how long to recover from vitamin b12 deficiency how long to recover from vitamin b12 deficiency

Means RT, et al. Stomach cancer. (11), In some cases, doctors recommend B12 supplementation for people suffering from chronic fatigue or fibromyalgia. But once you do, youll likely have some health problems. You need adequate levels of the protein intrinsic factor to help absorb vitamin B12. Advertising revenue supports our not-for-profit mission. (30), Non-animal options of vitamin B12 include nutritional yeast and vitamin B12 fortified products, such as B12 fortified almond milk and cereals, and some breads. Its also found in poultry, eggs, dairy, and some plant-based or fortified foods. According to research published in the journal Nutrients, vitamin B12 is usually found in protein in most animal foods. Some experts think its because your homocysteine levels go up when your B12 levels are too low. Most people have healthy levels of vitamin B12. Also known as cobalamin, it is a water-soluble vitamin found in meat, fish, and dairy. A review of trials using vitamin B12 supplementation for depression found that fixing the deficiency can help manage depression. Any person can develop vitamin B12 deficiency at any age. Cleveland Clinic is a non-profit academic medical center. Blocking stomach acid and other secretions may also block B Therefore, doctors evaluate the need for using cobalamin injections to correct severe vitamin B12 deficiency anemia on a patient-to-patient basis. The reason why it is so important to correct a vitamin B12 deficiency is that a lack of this vitamin can lead to macrocytic anemia. Regular vitamin B12 injections can help you avoid B12 deficiency. Means RT, et al. Policy. Vitamin B12 deficiency: Recognition and management. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. If we combine this information with your protected The good news is your body stores extra B12 in your liver. This can cause subtle or off-and-on symptoms. However, if your deficiency is so severe that you've developed neurological symptoms, like numbness and tingling in the hands and feet or difficulty balancing, then you'll be given an injection every other day until those symptoms resolve, and then once a month for two months. If you ignore your B12 deficiency, it could lead to health issues -- some minor and some serious. Vitamin B12deficiency may cause serious complications, such as bleeding, infections, and problems with your brain or nerves that may be permanent. Over time, you may have numbness. Doctors from the Mayo Clinic say that vitamin B12 is mainly found in meat, dairy product, and eggs. American Family Physician. Not having adequate levels of B12 vitamin can also make your tongue look inflamed, swollen, and feel sore. Children need vitamin B12 to help their brains and bodies develop and grow. One way that B12 malabsorption or a lack of vitamin B12 from your diet can affect your nerves is by causing tingling sensations. Some people may have no symptoms despite having a low level of vitamin B12 in their bodies. According to Harvard Health, a severe vitamin B12 deficiency can usually be corrected with either regular vitamin B12 shots or high-dose B12 pills or capsules. High doses of B12 may cause: Dizziness Headache Anxiety Nausea Vomiting What to Expect After Treatment If you have anemia, itll likely get better in 6-8 weeks. To help recover from a vitamin B12 deficiency, doctors will recommend a course of treatment involving oral supplementation or injections. (1). Also, digestive problems that are caused by intestinal diseases such as celiac disease, Crohns disease, or intestinal bacterial overgrowth can also affect vitamin B12 absorption. Vitamin B12 is found in animal products you eat and drink such as meat, dairy and eggs. Verywell Health's content is for informational and educational purposes only. (3 marks) Ans. CBC - Complete Blood Count (CBC) Analyzer: Decode Your Results Inadequate B12 levels can suppress the immune system and inhibit the body's ability to produce antibodies to viral infections. B12 deficiency is associated with a particular type of anemia. It is also easily mistaken for other conditions, and therefore remains misdiagnosed. You might not have sudden symptoms of B12 deficiency. https://www.nhlbi.nih.gov/health-topics/pernicious-anemia. (31). Nasal spray. Recommended Daily Amounts of Vitamin B12, in micrograms (mcg), 2.4 mcg (mostly from fortified foods or a supplement). One serving of liver contains 65 mcg of vitamin B12 which is 2700% of your recommended daily vitamin B12 intake. That means itll get into your body even if you have absorption problems. A deficiency may also negatively affect sperm. Serious nerve damage that lasts a year or longer may not go away. All rights reserved. If