Low Vitamin B12 Symptoms May Mimic MS or Alzheimer's Dementia

Vitamin B12 or Cobalamine - Photo by Ymwang42

Vitamin B12 deficiency symptoms can easily be overlooked on routine physical examinations and acute care appointments. The vitamin is necessary for normal functioning of the brain and nervous system as well as in the formation of blood. People who have low levels of vitamin B12 may initially experience vague symptoms that may spiral into serious health concerns if left untreated.

The incidence of vitamin B12 deficiency may be more difficult to determine due to folic acid fortification in grains and cereals since 1998. Low vitamin B12 levels and folic acid deficiency tended to be found together previously. Low folic acid levels produced anemia. Diagnosing anemia is relatively simple because it shows up on very basic bloodwork tests. Those who have vitamin B12 deficiency may not have anemia but can still experience progressive neurologic symptoms.

According to several studies, only 56-77% of people with low vitamin B12 levels have megaloblastic anemia. A 2013 study found that people who experience neurologic symptoms from vitamin B12 deficiency may be less likely to experience anemia and often test positive to H. pylori, a bacteria that causes stomach ulcers in many people.

Vitamin B12 Found in Animal Products and Some Cereals - Photo by Zoe

What are the symptoms of vitamin B12 deficiency?

Symptoms of low vitamin B12 include but are not limited to:

• numbness or tingling in the hands/feet
• generalized weakness that can progress to difficulty walking
• balance problems
• tension-type headache
• dementia, confusion (1.5% of dementia cases who are found to have untreated vitamin B12 deficiency are fully reversible with vitamin B12 treatment)
• depression
• personality, behavioral changes
• vision loss
• hallucinations, paranoia, psychosis
• anorexia, flatulence
• diarrhea, constipation
• failure to thrive
• developmental delays

Vitamin B12 deficiency also has the potential to increase one's risk for heart disease and stroke. A study published in 2009 looked at people in the Indian culture and found that those with coronary artery disease tended to have significantly lower vitamin B12 levels than those who did not have heart disease. Vitamin B12 tends to lower homocysteine levels, a compound often found in higher than normal levels in people with heart disease, stroke, and dementia.

This video shows several people who experienced multiple symptoms related to low vitamin B12 levels

Vitamin B12 Shot - Photo from Wikimedia Commons

What can cause low vitamin B12 levels?

Vitamin B12, also called cobalamine, is a water-soluble micronutrient naturally found in animal products and in some fortified foods. Low vitamin B12 levels may result from inadequate dietary intake, such as with people who observe a strict vegan diet. Babies who are fed breastmilk by mothers who observe a strict vegan diet may have low vitamin B12 levels, even if the mother does not have symptoms of the deficiency.

Older adults tend to have less hydrochloric acid in the stomach region, which may lead to poor absorption of vitamin B12 and resulting deficiencies of the vitamin. People with other conditions causing poor absorption of nutrients, such as those with a history of gastric surgery, Crohn's disease, HIV infection, or celiac disease, may experience vitamin B12 deficiency despite adequate dietary intake of the nutrient.

Some medications may cause poor absorption of vitamin B12, including:

• Some antibiotics
• Proton pump inhibitors
• H2 receptor agonists
• Some drugs used to treat diabetes

Information in this article is for informational purposes only and should not be considered medical advice. Those who are experiencing any symptoms of vitamin B12 deficiency should speak with his or her healthcare provider.

Readers may also wish to read:

• How to Talk with Your Doctor – Tips for Effective Communication
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• Coconut Oil and Its Affect on Cholesterol, Blood Sugar, BP, and Alzheimer's

Find more of Katrena's health-related articles at the Fit Tips 4 Life site map.

References:

• Centers for Disease Control and Prevention online article Manifestations of Low Vitamin B12 Levels accessed on 11/13/13.
• Kumar, Jitender et. al, Clinical Chemistry & Laboratory Medicine, March 2009, Vol. 47, Issue 3, Vitamin B12 deficiency is associated with coronary artery disease in an Indian population.
• National Institutes of Health article Dietary Supplement Fact Sheet: Vitamin B12 accessed on 10/16/13.
• Ozcan, Tuba Aydemir et. al., Journal of Neurological Sciences, 2013, Vol. 30, Issue 3, Helicobacter Pylori Infection in Patients with Neurological Symptoms of Vitamin B12 Deficiency

Shigellosis Symptoms and How to Prevent the Spread of Shigella Bacteria

Symptoms of Shigella - Photo of Shigella under a microscope by CDC

Infection with Shigella bacteria, a condition called Shigellosis, shigella gastroenteritis, Shigella dysentery, or Bacterial dysentery, is a food-borne illness. People often refer to food-borne illnesses as food poisoning. The most common type of Shigella seen in the United States is Shigella sonei or Group D Shigella. Click the words in blue within this article to hear how to pronounce them.

