Ngā tohu o te korenga huaora B12: te āhua, ngā take me ngā whakamātautau

Ko te huaora B12 (cobalamin) e hiahiatia ana hei hanga pūtau toto whero ora, hei pupuri hoki i te mahi tika a ngā io (nerves), te roro me te io tuaiwi (spinal cord). Kāore e taea e te tinana te hanga: ka ahu mai i ngā kai kararehe pērā i te miraka, te miraka tepe (yoghurt), te tīhi, ngā hēki, te mīti me te ika, ā, i ngā kai kua tāpirihia he B12 (fortified).

Kia ngongia ai te B12, ka hangaia e te puku tētahi pūmua ko intrinsic factor te ingoa, kātahi ka ngongia te B12 ki te pito o te whēkau iti. Ki te raru tētahi wāhi o taua ara, ki te iti rawa rānei te B12 i te kai, ka puta pea te korenga.

Ka penapena te tinana i te B12 mō ētahi tau ki te ate, nō reira i te nuinga o te wā ka āta piki haere ngā tohu i roto i ngā marama, ngā tau rānei. Koia te take he māmā te whakapae i te iti o te B12 nā te pakeke, nā te āwangawanga, nā te pukumahi rānei.

• Te kai: he iti, kāore rānei he kai kararehe e kainga ana. Ko te hunga kai huawhenua (vegetarians) e iti ana te kai miraka, me te hunga vegan kāore e kai i ngā kai fortified, i tētahi tāpiri (supplement) rānei, he nui ake tō rātou tūraru. I Īnia, he tokomaha te hunga kai huawhenua, ā, he noa te iti o te B12.
• Pernicious anaemia: he mate autoimmune ka mutu ai te hanga a te tinana i te intrinsic factor, nō reira kāore rawa e taea te ngongo i te B12 mai i te kai.
• Ngā mate o te puku me te whēkau: te atrophic gastritis, te mate coeliac, te mate Crohn's, me ngā hāparapara i te puku, i te whēkau rānei, tae atu ki te maha o ngā hāparapara whakaheke taumaha.
• Ngā rongoā: te tango roa i te metformin (mō te mate huka) me ngā rongoā whakaiti waikawa pērā i ngā proton pump inhibitors (omeprazole me ērā e rite ana) me ngā H2 blockers, tae atu ki ētahi atu kua whakaingoatia i ngā aratohu a NICE. Kaua e whakamutu i tētahi rongoā nā tēnei: pātai ki tō rata mō te whakamātautau B12.
• Te pakeke: ka heke te ngongo i te B12 i te pakeke haere, nō reira he nui ake te tūpono ka iti te B12 o ngā kaumātua.
• Te nitrous oxide hei whakangahau ("laughing gas", "whippets"), ka whakakorehia e ia te mahi a te B12, ā, ka taea e ia te whakakino rawa i ngā io ahakoa he pai te āhua o ngā taumata toto.

He āta puta mai ngā tohu i te nuinga o te wā, ā, kāore e pā katoa ki te katoa.

Ngā tohu toto (anaemia): te ngenge, te kore kaha, te poto o te hā, te tere o te manawa, ngā mamae upoko, te kiri koma, kōwhai paku rānei. Nā te iti rawa o ngā pūtau toto whero ora ēnei.

Ngā tohu io: te kakati (pins and needles), te kore rongo, te wera rānei i ngā ringa me ngā waewae, te ngoikore o ngā uaua, te koretake o ngā nekehanga, te ngoikore o te tauritenga, te tūrorirori o te hīkoi rānei, ā, i ētahi wā, he raruraru kitenga. Ka puta pea ēnei i mua i te kitenga o te anaemia i tētahi whakamātautau toto.

Te hinengaro me te ngākau: te ngoikore o te mahara, te uaua o te whakaaro mārama, te pukuriri, te ngākau pōuri, te māharahara rānei, ā, ki te tino kino, te rangirua.

Te waha: he arero mamae, whero, māeneene (glossitis) me ngā tunga i te waha.

