Vitamin B12 Deficiency with Crohn’s: Vitamin B12 deficiency is a condition that is often comorbid with Crohn’s disease, ulcerative colitis and other forms of inflammatory bowel disease (IBD). For prevention, it’s important to test for vitamin B12 deficiency in its earliest stages.

Vitamin B12 Deficiency with Crohn’s Disease

There are many risk factors that increase your odds for vitamin B12 malabsorption, the leading cause of vitamin B12 deficiency, and many of them occur with Crohn’s disease and other forms of gastrointestinal illnesses.

Here are three basic risk factors for vitamin B12 deficiency that correlate with Crohn’s disease:

Three basic risk factors are:

1) Digestive tract damage

With Crohn’s, damage to the digestive tract makes it difficult for the stomach cells to produce intrinsic factor (IF), a necessary enzyme for digesting vitamin B12 from the foods you eat. The less IF you have, the fewer vitamin B12 molecules make it into your blood stream. Instead, vitamin B12 passes through your digestive system, unabsorbed. Lack of intrinsic factor is the main cause of pernicious anemia, a condition that occurs with long-term vitamin B12 deficiency.

2) Gastro surgery

If you have had gastrointestinal surgery to treat Crohn’s disease, such as removal of the ileum, then you are also at risk for dangerously low vitamin B12. This is because the ileum plays a crucial role in the last step of vitamin B12 absorption- detaching the B12 molecules from intrinsic factor and depositing it into the blood stream. Bariatric surgeries such as gastric bypass are also high risk factors for vitamin B12 deficiency caused by corrective surgery.

3) Medications

Some of the medications used to treat Crohn’s disease can ultimately interfere with vitamin B12 absorption, as well.  Long-term antibiotics,protein pump inhibitors (PPIs), and other acid reflux medications are included in a list of drugs that interfere with vitamin B12 absorption, resulting in vitamin B12 deficiency.

Treating B12 deficiency

If you suspect you have vitamin B12 deficiency, then take the following steps.

Get tested

Don’t put off getting a blood test to check your vitamin B12 levels; in fact, you should be testing a few times per year, if you aren’t already. A routine blood test can tell you if you are have medium-low or severely low serum vitamin B12 levels.

Symptoms of B12 deficiency

Don’t rely on blood tests alone to determine if you are approaching vitamin B12 deficiency, as the tests are not always accurate, and don’t measure complete “active vitamin B12” molecules.

To catch vitamin B12 deficiency in its earliest stages, it’s good to recognize the symptoms:

• Crushing fatigue
• Dizziness
• Depression
• Anxiety
• Brain fog
• Memory problems
• Painful numbness and tingling in the fingers, toes, hands, and feet

Take daily B12

With vitamin B12 malabsorption, you will not get enough vitamin B12 from foods or from pills that you swallow. Instead, your doctor will recommend taking large doses of vitamin B12 in a non-dietary form, such as vitamin B12 injections and/or similarly potent vitamin B12 supplements that are absorbed directly into your blood through the skin.

What’s your take?

If you’ve been diagnosed with Crohn’s disease, has your doctor fully explained the risk factors for vitamin B12 deficiency?

Do you feel that you get just the right amount of vitamin B12 that you need to keep symptoms at bay, or do you feel that your prescription should allow for more vitamin B12 injections than you’re currently receiving?

In addition to getting vitamin B12 shots, what other forms of vitamin B12 do you use?

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