CASE STUDYKAITLYN STALBERGER

CONSIDER THE FOLLOWING PATIENT

• A 30 year old female has been experiencing fatigue, numbness in limbs, nausea and mood swings for quite some time now. She has noticed her tongue is red. At her annual physical she mentions these symptoms to her doctor, along with the fact that she is a practicing vegan.

What is the test the doctor should run to determine the diagnosis?

The doctor should take a sample of the patients blood or urine.

What levels should the doctor be looking at?

LEVELS OF CONCERN

• Vitamin B12 levels• Methylmalonic acid levels• Homocysteine levels• Holotranscobalamin levels

What is your diagnosis for this woman?

DIAGNOSIS

• After looking at the 4 levels of concern the doctor finds the patient has low B12 and high MMA levels to conclude the patient has a

Vitamin B12 deficiency

WHAT IS THE CAUSE OF VITAMIN B12 DEFICIENCY?• Lack of B12 in diet• Unable to absorb B12• Heavy drinking• Immune system disorders• Long term use of acid

reducers• Certain medications

TREATMENT OPTIONS• Change in diet (eat more animal

products)• Take a B12 supplement• Consider a B12 injection

HOW VITAMIN B12 IS USED

• B12 is absorbed in the stomach lining

• Intrinsic factor is needed to absorb B12

• Stored for usage in liver

If left untreated:

• Permanent nerve damage• Memory loss• Infertility• Deteriorating brain functions

Studies have linked to B12 deficiency:

• Alzheimer's disease• Dementia• Learning disorders• Cancers• Autoimmune disease• Cardiovascular disease

REFERENCES

• http://www.healthline.com/health/vitamin-b12-level#Whogetstested3

• http://www.webmd.com/food-recipes/guide/vitamin-b12-deficiency-symptoms-causes#1