What vitamins are included in the group and what they are responsible for
Group B combines several independent vitamins: B1 is involved in obtaining energy from carbohydrates and is critical for nervous tissue, B2 and B3 ensure metabolism and the condition of the skin and mucous membranes, B6 is needed for the metabolism of amino acids and the synthesis of neurotransmitters, B9 and B12 are responsible for cell division and maturation of red blood cells, and B12 is also for the construction of the sheath of nerve fibers. The body does not store most of them for a long time, so intake must be regular. The exception is B12: its reserves in the liver last for years.
- B1 - energy and work of the nervous system
- B2 and B3 - metabolism, skin and mucous membranes
- B6 - amino acid metabolism and neurotransmitters
- B9 - cell division and fetal development
- B12 - hematopoiesis and nerve sheath
- B12 reserves are large, others are small
Who is more likely to have a deficiency?
The most vulnerable group for vitamin B12 are strict vegetarians and vegans, since it is found almost exclusively in animal products. Next come people after operations on the stomach and intestines, with atrophic gastritis, Crohn's disease and celiac disease, since absorption is impaired. Separately, long-term use of certain medications for heartburn and hypoglycemic agents is worthwhile. B1 deficiency is typical for alcohol abusers and prolonged vomiting. A lack of folic acid is typical during pregnancy and a poor diet without greens.
- Strict vegetarians and vegans
- Stomach and intestinal surgeries
- Atrophic gastritis, celiac disease, Crohn's disease
- Long-term use of heartburn medications and metformin
- Alcohol abuse
- Pregnancy and breastfeeding
- Old age and monotonous diet
Symptoms
General manifestations are weakness, fatigue, irritability, loss of appetite. Changes in the mucous membranes are more recognizable: an inflamed, smooth tongue with a burning sensation, cracks in the corners of the mouth, and seizures. On the blood side, anemia with large red blood cells develops. The most important to recognize are the neurological symptoms of B12 deficiency: symmetrical numbness and tingling in the feet and hands, a feeling of wobbly legs, unsteadiness of gait, memory impairment. When B1 is deficient, people with alcohol dependence may experience confusion, impaired eye movements, and unsteadiness.
- Weakness and fatigue
- Burning and flattened tongue
- Cracks in the corners of the mouth
- Pallor and shortness of breath
- Numbness and tingling in the arms and legs
- Unsteadiness of gait and imbalance
- Deterioration of memory and mood
Diagnostics
They start with a general blood test: an increased average volume of red blood cells indicates a deficiency of B12 or folic acid. Next, both vitamins are determined simultaneously, since their blood picture is the same, but the consequences of an error are different. Values at the lower limit of normal with obvious symptoms do not exclude a deficiency, and the doctor can focus on additional indicators. If a deficiency is confirmed, they look for the cause: examine the stomach and intestines, clarify the diet and medications taken. In case of neurological complaints, a neurologist is involved.
- Complete blood count with erythrocyte indices
- Vitamin B12 and folic acid together
- Vitamin B6 according to indications
- Ferritin, as deficiencies often coexist
- Gastroscopy and examination of the intestines for malabsorption
- Assessing your medication and diet
- Examination by a neurologist for numbness and unsteadiness
Treatment and nutrition
Replenishment is carried out in tablets or injections: the doctor chooses the method, focusing on the cause and severity. In case of impaired absorption and severe neurological symptoms, injections are preferred, followed by a transition to maintenance therapy. An important rule: if you suspect B12 deficiency, you should not start with folic acid alone - your blood count will improve, and nerve damage will continue unnoticed. At the same time, the diet is adjusted and the cause is treated. People on a strict plant-based diet need a B12 supplement constantly, not in courses.
- B12 preparations in tablets or injections as prescribed by a doctor
- Folic acid only after B12 testing
- Thiamine for alcohol dependence and vomiting
- Meat, fish, eggs, dairy products in the diet
- Greens, legumes, grains as a source of folates
- Continuous B12 Supplementation When Vegan
- Treatment of bowel disease and review of medications
- Control tests after the course
