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FAQ for Vitamin B12 deficiency Anaemia

What is Vitamin B12 deficiency Anaemia?

Vitamin B12 is essential for life. It is needed to make new cells in the body such as the many new red blood cells which are made every day. Vitamin B12 is found in meat, fish, eggs, and milk - but not in fruit or vegetables. A normal balanced diet contains enough vitamin B12. A lack of vitamin B12 leads to anaemia, and sometimes to other problems.

What are the symptoms of vitamin B12 deficiency ?

ITP is a blood disorder characterized by an abnormal decrease in the number of platelets in the blood. Platelets are cells in the blood that help stop bleeding. A decrease in platelets can result in easy bruising, bleeding gums, and internal bleeding.

Symptoms due to anaemia

They are caused by the reduced amount of oxygen in the body.

Common symptoms include: tiredness, lethargy, feeling faint, becoming easily breathless.

Less common symptoms include: headaches, palpitations, altered taste, and ringing in the ears (tinnitus).

Other symptoms

Cells in other parts of the body may be affected if you lack vitamin B12. Other symptoms that may occur include a sore mouth and tongue. If left untreated, problems with nerves can develop. For example: confusion, numbness and unsteadiness. These are rare as treatment is simple and usually started when the anaemia is found, and before nerve problems develop.

What are the causes of vitamin B12 deficiency ?

Stomach or gut problems

Past surgery to remove the stomach or certain parts of the gut will mean absorption of vitamin B12 may not be possible. Some diseases which affect the area of gut where vitamin B12 is absorbed may affect the absorption of the vitamin. For example, Crohn's disease.

Dietary causes

It is the commonest cause of B12 deficiency in our country. Strict vegans who take no animal or dairy produce may become vitamin B12 deficient.

Pernicious anaemia

Normally, when you eat foods with vitamin B12, the vitamin combines with a protein called intrinsic factor in the stomach. The combined vitamin B12/intrinsic factor is then absorbed into the body further down in the gut. (Intrinsic factor is made by cells in the lining of the stomach and is needed for vitamin B12 to be absorbed.) 

Pernicious anaemia is the common cause of B12 deficiency in western world. It is due to an 'autoimmune disease'. The immune system normally makes antibodies to attack bacteria, viruses and other 'germs'. If you have an autoimmune disease, the immune system makes antibodies against certain tissues of your body. If you have pernicious anaemia, antibodies are formed against your intrinsic factor, or against the cells in your stomach which make intrinsic factor. This stops intrinsic factor from attaching to vitamin B12, and so the vitamin cannot be absorbed into your body. It is thought that something triggers the immune system to make antibodies against intrinsic factor. The 'trigger' is not known.

What is the treatment for vitamin B12 deficiency ?

You will need vitamin B12 injections. This quickly builds up the body's store of vitamin B12. Vitamin B12 is stored in the liver. Once a store of vitamin B12 is built up, this can supply the body's needs for several months. An injection is then only needed every three months to top up the supply. 
The injections are needed for life in Pernicious anaemia. You should have no side-effects from the treatment as it is simply replacing a vitamin that you need.

Follow up

The symptoms of anaemia usually improve quickly once treatment has begun. You may be advised to have a blood test every year or so. This will check that the anaemia is being treated successfully. A blood test may also be done to see that your thyroid gland is working well. (Thyroid problems are more common in people with pernicious anaemia.) 

If you have any further questions, please donot hesitate to contact me.

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