Here is the lowdown on this Big B in our lives: This water-soluble vitamin also known as cyanocobalamin, helps support our adrenal functions, regulates DNA synthesis, calms down and ensures the health of our brain and nervous system, and is the king for key metabolic processes. When we become deficient in it, our body functioning tends to go awry. That's the case with many of us, but it all comes down to getting diagnosed on time. "In India, approximately 60-70 per cent of the population and nearly 80 per cent of the urban middle class is believed to be having low levels of vitamin B12," says Dr Anoop Misra, Chairman, Fortis Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology.
Many of us tend to lack this vital vitamin because of different reasons like lifestyle habits to biochemical absorption problems. "While 80 per cent of this vitamin comes from the gut, it can easily be sourced through diet like probiotics and seafoods," points out Dr Seema Bhargava, Senior Consultant, Department of Biochemistry, Sir Gangaram Hospital and lead researcher of a recently released study on vitamin B12. The study, published in the Journal of Clinical Biochemistry and Nutrition says that adequate intake of folic acid and vitamin B12 can help reduce the risk for vascular diseases.
"Plasma homocysteine concentrations, responsible for plaque formation that lead to blockage of arteries have a negative correlation with vitamin B12 levels in people with stroke and deep vein thrombosis. It is therefore, important to eat foods containing the Bvitamins like greens, beans, fish, among others regularly," says Dr Bhargava. The study also suggests that large scale corrective measures like food fortification or dietary supplementation with folate and B12 might help reduce the incidence of vascular diseases in the Indian population.
Often missed than not
Signs of vitamin B12 deficiency mimic other illnesses and thereby, it is under-diagnosed. "Its symptoms are similar to other chronic conditions like multiple sclerosis and psychosis, learning disorders among others. It isn't just another nutritional deficiency as it can lead to anaemia, and neurological symptoms like confusion and memory loss. Moreover, if left untreated, it is passed on from one generation to the other," says Dr Mridul Arora, New Delhi based internal medicine specialist. While diagnosis is done through a serum B12 test, treatment methods involve pills and injections, depending on the cause and severity of the deficiency.
So, the next time you know somebody is having a senior citizen moment (memory loss or confusion), don't just dismiss it as a sign of grey hair, instead get the person checked for vitamin B12 deficiency.
If you plan to start a family
This vitamin is central to prevent development of birth defects. So,any woman planning a pregnancy should get herself checked. "It is just as essential as folic acid. And one should ensure the right levels even before getting pregnant, as it would be too late to start on B12 during pregnancy. Along with folic acid, vitamin B12 can help reduce the risk of neural tube defects of the brain and spinal cord," says Dr Arora. Women who don't eat meat or enough dairy products should especially ensure that they don't lack this vitamin.
If you are diabetic
Vitamin B12 could lead to dysfunction of nerves, which is compounded by high blood sugar. "In such cases, diabetes needs to be controlled well, and vitamin B12 should be supplemented. In addition, a frontline drug for diabetes, metformin, causes vitamin B12 levels to go down. Hence, monitoring and supplementation of B12 is all the more important in diabetics," explains Dr Misra. Studies have shown that low vitamin B12 levels in mothers was related to higher levels of insulin resistance in their children. This may contribute to the epidemic of obesity and type 2 diabetes in India. "Studies have also indicated that folate and vitamin B12 treatment improved insulin resistance and endothelial dysfunction (a condition where the inner lining of blood vessels doesn't function well), along with decreasing homocysteine levels in patients with the metabolic syndrome," says Dr Misra.
The appropriate treatment method varies depending on the cause and severity of deficiency. People with pernicious anaemia or inflammatory gut disorders like Crohn's disease are likely to have impaired absorption for their entire lives, and will likely require B12 injections indefinitely.
Pills: "Vitamin B12 can be supplemented in healthy people by oral pills, sublingual pill (applied under the tongue), or strips. It is available singly or in combination with other supplements. Oral treatments involve giving 250 g to 1 mg of B12 daily," says Dr Misra.
Injections: Vitamin B12 can be given as intramuscular or subcutaneous injections. "The treatment of vitamin B12 deficiency in pernicious anaemia is the intramuscular injection of vitamin B12 every other day for 1 to 2 weeks, followed by monthly injections for 3 months, and thereafter every 3 months for life. Those who are deficient for nutritional reasons are given oral cobalamin tablets after their course of injections," says Dr Misra.