Early detection of Vitamin B-12 deficiency is vital, because if untreated, it can cause megaloblastic anemia and a myriad of persistent symptoms, including fatigue, muscle weakness, constipation, decreased appetite, weight loss and mouth soreness. Neurologic symptoms of B-12 deficiency include numbness and tingling in the hands and feet, balance problems, depression, dementia and memory difficulties. According to the Oxford Journals, it is important, particularly in diabetics, to assess the medications the patient is taking, as Metformin may promote malabsorption of Vitamin B-12.
Function
Vitamin B-12 from food combines with intrinsic factor in the gut and is absorbed by a process called endocystis, via the distal ileum of the bowel. Vitamin B-12 is naturally found in such foods as meat, poultry, fish, eggs and dairy, and is released in the stomach in conjunction with hydrochloric acid and DNA processing. Vitamin B-12, contains the mineral cobalt and is considered to be a cobalamin compound. Synthetic Vitamin B-12, also known as free-form B12, from pills and cyanocobalamin injections, is spontaneously absorbed more efficiently.
Significance
In people experiencing numbness and tingling in their hands and feet, it is important to specifically look at homocystine levels and B-12 levels to assess for Vitamin B-12 deficiency. In patients not known to have diabetes, these symptoms may signal neurological dysfunction that may require the expertise of an experienced neurologist, especially if other signs and symptoms exist such as fatigue, mental changes, or balance problems not attributed to another medical condition.
B-12 Deficiency and Metformin
In known diabetic patients that are taking Metformin, a hypoglycemic agent, there is an increased chance of malabsorption of Vitamin B-12, causing a deficiency of this essential vitamin. Vitamin B-12 is vital to the production of red blood cell formation, neurological function, and is needed for DNA processing in the body. Vitamin B-12 deficiency is often cryptic and can even be baffling to the most learned of physicians.
Effects
A deficiency in Vitamin B-12 can cause pernicious anemia, an auto-immune disorder, leading to megaloblastic anemia associated with low red blood counts, gastric atrophy, and even the obliteration of parietal cells needed to produce intrinsic factor, vital to endocystis. Early, timely, treatment of vitamin B-12 deficiency is critical to preventing lasting symptoms, including sensory loss in hands and feet and significant diabetic nerve pain for those living with diabetes.
Warning
Though there are no known side effects associated with elevated levels of Vitamin B-12, the extent of damage from B-12 deficiency may be far-reaching and permanent, if left untreated. It is noteworthy that according to the National Institutes of Health, 10 to 30 percent of patients in a study that were taking Metformin were found to have a decrease in absorption of Vitamin B12.
