Kungani i-B12 Ibalulekile Kwabesifazane Abakhulelwe

Ukukhulelwa kunikeza ithuba elijulile lokukhulisa impilo efanele, hhayi kuphela yomntwana okhulayo kodwa futhi nomuntu othwele umntwana. Izinto zokudla okhethiwe zidlala indima ebalulekile kulo msebenzi, ngoba zingathinta inhlalakahle yomntwana impilo yakhe yonke. Phakathi kwabantu abaningi abadingekayo ekukhuleni kwembungu okunempilo, i-vitamin B12 kwabesifazane abakhulelwe isizuze ukunakwa okukhethekile ngenxa yomnikelo wayo ezindaweni eziningi emsebenzini wezinhlelo zemizwa, ekwakhekeni kwamaseli egazi abomvu, nasekuhlanganisweni kwe-DNA. Nakuba le vithamini ivame ukuhlotshaniswa nokuguqulwa kwamandla omzimba kanye nempilo yamathambo emizwa, ukubaluleka kwayo ngesikhathi sokukhulelwa kudlula le mibono ejwayelekile. Ukucubungula okulandelayo kungena ngokujulile emibonweni eyisisekelo ehlobene ne-B12, kuhlanganisa yonke into kusukela emithonjeni yokudla nasezinhlelweni zokuthatha izithasiselo kuya ekusebenzeni kwansuku zonke kokuhlanganisa le vithamini ebalulekile ohlelweni oluphelele lokunakekelwa kwangaphambi kokubeletha. Ngokuhlola lezi zihloko ngokuningiliziwe, omama abakhulelwe nochwepheshe bezempilo bangathatha izinqumo ezinolwazi, beqinisekisa ukuphepha nokusebenza kahle lapho befaka le nto ebalulekile ohlelweni olubanzi lokuphila kahle ngesikhathi sokukhulelwa.

Ngesikhathi sonke sokukhulelwa, izidingo zokusebenza komzimba ziyakhula, kubonisa inqubo enamandla yokwakheka kwezicubu zembungu. Ama-micronutrients abalulekile—njengezivithamini, amaminerali, nama-antioxidants—ndawonye asiza ukulungiselela ukukhula okunempilo. Idatha yakamuva iphakamisa ukuthi abesifazane abaneminyaka yokuzala bavame ukubhekana nezinselele ekufinyeleleni izinga lokudla elinconyiwe lamanye ama-nutrient, ikakhulukazi i-B12. Ngenkathi imifino emisha, amaprotheni angenamafutha, nezinhlanga eziphelele zivame ukuba seqhulwini uma kukhulunywa ngokudla kwangaphambi kokubeletha, ukukhathazeka ngama-vitamin B12 ngesikhathi sokukhulelwa kubalulekile ngokulinganayo. Lokhu kungenxa yokuthi i-B12 isiza ekwakhekeni kwe-myelin, into ebalulekile ekusebenzeni kahle kwemizwa. Amazinga anele futhi akhuthaza ukukhiqizwa okuqinile kwamaseli egazi abomvu, okuvumela umoya-mpilo ukuthi ujikeleze kahle, okuyinto ebaluleke kakhulu ekusekeleni umbungu okhulayo [1].

Abantu abaningi bacabanga ukuthi ukudla okulinganisekile ngokwemvelo kunikeza zonke izivithamini ezidingekayo ekuthwaleni umntwana. Nokho, izindlela zokuphila zesimanje zingaphazamisa ukutholwa kwama-nutrient abalulekile. Izinto ezinjengokuzikhawulela ekudleni, izifo zohlelo lokugaya ukudla, noma ezinye izinhlobo zofuzo ezingajwayelekile zingavimba ukumuncwa kahle kwalena vithamini. Ngenxa yalokhu, amasu aqondiswe ngqo, aqaphela lezi zinselele ezihlukile, angaba yingxenye ebalulekile ekuthuthukiseni imiphumela engcono yezempilo. Nakuba izinhlobo ezahlukene zokudla ziqukethe i-B12, ukuthembela kuphela emithonjeni yokudla kungahle kungabi kwanele kwesinye isikhathi, ikakhulukazi ezimeni lapho imikhuba yokudla esekelwe kakhulu ezitshalweni ibusa. Ukubhekana nale mininingwane ngokuhlela kahle nangokwelulekwa uchwepheshe kubeka isisekelo semiphumela engcono yokukhulelwa.

