• The body requires vitamin B-12 in order to produce red blood cells.
• Red blood cells carry energy (oxygen) throughout the body.
• If the body lacks vitamin B-12 for whatever reason, it makes fewer red blood cells and the ones it does make are abnormal – they can’t transport energy nearly as efficiently.

So you feel low-energy because your red blood cells are low-energy!

Aside from diet, the most common cause of B-12 deficiency is pernicious anemia.  In pernicious anemia, the body stops producing  intrinsic factor (IF), the digestive enzyme necessary to absorb B-12.  The most common reason is plain old age – the parietal cells atrophy and just stop making IF.

 
Pernicious anemia doesn’t effect all people equally; some people are more likely to get it than others.  Pernicious anemia

• is more commonly found in those of northern European descent and Africans (southern Europeans and Asians are less effected),
• occurs in equally amongst men and women,
• seems to run in families, so if you have a family member with it you are much more at risk,
• is frequently seen with autoimmune disorders (particularly those affecting the thyroid, parathyroid, and adrenals).

Aside from fatigue, what are the other symptoms of pernicious anemia related B-12 deficiency?  Quite a few!  Dizziness, ringing in the ears, pale or yellowish skin,  sore and brightly red tongue, loss of appetite, weight loss, diarrhea, and abdominal cramping, numbness, tingling, or burning in the arms, legs, hands, and feet, muscle weakness, irritability, confusion, depression and more.

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1. Fatigued? Low Energy? Vitamin B-12 Can Help!

There are many types of weight loss surgery that can result in chronic vitamin B12 deficiency:

• Vertical Banded Gastroplasty (VBG)

  VBG is a purely restrictive procedure. In this procedure the upper stomach near the esophagus is stapled vertically for about 2-1/2 inches (6 cm) to create a smaller stomach pouch. The outlet from the pouch is restricted by a band or ring that slows the emptying of the food and thus creates the feeling of fullness. The risk of vitamin B-12 deficiency is lower than in other procedures.

• Biliopancreatic Diversion (BPD)

  BPD removes approximately 3/4 of the stomach to produce both restriction of food intake and reduction of acid output. Leaving enough upper stomach is important to maintain proper nutrition. The small intestine is then divided with one end attached to the stomach pouch to create what is called an “alimentary limb.” All the food moves through this segment; however, not much is absorbed. The bile and pancreatic juices move through the “biliopancreatic limb,” which is connected to the side of the intestine close to the end. This supplies digestive juices in the section of the intestine now called the “common limb.” The surgeon is able to vary the length of the common limb to regulate the amount of absorption of protein, fat and fat-soluble vitamins.

• Extended (Distal) Roux-en-Y Gastric Bypass (RYGBP-E )

  RYGBP-E is an alternative means of achieving malabsorption by creating a stapled or divided small gastric pouch, leaving the remainder of stomach in place. A long limb of the small intestine is attached to the stomach to divert the bile and pancreatic juices. This procedure carries with it fewer operative risks by avoiding removal of the lower 3/4 of the stomach. Gastric pouch size and the length of the bypassed intestine determine the risks for ulcers, malnutrition and other effects.

• Biliopancreatic Diversion with “Duodenal Switch”

  This procedure is a variation of BPD in which stomach removal is restricted to the outer margin, leaving a sleeve of stomach with the pylorus and the beginning of the duodenum at its end. The duodenum, the first portion of the small intestine, is divided so that pancreatic and bile drainage is bypassed. The near end of the “alimentary limb” is then attached to the beginning of the duodenum, while the “common limb” is created in the same way as described above.

• Gastric Bypass Roux-en-Y

  In this procedure, stapling creates a small (15 to 20cc) stomach pouch. The remainder of the stomach is not removed, but is completely stapled shut and divided from the stomach pouch. The outlet from this newly formed pouch empties directly into the lower portion of the jejunum, thus bypassing calorie absorption. This is done by dividing the small intestine just beyond the duodenum for the purpose of bringing it up and constructing a connection with the newly formed stomach pouch. The other end is connected into the side of the Roux limb of the intestine creating the “Y” shape that gives the technique its name. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption.

(taken from WeightLossSurgeryInfo.com)

You can read more about weight loss surgery and vitamin B-12 deficiency at ThinnerTimes Forum.

If you are considering weight loss surgery or have recently undergone weight loss surgery, be sure to discuss the possibility of vitamin B-12 deficiency with your doctor!

