Diagnosis Of Vitamin B12 Deficiency
Usually, vitamin B12 deficiency is suspected when routine blood tests detect large red blood cells. Doctors sometimes suspect it when people have typical symptoms of nerve damage, such as tingling or loss of sensation. If the deficiency is suspected, the level of vitamin B12 in the blood is measured.
Usually, doctors also measure the blood level of folate to rule out folate deficiency Folate Deficiency Folate deficiency is common. Because the body stores only a small amount of folate, a diet lacking in folate leads to a deficiency within a few months. Not eating enough raw leafy vegetables… read more , which can also result in large red blood cells.
If vitamin B12 deficiency is confirmed in an older person, no other tests are done because the cause, such as low stomach acidity, is usually not serious. In a younger person, other tests, including other blood tests, may be done to determine the cause.
Endoscopy may be done to check for destruction of stomach cells that produce intrinsic factor.
Screening For Vitamin B12 Deficiency Among Patients With T1dm
Among patients with T1DM, there are no clear guidelines regarding screening for vitamin B12 deficiency. However, due to the high prevalence of pernicious anaemia and subsequent vitamin B12 deficiency among T1DM patients reported in most cross sectional studies, it would be pragmatic to screen at diagnosis and then later yearly for 3 years, then five yearly thereafter or in presence of any clinical indication since vitamin B12 deficiency can develop at anytime . Screening should involve assessment of serum vitamin B12 levels and markers of gastric autoimmunity like PCA and AIF especially among T1DM patients with GAD-65 and thyroid peroxidase antibodies. Presence of these auto antibodies increases the propensity to developing vitamin B12 deficiency .
Significance Of This Study
What is already known about this subject?
Accumulating evidence suggests that metformin as the first choice of therapy for glycemic control may lead to low levels of serum vitamin B12.
What are the new findings?
Vitamin B12 insufficiency was frequently found in our population and may progress into B12 deficiency that is also associated with neuropathy in subjects on metformin.
How might these results change the focus of research or clinical practice?
In clinical practice, B12 levels may be checked especially in people with type 2 diabetes mellitus using metformin for > 2 years to confirm B12 deficiency and/or B12 insufficiency.
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It May Treat Mouth Ulcers
Another symptom of vitamin B12 deficiency? Mouth sores or ulcers. These can pop up on your tongue, gums, or on the inside of your mouth. This can also be indicative of a folate deficiency . While mouth ulcers usually donât need treatment, they can be quite painful, especially if you eat acidic fruits such as oranges, lemon, grapefruit, or something spicy. One way to decrease the pain and accelerate the healing process is to take vitamin B6 and B12 supplements.
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Can Vitamin Deficiency Cause High Blood Sugar
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Consequently, can low vitamin D cause high blood sugar?
If you have a vitamin D deficiency, you’re more likely to develop type 2 diabetes. Vitamin D helps your body produce hormones that regulate your blood sugar. Without it, your blood sugaris more likely to fluctuate and spiral out of control.
Secondly, what vitamin helps lower blood sugar? Here are 10 supplements that may help lower blood sugar.
- Cinnamon. Cinnamon supplements are either made from whole cinnamon powder or an extract.
- American Ginseng.
Also know, does vitamin D help with blood sugar?
Vitamin D is believed to help improve the body’s sensitivity to insulin the hormone responsible for regulating blood sugar levels and thus reduce the risk of insulin resistance, which is often a precursor to type 2 diabetes.
Can Vitamin b12 affect blood sugar?
It is more likely that you are deficient in iron, folate and/or vitamin B12. When red blood cells are old and A1c values show blood sugar levels to be higher than reality, insulin regimens can be mistakenly increased. This can cause hypoglycemia.
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What About The Glycemic Index
Your daily carb total, spread steadily across the day, is one key to good blood sugar control. Some people also use the glycemic index , a rating of how individual foods raise blood sugar levels. Beans and whole-grain breads and cereals have a lower GI than white bread and regular pasta. Juice has a higher GI than whole fruit. Craving a high-GI food? Eat it along with a lower-GI choice to help control your levels.
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Causes Of High Vitamin B12 Blood Levels
Increased levels of vitamin B12 can exist for a number of reasons, which can be divided roughly into the following categories:
This article will take a closer look at the causes of elevated B12 blood levels, as well as considering the necessary ways to respond. At the end, there is also a guide of what to do if this is the case.
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Assessment Of B12 Status Among Patients With Pernicious Anemia
Pernicious anemia is a condition in which the gastric parietal cells fail to synthesis the intrinsic factor, which is essential for B12 absorption. A positive test for intrinsic factor antibodies may be a useful assessment method in some patients with pernicious anemia . However, some individuals do test positive for the intrinsic factor antibody without actually having pernicious anemia. Parietal cell antibody test constitutes another, more accurate, assessment method. It is believed that up to 90 percent of patients with pernicious anemia will have a positive parietal cell antibody test . Both the intrinsic factor antibody and the parietal cell antibody may detect the presence of antibodies in the stomach secretions and in serum.
