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| Your body needs vitamin B12 in order to create healthy red blood cells; it is absorbed through the intestines from a variety of foods. Because a healthy liver is able to store several years' worth of vitamin B12, signs of deficiency may not be obvious for a long time. Vitamin B12 can not be absorbed on its own: it must first combine with another substance called 'intrinsic factor' which is produced by your stomach lining. The secreted intrinsic factor then binds to B12 and this complex (IF-B12) travels to the end of the small intestine where it crosses the intestinal wall into the bloodstream. B12 is stored in the liver after it is absorbed, and any excess is excreted in the urine. The body contains roughly a 3-year supply and 30% of that found in food is typically destroyed by cooking. Causes & Development The most common cause of B12 deficiency the stomach being unable to produce enough intrinsic factor. Another cause is the bowel failing to absorb vitamin B12 because it has been damaged by disease (e.g. Crohn's disease) or shortened by surgery (usually to treat bowel disease). Although it is also possible to become deficient in B12 by not eating enough food that contains the vitamin, this is rare. Diagnosis & Tests A laboratory test can measure the level of vitamin B12 in the blood. A test for low stomach acid (achlorhydria) is an important part of the investigation, and a blood test that shows the typical changes in the red blood cells is also essential. |
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