The primary presentation of mild vitamin B12 deficiency is anemia. Severe deficiency symptoms include fatigue, pale skin, rapid heartbeat, sore tongue, diarrhea or constipation, bleeding gums and weight loss [8]. Symptoms of vitamin B2 deficiency are angular stomatitis and cheilosis, that are gradually replaced by superficial linear cracks. These cracks can get infected by Candida leading to white lesions. Seborrheic dermatitis affects ears, scrotum, nasolabial folds and eyelids which later become reddish. Symptoms of vitamin B6 deficiency in adults include depression, seizures and confusion. Peripheral neuropathy, pellagra with glossitis, seborrheic dermatitis and cheilosis are also the symptoms of Vit.B6 deficiency.

• Weakness

  General weakness typically occurs after a bout of intense activity, like an extra-long hike. Your muscles may feel weak for a few days before you return to normal. [gethealthyu.com]

  Neurologic signs and symptoms: Numbness—tingling Weakness of legs, arms, trunk Impaired vibration—position sense Abnormal reflexes Unsteady or abnormal gait Balance problems Difficulty ambulating Dizziness Tremor Restless legs Visual disturbances Forgetfulness [b12awareness.org]

  Patients with anemia have pallor, tachycardia, weakness, and easy fatigability, and may complain of palpitations. [news-medical.net]

  Weakness Because the body cannot properly process fuel into energy, someone with a vitamin B1 deficiency may become excessively weak and lack the normal energy required for many routine functions. 3. [fitday.com]

  People often naturally think whatever fatigue or weakness they feel is the result of not enough time and rest, but symptoms could well be due to a Vitamin B12 deficiency. [worldhealth.net]

• Malnutrition

  Weight Loss The individual may lose weight as a general aspect of the malnutrition the often accompanies this vitamin deficiency. 2. [fitday.com]

  Malnutrition,51. Kwashiorkor,52. Marasmus,53. Obesity,54. Anaemia,55. Epidemic Dropsy,56. Deficiency Diseases,57. Food Hygiene,58. Milk Hygiene,59. Meat Hygiene,60. Fish Hygiene,61. Egg Hygiene,62. Hygiene of Fruits and Vegetables,63. [saraspublication.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]

  […] sugar, glucose including IV glucose or feeding given to patients in hospital Chronic alcohol excess, which is often the commonest and most serious cause High dietary intake of thiaminases (enzymes that destroy thiamine) from betel nuts and raw fish Malnutrition [stewartnutrition.co.uk]

  […] person consumes at least 140 pounds of sugar a year which robs the body of its vitamin B stores Drugs: both recreational and prescription drugs deplete vitamin B Toxins: poisons in the environment and personal care products deplete vitamin B complex Malnutrition [greenmedinfo.com]

• Dyspnea

  Cardiovascular symptoms include syncope, dyspnea, orthopnea, palpitations, and angina. Gastrointestinal symptoms include heartburn, flatulence, constipation, diarrhea, sore tongue, and early satiety. [emedicine.medscape.com]

• Ulcer

  Lastly, and less commonly B12 deficiency can result from certain medications such as metformin (a treatment for diabetes), anticonvulsants, colchicine (used to treat gout) and long-term use of ulcer medications such as omeprazole or ranitidine. [stuff.co.nz]

  Summary Background This study was designed to determine the effects of two dosages of vitamin D supplementation on inflammatory biomarkers in patients with ulcerative colitis (UC). [clinicalnutritionespen.com]

  […] source ( tinnitus ) loss of appetite and weight loss Symptoms of vitamin B12 deficiency If you have anaemia caused by a vitamin B12 deficiency, you may have other symptoms, such as: a pale yellow tinge to your skin a sore and red tongue (glossitis) mouth ulcers [nhs.uk]

• Tingling

  Tingling or Numbness in the Feet or Hands If you feel tingling sensation in either of these extremities, it could be indicative of a B12 deficiency. [thejoint.com]

  Tingling or Numbness in Limbs B12 deficiency can also cause your limbs (fingers, toes, hands, feet, or legs) to tingle and feel numb. This happens because of vitamin B12's role in maintaining proper nervous system function. [vitamins.lovetoknow.com]

  Updated 26 February 2016 If you have symptoms of weakness, constant tiredness, yellow skin, trouble thinking and tingling or numbness in your feet, hands or legs you may be deficient in vitamin B12, There is a good chance that you might not be getting [health24.com]

  […] nerves is by causing tingling sensations. [healthyandnaturalworld.com]

  Do you have bouts of depression, memory loss or tingling in your hands or feet? If so, you may be suffering from a vitamin B12 deficiency. [nutritiouslife.com]

• Peripheral Neuropathy

  Symptoms can include peripheral neuropathy, a pellagra-like syndrome, anemia, and seizures, which, particularly in infants, may not resolve when treated with anticonvulsants. [merckmanuals.com]

  Additionally, a clear link has been established between a lack of vitamin B12 and peripheral neuropathy. [foundationforpn.org]

