CAUSES AND HEALTH IMPLICATIONS OF VITAMIN B12 DEFICIENCY

Vitamin B12, an essential micro-nutrient, is crucial for the proper formation of red blood cells and health of the nerve tissues. Vitamin B12 deficiency, if left untreated can result in anemia, irreversible nerve and brain damage (Deficiency of B12 reduces the production of certain neurotransmitters like monoamines which are important in the regulation of mood and other brain functions) and also manifests with slight mental irritability, dyslexia and depression (Deficiency of folate, another B vitamin together with B12 deficiency reduces the body’s capacity to process Amino acids thus increasing the homocysteine levels, which is associated with heart diseases, strokes, vascular diseases and depression). The deficiency tends to develop gradually sometimes over a period of several years. At first, signs and symptoms may be subtle, but as time goes by they become more noticeable.
Some of the key factors causing Vitamin B12 deficiency are;

Ø  Excessive intake of fast foods and high-calorie drinks with corresponding reduction in dietary intake of foods rich in vitamin B12.

Ø  Excessive intake of drugs (like antibiotics) destroys the organisms present in the intestines that are essential for synthesizing vitamin B12

Ø  Consumption of antacids and other acid inhibitor drugs regularly to counter stress-related acidity reduces the stomach pH level, thereby affecting absorption of vitamin B12.

Ø  Mal-absorption of vitamin B12 due to lack of intrinsic factor (synthesizing agent present in the stomach that aids absorption of vitamin B12) and presence of antibodies against these proteins.

Ø  Low level of vitamin D coexists with calcium deficiency and vitamin B12 deficiency. Minimum exposure to sun light means low levels of Vitamin D and hence low levels of Vitamin B12.

Vitamin B12 is absent in plants, but is predominantly present in non-vegetarian food or animal sources of food like milk and milk products (the concentration is not sufficient to meet the daily requirements), Meat (abundant in liver, kidney and other organs), fish and eggs.
Many micro-organisms present in human intestines are also capable of synthesizing vitamin B12. Hence, the use of antibiotics, antacids and acid inhibitor drugs shall be minimized to maximize the absorption of B12.
In case of severe deficiency of vitamin B12, the patients is administered several doses of vitamin B12 supplements or injections (For those who cannot absorb vitamin B12 directly, doctors recommend injections).

(This subject is extensively covered in "Detailed information on B12 deficiency")

PSEUDO-DEMENTIA OR REVERSIBLE DEMENTIA

Dementia is defined as a serious illness affecting someone’s brain and memory in which they gradually stop being able to think or behave in a normal way. People are diagnosed for dementia when two or more brain functions, such as memory, language skills, perception or cognitive skills, including reasoning and judgment are significantly impaired without loss of consciousness. Most forms of dementia usually affect only older people who are past their sixties and are a result from the death of nerve cells and/or the loss of communication among these cells

Alarmingly, of late, bouts of forgetfulness and its manifestations (loss of emotional and behavioral control, developing personality changes, reduced problem solving abilities)on the normal lives, termed as pseudo-dementia is affecting many in the younger age groups, who are in their 30’s and 40’s. This state of forgetfulness is induced due to reasons like stress, depression, mental fatigue, alcohol consumption, smoking, poor diet, multiple strokes, drugs, neglect of minor injuries, diabetes, vascular diseases and deficiency of Vitamin B12 (Cyanocobalamin).

