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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Clinical Pearl Wednesday #186

Vitamin B pills dropped from bottle on blue. Letter B inscription from tablets. Vitamin B12 concept.

B12 deficiency in patients can cause a wide range of symptoms, including fatigue, weakness, numbness or tingling in the extremities, and cognitive impairment. Vitamin B12 is essential for the proper functioning of the nervous system, as well as the formation of red blood cells and DNA synthesis. Therefore, it is critically important to optimal health and well-being!

It is particularly important to be vigilant for vitamin B12 deficiency in patients who are elderly, have gastrointestinal disorders, or who have undergone gastrointestinal surgery, as these individuals are at increased risk of developing a deficiency. Additionally, strict vegetarians or vegans who do not consume animal products may be at risk of vitamin B12 deficiency.

Serum vitamin B12 levels can be used to diagnose deficiency, but it is important to note that low serum levels do not always indicate true deficiency. In cases where there is clinical suspicion of vitamin B12 deficiency despite normal serum levels, additional testing, such as methylmalonic acid or homocysteine levels, may be warranted.

Treatment for vitamin B12 deficiency typically involves regular injections of vitamin B12, although high-dose oral supplements may also be effective in certain cases. It is important to monitor patients for response to treatment and adjust therapy as needed to achieve optimal levels in the mid to higher ranges.

Overall, keeping vitamin B12 deficiency on the clinical radar and recognizing its wide-ranging clinical manifestations can help prevent long-term neurologic and hematologic complications. The good news, though, is that it is pretty rare to see a true B12 deficiency!

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