We always believe we are getting enough vitamins as long as we are having a balanced diet, taking the occasional multivitamin supplements, and generally feeling alright. But then out of the blue, more and more people are constantly tired. Hands numb, memory felt foggy, and simple tasks start to feel more difficult than they should be. Like most people I was also experiencing similar symptoms and so I went and got a routine blood test done, my doctor dropped a bombshell- my blood work was excellent but still vitamin B12 levels were deficient!

What most amazed me? My levels were technically within the "normal" limit. That's when I found out that vitamin B12 deficiency isn't always apparent—it can sneak up on you, even if your blood tests are all okay. And the effects? They can be serious, from taking a toll on your nerves to impairing your brain function. If you’ve ever dismissed fatigue or brain fog as just a part of life, it’s time to take a closer look at this essential nutrient.

Vitamin B12 is important to the overall health of the body, and its deficiency usually goes undetected until it has created irreparable harm. The majority of individuals believe that being within the normal range indicates that they are protected, but studies reveal otherwise. Even those who are within the normal range for vitamin B12 levels are showing cognitive impairment and neurological issues. This presents an imperative question: Are we ignoring the actual effect of the deficiency of vitamin B12?

Vitamin B versus Vitamin B12

The use of 'vitamin B' is to define a group of water-soluble vitamins whose functions serve to keep many different body functions. Of these, vitamin B12 (cobalamin) is unique in serving as an integral part of the production of red blood cells, DNA formation, and the nervous system. All other B vitamins are predominantly derived from animal food sources, a fact that leads to concerns from vegetarians as well as persons with absorptive problems.

Hidden Dangers of Vitamin B12 Deficiency

Deceptive as it takes, Vitamin B12 deficiency will gradually make one manifest its full blown effects when most often taken for granted with nonspecific unhelpful clinical findings or at worse, overlooked with wrong diagnosing. This impressive Massachusetts General Hospital case featured a 62-year-old male patient who developed two months before presentation with alarming neurological and bodily manifestations of paresthesias, walking impairment, jaundice, and dyspnea. What did they discover?

A severe deficit in vitamin B12. If not treated, advanced B12 deficiency can cause permanent neurological damage, depression, paranoia, and even dementia.

Who Is at Risk?

B12 deficiency is most prevalent among older adults, but other populations are also at risk. Some of the most important risk factors are:

Strict Vegetarian or Vegan Diets – Because B12 occurs naturally only in animal foods, vegetarians who do not eat meat, eggs, and dairy might have difficulty obtaining sufficient B12 from diet.

Weight-Loss Surgery – Certain operations, like gastric bypass, can inhibit the body's uptake of vitamin B12 from food.

Digestive Disorders – Certain disorders, including celiac disease, Crohn's disease, and atrophic gastritis, can impede B12 absorption.

Long-Term Use of Acid-Reducing Medications – Commonly prescribed for heartburn, these drugs reduce stomach acid, which is needed to absorb vitamin B12 efficiently.

Aging – As people grow older, their stomach acid production decreases, making it harder for the body to extract B12 from food.

Symptoms of Vitamin B12 Deficiency

Vitamin B12 deficiency can take on a wide variety of symptoms, which can appear gradually or abruptly. Among the most typical symptoms are:

• Numbness or tingling in hands, legs, or feet
• Problems with walking and balance
• Weakness and fatigue
• Anemia
• Tongue inflammation or swelling
• Decline in cognitive function, memory loss, and confusion

Since these signs can be suggestive of other ailments, vitamin B12 deficiency frequently goes undetected or misdiagnosed.

'Normal' B12 Levels May Not Be Enough

One of the widespread myths is that if B12 levels are within the normal range, then nothing is wrong. But research indicates that even people with "normal" B12 levels may develop cognitive impairment and neurological dysfunction. A recent study revealed that even at the lower end of normal, individuals had evidence of slowed nerve impulse conduction and impaired spatial processing speed.

In the USA, deficiency is characterized as blood levels below 148 pmol/L. Nonetheless, research indicates that neurological manifestations can be present at higher levels, particularly if bioavailable B12 (Holo-TC) is diminished. This serves to reinforce the value of measuring functional B12 levels in preference to total B12 levels in the diagnosis of deficiency.

Link Between B12 Deficiency and Brain Health

Low B12 status is increasingly linked with cognitive impairment, memory loss, and dementia. Research has shown that deficiency in B12 is a causative factor for white matter injury in the brain and spinal cord, resulting in delayed nerve conduction. Elevated homocysteine due to low levels of B12 may also promote further brain shrinkage and neurodegenerative disorders.

Surprisingly, although B12 supplementation has the ability to correct such blood abnormalities as anemia, its effect on neurological symptoms is not as predictable. In a few instances, even with supplementation, slight neurological dysfunctions remain, emphasizing prevention and early detection.

Diagnosing and Treating B12 Deficiency

Because the symptoms of B12 deficiency are often subtle and nonspecific, diagnosis usually depends on a blood test for total B12, methylmalonic acid (MMA), and homocysteine. Individuals at risk—vegetarians, people with gastrointestinal disorders, and older individuals—should seek out B12 testing from their healthcare providers actively.

