DEAR DR. GOTT: I would like some information on anemia. After a blood test my doctor suggested I have B12 shots – five the first five days, then one a week for two weeks and finally one shot a month. I’m 69 years young.
DEAR READER: A person is diagnosed with anemia when he or she does not have sufficient healthy red blood cells to provide enough oxygen to the tissues of the body. The condition can be temporary or long-term and can range from mild to severe and can result from the body incorrectly destroying red blood cells, or because the body doesn’t make a sufficient quantity of them, or a bleed causes the loss faster than the body can replace them. Symptoms can be so mild they go unnoticed for an extended period of time; however, as the condition worsens, so do the signs of fatigue, shortness of breath, chest pain, irregular heartbeat, headache, and more.
Before we get into B12 shots, I will outline just what red blood cells do. There are three types of blood cells – white to fight infection, platelets to help blood clot and red to carry oxygen throughout the body. Most blood cells are produced in our bone marrow, the material found within the center of the large bones in the body. Healthy red blood cells last between 90 and 120 days. After that, the body removes the old blood cells and a hormone made in the kidneys signals our bone marrow to produce more red blood cells. In order for the body to produce hemoglobin (the protein that gives blood its color and carries oxygen), the body requires vitamin B-12, iron, folate and nutrients from the foods we eat. Should a diet be lacking the necessary nutrients to keep the body healthy, red blood cell production falls off and anemia results. There are also instances when a person may consume sufficient B-12; however, the body remains unable to process it, resulting in vitamin deficiency anemia.
Those at increased risk for anemia include vegans, those that have specific disorders such as Crohn’s or celiac disease, have cancer or organ failure involving the liver or kidneys, have sickle cell anemia, consume a low-iron and vitamin B-12 diet, alcoholism, and more.
Treatment depends on the type of anemia found. For example, if a person has vitamin deficiency anemia, a physician will likely prescribe folic acid supplements and B-12 that could come either from food, pills or through injections. Iron deficiency anemia can be treated with iron supplements and changes to one’s diet. Should an underlying disorder be found, that condition must be discovered and treated. If a person’s diet is lacking, he or she should increase the consumption of beef, dark green leafy vegetables, dried fruits, lentil, shellfish, milk, cheese and cereals fortified with iron.
The injectable form of B-12 is given in a muscle or under the skin. A general dosage regimen for deficiency through injection is 1,000 mcg of intramuscular cobalamin once a day for 10 days. Following that, dosing is once a week for four weeks and then once a month for life. If oral B-12 is used, between 125 and 2,000 mcg have been taken successfully by mouth for more than two years. The sublingual form (under the tongue) is 500 mcg for up to four weeks. Dosage and whether the oral or injectable form is recommended depends on the type of anemia or medical reason for which a physician might prescribe B-12.
Readers who would like related information can order my Health Report “Vitamins & Minerals” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order payable to my attention and forwarded to PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
