Konzani Kusowa kwa Vitamini B12

Timafotokoza momwe kusowa kwa vitamini B12 kungadziwonetsere, mwachitsanzo, zomwe zimayambitsa. Zachidziwikire, muwerenganso momwe mungadziwire kuchepa kwa vitamini B12, zomwe zimayambitsa komanso, momwe mungathandizire kuchepa kwa vitamini B12.

Kuperewera kwa vitamini B12 kumakhudza anthu ambiri

Kuperewera kwa vitamini B12 kumakhudza anthu ambiri. Ku Germany, 5 mpaka 7 peresenti ya achinyamata ndi 30 peresenti ya okalamba ali ndi mavitamini B12 ochepa. Chiwerengero cha omwe sanafotokozedwe chikuyenera kukhala chokwera kwambiri chifukwa kusowa kwa vitamini sikumayang'aniridwa nthawi zonse pakapita kuchipatala.

Symptomatic kapena asymptomatic akusowa vitamini B12

Kuperewera kwa vitamini B12 kumatha kukhalabe popanda zizindikiro kwa zaka zambiri, chifukwa chakuti nkhokwe za thupi zimatha nthawi yayitali. Pafupifupi ma microgram 4000 a vitamini B12 amasungidwa m'chiwindi ndi minofu ya munthu wamkulu. Zosungirazi zimagwiritsidwa ntchito pang'onopang'ono pamene vitamini saperekedwa kotero kuti kuperewera kumangokhala chizindikiro pambuyo pa zaka zitatu kapena kuposa.

Miyezo ya vitamini B12 ikatsika koma palibe zizindikiro, izi zimatchedwa kusowa kwa vitamini B12.

Mwalamulo, kusowa kwa vitamini B12 kumaphatikizapo kuperewera kwa magazi koyipa komanso chotchedwa Hunter glossitis. Kumbali inayi, zizindikiro zosadziwika sizimayenderana ndi kusowa kwa vitamini B12 ndi madokotala.

Zizindikiro zoyambirira zosadziwika bwino za kuperewera

Zizindikiro zoyambirira zosadziwika bwino za kusowa kwa vitamini B12 ndi izi. Mukawona izi, yesani kuchuluka kwa vitamini B12:

• dzanzi pakhungu
• Kupweteka m'manja ndi/kapena miyendo
• kusowa kwa njala
• lilime loyaka moto
• wosweka ngodya za mkamwa
• kufooka kowonekera mu ntchito ndi kukumbukira
• kusinthasintha kwamalingaliro pafupipafupi popanda chifukwa chodziwikiratu
• chizungulire
• zovuta kuika patsogolo
• matenda ogona
• Kutopa ndi kutopa popanda chifukwa

Pambuyo pake, pali matenda aakulu, mwachitsanzo:

• matenda a mtima
• Matenda a Hematological (= matenda/kusokonezeka kwa mapangidwe a magazi), monga kuchepa kwa magazi m'thupi, mwachitsanzo B. Kuwonongeka kwa magazi. Anemia ndi kusowa kwa magazi.
• Zizindikiro za dementia kapena matenda a dementia
• Matenda a dongosolo lamanjenje: neuropathy (matenda a minyewa), mwachitsanzo B. funicular myelosis ndikuyenda kosakhazikika ndi ziwalo; kusokonezeka kwa chidwi; kuvutika maganizo

Kuchepa kwa magazi m'thupi chifukwa cha kusowa kwa vitamini B12

M'magazi owopsa, maselo ofiira amwazi amakulitsidwa. Amakhalanso ndi hemoglobin yambiri (mtundu wofiira wa magazi) kuposa maselo abwinobwino a magazi. Maselo okulitsawa amatchedwanso megaloblasts, pomwe maselo abwinobwino amagazi amatchedwa normoblasts. Choncho, kuwonongeka kwa magazi m'thupi ndi chimodzi mwa megaloblastic anemias, yomwe imaphatikizapo kuperewera kwa folic acid.