Te mea nui: ka tino ora anō te anaemia nā te iti o te B12 i te maimoatanga i te nuinga o te wā, engari ka noho pūmau pea te kino o ngā io ki te whakaroatia te maimoatanga. He take ngā tohu io kia whakamātauria wawetia koe, kaua ā tōna wā.

• Te hunga kai huawhenua me te hunga vegan, otirā te hunga e iti ana te kai miraka, hēki rānei, kāore hoki e kai i ngā kai fortified.
• Ngā kaumātua, i te mea ka heke te ngongo i te pakeke haere.
• Te hunga e tango ana i te metformin, i ngā rongoā whakaiti waikawa rānei, mō te wā roa.
• Te hunga he pernicious anaemia, he mate autoimmune kē atu rānei (pērā i te mate repe tenga, te mate huka momo 1 rānei), he mate coeliac, Crohn's rānei, he hāparapara puku, whēkau rānei i mua.
• Te hapūtanga me te whāngai ū: ka taea e te whaea he iti te B12 te tuku i te korenga ki tana pēpi. Ka māuiui pea ngā pēpi a ngā whaea vegan, kai huawhenua rānei he iti te B12, nō reira he mea nui te B12 i mua i te hapūtanga, i te wā hapū hoki.
• Te hunga e whakamahi ana i te nitrous oxide hei whakangahau.

Mā te whakamātautau toto e whakatau, i te nuinga o te wā me te tatauranga toto katoa (CBC), te ferritin (ngā rahui rino) me te folate.

Ko te aratohu NICE o te UK (2024) e tuku ana i ēnei paepae mō te whakamātautau B12 tuatahi, me te kī ka whakarite pea ngā taiwhanga i ō rātou ake:

Ko te 1 ng/L he ōrite ki te 1 pg/mL, te waeine e whakamahia ana e te maha o ngā pūrongo. Mēnā he hua korenga pea (kāore anō kia mārama) me ētahi tohu, ka whakamātau pea ngā rata i te methylmalonic acid (MMA), ka piki ina iti te B12 o te tinana.

I te CBC, he maha ngā wā ka kitea ngā pūtau whero nunui (MCV teitei) ina iti te B12. Ko te iti o te rino te tauaro, ā, ki te pā ngā mea e rua, ka āhua noa pea te MCV. Tirohia tā mātou aratohu CBC me tā mātou aratohu ferritin mō te tikanga o aua hua.

Ka rerekē pea te hua i ngā pire B12, ngā werohanga, ngā tāpiri rānei i tangohia tata nei, nō reira kōrerotia ki te rata, ki te taiwhanga rānei mēnā e tango ana koe i ētahi.

• Ka whai te maimoatanga i te take. Ka hoatu e ngā rata te B12 hei werohanga, hei pire rānei; ki te kore e taea e te whēkau te ngongo i te B12 (pērā i te pernicious anaemia), ko ngā werohanga te nuinga o te wā e hiahiatia ana, ā, mō te roanga o te ora i te nuinga o te wā. Mā tō rata e whakatau te momo me te auau.
• Ka maimoatia wawetia ngā tohu io, ā, ko te wawe o te tīmata o te maimoatanga, ko te pai ake o te tūpono kia tino ora anō.
• Kaua e tango i te folic acid anake mō te anaemia ki te kore he whakamātautau B12: ka pai ake pea te tatauranga toto, engari ka haere tonu te kino o ngā io nā te iti o te B12.
• Kainga ngā kai B12 mēnā ka taea: te miraka, te miraka tepe, te tīhi, ngā hēki, te ika me te mīti. Mēnā he vegan koe, he iti rānei tō kai miraka, kainga ngā kai fortified (ētahi miraka tipu, ētahi pata parakuihi, te nutritional yeast), tētahi tāpiri B12 rānei; ka āwhina tētahi kaiwhakarite rongoā (pharmacist) ki te kōwhiri.
• Kia mau tonu te tango i ngā rongoā kua tohua pērā i te metformin; engari pātai ki tō rata kia whakamātauria te B12.
• Whakamātauria anō e ai ki te tohutohu: ka whakahoki ngā rata i ngā whakamātautau toto i te nuinga o te wā kia kitea e whai hua ana te maimoatanga.