Indima Ye-B12 Ekuthuthukisweni Kwembungu

Ngesikhathi sokukhulelwa, ukuthuthukiswa kwembungu kuncike ekusebenzisaneni okuyinkimbinkimbi kwama-nutrient, kanti i-B12 ithatha indawo evelele. Uma amazinga ale vithamini enganele, kungavela ukungavaleki kahle komgogodla (neural tube defects), ukwehluleka kwengqondo, noma ezinye izinkinga ezihlobene nohlelo lwezinzwa. Ngokuphambene nalokho, ukufinyelela izidingo ezelulekiwe kuvame ukuhlobana nokwakheka okuqinile kwengqondo, usayizi ofanele wobuchopho, nokuvuthwa okunempilo komgogodla. Njengoba ukukhula kokuqala kobuchopho kukha isisekelo sokufunda nokuziphatha komntwana esikhathini esizayo, ukuqinisekisa ukunikezwa okwanele kwalena nto ngesikhathi sokukhulelwa kugcizelela indlela esebenzayo yokuvikela inhlalakahle yesikhathi eside.

Izinto okufanele zicatshangelwe mayelana ne-vitamin B12 ngesikhathi sokukhulelwa ziphinda ziveze ukubaluleka kokudla okulinganiselayo. I-Folate, i-ayoni, ne-choline zisebenzisana ne-B12 ukuhlela ukukhiqizwa kwamaseli egazi abomvu, ukuhlanganiswa kwama-neurotransmitter, nokuphindaphindwa kwe-DNA. Ngokuhlanganisa kahle lezi zinto ezibalulekile, omama abakhulelwe bangasiza ukudala indawo esekelayo yezicubu, izicubu, nezitho zombungu. Ukuhlela ngokucophelela ukuthathwa kwama-nutrient kubaluleke kakhulu ikakhulukazi esikhathini sokuqala nasesesibili sokukhulelwa, lapho umbungu eba nezinguquko ezisheshayo ekuthuthukisweni. Kulawa mazinga abucayi, ukushoda okuncane kokudla kungaba nomthelela omkhulu emiphumeleni. Ukuqonda lolu hlelo lwesikhathi kunika odokotela nabazali ithuba lokuhlela kahle, bacabange ukuthi izithasiselo noma izinguquko ekudleni zingazuza yini ibanga lokukhulelwa [2].

Izimpawu Ezingase Zibonise Ukushoda

Izimpawu ezithambile eziningi zingase zibonise isidingo sokuhlola amazinga e-B12 kabanzi. Lezi zingahluka zisuke ekukhathaleni okungapheli nasemuzwa wokuba ndikindiki ezithweni kuya ekuguquguqukeni kwemizwa nasezinkingeni zokuhambisana. I-B12 ngesikhathi sokukhulelwa ibalulekile ngoba lezi zimpawu zingase zibhekwe njengokungakhululeki okuvamile kokukhulelwa kodwa zibe zibonisa ukushoda okuyisisekelo. Ezimweni ezimbi kakhulu, ukungenele kahle kwalena nutrient kungase kube negalelo ekubeni ne-anemia, okunciphisa ukunikezwa komoya-mpilo emzimbeni wonke. Lokhu kungalimaza impilo yomama, kuholele esiyezi noma ekukhathaleni okukhulu, futhi kubeke engozini nempilo yembungu [3].

Ukubhekana nalezi zinkinga kusenesikhathi kunganciphisa ezinye izinkinga. Ngokwesibonelo, ukuthola ukuthi une-B12 ephansi ngesikhathi sokukhulelwa kungase kuholele ekwenzeni ukuhlolwa kwegazi noma ezinye izivivinyo ukuze kutholwe kahle ukuthi ukuphi ukushoda. Ukungenelela kusenesikhathi kuzuza kokubili unina nombungu, kunciphisa ingozi yokukhubazeka ohlelweni lwezinzwa noma ekusebenzeni komzimba (metabolism). Ukuhlolwa okuphelele kwezempilo kungaveza ukuthi izici zendlela yokuphila—njengokulandela ukudla kwe-vegetarian noma vegan—zithinta yini le miphumela. Ngokwazi izici zomuntu eziwubungozi nezimpawu, umuntu angakwazi ukwenza izinguquko ezicacile ukuze enze ngcono ukuthathwa kwama-nutrient ngesikhathi esifanele sohambo lokukhulelwa.

