Man hit with B12 deficiency diagnosis after suffering decline in healt

Dr Dawn Harper on signs of vitamin B12 and vitamin D deficiency

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Vitamin B12 plays a critical role in the maintenance of the central nervous system. A deficiency in the nutrient can therefore have a direct impact on the spinal cord, brain and optic nerve, causing an onslaught of symptoms. Occasionally, this may manifest as dysfunction in the olfactory senses, or trouble walking. One case study demonstrates how quickly some of these complications come on after B12 levels drop.

Over time, damage to the peripheral nervous system caused by low B12 levels can lead to movement problems.

Tingling, or numbness in the feet and limbs may make it increasingly difficult for a person to walk without support.

Patients can also experience a decline in muscle strength and reflexes, as muscles fail to respond to stimuli.

As one case report shows, people may live with these problems for a considerable amount of time without suspecting something is wrong.

In 2012, the Pakistan Journal of Biological Science presented an ‘atypical’ case of B12 deficiency in an elderly patient.

The authors wrote: “We describe a 61-year-old man who was admitted to the Emergency Department with trouble walking independently, suffering from weakness and a long history of dyspepsia that had worsened in the last four weeks.”

The patient had suffered progressive impairment of his cognitive function in the course of four weeks; with most of his reflexes absent on examination.

“All blood tests were normal except haemoglobin concentration which showed mild anaemia,” his report added.

“Further examination before the surge due to approach to anaemia showed severely decreased serum vitamin B12 level.”

The patient’s symptoms fortunately improved after receiving treatment with intramuscular cobalamin.

“Being a very commonly seen disorder in the general population, B12 deficiency should be born in mind as a probable diagnosis in patients with peripheral neuropathy and no clear underlying cause presenting to the emergency department,” added the authors.

Axia is a widely recognised sign of B12 deficiency that can be treated efficiently with supplementation.

When a patient with suspected ataxia is diagnosed with B12 deficiency, they should be referred to a haematologist.

Other neurological symptoms may manifest with the condition which may not involve movement and muscle, however.

Olfactory dysfunction, in the form of odour hallucinations or an inability to eat certain foods, known as parosmia, dysosmia or phantosmia, are all known complications of low B12.

Practical Neurology explains: “Parosmia is a form of dysosmia that refers to a usually very unpleasant odour triggered by any or specific environmental odour.

“Phantosmia is a form of dyspepsia that is usually unpleasant and triggered by any or specific tastes.”

Up to 72 percent of conditions affecting the sense of smell are related to issues in the sinus, following surgery or infection, so it’s important to look for more signs suggestive of B12 deficiency.

The NHS stresses the importance of getting any neurological problems probed swiftly, as when B12 is the cause, they may become irreversible.

Other long-term complications that may ensue are infertility and heart failure.

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