There are a number of conditions that can lead to Vitamin B12 deficiency but most B12 deficiency causes are found in one of two categories, inadequate absorption or nutritional deficiencies. The most common cause is a disease or condition that affects the body’s ability to breakdown and absorb the vitamin B12 in the foods that are eaten. These conditions may be related to diseases such as pernicious anemia, surgeries where parts of the stomach are removed or simply the effects of aging on the gastric system. Typically, patients with malabsorption conditions will require life long treatment such as vitamin B12 injections. The second and less common of B12 deficiency causes is inadequate intake of B12 foods. This condition is generally found in vegans or vegetarians whose diets do not include B12 rich foods which are mainly animal products. Regardless of the B12 deficiency causes, it is important to seek treatment if B12 deficiency occurs. If left untreated B12 deficiency can cause serious and permanent damage. Knowing some common B12 deficiency causes will help you determine if you are at risk.
Absorption B12 Deficiency Causes are:
Pernicious anemia – an autoimmune disease that creates antibodies that attack the immune system including the lining of the stomach, causing a lack of a protein in the stomach called intrinsic factor. Intrinsic factor is a substance that is produced from cells found in the lining of the stomach and is vital for the absorption of vitamin B12 in the intestines. Pernicious anemia is perhaps the most common of all B12 deficiency causes and the study of this disease led to the discovery of vitamin B12.
Atrophic Gastritis – is a condition where chronic inflammation of the stomach mucosa leads to thinning of the stomach lining. The condition impairs the stomach’s ability to secrete essential substances such as pepsin, hydrochloric acid and intrinsic factor. Intrinsic factor and gastric acids are vital for the breakdown of B12 in food protein. Atrophic Gastritis affects an estimated 30% of adults 50 years and older.
Chronic Alcoholism – excessive alcohol use can cause damage to the gastrointestinal tract leading to impairment of the stomach and intestines ability to breakdown and absorb vitamin compounds. Alcoholism can also be a contributing factor in pernicious anemia. Furthermore, heavy habitual alcohol consumption can result in nutritional deficiencies due to the lack of adequate intake of B12 nutrients. Often, in cases where heavy alcohol consumption is present, a depressed system causes a lack of hunger and the result is a diet where alcohol replaces food.
Long Term Use of Antacids – Antacids reduce the secretion of gastric acids and levels of hydrochloric acids in the stomach. Since gastric acids are important for releasing B12 from protein foods, decreased levels of stomach acids may reduce the absorption of vitamin B12 from foods. Although antacids are fine for short term or occasional use, prolonged use of 2 years or more is an increasing factor in B12 deficiency causes.
Bowel Problems – Short bowel syndrome is a condition caused by severe intestinal disease, birth defect or surgical removal of a portion of the small intestine. Persons with these conditions may not have enough surface area left in the remaining portion of the bowel to absorb adequate quantities of vitamins, including B12 and other nutrients. Some autoimmune diseases may also affect the proper function of the intestines such as Celiac disease, Crohn’s disease, Grave’s and others.
Nutritional B12 Deficiency Causes are:
Vegan Diet – because the best sources for vitamin B12 are animal products, strict vegans (people who don’t eat any animal products) are at an increased risk for Vitamin B12 deficiency. The only reliable vegan food sources are fortified with B12 such as some breakfast cereals, breads, soy products and plant milks or vitamin B12 supplements. Even in cases where vegans and vegetarians may consume enough B12 to avoid anemia and nervous system damage, they may not get enough to avoid potential risk of heart disease. Vegans who show adequate levels of B12 to avoid clinical deficiency may still show restricted activity of B12 related enzymes leading to increased homocysteine levels. There is strong evidence that elevated homocysteine levels increase the risk of heart disease, stroke and pregnancy complications.
Infants of Vegan Mothers – Vegan mothers whom breastfeed their infants and do not supplement their diet with B12 have babies at risk for severe B12 deficiency and nerve related disorders. If the mother is B12 deficient during pregnancy the baby will likely have low levels of B12 and show clinical signs at just a few weeks of age. Although at birth the infants typically have higher levels of B12 than their mothers, because the infants have no stores of B12, the signs present themselves much more rapidly than in adults.
Nutritional Deficiency – Although most people get adequate amounts of B12 through their intake of animal products. Nutritional deficiency can occur outside the vegan populations. Elderly people who live alone can slip into improper diets commonly known as the “tea and toast” diets. These diets may consist mainly of toast and jam, crackers and cheese or processed canned products. Chronic Alcoholics are also at especially high risk for nutritional B12 deficiency.
If you think you may have a B12 deficiency or if you are in a high risk group, seek the advice of your medical professional. There are many vitamin B12 deficiency causes that are serious health conditions and prompt diagnosis and treatment are crucial.