Bu mesajim B12 vitamin eksikliginde ortaya cikan rahatsizliklar hakkindadir.    

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http://www.merck. com/mmpe/ sec01/ch004/ ch004i.html

http://en.wikipedia .org/wiki/ Vitamin_B12

http://en.wikipedia .org/wiki/ Vitamin_B12_ deficiency

VITAMIN B12 DEFICIENCY

Dietary vitamin B12 deficiency usually results from inadequate absorption, but deficiency can develop in vegans who do not take vitamin supplements. Deficiency causes megaloblastic anemia (B12 eksikligi megaloblastic kansizliga sebep olur), damage to the white matter of the spinal cord and brain, and peripheral neuropathy. (Omurga, beyin ve cevresel sinirlerin beyaz tabakalarinda hasara sebep olur.) Diagnosis is usually made by measuring serum vitamin B12 levels. The Schilling test helps determine etiology. Treatment consists of oral or parenteral vitamin B12. Folate should not be used instead of vitamin B12 because folate may alleviate the anemia but allow neurologic deficits to progress.

Symptoms and Signs

Anemia usually develops insidiously (Genellikle sinsice gelisen bir kansizlik olusur.) It is often more severe than its symptoms indicate because its slow evolution allows physiologic adaptation. Occasionally, splenomegaly and hepatomegaly occur. Various GI symptoms, including weight loss and poorly localized abdominal pain, may occur. Glossitis, usually described as burning of the tongue, is uncommon. (Nadiren Dalak ve Karaciger buyumesi meydana gelir. Muhtelif sindirim sistemi rahatsizliklari, zorlukla belirlenen karin agrilari ve dilde yanma meydana gelebilir.)

Neurologic symptoms develop independently from and often without hematologic abnormalities. (Kan degerlerindeki anormallikten once ve bagimsiz olarak sinirsel rahatsizliklar gelisir.) In early stages, decreased position and vibratory sensation in the extremities is accompanied by mild to moderate weakness and hyporeflexia. (B12 eksikligin ilk safhalarinda, vucudun uzantili bolgelerinde, pozisyon ve titresim algilamasi azalir, buna zayiflik ve reflex azligi eslik eder.)  In later stages, spasticity, extensor plantar responses, greater loss of position and vibratory sensation in the lower extremities, and ataxia emerge. (Ä°lerleyen asamalarinda ise, Kasilmalar, Extensor Plantar Ayak Alti Refleksi, Ayaklarda Pozisyon ve Titresim Algilama Eksikligi, Adele Koodrinasyon Bozuklugu olusur.) These deficits may develop in a stocking-glove distribution. Tactile, pain, and temperature sensations are usually spared but may be difficult to assess in the elderly.

Some patients are also irritable and mildly depressed. Paranoia (megaloblastic madness), delirium, confusion, spastic ataxia, and, at times, postural hypotension may occur in advanced cases. The confusion may be difficult to differentiate from age-related dementias, such as Alzheimer's disease. (Bazi hastalarda Huzursuzluk, Orta Seviye Deprasyon, Paranoya, Hezayan, Beyin Karisikligi, Adelelerde Kasilmali Koordinasyon Bozuklugu ve bazen Postural Düşük Tansiyon olusur-Bu tur tansiyon dusuklugu ayakta ve uzanirken tansiyonun farkli gorulmesidir. )

 Presentation

Early and even fairly pronounced deficiency does not always cause distinct or specific symptoms. (B 12 eksikligi baslangicta herzaman belirgin ve spesifik bir semptom vermez) Common early symptoms are tiredness or a decreased mental work capacity, decreased concentration and decreased memory, irritability and depression. (Baslangic asamisinda yaygin olarak, yorgunluk, beyin calisma kapasitesinin azalmasi, Huzursuzluk ve Deprasyon gorulur.)

Sleep disturbances may occur (Uyku duzensizligi gorulur), because B12 may be involved in the regulation of the sleep wake cycle by the pineal gland (through melatonin).[ 1]

Neurological signs of B12 deficiency, which can occur without anemia, include sensory disturbances due to damage to peripheral nerves caused by demyelination and irreversible nerve cell death. (B12 eksikliginin sinirsel belirtileri, ki  bunlar kansizlik olusmadan once baslar, cevresel sinirlerin uzerindeki myelin tabakasinin siyrilmasi ve geri donulmez hucre olumleri nedeniyle meydana gelen algilama karisikliklarini icerir.) Symptoms include numbness and/or tingling of the extremities, impaired sense of smell, loss of appetite, disturbed coordination and, if not treated in time, an ataxic gait specially in the dark when there is less visual reference,[2] a syndrome known as subacute combined degeneration of spinal cord. (Semptomlar; ayak ve ellerde hissizlik, koku alma duygusunda zayiflama, istah kaybi, korrdinasyon bozuklugunu icerir ve zamaninda tedavi edilmez ise, ozellikle karanlikta-gorusun az oldugu ortamlarda adele koordinasyon bozuklugu olusur ki bu akut alti birlesik spinal kordon dejenerasyonu olarak isimlendirilir )

