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Vitamin B12 Mangel – Ursachen und Symptome

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Wer kann von einem Vitamin B12 Mangel betroffen sein?

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Wenn weniger Vitamine aufgenommen werden, als benötigt, können wichtige Stoffwechselprozesse nicht mehr reibungslos ablaufen. Ein Mangel kann durch eine einseitige Ernährung entstehen ( vegane Kost ), aber auch bei erhöhtem Bedarf, wie in der Schwangerschaft oder während der Stillzeit. Mit einer ausgewogenen vegetarischen Kost, mit Eiern und Milchprodukten, kann so ein Vitamin B12 Mangel eigentlich vermieden werden. Da Vitamin B12 aber lange im Körper gespeichert wird, kann man eine Unterversorgung oft erst nach einigen Jahren feststellen.

Es leiden geschätzt vier bis fünf Prozent der Bevölkerung an Vitamin B12 Mangel.

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Risikogruppen für einen Vitamin B12-Mangel:

1. Alkoholiker
2. Schwangere
3. Säuglinge
4. Personen über 60

Ein Vitamin B12 Mangel kann aber auch bei Personen auftreten, …

1. … die streng vegetarisch oder vegan leben.
2. … die an Chronisch atrophischer Gastritis oder Magenteilresektion leiden ( Intrinsic Factor ).
3. … die unter einer Aufnahmestörung im Darm leiden ( z. B. eine chronische Entzündung des Darms ).
4. … denen ein Teil des Dünndarms operativ entfernt wurde.
5. … die jahrelang Medikamente einnehmen, welche die Magensäure hemmen (z.B. Omeprazol)

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Was sind die Symptome eines Vitamin B12 Mangels?

Vitamin B12 ist für die verschiedensten Abläufe im Körper zuständig. Dazu zählen die Nervenfunktionen, die Zellteilung und die Blutbildung. Die Symptome können sich bei den Augen, Haaren, Nerven und bei der Muskulatur bemerkbar machen. Das wohl erste Symptom ist aber die Blutarmut (Anämie).

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Woran lassen sich Vitamin B12-Mangelerscheinungen erkennen?

Die sehr lange Speicherfähigkeit des Vitamin B12 in Leber und Nieren, die die Evolution geschaffen hat, deutet bereits darauf hin, welch hohe Bedeutung Cobalamin für den gesamten Stoffwechsel hat. Die lange Speicherfähigkeit ermöglicht es uns, über längere Zeit die Körperreserven zu mobilisieren.

[box type=“info“]Allerdings ist es so, dass sich bereits weit vor der völligen Erschöpfung der Reserven erste unspezifische Mangelerscheinungen zeigen, weil beispielsweise der Energie- und der Fettstoffwechsel nicht mehr einwandfrei funktionieren und sich Funktionsstörungen an den Nerven bemerkbar machen.[/box]

Typische Symptome, die auf sich leerende Vitamin B12 Speicher hindeuten können, betreffen vor allem den Energiestoffwechsel, das Immunsystem und Nervenstörungen im sensorischen Bereich und in der Psyche:

Energiestoffwechsel; schnelle Ermüdung und Konzentrationsschwäche nach kurzer körperlicher oder geistiger Anstrengung
Blutarmut; führt zu körperlicher und geistiger Leistungsschwäche und schwächt das Immunsystem
Nerven; Funktionsstörungen lösen Kribbeln, Muskelschwäche, Taubheit, Lähmungen, Schmerzen aus und Schwächung der Schutzreflexe
Zellteilungen; Probleme mit Haut und Schleimhäuten stellen sich ein
Immunsystem; häufige Infektionen und Entzündungen, Nahrungsmittelunverträglichkeiten, Autoimmunreaktionen
Magen-Darm-Trakt; chronische Verdauungsbeschwerden, Verstopfung und Durchfall
Psyche; Störungen im Bereich Hormone und Neurotransmitter können Depressionen, Migräne, Stimmungsschwankungen und Psychosen verursachen

Nach neueren Erkenntnissen wird ein B12-Mangel auch mit Neuropathien und Demenz in Verbindung gebracht.

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Wie kann es zum Vitamin B12-Mangel kommen?

