Inadequate vitamin b12 can cause what type of anemia

Symptoms of anemia due to vitamin B12 deficiency or folate deficiency develop slowly and are similar to symptoms caused by other types of anemia, such as fatigue, weakness, and paleness. Vitamin B12 deficiency Vitamin B12 Deficiency Vitamin B12 deficiency can occur in vegans who do not take supplements or as a result of an absorption disorder. Anemia develops, causing paleness, weakness, fatigue, and, if severe, shortness... read more can also cause nerves to malfunction, causing tingling, loss of sensation, and muscle weakness. Severe vitamin B12 deficiency may cause confusion. In older people, anemia caused by vitamin B12 deficiency may be mistaken for dementia Dementia Dementia is a slow, progressive decline in mental function including memory, thinking, judgment, and the ability to learn. Typically, symptoms include memory loss, problems using language and... read more because of this symptom.

The most common cause of vitamin B12 deficiency is inadequate absorption. The following conditions can cause absorption to be inadequate:

  • Surgery that removes the part of the small intestine where vitamin B12 is absorbed

  • Repeated exposure to nitrous oxide (laughing gas)

  • Decreased stomach acidity (common among older people)

Intrinsic factor may be lacking because abnormal antibodies, produced by an overactive immune system, attack and destroy the stomach cells that produce intrinsic factor—an autoimmune reaction called autoimmune metaplastic atrophic gastritis. Intrinsic factor may be lacking because the part of the stomach where intrinsic factor is produced was surgically removed. Vitamin B12 deficiency due to lack of intrinsic factor causes a type of anemia called pernicious anemia.

Among older people, absorption may be inadequate because stomach acidity is decreased. Decreased stomach acidity reduces the body’s ability to remove vitamin B12 from the protein in meat. However, the vitamin B12 found in vitamin supplements can continue to be well absorbed even in people with decreased stomach acid.

Antony AC. Megaloblastic anemias. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 39.

Anusha V. Pernicious anemia/megaloblastic anemia. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2020. Philadelphia, PA: Elsevier; 2020:446-448.

Elghetany MT, Schexneider KI, Banki K. Erythrocytic disorders. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 32.

Means RT. Approach to the anemias. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 149.


Page 2

Braithwaite SA, Perina D. Dyspnea. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 22.

Kraft M. Approach to the patient with respiratory disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 77.

Schwartzstein RM, Adams L. Dyspnea. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 36.


Page 3

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Wheezing, bronchiolitis, and bronchitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 418.

Woodruff PG, Bhakta NR, Fahy JV. Asthma: pathogenesis and phenotypes. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 41.


Page 4

Centers for Disease Control and Prevention website. Chest cold (acute bronchitis). www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/bronchitis.html. Updated August 30, 2019. Accessed January 20, 2020.

Cherry JD. Acute bronchitis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook Of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 19.

Walsh EE. Acute bronchitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 65.

Wenzel RP. Acute bronchitis and tracheitis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 90.


Page 5

Clauw DJ. Fibromyalgia, chronic fatigue syndrome, and myofascial pain. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 258.

Lindemann JC. Fatigue. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2021. Philadelphia, PA: Elsevier 2021:14-15.

Seller RH, Symons AB. Fatigue. In: Seller RH, Symons AB, eds. Differential Diagnosis of Common Complaints. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 14.


Page 6

Avidan AY. Sleep and its disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 101.

Hirshkowitz M, Sharafkhaneh A. Evaluating sleepiness. In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 169.

Mansukhani MP, Kolla BP, St.Louis EK, Morgenthaler TI. Sleep disorders. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2021. Philadelphia, PA: Elsevier 2021:755-770.


Page 7

American Psychiatric Association website. Depressive disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:155-188.

Fava M, Østergaard SD, Cassano P. Mood disorders: depressive disorders (major depressive disorder). In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 29.

Kraus C, Kadriu B, Lanzenberger R, Zarate Jr CA, Kasper S. Prognosis and improved outcomes in major depression: a review. Transl Psychiatry. 2019;9(1):127. PMID: 30944309 pubmed.ncbi.nlm.nih.gov/30944309/.

Walter HJ, DeMaso DR. Mood disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 39.

Zuckerbrot RA, Cheung A, Jensen PS, Stein REK, Laraque D; GLAD-PC STEERING GROUP. Guidelines for adolescent depression in primary care (GLAD-PC): part I. Practice preparation, identification, assessment, and initial management. Pediatrics. 2018;141(3). pii: e20174081. PMID: 29483200 pubmed.ncbi.nlm.nih.gov/29483200/.


Page 8

American Psychiatric Association. Depressive disorders. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing, 2013:155-233.

Nonacs RM, Wang B, Viguera AC, Cohen LS. Psychiatric illness during pregnancy and the post-partum period. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 31.

Siu AL; US Preventive Services Task Force (USPSTF), Bibbins-Domingo K, et al. Screening for depression in adults: US Preventive Services Task Force recommendation statement. JAMA. 2016;315(4):380-387. PMID: 26813211 pubmed.ncbi.nlm.nih.gov/26813211/.