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1. Other Medical Issues Often Accompanied By Vitamin B-12 Deficiency

Absorption of B-12 can actually start in the mouth, unlike most minerals and vitamins. Very small amounts of B-12 can make their way across the thin membranes in the mouth directly into the bloodstream. However, only pure crystalline B-12 can do this – the B-12 in foods can’t be absorbed this way. This is how sublingual B-12 supplements work.

B-12 locked inside of food can only be absorbed in the digestive track. Once the food enters the stomach, enzymes work to unlock it from the food. These enzymes need an acid environment to work, however – which is why people taking antacid medication can become vitamin B-12 deficient. The antacids lower stomach acidity, preventing the enzymes from working.

Once the B-12 is freed from the food it is attached to R-proteins and passes into the duodenum. In the duodeum, the B-12 is released from the R-proteins and intrinsic factor (IF) picks up the B-12 and forms a new B-12 complex. This B-12 complex passes from the duodenum into the small bowel, where it is finally absorbed into the bloodstream. The intrinsic factor/B-12 complex is the only form of B-12 that can enter the bloodstream from the digestive tract!

If you lack intrinsic factor, you won’t be able to digest B-12 at all. This mostly commonly happens to people as they age and they acquire ‘gastric parietal cell atrophy’, or pernicious anemia. The cells that make intrinsic factor simply wear out and stop producing it. This is also a problem for those who undergo gastric bypass surgeries, as the cells making intrinsic factor are taken out of the loop.

However, Healthy Habits® B-12 Transdermal Vitamin B-12 Patches elimates ALL of this digestive complexity! Unlike oral supplementation, which needs intrinsic factor, or sublingual B-12, which is limited in the amount of vitamin B-12 that can be easily absorbed, vitamin B-12 from our patches is absorbed directly into the bloodstream at full strengh.

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1. Weight Loss Surgery & Vitamin B-12 Deficiency
2. Other Medical Issues Often Accompanied By Vitamin B-12 Deficiency

While some people may have a sensitivity to vitamin B-12, it is very unlikely.  However, if you are sensitive the most common side effects are

• your skin is itchy
• you develop a rash
• you have mild, quickly passing diarrhea
• you’re mildly nauseous

Much rarer side effects include

• pores or hair follicles get red and inflamed (inflammatory acne or folliculitis), usually on the face or near the area the patch is applied
• headache
• dizziness/incoordination
• a feeling of swelling of the entire body
• back pain

People who are actually allergic to cobalamin/ cyanocobalamin or cobalt obviously should avoid vitamin B-12 supplementation without consulting with their doctor.  However, this allergy is extremely rare.  Even so, Healthy Habits’ Transdermal Vitamin B-12 Patches use only the best form of B-12, high quality methylcobalamin.  Most supplements use hard to digest and absorb cobalamin/ cyanocobalamin – be sure to read your labels!

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• Anticonvulsants
• Aspirin
• AZT
• Cimetidine
• Clofibrate
• Colchicine
• Cycloserine
• Erythromycin
• Famotidine
• Fenofibrate
• Gabapentin
• Gentamicin
• H2-blockers (such as Tagamet, Pepcid, Axid, and Zantac)
• Isoniazid
• Lansoprazole
• Metformin
• Methyldopa
• Neomycin
• Nicotine
• Nitrous Oxide
• Nizatidine
• Omeprazole
• Oral Contraceptives
• Phenobarbital
• Ranitidine
• Sulfamethoxazole
• Tetracycline
• Tricyclic Antidepressants
• Trimethoprim
• Valproic Acid

If you are using any of these medications, you should be using transdermal patch supplementation as it avoids the gut altogether.  Avoid the gut, avoid the problems with medication absorbing your B12 or blocking it’s uptake altogether in your gastrointestinal tract.

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• Chronic fatigue syndrome.
• Fibromyalgia.
• Autoimmune diseases.
• Poor nutrition.
• Smoking.
• Alcoholism.
• High stress.
• Stomach or ileum resectioning.
• Gastric bypass surgery.
• Stomach surgery.
• Gastrointestinal mucosa atrophy.
• Crohn’s disease.
• Diabetes.
• Rheumatoid arthritis.
• Hypothyroidism.
• Anorexia.
• Bulemia.

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1. Medical Conditions Linked With B-12 Deficiency Risks
2. Weight Loss Surgery & Vitamin B-12 Deficiency

Neurological Symptoms:

• Numbness or tingling in the hands and feet.
• Problems coordinating your body movements (ataxia).
• Impaired reflexes.
• Problems walking (gait disturbances).
• Impaired vibration perception.
• Closing your eyes makes you very unsteady (positive Romberg's test).
• Extending your big toe while curling the rest when your sole is tickled (Babinski's sign).
• Sudden electricity-like shocks down the spine when moving your head.
• Degraded vision (optic nerve damage).

