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Doctor Warns B12 Deficiency Can Take Up To Decade To Appear - Symptoms In 'early Stages'

"B12 is found in meat, fish, poultry, eggs and fortified dairy products," said Dr Lee.

"Only 50-60 percent of what is ingested is absorbed in the gut, via a special protein called Intrinsic Factor (IF)."

Dr Lee added: "There are no plant sources of B12, so vegans and vegetarians need to eat fortified foods such as cereals, two to three times a day.

"It is difficult to meet the B12 requirements and they are strongly advised to take B12 supplements if not ingesting enough B12 on a regular basis."


Understanding Newborn Jaundice

Newborn jaundice is when a baby's skin and eyes turn yellow from too much bilirubin. It usually resolves as their liver matures and they start feeding, but if it persists, there may be another cause.

In most cases, jaundice (also called hyperbilirubinemia) in newborns will disappear within 2 to 3 weeks.

The higher the bilirubin levels are, the more the baby is at risk for brain damage.

Bilirubin is a yellow pigment produced during the typical breakdown of red blood cells. In older babies and adults, the liver processes bilirubin, passing it through the intestinal tract. However, a newborn's still-developing liver may not be mature enough to do this.

There are two types of newborn jaundice: physiological and pathological.

Physiological jaundice is the most common, accounting for 75% of cases. This just means the baby's metabolism cannot clear out bilirubin as quickly as it is produced. This type typically develops in a few days and clears up on its own in a few weeks when the breakdown of red blood cells slows and liver function improves.

On the other hand, pathological jaundice means that there is another underlying condition that's causing a problem with filtering out bilirubin. This type may show up in the first 24 hours after birth.

Possible causes include:

Pathological jaundice can also be caused by certain medications, such as certain antibiotics.

The first sign of jaundice is the yellowing of a baby's skin and eyes, which may start in the face before spreading across the body. With physiological jaundice, the yellowing may begin and peak within 2 to 5 days after birth. With other causes, it may begin closer to birth.

However, this yellowing can be harder to see in darker skin tones. Another way to tell is by pressing your finger lightly on the baby's skin. The spot should briefly appear paler. If it looks more yellow, it's likely a sign of jaundice.

If you have concerns or are unsure, contact your baby's doctor, particularly if the whites of their eyes look yellow.

If untreated, severe newborn jaundiced can lead to acute bilirubin encephalopathy, which is caused by the toxic levels of bilirubin in the brain.

A baby may get a fever, act listless and lethargic, have a shrill cry, refuse to feed, and curve their neck and body backward. This can, in turn, progress to kernicterus, which is permanent brain damage.

In the United States, many hospitals discharge birthing parents and newborns after 24-48 hours before jaundice may become very apparent. If the baby has not developed jaundice within 72 hours of delivery, they're less likely to have the pathological form. But they can still develop the physiological form, leading to complications.

Once you're home, contact your doctor if you notice the following symptoms:

  • Jaundice spreads or becomes more intense.
  • Your baby develops a fever over 100°F (38°C).
  • Your baby's yellow coloring deepens.
  • Your baby feeds poorly, appears listless or lethargic, and makes high-pitched cries.
  • There are some things that can increase the chance of a newborn developing physiological jaundice.

    These include:

  • premature birth
  • history of newborn jaundice in siblings
  • being male assigned at birth (MAAB)
  • being of Asian descent
  • In addition, certain risk factors can increase your baby's chance of developing severe jaundice, which may be physiological or pathological. These include:

  • jaundice within 24 hours after birth
  • birth before 40 weeks, with the chance increasing the earlier the baby is born
  • treatment with phototherapy or a history of a sibling being treated with phototherapy for jaundice
  • family history of inherited red blood cell disorders such as G6PD deficiency
  • difficulty breastfeeding or chestfeeding
  • bruising on the head or scalp from the birth
  • having Down syndrome
  • Being born bigger than average for gestational age (macrosomia)
  • Though distinct yellow coloring confirms that a baby has jaundice, additional tests may be needed to determine the severity.

    Babies who develop jaundice will get a bilirubin blood test to determine the levels of bilirubin in their blood.

    Additional tests may be needed to see if a baby's jaundice is due to an underlying condition. This may include testing your baby for their complete blood count (CBC), blood type, and Rh incompatibility.

    Additionally, a Coombs test may be done to check for antibodies that show an elevated risk of increased red cell breakdown (hemolysis).

    Mild jaundice will usually resolve on its own as a baby's liver matures. Frequent feedings (at least 8 times a day) will help babies pass bilirubin through their bodies.

    More severe jaundice may require other treatments. Phototherapy (light therapy) is a common and highly effective method of treatment that uses light to break down bilirubin in your baby's body.

