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Q: Can a vitamin B12 deficiency cause brain lesions?
A: Vitamin B12 may be found in all foods of animal origin. Hence, dietary vitamin B12 deficiency is very rare and is only found in strict vegetarians, who avoid all types of meat and fish, as well as all sorts of dairy products. After being ingested, vitamin B12 is bound to a protein produced in the stomach, usually referred to as intrinsic factor, and which is necessary in order for this vitamin to be absorbed in the intestine. The most common cause of vitamin B12 deficiency is pernicious anemia. This is a hereditary disease in which there is a deficiency in intrinsic factor production, so that vitamin B12 cannot be properly absorbed in the organism. Other possible causes of vitamin B12 deficiency include: surgical removal of the stomach due to various illnesses, intestinal parasites, pancreatic insufficiency, bacterial overgrowth in the intestine, intestinal inflammation, and surgical removal of that part of the intestine responsible for the absorption of vitamin B12 ( the ileum).
The main sign associated with vitamin B12 deficiency is anemia (a decrease in the red blood cell count). In particular, the anemia associated with this deficiency is a so called megaloblastic anemia, in which the red blood cells are much larger than usual. However, vitamin B12 deficiency also may lead to neurological manifestations. Typically, the peripheral nerves are usually first affected, and patients notice the presence of of abnormal spontaneous sensations (paresthesias. Furthermore, a decrease in the vibratory and positional sense may also be present, leading to disturbances of coordination and difficulty with balance, which are referred to as ataxia. In more severe cases, cerebral function may also be affected. In these cases, confusion, dementia, and other possible psychiatric conditions may occur.
Updated: 08/29/99
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