Anemia megaloblastnaya – Vitamin B12 deficiency – Pernitsioznaya anemia

Description of vitamin B12 deficiency

Vitamin B12 deficiency may occur, when the body needs more vitamin B12, than it receives from the diet. Besides, The situation can be observed, where the body can not use vitamin B12 from food. Lack of vitamin B12 can lead to anemia. Anemia called insufficient supply of red blood cells with oxygen cells organizma.Chem before beginning treatment of anemia, the more favorable will be the outcome.

Causes of vitamin B12 deficiency

There are many causes of vitamin B12 deficiency. Some of them are listed below:

• Removing a portion of the small intestine or stomach;
• Advanced age;
• Long-term use of drugs, reduce stomach acidity:
  • H2 blockers;
  • Proton pump inhibitors;
• Atrophic gastritis (inflammation of the stomach) in connection with the:
  • Iron-deficiency anemia;
  • Bacterial infection of Helicobacter Pylori;
  • Chronic alcohol abuse;
  • Autoimmune response;
• Disease, associated with a decrease in the absorption of vitamins:
  • Crohn's Disease;
  • Mukovystsydoz;
  • Celiac disease;
  • Whipple's disease;
  • Tuberculosis;
  • Prolonged pancreatitis;
  • Zlokachestvennaya anemia;
  • AIDS;
• Inadequate intake of vitamin B12:
  • Long-term veganism (rejection of products of animal origin) or vegetarianism;
  • Infants do vegetarians;
  • Poor nutrition baby;
  • Malnutrition of pregnant women;
  • Chronic alcohol abuse;
• Incorrect work of intestines, which may be caused by:
  • Anomalous narrow bowel;
  • Cavities in the gut;
  • Other diseases of intestine;
• Kišečnae blockade, which may be caused by:
  • Diabetes mellitus;
  • Scleroderma;
  • Amiloidozom;
• Inflammation of the intestine due to radiation therapy;
• Inability absorption of vitamin B12:
  • The lack of the necessary enzymes;
  • Cancer;
  • Malnutrition;
  • The inability to transport protein;
• Increased need for vitamin B12:
  • Hyperthyroidism;
  • Infection with tapeworm (tapeworm);
  • Other types of anemia;
• Excessive use of nitrous oxide:
  • Frequent use it;
  • Long single use nitrous oxide (more than six hours);
• Metabolic disorders:
  • Metilmalonovoâ aciduria;
  • Gomocistinuriя.

Risk factors

Factors, which increases the risk of vitamin B12 deficiency:

• Alcoholism;
• The use of some drugs:
  • Biguanides for diabetes;
  • Para-aminosalicylic acid in the treatment of tuberculosis;
  • Calcium-chelating (linking calcium) preparations, taken orally;
  • Colchicine;
  • Neomycin;
  • Cimetidine;
  • Cholestyramine;
• Age: senior 50 years;
• Being a vegan or vegetarian diet.

Vitamin B12 deficiency symptoms

Symptoms of pernicious anaemia may vary. Symptoms may change or worsen over time. These symptoms may be caused by other diseases. You must inform your doctor, if they came any.

Symptoms may include:

• Tingling sensation in the feet or hands;
• Alternating constipation and diarrhea;
• Burning sensation on the tongue or red-sensitive language;
• Substantial weight loss;
• The inability to differentiate yellow and blue colors;
• Fatigue;
• Paleness;
• Changed ošuŝeniâ taste;
• Depression;
• Violation of the sense of balance, especially in the dark;
• Tinnitus;
• Chapped lips;
• Yellow skin;
• Fever;
• The inability to feel the vibrations in the legs;
• Dizziness when moving from a sitting to standing position;
• Cardiopalmus.

Diagnosis of vitamin B12 deficiency

Tests to diagnose vitamin B12 deficiency include:

• Complete blood count – count the number of red and white blood cells in the blood;
• Vitamin B12 test, which measures the amount of vitamin B12 in the blood;
• Measuring the amount of methylmalonic acid in the blood – This test shows, whether there is a deficiency of vitamin B12;
• Homocysteine – test, which measures the amount of homocysteine ​​in the blood (homocysteine is a component, who participates in the formation of protein). Homocysteine levels will be elevated, If there is a deficiency of vitamin B12, folic acid or vitamin B6;
• Schilling test – analysis, which uses harmless amount of radiation, for assessing vitamin B12 deficiency (rarely used);
• Measuring the amount of vitamin, called folic acid;
• Test gastrin, that can help determine the cause of vitamin B12 deficiency;
• Measurement of protein, called internal factor (Newcastle factor) – commonly produced in the stomach; this test helps to rule out pernicious anemia as the cause of symptoms;
• Staining bone marrow Prussian blue – test, which indicates, there is iron deficiency.

Treatment of vitamin B12 deficiency

Treatment may include:

Oral intake of vitamin B12

This procedure consists in taking high doses of vitamin B12 oral.

Vitamin B12 injections

The doctor may advise the patient to receive injections of vitamin B12 intramuscularly. Injections of vitamin B12 can be administered 2-4 times a week. If blood tests show improvement, your doctor may reduce the number of injections to one per month.

Treatment with antibiotics

Antibiotics may be necessary in cases, When the gut increase the number of bacteria. Bacteria hinder the body absorb vitamin B12 in the gut.

Intranasal intake of vitamin B12

Doctor gives patient medications of B12, that you enter through the nose.

Oral iron preparations

The doctor will recommend this method, When there is a deficiency of iron. In this case, you need to take iron supplements in parallel with vitamin B12.

Prevention of deficiency of vitamin B12

To reduce the risk of developing vitamin B12 deficiency, you must take the following steps:

• It is necessary to avoid prolonged excessive alcohol consumption;
• In accordance with the instructions of the physician, take daily supplements, soderžaŝiâ vitamin B12;
  • In accordance with the instructions of the physician, taking vitamin B12, vegetarians, especially if you have a baby;
• Avoid excessive use of nitrous oxide;
• Ask for the diagnosis and treatment of suspected contamination of a tape worm;
• Ask the doctor to do tests for iron deficiency;
• Pass testing, If the doctor suspects the infection with the bacterium Helicobacter Pylori;
• Ask your doctor to control state across round trips shall therefore medicines:
  • Biguanidы;
  • Aminosalicylic acid;
  • Calcium-chelating (linking calcium) preparations, taken orally;
  • Colchicine;
  • Neomycin;
  • Cimetidine;
  • Cholestyramine.