Diagnosing Vitamin B12 Deficiency: What Doctors are Missing

Usually, the presence of a condition called macrocytic anemia is what makes doctors suspect and begin to look for vitamin B12 Deficiency. But macrocytic anemia is the result of years of vitamin B12 deficiency. This means that until a doctor is willing to even LOOK FOR the easily correctable problem of vitamin B 12 deficiency, a patient will have suffered for years with symptoms. This would have been prevented if they had looked for the deficiency based simply on one of the most common physical complaints that patients have- fatigue.

Fatigue is a problem that affects most of the population at one time or another, but when it becomes chronic it can seriously affect quality of life to the extent that people become disabled. While fatigue can have MANY different causes, one underappreciated cause of fatigue is Vitamin B 12 deficiency.

When doctors suspect vitamin B12 deficiency, they will often do a routine blood test that checks for a condition called macrocytic anemia. Macrocytic anemia is characterized by particularly large red blood cells that are accompanied by a decreased Number of total cells. It is often a Consequence of vitamin B12 deficiency, but can have several other causes as well. Macrocytic anemia, however, is NOT vitamin B12 deficiency, and Vitamin B 12 deficiency can exist with or without the presence of macrocytic anemia. In fact, macrocytic anemia may not occur for up to 2 years after the Start of vitamin B12 deficiency, yet the 'standard of care' that doctors use has them look for vitamin B12 deficiency ONLY if macrocytic anemia is present!

"clinical features that are associated with
vitamin B12 deficiency may indeed precede
evidence of macrocytic anemia"

How B12 Deficiency Can Impact on the Individual...

If Vitamin B 12 deficiency were a rare problem that required expensive and invasive testing in order to find, this would be a reasonable way to look for this problem. But vitamin B12 deficiency is VERY common and testing is as easy as a simple blood test done right in the same lab that tests for macrocytic anemia! In addition, just like other medical problems that are evaluated on their OWN signs and symptoms, vitamin b12 deficiency ALSOhas its OWN signs and symptoms that can be evaluated in the same way.

Vitamin B12 deficiency has a whole list of common presenting features that include:

• Fatigue
  
• Brain fog
  
• Weakness
  
• Depression
  

People who go to the doctor with conditions such as Chronic Fatigue Syndrome often have these same symptoms, yet they are almost NEVER screened for this simple vitamin deficiency. Considering that there are over a million chronic fatigue sufferers in the US alone who are not getting help for their debilitating condition, there is no way of knowing how many people are suffering unnecessarily from a simple vitamin deficiency simply because doctors are not looking for it! One vitamin B12 researcher, Ralph Carmel, MD, a doctor who IS looking for it, believes that almost 800,000 elderly people in the United States have undiagnosed vitamin B12 deficiency- and that is just in ONE high risk group.

Besides Chronic Fatigue Syndrome, the somewhat vague symptoms of vitamin B12 deficiency can mimic many other diseases as well. According to Doctors Norbert Goebels and Michael Soyka, "Vitamin B(12) deficiency has long been associated with a wide variety of hematological, neurological, and psychiatric disorders." Unfortunately, until doctors begin to look for Vitamin B12 deficiency and not macrocytic anemia, we are calling these problems things like:

• Chronic Fatigue
  
• Fibromyalgia
  
• Dementia
  
• Mental Illness
  
• And Even Multiple Sclerosis
  

Many of these patients really should be diagnosed with simple vitamin B12 deficiency. Testing for vitamin B12 deficiency is the 'standard of care' for doctors ONLY in the case of macrocytic anemia EVEN when vitamin B12 deficiency is seemingly staring them right in the face. And because standard of care is a legal protection for doctors in court, most doctors are unlikely to go 'outside of the box' to try to find answers to patient problems.

Standards of care change slowly in the medical world; with clinical guidelines lagging scientific finding by years and even decades, things are not likely to change soon until people with illnesses become educated and DEMAND testing for these simple problems that can have DRAMATIC effects on their health and their quality of life. Since doctors are not likely to look for vitamin B12 deficiency, patients and their families need to.