Presentation
Possibly such malabsorption may also be present in many of those vegans developing overt vitamin-B12 deficiency in whom Schilling test findings have been normal. [ncbi.nlm.nih.gov]
Known causes of vitamin B 12 malabsorption such as intrinsic-factor deficiency, anti-intrinsic-factor antibodies, ileal disease and bacterial overgrowth were not present. [nejm.org]
Otherwise, no hitherto known causes of the reduced vitamin B 12 absorption could be found, in particular no other malabsorption symptoms were present. [onlinelibrary.wiley.com]
Entire Body System
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Malnutrition
The outcome is malnutrition. Malnutrition may also be caused by inadequate diet with or without malabsorption. See also the separate Malnutrition article. [patient.info]
Deficiency may be caused by malabsorption, malnutrition, or an increased demand. The most common underlying cause of vitamin B 12 deficiency is pernicious anemia, an autoimmune disorder characterized by the absence of intrinsic factor (IF). [amboss.com]
Peripheral neuropathy may occur as a result of malnutrition, for which there are many causes including poor nutrition caused by an unbalanced diet and/or alcoholism. [foundationforpn.org]
You may have anemia, malnutrition, low blood pressure, weight loss, or muscle wasting. Malabsorption may affect people based on age or gender. For instance, women may stop menstruating, and children may not grow properly. [healthline.com]
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Turkish
Familial selective vitamin B 12 malabsorption (Imerslund-Grasbeck syndrome) in a pool of Turkish patients. Pediatr Hematol Oncol 1995 ; 12 : 19 -28. Altay C, Cetin M. Oral treatment in selective vitamin B 12 malabsorption. [clinchem.aaccjnls.org]
One Turkish study compared the vitamin B12 levels of patients who sought treatment in the ER for dizziness with those of 100 healthy volunteers. The result: Those dizzy patients had 40% less B12 than the volunteers. Your skin looks pale. [prevention.com]
A Turkish study found endoscopic evidence of H pylori infection in more than 50% of vitamin B-12–deficient patients. Antibiotics alone eradicated H pylori in 31 patients, with resolution of vitamin B-12 deficiency. [emedicine.medscape.com]
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Malaise
Other symptoms include fatigue and malaise. Cardiovascular symptoms include syncope, dyspnea, orthopnea, palpitations, and angina. Gastrointestinal symptoms include heartburn, flatulence, constipation, diarrhea, sore tongue, and early satiety. [emedicine.medscape.com]
Gastrointestinal
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Overeating
He has written or edited over 550 articles, which includes over 160 peer-reviewed manuscripts based on original research and 85 reviews and 30 books. [books.google.de]
Vitamin B 12 deficiency symptoms Vitamin B 12 deficiency can be slow to develop, causing symptoms to appear gradually and intensify over time. It can also come on relatively quickly. [health.harvard.edu]
Donaldson RM Jr: Small bowel bacterial over-growth. Adv Intern Med 16:191–212, 1970 Google Scholar 28. [link.springer.com]
This means that many people have a large reserve of the vitamin, sufficient to tide over several years of deficient diet. [news-medical.net]
Over time, untreated vitamin B12 malabsorption leads to severe depletion of vitamin B12 in the blood, causing debilitating symptoms indicating nerve damage (neuropathy), reduced oxygen (hypoxemia), or a variety of other ailments. [b12patch.com]
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Intestinal Disease
Cluysenaer, dr. van Tongeren and their as sociates have been involved in long-term studies of patients with intestinal disease for the past fifteen years. [books.google.de]
Skin
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Purpura
The classic hematological abnormalities encountered include aregenerative macrocytary anemia and other less common, though more severe, hematological abnormalities as: intramedullar hemolysis, thrombopenic purpura, myelodysplasia, medullar aplasia, early-stage [omicsonline.org]
Psychiatrical
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Withdrawn
A 3 year old girl with Down's syndrome became lethargic and withdrawn, and investigations showed a specific malabsorption of vitamin B12 without proteinuria. [ncbi.nlm.nih.gov]