Ein Vitamin B12 Mangel bleibt aufgrund der zunächst unspezifischen Symptome meist unentdeckt oder wird fehlinterpretiert. Nur in eher seltenen Fällen wird die Unterversorgung durch mangelnde Zufuhr über die Nahrung verursacht. Allerdings steigt die Gefahr bei älteren Menschen und bei vorwiegend vegetarischer und besonders bei veganer Ernährung, weil rein pflanzliche Nahrungsmittel nur Spuren von Vitamin B12 enthalten. Wesentlich häufiger liegt die Ursache des Vitaminmangels in einem erhöhten Bedarf oder in einer gestörten Aufnahme und Resorption im Darm.

Ein erhöhter Bedarf an Vitamin B12 stellt sich natürlicherweise bei Schwangeren und bei stillenden Müttern ein. Risikogruppen mit erhöhtem „Verbrauch“ an Cobalamin sind aber auch starke Raucher, Alkoholiker und Patienten, die beispielsweise an Blutarmut (Anämie) oder an neurologischen Störungen leiden. In vielen Fällen können auch bestimmte Medikamente, die zur Reduzierung der Magensäure eingenommen werden, als unerwünschte Nebenwirkungen zu einem erhöhten Bedarf an Vitamin B12 führen.

Eine weitere Möglichkeit, die eine B12 Hypovitaminose verursachen kann, ist eine gestörte Aufnahme und Resorption des Cobalamins im Darm. Chronische Entzündungen im Darm oder häufiger Durchfall reichen bereits aus, den Vitamin B1 Haushalt gehörig zu beeinträchtigen. Für die Aufnahme des Cobalamins durch die Darmschleimhaut wird ein bestimmtes Glykoprotein, der sogenannte Intrinsic Factor (IF) benötigt, das von bestimmten Magenzellen synthetisiert wird. Eine geringfügige Störung in der Synthetisierung des IF führt zu gravierenden Auswirkungen auf den Vitamin B12 Haushalt mit der Folge einer Unterversorgung mit Vitamin B12, obwohl eine normalerweise ausreichende Menge über die Nahrung zugeführt wird.

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Weitere Symptome und Mangel-Erscheinungen:

1. Taubheitsgefühle auf der Haut
2. Muskelschwäche
3. Appetitlosigkeit
4. Müdigkeit, Konzentrationsschwäche, Gedächtnisschwäche
5. Brennen auf der Zunge
6. Kopfschmerzen, Migräne
7. Eingerissene Mundwinkel
8. Depressionen
9. Koordinationsstörungen sowie Gangunsicherheit
10. Haarausfall
11. Degeneration des Sehnervs
12. Zellteilungsstörungen in Haut und Schleimhaut
13. Allergien
14. Bei Säuglinge können (schwere) Entwicklungsstörungen auftreten

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Welche Vitamin B12-Präparate gibt es?

Vitamin B12 Präparate unterscheiden sich hinsichtlich Zusammensetzung ihrer Wirkstoffe, ihrer Dosierung und hinsichtlich ihrer Darreichungsform. Die Wirkstoffe, die angeboten werden, sind die natürlich vorkommenden Varianten des Vitamins in Form von Methylcobalamin, Adenosylcobalamin und Hydroxocobalamin.

[box type=“warning“]In vielen besonders preisgünstigen Produkten wird als synthetischer Wirkstoff Cyanocobalamin verwendet, das natürlich nur in sehr geringen Mengen vorkommt. Die angebotenen Dosierungen reichen von niedriger Dosierung (3 bis 50 Mikrogramm) über eine mittlere und erhöhte Dosierung bis zu hochdosierten Präparaten, die 500 bis 3.000 Mikrogramm Cobalamin pro dargebotener Einheit.[/box]

Es sind auch Präparate mit einem Gehalt von über 3.000 Mikrogramm, sogenannte Megadosen, verfügbar. Die gebräuchlichsten Darreichungsformen sind Kapseln, Tabletten/Lutschtabletten oder Tropfen/Spray und Injektionen. Der Vorteil von Lutschtabletten, Tropfen und Sprays liegt in der Möglichkeit der Aufnahme des Wirkstoffes durch die Mundschleimhaut unter der Zunge (sublingual), wodurch die Aufnahme über die Darmschleimhaut umgangen wird. Das ist besonders von Vorteil, wenn die Resorption im Darm gestört ist.