you have vitamin B12deficiency anemia, you may have the typical symptoms of anemia at first, such as fatigue, paleness, shortness of breath, headaches, or dizziness. More severe side effects of vitamin B12 deficiency include: Untreated vitamin B12 deficiency can lead to severe neurological (nervous system) damage, which can put an individual at a higher risk of mortality. Causes of impaired B12 absorption include: The diagnosis of vitamin B12 isn't always obvious. A vitamin B12 deficiency can cause megaloblastic anemia. Malabsorption could be one reason for showing signs of a vitamin B12 deficiency even if you include meat in your diet. It is usually possible to completely correct a vitamin B12 deficiency within 6 weeks to 3 months. Having a tapeworm infection in your body can cause many symptoms, including having a lack of B12. Office of Dietary Supplements (NIH): Vitamin B12., National Organization for Rare Disorders (NORD): Anemia, Megaloblastic., National Heart, Lung, and Blood Institute: Pernicious Anemia., Merck Manual: Vitamin B12 Deficiency., Nutrients: Cobalamin Deficiency: Clinical Picture and Radiological Findings, Neuroenhancement with Vitamin B12 Underestimated Neurological Significance., Clinical Medicine (Royal College of Physicians): Vitamin B12 deficiency A 21st century perspective., American Family Physician: Vitamin B12 Deficiency: Recognition and Management., American Journal of Preventive Medicine: Is vitamin B12 deficiency a risk factor for cardiovascular disease in vegetarians?, Child and Adolescent Psychiatry and Mental Health: Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report., Journal of Tropical Pediatrics: Psychotic Disorder and Extrapyramidal Symptoms Associated with Vitamin B12 and Folate Deficiency., Neurology: Vitamin B12, cognition, and brain MRI measures., Neurobiology of Aging: Critical levels of brain atrophy associated with homocysteine and cognitive decline., American Cancer Risk Factors: Stomach Cancer Risk Factors., Journal of Reproductive Medicine: Vitamin B23 deficiency, infertility and recurrent fetal loss., NHS (UK): Complications: Vitamin B12 or folate deficiency anaemia., BMC Pulmonary Medicine: The diagnostic value of homocysteine for the occurrence and acute progression of chronic obstructive pulmonary disease.. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Theyre specialists trained to help you come up with a food plan you can stick to. Options for consuming vitamin B12 include: Other things you can do to help prevent vitamin B12 deficiency include: The prognosis for people who have vitamin B12 deficiency depends on how early the deficiency is diagnosed and treated. (28), Other foods high in vitamin B12 help prevent B12 deficiency anemia due to poor diet. Vitamin B12 intramuscular injections (a shot that goes into the muscle). Ter Arkh. Takedown request | View complete answer on carenow.com It takes up to seven years to digest swallowed chewing gum FALSE Chewing gum is made of sweeteners, preservatives and softeners, which your digestive system mostly breaks down, says Lambert. Read more: The Side Effects of Too Much Vitamin B12. Vitamin B12 is needed to make red blood cells. Peter Pressman, MD, is a board-certified neurologist developing new ways to diagnose and care for people with neurocognitive disorders. If you suffer from constant tingling in your arms, hand, or feet, find out what else could be the cause. Certain drugs, including metformin and antacids, can lessen your bodys ability to take in B12. The two primary causes of B12 deficiency are low B12 levels in the diet and problems absorbing the vitamin. Your liver stores this nutrient for a long time. When the process of absorption doesn't work right, you may develop B12 deficiency. When it comes to vitamin B12 and iron, omnivores are in luck. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This bypasses your stomach. If you have pernicious anemia, you dont make enough intrinsic factor. But if you ignore your deficiency, here are some of the things that can happen. But you shouldnt take lots of it unless your doctor tells you to. Dont worry if you dont know how to change your diet. National Heart, Lung, and Blood Institute. A tapeworm infection will also make it more difficult to recover from a B12 deficiency. It can be treated with vitamin B12 medications. This is why vegans and vegetarians have a higher risk of developing a vitamin B12 deficiency than meat eaters. Being deficient in vitamin B-12 or folate increases your risk of many health problems, including: You can prevent some forms of vitamin deficiency anemia by choosing a healthy diet that includes a variety of foods. Accessed Oct. 21, 2021. Eliminating sources of B12 from your diet can result in gradually developing B12 deficiency signs. If left untreated, you may start to notice brain and nervous system symptoms. COPD symptoms. Higher doses can cause unwanted side effects. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4953733/. These include nerve conduction studies, which measure the speed of the electrical signals in your nerves. StatPearls [Internet]. One of the main reasons for developing below normal B12 levels is not getting enough vitamin B12 from your diet. Many of these symptoms can be confused with other conditions, making vitamin B12 deficiency hard to diagnose. 26th ed. Taking vitamin B-12 with vitamin C might reduce the available amount of vitamin B-12 in your body. Kellerman RD, et al. When it comes to vitamin B12 and iron, omnivores are in luck. If you run low for a long time, it can lead to serious health issues. When they dont get enough of the vitamin, they can feel weak and tired, and it can cause other health problems. (14, 11). https://www.uptodate.com/contents/search. To prevent a vitamin B12 deficiency, your body needs to absorb this vitamin during digestion. This is when your body cant make enough healthy red blood cells. An apple a Vitamin B12 deficiency is also recognized as a risk factor for ischemic stroke. (15), In one case, the B12 deficiency was corrected very quickly with one injection of 1,000 g of vitamin B12. Vitamin deficiency anemia can occur if you don't eat enough foods containing vitamin B-12 and folate, or if your body has trouble absorbing or processing these vitamins. Accessed Aug. 18, 2021. Treatment for vitamin B12 deficiency usually consists of supplementation, but the type of supplement you need depends on the severity of your deficiency and what the underlying cause is. Because of this, their body cannot properly absorb vitamin B12, which causes a vitamin B12 deficiency. Pernicious anemia. Oxygen helps your body produce energy. Options for vitamin B12 treatment include: A person is more likely to develop vitamin B12 deficiency if they have one or more of the following risk factors: Most people can prevent vitamin B12 deficiency by consuming foods and drinks that have vitamin B12. Our body absorbs only as much as it needs, and any excess passes through your urine. At least 3% of people aged 20 to 39 years old. Your medical history can help your doctor understand your symptoms. All rights reserved. National Institutes of Health Office of Dietary Supplements. Get useful, helpful and relevant health + wellness information. Smita Patel, MD is triple board-certified in neurology, sleep medicine, and integrative medicine. Researchers from the University of Rochester say that intrinsic factor is a protein in the lining of the stomach that helps absorb vitamin B12. All of these may require Vitamin B12 supplementation for quick correction. While everyones brain shrinks with age, theres evidence that a B12 deficiency may speed up this process. Quora - A place to share knowledge and better understand th Intrinsic factor is a protein that's secreted by the cells in the lining of your stomach. Some symptoms will "disappear" quite quickly whereas others may take months or even years. Vitamin B12, or cobalamin deficiency, is common in older adults and vegetarians. Vitamin B12 deficiency happens when your body is either not getting enough or not absorbing enough vitamin B12 from the food that you eat that it needs to function properly. Vitamin B12 deficiency can be a complicated diagnosis. Once your levels are normal, you may need 100-500 micrograms a day or 1,000 micrograms one or two times a week. 3. A vitamin B12 deficiency can cause headaches, fatigue, muscle weakness, and depression. Others have problems absorbing B12 in the intestines. These symptoms can be worse if you also have anemia. Accessed Aug. 18, 2021. You may get a shot once a week for a month. If your healthcare provider detects low B12 levels, theyll tell you how you can expect to see symptoms persist after youve begun their treatment protocol. A physical exam may also help identify the signs of B12 deficiency. Vitamin B12 deficiency is diagnosed with a medical history, exam, laboratory tests, and other tests. The tests used to diagnose vitamin B12 deficiency are a complete blood count (CBC) and a vitamin B12 blood test level. Improvement may be gradual and may continue for up to six to 12 months. Lets look in more detail as the main reasons for showing symptoms of a B12 deficiency. You may still have the condition even if your vitamin B12 levels are normal. Vitamin B12 deficiency, also called cobalamin deficiency, is a medical condition of low B12 levels in the blood. This is why B12 deficiency has so many potential symptoms. Vitamin supplements, taken by pill or injection, can correct the deficiencies. But over