B12-deficiency anemia: causes, symptoms and treatment
Mar 23, 2018
B12 deficiency anemia is a disease characterized by impaired hematopoiesis and is caused by a deficiency of vitamin B12 in the human body.This pathology is rare, but vitamin B12 suffers more often than women, and it can be associated with pregnancy.Table of contents: Causes of development of B12 deficiency anemia Symptoms of B12 deficiency anemia Diagnosis of B12 deficiency anemia Treatment of B12 deficiency anemia
Causes of development of B12 deficiency anemia
Modern medicine knows quite a lot of reasons that trigger the development of the pathological condition under consideration, but they all come downTo a lack of vitamin B12 in the human body.Therefore, the causes of B12 deficiency anemia should be considered in conjunction with the reasons for the shortage of the vitamin mentioned above.
The main reasons for the development of the disease in question are:
- Inadequate intake of vitamin B12 with food.The human body is not able to synthesize this vitamin by itself, it comes only with food.Plants do not contain vitamin B12, its source is only meat, fish, sour-milk products.As a rule, these products are included in the diet of every normal person, but in the case of development of chronic alcoholism or fasting, the development of B12 deficiency anemia is almost inevitable.
- Absorption of absorption of vitamin B12 in the intestine.Factors leading to such impaired intestinal activity are:
- gastritis autoimmune or atrophic;
- stomach cancer;
- congenital deficiency of the internal factor of the Castle;
- inflammatory diseases of the small intestine( enteritis);
- intestinal tumors;
- parasitic infections.
Naturally, a violation of intestinal absorption of vitamin B12 will occur after removal of part of the stomach and small intestine for medical reasons.
- Increased use of the body by vitamin B12.An adult, for normal activity of the body, requires 3-5 μg of the vitamin in question per day.But under certain conditions, the body's need for vitamin B12 is significantly increased, and it can happen with:
- pregnancy - in the fetus the processes of cell growth and division are rapidly proceeding, which requires more vitamin B12;
- hyperthyroidism - a large number of thyroid hormones enter the bloodstream, metabolic processes are intensified and the body requires more of the vitamin in question;
- Malignant tumors - vitamin B12 is actively consumed by such neoplasms and the rest of the body does not get anything.
- Hereditary diseases, which are accompanied by a violation of the metabolism of vitamin B12.A fairly large group of pathologies can be attributed to this factor, but we will single out only a few of them:
- syndrome of Imerslund-Gresbek;
- deficiency of transcobalamin II;
- a violation of the use of vitamin B12 in cells.
It should be noted that the most frequent cause of the development of B12 deficiency anemia is the inadequate intake of the vitamin in question into the body.
Note: often B12 deficiency anemia develops in vegans that do not consume animal food.The fact is that in the food of plant origin this vitamin is not contained, so vegan should use products artificially enriched with B12, as well as special vitamin complexes.More details on the importance of vitamin B12 in the diet of vegan and the sources of this vitamin read in the article "Vitamin B12 in the vegan diet: why is it important?".
Symptoms of B12 deficiency anemia
The stocks of the vitamin in question in the human body are large enough, so the clinical manifestations of B12 deficiency anemia may not be for a long time. The disease develops very slowly and at initial stages is characterized by weakness, increased fatigue and drowsiness - absolutely nonspecific symptoms.
The main clinical manifestations of B12 deficiency anemia are:
- Violation of the formation of blood cells.It is manifested by dizziness and frequent fainting, pallor and icterus of the mucous membranes / skin, intolerance to physical exertion, pain in the heart, palpitations, the appearance of "flies" before the eyes and enlarged spleen.In principle, when only one of the above manifestations appears, a person should seek qualified help, because it is not at all necessary that a complex of symptoms of disturbance of the formation of blood cells will be present simultaneously.
- The defeat of the digestive system.It is this symptom that is the earliest sign of B 12 deficiency anemia, and it will manifest itself:
- a digestive disorder;
- decreased appetite;
- pain and burning in the mouth;
- is a taste disorder;
- pain in the epigastric region after ingestion;
- is a frequently occurring infection in the oral cavity.
- The defeat of the nervous system.Usually they appear only in case of neglected form of B12 deficiency anemia and are:
- impaired sensitivity in the fingers and wrists;
- paresthesia - numbness, "pricking" in certain places of the body;
- reduction in muscle strength;
- problems with urination and defecation.
The most dangerous manifestation of B12 deficiency anemia is mental disturbances, as evidenced by psychosis, depression, hallucinations, convulsions, insomnia.
Please note: all symptoms of the disease in question are nonspecific, that is, they may indicate the development of other diseases.Therefore, doctors always treat them only in combination with other diagnostic data.
