Causes Dietary deficiency strict vegetarian or vegan diet Pernicious anemia autoimmune destruction of stomach cells that absorb B12 Malabsorption disorders celiac disease, Crohns disease, atrophic gastritis Medications long-term use of proton pump inhibitors, metformin Surgical removal of stomach or intestines reduces absorption Signs and Symptoms Fatigue and weakness Pale or jaundiced skin Tingling or numbness in hands and feet (neuropathy) Difficulty walking or balance problems Memory loss, confusion, or mood changes Glossitis swollen, red tongue Shortness of breath, dizziness Complications (if untreated) Permanent nerve damage tingling, numbness, or difficulty walking Megaloblastic anemia large, immature red blood cells Cognitive decline or dementia in severe cases Diagnosis Blood tests low B12 levels, high homocysteine and methylmalonic acid Complete blood count (CBC) shows anemia Intrinsic factor antibodies if pernicious anemia is suspected Treatment Vitamin B12 supplementation: Oral B12 tablets for mild deficiency Intramuscular B12 injections for severe deficiency or absorption problems Dietary sources: Meat, fish, poultry, eggs, dairy products Fortified cereals or plant-based milk for vegetarians Vitamin B12 deficiency can cause anemia and nerve damage
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Before starting any B12 supplementation, ask your healthcare provider to check your baseline B12 level through a simple blood test
For recurrent injection site reactions that occur with every dose, schedule a non-urgent appointment with your healthcare provider or diabetes care and education specialist (CDCES)
Your immune system produces inflammatory cytokines when it detects foreign substances that have entered the body like bacteria, viruses, toxic substances, and certain foods
