A water-soluble vitamin, B12 is presented as a nutritional nutritional supplement, and a prescription drug, and is also the natural way uncovered in some foodstuff. But can one overdose on it? Addressing this concern, Hyderabad-based neurologist Dr Sudhir Kumar took to Twitter to notice that while vitamin B12 deficiency is acknowledged to bring about “anaemia, peripheral neuropathy, dementia, psychosis and skin pigmentation”, calling for supplementation, too much vitaminB12 may perhaps have adverse outcomes on well being and life.”
Excess of vitamin B12 could be hazardous”
1. Vitamin #B12 deficiency is recognized to induce anemia, peripheral neuropathy, dementia, psychosis and skin pigmentation. Vitamin B12 supplementation is essential in them, even so, #vitaminB12 excessive may perhaps have adverse results on wellness and lifetime.
— Dr Sudhir Kumar MD DM🇮🇳 (@hyderabaddoctor) January 23, 2023
As such, we achieved out to experts to fully grasp the function of vitamin B12, its deficiency, and regardless of whether it is doable to overdose on health supplements or injections.
What is vitamin B12?
According to Mayo Clinic.org, vitamin B12 (cobalamin) plays an essential function in the development of red blood cells, mobile metabolic rate, nerve operate and the generation of DNA. Cobalt-containing compounds with vitamin B12 action are referred to as cobalamin. The metabolically energetic varieties of vitamin B12 are methylcobalamin and 5-deoxy adenosylcobalamin. Nevertheless, two other types — hydroxocobalamin and cyanocobalamin — become biologically lively soon after they are transformed to methylcobalamin or 5-deoxy adenosylcobalamin, claimed Dr Aravinda G M, marketing consultant, inner medicine, Manipal Medical center, Jayanagar, Bangalore.
Vitamin B12 deficiency
Getting trouble absorbing vitamin B12 from foods, missing intrinsic factors (for example, as a outcome of pernicious anaemia), obtaining gastrointestinal surgical procedure, having specified drugs for an extended time period of time (this sort of as metformin or proton pump inhibitors), and nutritional deficiencies are all will cause of vitamin B12 deficiency.
According to Dr Aravinda, congenital ailments involve Immerslund-Gräsbeck disease, which results in intense vitamin B12 insufficiency, and genetic intrinsic issue abnormalities which can the two guide to critical vitamin B12 deficiency.
If you never get adequate vitamin B12, you could get anaemia. The signs are:
Reduced electrical power
Heart palpitations and shortness of breath
Pale pores and skin
Dental issues, these kinds of as mouth sores and bleeding gums
Sore purple tongue
Yellowing of the pores and skin
Constipation, diarrhoea, nausea, decline of urge for food, or gasoline
Nerve troubles these types of as tingling or numbness, muscle mass weak point, and problems strolling
Psychological health issues, memory loss, or behavioural changes
Dr Aravinda more noted that severe clinical signs like dementia, weariness, temper disruption, and megaloblastic anaemia can end result from critical vitamin B12 insufficiency. “Serious neuropsychiatric and neurological troubles can build, if remaining untreated. A better hazard of myocardial infarction and stroke has also been involved with vitamin B12 deficiency. Some of these indications can also take place in individuals who have a vitamin B12 deficiency but have not formulated anaemia,” reported Dr Aravinda.
Managing vitamin B12 deficiency
Vitamin B12 injections are typically applied to address anaemia brought about by vitamin B12 deficiency. There are 2 varieties of vitamin B12 injections:
The decision that stays in the entire body more time, hydroxocobalamin, is typically encouraged, mentioned Dr Aravinda. “These injections will originally be administered each and every other day for two months, or until your signs or symptoms start off to subside. Immediately after the initial stage, your procedure will depend on no matter whether your vitamin B12 lack is induced by your food items or no matter if it is ensuing in any neurological problems, these as concerns with imagining, memory, and behaviour,” Dr Aravinda commented.
Oral complement: To improve vitamin B12, opt for large-dose oral dietary supplements. Proof implies that growing vitamin B12 degrees in clients with deficiencies with substantial-dose oral supplementation at 1000mcg is a successful tactic. In addition, oral supplementation is related with sizeable charge price savings, no side effects and amplified compliance, when compared to intramuscular injections.
Diet program-similar: If your vitamin B12 deficiency is caused by a lack of nutritional vitamins in your diet, you may well be recommended vitamin B12 tablets to consider just about every working day involving foods. Alternatively, you may possibly have to have hydroxocobalamin injections twice a 12 months. Folks who obtain it hard to get sufficient vitamin B12 in their meal plans, this kind of as those people subsequent a vegan diet plan, may well need to have vitamin B12 tablets for daily life. Considerably less normally, persons with vitamin B12 deficiency thanks to prolonged-time period lousy diet regime might be suggested to cease using the pill when vitamin B12 levels have been restored to usual and their diet plan has enhanced.
Great resources of vitamin B12 contain:
• Fish like Salmon
• Milk and other dairy products and solutions
If you are a vegetarian or vegan, or are wanting for alternate options to meat and dairy solutions, there are other foodstuff that include vitamin B12, these types of as yeast extract, as properly Like fortified breakfast cereals and soy goods, Dr Aravinda shared.
So, is there a problem about overdose?
Vitamin B12 nutritional supplements are generally regarded as safe when taken in proper dosages. The recommended every day dose of vitamin B12 for grown ups is 2.4 micrograms, but better doses have been revealed to be safe. The human body usually takes in as a lot as it requirements and the extra is excreted in the urine, Dr Aravinda explained.
Instead than diet or oral nutritional supplements, an overdose of B12 is majorly prompted thanks to high doses of injection, explained (Ms) Roshan Kore, senior dietitian and nutritionist, SRCC Children’s Hospital, managed by Narayana Health and fitness (Haji Ali, Mumbai).
Overdose of B12 can trigger anxiety, zits, skin redness, headache, nausea, vomiting, coronary heart stroke, confront paralysis, palpitations, facial ruddiness, and sleeplessness. “Patients with current diabetic issues or kidney condition can have extra adverse outcomes like even more reducing the kidney functionality. Pregnant girls owning particularly higher B12 ranges because of to overdose raises the possibility of autism spectrum problem in their unborn boy or girl,” Dr Kore instructed indianexpress.com.
In accordance to Dr Aravinda, significant doses of vitamin B12 made use of to address deficiency can lead to:
Nausea and vomiting
Exhaustion or weak spot
Tingling sensation in arms and toes
Dr Aravinda further commented that doable interactions with other medications include
• Aminosalicylic acid. Getting this drug to deal with digestive difficulties may perhaps lower the body’s skill to take in vitamin B12.
• Colchicine. Having this anti-inflammatory drug to avert and treat gout assaults may possibly reduce the body’s capability to absorb vitamin B12.
• Metformin. Having this diabetic issues drug may possibly lessen your body’s means to soak up vitamin B12.
• Proton pump inhibitors. Getting omeprazole, lansoprazole or other stomach acid-decreasing prescription drugs might minimize your body’s means to soak up vitamin B12.
• Vitamin C (ascorbic acid) dietary supplements. Having vitamin B12 alongside with vitamin C can reduce the amount of vitamin B12 offered in the system. To stay clear of this conversation, take vitamin B12 health supplements right before getting Get vitamin C at least 2 several hours later.
How to treat overdose?
Kore claimed that the toxicity of vitamin B12 can be addressed by supplying extra hydration orally or via an IV line, depending on the severity of the indications.