Zizindikiro za megaloblastic anemia ndi zofanana ndi za matenda ena a magazi m'thupi ndipo zimakhala ndi kutopa, kutopa mofulumira, kuchepa kwa ntchito, tachycardia, kupukuta, ndipo mwina Hunter glossitis. Hunter glossitis ndi kusintha kwa pathological lilime ndi lilime loyaka, losalala pamwamba pa lilime, ndi lilime lomwe poyamba limakhala lotumbululuka ndipo kenako limasintha lilime lofiira. Nthawi zambiri, kuwonongeka kwa magazi m'thupi kumatha kukhala funicular myelosis.

Funicular myelitis chifukwa cha kuchepa kwa vitamini B12

Funicular myelitis ndi matenda omwe ali ofanana ndi multiple sclerosis koma, mosiyana ndi iwo, akhoza kuchiritsidwa ndi makonzedwe a vitamini B12. Funicular myelosis imayambitsanso kuwonongeka kwa mitsempha ya myelin ya mitsempha mu ubongo ndi msana. (Myelin sheaths ndi mtundu wa chitetezo chomwe chimazungulira mitsempha ya mitsempha). Nthawi zambiri, kumva kwachilendo monga kunjenjemera kapena kupweteka kumachitika koyamba, kenako ndikuyenda kosakhazikika, kufooka kwa minofu, ndi (spastic) ziwalo. Ngati ubongo wakhudzidwa, kusokonezeka kwa chidziwitso, kutopa, ndi psychosis zimawonekera.

Kuwongolera kumabwera mwachangu kwambiri

Nthawi zambiri amafunsidwa kuti zizindikiro za kuchepa kwa vitamini B12 zimakula bwanji mukayamba kumwa vitamini B12 ngati chowonjezera chazakudya. Ngati mutenga vitamini B12 pazizindikiro za kuchepa kwa vitamini B12, zizindikiro za hematological nthawi zambiri zimakhala bwino pakatha sabata limodzi, zizindikiro za minyewa mkati mwa miyezi itatu - kutengera kuopsa kwake.

Chofunikira chatsiku ndi tsiku

Ngakhale kuti nthawi zambiri mumatenga mlingo waukulu wa vitamini B12 pakagwa vuto kuti muthe kuthetsa vutoli mwamsanga, thupi limangofunika vitamini B12 pang'ono tsiku lililonse litadzaza masitolo ake. Chofunikira pa tsiku la vitamini B12 ndi motere (chilichonse mu µg (micrograms) patsiku):

mwana

• 0 mpaka miyezi 4: 0.5
• 4 mpaka miyezi 12: 1.4

ana

• 1 mpaka zaka 4: 1.5
• 4 mpaka zaka 7: 2.0
• 7 mpaka zaka 10: 2.5
• 10 mpaka zaka 13: 3.5
• 13 mpaka zaka 15: 4.0

achinyamata ndi akuluakulu

• 15 mpaka zaka 19: 4.0
• 19 mpaka zaka 25: 4.0
• 25 mpaka zaka 51: 4.0
• 51 mpaka zaka 65: 4.0
• Zaka 65 ndi kupitirira: 4.0
• Mimba: 4.5
• Kuyamwitsa: 5.5

Konzani kusowa kwa vitamini B12

Kuperewera kwa vitamini B12 kumatha kuzindikirika mosavuta ndi dokotala, sing'anga wina, kapena kuyezetsa kunyumba. Ngati muli ndi vuto la vitamini B12, mukhoza kukonza mosavuta.

Zifukwa za kuchepa kwa vitamini B12

Popeza vitamini B12, mosiyana ndi mavitamini ena onse a B complex, amapezeka pafupifupi muzakudya za nyama, zamasamba zimaganiziridwa kuti zidakonzedweratu chifukwa cha kusowa kwa vitamini B12. Koma omwe si anyama amathanso kudwala kusowa kwa vitamini B12.

Chifukwa cha mankhwala ena, zakudya zopanda thanzi, kapena matenda amatha kuwononga m'mimba ndi matumbo, zomwe zimapangitsanso kuchepa kwa vitamini B12. Kumwa mowa mopitirira muyeso, anorexia, ndi mitundu ina ya kuperewera kwa zakudya m'thupi (monga ukalamba, mukamadya pang'ono kapena m'mbali imodzi) zimaganiziridwanso kuti ndizo zimayambitsa kuchepa kwa vitamini B12.

