Classically presents with megaloblastic anaemia, but can also present with peripheral neuropathy and neuropsychiatric complaints.
Older people, patients with chronic malabsorption, patients with a history of gastric resection or bypass, and those taking certain medicines (metformin, proton-pump inhibitors) are at risk.
Early diagnosis is critical in preventing and halting the progression of neurological disorders such as peripheral neuropathy and dementia.
Methylmalonic acid and homocysteine levels may help to diagnose vitamin B12 deficiency at an early, asymptomatic state.
Once vitamin B12 deficiency is confirmed, the cause should be searched for.
High-dose oral therapy may be as effective as parenteral vitamin B12 in the treatment of vitamin B12 deficiency.
Vitamin B12 deficiency is a common condition that can manifest with neurological, psychiatric, and haematological disorders. It is an essential vitamin, and deficiency generally occurs with inadequate absorption or lack of dietary vitamin B12. While severe deficiency can cause permanent neurological damage, earlier manifestations are generally subtle or asymptomatic.
The likelihood of vitamin B12 deficiency is defined according to the serum vitamin B12 level as follows: <148 picomols/L (<200 picograms/mL) indicates probable deficiency, 148 to 258 picomols/L (201 to 350 picograms/mL) indicates possible deficiency and >258 picomols/L (>350 picograms/mL) indicates that deficiency is unlikely.
Chief Medical Officer
Martin Army Community Hospital
RCO declares that he has no competing interests.
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