D51.8

Clinical Causes: Inadequate dietary intake of vitamin B12, often seen in vegetarians or vegans Malabsorption issues due to conditions like pernicious anemia, where the body's immune system attacks stomach cells that produce intrinsic factor necessary for B12 absorption Gastrointestinal surgeries that remove parts of the stomach or intestines, impairing absorption Chronic gastrointestinal conditions such as Crohn's disease or celiac disease Certain medications that interfere with vitamin B12 absorption, such as proton pump inhibitors or metformin Atrophic gastritis, leading to decreased stomach acid production and reduced B12 absorption

Key Symptoms: Fatigue and weakness Pallor or paleness of the skin Shortness of breath during exertion Glossitis, which appears as a swollen, inflamed tongue Neurological issues such as numbness or tingling in hands and feet Difficulty walking or balance problems Memory loss or cognitive disturbances Digestive discomfort or loss of appetite Dizziness or lightheadedness

Diagnosis Path: Diagnosis involves a combination of blood tests to measure vitamin B12 levels and identify anemia. Additional tests may include a complete blood count (CBC), which shows the size and appearance of red blood cells, and tests for intrinsic factor antibodies or anti-parietal cell antibodies to detect autoimmune causes. Sometimes, specialists perform Schilling tests or endoscopic examinations to evaluate absorption issues and examine the gastrointestinal tract.

Treatment Protocols: Treatment primarily focuses on restoring vitamin B12 levels. This can be achieved through oral supplements or intramuscular injections of vitamin B12, especially if absorption is impaired. Addressing underlying causes, such as managing gastrointestinal disorders or modifying medications, is essential. Most patients experience improvement in symptoms with appropriate therapy, although neurological damage may become permanent if the deficiency persists untreated for a long time.