Vitamin B12, or Cobalamin, is the largest and most complex vitamin currently known to man. It is an essential Vitamin for the body to work correctly. It helps make DNA, nerve and red blood cells. It’s also crucial for healthy brain and immune system and the running of your metabolism. We cannot make it ourselves and Vitamin B12 (B12) is only found in animal products.
Symptoms and Signs of Vitamin B12 Deficiency
There are many symptoms that can indicate a lack of B12. These include:
- Weakness and fatigue – red blood cell production is affected leaving us with fewer larger and inefficient cells. Red cells carry oxygen, so we may feel heavy-limbed, confused and weak.
- A lack of energy or lethargy
- Being out of breath
- Feeling faint
- Headache
- Tinnitus
- Memory loss, disorientation and difficulty thinking and reasoning – which may resemble dementia.
- Tingling, weakness and balance issues – due to nerve damage from B12 deficiency.
- Pale / yellowing of the skin, mouth ulcers, a red and swollen shiny tongue.
Deficiency can be difficult to recognise as the body can store B12 for 2-4 years, and the symptoms and signs usually appear gradually so you are unlikely to notice them.
Immune System Issues
B12 plays a vital role in white blood cell production which is essential for proper immune system functioning. Lack of B12 can lower your immunity, but if you have an immune system disorder this can lower your B12.
Pernicious Anaemia
If B12 deficiency is high it may be due to an autoimmune condition that causes a lack of intrinsic factor in the stomach that’s needed to absorb B12. Known as Pernicious Anaemia, it is more common in women over 60 and those with a family history of autoimmune conditions.
Causes of Vitamin B12 Deficiency:
- Vegetarians and Vegans are at risk. If you have a baby, they may also be B12 deficient.
- Adults over 50 – as we age our stomach produces less stomach acid – which is key for B12 absorption. 1 in 10 people over 75 will be affected.
- Taking heartburn medication – that suppresses the production of stomach acid (proton pump inhibitors). If you have been taking these for over 2 years you may have a 65% higher risk of B12 deficiency. (Examples include: Omeprazole, Lansoprazole, Esomeprazole, Pantoprazole and Rabeprazole Sodium)
- Taking birth control pills
- Alcohol – not only can drinking irritate the stomach lining leading to reduced B12 absorption, as B12 is stored in the liver alcohol can impair liver function and deplete B12 stores or make it harder for the liver to use it.
- Digestive problems – this may affect the absorption of the vitamin. Crohn’s disease, inflammatory bowel disease, leaky gut syndrome, coeliac disease.
- Taking Metformin – prescribed for people with type 2 diabetes or polycystic ovary syndrome
Recommended Dietary Allowance and Foods:
The best natural sources are:
- Shellfish
- Beef liver
- Fish (mackerel, salmon and sardines)
- Crab
- Red meat
- Dairy
- Cheese
- Eggs
- Fortified soy products
- Fortified cereals
Fortified food and supplements can help.
As B12 is a water-soluble vitamin your body only absorbs a small amount, it is hard to overdo B12. If you do, you may have diarrhoea and all-over itchiness.
The UK recommends adults (19-64 years) 1.5mcg per day. (It is higher in the USA.) If you eat the above foods daily you should get enough from your diet.
If you are deficient or vegetarian, then you can take supplements and injections may be prescribed by your GP if you are severely B12 deficient.
If you have any of the above symptoms, signs or causes, please contact you GP. A blood test is the only way to confirm your B12 levels.