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
• UTI May Cause Sudden Confusion
• 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

UTI May Cause Sudden Confusion

UTI and Confusion – Photo by Chalmers Butterfield at Wikimedia Commons

If a person suddenly becomes confused, family members and friends often assume that Alzheimer's must be setting in or that all older people tend to lose their memories and prepare for the worst. Many times, the source of sudden confusion can be identified and corrected, and a urinary tract infection (UTI) is often to blame.

What are symptoms of a UTI?

Infections can occur anywhere along the urinary tract, including the:

• kidneys (pyelonephritis)
• ureters (rarely the site of infection)
• bladder (cystitis - most common)
• urethra (urethritis)

The urinary tract is a common site of infection because it serves as an opening in the body that leads to the outside. Bacteria is the most common germ causing urinary tract infections.

Symptoms may begin as mild and can progress in severity. Symptoms commonly associated with a UTI include:

• Confusion (this may be the only symptom of a UTI, particularly in the elderly)
• Urine that is cloudy or bloody
• Foul odor in the urine
• Burning or pain while urinating
• Cramping pain or pressure in the lower abdomen or low back
• Feeling the need to urinate frequently
• Fever
• Chills
• Nausea and vomiting

A UTI can lead to sepsis and decreased kidney function and in the most severe cases can lead to death. Someone who has dementia may experience a sudden increase in confusion, which can be a red flag indicating that an infection has developed. Checking the urine for the presence of bacteria and infection-causing germs is often a first step in discovering the source of sudden and increased confusion. The NIH recommends calling 911 if a person develops sudden confusion, particularly if the person has a fever, other changes in vital signs, or if the person has other health conditions such as diabetes.

What increases risk for a UTI?

Older women are particularly at risk for a urinary tract infection. A woman's urethra is shorter than a man's urethra, reducing the distance infection-causing bacteria must travel to cause infection. Increased age, sexual activity, and menopause also increase one's chance to develop a UTI in women.

Other common factors that increase risk for developing a urinary tract infection include:

• Diabetes (many people have this condition and do not realize it)
• Urinary retention
• Enlarged prostate
• Urinary catheters (a tube usually inserted through the urethra to empty the bladder)
• Kidney stones
• Immobility and inactivity (especially those confined to bed)
• Bowel incontinence
• Living in a long-term care facility or nursing home
• Pregnancy
• Surgery or procedures (particularly of the urinary tract)

Can confusion due to a UTI be reversed?

Fortunately, sudden confusion or increased confusion due to a urinary tract infection may completely reverse with prompt and effective treatment. A healthcare provider will typically prescribe antibiotics to treat a UTI. Some people may need to be admitted to a hospital or other facility for treatment, particularly if the symptoms are severe or if the person has other variables that could affect his or her health.

Those who are prone to recurrent or chronic urinary tract infections may wish to check with a healthcare professional about options for trying to prevent future infections. People with known risk factors for UTI, such as diabetes and conditions that make it difficult to completely empty the bladder, may wish to weigh pros and cons for treating those risk factors in order to potentially increase quality of life and decrease risk for urinary tract infections.

Readers may also wish to read:

• Low Vitamin B12 Levels May Mimic MS or Alzheimer's Dementia
• Energy Drinks and Alcohol – A Dangerous Combination
• Fall Prevention and Exercise

Information in this article is not medical advice and is for information only. Find more articles on Katrena's blog at the Fit Tips 4 Life site map.

Sources:

• Centers for Disease Control and Prevention "Urinary Tract Infections" last updated October 25, 2005.
• National Institutes of Health "Urinary Tract Infection – Adults" last updated 9/13/2011.
• National Institutes of Health "Confusion" last updated 2/16/2012.