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Clinician’s Corner: Vitamin B-12

Vitamin B-12 (cyanocobalamin)- the number one vitamin your Thompson Pharmacist recommends!

Source of B12: muscle meats, liver & dairy products. Not found in vegetables. Vegetarians are at risk.

  • Function: involved in cell division, and recycling of folate. Folate deficiency is observed as a feature of B12 deficiency.  Symptoms of deficiency are reflected in organ systems with rapidly duplicating cells. Vitamin B12 is required for proper red blood cell formation, neurological function, and DNA synthesis
  • Deficiency:
    • Pernicious anemia.
    • Untreated Vitamin B12 deficiency may cause burning in the extremities.
  • Remember –large doses of folic acid will correct the anemia symptoms but will allow neurological damage to progress.
  • Vitamin B12 is bound to protein in meats and dairy products and is released by the activity of hydrochloric acid and gastric protease (an enzyme that breaks down protein) in the stomach.
  • Decreased absorption: anemia, stomach surgery or bariatric weight loss surgery.

Causes of Vitamin B12 deficiency

  • Dietary deficiency of Vitamin B-12 is rare. Noticeable symptoms of a vitamin B12 deficiency can take years to develop. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with very low levels of vitamin B12. True vegans need to supplement B12.
  • Many patients have trouble absorbing B12 from food due to reduced gastric acidity from acid suppressing drugs, like Zantac and Prilosec.
  • Metformin long term will deplete vitamin B12 levels. The challenge becomes that Vitamin B12 deficiency may look like diabetic peripheral neuropathy, with numbness and tingling in the feet and hands.  I have reversed at least 6 patients “neuropathy” by recommending Vitamin B12 1,000mcg per day.  What they really had was a B12 deficiency, and not neuropathy!

Noticeable symptoms of a vitamin B12 deficiency can take years to develop. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with very low levels of vitamin B12.

Anyone taking any acid suppressing drugs, metformin or have had any stomach surgery are excellent candidates for vitamin B12 therapy.  Ask your Thompson Pharmacist to check your med list. Go ahead and ASK, at Thompson Pharmacy it’s all for YOU!

Have a great day on the bench!

Pete Kreckel   Thompson Pharmacy Broad Ave