Neurologic
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Neglect
Could be from a Common Vitamin B12 Deficiency Deficiencies You Can Deal With The rationale for using high-dose cobalamin (vitamin B12) CFIDS Chronicle Physicians’ Forum A pilot study of vitamin B12 in the treatment of tiredness Vitamin B-12: placebo or neglected [b12patch.com]
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Cognitive Disorder
Clinical features of food-cobalamin malabsorption syndrome Mean age years 76 8 Sex ratio (women/men) 2 Symptomatic patients Clinically 70% Biologically 76% Main clinical manifestations Sensitive polyneuropathy 45% Cognitive disorders 23% Asthenia 21% [omicsonline.org]
Workup
PET, SPECT
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Abnormal Schilling Test
Despite the frequency of abnormal Schilling tests, vitamin B12 deficiency is very rare in cases of exocrine pancreatic dysfunction, in adults as well as in children with cystic fibrosis. [ncbi.nlm.nih.gov]
Eight subjects (73%), including these 3 subjects plus 5 others with normal vitamin B 12 levels, had abnormal Schilling test results. [jamanetwork.com]
Serum
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Macrocytic Anemia
Megaloblastic macrocytic anemia Antony AC. Megaloblastic anemias. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 39. Bunn HF. Approach to the anemias. [medlineplus.gov]
anemia Folate deficiency Myelodysplastic syndrome Starting folate treatment before excluding vitamin B 12 deficiency may correct anemia, but could worsen neuropathy! [amboss.com]
The opposite of Macrocytic Anemia is Iron Deficiency Anemia, technically called, “Microcytic Anemia” micro meaning little. [health-boundaries.com]
Doctors usually wait for enlarged red blood cells and/or macrocytic anemia to be present. But that is the last, advanced stage of B12 deficiency. At this point, some of the damage can’t be reversed. [regevelya.com]
Vitamin B 12 deficiency is one of the most common causes of macrocytic anemia [ 3, 4 ]. If it is not treated, anemia symptoms and neurological disturbances resulting in spinal cord and cerebral cortex demyelination may emerge [ 5 ]. [intechopen.com]
Microbiology
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Giardia Lamblia
Jameson JE: Notes on cases of chronic diarrhoea and vague ill health, apparently due to the flagellate Giardia lamblia. J R Army Med Corps 77:320–323, 1941 Google Scholar 7. Fraser JF, Taylor R: Diarrhoea due to Giardia lamblia. [link.springer.com]
In addition, as you will see below, other digestive infections such as tapeworm and Giardia lamblia can also result in a reductino in B12 absorption. [h-pylori-symptoms.com]
Treatment
Defective absorption was also found in six patients with an adequate dietary intake of vitamin B12, normal Schilling test results, low serum vitamin concentrations, and tissue changes responding to treatment with vitamin B12. [ncbi.nlm.nih.gov]
Lane LA, Rojas-Fernandez C (2002) Treatment of vitamin b(12)-deficiency anemia: oral versus parenteral therapy. Ann Pharmacother 36: 1268-1272. [omicsonline.org]
Central Hospital, Næstved, Denmark Search for more papers by this author Herlufsvænge 18, Næstved Denmark Abstract A 44-year-old woman underwent extirpation of a reticulum cell sarcoma in the right anxilla 10 years previously, followed by local roentgen treatment [onlinelibrary.wiley.com]
Oral treatment in selective vitamin B 12 malabsorption. J Pediatr Hematol Oncol 1997 ; 19 : 245 -246. Altay C, Cetin M. Vitamin B 12 absorption test and oral treatment in 14 children with selective vitamin B 12 malabsorption. [clinchem.aaccjnls.org]
Prognosis
Prognosis Prognosis is good. Without treatment, neurological and hematopoietic complications can occur that can also be fatal. The documents contained in this web site are presented for information purposes only. [orpha.net]
Prospective parents with a family history of the disorder may benefit from getting genetically tested and seeking genetic counselling With sustained treatment, the prognosis of Imerslund-Gräsbeck Syndrome is excellent. [dovemed.com]
[…] improve in the first week Neurologic symptoms improve within 6 weeks to 3 months Anemia, Leukopenia, MCV and Thrombocytopenia improve within 2 months Monitor Serum Potassium levels while replacing Vitamin B12 Hypokalemia occurs as hematopoiesis increases Prognosis [fpnotebook.com]