Imithombo Yokudla Nokumuncwa Komzimba

Nakuba ukuthatha ama-nutrient ekudleni kusalokhu kuyindlela esemqoka yokuvimbela ukushoda, akuwona wonke amafutha okudla anikeza inani elifanayo le-B12. Imithombo evelele kakhulu ifaka inyama, inhlanzi, amaqanda, nemikhiqizo yobisi. Kulabo abalandela ukudla kwe-vegan noma kwe-vegetarian, ama-cereal afakwe izivithamini, ubisi lwezitshalo, kanye ne-nutritional yeast kungaba kubalulekile. Nokho, lezi zingase zinikeze inani elincane noma zinikeze izinhlobo ezimuncwa kancane umzimba. Ngenxa yalokho, ucwaningo nge-B12 nokukhulelwa luyaqaphela ukubaluleka kokuhlola izindlela zokupheka, ngoba ukushisa ngokweqile kunganciphisa okuqukethwe kwalenza nutrient kokunye ukudla [4].

Indima Yezithasiselo

Labo abacabanga ngokusebenzisa izithasiselo bangase bazibuze, “ingabe ungathatha i-B12 ngesikhathi ukhulelwe?” Ezimweni eziningi, impendulo ithi yebo, kodwa isimo somuntu ngamunye sidinga iseluleko soqeqeshiwe. Odokotela banganikeza imininingwane ngezibalo zemithamo, imvamisa yokusebenzisa, kanye nohlobo lwe-supplement olungcono kakhulu ngokuya ngesimo somuntu. Umbuzo othi, “ingabe i-B12 iphephile ngesikhathi sokukhulelwa?” uvame ukuvela kulezi zingxoxo, uveza isidingo sokucacisa ngemiphumela engemihle engase ibe khona noma amazinga obuthi. Ngokuvamile, ukusebenzisa izinga eliphakathi nezithasiselo ngaphansi kokuqondisa kochwepheshe kuletha ingozi encane kakhulu. Noma kunjalo, izingxoxo mayelana nezidingo zamanye ama-nutrient—njenge-ayoni, folate, noma i-vitamin D—zingabaluleka ukuze kuqinisekiswe indlela elinganiselayo.

Uma uphinde unentshisekelo yokuthi izithasiselo zingase zikusize kanjani empilweni yonke ngesikhathi sokukhulelwa, ungase uthole kuwusizo i-athikili yethu ethi ama-multivitamin kwabanesifo sikashukela ukuze uqonde ukuthi angahambisana kanjani nohlelo lwakho lokunakekela impilo.

Ukusebenzisana Okungenzeka Nezinto Okufanele Zicatshangelwe

Kuyinto ejwayelekile ukuzibuza, “ngingayithatha i-B12 ngesikhathi ngikhulelwe uma sengivele ngisebenzisa ama-vitamin angaphambi kokubeletha?” Nempela, ama-vitamin amaningi angaphambi kokubeletha afaka i-B12, kodwa izinga lawo liyahluka kakhulu. Ngenxa yalokhu, ukufunda amalebuli ngokucophelela kuyasiza. Omama abakhulelwe abanezimo zezempilo ezifana ne-pernicious anemia noma izinkinga zokumuncwa kokudla ohlelweni lokugaya bangase badinge imithi ekhethekile yokujova i-B12 noma imithamo ephakeme ngomlomo. Odokotela bavame ukuqinisekisa amazinga okuqala kanye nomlando wezempilo ngaphambi kokuncoma i-supplement eyengeziwe ngaphezu kohlelo olujwayelekile lwama-vitamin angaphambi kokubeletha.

Abanye nabo bayazibuza, ingabe i-B12 iphephile ngesikhathi sokukhulelwa uma ithathwa kanye nezinye izivithamini noma amaminerali? Ngokuvamile, ukusetshenziswa okulinganiselayo kubhekwa njengokuvumelekile. Nokho, ukudlula ngaphezulu izinjongo zansuku zonke ngokuhlanganisa imikhiqizo eminingi yezithasiselo kungavusa ukukhathazeka ngokungalingani okungenzeka. Ngokufanayo, ukusebenzisana kwamaphilisi athile—njengewalabo abanezifo zoshukela noma izinkinga zamafinyila esiswini (acid reflux)—kungase kuthinte izinga lokumuncwa. Nakuba ukushoda kwe-B12 kudinga ukulungiswa ngokushesha, ukuqinisekisa ukuvumelana phakathi kwezingxenye ezahlukene zohlelo lwezithasiselo kuhlala kubalulekile. Izingxoxo ezinemininingwane nochwepheshe bezempilo, kanye nokuhlolwa okuhleliwe ngezikhathi ezithile, kwakha umsizi oyinhloko wesu lokunakekelwa kokukhulelwa elihleleke kahle [5].

