The woman's paranoia turned out to be a vitamin B12 deficiency

Recently, a 62-year-old female breakfast shop owner was accompanied by her daughter to the Department of Neurology for a consultation. She complained that her personality had gradually and continuously deteriorated over the past year. The female patient became irritable and forgetful. She immediately forgot the breakfast that the customer had just ordered and asked the customer to order again, which annoyed the customer. After closing the stall, the patient became suspicious and thought that her family and customers were stealing her things, and even that someone was trying to harm her. As these strange behaviors became more and more serious, her family was worried that she was being cursed. Taking her to ask gods for help was ineffective, so they "took" the patient to the hospital for treatment.

Brain lesions and neurobehavioral symptoms caused by vitamin B12 deficiency are best treated within the golden period of one year.

Lin Zhiyuan, attending physician of the Department of Neurology at the Yang-Ming Branch of Taipei Municipal United Hospital, pointed out that after taking the medical history and physical examination, it was found that the patient was originally a gentle and compassionate elder who took good care of his family and daughter-in-law, had good living habits, and had no risk factors for common cardiovascular diseases. Because the patient met the diagnosis of dementia, he was carefully inquired about the possible causes of dementia and found that the patient had been a vegetarian for about 30 years. Therefore, the doctor confirmed through blood tests that the patient was suffering from vitamin B12 deficiency.

After the doctor explained in detail and told the patient that it was just a "nutritional injection", the patient became less resistant to the treatment. After three months of follow-up treatment, the patient was able to go to the hospital on his own. Lin Zhiyuan said that vitamin B12 plays a very important role in the development and maintenance of the nervous system and needs to be effectively absorbed in the acidic gastrointestinal tract. In recent years, vitamin B12 deficiency is not a rare disease. In the past, it was common in patients who had been vegetarians for a long time and had undergone gastrectomy. In recent years, the healthy eating habits of vegetarians have been promoted, and various stomach medicines and antacids are widely used in the National Health Insurance era. Taking stomach medicines leads to insufficient stomach acid, which makes it impossible to effectively absorb vitamin B12, resulting in an increasing number of cases of vitamin B12 deficiency.

The best treatment method currently is regular intramuscular injections of vitamin B12. The reason is that patients are often elderly and have the habit of taking stomach medicine. If they take vitamin B12 orally, they will not be able to effectively digest and absorb the vitamin B12 in their stomach due to insufficient stomach acid.

Lin Zhiyuan reminded the public that according to literature reports, brain lesions and neurobehavioral symptoms caused by vitamin B12 deficiency are best treated within the golden period of one year. At the same time, if the following 10 warning signs of dementia are present, it is recommended to seek medical attention from a neurology department as soon as possible in order to detect possible vitamin B12 deficiency or other causes of dementia early and receive treatment early.

10 warning signs of dementia:

1. Memory loss, affecting work: forgetfulness frequency increases, and the memory cannot be recalled even when reminded.

2. Unable to perform familiar tasks: such as an English teacher who cannot remember simple words.

3. Problems with verbal expression: Use alternative ways to explain vocabulary, such as "used for writing" instead of "pen".

4. Loss of concept of time and place: Can’t tell day from night, getting lost around home.

5. Poor judgment, decreased alertness: Taking more than a day's worth of medication at one time.

6. Difficulty with abstract thinking: problems with daily operations such as using the remote control.

7. Things are placed in a disorderly manner: such as putting fruits in the closet and clothes in the refrigerator.

8. Behavioral mood changes: Unexplained mood changes.

9. Personality changes: becoming suspicious, talking without thinking, or being overly extroverted, etc.

10. Loss of activity and creativity: becoming passive and losing interest in hobbies.

《Source/Taiwan Alzheimer's Association》