A vitamin B12 deficiency (or Pernicious Anemia) is usually due to an issue with absorbing B12, rather than a lack of B12 in the diet. B12 needs sufficient hydrochloric acid in the stomach and the efficient production of a compound called the intrinsic factor produced by the parietal cells in the stomach, which then binds with B12 for absorption at a site further down the small intestine. This type of vitamin B12 deficiency anemia is called Pernicious Anemia and is a subgroup of a Megaloblastic anemia producing enlarged red blood cells. All well as extreme fatigue, people may experience lack of concentration or focus and problems with memory and recall. Even though it is a water-soluble vitamin, vitamin B12 can be stored in the body for some time[i], which is why it can take a while for symptoms to occur. Vegan diets are typically low in vitamin B12 and so either consumption of food choices such as algaes or supplementation may be helpful as a preventative measure.
If a deficiency has been diagnosed, then addressing the diet is advised. This can be through additions of specific foods or food combinations in the diet and supplementation can be helpful in the interim to support this.
Food sources of vitamin B12 include animal meats, especially liver and kidney, eggs, cheese, fish are also good sources. Vitamin B12 found in sea vegetables is not utilized by the body well and therefore shouldn’t be used as an alternative for supplementing B12 if there is a deficiency. It might be necessary for someone with a B12 deficiency to have regular B12 injections and this will be decided by a medical professional. It is generally recommended that vegans supplement with vitamin B12 to prevent any deficiencies.
See also Therapedia Article on Anemia for Iron Deficiency.
[i] Jansen EH, Beekhof PK, Cremers JW, Schenk E. Long-term (in)stability of folate and vitamin B12 in human serum. Clin Chem Lab Med. 2012;50(10):1761‐1763. doi:10.1515/cclm-2012-0108
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