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==History and Symptoms==
==History and Symptoms==
Early and even fairly pronounced deficiency does not always cause distinct or specific symptoms. Common early symptoms are tiredness or a decreased mental work capacity, decreased concentration and decreased memory, irritability and depression.


Sleep disturbances may occur, because B12 may be involved in the regulation of the sleep wake cycle by the [[pineal gland]] (through [[melatonin]]).<ref name="pmid8981490">{{cite journal |author=Hashimoto S, Kohsaka M, Morita N, Fukuda N, Honma S, Honma K |title=Vitamin B12 enhances the phase-response of circadian melatonin rhythm to a single bright light exposure in humans |journal=Neurosci. Lett. |volume=220 |issue=2 |pages=129-32 |year=1996 |pmid=8981490 |doi=}}</ref>
==== Early symptoms ====
* Tiredness
* Decreased mental work capacity
* Decreased concentration and memory
* Irritability and depression
* Sleep disturbances because B12 involved in the regulation of the sleep wake cycle by the [[pineal gland]] (through [[melatonin]]).<ref name="pmid8981490">{{cite journal |author=Hashimoto S, Kohsaka M, Morita N, Fukuda N, Honma S, Honma K |title=Vitamin B12 enhances the phase-response of circadian melatonin rhythm to a single bright light exposure in humans |journal=Neurosci. Lett. |volume=220 |issue=2 |pages=129-32 |year=1996 |pmid=8981490 |doi=}}</ref>


Neurological signs of B<sub>12</sub> deficiency, which can occur without anemia, include sensory disturbances due to damage to peripheral nerves caused by [[demyelination]] and irreversible nerve cell death. Symptoms include [[numbness]], tingling of the extremities, disturbed coordination and, if not treated in time, an [[ataxic gait]], a syndrome known as [[subacute combined degeneration of spinal cord]].
=== Neurological signs ===
 
* Sensory disturbances due to damage to peripheral nerves caused by [[demyelination]] and irreversible nerve cell death
B12 deficiency can also cause symptoms of [[mania]] and [[psychosis]].<ref name="ijnwvitaminb12">{{cite journal | author=Sethi NK, Robilotti E, Sadan Y | title=Neurological Manifestations Of Vitamin B-12 Deficiency | journal=The Internet Journal of Nutrition and Wellness | volume=2 | issue=1 | year=2005 | doi=}}</ref><ref name="imajvitaminb12">{{cite journal | author=Masalha R, Chudakov B, Muhamad M, Rudoy I, Volkov I, Wirguin I | title=Cobalamin-responsive psychosis as the sole manifestation of vitamin B12 deficiency | journal=Israeli Medical Association Journal | volume=3 | year=2001 | pages=701-703 | doi=}}</ref>
* Numbness
 
* Tingling
Recent studies have devalued a possible connection between B12 deficiency and [[Alzheimer's]] dementia, and such a correlation is unlikely as of June 2007.<ref name="pmid16917153">{{cite journal |author=Morris MC, Evans DA, Schneider JA, Tangney CC, Bienias JL, Aggarwal NT |title=Dietary folate and vitamins B-12 and B-6 not associated with incident Alzheimer's disease |journal=J. Alzheimers Dis. |volume=9 |issue=4 |pages=435-43 |year=2006 |pmid=16917153 |doi=}}</ref>
* Ataxic gait  
 