Ukuthuthukisa Inhlalakahle Kanina

I-B12 ngesikhathi sokukhulelwa ayithinti nje kuphela impilo yembungu kodwa futhi nenhlalakahle kanina. Ukuthatha inani elanele kungasiza ukugcina amazinga wamandla azinzile, kusekele ukucaca kwengqondo, futhi kunciphise amathuba e-anemia. Ukunqoba ukukhathala okuncane noma “inkungu yengqondo” kungaletha umehluko omkhulu emisebenzini yansuku zonke nasemizweni. Ukubhekana nokushoda okungenzeka kusenesikhathi kunganciphisa ingozi yezinkinga ezimbi kakhulu esikhathini esizayo, kunikeze umama amandla amaningi okubhekana nezinselele zemvelo zokukhulelwa.

Abantu abahlangabezana nokukhathala okuqhubekayo noma umuzwa wokuba ndikindiki ongapheli bangase bazibuze, imiphi imiphumela emibi ye-vitamin B12 ngesikhathi sokukhulelwa—ingabe kukhona okufanele bakukhathazelele? Ngokuvamile, imiphumela engemihle ehlobene nokuthatha i-B12 ayivamile futhi imnene, futhi ivamise ukunqotshwa yizingozi ezingase zidalwe ukushoda. Noma kunjalo, umthamo ophezulu kakhulu ngezikhathi ezithile ungase ubangele ukuphazamiseka emathunjini noma ukungakhululeki. Ukugcina ingxoxo evulekile nochwepheshe bezempilo kungasiza ukuphatha noma yiziphi izimpendulo ezingalindelekile ekusebenziseni izithasiselo noma ekwenzeni izinguquko ekudleni. Amazinga alinganiselayo e-B12 angaletha umehluko omkhulu hhayi ngokomzimba kuphela, kodwa nangokomzwelo, ngokukhuthaza umuzwa wamandla nokuphila kahle.

Kulabo abahlangabezana nokuhlanza noma isicanucanu esingapheli ngesikhathi sokukhulelwa, ungase uthole ukukhululeka ku-vitamin B6 yokusiza i-morning sickness, i-nutrient eyaziwayo ngendima yayo ekunciphiseni isicanucanu esihlobene nokukhulelwa.

Imibono Ebalulekile Evela Ocwaningweni Lwakamuva

Ucwaningo oluqhubekayo luqhubeka lukhanyisa izinguquko neziphetho ezihlobene ne-vitamin B12 ngesikhathi sokukhulelwa. Ama-cohort amakhulu abonise ukuhlobana phakathi kwesimo se-B12 sikanina nokusebenza kwengqondo kwezingane, okuqinisa ukubaluleka kwamasu okudla aqinile. Ukutholwa kusenesikhathi kokushoda ngokuhlolwa kwegazi kusalokhu kuyindlela ejwayelekile ekuskeneni kwangaphambi kokubeletha. Odokotela bangase bacele ukuthi kubuyekezwe kabusha isimo se-B12 uma ezinye izimpawu noma imiphumela yamalabhorethri zivusa ukukhathazeka.

Amathiphu Asebenzayo Nesiqondiso

Ukuthuthukisa indlela yomuntu siqu yokuthatha i-B12 kudinga okungaphezu kokumane ugwinye i-supplement. Ngaphezu kwalokho, ukulindela imibuzo efana nokuthi “ingabe i-vitamin B12 ilungile ngesikhathi sokukhulelwa?” kugcizelela ukubaluleka kwemithombo yolwazi ethembekile, okuhlanganisa odokotela bokudla abaqinisekisiwe nochwepheshe bezokwelapha abakhethekile ekunakekelweni kukamama. Laba nochwepheshe bangakwazi ukuqinisekisa ucwaningo lwamanje, batusa imikhiqizo yezithasiselo ethembekile, futhi balungise imiyalelo yemithamo. Lolu qondiso oluhleliwe lususa ukucatshula, luhlanganise ukuthathwa kwe-B12 nezinye izinto ezibalulekile zangaphambi kokubeletha njengokuphuza amanzi anele, imikhuba yokuzivocavoca emnene, nezivakashi ezijwayelekile kudokotela wokubelethisa.