Pscyhiatric Symptoms:

• Difficulty concentrating.
• Confusion.
• Irritability.
• Impaired memory / memory loss.
• Dementia.
• Depression.
• Major personality changes.
• Psychosis/delusions.

Anemic Symptoms:

• Fatigue.
• Apathy.
• Difficulty breathing during exertion.

Other Symptoms:

• Aversion to meat (the only significant dietary source of vitamin B12).
• Impotence.
• Incontinence / loss of bladder control.
• Infertility.
• White patches of skin (vitiligo).
• Diarrhea.
• Hair loss.

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1. Fatigued? Low Energy? Vitamin B-12 Can Help!
2. Fatigue, B-12 Deficiency & Pernicious Anemia

For example. doctors from the Union Memorial Hospital in Baltimore reported in a letter to the Journal of American Geriatrics Society on a case of vitamin B-12 deficiency.  Their patient had developed progressive memory loss and lethargy/fatigue over a two year period.  However, after just two months of vitamin B-12 supplementation the patient's mental status had vastly improved and his fatigue had completely vanished.

Along with fatigue or excessive tiredness, people may also experience tingling in the hands and feet, memory loss, inability to concentrate, irritability, depression, impaired reflexes, and a host of other issues. Vitamin B-12 deficiency can also be caused by or contribute to other medical conditions.  Worse yet, many common medications such as antacids and anti-depressants can also induce vitamin B12 deficiency and  contribute to fatigue and tiredness throughout the day.

Vitamin B12 also plays a vital role in the production and functioning of red blood cells.  These cells carry oxygen throughout the body and, of course, to the muscles.  If you don't have enough B12, you don't have enough red blood cells. Without these cells, your  body will not get the oxygen it needs and you'll feel tired. Even mundane daily activities become a struggle when the body is low on energy!  Just tidying up can sap all your energy and make you tired for the rest of the day.

Transdermal vitamin B-12 supplementation is the solution! It's an easy and effective way to build B12 stores in your body and avoid feelings of fatigue.  Healthy Habits' transdermal vitamin B-12 patch avoids the digestive tract absorption issues that oral supplements  & vitamin B12 from foods can encounter  - especially as your body gets older.

Even better, instead of using cobalamin or cyanocobalamin that your body must convert to become usable, Healthy Habits' patch provides your body with high bioavailability methylcobalamin directly.  And patches are both inexpensive and painless... unlike visits to a doctor's office for B12 injections.

The Healthy Habits B-12 Energy Patch delivers 1,000 mcg of fatigue destroying vitamin B12 straight to your bloodstream at a steady rate throughout the day! Say goodbye to days of fatigue... tiredness... and low energy levels.  G.M. from Arizona did! "Since using the B-12 energy patch I have noticed that I do not get as tired during the day.  This is enabling me to get a lot more accomplished." You can too - get the patch now!

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1. Vitamin B-12 Deficiency Symptoms
2. Fatigue, B-12 Deficiency & Pernicious Anemia

• Pernicious anemia.  The immune system destroys digestive tract cells that aid in B-12 absorption.
• Nutritional deficiency from diet.  Most commonly the elderly, vegans, alcoholics, HIV+ patients, breast-fed children of vegetarian mothers.
• Atrophic gastritis.  This problem affects approximately 20% of people between 60 and 69 years of age, and 40% of people over 80.  The individual is unable to secrete sufficient stomach acid to kill bacteria. Ingested bacteria can thus survive and reside in the stomach and the upper part of the small bowel, where they block B-12 uptake.   The deficiency of vitamin B12 may not be severe enough to show up in the blood, but it can be associated with psychiatric dementias.  These deficiencies may be disguised as Alzheimer's disease or senile dementia.
• Bowel issues (pathology of distal ileum).  This can be from surgery such as distal ileal resection, or an inflammatory bowel diseases like Crohn's disease, Whipple's disease, or tropical sprue.
• Surgical gastrectomy.   The partial or full removal of the stomach.
• Bowel bactrial colonization.
• Intestinal parasities. For example, a tapeworm (Diphyllobothrium latum)
• Congenital conditions such as Imerslund-Grasbeck syndrome.

Sources:

N.K. Sethi, E. Robilotti & Y. Sadan: Neurological Manifestations Of Vitamin B-12 Deficiency: The Internet Journal of Nutrition and Wellness. 2005; Volume 2, Number 1.

DiagnoseMe.com - Atrophic Gastritis

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1. Other Medical Issues Often Accompanied By Vitamin B-12 Deficiency