lipids, however, are a component of myelin sheaths. These act like a protective cover around the nerves, comparable to the insulating layer of electrical cables. If these protective covers are missing, which can result from vitamin B12 deficiency, those affected suffer from tingling, muscle weakness, paralysis, coordination disorders or memory disorders. In return, vitamin B12 should also have a regenerating effect on nerves.

Nitrosative stress

Nitrosative stress is a type of oxidative stress. However, not the oxygen radicals are the bad ones here, but the nitric oxide radicals (NO). Too many of them burden the body and can damage it. Nitrosative stress is caused by inflammation, chemicals, medications, nicotine, mental and physical stress. NO is important in a normal, balanced amount. This relaxes, for example, the inner walls of the vessel, which has a positive effect on high blood pressure. Vitamin B12, in the form of hydroxocobalamin, can assert itself against too many nitric oxide radicals and renders NO harmless. This combats so-called nitrosative stress.

homocysteine

Homocysteine ​​is formed during the protein metabolism during the degradation of the essential amino acid methionine (from protein of food). Homocysteine ​​oxidizes in the blood and attacks the inside of the blood vessels, which over time can lead to arteriosclerosis and later to a heart attack. Vitamin B6, B12 and folic acid can break down the dangerous homocysteine.

Vitamin B12 is of fundamental importance for the functioning of the nerves and the transmission of nerve impulses. (Image: adimas / fotolia.com)

Synthesis of neurotransmitters

Neurotransmitters are messenger substances that are needed for the transmission of nerve impulses. Vitamin B12 is indispensable for the synthesis of various messengers such as serotonin, dopamine, epinephrine, norepinephrine and acetylcholine.

What Cobalamin can do

Cobalamin provides sufficient energy and thus acts against tiredness. The vitamin supports the growth of the nerves, is involved in the production of erythrocytes, ensures healthy cell division, protects the vessels, is important for concentration, good memory and mental energy and has a positive effect on our mood. For pregnant women and also for successful conception, the presence of vitamin B12 is essential in addition to folic acid.

Interplay of vitamin B12 and folic acid

Vitamin B12 and folic acid (also called folate or vitamin B9) work closely together in the body. Thus, the two, as already mentioned, massively involved in the degradation of harmful homocysteine. Cobalamin is needed to activate folate (this is the natural, bioactive form of folic acid). This means that a vitamin B12 deficiency can develop a functional folic acid deficiency.

The vitamin in the food

Foodborne vitamin B12 is bound to the so-called intrinsic factor in the stomach in the human organism. So this is transported to the terminal ileum (last section of the small intestine), where the cobalamin is then delivered to the bloodstream.

Causes: What can upset the intake of vitamin B12

The causes of a disturbed intake of vitamin B12 include a gastritis, a removal of parts of the stomach, a so-called TYP-A gastritis (an autoimmune disease in which the body attacks its own stomach and thus the intrinsic factor is no longer properly formed atrophic gastritis (atrophic mucous membrane changes, decrease in enzyme and hydrochloric acid production), drugs (for example, gastric acid blockers), and chronic intestinal inflammation or dislocations of intestinal tracts.

In celiac disease, caused by gluten intolerance, sufferers often suffer from a vitamin B12 deficiency. (Image: J.Mühlbauer exclus./fotolia.com)

The vitamin B12 deficiency

In addition to the above causes, which may underlie a vitamin B12 deficiency, there are more. This includes:

• too low a dietary intake, such as a strict vegetarian or vegan diet;
• a malabsorption in which the vitamin can not even be absorbed by the intestine, as is the case, for example, with celiac disease and also with exocrine pancreatic insufficiency;
• heavy alcohol consumption,
• an infestation with the fish tapeworm,
• a colonization of the intestine,
• an increased need (for example as part of an infection or during pregnancy),
• Displacement by B12 analogues (for example spirulina),
• old age
• or the genetically-related "Imerslund-Gräsbeck syndrome".

Symptoms of vitamin deficiency

The liver can store vitamin B 12 for up to three years. Therefore, vitamin deficiency symptoms usually appear only after several years of prolonged undersupply. These include, above all, tiredness, fatigue and paleness, triggered by pernicious anemia (vitamin B12 deficiency anemia).

The deficiency also affects the nervous activity. This causes discomfort, such as discomfort on the hands and feet, tingling, paralysis and diminishing mental ability. A well-known symptom of deficiency is a smooth red tongue, along with tongue burning and oral mucosal injury. Other symptoms include immune deficiency, bleeding, loss of appetite and weight loss.

Vitamin B12 is found in high concentrations mainly in meat and some other animal products. (Image: bit24 / fotolia.com)

Daily consumption - B12 in food

The daily consumption of an adult of vitamin B12 is approximately 3 μg (micrograms). During pregnancy and lactation, this increases to 3.5 to 4 μg. Especially in the human liver are stored about 2000 to 4000 micrograms. If there is a shortage, this will be reduced first.

Vitamin B12 is almost exclusively found in animal products such as meat, sausage, fish, dairy and eggs. Exceptions of non-animal origin, with very low concentration are sauerkraut, sea buckthorn and shitake. For example, 100 g of Emmentaler, 70 g of beef, 100 g of salmon or 60 g of minced beef are sufficient for the daily requirement. Here it is already clear that vegans and especially vegans can develop a vitamin B12 deficiency.

How a defect is detected

The symptoms listed above usually lead to the doctor. He will use a detailed medical history to order a blood test and a urine test. The diet is discussed, possibly reconsidered and changed.

A nutritional deficiency must be distinguished from a resorption-related deficiency. This requires a special examination. Basically, determining the cause of the later treatment is important. For example, a parenteral supply in the form of syringes or infusions may be necessary. This initially replenishes the body with high doses. This is followed by maintenance therapy, often in the form of tablets. A not so serious deficiency can also be compensated by oral substitution.

With a blood test, a present vitamin B12 deficiency can be detected relatively easily. (Image: jarun011 / fotolia.com)

Important for oral therapy is the type of cobalamin that is included in the tablets. Recommended are preparations containing methylcobalamin, hydroxocobalamin and adenosylcobalamin. These three types are also found in natural foods and are needed in the body for different tasks.

Summary

Vitamin B12 is an essential, vital vitamin and is one of the B vitamins responsible for nerves, brain and fitness. A deficiency can cause quite extensive complaints and must be treated or eliminated. Here is a diagnosis of the underlying disease inevitable. People who live for a long time strictly vegetarian or vegan, run the risk of developing such a cobalamin deficiency. Here is possibly to think of a daily substitution with a suitable preparation. (Sw)