B-12 deficiency can also cause symptoms of mania, psychosis, fatigue, memory impairment, irritability, depression and personality changes. (B 12 eksikligi Asiri Hareketlilik, Gercegi Degerlendirememe, Halsizlik, Hafiza Zayifligi, Huzursuzluk, Deprasyon ve Kisilik Degisiklikleri gibi psikolojik rahatsizliklara da sebep olabilir. ) [3][4][5][6] Recent studies have devalued a possible connection between B12 deficiency and Alzheimer's dementia, (Son calismalar, B 12 eksikligi ile Alzeimer Demasni arasinda iliski oldugunu ortaya koymustur). and such a correlation is unlikely as of June 2007.[7]

Studies showing a relationship between clinical depression levels and deficient B12 blood levels in elderly people are documented in the clinical literature.[ 8] and 2002 [9]

Bipolar disorder appears to genetically co-segregate with the hereditary B12-deficiency disorder pernicious anemia [10][11].

Science Daily reported that "a deficiency of B-vitamins may cause vascular cognitive impairment, according to a new study by the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University." Aron Troen, PhD, said that: "The vascular changes occurred in the absence of neurotoxic or degenerative changes. Metabolic impairments induced by a diet deficient in three B-vitamins -folate, B12 and B6- caused cognitive dysfunction and reductions in brain capillary length and density in our mouse model."[12][ 13][14][15]

The following symptoms have been recorded, beginning with those perhaps most likely to be indicative of B12 deficiency. (B12 eksikligi olanlarda asagidaki semptomlara rastlanmistir. )

1. Itchy or tingling tongue. (Dilde kasinma,sizlama- yanma) The tongue suddenly itches from time to time without warning. This occurs on the edge of the tongue, along one side or the other or at the tip. Some individuals experience stinging, pain, or tingling instead of itching.

2. White spots in the skin (Deride beyaz lekeler), resulting from melanin becoming absent in the area. These often occur on the outside of the forearm, but may occur in other places. The longer these spots are there, the whiter they get. As time goes by, the spots become very dry and flaky to the extent that small raw spots of skin may be exposed.

3. Sharp stabbing, tingling pain in the palm of one or both hands. (Bir veya iki el icinde picak batmasi, sizlama, yanma veya karincalanma gibi hisler olusmasi) This occurs suddenly and for no apparent reason in a spot directly below the ring finger, approximately where the first palm crease is. If B12 deficiency is not treated, a tingling pain may begin to occur along the outside edge of the hand, starting from the wrist. This pain occurs when the wrist is extended.

4. Sores at the corners of the mouth (Agiz kenarlarinda agri-sizi), sometimes extending along the edge of the lip. These are raw spots, not blisters, and they tend to come and go. (Agiz kenarlarinda olusan, ama su toplanmasi seklinde olmayan, beyaz kaba kabarikliklar)

5. Nerve shock in the side of the body (Vucut kenarlarinda sinirsel sok). It can be felt coming on a few seconds before it hits, and then it hits almost like a mild but deep electric shock and quickly subsides. It can occur at the side of either hip or on either side of the upper body, along the ribs. It can occur consecutively in at least two or three locations, one right after the other.

6. Shortness of breath, but without chest pain (Gogus agrisi olmadan nefes yetersizlik hissi). This can occur when walking just a few yards.

7. Eye twitch (Goz segirmesi), usually in one eye or the other. It can occur on the eyelid or just below the eye.

8. Facial pain (Yuzde agri), usually on only one side of the face at a time. This pain varies so much that it would be difficult to describe all the possibilities. This can present as a dull pain in the cheek bone right underneath an eye, or a sharp shooting pain across the forehead, sometimes coming downward from the scalp to the edge of the nose by the eye.

9. Tingling along the back of one or both thighs (Tek veya her iki baldirda sizlama- yanma), starting at the hips and shooting downward. (Kalcada baslayip asagi dogru yayilan)

10. Memory loss and/or disorientation. (Hafiza kaybi ve/veya sasirma-yolunu kaybetme)

11. Migraine headaches (Migren). These may be preceded by a temporary blind spot in the center of the field of vision, usually lasting about ten minutes, and sometimes followed by facial pain under the eyes. After the blind spot vanishes, there may be zigzag streaks through the vision that may last up to hours. Even in the same person, there may be extreme variations in the headaches themselves. They may be quite severe with nausea or they may be virtually nonexistent.

Migraines of most individuals have causes other than B12 deficiency, but migraines of certain individuals diminish or stop completely after they are treated for B12 deficiency.

12. Irritability and/or depression and/or personality changes. (Huzursuzluk, Depresyon ve Kisilik Degisiklikleri)