Dr. Faisal Al-Sayegh: B12 deficiency is not treated with supplements alone... seek the underlying cause

Dr. Wala' Hafez reported that Dr. Faisal Al-Sayegh, a consultant in internal medicine and hematology, stated that managing vitamin B12 deficiency should not be limited to prescribing supplements, emphasizing the importance of investigating the underlying cause of its low levels in the body. He explained that vitamin B12 deficiency may be associated with malabsorption resulting from certain gastric or intestinal diseases, or pernicious anemia, in addition to bariatric and gastric surgeries, as well as the long-term use of certain medications, such as metformin and drugs that reduce gastric acidity. Al-Sayegh noted that vitamin B12 deficiency can cause symptoms that extend beyond the blood to the nervous system, including numbness, weakened sensation, balance disorders, and memory problems, pointing out that these symptoms may sometimes appear before changes related to the vitamin deficiency are detected in blood tests. He added that having a vitamin B12 level within the normal range does not completely rule out deficiency in all cases, explaining that some patients may have normal or near-normal levels despite the presence of a functional deficiency in tissues. He clarified that when symptoms raise suspicion of vitamin deficiency, a physician may resort to more precise tests, including measuring methylmalonic acid (MMA), to help confirm the diagnosis. Al-Sayegh affirmed that relying solely on a B12 level test may not be sufficient in some cases, especially when symptoms are consistent with a deficiency of this essential vitamin.