What The Health?! Woman's 'dementia' was actually a vitamin deficiency

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A woman who lived for years with symptoms mimicking dementia was found to have actually experienced things like memory loss, confusion, and slurred speech because of a vitamin B12 deficiency.

The 61-year-old’s case of “reversible dementia” shows just how important the B vitamin is for our health.

According to BMJ Case Reports, the 61-year-old woman’s mental condition deteriorated over a period of five years. Her sister, who cared for her, said that she couldn’t go out on her own because she would get lost and be unable to return home without help.

The woman also experienced visual and auditory hallucinations.

“According to her sister, she continued talking and shouting about the spirits of dead relatives whom she could see clearly and who told her not to take her medication,” the report says. “She feared that her family would poison her and refused to share meals with them.

“The patient was conscious but disoriented in time and space,” it says. “Her speech was slurred, and, according to her sister, sometimes incomprehensible.”

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It turned out that woman was living with Addison’s anemia. Also known as pernicious anemia, it's caused by a decrease in red blood cells due to a lack of vitamin B12.

Healthy red blood cells provide the body’s tissues with oxygen.

She was treated with an antipsychotic medication, which eliminated the mental symptoms that were assumed to be caused by dementia. And she began taking vitamin B12 supplements.

Besides contributing to the formation of DNA red blood cells, vitamin B12 is required for proper neurological function.

When people have a low level of the vitamin for a long period, pernicious anemia can cause damage to the nervous system. In addition to the symptoms that the woman in the case study experienced, other effects include depression, irritability, trouble concentrating, poor balance, numbness and tingling in the hands and feet, and optic-nerve atrophy.

While the case reported in BMJ was out of the ordinary, vitamin B12 deficiency is not.

Dr. Bobby Parmar, a naturopathic physician in Vancouver, says he regularly sees patients who have been told they have everything from arthritis to ADHD when in fact, upon testing, they’re found to have a low level of the vitamin. Typically, their symptoms improve upon regularly acquiring sufficient amounts through food or supplements. (A diagnosis can be confirmed with a blood test.)

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“That woman’s case is super rare, but it’s an example of how extreme symptoms can get when you aren’t able to get or absorb B12 in your body,” Parmar says. “It’s a way we know the worst that can happen.

“The few people who do have pernicious anemia are typically identified early on,” he adds. “She would have had lots of complaints, and it’s strange that nobody picked up on that earlier. She fell through the cracks.”

Vitamin B12 must be acquired through supplements or food. It’s found in certain fortified foods like grains and in animal products such as meat, eggs, poultry, and dairy.

Plants, on the other hand, do not contain the vitamin. That means strict vegetarians and vegans are at high risk of developing a deficiency.

While some people don’t consume enough vitamin B12 through their diet or supplements, others can’t absorb enough no matter how much they get. Celiac and Crohn’s disease can interfere with absorption; so can certain medications, including those for heartburn and diabetes (such as metformin).

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Age can also hamper absorption. Stomach acid is needed to absorb the vitamin, and older people produce less of it.

The National Health and Nutrition Examination Survey estimated that just over three per cent of adults over age 50 have a seriously low B12 level, while up to 20 per cent may have a borderline deficiency.

“B12 deficiency is rampant,” Parmar says. “Even if somebody suspects they have B12 problems, doctors don’t take it seriously. Education needs to happen on a professional level so we all take it more seriously. Doctors need to be looking at B12 whether there are signs of pernicious anemia or not.

“If after a few weeks of taking B12 you feel better, that in and of itself is highly diagnostic that B12 was probably low and that you weren’t getting enough or there was something prohibiting you from getting enough,” he adds. “There’s nothing more inexpensive or easy than to take B12.”

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