Samuel is a 63 yr old single man who works full-time in a food processing plant. Has a history of esophageal cancer, that was treated successfully with anti-cancer drugs and surgery 4 yrs ago. His weight was stable at 135 lbs, until the last 6 months, in which he has involuntarily lost 10 lbs. He's 67" tall and his BMI is 19.5. Complains of a poor appetite, being overly weak, tired, cracks in the corner of mouth and a chronic sore throat which concerns him due to his history. His diet is fairly consistent, states he rarely eats breakfast because he starts work at 6 am. Eats two deli sandwiches " usually pastrami and salami" and drinks a soda at 10 am. He often prepares frozen dinners or pizza at home in the evening and routinely drinks 4-5 beers before bed. He occasionally eats roast and mashed potatoes, milk with cereal and rarely eats fruits and veggies. He would like to know which vitamin supplement will give him energy.
-Discuss the difference among anemias associated with B vitamin deficiency states. Why is it potentially difficult to diagnose B complex vitamin deficiency state?