Approximately 14,000 people in the United States develop a reported case of Shigellosis. Actual numbers are likely much higher because many cases go unreported. The health department will seek to determine the source of a Shigella outbreak in order to help prevent the spread of this germ to more people in the area.

Shigella Symptoms and Treatment - Photo by Grosser Schlumpf

What are the Symptoms of Shigellosis?

Shigellosis often begins with sudden (acute) symptoms including:

• Stomach (abdominal) cramps or pain
• Fever
• Diarrhea that may contain mucous, blood, and/or pus
• Nausea (feeling sick to your stomach)
• Vomiting
• Rectal pain

People with a strong immune system who do not have conditions that may cause the infection to be more severe may not need any treatment other than getting rest and drinking electrolyte solutions and plenty of fluids. However, some people can get very ill if they are infected with Shigella. Anyone who has questions regarding his/her health should contact his or her healthcare provider.

People who become dehydrated due to this food-borne illness should seek medical assistance because they may need to receive electrolyes and fluids through a vein. Those who are experiencing bloody diarrhea should also seek medical advice.

Immediate emergency medical attention should be sought if the person develops serious symptoms such as:

• Confusion and/or lethargy
• Headache with a stiff neck
• Seizures

Each of these symptoms may have other causes. A physician may need to order tests in order to determine the cause of the symptoms. Medications to slow diarrhea are not generally recommended because the medication can cause it to take longer to clear the bacteria from the body. An antibiotic may help the infection to clear quicker and may be needed in cases with more serious symptoms.

How Shigella is Spread - Photo by Paul Nasca

How Do People Get Shigella?

Shigella can easily spread to large numbers of people in a short period of time. Small amounts of the bacteria can cause symptoms. A person may have Shigella bacteria in his or her body for one to seven days, averaging three days, before symptoms appear. Some people may be infected without symptoms but can spread the infection to others. Shigella bacteria exit the body through an infected person's stools or bowel movements. A person can still be contagious for up to two weeks after symptoms resolve.

The infection may be spread by direct contact. For example, if someone with contaminated hands touches someone else's hands, the bacteria may be transferred to the second person's hands. If the second person touches his mouth or food, the bacteria can easily be transferred into the second person's body. This type of spread is particularly common in daycare settings or areas where young children may play together.

People who provide assistance with elimination may also spread Shigella. If the caregiver's hands become contaminated and the caregiver fails to wash his or her hands with soap and water before providing care to the next person, the caregiver and next person(s) receiving hands-on care are at risk for developing the infection.

Shigella bacteria may also be spread through contaminated food. The food typically looks and smells normal. Some of the most common food sources include those that are raw and tend to be handled with hands, such as:

• salads
• sandwiches
• raw vegetables (particularly if harvested in a field containing sewage)

Contaminated water may also spread Shigella if a person drinks water from an untreated pool, pond or lake contaminated with the bacteria. The bacteria can also be spread via splash pads, untreated wading pools, or play fountains. If someone drinks, plays, or swims in untreated contaminated water, this can also cause the person to develop Shigellosis.

How to Prevent Shigella Infection - Photo by jdurham

How Can People Prevent the Spread of Shigella?

Although shigellosis is quite contagious, several preventive measures can help prevent its spread including:

• Proper hand washing with soap and water
• Proper food preparation and storage
• Proper disposal of diapers
• Proper cleaning of surfaces such as diaper changing areas
• Children who have diarrhea should not be in child care settings
• Avoid preparing food for others when experiencing diarrhea
• Avoid contaminated food and water
• Drink only treated or boiled water
• When traveling to developing countries, eat only cooked hot foods or fruits you peel for yourself

At this time, there is not a vaccine to help prevent development of Shigellosis.

Readers may also wish to read:

• Norovirus or Food Poisoning or Stomach Flu Causing Gastroenteritis?
• Katrena's Good Hygiene Scavenger Hunt
• How to Keep From Getting MRSA in the Gym: Staph Infection Prevention

See more of Katrena's articles at the Fit Tips 4 Life site map.

References:

• Centers for Disease Control and Prevention article Shigellosis accessed on 11/8/13.
• FoodSafety.net article Shigella accessed on 11/8/13.
• National Institutes of Health article Shigellosis accessed on 11/8/13.
• Nemours KidsHealth article Shigella Infection accessed on 11/8/13.