    In phototherapy, your baby will be placed on a special bed under a blue spectrum light while wearing only a diaper and special protective goggles. A fiber-optic blanket may also be placed underneath your baby.

    In very severe cases, an exchange transfusion may be necessary. In this procedure, a baby receives small amounts of blood from a donor or a blood bank.

    This replaces the baby's damaged blood with healthy red blood cells. This also increases the baby's red blood cell count and reduces bilirubin levels.

    In addition, if there's an underlying cause, the baby will need to be treated for the condition to resolve symptoms.

    Physiological jaundice can't be prevented. But you can reduce the chance of development by frequently feeding your newborn, which can help their bilirubin pass through the body more quickly.

    If you or your doctor thinks there is a likely underlying issue that could cause jaundice in your newborn, there are tests that can verify this so that you or the baby can get preventive treatment if appropriate.

    For example, during pregnancy, you can have your blood type tested to rule out the possibility of Rh incompatibility. If you're Rh-negative, you can get intravenous immunoglobulin during pregnancy.

    What does jaundice poop look like?

    Newborns that develop jaundice can have a pale-colored stool, but not often. Most newborns with jaundice will have the same color stool as newborns without jaundice. It may begin as black, dark brown, or dark green in the first few days, and then transition to yellow or orange-colored stool. For this reason, it can be hard to recognize jaundice from the stool color alone.

    What color is jaundice pee in newborns?

    A newborn with jaundice may have dark yellow urine. As you feed the baby, it should become colorless. Make sure your baby is having at least six diapers daily.

    What do babies' eyes look like with jaundice?

    In addition to the yellowing of the skin, jaundice also causes the yellowing of the white part of the eyes.

    Most cases of physiological newborn jaundice will clear away, often without treatment. Frequent feedings will help it resolve. But your doctor will still monitor your baby to make sure it is improving.

    The outlook of pathological jaundice depends on the underlying cause and what treatment the baby requires. In both cases, without immediate treatment, complications can begin to develop.

    The most recent guidelines by the American Academy of Pediatrics (AAP) recommend that all newborn babies be examined for jaundice at least every 12 hours after birth and until their discharge from the hospital


    All About Mononucleosis (mono)

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    Mononucleosis, infectious mononucleosis, or "mono," refers to a group of symptoms that can occur after infection with the Epstein-Barr virus (EBV). Also also known as glandular fever, symptoms include fatigue, a fever, and a sore throat.

    According to the Centers for Disease Control and Prevention (CDC), most people experience infection with EBV at some point in their lives. Many do not develop symptoms of mono, but they become carriers.

    Symptoms can vary between age groups. In young children, any symptoms that appear tend to be mild. In teenagers and young adults, however, they can be more severe.

    Here, learn more about the symptoms and treatment of mono.

    The classic symptoms of mono are:

    However, the symptoms vary widely between different age groups.

    Teens and young adults

    People aged 15–24 years are most likely to develop the classic symptoms of mono. They also tend to have the most severe symptoms.

    Symptoms often last 2–4 weeks, but they can persist for longer. Fever, sore throat, and other common symptoms may last for several days and then gradually get better.

    However, the tiredness can last for weeks or months after other symptoms have gone.

    Why symptoms affect teens and young adults more severely remains unclear.

    If kissing is a factor in spreading mono, it may be that the higher levels of saliva exchange lead to more severe symptoms.

    Another theory is that younger children gradually build up an immunity to the virus if exposure occurs from a lower age, as happens in some countries.

    In the United States, exposure to EBV is less common during infancy and young childhood. An adolescent with no previous exposure to the virus may be more vulnerable, as their immune system is less able to repel the attack.

    Young children

    Children often do not have classic symptoms, or they may have mild symptoms that resemble those of a common cold or the flu.

    It is unclear how they get the virus. One possiblity is that parents, as carriers, pass the virus on to their children when it reactivates and sheds. The amount of virus spread from a parent's past infection may be lower, causing fewer, milder symptoms in a child.

    If a child has mild mono symptoms, a parent may think this is a cold or flu, especially if fever and a sore throat are the main symptoms.

    Older adults

    A study from 2006 notes that mono is less common in adults aged over 40 years. Adults may not experience the classic symptoms of a red throat and swollen lymph nodes.

    Instead, liver problems may occur. A fever with liver inflammation can make mono harder to spot in this age group. Muscle aches may also be more common in this group, according to one older study.

    When to see a doctor

    Many illnesses cause fever and sore throat, particularly colds, flu, and common viruses.

    Mono can resemble other illnesses, so people should contact a doctor if they have concerns about symptoms that may indicate mono.

