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Initially in high daily doses, followed by less frequent lower doses, as the condition improves. [3] If a reversible cause is found, that cause should be corrected if possible. [11] If no reversible cause is found, or when found it cannot be eliminated, lifelong vitamin B 12 administration is usually recommended. [12] A nasal spray is also ...
If the symptoms are serious, frequent injections are typically recommended initially. [7] There are not enough studies that pills are effective in improving or eliminating symptoms. [12] Often, treatment may be needed for life. [13] Pernicious anemia is the most common cause of clinically evident vitamin B 12 deficiency worldwide. [14]
The disease can also be caused by inhalation of nitrous oxide, which inactivates vitamin B12. [11] Vitamin E deficiency, which is associated with malabsorption disorders such as cystic fibrosis and Bassen-Kornzweig syndrome, [12] can cause a similar presentation due to the degeneration of the dorsal columns. [5]
[6] [15] [26] Vitamin B 12 deficiency can also cause symptoms of mania and psychosis. [27] [28] Among other problems, weakened immunity, reduced fertility and interruption of blood circulation in women may occur. [29] The main type of vitamin B12 deficiency anemia is pernicious anemia, [30] characterized by a triad of symptoms:
As a consequence of the biochemical reactions in which homocysteine is involved, deficiencies of vitamin B 6, folic acid (vitamin B 9), and vitamin B 12 can lead to high homocysteine levels. [2] Other possible causes of hyperhomocysteinemia include genetics, excessive methionine intake, and other diseases. [3]
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Neutrophil hypersegmentation is one of the earliest, most sensitive and specific signs of megaloblastic anemia (mainly caused by hypovitaminosis of vitamin B12 & folic acid). Nuclear hypersegmentation of DNA in neutrophils strongly suggests megaloblastosis when associated with macro-ovalocytosis.
An underlying disorder can have 2 main causes: Metabolic causes: Genetic defects in enzymes (e.g. kynureninase) involved in the kynurenine pathway of synthesis of niacin from tryptophan can lead to pellagra (niacin deficiency). [1] Lifestyle choices: Lifestyle choices and habits that increase vitamin needs, such as smoking or drinking alcohol. [2]
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