With anemia, your body doesn't have enough healthy red blood cells to carry oxygen to tissues. A vitamin B12 deficiency can lead to a type of anemia known as megaloblastic anemia. Megaloblasts may be detected through routine blood testing before you develop symptoms of anemia.
Diagnosis and Tests
The tests used to diagnose vitamin B12 deficiency are a complete blood count (CBC) and a vitamin B12 blood test level. A person is diagnosed with vitamin B12 deficiency if the amount of vitamin B12 in their blood is less than 150 per mL.
ICD-10 code D51. 9 for Vitamin B12 deficiency anemia, unspecified is a medical classification as listed by WHO under the range - Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism .
The Centers for Medicare & Medicaid Services also do not provide coverage for routine testing for vitamin B12 deficiency.
Key points about vitamin B12 deficiency anemia
Without enough red blood cells, your tissues and organs don't get enough oxygen. Without enough oxygen, your body can't work as well. Symptoms include weak muscles, numbness, trouble walking, nausea, weight loss, irritability, fatigue, and increased heart rate.
Inadequate dietary intake
A balanced diet typically provides sufficient vitamin B12; however, strict vegans and people with a poor diet are at higher risk of developing a deficiency. Good sources of vitamin B12 include: Meat. Fish.
Main causes of B12 deficiency include lack of intrinsic factor and other intestinal factors (eg, malabsorption), rare genetic disorders, and inadequate intake.
There is only one cause for a B12 deficiency, auto-immune pernicious anaemia. After a B12 deficiency is diagnosed, several tests can be done to try to find the cause of the deficiency. Often nothing is tested at all, because it is believed that a cause often can't be found.
To screen for vitamin B12–deficiency anemia, your healthcare provider may order blood tests to see whether you have low hemoglobin or vitamin B12 levels. Tests to screen for vitamin B12-deficiency anemia. A complete blood count measures hemoglobin. Another blood test measures vitamin B12 levels in the blood.
A lack of vitamin B12 can cause neurological problems, which affect your nervous system, such as: vision problems. memory loss. pins and needles.
Coding a B12 injection
Is 90782, “Therapeutic, prophylactic or diagnostic injection (specify material injected); subcutaneous or intramuscular,” the proper code for administering a vitamin B12 injection in the office if the patient provides the medication?
Pernicious anemia is a type of vitamin B12 anemia. The body needs vitamin B12 to make red blood cells. You get this vitamin from eating foods such as meat, poultry, shellfish, eggs, and dairy products. A special protein, called intrinsic factor (IF), binds vitamin B12 so that it can be absorbed in the intestines.
ICD-10 code E53. 9 for Vitamin B deficiency, unspecified is a medical classification as listed by WHO under the range - Endocrine, nutritional and metabolic diseases .
Symptoms of Vitamin B12 Deficiency
A mild deficiency may cause no symptoms. But if untreated, it may lead to symptoms such as: Weakness, tiredness, or lightheadedness. Heart palpitations and shortness of breath.
For the patients with a very low serum B12 level (<100ng/l) and anaemia, macrocytosis or neurological symptoms, the treatment is simple: load the patient with vitamin B12 parenterally (by IM injection) and continue with maintenance vitamin B12 by IM injection every 3 months indefinitely (see below for more details).
Methylmalonic Acid (MMA). A blood or urine test, sometimes used to help detect mild or early B12 deficiency, or to exclude true B12 deficiency in cases of a misleadingly low laboratory B12 result. MMA production increases if there is inadequate B12 available to the tissues.
Stage 1 is decreased levels of vitamin B12 in the blood. Stage 2 is low concentration of vitamin B12 in the cell and metabolic abnormalities. Stage 3 is increased levels of homocysteine and MMA and decreased DNA synthesis resulting in neuropsychiatric symptoms. Stage 4 is macrocytic anemia.
B12 deficiency is associated with depression, fatigue, paraesthesia, memory problems and macrocytosis. Levels below 150 pmol/L (203 pg/ml) are classified as low and can cause permanent neurological damage and fetal abnormalities in babies of untreated mothers.
MMA is a very sensitive test in indicating a B12 deficiency. It is more specific than homocysteine and is the confirmatory test of choice for a B12 deficiency.
The main causes of B12 malabsorption include inherited disorders (Intrinsic factor deficiency, Imerslund-Gräsbeck disease, Addison's pernicious anemia, obesity, bariatric surgery and gastrectomies.
Vitamin B12 deficiency can indeed lead to weight gain. But the weight gain is not a direct result of the deficiency. Instead, vitamin B12 deficiency causes lethargy or lack of energy, and in turn, inactivity causes weight gain. When you lack the energy to move, you don't burn fat.
There are a lot of other drugs that can impair vitamin B12 status; metformin (to treat diabetes), antibiotics, methotrexate (used in chemotherapy), colchicine (used to treat gout), anti-seizure medications (i.e. phenytoin, pirimidone), and a group of cholesterol-lowering drugs (i.e. cholestyramine).
Other neurological findings include altered sensation, paresthesia in the extremities, gait ataxia, poor vision, dizziness, loss of taste or smell, urinary or fecal incontinence, loss of cutaneous sensation, impaired sense of vibration, proprioception, psychiatric manifestation, memory impairment, personality changes, ...
How to raise your B12 levels fast. The most common way to treat B12 deficiencies is by adjusting your diet. If this is unsuccessful, vitamin supplements may be recommended. If you're looking to boost the amount of vitamin B12 in your diet, you should eat more animal products, like meat, seafood, dairy and eggs.