A Case Study Highlights the Importance of B12 Testing in Diagnosing and Treating Mental Health Conditions
In a recent case report, a 13-year-old boy initially diagnosed with acute schizophrenia-like psychotic disorder underwent a series of treatments that failed to improve his condition. It wasn’t until doctors identified a severe vitamin B12 deficiency that the patient’s symptoms began to resolve. This case raises critical questions about the standard diagnostic and treatment protocols for neuropsychiatric disorders and emphasizes the need for comprehensive testing, including vitamin B12 levels.
HCN Medical Memo
This case serves as a cautionary tale about the importance of comprehensive diagnostic testing for neuropsychiatric disorders. Before reaching for the prescription pad, consider the potential underlying causes that could be contributing to a patient’s symptoms, such as vitamin B12 deficiency. A simple blood test could lead to more effective and less invasive treatments, improving patient outcomes and potentially reducing healthcare costs.
- The 13-year-old patient was initially diagnosed with “acute schizophrenia-like psychotic disorder” and treated with a combination of four drugs, including lorazepam and olanzapine.
- Despite medication, the patient’s condition worsened, leading to a revised diagnosis of “schizoaffective disorder, manic type.”
- A test for vitamin B12 levels revealed a severe deficiency, with levels at 112 ng/mL, far below the normal range of 180–914 ng/mL.
- After receiving vitamin B12 injections, the patient’s symptoms resolved, and he was able to taper off medications.
The level of 180 ng/mL is associated with the most severe manifestation of B12 deficiency—pernicious anemia—and in Japan and some European countries, a level of 500–550 ng/mL is associated with psychological and behavioral manifestations such as dementia and memory loss.
- Vitamin B12 deficiency is associated with a wide range of psychological disorders, including depression, memory loss, and violent behavior.
- B12 is primarily found in animal products, and its absorption can be compromised by various factors, including a low-salt diet and lack of certain enzymes.
- Traditional diets in regions like southern India provided natural sources of B12, but modernization has reduced these sources, increasing the risk of deficiency.
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