From the Guidelines
Vitamin B12 deficiency and malabsorption are associated with various medical conditions that can cause delayed periods, including pernicious anemia, celiac disease, and autoimmune disorders like thyroid dysfunction, which can be treated with hydroxocobalamin 1 mg intramuscularly every 2-3 months lifelong after initial treatment 1. These conditions can lead to menstrual irregularities due to the crucial role of B12 in DNA synthesis, red blood cell formation, and nervous system function.
- Pernicious anemia is a condition where the body cannot absorb B12 due to lack of intrinsic factor, leading to deficiency and potential menstrual disturbances.
- Celiac disease and Crohn's disease are intestinal disorders that impair nutrient absorption, including B12, and can cause menstrual irregularities.
- Autoimmune disorders like hypothyroidism can also contribute to B12 malabsorption and menstrual irregularities. Treatment of underlying conditions and B12 supplementation are essential to address these issues, with hydroxocobalamin 1 mg intramuscularly every 2-3 months lifelong being a recommended maintenance treatment after initial treatment 1. It is crucial to seek urgent specialist advice from neurologist and haematologist if there is possible neurological involvement, such as unexplained sensory and/or motor and gait symptoms 1. Dietary changes to include B12-rich foods like meat, fish, eggs, and dairy products are also recommended to help manage B12 deficiency and related menstrual disturbances.
From the Research
Medical Conditions Associated with B12 Deficiency/Malabsorption
- Vitamin B12 deficiency can cause megaloblastic anemia, various neuropsychiatric symptoms, and other clinical manifestations 2
- Subclinical deficiency can affect between 2.5% and 26% of the general population, with elderly individuals and those with restricted dietary intake of B12-containing animal-derived foods being at high risk 3
- B12 deficiency can masquerade as a multitude of illnesses, presenting different perspectives from the point of view of the hematologist, neurologist, gastroenterologist, general physician, or dietician 4
Delayed Periods and B12 Deficiency
- Vitamin B12 deficiency has been linked to infertility and recurrent fetal loss, with hypercoagulability due to raised homocysteine levels potentially leading to fetal loss 5
- A more prolonged deficiency may result in infertility by causing changes in ovulation or development of the ovum or changes leading to defective implantation 5
- There is evidence to suggest that B12 deficiency can affect menstrual cycles, although the exact relationship between B12 deficiency and delayed periods is not fully understood 5
Other Medical Conditions Associated with B12 Deficiency
- B12 deficiency can affect the blood, bone marrow, and nervous system, leading to megaloblastic anemia, cognitive impairment, and psychosis 6
- Malabsorption and defects in cellular delivery and uptake, as well as limited dietary intake, can cause B12 deficiency 6
- B12 deficiency can be caused by various factors, including gastric or small intestine resections, inflammatory bowel disease, use of certain medications, and vegan or strict vegetarian diets 2