What happens if my B-12 level is low?

If you have a very low Vitamin B-12 level, you might get anemia, depression, dementia, or a serious problem with your nervous system. 

You might not have any symptoms if your Vitamin B-12 level is just a little bit low. 

Some people with low Vitamin B-12 also have high levels of homocysteine, and amino acids in the blood.  If you have both of these problems, you have a higher risk of heart disease and stroke. 

How does my doctor know that I have a low Vitamin B-12 level?

Your doctor may check your blood to see if your Vitamin B-12 level is low.  If your Vitamin B-12 level is close to low, and you have symptoms, your doctor may also check your methylmalonic acid (blood test) to confirm that your Vitamin B-12 level is truly low. 

I eat meat and dairy products, so why do I have a low Vitamin B-12?

Vegetarians who do not eat meat or dairy products are at risk for low Vitamin B-12, usually about two years after they become vegetarians.  However, most people who have low Vitamin B-12 are not strict vegetarians.  Most people with low Vitamin B-12 levels have trouble absorbing Vitamin B-12 from their stomach or small intestines. 

What causes problems with absorbing Vitamin B-12?

Here are some reasons that you might have trouble absorbing Vitamin B-12:

• A disease called pernicious anemia could destroy the cells in your stomach that help absorb Vitamin B-12.
• If you have had surgery on your stomach or your intestines, you may have trouble absorbing Vitamin B-12. 

Your doctor will be able to find out why you have a low Vitamin B-12 level by asking questions about your health, giving you a physical exam, and further checking your blood if necessary.

I have just been told that I have a low Vitamin B-12 level by my doctor. To raise it, can't I just stay on one multi-vitamin pill every day?

No. To raise your Vitamin B-12 level, you have to take at least 1000 mcg. of Vitamin B-12 every day.  Over-the-counter multivitamins do not have this much Vitamin B-12. To get enough Vitamin B-12, you will need to take special Vitamin B-12 pills. 

You can also get shots of Vitamin B-12 instead of taking the B-12 pills. Usually, these shots are given every one to two days for about two weeks.  After this, a shot is given once every month or so. Your doctor can help you decide what is the best treatment for you.

I have been getting a Vitamin B-12 shot every month for years. Can I change to a pill?

Possibly. In recent years we have found out that in most people, Vitamin B-12 pills work as well as shots.  Ask your doctor if changing to pills would be OK for you.

How long do I have to take the pills or get the shots?

Most people with true proven and confirmed low Vitamin B-12 take the pills or get the shots for the rest of their lives.

Where can I get more information about Vitamin B-12 deficiency?

Check out the National Institutes of Health (Facts About Dietary Supplements), their Web address is www.cc.nih.gov/ccc/supplements/vitb12.html.

Dr. Peterson is a doctor of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.