Vitamin B12 Deficiency

Dear Dr. B: Can you please tell me about vitamin B12 deficiency?

Answer: This is a very important subject. I have written about this in the past. And it is worth repeating as 30 per cent of the adults older than 50 may have vitamin B12 deficiency. It is estimated up to 40 per cent of the general population may be deficient in this vitamin.

Vitamin B12, also known as cobalamin, was first isolated in 1948 and was immediately shown to be effective in the treatment of pernicious anaemia. Pernicious anaemia is a fairly common condition in which the stomach does not have enough acid and does not make intrinsic factor normally. Intrinsic factor is essential for the absorption of B12 in the stomach.

Absorption of B12 is also impaired in individuals who have had intestinal illness or intestinal surgery, which makes it hard for the intestines to absorb vitamin B12. Absorption of vitamin B12 from foods is complex. A defect in any step can lead to deficiency.

B12 is obtained primarily from animal proteins (red meat, poultry, fish, eggs, and dairy). But the vegetarians can get enough of it from legumes. The cause of B12 deficiency is not usually poor diet but problems with absorption as explained earlier.

Our body needs vitamin B12 to make blood cells. Persons with the deficiency may have no symptoms or may have symptoms related to blood disorder or disorders of the nervous system including psychiatric problems. Fatigue may be one of the first indications of B12 deficiency.

The liver stores most of the body’s B12 followed by the kidneys, heart, spleen, and brain. The stored B12 can last up to two years in conditions where our body is deprived of B12.

The diagnoses of B12 deficiency is made by checking the blood levels in patients who have symptoms or who are prone to B12 deficiency. Screening for B12 deficiency (by way of a blood test) is recommended in the following groups of people:

-all elderly patients who are malnourished
-all patients in institutions and psychiatric hospitals
-all patients who have blood disorders, neurological or psychiatric problems.

Treatment is by B12 injections on regular basis for the rest of person’s life.


The golf season has started. It’s time to have little fun here before we get miserable on the golf course. Here is a joke from Golf Digest:

A man is stranded for years on a desert island. One day he looks up to see a gorgeous blond in scuba gear wading out of the water.

“Want a cigarette?” she asks, opening a waterproof pocket on her right arm, pulling out a pack and lighting one for him.

“How about a sip of whiskey?” she asks next, opening a pocket on her left arm and removing a flask.

As the man puffs on the cigarette and sips the whiskey, she slowly begins to unzip the front of her wet suit.

“Want to play around?” she asks.

And he says, “Oh, Lord, don’t tell me you’ve got a set of golf clubs in there, too.”

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