Zonse zamasamba ndi zopanda nyama zimatha kukhudzidwa ndi kusowa kwa vitamini B12 - chifukwa chokhacho chimakhala chosiyana.

Omnivores omwe ali ndi vuto la B12 nthawi zambiri amakhala ndi matenda a m'mimba, pomwe nyama zamasamba zimangosowa zopangira chifukwa chakudya chochokera ku mbewu chimakhala ndi vitamini B12 pang'ono, ngati chilipo, ndipo sichimangotanthauza kutenga vitamini B12 chowonjezera.

Momwe madandaulo a m'mimba angayambitse kuchepa kwa vitamini B12

Vitamini B12 imafuna kuti m'mimba muzitha kuyamwa mokwanira pazifukwa izi:

Zomwe zimatchedwa intrinsic factor zimapangidwa m'maselo a parietal a chapamimba mucosa - puloteni yonyamula yomwe vitamini B12 kuchokera ku chakudya imatha kudziphatika kuti ilowe m'matumbo aang'ono (ileum).

Komabe, mucous nembanemba ya m'mimba ikawonongeka, choyamba pamakhala kuperewera kwa zinthu zomwe zimapangitsa kuti B12 ikhale yoperewera. Koma anthu ambiri ali ndi mimba zoipa, omnivores kwambiri kuposa vegans.

N'chimodzimodzinso ndi matenda a m'mimba. Izi, nazonso, nthawi zambiri zimabweretsa kuchepa kwa vitamini B12 ngati vitamini sangathenso kuyamwa mokwanira, mwachitsanzo B. m'matumbo osakwiya ndi kutsekula m'mimba pafupipafupi kapena matenda otupa otupa, kapena ngati mbali za matumbo zachitidwa kale opaleshoni. kuchotsedwa.

Momwe kutentha pamtima kungayambitse kuchepa kwa vitamini B12

Pankhani ya mavuto a m'mimba, sikuyenera kukhala matenda aakulu a m'mimba, monga B. gastritis mtundu A (kutupa kwa m'mimba), zomwe zingayambitsenso kuchepa kwa vitamini B12. Kupsa mtima ndikokwanira. Chifukwa anthu ambiri amatenga ma acid blockers (proton pump inhibitors, monga omeprazole) chifukwa cha kutentha pamtima - ndipo ndi mankhwalawa omwe amalimbikitsa kukula kwa kusowa kwa B12.

Omeprazole ndi oletsa asidi ofanana osati ziletsa mapangidwe chapamimba asidi, komanso mapangidwe intrinsic factor kuti asatengenso (kapena pang'ono) vitamini B12 (malabsorption).

Momwe majeremusi angayambitse kuchepa kwa vitamini B12

Kugwidwa ndi tepiworm ya nsomba kungayambitsenso kuchepa kwa vitamini B12. Nsomba za tapeworm zimafala kwambiri podya nsomba zosaphika. Tizilombo toyambitsa matenda timataya mazira masauzande tsiku lililonse, omwe amapezeka mosavuta m'chimbudzi, zomwe zimapangitsa kuti munthu azindikire mosavuta.

Chifukwa chake, kuchepa kwa vitamini B12 sikuli vuto lomwe lingangokhudza anthu omwe ali ndi nyamakazi. Ndikusowa kwa vitamini komwe kumatha kukhudza aliyense, monga kusowa kwa vitamini D, kusowa kwa magnesium, kapena kuperewera kwina kulikonse.

Kutsimikiza kwa kuchuluka kwa vitamini B12 mu seramu

Madokotala ambiri amazindikirabe kuchuluka kwa vitamini B12 mu seramu yamagazi, koma izi sizomveka, chifukwa B12 yosagwira imayesedwanso, yomwe thupi silingathe kugwiritsa ntchito.

Chifukwa chake, ndizotheka kuti mtengo wonse wa B12 ukadali wabwino, koma zenizeni, pali kale kuchepa kwa vitamini B12. Pokhapokha pamene mulingo wa B12 wagwa kale kwambiri m’pamene munthu angathe kuuzindikira kuchokera pamtengo wonse wa B12 m’mwazi.

