Iyi fomu yeanemia inoitika nekuda kwekushayikwa kwevhitamini B12 (cobalamin). Vitamin B12 yakakosha pakuumbwa kwemasero matsvuku eropa, kunyanya. Iyi anemia inoumba zvishoma nezvishoma, mushure memwedzi kana makore ekushayikwa kwevhitamini. The vakwegura ndivo vanonyanya kukanganiswa: vanenge 12% vavo vanonzi vari kutambura nekushaikwa kwevhitamini iyi, pasina hazvo kuve neanemia.¹.

Vitamin B12 inowanikwa nekudya chikafu yekwakabva mhuka, senyama, mazai, hove nehove. Kune vanhu vazhinji, chikafu chinopa muviri B12 yakawanda kupfuura yaunoda. Iyo yakawandisa inochengetwa muchiropa. Zvinokwanisika kutambura neanemia kubva pakushayikwa kweB12 muzvokudya, asi hazviwanzoitiki. Kazhinji, anemia inokonzerwa nedambudzikoabsorption yevhitamini.

THEyakaipa anemia zvingakanganisa 2% kusvika 4% yehuwandu hwevanhu². Inonyanya kucherechedzwa zvishoma nekuti zviratidzo hazviwanzo kuoneka kuti zvionekwe.

Zvinokonzera

Kusagona kuita zvakanaka tora vhitamini B12 iri muchikafu: chikonzero ichi ndicho chakajairika. Heano zvinhu zvikuru zvinogona kutungamira mukunyura kwakashata.

• Kushaya intrinsic factor. Intrinsic factor imorekuru rakavanzwa mudumbu rinobvumira kutorwa kwevhitamini B12 muura hudiki nekusunga kwairi (ona dhairekitori). Kuti kusunga pakati pemukati memuviri neB12 zviitike, panofanira kunge paine dhigirii yakajairika yeasidhi mudumbu. Kana anemia inokonzerwa nekushaikwa kwemukati memukati, inonziyakaipa anemia kana kuti Biermer's anemia. Genetic factors dzaizopindira. 

• Low acidity mudumbu. 60% kusvika 70% yevhitamini B12 kushomeka mukati vakwegura zvingave zvichikonzerwa nekushaikwa kwegastric acidity¹. Nezera, maseru emudumbu anoburitsa acid shoma yemudumbu uye zvakare shoma intrinsic factor. Nguva dzose uye kwenguva refu kutora kwe Pharmaceuticals antacids³, senge histamine blockers (eg ranitidine) asi kunyanya kubva mukirasi yeproton pump inhibitors (eg omeprazole), inowedzerawo njodzi.¹.
• Kutora metformin. Vanhu vanotora metformin, kazhinji kurapa chirwere cheshuga, vari panjodzi huru yekushaikwa kwevhitamini B12⁴.

• Autoimmune chirwere (Chirwere cheGraves, thyroiditis, vitiligo, nezvimwewo): muzviitiko izvi, autoantibodies ichasunga iyo intrinsic factor, zvichiita kuti isawanikwe kusunga vhitamini B12. 

• Chirwere chebowel chisingaperi, iyo inodzivirira kupfuura kwevhitamini B12 kuburikidza nemadziro emukati (somuenzaniso, chirwere cheCrohn, ulcerative colitis, kana chirwere chechiliac). Kutora vhitamini yekuwedzera inowanzokurudzirwa nachiremba kudzivirira kukanganisa. Muchiitiko chechirwere chechiliac, kunwa kwevhitamini B12 kunodzokera kune yakajairika kana chikafu chisina gluten chagamuchirwa. Chero chero chimwe chirwere chinotungamira ku malabsorption, senge chisingaperi pancreatitis kana kashoma kwazvo parasite infestation inogona kukonzera kushomeka kwevhitamini B12.

• Kumwe kuvhiyiwa kwemudumbu kana ura hudiki. Varwere vanogamuchira kudzivirira vhitamini B12 supplementation.
  

  Anemia inogonawo kukonzerwa nea kushayikwa kwevhitamini B12 in zvitengeswa. Asi mamiriro ezvinhu aya haawanzo, sezvo zvinongotora zvishoma zvishoma zveB12 kuzadzisa zvinodiwa nemuviri. Pamusoro pezvo, iyi ine simba rekuita matura akakosha, ayo anogona kukwana kune zvinodiwa mukati memakore matatu kana mana. Vateveri veiyo yakasimba vegetarianism (inonziwo veganism), iyo isingadyi mapuroteni emhuka yakabva, inogona kutambura neanemia, nekufamba kwenguva, kana isingasviki zvido zvavo zveB12 (ona Kudzivirira). Tsvagiridzo yakaratidza kuti 92% yemavegan haina vhitamini B12 kana ikasatora chekuwedzera, zvichienzaniswa ne11% yemaomnivores.⁵.

kushanduka

THEvhitamini B12 kushomeka kupererwa neropa inopinda mukati zvishoma nezvishoma, insidiously. Zvisinei, anemia iyi inogona kurapwa nokukurumidza uye nyore. Kubva pamazuva ekutanga ekurapa, zviratidzo zvinopera. Mumavhiki mashomanana, kuperevedza kunogona kugadziriswa kazhinji.

Nekudaro, zvakakosha kurapa rudzi urwu rweanemia, nekuti nekufamba kwemakore, mitsipa zviratidzo inogona kuoneka (chiveve uye kurira mumigumo, gait kuvhiringidzika, kushanduka kwemafungiro, kuora mwoyo, psychosis, zviratidzo zvekuora mwoyo, nezvimwewo). Zviratidzo izvi zvinotora nguva yakareba kuti zvipere (dzimwe nguva mwedzi mitanhatu kana kupfuura). Dzimwe nguva pane sequelae.

Vanhu vane pernicious anemia vari zvakare panjodzi shoma yemamota emudumbu kupfuura vamwe vanhu vese.

chirwere

THEanemia inokonzerwa nekushaya B12 inogona kuonekwa nekuongororwa kweropa kwakasiyana-siyana. Zvinotevera abnormalities zviratidzo:

• kuderera kwenhamba yemasero matsvuku eropa, masero machena eropa uye maplatelet;
• kuderera kwehematocrit, kureva kuwanda kwemasero matsvuku eropa maererano neropa;
• kuderera kwe hemoglobin level;
• kuwedzera kukura kwemasero matsvuku eropa (kureva globular volume kana MCV): inogona zvakadaro kuramba yakagadzikana kana iron inoshaya anemia (iron deficiency) iripowo;
• kuchinja pakuonekwa kwemasero matsvuku eropa uye masero machena eropa, izvo zvinogona kuonekwa nekuongorora smear yeropa.
• Panogona kuve nekushaikwa kwevhitamini B12 pasina anemia.

Chiremba anotarisawo huwandu hwevhitamini B12, folic acid uye iron muropa. Tinofanirawo kutsvaga chikonzero cheanemia. Kana kushaikwa kwevhitamini B12 kukaonekwa, kuongororwa kwemukati memuviri autoantibodies kunowanzoitwa.