Lightheadedness when changing to standing position
Rapid heart rate
You will be asked about your symptoms and medical history. A physical exam will be done. Tests may include the following:
Complete blood count (CBC)—a count of the number of specific blood cells in a blood sample
Vitamin B12 level—a test that measures the amount of vitamin B12 in the blood
Methylmalonic acid (MMA) level
Folate level—a measurement of the amount of a B vitamin called folic acid
Intrinsic factor antibodies—this test helps to determine anemia as the cause of symptoms
options include the following:
Oral Vitamin B12 Supplement
Daily high doses of an oral vitamin B12 supplement may help improve levels in the body. These dosages should only be given under a doctor's care.
Vitamin B12 Injections
The doctor may advise injections of vitamin B12 into a muscle. Injections of vitamin B12 may be given frequently at first. When blood tests show improvement, the injections may be given on a monthly basis.
Intranasal Vitamin B12
This form of vitamin B12 supplement is as a spray through the nose.
Treatment with Antibiotics
A bacterial overgrowth in the intestines can slow or stop the absorption of B12. Antibiotics may help to control the bacteria and improve vitamin levels in the body.
To help reduce your chances of developing a deficiency of vitamin B12, take the following steps:
Include foods that are a source of vitamin B12, such as:
Eggs, milk, cheese, and milk products
Meat, fish, shellfish, and poultry
Soy-based meat substitutes
Some soy and rice beverages
Avoid long-term over-consumption of alcohol.
As directed by your doctor, take a daily supplement containing vitamin B12.
As directed by your doctor, give vitamin B12 to your breastfed baby if you are a vegan or vegetarian.
Have your doctor monitor your health closely if you are taking certain medications:
Vitamin B12. American Association of Clinical Chemistry—Lab Tests Online website. Available at: http://www.labtestsonline.org/understanding/analytes/vitamin_b12/glance.html. Updated April 24, 2015. Accessed November 7, 2017.
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