Some of the causes of Pseudo-dementia and preventive measures acknowledged by reputed medical professionals and confirmed by various medical studies are tabulated below:

CAUSES	PREVENTION
Stressful lifestyle or depression makes the brain overworked and hence it stops registering new information resulting in a state of dementia.	Engaging in intellectually stimulating activities, such as social interactions, chess, crossword puzzles and playing a musical instrument, can significantly lower the risk of developing dementia.
Vascular dementia develops when the blood supply to the brain is lowered. It is strongly correlated with risk factors for stroke, including high blood pressure, diabetes and elevated cholesterol levels.	Vascular dementia may be prevented in many cases by changing lifestyle factors, such as, poorly controlled diabetes, excessive weight and high blood pressure. Regular exercise (stimulates production of chemicals called growth factors that help neurons survive and adapt to new situations), healthy food, especially diet rich in omega 3 fatty acids, and maintaining a control over their glucose levels can prevent vascular dementia.
Deficiency of Vitamin B12 can reduce working capacity of the brain and results in progressive memory loss that has an impact on day to day activities.	Good amount of vitamin B12 in the blood delays the onset of dementia and slows the progression since it helps strengthen brain neurons. Consumption of vitamin B12 rich foods such as milk/milk products, fish, meat and eggs is essential.
Consumption of cholesterol and saturated fat rich foods causes inflammation in the brain, as well as the impairment of structural proteins that affect the functions of nerve cells. These causes memory loss and the failure of functions in other key organs such as the eye and the ear.	Restricting the intake of diet high in saturated fat and cholesterol. Consumption of fruits and fruit juices rich in antioxidants and anti-inflammatory properties is recommended.
Low-carbohydrate and no-carbohydrate diets have the strongest potential for negative impact on thinking and cognition. The body breaks carbohydrates into glucose, which it uses to fuel brain activity.	Consumption of low calorie, high-carbohydrate diet is recommended. (Proteins break down into glycogen, which can also be used for fuel by the brain, but not as efficiently as glucose from carbohydrates.)

UNPREJUDICED CRICKET VIEWING IS DELIGHTFUL

I am no different from other Indians when it comes to cricket. Cricket has been a weakness and continues to be a major distraction to me personally; following the fortunes of Team India irrespective of my work location across different parts of the world.

I have been a great admirer of Philanthropist, Steve Waugh, Gentleman cricketer, Adam Gilchrist and Mr. Cricket, Michael Hussey apart from   scores of Indian players. The admiration of these players may be partly due to non-cricketing reasons and exemplary personal traits. Nevertheless, there have been so many great players and few greatest players as well whose game, I was unable to appreciate and enjoy all these years, since patriotism had masked my unprejudiced admiration.

I am an ardent fan of Test cricket over the shorter versions. However, IPL 5 has helped me in removing my prejudices towards supporting a particlular team and taught me how to enjoy the game, irrespective of the end result and the competing teams. This is the first IPL tournament I have been watching from day one due to my stay outside India and in countries where Cricket is an alien game and is not available for viewing in TV.

In fact, it is Steven Smith’s cricketing exploits in IPL 5 that has inspired me to write this article. Although, I had watched a few games he played for Australia, I could not distinguish his special talent. He continues to impress greatly with his batting and fielding skills; but his bowling skills are not yet exploited by his captain Sourav Ganguly in this tournament. Trust we get to watch it too shortly. It is also delightful to watch, unprejudicedly, the performances and skills of other offshore promising talents; Sunil Naraine, Kevon Cooper, Owais Shah, Duplessis, Shaun Marsh together with Chris Gayle, Kevin Pieterson, Brad Hodge, Shane Watson and Azhar Mahmood who had been very consistent and successful in this years IPL.

It is a great pleasure and joy to watch Rahul Dravid and Sourav Ganguly, the Indian greats who are past their prime together with Indian Internationals; Virendra Sehwag, Gautam Gambhir, Suresh Raina and promising talents; Ajinkya Rahane, Umesh Yadav, Robin Uthappa, Ambati Rayudu, Dhawan, Ashok Maneria, Ankit Sharma, Parwinder Awana, Pawan Negi performing exceedingly well.

On the other hand, it leaves me greatly perplexed and sad to see the skill gap between promising Indian players and offshore cricketers. The greatest concern is the ground and aerial fielding which are many rungs below par. Moreover, the local talent looks to lack self belief and confidence. Trust the IPL exposure and interaction with offshore players will improve their self belief and talent.