Diagnosis of B12 deficiency anemia
Only patient complaints about the symptoms that are described above are not a reason to diagnose the disease in question. The process of diagnosing B12 deficiency anemia is rather complicated, as it will take the following measures:
- to examine blood by performing general clinical and biochemical analysis in the laboratory;
- to make a bone marrow puncture.
A patient with suspected or already established B12 deficiency anemia must be fully examined, as it will be necessary to find out the cause of the pathology.
Treatment of B12 deficiency anemia
Treatment of the considered disease is carried out only in a complex way, because the doctors have the task to restore the normal functioning of the hematopoietic, digestive and nervous systems as quickly as possible.
The essence of this type of therapy is the administration of vitamin B 12 from outside.Indications for the appointment of such treatment are a confirmed diagnosis of B12 deficiency anemia and a pronounced clinical picture of the disease.
Most often, the vitamin B12 preparation is administered intramuscularly, but it is also acceptable to take it inside as tablets in case of an accurate determination of the inadequate intake of vitamin B12 from food.
Treatment of the disease begins with intramuscular injection of 500-1000 μg of vitamin B12 once a day .The duration of drug treatment is at least 6 weeks, then the doctors transfer the patient to maintenance therapy - the dosage in this case will be 200-400 μg of the drug 2-4 times a month.In some cases, this supportive therapy is carried out throughout the life of the patient.
Note: during the period of medical treatment of B12 deficiency anemia, the patient must be monitored for the effectiveness of the therapy - 2-3 times a week, blood samples are taken for laboratory testing.As a rule, after 1 month, complete normalization of peripheral blood parameters occurs, a weakening of neurological manifestations, and the work of the digestive system is restored.Once the patient is transferred to maintenance therapy, blood sampling for analysis is performed once a month.
This method of treatment implies a blood transfusion to the patient, but more often the erythrocyte mass is used.Since this method is considered to be quite heavy and even dangerous in some sense, therefore it is used only if the patient's life is a direct threat due to the development of the 12 deficiency anemia .Unconditional indications for blood transfusion:
- severe anemia, when the patient has a hemoglobin level of less than 70 g / l;
- anemic coma, manifested by loss of consciousness.
Since blood transfusion is prescribed only with a confirmed diagnosis, simultaneously with this procedure, intramuscular administration of the vitamin B12 preparation is prescribed.But the transfusion of blood or erythrocyte mass is stopped immediately, as soon as the life threatening condition is eliminated.
Power supply correction
Very often, B12 deficiency anemia is treated with a diet, but this is only possible with timely diagnosis of the disease. The menu should include foods rich in vitamin B12 and important for the treatment of anemia:
- plum juice;
- green vegetables, greens, salads and breakfast cereals;
- meat, cream and butter;
- beets, carrots, corn, tomatoes;
- offal - beef and chicken liver, heart;
- cod, carp, mackerel;
- the rabbit.
It is important to eat fully and diversely. Here is an approximate menu for the day for patients with diagnosed B12 deficiency anemia:
- 1 breakfast - fresh cabbage salad with apples and sour cream, omelette, oatmeal porridge with milk;
- 2 breakfast - tea and 100 grams of cheese( maximum quantity);
- dinner - borscht on meat broth with sour cream, chicken roast with boiled rice and compote;
- afternoon snack - broth of dog rose;
- dinner - zrazy meat with onions and eggs, carrot puree, casserole from buckwheat groats with cottage cheese, not strong tea;
- at night - kefir.
Please note: should compose a diet menu for patients with diagnosed B12 deficiency anemia, since general health, common pathologies and individual susceptibility of the organism of different products should be taken into account.
Forecast for B12 deficiency anemia
If the disease in question was diagnosed at an early stage of its development, immediately it was prescribed and treated, and the normalization of peripheral blood counts occurred within a month and a half, then the predictions will be exceptionally favorable.As soon as the basic therapy is performed, the health condition is restored and the patient returns to the usual rhythm of life. But if there is:
- late onset of treatment;
- symptoms of central nervous system damage;
- no effect of treatment;
- hereditary form of B12 deficiency anemia,
then the predictions will be unfavorable.Most likely, the patient will have to undergo treatment all his life, often a severe form of B12 deficiency anemia ends with coma and death.
B12 deficiency anemia - a condition not dangerous to life, very insidious.If a person pays attention to the earliest signs of the condition in question, the doctor will be able to quickly establish the cause of the disease and conduct effective treatment.
Tsygankova Yana Aleksandrovna, medical reviewer, therapist of the highest qualification category