Patricia Thompson - NUTRITION TALKSO MANY persons, especially women, complain about feelings of tiredness and lethargy and often, the first remedy thought of are iron supplements. While a lack of iron can result in anaemia, this condition can also be due to a lack of vitamins such as folic acid and vitamin B12.
VITAMIN B12 DEFICIENCY
Those with a vitamin B12 deficiency complain of shortness of breath on exertion, exhaustion and may suffer with impaired mental function causing confusion, feelings of depression and impaired memory. There may also be numbness and tingling in the hands and feet, clumsiness and difficulty with walking especially at night.
Poor absorption of vitamin B12 is a more likely cause of deficiency than low intake from food. The vitamin is absorbed in the stomach and requires a substance known as intrinsic factor. Conditions affecting the stomach and the lower part of the small intestine can cause a vitamin B12 deficiency. Other causes are a decrease in stomach acidity as sometimes occurs in persons over 50 years or prolonged use of medication like antibiotics such as neomycin, certain antidiabetic drugs, some cholesterol-lowering agents and sodium replacement supplements such as potassium chloride.
Vitamin B12 is not found in plants but in animal-based foods and it is highest in liver, organ meats with good sources being fish, dairy and eggs. For strict vegetarians, Brewer's yeast and some fermented foods are reliable sources. Daily requirement for vitamin B12 is very small and adequate body stores would take about three to six years before depletion. If there is an absorption problem, the vitamin must be given by injection but if there is no problem with absorption, a B12 supplement can be taken orally.
FOLIC ACID DEFICIENCY
Folic acid is another B vitamin linked to the action of vitamin B12 and a lack of it can cause macrocytic anaemia. The deficiency symptoms are similar to that of iron and B12, so deficiency is often missed unless it shows up in a blood test. For this reason, you should test for folic acid when testing for iron. Mild deficiency can cause depression and, a painful, sore tongue which has a smooth appearance, should be suspect. It is only severe deficiencies that show up as anaemia.
Persons most at risk are pregnant women, the elderly and those under severe stress or with a psychiatric illness and alcoholics. A most significant effect of folic acid is to prevent neural tube defects in the new born, a condition where the spinal column of the developing foetus fails to form properly and the nervous system becomes damaged. Following hurricane Gilbert, many babies were born with this deformity because their mothers lacked folic acid in the diet. Best dietary sources are liver, kidneys and eggs but it is also rich in green, leafy vegetables and whole grain cereals for the vegan.
VITAMIN C
Anaemia does not result from a deficiency of vitamin C but this vitamin is important for the use and protection of anti-anaemic nutrients. Folic acid is destroyed by cooking but its break down appears to be protected by vitamin C. Vitamin C also enhances the absorption of iron from plant sources and from supplements. Rich sources of vitamin C are fresh fruits, especially guava, West Indian cherry, citrus, pawpaw and mango and fresh vegetables (especially the green ones), tomatoes and sweet pepper.
Next time you are tempted to self-treat with iron, consider other likely causes of anaemia and consult your doctor. Registered nutrition personnel can also help you assess your diet for nutrient adequacy.
Patricia Thompson M.Sc., Registered Nutritionist, Nutrition and Diet Services.
