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HindustanTimes Sat,30 Aug 2014

Tired? It could be vitamin deficiency

Rhythma Kaul, Hindustan Times  New Delhi, October 20, 2013
First Published: 23:45 IST(20/10/2013) | Last Updated: 09:58 IST(21/10/2013)

Chronic fatigue, weakness, pale skin colour, shortness of breath and an upset stomach are a few symptoms that may not sound quite frightening. But these could be indicators of low vitamin B12 level in the body.

Such deficiency, if not taken care of in time, could have serious consequences. Vitamin B12 is an important vitamin, responsible for several crucial functions in the human body. It contributes to building the human body’s genetic material, helps in producing red blood cells (RBCs) that are responsible for carrying oxygen through the blood across the body.

Despite being responsible for such crucial bodily functions, a lot of people these days do not have adequate levels of vitamin B12 required for the body to function properly.

“Almost 70% of my patients, who complain of weakness, aches and pains, test positive for vitamin B12 deficiency. The rising numbers of those suffering from vitamin B12 deficiency is because it is being diagnosed now, with most big hospitals having made it part of their health check-up packages,” says Dr Rommel Tickoo, senior consultant, department of internal medicine, Max Hospital, Saket.   

Among those deficient in the vitamin, a majority are vegetarians, as the best source of vitamin B12 are animal products such as milk, eggs, meat, etc. Those who are strict vegetarians and who do not consume milk are at a greater risk of developing the deficiency.

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According to doctors, even borderline cases - normal levels are between 200 and 900 pg/mL (picograms per millilitre), will show symptoms and need to be taken seriously.

“It may not be as bad as Vitamin D deficiency numbers in India, but it is not less either. Though it is an expensive test and we cannot prescribe it to our patients, we do put them on vitamin B12 supplements if they show related symptoms and also have unexplained low blood count,” said a senior doctor from the department of medicine at the All India Institute of Medical Sciences.

The blood test costs anywhere between Rs. 1,500 and Rs. 2,000. Apart from vegetarians, those with metabolic disorders are also at a risk of developing the deficiency as they are not able to absorb the vitamin from the food they eat.

“Those who suffer from short-bowel syndrome or any other intestinal condition have mal-absorption of vitamin B12 and in such patients oral supplements do not work. Such people require supplementation in the form of intra-muscular injections, in some cases, the injections may be needed for life,” said Dr Tickoo.

Symptoms may vary from mild ones like back ache, pain in limbs, memory loss, migraine, tingling sensation in the toes and fingers, bloating to more serious ones like paralysis due to the spinal chord getting affected.

The deficiency for a prolonged period of time can also lead to bone marrow depression that is visible in the blood picture test. “Most such patients will have what we call megaloblastic anemia without any specific reason. Their RBCs will be abnormally large in size that can even turn fat in some cases,” said Tickoo.

Treatmeant for vitamin B12 deficiency is usually oral capsules for three to six months, with diet improvement in non-vegetarians. However, vegetarians can take the capsules till the levels turn normal and take a break for some time and if the levels keep going down again and the symptoms persist, then start the supplementation once again.

“You obviously can’t take the medicines for life, so it is better to take a break in between and then take the capsules as and when symptoms reappear,” said the AIIMS doctor.

Quiz: are you Vitamin B12 deficient?

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