The most common cause of B12 deficiency is the disease known as pernicious anemia. In pernicious anemia, the body produces antibodies that attack and destroy parietal cells. These are cells in the stomach wall that make intrinsic factor.
Intrinsic factor is a protein made in the stomach that helps the absorption of vitamin B12 from the gut. In pernicious anemia, these antibodies attack the intrinsic factor or parchietal cells that produce this factor. The cause of this autoimmune response is unknown.
In pernicious anemia, 90% anti-parietal cell antibodies (APA) and 60% anti-intrinsic antibodies (AIA) are positive. In this case, a kind of autoimmune gastritis develops in the stomach and the intrinsic factor that functions in vitamin B12 absorption cannot be made. This leads to anemia by disrupting B12 absorption. Even if we take enough vitamin B12 orally, B12 deficiency develops. Autoimmune Gastritis accounts for 10% of chronic gastritis.
Hypochlorite (lack of acid in the stomach), achlorhydria (absence of acid in the stomach) progress with high serum gastrin. Indigestion is seen due to a lack of stomach acid. Especially in the stomach, glandular atrophy and metaplasia are dominant in the corpus and fundus. It is not typically seen in the antrum.
Atrophy seen in the antrum is mostly caused by “Helicobacter Pylori”. Submucosal blood vessels may appear clear due to thinned atrophic mucosa. Diffuse and deep lymphoplasmocytic infiltration is seen in the lamina propria. In advanced or recent examinations, pleats in the corpus and fundus are flattened or not observed. B12 deficiency occurs in those whose stomach is removed by surgery.
Vitamin B12 is needed for the normal and healthy production of erythrocytes (red blood cells). If B12 deficiency occurs, the number of erythrocytes (red blood cells) decreases and their volume increases. At the same time, additional autoimmune diseases such as Hashimoto’s thyroiditis may occur.
The most common cause of vitamin B12 deficiency is atrophic gastritis. The risk of gastric cancer is increased in these patients. Therefore, it may be necessary to consult a gastroenterologist doctor.
Vitamin B12 deficiency symptoms
The cause of fatigue that does not go away with rest may be vitamin B12 deficiency, anemia or depression that develops accordingly.
Vitamin B12, called cobalamin, is a water-soluble vitamin. It is stored in the body. It shows signs of forgetfulness, tiredness and lethargy. Severe B12 deficiency can cause much more serious problems than fatigue. It can cause inflammation (inflammation) called glossitis in the tongue, resulting in a red tongue that has lost its roughness.
Vitamin B12 deficiency is felt more especially in the elderly. Fatigue, shortness of breath with exertion, palpitations, pallor, and reluctance are seen. Those with deep anemia may also have complaints such as dizziness, tinnitus, and blackout. It can cause tingling in the tips of the hands and feet, impaired balance and dementia. Early diagnosis of nervous system findings is very important. Vitamin B12 is a vitamin of animal origin.
The daily requirement is 1 microgram. Vitamin B12 protects nerve cells and reduces the risk of depression and Alzheimer’s in later life. But in vitamin B12 deficiency originating from the stomach, oral B12 vitamins do not increase the level of B12. Then parenteral (needle) treatment is given. For this reason, it is important to understand whether the cause of stomach vitamin B12 deficiency is of stomach origin or not in terms of treatment method.