Treatment usually consists of dietary changes and supplementation:

Dietary Sources: Beef liver, clams, oysters, dairy foods, eggs, and fortified cereals are good sources of B12.

Oral Supplements: Use Standard B12 tablets or sublingual (under-the-tongue) tablets to ensure adequate levels.

B12 Injections: For serious situations or if there are absorption problems, intramuscular B12 injections are the answer.

Early detection of a vitamin B12 deficiency is important in order to avoid irreversible neurological harm. If you feel unusually tired, numbness, memory problems, or balance difficulties, ask your physician to check your B12 levels—despite the fact that they might be "normal." With ongoing research further emphasizing the intricacies of vitamin B12 metabolism, it is evident that trusting only on past definitions of deficiency can place many at risk.

B12 deficiency is far more prevalent than most people think and can be associated with profound health effects even when blood tests remain within so-called "normal" limits.

Diseases can often have different effects on men and women due to obvious biological differences as well as hormonal- between the genders like the levels of certain hormones as well as the body's capacity to do certain tasks, etc. While conditions like diabetes and high blood pressure can also have a different effect on them. There are also other factors like psychological factors like men ignoring their health. A survey done by the Cleveland clinic showed that 65% of men avoid medical care for as long as they can, 44% men do not see a primary care provider regularly as 49% admitted that they do not keep up with a healthy diet.

A new study published in the PLOS Medicine journal reported that men are more likely to die from high blood pressure, HIV/AIDS and diabetes than women. The study revealed that this higher mortality rate appears to be linked to men being less likely to seek and consistently engage with medical care for these conditions.

What Causes Disparity Between Sexes?

One of the points highlighted in the study was that interestingly, men and women are each equally susceptible to the diseases. So the problem did not lie in a genetic or biological reason, it was rather the fact that men did not receive the proper treatment needed for their conditions. The key difference lies in what happens after a diagnosis. Men, for various reasons, appear less likely to actively participate in their healthcare, which can mean delaying doctor visits, not adhering to medication schedules, or not prioritizing regular check-ups. This difference in engagement has serious consequences for their long-term health outcomes.

Given these findings, researchers are emphasizing the urgent need to find better ways to encourage men to take a more active role in looking after their health. This includes promoting the importance of preventive care, so men are more likely to get regular screenings and catch potential problems early. It also means addressing the barriers that might prevent men from seeking medical attention when they need it and ensuring they feel comfortable and supported in engaging with healthcare services consistently over time to manage conditions effectively.

Why Should Men And Women's Health Managed Differently?

Researchers involved in the study highlights a crucial point: the medical world needs to recognize that men and women often experience and deal with their health in different ways. Healthcare providers need to move beyond a one-size-fits-all approach and develop strategies that are sensitive to these gender-specific behaviors and attitudes towards health. This might involve tailoring communication, making services more accessible and appealing to men, and designing treatment plans that better align with their lifestyles and preferences to improve adherence and ultimately lead to better health outcomes.

The research also uncovered that the primary factors contributing to health problems can sometimes differ between men and women. For example, in a large majority of the countries studied, men were significantly more likely to be smokers, which is a major risk factor for developing high blood pressure.

On the other hand, women in most countries had higher rates of obesity. These different risk factors, combined with the observed differences in how men and women seek and engage with healthcare services, help to explain the concerning disparities in death rates from these common diseases. Understanding these variations is a vital step towards creating more equitable healthcare for everyone.

How Men Can Manage Diabetes and High BP

To effectively manage both high blood pressure and diabetes, men can focus on several key lifestyle changes. Creating a healthy eating plan, even still enjoying favorite foods in moderation, is crucial. Regular physical activity, aiming for at least 150 minutes weekly, helps lower blood glucose and blood pressure. Reaching and maintaining a healthy weight through diet and exercise is also vital. Additionally, getting enough sleep, managing stress through healthy coping mechanisms, and limiting salt and alcohol intake are important steps. For those who smoke, quitting and avoiding secondhand smoke is strongly recommended. Regular blood pressure monitoring is also essential for proactive management.

Spring is a beautiful time, but it often brings along runny noses, sneezing, and congestion. These symptoms can easily be mistaken for either a cold or seasonal allergies. Both share overlapping traits, but they stem from entirely different causes. A cold is caused by a virus, making it infectious, while seasonal allergies are your immune system’s reaction to harmless substances like pollen.

In many parts of the world, it is also the time when seasonal changes are occurring. With shorter springs, longer summers, or the transition in between, pollen is everywhere. However, it does not mean that other common virus and bacteria are gone. So, how do you differentiate between them, especially when you get sick? How do you know when you have a cold or an allergy.

Let us check this out!

What Are Seasonal Allergies?

Seasonal allergies, also known as hay fever or allergic rhinitis, happen when your immune system mistakenly sees pollen as a threat and releases chemicals like histamines to fight it. This overreaction leads to sneezing, a runny or stuffy nose, itchy eyes, and sometimes throat irritation.

