Vitamin B12 Deficiency Weird Symptoms (& Why They Occur)

vitamin B12 deficiency can cause weird or atypical clinical findings we're going to talk about those in this lesson and why they occur but let's first talk about vitamin B12 and how we can become deficient in it in the first place so vitamin B12 is also known as cobalamin it is a water-soluble vitamin and it is an essential vitamin that is acquired from our dietary consumption so it's an essential vitamin meaning that we have to get it from our diet and we're going to get vitamin B12 from animal products and these are going to include meat

poultry fish eggs and dairy products in vitamin B12 deficiency itself can come from either poor dietary intake so this can be from not eating enough of these animal products and we can see this from vegetarians and vegan diets but it can also be due to compromised absorption meaning that you might get enough in your diet but you're not absorbing it properly in a classic case is going to be pernicious anemia which is an autoimmune destruction of the parietal cells in the stomach that help to absorb vitamin B12 in vitamin B12 is important for two enzymes

in our body and not having enough vitamin B12 or having a vitamin B12 deficiency is going to lead to issues with central nervous system functioning and red blood cell functioning and because of this we can see weird or atypical findings with vitamin B12 deficiency and we'll talk about those and why they occur as we go through this lesson so the first set of findings that we can see with a vitamin B12 deficiency are psychological effects so vitamin B12 deficiency can cause psychological and neurological issues and the reason it does this is because of one of

those enzymes we talked about before and that enzyme is called methyl malinocoa mutase this is an enzyme that requires vitamin B12 as a cofactor and if there's not enough vitamin B12 for this enzyme to function we get a buildup of a toxic intermediary known as methylmionic acid so methylmalonic acid increases and this is actually damaging to our neurons it can actually lead to what we call axonal neuropathy which means that there's damage to the axons of neurons and more specifically it's going to affect a part of the central nervous system more specifically called the dorsal

column medial limniscus system or dcmls so because of these effects we can see some issues some of these can include depression so this depression is going to be a low mood but it's not going to be what we would call major depressive disorder because major depressive disorder occurs without a secondary cause so if there is some medical cause that is causing the depression it automatically is not considered major depressive disorder and we can also see along with the low mood irritability occurring as well another common psychological finding with a vitamin B12 deficiency is decreased cognition

so this is going to involve impaired memory understanding judgment it may appear like dementia in older patients this is oftentimes going to be something that can be looked at if a patient all of a sudden has some issues with their memory or understanding when they're older so this can be something that can be looked at to essentially eliminate as a potential cause and in some patients we may actually find that a vitamin B12 deficiency is the cause of some of their impaired cognition so in those patients that have impaired cognition due to a vitamin B12

deficiency if you replenish the vitamin B12 they can have Improvement of their cognition so these issues with memory understanding judgment they can all be treated and again that is going to be in those patients that have these issues because of a vitamin B12 deficiency and these findings these psychological effects are going to be something that's found more early on in a vitamin B12 deficiency but as the vitamin B12 deficiency becomes more and more chronic we can start to see other issues occurring like neurological effects so neurological effects are again due to that increased methylmalonic acid

that leads to that exonic neuropathy and it becomes irreversible if it's left untreated so the longer a vitamin B12 deficiency goes the more damage that can occur to those neurons and if left untreated it becomes irreversible so again that increased methylonic acid leads to axonal neuropathy and that again affects the axons of neurons so some of the neurological findings we can see with the vitamin B12 deficiency include symmetric paresthesias so paresthesias are going to be numbness tingling and burning Sensations they're going to occur mostly on the lower Limbs and what's characteristic about a vitamin B12

deficiency is that they're going to be symmetric meaning that they're going to be found on both sides of the body if you have it on your right leg you're also going to have it on your left leg as well we can also see a shuffling gait in patients with a vitamin B tall deficiency that have had it for a long period of time so a shuffling gate is going to be what we would call a parkinsonian-like symptom so it looks like Parkinson's in those patients and a Chevron gate is where the patient is often hunched

over and they slowly drag their feet along not fully lifting their feet so they slowly just Shuffle their gait they Shuffle their feet or drag their feet along while they emulate or walk another neurological issue that can occur is reduced to point discrimination so this is the reduced ability to discriminate between two points or two pin Pricks so if a clinician were to take a pin in poke here and then poke there they would be able to discriminate between those two points but if they were to take two pins and get closer and closer together

at some point the patient will not be able to discriminate between those two points so there's going to be a normal level of discrimination in people that don't have a vitamin B12 deficiency but in a vitamin B12 deficiency they start to lose that ability to discriminate so the distance between two points where if a clinician were to take a pin and put one point here and another point there if they have such a reduction of two-point determination they may not even be able to tell the difference between those two points they may think it's only

one point being touched in those cases so that is how you test two point discrimination and again vitamin B12 deficiency there is a reduced two-point discrimination there's also reduced proprioception as well so a decreased ability to balance and this also contributes to parkinsonian-like Features as well some other issues we can see with a vitamin B12 deficiency include reduced reflexes so hypo reflexia so we can either see reduced or loss of reflexes entirely and then poor cognitive development can occur in children who have long periods of vitamin B tall deficiency so there can be developmental delay

poor brain growth lethargy and failure to thrive now there are other findings of a vitamin B tall deficiency that can be found in the mouth for instance or the oral cavity so vitamin B12 deficiency can lead to issues with lips in the oral cavity and these are going to include glossitis so glossitis is an inflammation of the tongue this can actually occur in up to 25 percent of cases of vitamin B12 deficiency so it's going to be more specifically inflamed in red and tongue papilla so if you were to look at the tongue you can

see these little dots that are very reddened and inflamed and over time the glossitis can become atrophic meaning that these little papilla can be smoothened out and essentially the tongue becomes very smooth that's atrophic glossitis the patient can often complain of burning and pruritus of the tongue so pruritus is itching sensation and we can also see angular cheilitis occurring in a vitamin B tall deficiency this is what angular chelitis looks like this is inflammation of the lips with cracking of the corners of the lips this can be something that can be found in other deficiencies

as well in the fourth category of weird symptoms of vitamin B12 deficiency include blood disorders and related symptoms so vitamin B12 is important in DNA synthesis and production of immature erythrocytes or reticulocytes so these are immature red blood cells and what will happen is that if there's not enough vitamin B12 we have a deficiency and this can lead to reduced DNA synthesis and abnormalities of cell metabolism so the type of anemia we're going to see with a vitamin B tall deficiency is a macrocytic anemia macrocytic meaning that the red blood cells themselves are larger in

size as opposed to something we might see with an iron deficiency anemia where it is a microcytic anemia where the cells are smaller in size if you want more information on different types of anemia please check out my full lesson on this topic and because of this we can see signs and symptoms of anemia so these include fatigue shortness of breath exercise intolerance power and arrhythmias as well if you want to learn more about vitamin B12 and how it's absorbed please check out my full lesson on this topic and if you haven't already please like

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