A loss of this vitamin in the body's mechanism is long in coming, but once the vitamin is missed the body has a long and arduous return to health. Some of the first signals of a deficiency can come from the sensitive nervous system in the form of sore or weak extremities and poor reflex action. In addition, there are some general symptoms, such as exhaustion, diminished mental energy, loss of concentration and lethargy: nothing seems to stimulate interest or desire. Later there can be difficulties with walking, stammering or twitching of the limbs. The tongue may become smooth and shiny. And there may be a tingling sensation in the fingers, a stiffness throughout the body and arm and shoulder pain.
The end product of all these symptoms is pernicious anemia. Red blood cells are developed within the marrow of the bones. As vitamin B-12 becomes severely deficient, megalocytes (large red cells) are produced, whose life spans are only half those of the red blood cells. There is arrested maturation and quick destruction of these cells; many never get into the bloodstream. Hence anemia develops. The normal red blood cell count is 5,000,000; white, 5,000 to 10,000. Without vitamin B-12 these levels drop to 1,000,000 or fewer red cells and 3,000 to 5,000 white cells—obviously a very dangerous and potentially fatal loss.
Parallel damage may also occur in the nervous system, making a person shuffle along and lose the sense of position of his or her feet. Complete paralysis may result.
The best way to detect a vitamin B-12 deficiency is with the Schilling test, which measures the absorption of the vitamin. -r. ,,
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