May 15, 2012

Vitamin Deficiency Anemia

Since Allen ended up on the deficient side for Vitamin B12, we have been doing a lot of research about the signs, symptoms, and causes. We have found quite a bit of information. First, from the Mayo Clinic is their article on vitamin deficiency anemia, which covers the tests Allen was fortunate that the doctor did do. He was at the low point on folate, very low on vitamin B-12, and low normal range for vitamin C.

The doctor did tell him to add a daily men’s supplement to his regimen and make sure that he added a vitamin C to his regimen. The doctor told him that the prescription levels of vitamin D and vitamin B12 would be for a month only and then he should purchase the supplements in any store and set the lower limit at the level he ordered until the completion of the next tests. Allen commented that this was good to know and that he was surprised that the doctor was concerned about his supplements. Both Tim and I said that was a good thing and that he would probably continue to test for these until his body maintained them in the recommended range.

We did discuss this and three of our members said they were going to ask their doctor to run the same tests. We also pulled up several listings of what foods were high in the vitamins and some minerals. Allen now has his license back and feeling much more active. He did decide to use insulin after we presented him with several articles and did a lot of discussion. He did ask if he might be able to drop back to oral medications and we all agreed that could be a goal if he wanted it, but that may not be what he needs for the long term.

After we covered many of the myths about insulin, even Ben admitted that his blood glucose management was so much better; he doubted he would consider going back to oral medications. Ben also has decided to change doctors so that he could be tested for vitamin shortages. We all have been reading about vitamin B12 and several things we could do. Vitamin B12 deficiency is a risk for neuropathy, and several other health problems.

Since the Mayo Clinic article lists the signs and symptoms of vitamin deficiency anemia, we decided to study the article with care. They list the following signs and symptoms:
  • Fatigue
  • Shortness of breath
  • Dizziness
  • Pale or yellowish skin
  • Swollen tongue that may appear dark red
  • Weight loss
  • Diarrhea
  • Numbness or tingling in your hands and feet
  • Muscle weakness
  • Irritability
  • Unsteady movements
  • Mental confusion or forgetfulness

All of us could recognize something in the list that fits us and so the discussion would continue. Everyone agreed that if their doctor would not test them for the same tests that Allen had, they would be changing doctors. Ben is back with the VA and he and Allen both have had their appointments scheduled. Allen is happy since this will help get his insulin much cheaper and they have moved his appointment up to the middle of May. Even Barry is now set up for an appointment locally after his move and his records are now here.

We discussed vitamin B12 foods that would help prevent the deficiency. Most were not aware that much of the vitamin B12 needed could be obtained from eggs, milk, cheese, yogurt, red and white meats, shellfish, and some fortified foods. This was a discussion that opened some eyes and at the same time led to a discussion of low cholesterol and low fat. Tim took over in this discussion about the importance of lower levels of carbohydrates, medium protein and fat since there was much resistance to higher cholesterol and fat.

Brenda did surprise us when she spoke up and said Tim was right and that she had been following this food regimen for several years and her tests showed that the food ratio of carbohydrates, protein, and fat of 20 percent: 30 percent, 50 percent had not caused her test results to increase and that she was actually having better test results and had lost a few pounds. She said she would provide the test information to anyone needing confirm this. She continued by saying that her sister, a nutritionist, had worked with her for the last five years and could also discuss this with anyone needing guidance.

This took a lot of the argument out of the discussion and we moved on to other causes of vitamin B12 deficiency. We pulled up the article by the Mayo Clinic and since no one has had gastric bypass surgery, Crohn's disease or celiac disease, or other problems that interfere with absorption of the vitamin B12, we moved to discussion of the intrinsic factor as vitamin B-12 deficiency is most often due to a lack of this substance.

Intrinsic factor is a protein secreted by the stomach that joins vitamin B-12 in the stomach and escorts it through the small intestine to be absorbed by your bloodstream. Without intrinsic factor, vitamin B-12 cannot be absorbed and leaves your body as waste. Lack of intrinsic factor may be due to an autoimmune reaction, in which your immune system mistakenly attacks the stomach cells that produce it. Vitamin B-12 deficiency anemia caused by a lack of intrinsic factor is called pernicious anemia.

Vitamin B12 is important not only for the production of red blood cells, but also for a healthy nervous system. Vitamin B12 deficiency can lead to neurological problems in neuropathy, mental confusion and forgetfulness. This tells us how important vitamin B12 is for healthy brain function.

Allen joked that he did not want to be the cause of all this learning, but felt that our insistence of his being tested had helped all of us and he had learned a great lesson about nutrition.

We agreed that we may have found a good article to use as our center of discussion, but that we all had learned and needed to learn more. I thanked Tim and Brenda for leading much of the discussion. Brenda said that was why she wanted to be part of this discussion as this was what she had gone through several years ago and realized we were serious about discussing it. She knew some things had changed and she wanted to learn more if possible and she had.

We also gave this article to everyone for reading. It is from WebMD and is very specific to vitamin B12 deficiency.

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