Understanding the role of diet in Biermer's disease, characterized by a vitamin B12 deficiency

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What is Biermer's disease?

Biermer's disease (formerly called pernicious anemia) is none other than a autoimmune gastric atrophypredominantly fundic. (source 1). In other words, a chronic disease affecting the stomach. “This results in a reduction in gastric acid secretion and a decrease in the absorption of vitamin B12, which leads to macrocytic anemia, which means that the red blood cells are larger than normal,” explains Jean-Michel Cohen, a nutritionist.

Vitamin B12, what is its role in the body?

Also called cobalamin, vitamin B12 is a micronutriment essential for the production of red blood cells by the body. “It is also essential for the proper functioning of the nervous system,” adds Dr. Cohen.

What are our daily vitamin B12 requirements?

THE satisfactory contributions (AS) in vitamin B12 recommended by Anses (National Agency for Food, Environmental and Occupational Health Safety) vary according to age (source 2):

  • 1.5 micrograms per day (μg/d) for
  • children from 6 months to 10 years,
  • 2.5 μg/day for adolescents aged 11 to 17,
  • 4 μg/day for adults over 18 years old,
  • 4.5 μg/day for pregnant women,
  • 5 μg/day for breastfeeding women.

Since vitamin B12 requires stomach acidity to be well absorbed, these intakes should be particularly monitored in the elderly (stomach acidity decreasing with age) and in people who have had stomach surgery or who suffer from gastric pathologies (inflammations…).

Diagnosis: What are the symptoms of Biermer's disease?

This disease is generally diagnosed by anemic signs including: pale complexion, tachycardia, great fatigue, shortness of breath even without physical effort, mood disorders, rigidity of the limbs or even a change in the appearance of the tongue.

Biermer's disease (macrocytic anemia), what is the role of diet?

This disease can, in most cases, be regulated by a sufficient intake of vitamin B12 found in a diet rich in vitamin B12 such as offal (liver, kidneys, etc.), certain fish and shellfish (oysters, herring, mackerel, clams, etc.), eggs, dairy products (Emmental, mozzarella, Gouda, etc.). “Eat preferably semi-liquid when you have a vitamin B12 deficiency will also be recommended to facilitate the work of the stomach,” adds Dr. Cohen.

What is the food richest in vitamin B12?

The best food to replenish the body with vitamin B12 is animal liverespecially beef liver which contains 91 micrograms per 100 g (source 3), behind cooked lamb liver, also very rich, with 60 g (source 4) against only 16.9 (µg/100 g) for cooked chicken liver for example (source 5). To a lesser extent but still interesting from a nutritional point of view, the rabbit meat will also be consumed.

Vegetarian and vegan: how to get your fill of vitamin B12?

In vegetarian individuals, there is no particular problem, since we find Vitamin B12 in eggs and dairy productss. It will therefore be sufficient to consume it regularly. “On the other hand, the deficiency of this vitamin will be particularly more common in vegans given that it is only found in animal products and that those contained in certain plants are not assimilated by the body”, qualifies Jean-Michel Cohen, nutritionist doctor. Taking vitamin B12 dietary supplements is therefore essential for this type of person. A supplement that should however be supervised by a health professional in order to respect the recommended daily doses (source 2).

Algae and royal jelly to stock up on vitamin B12, false or good idea?

“Vitamin B12 that can be assimilated by the body is only found in animal flesh. There is therefore no reason to take algae and/or royal jelly in order to provide additional intake,” emphasizes Dr. Cohen.

What foods should you avoid if you are vitamin B12 deficient?

“None. There is no bad combination of foods/drinks that prevents the proper fixation of vitamin B12 because it is soluble in water (hydrosoluble). Jean-Michel Cohen, nutritionist.​​​​

An interaction with certain medications such as biguanides (a class of oral antidiuretic medications), gout medications and antiulcer medications should be taken into account and discussed with your healthcare specialist, if necessary.

Vitamin B12 deficiency: the importance of good hydration

As previously stated, vitamin B12 is soluble in water (hydrosoluble), so it is quickly eliminated in the urine. regular and sufficient water intake will therefore be essential to maintain a quantity necessary for the proper functioning of the body. Namely, approximately 1.5 liters per day for an adult.

Beyond diet, what medical treatment is available to remedy a vitamin B12 deficiency (Biermer's disease)?

In case of too advanced vitamin B12 deficiency, treatment in the form of intramuscular injections (at the shoulder or buttock level) will be necessary. “The frequency of these is generally brought closer together during the diagnosis and then more spaced out, adapted to individual needs, thereafter” recalls the medical site deuxième avis.fr (source 6). It will therefore be necessary to carry out regular dosages every 3-6 months to adapt the vitamin B12 supplementation.

Health: what are the consequences of untreated Biermer's disease?

If treated late or poorly monitored, Biermer's disease can sometimes lead to serious complications such as:

  • atrophy of the mucosa which can ultimately trigger stomach cancer.
  • neurological problems since vitamin B12 contributes to the proper functioning of the nervous system (memory problems, irritability, mood disorders, etc.)
  • an impact on the heart and its proper functioning.

What to remember: a diet supervised by a nutritionist, combined with follow-up with a gastroenterologist (specialist in the digestive system as a whole), will be strongly recommended to the patient suffering from Biermer's disease.

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