The Link Between Crohn's Disease and B-12 Deficiency

Recent research has again confirmed that those with Crohn’s disease are at high risk for vitamin B-12 insufficiency. In the abstract of a 2017 study printed in the Asia Pacific Journal of Clinical Nutrition, the conclusion reveals that “Vitamin B-12 insufficiency was highly prevalent in Crohn’s patients.” And, “their nutritional B-12 intake was higher than the recommended dietary allowance for that vitamin.” (PubMed)

Those research results go hand-in-hand with the newer medications for B-12 insufficiency that everyone’s talking about. (Progressive Health/PH)

Why should the results of this study matter? You might be thinking: I can just go to the drug store and pick up some OTC Vitamin B-12 pills, right?

Why B-12 insufficiency is common in those with Crohn’s

For people with Crohn’s, their inflamed intestines interfere with normal absorption of nutrients, to include certain vitamins. The tissue near the of the small intestines (distal ilium) is where B12 is absorbed. For those with Crohn’s, this part of the intestine is quite often damaged from the persistent inflammation. So, the absorption of B-12 is severely compromised. (PH)

That site also informs us that “the damage to the gastrointestinal tract can also lead to internal bleeding. Such bleeding can also contribute to anemia due to loss of Vitamin B-12 as well.”

The Progressive Health article also explains that’s why OTC B-12 pills won’t work; the intestinal tissue of a person with Crohn’s are damaged from the disease, and are just plain not able to absorb a swallowed source of B-12.

But, before we talk further about the treatment for B-12 insufficiency for those with Crohn’s, let’s first review the part B-12 plays in our body.

What does vitamin B-12 do for us?

Vitamin B-12 is necessary for our bodies to operate correctly. B-12 is responsible for a variety of body functions. It helps with the production of nerve cells, of DNA, and also of red blood cells, to name just a few. (University of Maryland Medical Center)

The signs of B-12 insufficiency include low serum B-12 levels, the presence of immature but unusually large red blood cells, and a deficiency in the hemoglobin protein. (Lab Tests Online)

Within our red blood cells is a material called hemoglobin. It is the “oxygen carrier” within our blood stream, and ferries about needed oxygen to our body organs. Lessened hemoglobin, combined with fewer healthy red blood cells leads to a decline in available oxygen. (Mayo Clinic)

There are a few different types of anemia (such as one caused by a low iron level, for example) but we will concentrate on the B-12 variety as this is the type most common to those with CD.

We have touched on the signs of B-12 insufficiency (signs being those observable by exam or testing). Now, we will talk about the symptoms that present with a B-12 deficiency.

Common symptoms of B-12 deficiency

When a person has B-12 insufficiency, their common symptoms are tiredness, being short-of-breath and ‘feeling faint.’ (IBD Relief)

Harvard School of Public Health speaks of more symptoms, as well: “memory loss, disorientation, hallucinations, and tingling in the arms and legs.”

A person with Crohn’s needs to report such symptoms to the gastroenterologist, as an untreated B-12 insufficiency can lead to a condition called pernicious anemia, where not enough healthy red blood cells are produced. (Progressive Health/PH)