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Here are seven herbs and supplements that may be of benefit to people with type 2 diabetes.
Using Supplements for Diabetes Treatment
- Chromium. Chromium is an essential trace element.
- Vitamin B-1. Vitamin B-1 is also known as thiamine.
- Alpha-Lipoic Acid. Alpha-lipoic acid is a potent antioxidant.
- Bitter Melon.
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Treatment Of B12 Deficiency In Diabetes Patients
There are a few different options as far as how you can treat your vitamin b12 deficiency if you are diabetic. The first possible treatment option is to look at your diet.
We understand that veganism is a popular diet that has many health claims behind it, and we know that many do it for animal rights. However, since B12 comes from animal protein, it may be difficult to get the proper vitamin nutrients from a plant-based diet.
Adding animal protein in your diet may help boost your vitamin B12 levels. This includes poultry, seafood, eggs, and dairy products. It is best to incorporate these foods into your diet prior to becoming deficient in B12 as a way to prevent it.
If deficiency of B12 is severe, then injections of B12 may be recommended by your doctor. A B12 injection costs up to $80, depending on your location and insurance. The two common injections are cyanocobalamin and hydroxocobalamin. Typically, as part of maintenance therapy, an injection of 100-200 mcg is given once a month.
Vitamin B12 supplements can also be taken by mouth. Discuss what dosage your doctor suggest for an oral B12 supplement. It is typically taken once daily.
Vitamin B6 For Lowering Blood Sugar
When diet is insufficient in Vitamin B6, tryptophan is converted into xanthurenic acid that damages the pancreatic tissues.
If fifty milligram of Vitamin B6 is given daily to a diabetic patient, there is a marked and rapid decrease in urinary xanthurenic acid. A continued daily dosage of ten to twenty milligrams shows total absence of urinary xanthurenic acid. Thereby diabetics can take Vitamin B6 in liberal quantities.
The main rich sources of Vitamin B6 are:
- Cereals like toasted wheat germ, brown rice and barley.
- Pulses and legumes like dry soybean, dry lentil and lima beans.
- Vegetables like spinach and other green leafy vegetables, cauliflower and carrot.
- Nuts and oil seeds like sunflower seeds and walnuts.
- Fruits like avocados and raisin.
- Milk and brewers yeast are other sources rich in Vitamin B6.
Can Too Much B12 Cause Headaches
. Accordingly, can taking b12 cause headaches?
Vitamin B12 deficiency symptoms include breathlessness, fatigue, and a loss of appetite. But headaches could also be a warning sign of the condition, it’s been revealed. Persistent migraines could be caused by peripheral nerve cell damage – a side effect of vitamin B12 deficiency, said medical company Migrant.
Similarly, can too much vitamins cause headaches? Vitamins. The excessive ingestion of fat-soluble vitamins, such as vitamin A and D, and some water-soluble vitamins, including the various B vitamins and vitamin C, has the potential for serious side effects. Niacin may cause headaches.
Subsequently, one may also ask, what happens if your b12 is too high?
The most common cause of high B12 in the blood is due to recent ingestion or injection of supplemental vitamin B12. Liver disease due to release of B12 from damaged liver cells into the bloodstream. Kidney disease due to impaired function of the kidneys to excrete excess B12.
Is too much vitamin B bad for you?
Potential Side Effects. Since B vitamins are water-soluble, it’s unlikely that you will consume too much of these nutrients through diet alone or by taking a B-complex supplement as directed. High doses of supplemental B3 may lead to vomiting, high blood sugar levels, skin flushing and even liver damage
Are You Overdoing It On The B12
4 years ago |Nutrition
Recently, a very good friend of mine who is about 60-years-old told me her blood test came back showing excessive vitamin B12.
When I inquired what her doctors advice was, she said she was told to stop taking her B12 supplements and return in a month to be retested. According to her doctor, my friends body was producing its own B12 and most likely she was over supplementing.
So I decided to do some research and determine for myself what the consequences of too much vitamin B12 are and whether, in fact, the body produces its own.
What is vitamin B12?
Water-soluble vitamins are generally carried to the body’s tissues and then leftover amounts of the nutrient leave the body through urine, reports the National Institutes of Health .
B12 helps keep the bodys nerve and blood cells healthy and helps make DNA. This is all important for metabolism, cellular and nervous system functions. Vitamin B12 also helps prevent a type of anemia called megaloblastic anemia, which makes people tired and weak.
Some reports say that a B12 deficiency may even lead to depression.
And age may affect how your body absorbs B12.
Taking certain drugs, like proton-pump inhibitors , may also affect the way your body absorbs B12.
Can humans produce vitamin B12?
Other animals, fungi and plants are also not capable of synthesizing B12.
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The Importance Of Time Intervals
A very common reason for high B12 levels is because the blood test has been carried out too soon after the administration of a B12 injection. This should be avoided and tests should be delayed by 7-10 days post-injection. Results can otherwise be very misleading, as B12 that has not yet been metabolised elevates the blood level. Nonetheless, high B12 levels are absolutely harmless in these cases.
