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Vitamin B12 (cyanocobalamin)

The role of vitamin B₁₂ (cyanocobalamin) in the body

Vitamin B₁₂ is a vital substance needed for:

  • Hematopoiesis -participates in the synthesis of red blood cells (prevents anemia).
  • Nervous system -supports the myelin sheath of nerves (protects against neuropathy).
  • DNA synthesis -provides cell division (especially in the bone marrow and gastrointestinal tract).
  • Metabolism – helps break down homocysteine (reduces the risk of heart disease).

The norm of vitamin B₁₂ in the blood

Reference values:

  • 180-900 pg / ml (or 150-670 pmol / l).
  • The optimal level is above 400 pg / ml (deficiency is possible even at ‘normal’ values).

Important: The standards depend on the laboratory. At borderline values , homocysteine and methylmalonic acid (MMC) are checked – they increase with a latent deficiency.

Vitamin B deficiency₁₂

Reasons:

  • Lack of nutrition (vegans, vegetarians).
  • Malabsorption (atrophic gastritis, Crohn’s disease, gastric/intestinal resection).
  • Deficiency of the internal Castle factor (pernicious anemia – autoimmune damage to the stomach).
  • Parasites (tapeworms, for example, broad tapeworm).
  • Taking medications (metformin, proton pump inhibitors-omeprazole).

Symptoms:

, Hematological services:

  • Megaloblastic anemia (large, immature red blood cells).
  • Weakness, pallor, shortness of breath.

🔹 Neurological:

  • Numbness, tingling in the hands/feet (polyneuropathy).
  • Coordination disorder (spinal cord injury).
  • Memory loss, depression, dementia.

🔹 Other:

  • Glossitis (red ‘varnished’ tongue).
  • Digestive disorders (loss of appetite, constipation).

Excess vitamin B₁₂

A rare condition, as the excess is excreted in the urine.

Reasons:

  • Overdose of B₁₂ injections.
  • Diseases of the liver and kidneys.
  • Oncology (leukemia, liver cancer).

Symptoms:

  • Allergic reactions (itching, rash).
  • Headache, dizziness.
  • Increased blood clotting (risk of thrombosis).

How can I fill the gap?

  1. Injections of B₁₂ (for severe deficiency and malabsorption) – cyanocobalamin or methylcobalamin.
  2. Tablets/sprays (for mild deficiency or prevention).
  3. Diet:
  • Liver, beef, fish (salmon, herring).
  • Eggs, dairy products (cheese, cottage cheese).
  • Vegans – fortified foods or supplements.

When should I take the test?

  • For symptoms of anemia or neuropathy.
  • Vegans/vegetarians (once every 1-2 years).
  • For chronic diseases of the gastrointestinal tract or taking metformin.

Important: B₁₂ deficiency can be disguised as other diseases (multiple sclerosis, dementia). If in doubt, check for homocysteine and MMC!