low b12 count

just had some blood test results back and the doctor has asked me to go in amd see him cause my b 12 levels are quite low. i had the blood test done because i have had weakness and pain in my legs and back and spasum (spasm) in my shoulder and leg i am also tierd all the time and seem to have a constant headache. i have looked on the internet to find out what a low b12 count could mean and the information i found quite confusing. so if anyone can tell me about it and what question i should ask me doctor when i go see him would be great thank you

[Dr. Kokil Mathur]

Hi!
Low intrinsic factor in gut that hampers absorption of B12 and causes pernicious anemia is the commonest cause. If this is so the increasing intake of B12 will not help, and you will need to take Vitamin B12 injections at regular frequency as prescribed by your doctor. Other causes are parasites in the gut, diet poor in Vit B12, Crohn's disease, IBS, or poor metabolism by liver are the causes behind it. Please consult a doctor to rule these out. Take a diet rich in Vit B12 which should include meat and animal products, cheese, such as beef, liver, salmon, cod, and eggs. Take B12 supplements and breakfast cereals fortified with vitamin B12. Finding the cause is important.
Please consult your PCP for primary examination followed by proper referral.
Take care!

[Red_Star]

Vitamin B12 is a water soluble vitamin that is essential for the normal functioning of the brain and nervous system, and for the formation of blood. Vitamin B12 deficiency also raises an amino acid called homocysteine. Elevated levels of homocysteine increases the risk of stroke and heart attack. Symptoms of a vitamin B12 deficiency are far too numerous to mention here. However, a short list includes:

Neurologic signs and symptoms:

Numbness - tingling
Weakness of legs, arms, trunk
Impaired vibration - position sense
Abnormal reflexes
Unsteady or abnormal gait
Balance problems
Difficulty ambulating
Dizziness
Tremor
Restless legs
Visual disturbances
Forgetfulness, memory loss
Dementia
Impotence
Urinary or fecal incontinence

Psychiatric symptoms:

Depression  
Irritability
Paranoia
Mania
Hallucinations
Psychosis
Violent behavior
Personality changes

Haematologic signs and symptoms:

Anaemia
Macrocytosis (enlarged red-blood cells)
Generalized weakness
Fatigue
Shortness of breath
Pallor

The main question to ask your doctor is what is causing your vitamin B12 deficiency so you can correct this ASAP.  

Causes of vitamin B12 deficiency include:

Decreased stomach acid
Atrophic gastritis
Autoimmune pernicious anaemia
Helicobacter pylori
Gastrectomy, intestinal resection
Gastric bypass surgery
Malabsorption syndromes
Crohn's disease
Celiac disease (gluten enteropathy)
Chronic pancreatitis
Bacterial overgrowth (small bowel)
Fish tapeworm
Alcoholism
Malnutrition - eating disorders
Vegetarianism
Advanced liver disease
Transcobalamin II deficiency
Inborn errors of B12 metabolism
Certain drugs (eg: acid blockers)
Nitrous oxide