Anemia occurs, paleness, weakness, fatigue, and in severe cases, symptoms such as shortness of breath and dizziness.
Severe vitamin B12 deficiency can cause nerve damage, tingling and numbness in the hands and feet, muscle weakness, loss of reflexes, difficulty walking, confusion, and mental retardation.
Vitamin B12 deficiency is diagnosed based on a blood test.
When high doses of vitamin B12 are used, the symptoms of anemia are relieved.
Neurological damage and psychiatric symptoms may persist in the elderly.
Along with folate, vitamin B12 (cobalamin) is necessary for the formation and maturation of red blood cells and the synthesis of DNA (deoxyribonucleic acid), the genetic material of cells. Vitamin B12 is essential for normal nerve function. Good sources of vitamin B12 are meat (especially beef, pork, liver and other organ meats), eggs, fortified cereals, milk, oysters, clams, salmon, and tuna. (See also Overview of Vitamins.)

Unlike most other vitamins, B12 is stored in large amounts, mainly in the liver, until needed by the body. If a person stops using this vitamin, the reserves of this vitamin in the body usually last for 3-5 years.

People should not be treated with high doses of vitamin B12, otherwise the vitamin does not appear to be harmful; Overdosing on B12 is not recommended.

Vitamin B12 is found in foods of animal origin. Normally, vitamin B12 is easily absorbed in the last part of the small intestine (ileum), which leads to the large intestine. However, to be absorbed, the vitamin must combine with intrinsic factor, a protein produced in the stomach. Without endogenous factors, vitamin B12 moves through the intestines and is excreted in the stool.

Vitamin B12 is necessary for the formation of mature blood cells, so a deficiency of this vitamin can cause anemia. Anemia is characterized by abnormally large red blood cells (macrocytes) and abnormal white blood cells. Because vitamin B12 is stored in large amounts in the liver, anemia does not develop until 3-5 years after the onset of deficiency.

Vitamin B12 deficiency can cause nerve damage (neuropathy) even without anemia.

Causes of vitamin B12 deficiency
Vitamin B12 deficiency can occur in the following situations:

People don’t get enough vitamin B12.
The body does not absorb or store enough vitamins.
Improper use
Vitamin B12 deficiency occurs in people who do not eat animal products (vegans) unless they take supplements. If a vegan mother breastfeeds her baby, the baby is at risk of vitamin B12 deficiency. Deficiencies caused by inappropriate use are rarely seen in other people.

Inadequate absorption
The most common cause of vitamin B12 deficiency is inadequate absorption. The following conditions may cause inadequate absorption.

Bacterial overgrowth in the small intestine
Malabsorption (absorption disorders such as celiac disease or certain pancreatic disorders)
Inflammatory bowel disease that affects the last part of the small intestine
Fish tapeworm infection
Bariatric surgery for weight loss
Surgery to remove the part of the small intestine that absorbs vitamin B12
Medicines such as antacids and metformin (used to treat diabetes)
Repeated exposure to nitrous oxide (laughing gas)
Lack of internal factors
Decreased stomach acid (common in the elderly)
Intrinsic factor may be lacking because abnormal antibodies caused by immune hyperactivity attack and destroy stomach cells, causing an autoimmune reaction called autoimmune metaplastic atrophic gastritis. Because the part of the stomach where intrinsic factor is produced has been surgically removed, intrinsic factor may be lacking. Due to the lack of endogenous factors, vitamin B12 deficiency can cause anemia known as pernicious anemia.

In the elderly, absorption is insufficient due to decreased stomach acidity. Decreased stomach acid reduces the body’s ability to remove vitamin B12 from meat protein. However, vitamin B12 in vitamin supplements can be absorbed well even by people with low stomach acid.

Insufficient storage
Most of the body’s vitamin B12 is stored in the liver, so liver disease can interfere with vitamin B12 storage.

Symptoms of vitamin B12 deficiency
Vitamin B12 deficiency anemia develops slowly, allowing the body to adapt. Therefore, even if the anemia is severe, the symptoms may be mild.

Signs of anemia

If the anemia is severe, shortness of breath, dizziness, and rapid heart rate may occur. Sometimes the spleen and liver are enlarged.

Young adults with pernicious anemia (due to a lack of endogenous factors) are more likely to develop stomach and other gastrointestinal cancers.

In people with nerve damage, the leg hurts earlier and more often than the arm. Suffering

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