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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for vitamin B12 deficiency

Dear Doctor,

I am 47 Years Male from INDIA.

I am Vitamin B12 Deficient & my readings are:

Holotranscobalamin(Active Vitamin B12) by

MEIA 24.36

19.1 to 119.3 pmol/L **

(Test done through Metropolis LAb)

Please advise me if i have to take medicines for these deficiancy . I do not eat non veg regularly.

I have Insomnia, I get disturbed sleep, I also forget

names, My joints Crack a lot through out the day.

I also have G6PD ( deficiency).

Thanks,

RRajesh.
Fri, 10 Apr 2015
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Dietitian & Nutritionist 's  Response
Dear Sir:
I highly suggest you make an appt. with a Dietitian in India to review your diet as there are foods and vitamins you should not be taking with your genetic disease that affects carbohydrate metabolism and may cause hemolytic anemia. You ask about a B 12 supplement. Lets start with the things to avoid to help your blood - fava bean, sufonamide antibiotics, vitamin C, possibly vitamin K. many other vitamins are suggested and even encouraged. Vitamin E in the range of 400 - 800 IU may be protective against your illness. Daily oral doses of 1000-2000 MCG/DAY OR INJECTION and it is imperative if you are deficient to become repleted as B12 deficiency prolonged can cause bone marrow failure. Also there are other foods to avoid, but I would feel more comfortable if you had a complete assessment and meal plan by an Indian dietitian either by video (telehealth) or walk-in. Best wishes to your health.
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Dietitian & Nutritionist Kathy Shattler's  Response
RRajesh,
I remember speaking with someone else recently with G6PD. This is a complicated inborn error of metabolism that may disrupt the levels of many nutrients. Your low level of B12 is likely pernicious anemia meaning you lack intrinsic factor to ABSORB vitamin B12, so I suggest getting injections per month. Are you following your diet strictly? No Fava beans, sulfites, menthol,blue dye,vitamin c, vitamin K, tonic water, gluten free products, garden egg and many chinese herbs as well as black and green tea. It is important to work with your doctor with this illness. Zest.MD also has virtual dietitian clinics throughout India if you are open to working with someone on achieving a balanced diet and what to do with the nutrients you are low in. Good luck to you!
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Suggest treatment for vitamin B12 deficiency

Dear Sir: I highly suggest you make an appt. with a Dietitian in India to review your diet as there are foods and vitamins you should not be taking with your genetic disease that affects carbohydrate metabolism and may cause hemolytic anemia. You ask about a B 12 supplement. Lets start with the things to avoid to help your blood - fava bean, sufonamide antibiotics, vitamin C, possibly vitamin K. many other vitamins are suggested and even encouraged. Vitamin E in the range of 400 - 800 IU may be protective against your illness. Daily oral doses of 1000-2000 MCG/DAY OR INJECTION and it is imperative if you are deficient to become repleted as B12 deficiency prolonged can cause bone marrow failure. Also there are other foods to avoid, but I would feel more comfortable if you had a complete assessment and meal plan by an Indian dietitian either by video (telehealth) or walk-in. Best wishes to your health.