Other areas of interest include identifying new biomarkers that can be used for diagnosis and prognosis of liver disease, understanding mitochondrial oxidative stress in Alzheimers disease and gastrointestinal dysfunction in autism. Dr. [books.google.de]
[…] nutritional plan, including foods high in vitamin B12 (such as meat, milk, cheese, and eggs) and folic acid (leafy, green vegetables, citrus fruits, and fortified cereals) foods high in the other B vitamins need to keep an accurate dietary history that the prognosis [quizlet.com]
Etiology
The etiology of these syndromes is not known, but evidence for a hereditary predisposition as well as environmental factors has been documented. [annals.org]
Besides the aforementioned manifestations, those related to the age of the patient or the etiology of malabsorption should also be considered. [omicsonline.org]
Etiology Patients have bi-allelic mutations in the GIF gene on chromosome 11 encoding the gastric Intrinsic Factor (IF), a protein necessary for the absorption of vitamin B12. [orpha.net]
Causes The etiological factors leading to a deficiency of vitamin B12 may be due to deficit of the vitamin in the diet, impaired absorption of the vitamin because of malabsorption syndromes, and various miscellaneous gastrointestinal pathologies. [news-medical.net]
Etiology Malabsorption Intrinsic factor Pernicious anemia : most common cause of vitamin B 12 deficiency Atrophic gastritis (e.g., secondary to H. pylori infection) Gastrectomy Reduced uptake of IF- vitamin B 12 complex : e.g., Crohn's disease ;, celiac [amboss.com]
Epidemiology
The goal of this study is to review epidemiological studies related to vitamin B12 deficiency and to point out the importance of identifying and treating it. Keywords epidemiology vitamin B12 anemia deficiency nutrition 1. [intechopen.com]
Summary Epidemiology The incidence and prevalence of IFD are unknown. Fewer than 100 cases have been reported in the literature and fewer than 50 cases have been confirmed molecularly. [orpha.net]
Vitamin B12 Deficiency, Pernicious Anemia, B12 Deficiency, Cobalamin Deficiency, Cyanocobalamin Deficiency Epidemiology Prevalence U.S.: 6% in patients under age 60 years (20% in those over age 60 years) Latin America: 40% Kenya: 70% East India: 70-80% [fpnotebook.com]
Heymsfield, SB, Ross, RR, Garry, PJ, and Lindeman, RD Epidemiology of sarcopenia among the elderly in New Mexico. Seite 149 - Kumar R, Riggs BL: Impaired vitamin D metabolism with aging in women. [books.google.de]
Epidemiology of anemia in the elderly: information on diagnostic evaluation. J Am Geriatr Soc. 2003 Mar. 51(3 Suppl):S2-9. [Medline]. Beach RS, Mantero-Atienza E, Shor-Posner G. Specific nutrient abnormalities in asymptomatic HIV-1 infection. [emedicine.medscape.com]
Pathophysiology
Balances summaries of relevant pathophysiology with clear, practical clinical guidance to help you thoroughly understand the underlying science of diseases. [books.google.de]
6% in patients under age 60 years (20% in those over age 60 years) Latin America: 40% Kenya: 70% East India: 70-80% Pathophysiology See Vitamin B12 Symptoms may lag Vitamin B12 Deficiency for as many as 10 years until vast hepatic stores are exhausted [fpnotebook.com]
during pregnancy, breastfeeding, fish tapeworm ( Diphyllobothrium latum ) infections, and leukemia References: [1] Pathophysiology Dysfunctional biochemical reactions Physiological function : Vitamin B 12 is a water-soluble cofactor for enzymatic reactions [amboss.com]
Vitamin B 12 treatment must be continued for life unless the pathophysiologic mechanism for the deficiency is corrected. Infants of vegan mothers should receive supplemental vitamin B 12 from birth. [merckmanuals.com]
Prevention
A failure to degrade haptocorrin can prevent the binding of vitamin B12 to intrinsic factor. [ncbi.nlm.nih.gov]
Colchicine in vitro did not prevent vitamin B 12 binding to intrinsic factor or binding of this combination to guinea-pig ileal mucosa. [nejm.org]
If B12 deficiency is due to alcoholism, abstinence may prevent further impairment of B12 absorption. Nutritional Supplements Commonly 3 to 4 mcg/day of vitamin B12 prevents deficiency. [anapsid.org]
Prevention The best prevention is adequate dietary intake of B12 vitamin. When the problem is caused by malabsorption, it is necessary to supplement vitamin B12 in injection form. [health-tutor.com]