People’s Pharmacy: Vitamin B12 deficiency leads to memory problems and more

Q. I had five falls in 14 months and injured myself each time. Concerned about this, I went to a neurologist. In addition, my memory was shot, and I could not focus on anything.

He put me through several tests, including one for vitamin B12. I was very deficient, but I did not have pernicious anemia. To address the problem, he started me on weekly injections of B12.

That was more than two years ago, and we have switched to monthly injections. I have not fallen since that time, and I’ve regained my memory. I would like others to recognize that vitamin B12 deficiency is serious.

A. Vitamin B12 deficiency is more common than many people realize and can easily go unrecognized. Pernicious anemia, in which people lack “intrinsic factor,” is not the only cause.

Symptoms include balance and memory problems such as you experienced. Other complications include tingling in hands and feet, fatigue, heart palpitations, depression, shortness of breath and sore tongue.

Certain medicines, especially those that block stomach acid such as the PPIs, can contribute to vitamin B12 deficiency. The diabetes medicine metformin also can lower levels of vitamin B12. Moreover, people who don’t eat animal products don’t get this vitamin in their usual diet.

To learn more about this and other vitamin and mineral deficiencies that can be caused by common medications, you could consult Dr. Tieraona Low Dog’s book “Fortify Your Life: Your Guide to Vitamins, Minerals and More.” A paperback edition is available from peoplespharmacy.com.

Q. As a dairy farmer, I have to wash my hands many times daily. The cracked fingertips that result are very painful. To counter that, I keep a tube of lip balm (any kind) handy in my pocket and apply it often. It is very thick and stays in the crack to help it heal.

A. Many people have trouble with cracked fingertips at this time of year. Low humidity and frequent handwashing to ward off colds or the flu can contribute.

Some people close the cracks with liquid bandage or household instant glue containing cyanoacrylate. Not everyone is enthusiastic about such approaches, though. One reader offered the following:

“I’ve tried liquid bandage as well as white glue on my cracked fingertips, but they don’t help much. Nothing works as well as A+D Ointment for cracked thumb and fingertips as well as split skin on my knuckles and heels.

“I rub it in and give it five minutes to soak in. Although A+D Ointment is traditionally used on babies’ bottoms, it works great on adults, too, and it is inexpensive.”

A+D Original Ointment contains lanolin and petrolatum. An “inactive” ingredient, cod-liver oil, provides the vitamins A and D. Like other products containing petrolatum (petroleum jelly), it is greasy but effective.

Q. I have been taking losartan and amlodipine for about 10 years. My blood pressure is under control, but my anxiety and depression are not. For the first time in my life, I am thinking about suicide. I blamed stress, but I wonder whether the medicine could be contributing.

A. A study published in JAMA Network Open (Oct. 16) reported an association between ARBs (angiotensin receptor blockers) like losartan and a higher risk of suicide.

This will no doubt come as a surprise to many health professionals. However, depression is listed as a possible side effect in the official prescribing information.