    Parents should call a doctor if a child:

  • shows unusual behavior
  • does not want to eat
  • has a severe headache or sore throat
  • has a rash
  • has a seizure
  • has a temperature of 104° Fahrenheit or above
  • shows signs of dehydration, such as not urinating
  • Those with symptoms of a ruptured spleen should seek emergency care immediately.

    Diagnosis

    In a teenager or young adult with classic symptoms, a doctor can usually diagnose mono through a physical examination.

    However, symptoms can be less obvious in younger children and older adults, so additional testing may be needed.

    Blood tests can identify whether or not a person has had a recent or past infection with EBV.

    Mono is a virus, so antibiotics cannot treat it.

    Doctors recommend managing symptoms through:

  • pain relievers and fever reducers, such as ibuprofen or acetaminophen, which is available to buy online.
  • salt water gargles for a sore throat
  • rest
  • avoiding sports until symptoms are gone
  • Infectious mononucleosis, also known as glandular fever, can emerge as a result of infection with EBV, or herpes virus 4.

    Mono refers to the symptoms of infection, and EBV is the most common cause.

    Many people are infected with EBV but never experience symptoms of mono, or the symptoms are very mild, and similar to those of another common illness, such as a cold or flu.

    Adolescents and young adults are most likely to have noticeable symptoms, and mono is common among college students.

    Even in a person with no symptoms, the virus can be active or reactivated at a later date. When it is active, symptoms may or may not appear, and the virus can be passed on to another person. This person may develop symptoms of mono.

    Once a person has experienced symptoms of mono, they are unlikely to have them again.

    While EBV is the most common cause of mono, other infections can cause mono symptoms.

    These include:

    Mono is often called the "kissing disease," but it is not only spread by kissing. Sharing drinks, toothbrushes, or a plate of food can spread it. It can also be passed on through breast milk, other bodily floods such as blood or semen, or through blood transfusions.

    The consquences are not usually serious, but the symptoms can be debilitating while they last, and it can take a long time to recover, especially from the fatigue.

    Risk factors

    The EBV virus, which causes mono, is most often spread through saliva.

    Many people contract the virus during childhood and never notice any symptoms. Once the virus enters the body, it stays there forever, and it can occasionally reactivate at a later time.

    The reactivated virus can spread to others through saliva, so a person can catch mono from someone who has no signs of illness.

    The following can increase the risk:

  • sharing drinks, toothbrushes, or anything that touches the mouth and saliva
  • sexual contact
  • having a blood transfusion
  • receiving a transplanted organ
  • A person whose immune system is compromised has a higher risk of:

  • developing symptoms on a first exposure to EBV
  • the virus reactivating and causing a second bout of mono
  • Mono is most common in teens and young adults. Most people will not have it a second time.

    The incubation period for mono is around 6 weeks.

    During this period, from the time of infection until symptoms appear, a person is contagious. They appear healthy, but they can spread mono to others.

    When symptoms emerge, they may be severe for a few days, then gradually get milder.

    Most people feel better after 2–4 weeks, but the fatigue can last for several weeks or months.

    Serious complications are rare, but 0.5% of people may experience a ruptured spleen. This can be fatal.

    Symptoms of a ruptured spleen include:

  • pain in the upper left abdomen
  • pain in the left shoulder that feels worse when breathing in
  • pain in the left chest area
  • a sudden drop in blood pressure, which may cause fainting, confusion, dizziness, or paleness
  • A blow to the abdomen near the spleen may cause a swollen spleen to rupture. For this reason, athletes should avoid contact sports for at least 3 to 4 weeks after getting mono.

    If mono causes liver problems, jaundice may occur. The whites of the eyes or the skin appear yellow. In most cases, the liver inflammation will improve on its own as the body clears the infection.

    In rare cases, mono can also cause:

  • blood problems such as anemia or low platelet counts
  • inflammation of the heart muscle
  • inflammation of the brain and spinal cord membranes, known as meningitis
  • encephalitis, or inflammation of the brain
  • Guillain-Barre syndrome
  • breathing problems due to swollen tonsils
  • These problems are rare. They are more likely in a person with a weakened immune system, due, for example, to HIV or AIDS, some kinds of cancer treatment, or having had an organ transplant.

    There is no proven way to prevent mono, but a few simple tips can help avoid it:

  • washing hands after using the bathroom and before eating
  • coughing or sneezing into a sleeve or tissue and washing hands afterward
  • avoiding people who have mono or symptoms of mono until they recover
  • staying home from work or school if you have symptoms
  • not sharing objects that come into contact with the mouth
  • Mono symptoms may interfere with life for several days or weeks, but most people recover without any long-term problems. Managing symptoms with self-care and rest is often the best way to deal with mono.






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