Why does Vitamin B12 deficiency need to be addressed in women faster? Here are easy ways to shore up its levels

There are specific conditions under which this deficiency affects women the most. But dietary management and supplementation can prevent long-term health complications, says Dr Anjana Singh, Director and HOD, Obstetrics and Gynaecology, Fortis, Noida

If you let the deficiency go on for too long, it can damage your heart, brain nerves, bones and other organs in your body. (Representational)

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Written by Dr. Anjana Singh

Vitamin B12 or Cobalamin is an important nutrient needed by the human body for various metabolic processes. This water-soluble nutrient keeps your nerve cells functioning normally and helps in red blood cell production as well as DNA synthesis. However, women who do not receive the proper amount of vitamin B 12, either through diet or supplements, have significant health issues, ranging from fatigue to jaundice, compared to men. Most women patients of mine complain of anaemia (because the body cannot make enough red blood cells and platelets) and depression, shortness of breath and memory loss. If you let the deficiency go on for too long, it can damage your heart, brain nerves, bones and other organs in your body. That’s why it needs to be addressed either through dietary correction or supplements and in the process prevent long-term health complications.

VITAMIN B 12 DEFICIENCY IN WOMEN
There are specific conditions under which this deficiency affects women the most. It is common during hormonal imbalances that occur during and after menopause. Since vitamin B12 is found mostly in animal-based food products, including eggs, milk, meat, fish, poultry, shellfish and cheese, women whose diet do not include any of these, or limited numbers of these products, may not be getting enough vitamin B12 naturally. Since the stomach and small intestine play key roles in breaking down and absorbing vitamin B 12, women with gastrointestinal tract issues and those who have undergone weight loss surgery involving the removal of part of either the stomach or small intestine may be at increased risk of deficiency. It is particularly common among women who suffer from chronic acid reflux and take medication to suppress stomach acid that breaks down and enables absorption of vitamin B12. This is because the stomach produces a protein called intrinsic factor, which is necessary for the effective absorption of the vitamin. Other than these, specific diseases or body conditions can imbalance vitamin B 12 levels in the body. Certain medications like Esomeprazole, Lansoprazole and Metformin decrease the absorption of vitamin B12.

WHAT ARE THE EASIEST DIETARY SOURCES?
As animal-based foods such as meat, fish, poultry and dairy are the predominant natural sources of this vitamin, meeting the daily intake quota of around 3 mcg or 3 micrograms (pregnant teens and women need 2.6 mcg while breastfeeding teens and women need 2.8 mcg) is not a difficult task. Most women who are not into too much animal meat or fish have milk, yogurt, cottage cheese, cheese and curd.

But for those who depend on plant-based food, obtaining the required quota of vitamin B12 can be a challenge. In such a scenario, women need to track their vitamin B 12 levels fairly regularly and opt for nutritional yeast, fortified foods, cereals, mushrooms and some algae. Your doctor might recommend that you also take a vitamin B12 supplement. The Vegan Society recommends you eat fortified foods two or three times a day to get at least three micrograms (mcg) of B12 a day or take one B12 supplement daily providing at least 10 micrograms. Alternatively, it recommends a weekly B12 supplement.

HOW SHOULD I TAKE MY SUPPLEMENTS?
In a scenario where your body is not able to produce enough vitamin B12, seek a doctor’s advice on the kind of supplementation you need, the dose required and how it should be spread out. It comes in pills or a nasal spray. If you are very low in this vitamin, you can get higher-dose shots. You might also need to get treated for the condition that causes your anaemia.

Usually, doctors prescribe oral supplements for a month or so. But if your levels are very low, then you may require Vitamin B12 injection. Five injections, twice a week, should take care of the deficit. Then one can carry on with the usual pills. Sometimes, we prescribe folic acid (also called folate or vitamin B9) with Vitamin B12 to improve iron levels for anaemia. The combination works best for boosting immune functions too. But take folic acid only on the doctor’s advice as taking it arbitrarily might just lead to excess concentrations which might cause them to work at cross purposes.