  Scientist have also found a clear link between a lack of vitamin B 12 and peripheral neuropathy, a term describing any disorder of the peripheral nerves, which carry information to and from the brain and spinal cord. [health24.com]

  Other deficiencies, like peripheral neuropathy, can be permanent. According to the National Institutes of Health (NIH), between 28 and 35 percent of the population in the United States take vitamin supplements containing vitamin B6. [medicalnewstoday.com]

  Much of the damage is to the large dorsal-root ganglion neurons; the peripheral nerve fibres also demyelinate, so that peripheral neuropathy also occurs. [britannica.com]

• Dizziness

  Dizziness Frequent bouts of dizziness or vertigo can often be a signal that your B12 stores are low. For instance, you may experience a feeling of wobbles when you get up too fast from a sitting position. [activebeat.com]

  In fact, one study that compared vitamin B12 levels of patients who went to the ER for dizziness and 100 healthy volunteers discovered that the dizzy patients had 40 percent less B12 than the volunteers. You feel sad and anxious. [gethealthyu.com]

  Initial symptoms of vitamin B12 deficiency can include: Dizziness Paleness Shortness of breath Fatigue Anaemia Hearing difficulties. [southerncross.co.nz]

  *Name changed You feel wobbly or dizzy. Being off-kilter is another common symptom. "I would get dizzy just walking up the stairs," says Mossess. [prevention.com]

  Vitamin B12 deficiency symptoms include everything from depression, fatigue, and memory loss to canker sores and dizziness. Vitamin B12 plays crucial roles in maintaining the health of your blood cells, digestive system, brain, and nervous system. [universityhealthnews.com]

• Neurologic Manifestation

  RESULTS: In total, 47 (0.7%) bariatric surgical patients (Roux-en-Y gastric bypass n = 36, sleeve gastrectomy n = 9, and duodenal switch n = 2) developed neurologic manifestations secondary to vitamin B deficiencies. [ncbi.nlm.nih.gov]

  Vitamin B 12 deficiency is associated with various symptoms, of which the haematological and neurological manifestations are the most prominent. [nature.com]

  Pathophysiology Of Neurological Manifestations Cyanocobalamin mediates two important enzymatic reactions in humans. [ispub.com]

  The neurological manifestations include myelopathy (disease of the spinal cord), neuropathy (disease of the nerves), sensory disturbances, gait abnormalities, and weakness, while the psychiatric problems range from cognitive and behavioral disturbances [brainblogger.com]

  Interestingly, hematologic and neurologic manifestations are occasionally dissociated. [14, 15] An inverse correlation in the severity of both manifestations has been suggested. [emedicine.medscape.com]

• Memory Impairment

  For example, "memory impairment due to vitamin B12 deficiency can precede blood symptoms of deficiency by years. [greenmedinfo.com]

  For example, “memory impairment due to vitamin B12 deficiency can precede blood symptoms of deficiency by years. [chetday.com]

  […] anemia Pancytopenia (leukopenia, thrombocytopenia) Neurologic Paresthesias Peripheral neuropathy Combined systems disease (demyelination of dorsal columns and corticospinal tract) Psychiatric Irritability, personality change Mild memory impairment, dementia [aafp.org]

Diagnosis of vitamin B12 deficiency is performed by measuring the levels of vitamin B12 and folate in the blood. Complete blood count is also done to look for anemia. If diagnosis of intrinsic factor deficiency is considered important, Schilling test is also performed. Most common diagnostic tool for Vitamin B6 deficiency is measuring the levels of serum pyridoxal phosphate. Urinary excretion of riboflavin is measured for diagnosing vitamin B2 deficiency. Diagnosis is also performed by therapeutic trial.

• Helicobacter Pylori

  Vitamin B₁₂ deficiency is expected to be higher in elderly Indians due to vegetarianism, varied socio-economic strata and high prevalence of Helicobacter pylori infection. [ncbi.nlm.nih.gov]

  These include malabsorption syndromes, autoimmune disease, diet, drugs, chemotherapy, radiation, eating disorders, Helicobacter pylori, gastrointestinal surgeries, nitrous oxide, hepatic disease, and genetic defects. [fibromyalgianewstoday.com]

  In this research 300… Continue Reading BACKGROUND A decreased rate of successful helicobacter pylori (H.pylori) infection treatment has revealed serious demand for more effective regimens to eradicate infection. [semanticscholar.org]

  Atrophic Gastritis can be caused by advancing age, by Helicobacter Pylori or by Autoimmune Gastritis where the patient produces antibodies that destroy either the Parietal Cells or Intrinsic Factor or both. [pernicious-anaemia-society.org]

  Archives of Internal Medicine, Vol. 162, February 25, 2002, pp. 484-85 Helicobacter pylori and low vitamin B12 ANKARA, TURKEY. [yourhealthbase.com]

The treatment for vitamin B12 deficient patients consists of vitamin B12 injections [9] [10]. Riboflavin of 5 mg to 10 mg orally once a day is given as a supplement along with other water soluble vitamins to treat vitamin B2 deficiency. In adults, the deficiency of vitamin B6 is treated using pyridoxine 50 mg to 100 mg orally once a day. People taking isoniazid can also be prescribed with pyridoxine of 30 mg to 50 mg orally once a day. High doses of pyridoxine are effective in the case of inborn errors of metabolism. For pyridoxine deficiency from metabolic demand, large amounts of pyridoxine are necessary.