time, you may get symptoms such as: Tiredness that comes on easily Weakness Pale skin Achiness Tingling, numbness, dizziness, and even seizures were reported as symptomatic of a chronic vitamin B12 deficiency (20). A complication is a problem caused by a medical condition or treatment. You can develop vitamin B12 deficiency for the following reasons: If you are otherwise healthy, maintaining a normal diet enriched in vitamin B12 is important. In this article, you will find out about the role of vitamin B12 in the body, causes and symptoms of vitamin B12 deficiency, how to treat this vitamin deficiency and how long it takes to fix B12 deficiency. Good food sources of vitamin B12 include dairy products, eggs, fish, meat, and poultry. For adults, the recommended daily amount of vitamin B12 is 2.4 micrograms, we can safely take higher doses. It causes weakness and imbalance. Talk to your doctor if you have side effects such as a bad metallic taste, vomiting, diarrhea, constipation, or upset stomach. Stomach Surgery. 2005-2023 WebMD LLC. If you stop absorbing it, itll take a few years to use whats left. Here are some of the best foods to consume to enjoy a diet rich in vitamin B12: Liver and kidneys. You may not have any improvement during the first few months of treatment. Most plant-based foods dont have much or any of this nutrient. So you could be on the right track. Studied at Ketogenic Diet Author has 247 answers and 540.1K answer views 1 y. Live Chat with us, Monday through Friday, 8:30 a.m. to 5:00 p.m. EST. other information we have about you. These usually need to be taken for 4 months. In: Goldman-Cecil Medicine. B12 deficiency is typically treated in one of two ways, and some providers use both methods simultaneously [4]: Correcting levels of vitamin B12 in people can help to improve symptoms of cognitive impairment if it was caused by B12 deficiency anemia. Your doctor can refer you to a dietitian. Vitamin B12 is essential for brain and nerve function. Your medical team may consider a number of diagnoses besides B12 deficiency. By Peter Pressman, MD In: Williams Hematology. Some symptoms may take months to improve, depending on how serious they are. By the time the condition gets detected, there might be some irreversible damage done already. (12). In many cases, correcting a B12 deficiency results is having more energy. (21). https://www.uptodate.com/contents/search. Vitamin B12 deficiency: recognition and management. Molecular and cellular effects of vitamin B12 in brain, myocardium and liver through its role as co-factor of methionine synthase. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. They can put B12 directly into your muscle with a needle. Accessed Aug. 18, 2021. It also helps your body make DNA, the genetic material in all of your cells. Laboratory tests can confirm your diagnosis. Laboratory evaluation for vitamin B12 deficiency: the case for cascade testing. Vitamin B12 supplements are usually necessary if malabsorption or digestive problems are the reasons for cobalamin deficiency. Most adults need these daily dietary amounts of the following vitamins: Pregnant and breastfeeding women may require more of each vitamin. You may not eat enough B12-rich foods if you drink a lot. The diagnosis of vitamin B12 deficiency is based on blood tests. Healthy and Natural World is supported by its audience. WebRecovery from vitamin B12 deficiency doesn't happen overnight. No matter whats causing your deficiency, your doctor will work with you to get your levels back up. If your doctor diagnoses you with vitamin B12deficiency anemia, your treatment will depend on the cause and seriousness of your condition. These tests include a complete blood count (CBC) and a vitamin B12 level. Vitamin B12 deficiency is a treatable condition that happens if you are not consuming enough vitamin B12 in your diet or if your body is not absorbing it properly. For adults, the recommended If you can, it's a good idea to address what's causing the deficiency. At Healthy and Natural World, our mission is to empower people to take control of their own health by providing comprehensive, practical and well researched information. See additional information. If you have a vitamin B12 deficiency, it can take monthseven a yearto correct it. Large amounts of B12 come from animal products, like red meat and fish. How long might it take for my Vitamin B12 deficiency to be corrected? If left untreated for a long time, B12 deficiency can lead to paralysis that doesnt go away. This can happen if you don't eat enough foods containing vitamin B-12 and folate, or if your body has trouble absorbing or processing these vitamins. Vitamin B12 deficiency anemia happens when your body does not have enough healthy red blood cells because your