WHO IS AT RISK OF VITAMIN B12 DEFICIENCY?
Dietary vitamin B12 deficiency is usually determined by inadequate absorption, use of certain medications, or insufficient intake of the vitamin.
Insufficient intake
Vitamin B12 deficiency usually develops in individuals who consume neither animal products (vegans) nor dietary supplements containing vitamin B12.
We can say that infants nursed by a vegan mother may be at risk for vitamin B12 deficiency.
Inadequate absorption
Inadequate absorption of vitamin B12 can be caused by the following conditions:
- Intestinal bacterial overproliferation: in this case, bacteria utilize ingested vitamin B12 and less of it is absorbed.
- Inflammatory bowel disease (ulcerative colitis, Crohn's disease).
- Celiac disease.
- AIDS.
- Bariatric surgery.
- Liver disease (may interfere with vitamin B12 storage) and pancreatic diseases.
- Decreased gastric acid which is more common in the elderly.
Use of medications
The use of certain drugs may change the absorption and metabolism of vitamin B12.
Metformin significantly decreases vitamin B12 levels, causing hyperhomocysteinemia. Therefore, patients with diabetes are more susceptible to vitamin B12 deficiency.
Long-term proton pump inhibitor therapy increases the risk of vitamin B12 deficiency by reducing the digestive ability to release vitamin B12 from food. Eventually the amount of vitamin B12 absorbed by the body is reduced.
Antiacids block acid secretion from the stomach, which can lead to vitamin B12 malabsorption.
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