SUPPLEMENT OF THE WEEK

VITAMIN B₁₂

Vitamin B₁₂, also called COBALAMIN, is a micro nutrient which the body cannot make by itself and is important for many essential body functions. It is one of the water-soluble vitamins that can be stored in the liver for years when in excess.  Lots of problems can develop when the body is deficient of vitamin B₁₂. Plants and animals do not produce it on their own. One way in which it is synthesized or produced is by bacteria in the gut.

There are different forms of vitamin B₁₂ in food. The two main forms are methylcobalamin and cyanocobalamin.  Methylcobalamin is the natural and the most bioavailable type of the vitamin as it can be easily absorbed by the body. This form can be found in foods and supplements. Cyanocobalamin is a synthetic form of vitamin B₁₂ and is frequently used in supplements.

 SOURCES OF VITAMIN B₁₂

DIET: Vitamin B₁₂ is obtained from animal sources which include liver, mackerel, mussels, clams, crab, chicken, meat, sardine, dairy products, and in some fermented foods like cheese. They can also be obtained from fortified foods like cereals and nutritional yeast. Most people obtain their daily requirements by consuming balanced meals. Getting B₁₂ from food is the best and safest way of obtaining the vitamin.

SUPPLEMENTS: Getting vitamin B₁₂ from supplements may be beneficial if the dietary source does not give the required daily amount needed. These include QC vitamin B₁₂ pills, multivitamins, Vitamin B₁₂ injections and nasal sprays. Supplements containing the natural version which is methylcobalamin are preferable.  Doctor’s consultation is important before choosing or taking Vitamin B₁₂ supplements.

FUNCTIONS OF VITAMIN B₁₂

Vitamin B₁₂ plays a very significant role in the overall wellbeing of the body.

• It plays an essential role in red blood cell formation.
• It is important for the production of DNA (the central information storage system of the body).
• It plays a key role in energy production.
• Vital for proper brain and nerve functioning.
• Stimulates the production of serotonin (the ‘feel good’ hormone) thus boosting one’s mood.

DEFICIENCY OF VITAMIN B₁₂

Deficiencies are not common but can be serious when they occur. Vitamin B₁₂ deficiency include pernicious anaemia (also caused by folate deficiency), in which the body produces few red blood cells that are too large, thereby reducing their ability to function properly. This reduces the amount of oxygen that is carried. Other deficiencies of the vitamin include atrophic gastritis (thinning of stomach lining) and diseases which affect the small intestine such as Crohn’s and Celiac diseases.

SYMPTOMS OF VITAMIN B₁₂ DEFICIENCY include anaemia, fatigue, lightheadedness, pale or yellow skin, headaches, blurred vision, depression, memory loss, burning or numbness or tingling of the hands and feet due to nerve damage, smooth and lightly swollen tongue, sores in mouth, irritability, loss of appetite, problems with balance when walking, loss of appetite, fast pulse rate and tinnitus (hearing sounds from inside the body rather than from an outside source). Many symptoms improve with treatment and some of the problems caused due to low levels of the vitamin may be reversed. However, the longer these conditions go untreated, the more severe the damage caused which may be permanent or irreversible. It is advisable to seek medical help as soon as symptoms begin.

People at risk of vitamin B₁₂ deficiencies include strict vegetarians; some elderly people over 60 years of age with atrophic gastritis; individuals who have gone through weight loss surgery or other operations where part of the stomach is removed; people whose stomach cannot produce enough stomach acid causing less absorption of vitamin B₁₂; alcoholics; pregnant and nursing women who breastfeed exclusively, especially those who are strict vegetarians; and people who take certain medications that interfere with the absorption of vitamin B₁₂ (such as certain diabetic medications like metformin, and taking vitamin B₁₂ together with vitamin C).

              SOME WAYS OF PREVENTING VITAMIN B₁₂ DEFICIENCY

• Consuming meals containing animal food sources like meat, fish, poultry, eggs and milk.
• Taking vitamin B₁₂ supplement like QC vitamin B₁₂ and multivitamins. This is important for those who do not consume foods from animal sources like strict vegetarians. Seek medical advice before commencing the intake of supplements.
• Eating of vitamin B₁₂ fortified foods by people who do not consume foods from animal sources.

              TREATMENT OF B₁₂ DEFICIENCY

              Below are suggested ways of treating vitamin B₁₂ deficiencies:

• Taking of vitamin B₁₂ injection for a very short period (or until symptoms begin to improve) may help improve vitamin B₁₂ deficiency anemia.
• Consuming meals very rich in sources of the vitamin.
• Taking high doses of vitamin B₁₂ supplement for those who cannot easily absorb the vitamin. This should be done in consultation with a doctor.
• Including vitamin B₁₂ fortified foods in meals.
• Taking multivitamins.

RECOMMENDED DIETARY ALLOWANCE: 2.4mcg/day is the recommended dietary allowance. However, requirement may be dependent upon one’s eating habits, age, medical conditions and the types of medication one is taking. Higher dosage may be required if vitamin B₁₂ level is very low. Seek medical advice before taking any form of vitamin B₁₂.

EXCESS OR TOXICITY – This is less likely to occur as the body can absorb what it requires, and any excess removed by the kidneys through urine. However, supplementing with very high doses, especially high injection doses, may cause side effects like headaches, acnes and nausea.