Vitamin B12 deficiency and Anemia

Weeks back I had an AMA session on Instagram and there were questions related to Vitamin B12 rich foods apart from nonplant based sources. 

Before going into it, I would like to elaborate some basics of this deficiency here. 

Besides Iron, our body needs Vit C and Vit B-12/ folate or folic acid to produce enough healthy red blood cells (RBC). A diet lacking in these and other key nutrients can cause decreased RBC production i.e. low Hb levels.

Vitamin B12 (Cobalamin) is a water-soluble vitamin that is mostly derived from animal-based products such as meat, poultry, dairy, and eggs mainly.  

Also, even though some seem to consume enough B-12 their body won’t be able to absorb the vitamin from the foods they eat due to various factors. This can lead to vitamin deficiency anemia, also known as pernicious anemia.

The various factors are
Autoimmune: 
A common cause of B-12 deficiency anemia is a lack of a substance called intrinsic factor, which is a protein secreted by the stomach that joins B-12 in the stomach and moves it through the small intestine to be absorbed by the bloodstream. Without intrinsic factor, B-12 cannot be absorbed and leaves the body as waste. Thus, when B12 cannot be absorbed for a prolonged period due to dietary insufficiency, malabsorption, lack of intrinsic factor, deficiency sets in. 

People with endocrine-related autoimmune disorders, such as diabetes or thyroid may have an increased risk of developing this kind of anemia.

Malabsorption: 
Stomach's inner lining (parietal cells) produce intrinsic factor; therefore, any patient with a history of gastric bypass surgery may be at risk for developing a B12 deficiency because their new alimentary pathway bypasses the site of intrinsic factor production. Other damage to the small intestine, such as inflammation from Celiac disease or a presence of tapeworm may also, cause this vitamin deficiency. 

Dietary Insufficiency: 
Those who follow a strict vegan diet for years may develop a B12 deficiency from a lack of vitamins in the dietary intake.

Coming to Vit B12, which is an essential water-soluble nutrient that our body can’t make on its own.  Whereas, B12 is required for proper RBC formation, neurological function, and DNA synthesis. It is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA and plays a major role in the synthesis of RBC cells preventing anemia. 

What foods provide vitamin B12?
Fish, meat, poultry, eggs, milk, and other dairy products.

Since vitamin B12 is naturally found only in animal-based foods, vegetarians are considered an at-risk group for vitamin B12 deficiency. 

Fortunately, fermented foods are an excellent source of Vit B12. 
Any Fermented food for that matter has substantial amounts of Vit B12, because of the yeast that synthesizes Vit B12 during the fermentation process. 

Like Fermented rice gruel/ Pazhayadhu- A naturally fortified food that’s an all-rounder I would say apart from being an excellent source of probiotics and prebiotics. 

Especially when the rice variety is brown/ red/ black rice, the amounts of Vit B12 present is exceptional (based on scientific evidence). 

My recommendation would be to eat such “wholesome” foods rather going for any specific nutrient-based food.
So I won’t suggest the recommended dosage per age or the number of nutrients present in any foods.
“The more Wholesome, the Better!”
 
References:
1. Layden AJ, Täse K, Finkelstein JL. Neglected tropical diseases and vitamin B12: a review of the current evidence. Trans. R. Soc. Trop. Med. Hyg. 2018 Oct 01;112(10):423-435. 
2. Watson J, Lee M, Garcia-Casal MN. Consequences of Inadequate Intakes of Vitamin A, Vitamin B12, Vitamin D, Calcium, Iron, and Folate in Older Persons. Curr Geriatr Rep. 2018;7(2):103-113. 
3. Herbert V. Staging vitamin -B12 (cobalamin) status in vegetarians. Am J Clin Nutr. 1994;59:1213S–1222S.
4. Burgess CM, Smid EJ, van Sinderen D. Bacterial vitamin B2, B11 and B12 overproduction: An overview. Int J Food Microbiol. 2009;133:1–7. 

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