The prognosis of vitamin B2 deficiency is extremely good when vitamin B2 supplements along with a well-balanced diet are taken. Several patients taking treatment with these supplements will recover in a few weeks period. Negative prognosis is related to conditions like alcoholism, anorexia nervosa or bulimia nervosa. These diseases prevent the patient from taking healthy diet and vitamin supplements [7].

The primary deficiency of vitamin B6 can result from depletion of B6 rich foods in the body. Secondary deficiency is caused by malabsorption, under-nutrition, the use of pyridoxine inactivating drugs and enhanced metabolic demand as seen in hyperthyroidism. Rare intricate errors in metabolism can influence metabolism of pyridoxine. Primary riboflavin deficiency occurs due to insufficient intake of fortified cereals, animal products and milk. Secondary riboflavin deficiency occurs due to chronic diarrhea, liver disorders, peritoneal dialysis, malabsorption syndrome, hemodialysis, chronic alcoholism, long-term use of barbiturates. Autoimmune disorders, pernicious anemia, atrophic gastritis, Crohn’s disease, celiac disease, weight-loss surgery, Grave’s disease and long-term use of acid-reducing drugs are some of the causes of vitamin B12 deficiency [2].

Framingham offspring study found that 39 percent of US adults are at a higher risk for vitamin B12 deficiency with serum vit. B12 < 258 picoMol/L or <350picograms/mL. Prevalence of vitamin B12 deficiency is observed in 5% to 15% of population. This deficiency is higher in developing countries. Low serum vitamin B12 was <148picomols/L or <200 picograms/mL in 25% to 70% of the population studied. According to the national institute of health, deficiency of Vit. B6 is considered as rare in the United States. When present, it can lead to anemia. A European population based study revealed higher plasma concentrations of vitamin B2 and B6 to be associated with a lower risk in colorectal cancer [3] [4].

During cobalamin deficiency, methylmalonic acid and homocysteine levels increase in the blood. The gastrointestinal and hematologic anomalies in this condition might be due to deficiency in DNA synthesis in the quickly dividing cells of bone marrow and gastrointestinal tract. Neurological effects of this condition are thought to be due to the incorporation of cobalamin based synthesis of succinyl CoA into branched chain fatty acids leading to abnormal myelination. Cobalamin in the food is attached to the salivary protein called “R binders” at lower pH in the stomach. Higher duodenal pH promotes the transfer of cobalamin to the proteins of gastric parietal cell protein called intrinsic factor. Cells of ileum absorb the cobalamin-intrinsic factor complex [5] [6].

Eating sufficient amounts of meat, dairy products, eggs, sea food and poultry can help in preventing vitamin B12 deficiency. A vegetarian is recommended to take B12 and multivitamin along with cereal fortified with vitamin B12.

The fuel that is essential for the body consists of a nutritious diet containing carbohydrates, proteins and fats. B vitamins help the body to make use of this fuel. As a result, the human body lacks energy in the absence of vitamin B.. Other B-group vitamins play an important role in the multiplication of cells by making new DNA. Vitamin B supplements are known for suppressing the deficiencies of other vitamins. DNA and red blood cells are made in the body with the help of vitamin B12. Diseases of small intestine, thinning of stomach lining and surgery that removes part of the stomach are some of the reasons for vitamin B12 deficiency. There are eight types of vitamin B. They are B1 or thiamine, B2 or riboflavin, niacin, pantothenic acid, biotin, vitamin B6 or pyridoxine, folate and vitamin B12 [1]. Riboflavin is associated with carbohydrate metabolism and acts as a coenzyme in the oxidation-reduction reactions. Deficiency of riboflavin leads to sore throat, lesions of lips and mucosa of the mouth. If B6 vitamin is excessively processed, it will get depleted from the resultant food. Secondary deficiency results from various conditions.

Vitamin B deficiency does not allow the human body to synthesize carbohydrates, fats and proteins. Therefore, the body will not be able to utilize the necessary fuel it needs. Vitamin B deficiency leads to lack of energy in the body. Some of the symptoms of vitamin B12 deficiency include fatigue, rapid heartbeat and sore throat. Some of the symptoms of vitamin B6 include pellagra, depression and seizures. Some of the symptoms of vitamin B2 include angular stomatitis and cheilosis. Vitamin B6 and vitamin B2 deficiency can be treated by providing 50 mg to 100 mg of pyridoxine orally once a day, and 5 mg to 10 mg of riboflavin orally once a day. Vitamin B12 injection serves best for vitamin B12 deficiency.

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