Throughout the summer of 2022, my dog Scout experienced a persistent pattern of vomiting at 3 a.m. nearly every day for several months. If you’re a dog owner, you’re familiar with the unmistakable sound. Complicating the diagnostic process, she quickly consumed her vomit each time, making it challenging to pinpoint the cause.
After consultation with the vet, we attributed the issue to my hydrangeas, but even efforts to keep Scout away from them proved unsuccessful. Concerningly, she began displaying constant fatigue, a stark contrast to her typically energetic demeanor as a young yellow Lab.
The breakthrough came when Scout regurgitated a hairball, but this wasn’t an ordinary one. While dogs usually pass hair easily through their digestive system, this hairball was entangled around a brillo pad too large to navigate. Removal of this foreign object brought an end to the nightly vomiting. However, Scout still required treatment for an unexpected reason: the object had impeded her body’s absorption of vitamin B12. B12 is a crucial nutrient vital for the proper functioning of blood cells, nerves, and various other essential processes in the body.
Signs and Symptoms of Vitamin B12 Deficiency
A primary indication of B12 deficiency is profound fatigue, a level of weariness so pervasive that it interferes with everyday activities.
Neurological symptoms may also manifest, encompassing sensations of tingling in the extremities, confusion, memory lapses, depression, and challenges in maintaining balance. Some of these neurological effects can become permanent if the deficiency remains unaddressed.
However, due to the myriad potential causes of these symptoms, healthcare providers might overlook the prospect of a B12 deficiency and omit screening for it. Additionally, even with a well-balanced diet, the assumption of no vitamin deficiency can be misleading. For instance, I overlooked the possibility of a B12 deficiency in Scout’s case because I was confident in the quality of her diet.
B12 Absorption Process
Research emphasizes that individuals adhering to plant-based diets should supplement B12 in amounts commonly found in standard multivitamins. However, a significant number of Americans who do consume B12 may still face risks due to conditions that could hinder the absorption of B12 in their bodies.
B12 absorption is an intricate, multistep process commencing in the mouth and concluding at the far end of the small intestine. During chewing, food mixes with saliva, and a component of saliva called R-protein, designed to shield B12 from stomach acid, travels to the stomach with the food upon swallowing.
Within the stomach lining, specific cells known as parietal cells secrete two vital substances for B12 absorption. The first is stomach acid, which separates food and B12, enabling the vitamin to bind with the saliva’s R-protein. The second substance, intrinsic factor, blends with the stomach’s contents and accompanies them into the duodenum, the initial segment of the small intestine. In the duodenum, pancreatic juices release B12 from R-protein, allowing intrinsic factor to facilitate B12 absorption into cells. This absorption process supports the maintenance of nerve cells and the formation of healthy red blood cells.
A B12 deficiency typically arises from a breakdown at one or more points in this absorption pathway. Enhance your overall health by adopting positive lifestyle choices, including regular exercise, a balanced diet, and adequate sleep.
Factors Contributing to B12 Deficiency
The absence of saliva hinders the binding of B12 to R-protein, impeding the body’s capacity to absorb it. Numerous medications can induce dry mouth, resulting in reduced saliva production. Among these drugs are opioids, inhalers, decongestants, antidepressants, blood pressure medications, and benzodiazepines such as Xanax, prescribed for anxiety. The last three categories alone contribute to over 100 million prescriptions annually in the U.S.
Another potential factor contributing to B12 deficiency is low levels of stomach acid. A substantial number of Americans take anti-ulcer medications designed to diminish stomach acids that cause ulcers. Researchers have definitively established a link between the use of these medications and B12 deficiency, although the necessity of the medication may outweigh this potential risk.
Treatment for B12 Deficiency
While some healthcare providers routinely assess B12 and other vitamin levels, a standard well-check exam typically includes only a complete blood count and a metabolic panel, neither of which gauges B12 status. If you exhibit potential symptoms of a B12 deficiency and have any of the mentioned risk factors, it’s advisable to consult with a doctor for testing. A comprehensive lab workup and a discussion with a physician are essential to determine whether insufficient B12 levels may be a contributing factor.
In the case of my dog Scout, her symptoms prompted the vet to conduct two blood tests: a complete blood count and a B12 test. These serve as useful initial assessments for humans as well. Scout’s symptoms resolved after a few months of taking oral B12 supplements that also included an active form of the B vitamin folate.
In human cases, the treatment approach and duration of recovery hinge on the cause and severity of the B12 deficiency. Full recovery can be achieved with appropriate and timely intervention.
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