Vitamin B12 is a water-soluble vitamin that is necessary for the health of your red blood cells and nerve cells. It also helps make DNA and binds to the protein you get from food. Most people get vitamin B12 from the foods they eat or through supplementation. According to the Mayo Clinic website, vitamin B12 deficiency is rare. However, it can occur due to a number of factors.
Causes
When the body destroys cells in the stomach that help absorb vitamin B12 and impairs the body's ability to utilize vitamin B12 from the gastrointestinal tract, it results in a vitamin B12 deficiency known as pernicious anemia. Surgery that removes your lower intestine or part of your stomach can also cause a deficiency. Crohn's or celiac disease, both of which affect how the body digests food, can cause vitamin B12 deficiency, as can a diet lacking in vitamin B12.
Symptoms
Mild symptoms of vitamin B12 deficiency include pale skin, weight loss, constipation or diarrhea, bleeding gums or sore, red tongue, weakness or tiredness, nausea or lightheadedness. Left untreated, a vitamin B12 deficiency can lead to more serious symptoms, such poor muscle coordination and balance; peripheral neuropathy --- characterized by twitching, tingling or numbness in the toes and fingers; impaired mental clarity, i.e., forgetfulness, confusion, difficulty concentrating, impaired judgment and control of impulses; tinnitus, or ringing in the ears; and dementia.
Diagnosis
Your doctor can perform a physical examination and a series of tests that include a complete blood count (CBC) test to check red blood cell count and a blood test to check vitamin B12 levels. He may also check your folic acid levels because the deficiency symptoms are similar. In addition, people who are vitamin B12 deficient tend to also be deficient in folic acid. Your homocysteine and methymalonic, or MMA, levels may also be checked because high levels of these substances indicate low vitamin B12 levels.
Treatment
Treatment usually involves injections of 100 to 1,000 mcg of vitamin B12. You must take a shot every day for a week, then once a week for one month, and once every month for the rest of your life. Vitamin B12 pills are a less expensive and easier option if your doctor determines they will be as effective.
Prevention/Solution
Healthy adults should get 2.4 mcg of vitamin B12 per day; 2.6 to 2.8 mcg for pregnant or lactating teens and women. A healthy diet that includes plenty of meat, eggs, milk and cheese can provide all the vitamin B12 you need. Beef liver and clam are the best sources, as are poultry and fish. Some breakfast cereals are also vitamin B12-fortified. Leafy green vegetables and citrus fruits are good sources of folic acid, which can help keep vitamin B12 levels at a healthy level. For persistent muscle twitching in your feet, see a physician.
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