Different types of pollen trigger allergies depending on the season. In spring, tree pollen is the main culprit. As the year progresses, grass and weed pollens take over. Due to rising global temperatures, allergy seasons are starting earlier and lasting longer than before.

What Is a Cold?

A cold is typically caused by viruses like the rhinovirus and is more common during seasonal transitions. It spreads easily through the air or by touching contaminated surfaces. Cold symptoms often include a sore throat, fatigue, congestion, sneezing, and a runny nose. You may also experience body aches and a mild fever.

Unlike allergies, which persist for weeks or even months, colds usually last between three and seven days for most healthy individuals.

Key Differences Between a Cold and Allergies

Despite their similarities, colds and allergies have a few clear distinctions:

Duration: A cold is short-lived, usually resolving within a week. Allergies persist throughout the pollen season.

Itchiness: Allergies commonly cause itchy eyes and throat. Colds may bring soreness but rarely itchiness.

Fever and Body Aches: Colds can come with mild fever and aches. Allergies do not.

Contagiousness: Colds are infectious; allergies are not. If you’re sneezing and spreading droplets, you could pass on a cold.

Mucus Color: Colds may lead to yellow or green mucus. Allergy mucus tends to stay clear.

Treating Seasonal Allergies

To manage allergy symptoms:

• Use saline nasal rinses to clear allergens.
• Apply anti-itch eye drops for relief.
• Take over-the-counter antihistamines or corticosteroid nasal sprays.
• Track local pollen levels and avoid high-pollen days.
• If symptoms persist despite self-care, consult a healthcare provider.

Treating a Cold

There’s no quick fix for a cold, but you can ease symptoms by:

• Getting plenty of rest.
• Drinking fluids to stay hydrated.
• Avoiding contact with others to prevent spreading the virus.
• Recovery usually comes with time and supportive care.

Susana Moreira, a 41-year-old woman from Santiago, Chile, has lived with a debilitating form of muscular dystrophy since childhood. She was diagnosed with this condition at the age of 8. Her condition has been progressive since then. As a result, she was bedridden for over 20 years. She was once able to move, but can now no longer walk, bathe, or care for herself.

Her muscles have continued to weaken and she is expected to eventually lose the ability to speak and breathe without help.

What Happens In Muscular Dystrophy?

As per the National Institute of Neurological Disorders and Stroke, muscular dystrophy or MD refers to a group of genetic diseases that cause progressive weakness and degeneration of skeletal muscles. These disorders vary in age of onset, severity, and the pattern of affected muscle. However, one thing that is definite is that this condition is progressive in nature.

As per NIH, it affects by weakening the muscles. Muscles are made of thousands of fibers and these fibers contain cells surrounded by an outer layer of membrane. Muscle fibers that make these individual muscles are bound together by connective tissue. Muscles are activated when an impulse, or signal is sent from the brain. What happens in MD is the protective membrane of the muscle is damaged and the muscle fibers begin to leak protein creatine kinase and take excess calcium. This damages the muscle fibers and then causes the fibers to die, and thus leads to progressive muscle degeneration.

Right To Die

Moreira, is also facing the same condition, which will eventually make her unable to live with dignity. Therefore, she wants to be able to choose a dignified death, though euthanasia.

However, euthanasia and assisted dying are currently illegal in Chile. Her deeply personal plea has reignited a national conversation and become a symbol of the push for legal reform.

The Bill Is Stuck

Chile’s debate over euthanasia is not new. In 2021, the Chamber of Deputies approved a bill to allow both euthanasia and assisted suicide for adults suffering from terminal or incurable illnesses. But the legislation has since stalled in the Senate.

If passed, Chile would join countries like Belgium, Spain, Canada, and the Netherlands in legalizing both practices. In Latin America, Colombia already allows euthanasia, and Ecuador recently decriminalized it, though regulations are still pending.

Speaking Out Before It's Too Late

Confined to her home, Moreira spends her days reading, watching movies, and playing video games. Outings are rare due to the pain caused by sitting in a wheelchair for too long. In a letter to President Gabriel Boric, she urged him to support the bill and shared her fears about reaching a stage where she could no longer communicate her wishes.

President Boric responded publicly, calling the bill “an act of empathy, responsibility and respect,” and promised to prioritize it in his final year in office. However, political turmoil has since pushed the issue to the sidelines.

A Growth In Support

While Chile was once considered one of Latin America’s most conservative nations, attitudes toward euthanasia have shifted. A 2024 Cadem survey found that 75% of Chileans support euthanasia. Another study by the Center for Public Studies reported 89% support for allowing it either always or in special cases.

Supporters argue the law would offer people suffering from terminal conditions a humane and legal option. Critics, however, say better access to palliative care must come first. Chile passed a law in 2022 guaranteeing palliative care, but experts argue its implementation is uneven.

The debate has also been shaped by other moving stories, such as that of Valentina Maureira, a teen who pleaded publicly for euthanasia in 2015 but was denied and died shortly after.