Inani Lezinhlelo Zokudla Ezihlanganisayo

Abesifazane abaningi bagxila ku-folate, i-ayoni, ne-calcium uma sebethola ukuthi bakhulelwe, kwesinye isikhathi bekhohlwa umbuzo othi ingabe ungathatha i-B12 kanye nama-vitamin angaphambi kokubeletha ndawonye. Ngokuvamile, ukuhlanganisa i-B12 ema-vitamin angaphambi kokubeletha nokudla okulinganiselayo nezithasiselo eziqondiswe kahle kuyenzeka futhi kunganikeza izinzuzo ezinkulu. Nokho, ukufunda amalebuli omkhiqizo ngokucophelela kuqinisekisa inani eliqondile lawo wonke ama-nutrient. Lokhu kuvimbela ukuthatha kabili ngengozi uma i-vitamin yangaphambi kokubeletha isivele iqukethe amazinga aphezulu e-B12.

I-B12 Yangaphambi Kokubeletha Nezibono Ezisanda Kuvela

Indawo yezempilo yanamuhla iyaqhubeka nokuzivumelanisa njengoba okutholakele okusha kwakha imikhuba emihle kwezokubelethisa. “I-B12 ema-vitamin angaphambi kokubeletha” kungase kuzwakale kulula, kodwa izinhlobo eziningi zemikhiqizo zikhona, ezinokwakheka okuhlukene okuthinta ukutholakala kwalenza nutrient. Ochwepheshe bezempilo ngokuya besebenzisa ukubaluleka kwe-B12 yangaphambi kokubeletha njengengxenye yesu elihlangene lokunakekela ukukhulelwa, okuveza intshukumo ebanzi eya ekunakekelweni kwezempilo komuntu ngamunye okusekelwe ebufakazini. Ngokuhlanganisa okutholakele kwesayensi ngama-micronutrient nombono onolwazi wemikhuba yokudla, indlela yanamuhla yokudla ngesikhathi sokukhulelwa ikhuthaza ibhalansi nokuvimbela izinkinga.

Into Ebalulekile Ekugcineni

Ngenkathi ukuqonda kwesayensi kuqhubeka kujula, ukuqinisekisa amazinga anele e-B12 kumuntu okhulelwe kungaletha izinzuzo zesikhathi eside kumama nomntwana. Kungaba ngokudla, ngezithasiselo, noma inhlanganisela yalokhu kokubili, ukuhlela isimo esiqinile sokudla kusiza ukweseka izinqubo ezibalulekile zomzimba. Ukubhekana nemibuzo kusenesikhathi—kusukela ku- “ngingayithatha i-B12 ngesikhathi ngikhulelwe?” kuya ku- “ingabe i-B12 iphephile ngesikhathi sokukhulelwa?”—kubeka isisekelo sokuthatha izinqumo ngokuzethemba. Uhambo lokuya empilweni engcono ngesikhathi sokukhulelwa lubandakanya imfundo eqhubekayo, ukubambisana okuvulekile nochwepheshe bezempilo, nokucabangisisa ngendlela yokudla. Ngokubheka yonke into ndawonye, omama bangakwazi ukuqinisa isizukulwane esilandelayo kusukela ekuqaleni. Ngokwenza kanjalo, babonisa ukubaluleka okuhlala njalo kwe-B12 kubantu abakhulelwe abafuna ukunikeza izingane zabo ukuqala impilo okungcono kakhulu.

Izinkomba

1. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US); 1998. Available from: https://www.ncbi.nlm.nih.gov/books/NBK114310/ doi: 10.17226/6015
2. Rufenacht P, Mach-Pascual S, Iten A. Hypovitaminose E12: challenge diagnostique et thérapeutique [Vitamin B12 deficiency: a challenging diagnosis and treatment]. Rev Med Suisse. 2008 Oct 15;4(175):2212-4, 2216-7. French. PMID: 19024576.
3. García-Casal MN, Osorio C, Landaeta M, Leets I, Matus P, Fazzino F, Marcos E. High prevalence of folic acid and vitamin B12 deficiencies in infants, children, adolescents and pregnant women in Venezuela. Eur J Clin Nutr. 2005 Sep;59(9):1064-70. doi: 10.1038/sj.ejcn.1602212. PMID: 16015269.
4. Cuskelly GJ, Mooney KM, Young IS. Folate and vitamin B12: friendly or enemy nutrients for the elderly. Proc Nutr Soc. 2007 Nov;66(4):548-58. doi: 10.1017/S0029665107005873. PMID: 17961276.
5. Cruz-Rodríguez J, Díaz-López A, Canals-Sans J, Arija V. Maternal Vitamin B12 Status during Pregnancy and Early Infant Neurodevelopment: The ECLIPSES Study. Nutrients. 2023 Mar 22;15(6):1529. doi: 10.3390/nu15061529. PMID: 36986259; PMCID: PMC10051123.