body has a vitamin B12 deficiency. Normal vitamin B12 levels are 160 to 950 picograms per milliliter (pg/mL) or 118 to 701 picomoles per liter (pmol/L). This content does not have an Arabic version. The many faces of cobalamin (vitamin B12) deficiency. Fatigue is a common symptom with most types of anemia because a lack of red blood cells results in not enough oxygen feeding your cells. You can't properly absorb vitamin B12 without intrinsic factor, no matter how much you take in. WebThat said, B12 deficiency can present with balance issues. Next, vitamin B12 combines with something called intrinsic factor, a protein made by your stomach. You should start to notice improvements within 6 months to a year through the intake of supplements and vitamin B12 rich foods. Goldman L, et al., eds. Once your deficiency is corrected and supplements aren't needed anymore, it's important to make sure that you're regularly getting enough vitamin B12 from the foods that you eat so you don't develop a deficiency again. Having a hard time remembering things or getting confused easily. Some symptoms related to the brain or the nerves, such as numbness and tingling, may not go away even with treatment. If you have an inflammatory GI condition or if you have had gastric bypass, you may need preventive treatment. The amount of time it takes you to feel better after beginning treatment for a vitamin B12 deficiency depends on the severity of your deficiency and how well your body absorbs the vitamin. Youll need a little more if youre pregnant or breastfeeding. These symptoms may include: Severe and long-term vitamin B12 deficiency can lead to psychosis. (8), According to the journal Nutrients, nori (edible seaweed) is a good food to help prevent a vitamin B12 (cobalamin) deficiency in people who are vegan. (25), A similarly sized portion of beef kidney will give you 21 mcg of vitamin B12 which is 875% of your recommended daily intake (RDI) of vitamin B12. Making sure your diet includes foods rich in vitamin B12 will help keep your levels within the normal range. Web1. Despite being a water-soluble, vitamin B12 gets stored in your liver, kidneys and other body tissues, so vitamin B12 deficiency can go unnoticed for a long time. Be sure to tell them about any medications or supplements youre taking. This can result in tingling in the feet and hands, weakness in the limbs, and even loss of sensation. Langan RC, Goodbred AJ. Do they really help? One of the important roles of B12 is to help produce red blood cells of the proper size in your body. Doctors say that the tongue may have red lesions on it and also develop a burning sensation. 2017;10(1):72. doi:10.1186/s13104-017-2393-3, Guant JL, Caillerez-Fofou M, Battaglia-Hsu S, et al. (6). Because of this, people who don't make intrinsic factor are at a much higher risk of developing a vitamin B12 deficiency. 2017;18(5):200-204. doi:10.1002/jgf2.31, Chan CQ, Low LL, Lee KH. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Low levels of vitamin B12 can result in noticeable mood changes such as depression and mood swings. When there is not enough cobalamin in your body, large blood cells cause megaloblastic anemia. People with vitamin B12 deficiency can have neurological symptoms and/or damage without anemia (lack of red blood cells). These categories can cause a range of symptoms. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. If neurological problems develop from vitamin B12 deficiency, they may not be reversible. Experts are still trying to figure out if B12 deficiency alone causes problems with thinking and memory. Pernicious anemia. How long does it take to recover from vitamin B12 deficiency? Dietary supplements. Patients with other brain pathologic conditions, such as traumatic brain injury, brain tumor, and hemorrhagic stroke, were excluded. Clinical manifestations and diagnosis of vitamin B12 and folate deficiency. 2023 Dotdash Media, Inc. All rights reserved. (19), Other studies have shown that a lack of vitamin B12 or folate (vitamin B9) can result in megaloblastic anemia. Medicines to treat heartburn, also called gastroesophageal reflux disease (GERD), work by suppressing stomach acid. (8). It is usually possible to completely correct a vitamin B12 deficiency within 6 weeks to 3 months. (18). That includes conditions like Crohns disease, ulcerative colitis, or celiac disease. Shipton MJ, Thachil J. Vitamin B12 deficiency a 21st century perspective. The symptoms of vitamin B12 deficiency are often not very specific, so vitamin B12 deficiency can go unnoticed for a long period of time. A registered dietitian unpacks what vitamin B12 deficiency is, the vitamin also helps boost your recovery from a workout, as well. (10). (13). (16). To avoid this interaction, take vitamin