Kutsimikiza kwa methylmalonic acid mumkodzo (MMA test)

Njira yosavuta ndiyo kuyesa mkodzo wa vitamini B12, womwe mutha kuyitanitsa pa intaneti ndikudzichitira nokha kunyumba. Mayesowa amayesa kuchuluka kwa methylmalonic acid mumkodzo, yomwe imachulukitsidwa mukusowa kwa vitamini B12 (mu mkodzo ndi m'magazi).

Komabe, popeza palinso anthu (makamaka omwe ali ndi zaka zoposa 70) omwe akweza ma methylmalonic acid popanda kukhala ndi vuto la B12 komanso (pa msinkhu uliwonse) matenda a m'mimba amatha kusokoneza ma methylmalonic acid, mayesero ena ayenera kuchitidwa. kukhala kumbali yabwino (ngati mayeso a methylmalonic acid adakwezedwa). Mayesowa amayesa zomwe zimatchedwa holo-transcobalamin mtengo (holo-TC) m'magazi.

Transcobalamin ndi mapuloteni onyamula vitamini B12 (cobalamin). Pamene vitamini B12 yogwira imamanga ku transcobalamin, mankhwalawa amatchedwa holo-transcobalamin

Magazi a holo TC mayeso

Ndi mayeso a Holo-TC, vitamini B12 yokhayo ndiyomwe imayezedwa, kotero kuti kusowa kwa B12 kungathe kudziwika pachiyambi pomwe osati kokha pamene masitolo a vitamini B12 am'thupi atayika kale. Zachidziwikire, mutha kukhalanso ndi mtengo wa holo-TC wotsimikizika.

Kuyesa kwa methylmalonic acid sikofunikiranso. Ndiwothandiza makamaka kwa iwo omwe sakonda kutengedwa magazi ndipo amapezekanso ngati kuyezetsa kunyumba.

Kutsimikiza kwa homocysteine ​​​​m'magazi

Kuphatikiza apo, mulingo wa homocysteine ​​​​m'magazi ukhoza kutsimikizika kukhala mbali yotetezeka. Ngati ili pamwamba, kusowa kwa vitamini B12 - komanso kuperewera kwa folic acid ndi / kapena kusowa kwa vitamini B6 - kungakhalepo (kapena zofooka zonse zitatu pamodzi).

Makhalidwe a vitamini B12

Pansipa pali zowerengera za vitamini B12 (za akulu) kuti mutha kugawa zowerengera zanu molondola.

Makhalidwe a vitamini B12 mu seramu

Ngati dokotala akuyesa vitamini B12 mu seramu ndipo ndi yotsika kwambiri, pali kusowa kwa vitamini B12. Komabe, ngati zili zachilendo koma kumapeto kwa sikelo yabwinobwino (yotsika kwambiri), muyenera kuyezetsanso zina, monga mphambu ya holo-TC kapena mayeso a MMA. Chifukwa mulingo wa vitamini B12 wa seramu ukhoza kukhala wabwinobwino pomwe pali kuchepa kwa vitamini B12, kuyeza kwa seramu sikoyenera kuzindikira kuperewera kwa incipient:

• Nthawi zambiri: 300 - 900 pg/mL (220 - 665 pmol/L)
  zotheka kuchepa: 200 - 300 pg/ml (150 - 220 pmol/l)
• Kuperewera: pansi pa 200 pg/mL (150 pmol/L)
  kuchepa kwakukulu: pansi pa 150 pg/ml (110 pmol/l)

Makhalidwe a methylmalonic acid MMA mumkodzo ndi magazi

Miyezo yodziwika bwino ya methylmalonic acid mumkodzo ndi motere:

• Kuperewera kwa B12 sikutheka: milingo yochepera 1.5 mg MMA pa g creatinine
• Kuperewera kwa B12 kotheka: milingo pakati pa 1.5 ndi 2.5 mg MMA pa g creatinine
• Kuperewera kwa B12: milingo yapamwamba kuposa 2.5 mg MMA pa g creatinine

Miyezo yowunikira kutsimikiza kwa methylmalonic acid mu seramu yamagazi ndi motere:

• Kuperewera kwa B12 sikutheka: pakati pa 9 ndi 32 µ/l (zofanana ndi zomwe zili pakati pa 76 ndi 280 nmol / l)
• Kuperewera kwa B12 kotheka: milingo yopitilira 32 μg/l (yofanana ndi pafupifupi 280 nmol/l)

Ngati pali mulingo wochepa wa holotranscobalamin panthawi imodzimodzi, kuperewera kwa vitamini B12 kungaganizidwe motsimikizika.

