 What comes in nursing school explain in this video on B12 deficiency anemia? Just as a quick review B12 is needed for our central nervous system to function appropriately to form red blood cells and to synthesize DNA. So these three things are the main things that we need B12 for and So when we don't have enough B12 it affects the red blood cell formation And then it can have effects on the central nervous system and we'll look at those here in a moment So from a pathophysiological standpoint B12 needs intrinsic factor Which is IF in the stomach to be absorbed from the distal ileum in the small intestine So if we have no intrinsic factor, we cannot absorb B12 And that is a special type of B12 deficiency anemia. That's actually called pernicious anemia So sometimes you might hear this term and you might think oh is this something else But pernicious and B12 deficiency are the same thing Except that pernicious anemia just pertains to the lack of intrinsic factor in particular So other risk factors or risk factors for developing B12 Deficiency are then anything that could go wrong with the stomach because we cannot produce this intrinsic factor So this would be gastric disorders such as gastric mucosal atrophy or autoimmune disorders And then any kind of surgery may be a gastrectomy for cancer or some other things gastric bypass or Crohn's disease where maybe the stomach is not functioning properly or Parts of it have been removed or bypassed. So now we cannot access that intrinsic factor And then there is also so besides this pernicious anemia There's also risk factor of decreased dietary intake and particularly here We usually hear about vegetarians and vegans so plant-based folks who are at higher risk for B12 deficiency But we also know now that many carnivores are also B12 deficient and we'll talk about diet here in a moment So signs and symptoms for B12 deficiency anemia like most anemias that pertain to a mineral vitamin deficiency develop fairly slowly and A term that we hear here a lot is Glossitis or a red swollen inflamed tongue and Then because we have problems with our CNS like I referred to over here The patient might have symptoms that pertain to the central nervous system such as such as weakness and Peristasia so think about numbness and tingling kind of neuropathy type symptoms through the lower extremities But they also might have confusion or dementia type symptoms that are not necessarily dementia itself But it might be underlying B12 deficiency and then they might have classic symptoms of anemia Which usually is tachycardia, tachypnea, shortness of breath, dizziness And that is because we need the B12 for the RBC formation that we now can't form because we're lacking the B12 And the important thing about the B12 deficiency is that if the patient develops these signs and symptoms They might not be reversible and we'll talk more about nursing considerations and treatment when about what to do about that For diagnostic tests many times it is detected on a regular CBC where we have decreased red blood cells and decreased hemoglobin and then we have an increase in MCV Which is the mean corpuscular volume Which tells us that the cells that red blood cells are large compared to normal and there's also sometimes referred to as megaloblastic or macrosidic and I have a separate video that goes into all the red blood cell indices so you can distinguish which one is iron deficiency Which one is microcytic macrosidic so take a look at that video Then of course we also go into measure B12 levels and that's going to be low But we also want to rule out folate deficiency Which is another nutritional deficiency the patient can develop that will manifest itself in megaloblastic or macrosidic anemia So these lab values will pretty much be the same But now we have to check other things to distinguish between B12 and B9 deficiency We also can check patients gastrin and intrinsic factor levels and then MMA methylmalonic acid and homocysteine levels are special lab tests that can be helpful in detecting B12 deficiency specifically and So over here for complications like I already talked about it can cause decreased CNS function and Neuropathy and again those might not be reversible So the most important thing here is for us to identify patients who are at risk so all those with some sort of intrinsic factor deficiency gastric surgery or Those with with dietary choices that might not support enough B12 in their diets So we want to make sure we encourage dietary B12 if B12 cannot sufficiently be obtained by a diet then we can recommend supplements and they are available PO or IM and those would have to be administered weekly for severe B12 deficiency and Then also we would want to rule out any gastric disorders If the patient doesn't have anything that we're already aware of because maybe there is some underlying cancer or autoimmune disease That the patient doesn't know about but now we have signs and symptoms of B12 deficiency and actually the underlying cause is Something else not the dietary sources because why can't they absorb it? And so for nursing considerations again identifying patients at risk and educating them is very important not only about the possible signs and symptoms, but also about the importance of the dietary Intake and then also educating them about the long-term effects that they might not be reversible, which usually helps us Have the patient more compliant And then we want to monitor B12 levels regularly to make sure that we are in the ideal range especially for those patients at risk and then B12 dietary resources So I have separated them into animal-based and then Plant-based resources so dietary sources beef liver clams and salmon if don't if those don't sound good to you We you can obtain B12 by fortified cereals. So make sure that you look at the at the label and then nutritional yeast and so It was actually originally thought that the B12 comes from the animals But the animals do not produce B12 the B12 actually originally comes from the soil So from the dirt that the animals ingest with their food But nowadays we're doing so much to process the animals or the food that the animals eat They don't actually get to eat the grass directly from the meadow and get some dirt there with their grass So because all the food that we give them is not really Conducive to give in the animals B12 so then the animal sources are not going to give us enough B12 And so fortified cereals and nutritional yeast which is kind of like a powder There's a has almost like a cheesy consistency and it's very high in B12 and it's highly recommended I actually prefer eating that because it tastes very good. So Thank you for watching this video on B12 deficiency and pernicious Anemia also check out my other videos about iron deficiency folate deficiency and all the other types of anemias Along with the videos that pertain to erythropoiesis and how actually red blood cells are formed I'll make sure to put all the links in the description below. Thanks for watching nursing school explained. See you soon