Vitamin B12 and IBD

What is Vitamin B12?

Vitamin B12 is an essential nutrient that our bodies need for key processes like DNA synthesis, energy production and to aid the central nervous system. It is a water-soluble vitamin and is stored in our liver. A lack of vitamin B12 could leave our bodies producing less red blood cells and result in symptoms like weakness, tingling in the hands and feet.

 

Why is it important to consider in IBD?

Vitamin B12 is absorbed in the small intestine (1). Therefore, Crohn’s Disease patients who have had surgery to remove sections of the small intestine or excessive inflammation in the small intestine are at risk of not being able to absorb vitamin B12. Many studies have also suggested that vitamin B12 and folate (B9) concentrations influence the development of IBD (2). Another study showed that resection of more than 50-60 cm of the ileum frequently results in vitamin B12 malabsorption (3).

 

Symptoms of vitamin B12 deficiency

  • Fatigue

  • Pale/yellow skin

  • Headaches

  • Depressive symptoms

  • Gastrointestinal issues

  • Difficulty concentrating and mental impairment

  • Pain and inflammation in the mouth

  • Paresthesia- tingling in the hands and feet

  • Muscle cramps

  • Weakness

  • Vision disturbances

 

How much vitamin B12 do I need?

Depending on where you live the recommendations vary from 1.5 - 2.4mcg per day for people over the age of 15 (4, 5).

 

Where can I find vitamin B12?

  • Fish

  • Meat

  • Eggs

  • Milk

  • Clams

  • Beef liver

  • Fortified plant based milks and yoghurts

  • Fortified breakfast cereals

  • Fortified nutritional yeasts

 

How is vitamin B12 deficiency treated?

Vitamin B12 deficiency is usually diagnosed through a blood test. Your doctor or IBD team will then recommend a supplement. This could be in a tablet form, injection or a liquid form. Evidence shows that oral vitamin B12 treatment provides effective acute and maintenance treatment for vitamin B12 deficiency in patients with Crohn’s Disease, with or without and ileum resection (6). If tablets do not work for you injections may be suggested or oral sprays may be effective.

 

If you want support with your diet, nutrition and IBD journey we can help.

At The NALM Clinic we have me (Clemmie), an IBD specialist Nutritional Therapist, and specialist gastroenterology Dietician (Jess) and and we are here to support you. We both have IBD too so we ‘get it’ and are so passionate about helping others.

If you would like support with your IBD please book a call with me via the button below.

I have also written a free e-book to help you find a way forward for your everyday life with Inflammatory Bowel Disease. Whether you are right at the beginning of your journey with IBD or have been living with your condition for years and feel like you have tried almost everything, there are things you can do everyday, beyond the medication you are taking, to help you take back control.

Disclaimer: All content found on the nalmclinic.com website, including: text, video, or other formats have been created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor, consultant or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

We are all wonderfully unique and what works for one person may not work for another so please seek help and advice before changing your diet to work out the right way forward for you.

References

1. Langan RC, Goodbred AJ. Vitamin B12 deficiency: recognition and management. American family physician. 2017 Sep 15;96(6):384-9.

2, Pan Y, Liu Y, Guo H, Jabir MS, Liu X, Cui W, Li D. Associations between folate and vitamin B12 levels and inflammatory bowel disease: a meta-analysis. Nutrients. 2017 Apr 13;9(4):382.

3. Bermejo F, Algaba A, Gisbert JP, Nogueiras AR, Poza G, Chaparro M, Valer P, Piqueras BM, Villa JC, Bermejo A, Agullo JL. Prospective Controlled Analysis of Vitamin B12 and Folate Deficiency in Crohn's Disease. Gastroenterology. 2011;5(140):S-434.

4. Office of Dietary Supplements - Vitamin B12 [Internet]. Ods.od.nih.gov. 2022 [cited 16 June 2022]. Available from: https://ods.od.nih.gov/factsheets/VitaminA-Consumer/

5. British Dietetic Association – Practical Guide for Dietitians – Other sources of B12. [Internet] 2022 [cited 16 June 2022]. Available from: https://www.bda.uk.com/uploads/assets/5378b751-58bd-4e85-b15b360d8165a3f8/Practical-guide-other-sources-of-B12.pdf

6. Gomollón F, Gargallo CJ, Muñoz JF, Vicente R, Lue A, Mir A, García-Alvarado M, Gracia M, García-López S. Oral cyanocobalamin is effective in the treatment of vitamin B12 deficiency in Crohn’s disease. Nutrients. 2017 Mar 20;9(3):308.

Clemmie Macpherson