Makhalidwe a holotranscobolamine mu seramu

Miyezo yodziwika bwino ya holotranscobalamin mu seramu ndi motere:

• Kuperewera kwa B12 ndikokayikitsa: pamitengo yopitilira 70 pmol/l
• B12 kuchepa kotheka / zotsatira za malire: 35 - 70 pmol / l
• Kuperewera kwa B12 mwina: pamitengo yochepera 35 pmol/l

Popeza milingo yotsika ya holo-TC iliponso pakalephera aimpso, milingo ya impso iyenera kuyang'aniridwa nthawi zonse, makamaka mwa okalamba.

Magawo osiyanasiyana: momwe mungasinthire

Ngati mulingo wa vitamini B12 mu seramu yanu udatsimikiziridwa koma zotsatira zanu zidaperekedwa mugawo lina, mutha kusintha motere ndikufaniziranso ndi zomwe zili pamwambapa:

• pmol/L x 1.355 = pg/mL = ng/L
• ng/L x 1 = pg/mL

Chonde dziwani, komabe, kuti zikhulupiriro zimasiyana nthawi zambiri kutengera mtundu wa kusanthula ndi labotale chifukwa chake muyenera kugwiritsa ntchito zowunikira za labotale ngati chenjezo.

Umu ndi momwe vitamini B12 imatengedwa ndi thupi

Vitamini B12 imatha kuyamwa ndi thupi kudzera munjira ziwiri:

• Musapitirire 1.5 ma micrograms a vitamini B12 omwe amatha kulowetsedwa pa chakudya chilichonse kudzera mu mayamwidwe achangu pogwiritsa ntchito mapuloteni onyamula (intrinsic factor).
• 1 peresenti ya vitamini B12 yodyedwa imatha kuyamwa (popanda mapuloteni onyamula) kudzera m'mayamwidwe ang'onoang'ono ndi kufalikira, komwe kumakhala kosangalatsa kwambiri mukamamwa zakudya zopatsa thanzi. Chifukwa ngati kukonzekera kwa vitamini B12 kumapereka mlingo wa tsiku ndi tsiku wa 1000 micrograms wa vitamini B12, mwachitsanzo, mutha kuyamwa ma micrograms 10 a vitamini B12 kudzera mu kufalikira kwapang'onopang'ono, komwe kungathe kuphimba zofunikirazo.

Umu ndi momwe mungakonzere kuchepa kwa vitamini B12

Ngati tsopano zikuwonekeratu kuti pali kusowa kwa vitamini B12, ndiye kuti mwachibadwa funso limakhala loti izi zingatheke bwanji. Zofunikira zimadalira chomwe chimayambitsa chilemacho.

Chotsani kusowa kwa vitamini B12 m'madandaulo osatha am'mimba
Ngati mukudwala matenda obwera chifukwa cha m'mimba, kukulitsa thanzi lanu la m'mimba kuyenera kukhala koyenera kuchitapo kanthu. Nthawi yomweyo, kukonzekera kwa vitamini B12 wambiri (mlingo watsiku ndi tsiku wa 1000 micrograms) ndizomveka, chifukwa izi zimatha kutengeka ndi kufalikira kwapang'onopang'ono, kotero zimatha kuchiritsa kuperewera kwapambuyo ngakhale ndi matenda am'mimba.

Nthawi zina, jakisoni wa vitamini B12 ndi njira yabwinoko, makamaka ngati pali kusowa kwa vitamini B12. Iwo amapatsidwa intramuscularly, mwachitsanzo mu minofu, ndipo nthawi zambiri amatha kuthetsa vuto la vitamini B12 mkati mwa masabata angapo.