Taking high-dose oral B12 supplements can also greatly increase blood levels here, the same period of 7-10 days should be observed before testing.
Should high blood levels occur during a course of vitamin B12, then another measurement should be taken 10 days after supplementation has ended.
Vitamin B12 Deficiency And Type 2 Diabetes
Getting enough Vitamin B12 in your diet through the food you eat is only one piece of the picture. After it has been ingested, the B12 then needs to be absorbed from the gut into the body, then travel to the cells to do its work. Vitamin B12 requires something called intrinsic factor in order to be absorbed from the lumen of the gut into the body. Some people dont make as much intrinsic factor, and generally speaking, as we get older, we make less and less, which is a reason why the elderly are at higher risk for B12 deficiency, too.
Additionally, metformin , is one of many medications that interferes with absorption of Vitamin B12. It has been estimated that 10-30% of people who take metformin may not be able to absorb Vitamin B12. Another study showed that 75% of metformin users were deficient. Whether the range is 10% or 75%, its still something to be concerned about if youre taking metformin, you are at higher risk for B12 deficiency.
Interestingly, it also seems to be the case that B12 deficiency may cause hyperglycemia so there may be a bit of a cyclical relationship between the two.
People who have had bariatric surgery are at high risk for deficiency also, since their absorptive area has been reduced and the portion of the stomach that secreted intrinsic factor may be gone or destroyed.
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Routine Vitamin B12 Screening May Prevent Irreversible Nerve Damage In Type
Patients with type-2 diabetes, taking metformin, should have their vitamin B12 levels assessed more regularly to avoid irreversible nerve damage, according to a new study presented at the Society for Endocrinology annual conference in Glasgow. The study findings suggest that earlier detection of vitamin B12 deficiency through routine screening of all metformin-treated, type-2 diabetes patients could reduce their risk of developing irreversible, painful and potentially disabling nerve damage.
The increasing incidence of type-2 diabetes is a serious health issue worldwide. Its prevalence is associated with poor diet and unhealthy lifestyle choices, and it is characterised by high blood glucose levels that need to be controlled by medication. Nerve damage in the periphery is a common complication of diabetes, with symptoms that range from numbness to pain, and can lead to debilitating loss of balance and co-ordination. Metformin is the recommended and most effective first-line drug for type-2 diabetes but its use has also been linked to vitamin B12 deficiency, which increases the risk of peripheral nerve damage. Despite the irreversibility of peripheral nerve damage, no official guidelines exist on screening vitamin B12 levels in patients treated with metformin.
The poster, Metformin use and Vitamin B12 Deficiency was presented by Kaenat Mulla at the Society for Endocrinology BES 2018 Conference 19-21 November, in Glasgow, UK.
Folate Folic Acid Or B9
The term folate includes 150 components of the family of pteroilglutamate, which participate in cell replication by enzymatic activity in purine base synthesis for DNA and are a primary co-factor for transamination in the transformation of amino acids, particularly homocysteine into methionine. Folates are present in animal tissue, leafy vegetables, legumes and nuts and their deficiency has been associated to megaloblastic anemia, neural tube defects, cardiovascular disease, cancer and senile dementia .
Implication of folate in pathogenesis of type 2 DM is linked with vitamin B12 shortage and its consequent hyperhomocysteinemia, and although its deficiency is not widespread, supplementation trials have been carried out in diabetic patients .
Folates are made up of 4 benzoic acid, pteroic acid which is bonded with multiple or single monomers of L-glutamate. They lie in the family of heterocyclic organic compounds group .
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Symptoms Of Other Conditions
Certain people are more at risk of vitamin B-12 deficiency than others, especially those who have low stomach acid or other digestive issues. Stomach acid separates vitamin B-12 from food so that the body can absorb it more efficiently.
The following groups of people are more likely than others to experience low vitamin B-12 levels:
- older adults
Metformin Causing Vitamin B12 Deficiency: A Guilty Verdict Without Sufficient Evidence
Metformin causing vitamin B12 deficiency has become a traditional myth in medical literature . But what evidence do we have? The possibility to measure holotranscobalamin and the metabolic marker, methylmalonic acid , has changed the practice of diagnosing B12 deficiency in recent years. We have learned that not all low plasma B12 means a deficiency and not all high plasma B12 mean sufficiency. When B12 is internalized and is able to maintain the B12-dependent intercellular enzyme activities , plasma total homocysteine and MMA will be within the reference range. This revolution in diagnosing B12 deficiency has provided convincing evidence that metformin is not as bad as its reputation.
Taken together, there is no evidence that pathological levels of the biochemical markers of B12 are more common in metformin-treated compared with nonmetformin-treated patients, despite lowering B12 in serum or plasma. This letter aims to raise the consciousness of medical practitioners of the common misleading statements on metformin causing vitamin B12 deficiency. A combined assay of vitamin B12 and MMA can identify the deficiency in suspected cases.
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