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Deficiency
Main manifestations
glossitis, symptoms of anemia (weakness,
pallor, shortness of breath), and GI problems
(weight loss and infertility)
and <20%Hct
reticulocyte count Low retic. count
Depression Headaches
Paranoia Irritability
Mood swings Mania
Psychosis Tinnitus
Glossitis Premature greying
Chronic fatigue Heavy periods
Weight loss Visual disturbance
Case Study
Sara was vegetarian from her early teens until her early thirties.
Her eyesight was affected at age eighteen and by her thirties
severe depression had set in. Her periods became progressively
more painful and tinnitus and chronic fatigue began.
Sara like many others, had never been screened for physical
reasons for her depression. She was misdiagnosed with bipolar
and was sectioned following a psychotic episode. Her doctor was
completely unaware of the psychiatric manifestations of B12
deficiency and initially refused to even test for either thyroid
dysfunction or B12 deficiency both of which cause psychosis.
Once tested she was shown to be deficient but was refused
treatment as the doctor insisted there were no symptoms present.
A second doctor would only prescribe low dose oral B12
which was entirely useless for the advanced neurological
symptoms. Eventually after changing doctor a third time,
injection loading doses were given. Luckily Sara is now in
safe hands with a doctor who has updated their previously
poor knowledge of B12 deficiency. She now self injects every
other day and takes a good vitamin B complex and 5mg of
folic acid daily. Her depression and anxiety improve every
day, her periods are far less painful and her tinnitus is
quietening.
Once Sara was given ferrous sulphate to raise her low ferritin
levels her chronic fatigue improved enormously and she is
now firmly on the road to recovery.
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