Pewani kuchepa kwa vitamini B12 mukamamwa mankhwala

Ngati mukumwa mankhwala omwe angapangitse kusowa kwa vitamini B12, lankhulani ndi dokotala wanu ngati akufunikirabe kapena ngati mungasiye kumwa. Ngati mukuyenera kupitiriza kumwa mankhwala anu, funsani dokotala ngati kuli kokwanira ngati mutenga vitamini B12 nthawi zonse kapena - ngati kuperewera kuli kwakukulu - kaya simukuyenera kukhala ndi jekeseni wa B12 poyamba apo ayi kusowa kwa vitamini B12 sikungakhale. kuwongolera kapena kuwongolera pang'onopang'ono.

Zakudya zimawongolera kusowa kwa vitamini B12

Ngati kusowa kwa vitamini B12 kwayamba chifukwa cha zakudya zamasamba kapena zifukwa zina zosadziwika, mutha kuthana ndi vutolo mwa kumwa pafupipafupi vitamini B12. Kukonzekera kosiyanasiyana kulipo pazifukwa izi.

Konzani kusowa kwa vitamini B12 ndi mankhwalawa

Ngati mukufuna kuthana ndi vuto lodziwika bwino la vitamini B12, kukonzekera kwa vitamini B12 ndi mlingo wa tsiku ndi tsiku wa 1000 micrograms wa vitamini B12 akulimbikitsidwa.

Makapisozi okhala ndi vitamini B12

Kukonzekera kwa kapisozi komwe kumakhala ndi mitundu yabwino kwambiri ya vitamini B12, mwachitsanzo, kusungirako vitamini B12 (hydroxocobalamin) ndi mitundu yogwira ya B12 (methylcobalamin ndi adenosylcobalamin), ndi yabwino.

Mphuno imatsika ndi vitamini B12

Madontho a m'mphuno a Vitamini B12 tsopano akupezekanso pamalonda. Ndi madontho achilengedwe othandiza, mwachitsanzo, mutha kutenga ma microgram 1000 a vitamini B12 pa mlingo watsiku ndi tsiku (madontho awiri). Vitamini amatha kuyamwa kudzera mucosa ya m'mphuno, ndikudutsa m'mimba.

Mankhwala otsukira mano okhala ndi vitamini B12

Mankhwala otsukira m'mano okhala ndi vitamini B12 angathandizenso kuphimba zofunikira za tsiku ndi tsiku za vitamini B12. Ayenera kugwiritsidwa ntchito kawiri pa tsiku kuti akhudze kuchuluka kwa vitamini B12.

Pakafukufuku wa 2017, nyama zomwe zidagwiritsa ntchito mankhwala otsukira mano oyenera kwa milungu 12 zidawonjezeka kwambiri mu holo-TC ndi seramu B12, zomalizirazo zidakwera pafupifupi 81 pg/mL, zomwe ndizochuluka kwambiri. Ngati zikhalidwe zili pansipa 150 mpaka 200 pg/ml, pali kuchepa. Miyezo ya 300 pg/ml ndi kupitilira apo imawonedwa ngati yabwinobwino, motero kugwiritsa ntchito mankhwala otsukira mano nthawi zonse kumatha kusintha kapena kukhala ndi B12 wathanzi.

jakisoni nthawi zambiri amathandizira kuchepa kwa vitamini B12 mwachangu

Majekeseni a vitamini B12 a intramuscular (mwachitsanzo kuchokera ku Medivitan) angagwiritsidwenso ntchito pankhani ya kuchepa kwa vitamini B12 yokhudzana ndi zakudya - ngati mtengo uli wotsika kwambiri. Izi nthawi zambiri zimaperekedwa kamodzi kapena kawiri pa sabata kwa milungu ingapo. Chifukwa kumwa m'kamwa kwa vitamini B12 kukonzekera kapena kugwiritsa ntchito mankhwala otsukira m'kamwa owonjezera nthawi zambiri sikukwanira kuthetsa vuto la vitamini B12 mwachangu komanso kuwongolera zizindikiro.