Vitamin B-12: Urology Treatment

Vitamin B-12, also called cobalamin, is a water-soluble vitamin. It plays key roles in the normal functioning of the brain and nervous system, and in the formation of blood.

The ileum (the end of the small intestine farthest from the stomach, also called the distal end) absorbs vitamin B-12 into your body. Sometimes, the ileum is used in reconstructive urologic surgeries—for example, for bladder reconstruction or to create a channel. When this is done, it can reduce your ability to absorb vitamin B-12. That can result in you having a low level—a deficiency—of vitamin B-12.

Vitamin B-12 deficiency can cause severe and irreversible damage, especially to the brain and nervous system. If your vitamin B-12 levels are lower than normal, you can experience a range of symptoms including fatigue, depression and poor memory.

Pernicious anemia, a metabolic disorder, also causes vitamin B-12 deficiency.

If you’ve had surgery that used your ileum for reconstructive urologic purposes, you should have a blood test to check your vitamin B-12 levels every year. 

• If your results show a vitamin B-12 level greater than 300pg/dl: Continue to have your vitamin B-12 checked every year.

• If your results show a vitamin B-12 level less than 300pg/dl: You’ll need additional blood tests and you’ll need to start vitamin B-12 replacement therapy.

  That means you’ll start taking an oral vitamin B-12 replacement. You’ll also need to check your vitamin B-12 level and have other lab tests done every 3-6 months.

It’s very important that you follow a management plan to monitor your vitamin B-12 level.

• Before you start treatment: You have blood work done for vitamin B-12 levels, folate, complete blood count (CBC), peripheral blood smear, reticulocyte count and iron levels.
• One month after treatment starts: You have blood work done for vitamin B-12 levels, CBC and peripheral blood smear.
• Every three to six months after treatment starts: You have blood work for vitamin B-12 levels, CBC and peripheral blood smear. 

You may have your blood work done by your primary health care provider or the lab of your choice. But you MUST make sure the provider doing the tests sends your results to the Gillette provider who will continue to monitor and manage your treatment.

Your vitamin B-12 deficiency management plan will depend on how your vitamin B-12 level responds to replacement therapy. Over time, you might need adjustments or changes to your treatment plan.