Deficiency Signs And Symptoms

Vitamin B12 deficiencies manifest primarily as haematological and neurological disturbances, and are estimated to affect 10-15% of individuals over the age of 60 years (Baik & Russell 1999):

• Haemotological: macrocytic (megaloblastic) anaemia, pancytopenia (leukopenia, thrombocytopenia); symptoms may include lethargy, dyspnoea, anorexia, weight loss and pallor (Wahlqvist 2002).

• Neurological disturbances: paraesthesias, optic neuropathy (reversible), peripheral neuropathy and demyelination of the corticospinal tract and dorsal columns (subacute combined systems disease).

• Psychological disturbances: impaired memory, irritability, depression, personality change, dementia and psychosis (Lee 1999, Lindenbaum et al 1988).

• Various gastrointestinal symptoms can also develop, such as loss of appetite, intermittent constipation and diarrhoea, glossitis and abdominal pain.

• Folic acid supplementation may mask an underlying B12 deficiency, leading to the progression of neurological symptoms.

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