Mr P receives a GP notification of a vitamin deficiency likely contributing to recurrent mouth ulcers and neurological symptoms such as pins and needles. Which vitamin deficiency is most likely responsible?

Mr P receives a GP notification of a vitamin deficiency likely contributing to recurrent mouth ulcers and neurological symptoms such as pins and needles. Which vitamin deficiency is most likely responsible?

• A. Vitamin A
• B. Vitamin C
• C. Vitamin B6
• D. Vitamin B12

Answer: (D)

Neurological symptoms like pins and needles plus recurrent mouth ulcers point to a deficiency of a vitamin that is essential for both nerve health and rapidly dividing mucosal cells. Vitamin B12 (cobalamin) fits this pattern because it is required for proper myelin formation in nerves and for DNA synthesis in rapidly renewing tissues such as the oral mucosa. When B12 is deficient, nerves become damaged, causing peripheral neuropathy and paresthesias, while mucosal tissues can become fragile and develop ulcers or glossitis. This combination is characteristic of B12 deficiency, often seen with pernicious anemia or malabsorption. The other vitamins don’t explain both findings as well: A deficiency mainly affects vision and skin/immune health; C deficiency causes gum disease and poor wound healing but not neuropathy; B6 deficiency can cause neuropathy and mucosal changes but the classic pairing of neuro symptoms with mouth ulcers points more specifically to B12.

Neurological symptoms like pins and needles plus recurrent mouth ulcers point to a deficiency of a vitamin that is essential for both nerve health and rapidly dividing mucosal cells. Vitamin B12 (cobalamin) fits this pattern because it is required for proper myelin formation in nerves and for DNA synthesis in rapidly renewing tissues such as the oral mucosa. When B12 is deficient, nerves become damaged, causing peripheral neuropathy and paresthesias, while mucosal tissues can become fragile and develop ulcers or glossitis. This combination is characteristic of B12 deficiency, often seen with pernicious anemia or malabsorption. The other vitamins don’t explain both findings as well: A deficiency mainly affects vision and skin/immune health; C deficiency causes gum disease and poor wound healing but not neuropathy; B6 deficiency can cause neuropathy and mucosal changes but the classic pairing of neuro symptoms with mouth ulcers points more specifically to B12.