15-year-old boy’s health deteriorates from suspected B12 deficiency

Dr Dawn Harper on signs of vitamin B12 and vitamin D deficiency

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Vitamin B12 ensures the body’s hardware runs smoothly. It does this by helping to fight fatigue, keeping nerve and blood cells healthy and producing DNA. Indeed, a chilling case study published in the journal BMJ Case Reports reveals the toll B12 deficiency can exact on the body.

A 15-year-old vegetarian boy presented with easy fatigue, breathlessness and pain in the legs on walking, noted during the past few weeks.

Paleness and jaundice in the whites of his eyes had been noted by the parents for about two years, although these findings became more obvious within the last few weeks.

The vegetarian patient had not consumed any food of animal origin for many years – a relevant detail because B12 is mainly found in animal products.

Besides, the family only rarely ate fresh fruits or vegetables.

The patient had a history of an upper respiratory tract infection that began about 15 days earlier and resolved one week later.

No fever was noted. In the physical examination, the patient looked pale and weak, and his eyes were jaundiced.

His heart rate was 96 beats per minute, which is on the higher end of the scale. According to Harvard Health, resting heart rates range from 60 to 100 beats per minute in most healthy adult women and men.

Laboratory investigations revealed “severe” vitamin B12 deficiency.

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Following vitamin B12 replacement therapy, the patient reported increased well-being, including appetite and weight gain, and his icterus resolved.

The report is shocking but not surprising. The impact of low B12 on the body is well documented.

Vitamin B12 deficiency can cause a wide range of symptoms. These usually develop gradually, but can worsen if the condition goes untreated.

Symptoms include:

  • A pale yellow tinge to your skin
  • A sore and red tongue (glossitis)
  • Mouth ulcers
  • Pins and needles (paraesthesia)
  • Changes in the way that you walk and move around
  • Disturbed vision
  • Irritability
  • Depression
  • Changes in the way you think, feel and behave
  • A decline in your mental abilities, such as memory, understanding and judgement (dementia).

How to respond

The NHS says: “See a GP if you’re experiencing symptoms of vitamin B12 or folate deficiency anaemia.”

According to the health body, these conditions can often be diagnosed based on your symptoms and the results of a blood test.

It’s important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible.

“Although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible if left untreated,” warns the health body.

“The longer the condition goes untreated, the higher the chance of permanent damage.”

How to treat B12 deficiency

The treatment for vitamin B12 or folate deficiency anaemia depends on what’s causing the condition.

Most people can be easily treated with injections or tablets to replace the missing vitamins.

Good sources of vitamin B12 include:

  • Meat
  • Salmon and cod
  • Milk and other dairy products
  • Eggs.

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