You could probably visit ANY street in the world and find B12 deficient residents. In 20 homes you may find eight people who are deficient, and this may be just two families, including the children of course. B12 deficiency is very common, however it is very commonly given another name.
My symptom list overlaps with those of my loved ones, however some we don’t share at all. Please remember we don’t all present in the same way.
What we need our doctors to recognise is that misdiagnosis of B12 deficiency is, in itself, an epidemic.
We need our doctors to diagnose correctly and of course to rule out what may be considered to be ‘more serious’ conditions. Please start by ruling out B12 deficiency, make this condition your first port of call. After all, it’s safe, it’s exceedingly cheap to treat and it does not interfere with any other treatment you might feel it appropriate to explore.
I know a B12 deficient patient who has been restricted to quarterly B12 injections. They have also been given, lithium and its associated monitoring, anti psychotics, anti epileptics, anti depressants, MRI scanning, CT scanning. We know she deteriorates because those in charge of her care refuse to recognise the vital importance of this essential vitamin and that each of her symptoms traces it roots to B12 deficiency. Tragically this is not an isolated case.
In the face of flawed serum B12 tests, using a therapeutic trial of B12 loading doses whilst you spend the time ruling out, or confirming other illnesses is quite simply, common sense and good medical practice.
We need our doctors to KNOW the symptoms of B12 deficiency, yes there are a lot, but you have been trained to retain information, learning the symptoms of this condition will save more lives than you can imagine, I list them below.
Remember, this deficiency affects ALL body systems but not every sufferer will present in the same way, each family member can have a different set of symptoms and please don’t forget the children! If you diagnose a mother, make it your job to screen any children too.
Make it your job to listen to your patient’s when their symptoms return only a week after an injection. Make it your job to follow the BNF guidelines and give the injection every other day until the patient’s symptoms stop improving.
Make it your job to understand the need for optimum ferritin and folate levels. Treat your patient’s as individuals, teach them to self inject, as you do your diabetic patients, just think of the nurses time saved! Put their B12 on repeat prescription so they don’t need to plead for health, this will free up more of your time.
Please, please, please, skip the cyanocobalamin tablets unless you KNOW, without a doubt, that your patient’s deficiency is due to diet alone.
Many with this condition have been misdiagnosed, they become expensive to treat, some cannot contribute to society and this costs the NHS a fortune. You will see that the following conditions share many vitamin B12 deficiency symptoms.
I hope you will look closely at the diagnoses you have made for your patient’s and that you can find it within yourself to revisit the treatment prescribed.
• numbness and tingling
• blurring of vision
• chronic pain
• muscular spasticity
• muscle weakness and tightness
• bladder incontinence
• cognitive problems
• erectile dysfunction
• mood swings
• speech problems
• vision problems
• weight loss
• loss of appetite
• memory loss
• increased vulnerability to infection
• difficulty moving
• difficulty performing spatial tasks
• stiffness of muscles
• postural instability
• cognitive impairment
• sudden outbursts of emotion
• poor concentration
• urinary incontinence
• erectile dysfunction
• orthostatic hypotension
• balance problems
Congestive heart failure
• ankle swelling
• a persistent cough
• lack of appetite
• weight loss
• slowed or confused speech
• cognitive impairment
• widespread pain
• inability to regulate body temperature
• tingling and numbness
• painful periods
I could of course go on…… and on …………
Here are the symptoms of B12 deficiency
• paresthesia – numbness, tingling and pain.
• Confusion / disorientation.
• Weakness of legs, arms, trunk.
• Impaired vibration – position sense.
• Abnormal reflexes.
• Unsteady or abnormal gait / falls.
• Ataxia (Neurological disorder affecting balance, coordination and speech).
• Balance problems.
• Difficulty walking.
• Restless legs.
• Visual disturbances / decreased-blurred vision / damaged of optic nerve.
• Forgetfulness, memory loss.
• Dementia / intellectual deterioration.
• Impaired fine motor coordination.
• Muscular spasticity.
• Bladder or bowel incontinence.
• Impaired pain perception.
• Nocturnal cramping.
• Disturbance in taste and smell.
• Optic atrophy.
• Depression / suicidal.
• Post natal depression.
• Violent behaviour.
• Personality changes.
Haematological signs and symptoms
• Macrocytosis (large red blood cells).
• Hyper segmented neutrophils.
• Generalised weakness, fatigue.
• Pallor / jaundice.
• Chronic fatigue.
• Orthostatic hypotension / Postural hypotension
• Recurrent miscarriage.
• Abnormal PAP smears.
• Low sperm motility.
• Low sperm count.
• Loss of appetite/weight loss or anorexia.
• Epigastric pain (poor digestion, bloated feeling after eating small or normal sized meals).
• IBS – Irritable bowel syndrome.
• GERD – Gastric reflux disease – ulcers / mouth ulcers.
Additional Signs and Symptoms
• Dry cracked corners of the mouth.
• Premature greying.
• Glossitis – swollen / sore tongue, geographic tongue.
• Fainting/light headedness.
• Symptoms mimicking Parkinson’s and MS.
• Nominal aphasia – difficulty recalling names or words.
• Radiculopathy, spinal nerve pain – commonly in lower back and neck.
• Increased susceptibility to infections.
• Poor wound healing.
• Loss of appetite.
Please click here to see the signs and symptoms in children.
Please also see the What to do next page.
Best wishes, Tracey