* Subacute combined degeneration of spinal cord  
Studies showing a relationship between [[clinical depression]] levels and deficient B<sub>12</sub> blood levels in elderly people are documented in the clinical literature.<ref>{{cite journal | author= Brenda W. J. H. Penninx ''et al''| title= Vitamin B{{ssub|12}} Deficiency and Depression in Physically Disabled Older Women: Epidemiologic Evidence From the Women’s Health and Aging Study | journal= Am. J. Psychiatry| year= 2000| volume= 157| pages= 715-721| id= PMID 10784463}}</ref><ref>{{cite journal | author= Henning Tiemeier ''et al''| title= Vitamin B12, Folate, and Homocysteine in Depression: The Rotterdam Study| journal= Am. J. Psychiatry| year= 2002| volume= 159| pages= 2099-2101| id= PMID 12450964}}</ref>
* [[mania]] and [[psychosis]].<ref name="ijnwvitaminb12">{{cite journal | author=Sethi NK, Robilotti E, Sadan Y | title=Neurological Manifestations Of Vitamin B-12 Deficiency | journal=The Internet Journal of Nutrition and Wellness | volume=2 | issue=1 | year=2005 | doi=}}</ref><ref name="imajvitaminb12">{{cite journal | author=Masalha R, Chudakov B, Muhamad M, Rudoy I, Volkov I, Wirguin I | title=Cobalamin-responsive psychosis as the sole manifestation of vitamin B12 deficiency | journal=Israeli Medical Association Journal | volume=3 | year=2001 | pages=701-703 | doi=}}</ref>
 
* [[Bipolar disorder]] appears to genetically co-segregate with the hereditary B12-deficiency disorder [[pernicious anemia]].<ref>{{cite journal | author=Reading CM.  | title= X-linked dominant manic-depressive illness: Linkage with Xg blood-group, red-green color-blindness and vitamin-B12 deficiency.  | journal=  Orthomolecular Psychiatry  | year= 1979 | volume= 8  | pages=  68-77| id=  }}</ref><ref>{{cite journal | author=Reading CM. | title= Latent pernicious anemia: A preliminary report. | journal= Medical Journal of Australia  | year= 1975  | volume= 40 | pages= 91-4  | id=  }}</ref>
[[Bipolar disorder]] appears to genetically co-segregate with the hereditary B12-deficiency disorder [[pernicious anemia]].<ref>{{cite journal | author=Reading CM.  | title= X-linked dominant manic-depressive illness: Linkage with Xg blood-group, red-green color-blindness and vitamin-B12 deficiency.  | journal=  Orthomolecular Psychiatry  | year= 1979 | volume= 8  | pages=  68-77| id=  }}</ref><ref>{{cite journal | author=Reading CM. | title= Latent pernicious anemia: A preliminary report. | journal= Medical Journal of Australia  | year= 1975  | volume= 40 | pages= 91-4  | id=  }}</ref>


==References==
==References==
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{{Reflist|2}}
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[[Category:Hematology]]
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Latest revision as of 00:42, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

History and Symptoms

Early symptoms

  • Tiredness
  • Decreased mental work capacity
  • Decreased concentration and memory
  • Irritability and depression
  • Sleep disturbances because B12 involved in the regulation of the sleep wake cycle by the pineal gland (through melatonin).[1]

Neurological signs

References

  1. ↑ Hashimoto S, Kohsaka M, Morita N, Fukuda N, Honma S, Honma K (1996). "Vitamin B12 enhances the phase-response of circadian melatonin rhythm to a single bright light exposure in humans". Neurosci. Lett. 220 (2): 129–32. PMID 8981490.
  2. ↑ Sethi NK, Robilotti E, Sadan Y (2005). "Neurological Manifestations Of Vitamin B-12 Deficiency". The Internet Journal of Nutrition and Wellness. 2 (1).
  3. ↑ Masalha R, Chudakov B, Muhamad M, Rudoy I, Volkov I, Wirguin I (2001). "Cobalamin-responsive psychosis as the sole manifestation of vitamin B12 deficiency". Israeli Medical Association Journal. 3: 701–703.
  4. ↑ Reading CM. (1979). "X-linked dominant manic-depressive illness: Linkage with Xg blood-group, red-green color-blindness and vitamin-B12 deficiency". Orthomolecular Psychiatry. 8: 68–77.
  5. ↑ Reading CM. (1975). "Latent pernicious anemia: A preliminary report". Medical Journal of Australia. 40: 91–4.

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