Man, 32, hospitalised with B12 deficiency after his 3 signs worsened

Dr Dawn Harper on signs of vitamin B12 and vitamin D deficiency

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Vitamin B12 deficiency is behind most things you care about. For example, it supports the nervous system – a complex network that takes in information through your senses, processes the information and triggers reactions. A case study published in the journal Oxford Medical Case Reports shows the hammer blow B12 deficiency can have on the nervous symptom.

In the report, researchers describe the case of a 32-year-old man with neurological symptoms as a result of B12 deficiency.

The 32-year-old was admitted due to generalised fatigue, weakness in the lower limbs and difficulty in walking for the last two months.

For the same reasons, he had visited several hospitals during the last month.

According to the case report, his symptoms got “worse during the last 10 days”.

Getting to the bottom of it

The patient’s medical history was unremarkable. He denied any alcohol or drug consumption.

He was not a vegetarian and his family history was negative for any hereditary or metabolic disorders – B12 deficiency risk factors.

He was well nourished without any cognitive impairment. During his neurological examination, muscle tone, motor strength and sensory functions were normal.

In the absence of findings indicating B12 deficiency, researchers sought to find the possible cause for his low levels.

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Biopsies revealed lesions compatible with chronic gastritis – a complication whereby the lining of your stomach becomes irritated (inflamed).

The finding was significant because some conditions that affect your intestines can also stop you absorbing the necessary amount of vitamin B12.

He was treated with 40 mg esomeprazole – a medicine that reduces stomach acid – once daily and injections of hydroxocobalamin (5 mg per injection) for five days, followed by one injection weekly for four weeks and one injection monthly thereafter.

Hydroxocobalamin is one of the main B12 injections administered in the UK.

“Hydroxocobalamin is usually the recommended option as it stays in the body for longer,” explains the NHS.

After three months, the man was feeling better while a physical examination revealed his symptoms had improved.

Treating B12 deficiency

The treatment for vitamin B12 deficiency depends on what’s causing the condition.

Most people can be easily treated with injections or tablets to replace the missing vitamins.

“If your vitamin B12 deficiency is caused by a lack of the vitamin in your diet, you may be prescribed vitamin B12 tablets to take every day between meals,” notes the NHS.

B12 is mainly found in animal sources, such as meat, salmon and cod.

|If you’re a vegetarian or vegan, or are looking for alternatives to meat and dairy products, there are other foods that contain vitamin B12, such as yeast extract (including Marmite), as well as some fortified breakfast cereals and soy products,” says the NHS.

The health body adds: “Check the nutrition labels while food shopping to see how much vitamin B12 different foods contain.”

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