Tongue in b12 deficiency

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Tongue Manifestations in Vitamin B12 Deficiency

Vitamin B12, also known as cobalamin, is essential for various bodily functions, including DNA synthesis, RNA synthesis, and myelin production, particularly in the spinal cord. Deficiency in this crucial vitamin can lead to a range of neurological symptoms, some of which manifest in the tongue.

Tongue Fasciculations as an Early Sign of B12 Deficiency

Tongue fasciculations, which are visible, spontaneous, and intermittent contractions of muscle fibers, can be an early clinical sign of B12 deficiency. These fasciculations are often associated with motor neuron disorders like ALS but can also occur due to cobalamin deficiency. A case study highlighted a 40-year-old female presenting with progressive fatigue, dysphagia to liquids, and left-sided tongue fasciculations. Despite normal MRI and EMG/NCV results, her low B12 levels (222 pg/mL) confirmed the deficiency. Following B12 supplementation, her symptoms completely resolved within six months .

Lingual Linear Lesions (LLLs) and Severe B12 Deficiency

Lingual linear lesions (LLLs) are another significant oral manifestation of severe vitamin B12 deficiency. These lesions appear on the dorsum, lateral borders, and ventral surface of the tongue. A retrospective study involving 57 patients found that 98.25% of those with LLLs had severe B12 deficiency. The patients responded positively to cobalamin replacement therapy, further validating LLLs as a strong clinical indicator of severe B12 deficiency .

Conclusion

Tongue manifestations such as fasciculations and lingual linear lesions can be critical early indicators of vitamin B12 deficiency. Recognizing these signs can lead to timely diagnosis and treatment, preventing further neurological complications. Physicians should consider B12 deficiency in patients presenting with these specific tongue symptoms, even in the absence of other neurological findings.

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Most relevant research papers on this topic

Tongue Fasciculations Presenting as an Early Clinical Sign of Cobalamin Deficiency (5164)

Tongue fasciculations can be an early clinical sign of cobalamin deficiency, suggesting that physicians should consider it in patients with tongue fasciculations without other neurologic findings.

Case ReportRigorous Journal

2020·

0citations

·Anuradha Singhet al.

Neurology

Lingual Linear Lesions: A Clinical Sign Strongly Suggestive of Severe Vitamin B12 Deficiency.

Lingual linear lesions (LLLs) are a strong clinical sign strongly suggesting severe vitamin B12 deficiency, which can be effectively treated with cobalamin replacement therapy.

Observational Study

2020·

4citations

·Zhe-Xuan Baoet al.

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

Taste Disorder Caused by Vitamin B12 Deficiency

Vitamin B12 deficiency can cause taste disorders and tongue pain, and treating it with intramuscular vitamin B12 administration can improve symptoms and tongue appearance.

2020·

2citations

·B. Kanget al.

PDF

Vitamin B12 deficiency

Vitamin B12 deficiency affects individuals of all ages, particularly the elderly, and is caused by inadequate intake, bioavailability, or malabsorption, with management relying on B12 supplementation.

Highly Cited

2017·

463citations

·R. Greenet al.

Nature Reviews Disease Primers

Vitamin B12 deficiency

Vitamin B12 deficiency can lead to serious clinical consequences, and diagnosis and management require careful consideration of individual factors and dietary habits.

Systematic ReviewVery Rigorous JournalHighly Cited

2014·

232citations

·A. Huntet al.

BMJ : British Medical Journal

Oral signs and symptoms in patients with undiagnosed vitamin B12 deficiency.

Undiagnosed vitamin B12 deficiency can cause oral symptoms, including glossitis, stomatitis, and mucosal ulceration, without causing generalized symptoms or macrocytosis.

Case ReportHighly Cited

1995·

90citations

·E. Fieldet al.

Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology

Vitamin B12 deficiency induces glucose intolerance, delays peak insulin levels and promotes ketogenesis in female rats.

B12 deficiency in female rats leads to glucose intolerance, delayed peak insulin levels, and increased ketogenesis, potentially promoting the development of metabolic disorders like diabetes mellitus.

RCTAnimal StudyRigorous Journal

2022·

2citations

·Elliott S. Nealet al.

The Journal of endocrinology

Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency.

Oral vitamin B12 may be a more effective treatment for vitamin B12 deficiency than intramuscular vitamin B12, but more research is needed to confirm this.

Meta-AnalysisVery Rigorous Journal

2018·

53citations

·Haiyan Wanget al.

The Cochrane database of systematic reviews

PDF

Falsely elevated serum vitamin B12 levels in a case of pernicious anemia

Serum vitamin B12 levels can be falsely elevated in cases of pernicious anemia, causing misdiagnosis and potentially causing delayed treatment.

Case Report

2021·

0citations

·Edwin W. S. Thonget al.

Annals of Hematology

Vitamin B12 deficiency from the perspective of a practicing hematologist.

B12 deficiency can cause megaloblastic anemia and can be diagnosed using a combination of tests, with timely diagnosis being crucial for preventing neurological consequences.

Highly Cited

2017·

290citations

·R. Green

Blood

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