Understanding the facts

Vitamin B12 is really important as in combination with folate (folic acid) it is needed to help form red blood cells, white blood cells and platelets. Deficiency of these water-soluble vitamins occurs when there is reduced absorption in our gastro-intestinal tract. Insufficient amounts result ultimately in a range of disorders such as types of anaemia and neuropathy (nerve-related problems) especially in hands and feet, with long- term depletion being now linked with Alzheimers disease. It also occurs in milder forms with symptoms such as tiredness, weakness, insomnia, depression, or loss of mental sharpness.

About 1.5% of the general population is postulated to have a deficiency of B12 but this figure increases sharply with age to about 6%. So, what has this got to do with prediabetes? Well, quite a lot actually. Although a diagnosis of prediabetes does not mean that you will have a B12 deficiency it does make you more susceptible under certain circumstances. To find out why this happens let’s first look at the following listed causes:

Reduced intake:
Vegetarians and vegans at most risk due to a reduced or no consumption of animal products (especially red meat)

Reduced absorption:

• Bariatric surgery (depends on type of procedure and the absorption surface removed from the intestine)
• Gastrectomy
• Chrohns disease
• Coeliac Disease
• Pancreatic insufficiency (e.g. post-surgery; pancreatitis)
• Autoimmune Disorders such as thyroid disease
• Certain medications such as metformin, omeprazole, cimetidine or neomycin
• Bacterial overgrowth in the intestine
• Alcohol related liver disease
• Renal disease requiring dialysis
• Rare Genetic disorders

As you can see most of the causes are a result of not being able to absorb the B12 in the first place not actually from intake itself.

Those with type 1 diabetes are at a higher risk for other autoimmune disorders such as coeliac disease or thyroid problems, which can increase the likelihood of B12 deficiency.

In type 2 diabetes metformin therapy is associated with B12 deficiency, resulting in a 10% higher risk of developing B12 depletion. Metformin use and risk of B12 Deficiency increases with the dose and the duration… depletion can be seen as early as 3-4 months after starting so it is important to attend for follow up blood tests and talk to your doctor.

Treatment of B12 deficency

Diagnosis of a deficiency of B12 is based on a simple blood test. Sometimes there are conditions such as the oral contraceptive pill; infection; pregnancy; kidney or alcohol related liver disease which can actually affect how accurate the blood test result is and your doctor will be able to advise you about your own results. Folate levels can also be assessed by a blood test and it is recommended that those at risk of B12 and Folate increase amounts of vegetables (especially green leafy ones); fortified grains; meat; milk (but not goats milk which is low in folate) and eggs.

Treatment is really simple and your doctor will often prescribe injections of B12 or suggest a daily oral supplement. Intramuscular injections are often a better alternative as the intestine may not be able to absorb enough of the vitamin if taken orally.

Warning: Supplements are simple, considered very safe and are not expensive…Treatment may cause you to feel an awful lot better!!!