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Was sollte man beim Kauf von Vitamin B12-Präparaten beachten?

Vor dem Kauf eines Vitamin B12 Präparates empfiehlt es sich, über einen MMA-UrinVergleich den zellulären Status des Vitamin B Komplex festzustellen, um einen Anhaltswert für die mögliche Dosierung des Präparates zu erhalten. Darüber hinaus sollten die Ursachen für den Vitaminmangel festgestellt werden, da beispielsweise bei Vorliegen einer Aufnahmestörung im Darm nur sublingual nutzbare Präparate oder Injektionen, mit denen die sonst notwendige Aufnahme im Darm umgangen werden kann, eine Lösung des Problems der Hypovitaminose erreichen können. Vitamin B12 Vergleich.

Last but not least spielt die Zusammensetzung der Wirkstoffe eine Rolle. Ideal ist für alle Darreichungsformen ein Gemisch aus dem direkt verwertbaren Methylcobalamin und dem Hydroxocobalamin, das vom Stoffwechsel bei Bedarf direkt gespeichert oder in wenigen Schritten in die bioaktive Form überführt wird. Grundsätzlich ist es empfehlenswert, von Cyanocobalamin, dem synthetischen Vitamin B Komplex Abstand zu nehmen, da es kaum natürlich vorkommt und erst vom Körperstoffwechsel in mehreren Schritten in die aktive Form überführt werden muss.

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Lebensmittel mit Vitamin B12

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100 Gramm Austern enthalten 14 Mikrogramm Vitamin B12. Die „Königin der Muscheln“ hat unter der Schale einiges zu bieten. Viele Vitamine und Mineralstoffe wie Vitamin A, B-Vitamine, Vitamin D, E sowie Eisen, Kalium und Calcium vorhanden.

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2 Mikrogramm Vitamin B12 sind in einem Eigelb enthalten. Neben Vitamin B12 sind auch viele andere wichtige Inhaltsstoffe enthalten.

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100 Gramm körniger Frischkäse enthalten 2 Mikrogramm Vitamin B12. Alle Vitamin B12 Lieferanten sind tierischen Ursprungs. Deswegen haben Veganer es besonders schwer an Vitamin B12 zu kommen. Vegetarier haben es da ein wenig einfacher, da sie Eier und Milchprodukte zu sich nehmen können und sich dadurch mit Vitamin B12 versorgen. Der Hüttenkäse ist fettarm, enthält wenig Kalorien, aber dafür viel gesundes Eiweiß.

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100 Gramm Emmentaler liefern 2,2 Mikrogramm Vitamin B12. Milchprodukte wie Käse können mit Fisch und Fleisch nicht mithalten, sind aber trotzdem gute Lieferanten für B-Vitamine. Die Werte von Tilsiter und Butterkäse ähneln denen von Emmentaler.

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100 Gramm Rindfleisch enthält 5 Mikrogramm Vitamin B12. In Rinderleber sind sogar 65 Mikrogramm enthalten. Ein normal großes Rinderfilet reicht aus, den Tagesbedarf an Vitamin B12 zu decken. Vitamin B12 ist dazu wasserlöslich und so kann keine Überdosierung stattfinden, da überschüssiges Vitamin B12 einfach ausgeschieden wird.

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200 Milliliter Milch (1 Glas) liefern circa 0,6 Mikrogramm Vitamin B12. 100 Gramm Kefir und Joghurt enthalten 0,5 Mikrogramm Vitamin B12. Milchprodukte sind auch in Hinsicht zu Vitaminen und anderen Mineralien eine gute Wahl.

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100 Gramm Lachs liefert 2,9 Mikrogramm Vitamin B12. Vitamin B 12 ist in tierischen Lebensmittel vorhanden. Das in Lachs hochwertige Eiweiß, liefert auch wertvolle Aminosäuren, die der Körper in körpereigenes Eiweiß umwandeln kann.

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In 100 Gramm Parmesan sind 2 Mikrogramm Vitamin B12 vorhanden. Auch wie bei Emmentaler und anderen Käsesorten ist Parmesan ein guter Vitamin B12 Lieferant, den man gerne über seine Nudeln streuen kann.

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