2. CONSIDER THE FOLLOWING PATIENT
• A 30 year old female has been experiencing fatigue,
numbness in limbs, nausea and mood swings for quite
some time now. She has noticed her tongue is red. At her
annual physical she mentions these symptoms to her
doctor, along with the fact that she is a practicing vegan.
3. What is the test the doctor should run to
determine the diagnosis?
4. The doctor should take a sample of the patients
blood or urine.
What levels should the doctor be
looking at?
5. LEVELS OF CONCERN
• Vitamin B12 levels
• Methylmalonic acid levels
• Homocysteine levels
• Holotranscobalamin levels
What is your
diagnosis for
this woman?
6. DIAGNOSIS
• After looking at the 4 levels of concern the
doctor finds the patient has low B12 and
high MMA levels to conclude the patient
has a
Vitamin B12 deficiency
7. WHAT IS THE CAUSE OF VITAMIN B12
DEFICIENCY?
• Lack of B12 in diet
• Unable to absorb B12
• Heavy drinking
• Immune system disorders
• Long term use of acid
reducers
• Certain medications
8. TREATMENT OPTIONS
• Change in diet (eat more animal
products)
• Take a B12 supplement
• Consider a B12 injection
9. HOW VITAMIN B12 IS USED
• B12 is absorbed in the
stomach lining
• Intrinsic factor is needed to
absorb B12
• Stored for usage in liver
10. If left untreated:
• Permanent nerve damage
• Memory loss
• Infertility
• Deteriorating brain functions
Studies have linked to
B12 deficiency:
• Alzheimer's disease
• Dementia
• Learning disorders
• Cancers
• Autoimmune disease
• Cardiovascular disease
