Causes Of Vitamin B12 Deficiency - Quick Bites Internal medicine (Hematology)

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Causes of Vitamin B12 Deficiency:

Dietary Insufficiency: A lack of dietary intake of vitamin B12 is one of the primary causes of deficiency, especially in individuals following strict vegetarian or vegan diets. Vitamin B12 is primarily found in animal-based foods such as meat, fish, eggs, and dairy products.

Malabsorption Disorders: Various medical conditions can impair the absorption of vitamin B12 in the gastrointestinal tract, leading to deficiency. These conditions include:

Pernicious Anemia: An autoimmune condition where the body destroys intrinsic factor, a protein needed for vitamin B12 absorption.
Celiac Disease: An autoimmune disorder characterized by damage to the lining of the small intestine, which can reduce nutrient absorption, including vitamin B12.
Crohn's Disease: Inflammatory bowel diseases like Crohn's can affect the intestine's ability to absorb nutrients, including vitamin B12.
Atrophic Gastritis: Chronic inflammation of the stomach lining can lead to a decreased production of intrinsic factor and hinder vitamin B12 absorption.
Surgical Removal: Procedures such as gastric bypass surgery can alter the digestive tract and impair vitamin B12 absorption.
Aging: As individuals age, their ability to absorb vitamin B12 from food may diminish. This can result from reduced stomach acid production or changes in the gastrointestinal tract.

Medications: Certain medications can interfere with vitamin B12 absorption or utilization. These include proton pump inhibitors (PPIs), H2 receptor antagonists, and metformin, commonly used for acid reflux and diabetes management, respectively.

Gastrointestinal Surgery: Surgical procedures that involve the removal or bypass of parts of the stomach or small intestine can reduce the body's ability to absorb vitamin B12.

Parasitic Infections: Certain parasitic infections in the digestive tract, such as fish tapeworm (Diphyllobothrium latum), can consume vitamin B12 or disrupt absorption.

Alcoholism: Chronic alcohol consumption can lead to gastritis and damage to the gastrointestinal tract, affecting vitamin B12 absorption.

Genetic Factors: Rare genetic conditions, such as transcobalamin II deficiency and Imerslund-Gräsbeck syndrome, can impair the transport or utilization of vitamin B12 in the body.

Dietary Factors: Unbalanced diets that lack a variety of foods or do not include sufficient animal-based sources of vitamin B12 can contribute to deficiency.

Vegetarian and Vegan Diets: Individuals adhering to strict vegetarian or vegan diets are at higher risk of vitamin B12 deficiency due to the absence of animal-based foods in their diet. They may need to rely on fortified foods or supplements.

Chronic Illness: Certain chronic diseases or conditions, such as chronic kidney disease, HIV/AIDS, and malignancies, can lead to vitamin B12 deficiency due to increased metabolic demands or medication side effects.

Inadequate Intrinsic Factor: Some individuals may have a congenital or acquired deficiency of intrinsic factor, a protein necessary for vitamin B12 absorption, leading to pernicious anemia.

Dietary Practices: Cultural or dietary practices that involve consumption of raw or fermented foods, which may contain vitamin B12 analogs that interfere with absorption.

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