C two or more hours after taking a vitamin B-12 supplement. American Family Physician: Vitamin B12 Deficiency: Recognition and Management., Office of Dietary Supplements (NIH): Vitamin B12., Merck Manual: Vitamin B12 Deficiency (Pernicious Anemia)., Clinical Medicine (Royal College of Physicians): Vitamin B12 deficiency A 21st century perspective., National Heart, Lung, and Blood Institute: Pernicious Anemia., World Journal of Gastroenterology: Nutrition in alcohol-related liver disease: Physiopathology and management., European Journal of Clinical Nutrition: Effects of moderate alcohol consumption on folate and vitamin B12 status in postmenopausal women.. Some studies have found an association between heartburn medications and increased risk of vitamin B-12 deficiency. The B12 from oral supplements or foods won't be properly absorbed. In many cases, treatment can last weeks to months, but it's likely that you may experience some relief of symptoms even before your treatment is complete. Oral vitamin B12 replacement for the treatment of pernicious anemia. Pernicious anemia/megaloblastic anemia. Your healthcare provider can look at your medical history to help determine how much vitamin B12 you need each day. Elderly people who show signs of low B12 often have difficulty keeping their balance. Adelia Megawati. The two most common causes of vitamin B12 deficiency is not consuming enough of the vitamin in your diet and an inability to absorb B12 in the intestines. Learn about symptoms of B12 deficiency and how it can be treated. Pernicious anemia, a deficiency in the production of red blood cells due to a lack of vitamin B12, can cause permanent neurological damage that can lead to death if it is untreated. Cells all over your body depend on vitamin B12. Sometimes, you can help to fix a vitamin B12 deficiency or prevent anemia through diet. Supplementing the diet with cobalamin (vitamin B12) helps to normalize metabolism in the body and prevent a worsening of neurological conditions. Vitamin B12 supplements are hailed as a remedy for everything from weight loss to Alzheimers. Alcohol misuse. People who are 60 years old or older are more likely to have vitamin B12 deficiency compared to other age groups. If you have pernicious anemia or another condition that doesnt go away, you may need shots or supplements forever. If these symptoms are caused by a B12 deficiency, theyll likely get better once your levels are back to normal. Bringing levels of vitamin B12 to be within the normal range of between 200 and 900 ng/mL depends on the severity of your B12 deficiency. A B12 deficiency is often misdiagnosed, yet the consequences of it can be fatalespecially for those who have contracted coronavirus and are already at high risk, Pacholok says. This is because the effects and symptoms are so varied. B12 injections or supplements can help correct a deficiency, but there's no way to predict how long it will take for you to start feeling better. If you are a Mayo Clinic patient, this could People with myelopathy may also have problems with proprioception. Tunis Med. Read more: Vitamin B12 Shots vs. A deficit in vitamin B12 causes an increase in serum homocysteine levels, which is one of the risk factors for the development of ischemic stroke. Approximately 1.5% to 15% of people have vitamin B12 deficiency. In this short article, we answered the question How long to recover from vitamin B12 deficiency?, and discussed the major causes, signs and treatment of a vitamin B12 deficiency. Mood and memory troubles are common signs of a B12 deficiency. When you consume vitamin B12, either through food or supplements, intrinsic factor attaches to the vitamin and allows you to absorb it in your small intestine. Neurological disorders in vitamin B12 deficiency, Vitamin B12 deficiency neuropathy; a rare diagnosis in young adults: a case report, Molecular and cellular effects of vitamin B12 in brain, myocardium and liver through its role as co-factor of methionine synthase, Vitamin B12 deficiency: recognition and management, The many faces of cobalamin (vitamin B12) deficiency, Bariatric surgery and long-term nutritional issues, Laboratory evaluation for vitamin B12 deficiency: the case for cascade testing, Diagnosis and treatment of macrocytic anemias in adults, Oral vitamin B12 replacement for the treatment of pernicious anemia, Vitamin B12 - Fact sheet for health professionals, Anemia, when you don't have enough red blood cells, Fatigue, dizziness, paleness, and a rapid heart rate, Tingling, numbness, weakness, and balance problems, Cognitive decline when the brain has difficulty with things like memory and judgment, Inflammatory gastrointestinal (GI) disorders like, Prolonged use of certain medications like the diabetes medication.