Leli fomu le-anemia livela ngenxa yokushoda kukavithamini B12 (cobalamin). Vitamin B12 kubalulekile ekwakhekeni kwamangqamuzana abomvu egazi, ikakhulukazi. Le anemia yakha kancane, ngemuva kwezinyanga noma iminyaka yokushoda kwamavithamini. I- asebekhulile yibo abathinteka kakhulu: cishe u-12% wabo kuthiwa uhlupheka ngokushoda kwale vithamini, ngaphandle kokuthi kube nokushoda kwegazi¹.

I-Vitamin B12 itholakala ngokudla ukudla yemvelaphi yezilwane, njengenyama, amaqanda, inhlanzi kanye ne-shellfish. Kubantu abaningi, ukudla kunika umzimba i-B12 kakhulu kunalokho okudingayo. Okweqile kugcinwa esibindini. Kungenzeka uhlupheke ngenxa yokuntuleka kwegazi ngenxa yokuntuleka kwe-B12 ekudleni, kepha akuvamile. Imvamisa, i-anemia ibangelwa yinkinga ngeukumuncwa amavithamini.

THEi-anemia eyingozi kungathinta u-2% kuye ku-4% wabantu jikelele². Kungenzeka ukuthi ayitholakali kalula ngoba izimpawu azibonakali ngaso sonke isikhathi ukuthola.

Izimbangela

Ukwehluleka ukwenza kahle umswakama uvithamini B12 oqukethwe ekudleni: lesi sizathu yiso esivame kakhulu. Nazi izinto eziyinhloko ezingaholela ekumungeni okungekuhle.

• Ukuntuleka kwesici esingaphakathi. Isici se-Intrinsic yi-molecule ekhishwe esiswini evumela ukumuncwa kwe-vitamin B12 emathunjini amancane ngokuyibophezela kuyo (bona umdwebo). Ukuze ukubopha phakathi kwento engaphakathi ne-B12 kwenzeke, kufanele kube nezinga elijwayelekile le-asidi esiswini. Lapho i-anemia ibangelwa ukuntuleka kwesici esingaphakathi, ibizwa kanjaloi-anemia eyingozi noma i-anemia ye-Biermer. Izici zofuzo bezingangenelela. 

• I-asidi ephansi esiswini. Amaphesenti angama-60% kuya ku-70% wevithamini B12 ku asebekhulile kungaba ngenxa yokushoda kwe-asidi esiswini¹. Ngokukhula, amangqamuzana esisu akhipha i-asidi yesisu encane kanye nesici esincane esingaphakathi. Ukudla okuvamile nokuhlala isikhathi eside kwe- izidakamizwa ama-antiacids³, njengama-histamine blockers (isb. i-ranitidine) kepha ikakhulukazi evela esigabeni sama-proton pump inhibitors (isb. omeprazole), futhi kwandisa ubungozi¹.
• Ukuthatha i-metformin. Abantu abathatha i-metformin, imvamisa ukwelapha isifo sikashukela, basengozini enkulu yokushoda kwevithamini B12⁴.

• Isifo se-Autoimmune (Isifo samathuna, i-thyroiditis, i-vitiligo, njll.): Kulezi zimo, ama-autoantibodies azobopha isici esingaphakathi, akwenze kungatholakali ukubopha uvithamini B12. 

• Izifo ezingapheli zamathumbu, evimbela ukudlula kukavithamini B12 odongeni lwamathumbu (ngokwesibonelo, isifo sikaCrohn, isifo sezilonda, noma isifo se-celiac). Ukuthatha izithasiselo zamavithamini kuvame ukuphakanyiswa udokotela ukuvikela ukusilela. Endabeni yesifo se-celiac, ukumuncwa kwe-vitamin B12 kubuyela kokujwayelekile lapho ukwamukelwa kokudla okungenayo i-gluten. Noma yisiphi esinye isifo esiholela ku-malabsorption, njenge-pancreatitis engapheli noma isifo se-parasite esingavamile kakhulu singabangela ukuntuleka kwe-vitamin B12.

• Ukuhlinzwa okuthile esiswini noma kwamathumbu amancane. Iziguli zithola ukwesekwa okuvimbela uvithamini B12.
  

  Ukushoda kwegazi nakho kungabangelwa i- ukuntuleka kukavithamini B12 in supply. Kepha lesi simo asijwayelekile, ngoba kuthatha amanani amancane we-B12 ukuhlangabezana nezidingo zomzimba. Ngaphezu kwalokho, lena inamandla okwenza izinqolobane ezibalulekile, ezinganela izidingo phakathi neminyaka emi-3 noma emi-4. Abalandeli bokudla imifino okuqinile (okubizwa nangokuthi veganism), ezingadli amaprotheni emvelaphi yezilwane, zingaba nenkinga yokushoda kwegazi, ngokuhamba kwesikhathi, uma zingahlangabezani nezidingo zazo ze-B12 (bheka i-Prevention). Ucwaningo lukhombisile ukuthi ama-vegans angama-92% entula uvithamini B12 uma engathathi ibhekwa, uma kuqhathaniswa no-11% wama-omnivores.⁵.

Evolution

THEi-vitamin B12 yokuntuleka kwe-anemia isetha ngokunensa, ngobuqili. Kodwa-ke, le anemia ingelashwa ngokushesha futhi kalula. Kusukela ezinsukwini zokuqala zokwelashwa, izimpawu ziyancipha. Kungakapheli amasonto ambalwa, ukushoda kungalungiswa.

Kodwa-ke, kubalulekile ukwelapha lolu hlobo lwe-anemia, ngoba eminyakeni edlule, izimpawu zemizwa kungavela (ukuba ndikindiki nokushosheka emaphethelweni, ukuphazamiseka kokuhamba, ukushintsha kwemizwelo, ukucindezeleka, isifo sengqondo, izimpawu zesifo sokuwohloka komqondo, njll.). Lezi zimpawu zithatha isikhathi eside ukuthi zinyamalale (kwesinye isikhathi izinyanga eziyisithupha noma ngaphezulu). Kwesinye isikhathi kusekhona ama-sequelae.

Abantu abane-anemia eyingozi nabo basengozini ethe xaxa yezicubu zesisu kunabo bonke abantu.

kwesifo

THEi-anemia ebangelwa ukuntuleka kwe-B12 kungatholakala ngokuhlolwa kwegazi okuhlukahlukene. Okungajwayelekile okulandelayo kuyizimpawu:

• ukwehla kwenani lamaseli abomvu, amaseli amhlophe egazi nama-platelets;
• ukwehla kwe-hematocrit, okungukuthi ivolumu ehlala amangqamuzana abomvu egazi ahlobene nalelo gazi;
• izinga le-hemoglobin elehlisiwe;
• usayizi owandisiwe wamaseli abomvu egazi (kusho ivolumu ye-globular noma i-MCV): ingahle ihlale izinzile uma i-anemia yokushoda kwe-iron (ukuntuleka kwensimbi) ikhona;
• ushintsho ekubukeni kwamaseli abomvu egazi namaseli amhlophe egazi, okungabonakala ngokuhlola i-smear yegazi.
• Kungaba nokushoda kukavithamini B12 ngaphandle kwegazi.

Udokotela ubuye ahlole amazinga kavithamini B12, folic acid kanye nensimbi egazini. Kumele futhi sithole imbangela yokushoda kwegazi. Uma kutholakala ukuntuleka kwe-vitamin B12, kuvame ukwenziwa ukuhlolwa kwama-autoantibodies wangaphakathi.