Vitamins & Supplements

Vitamin B12 Deficiency: Symptoms and Causes

What is Vitamin B12?

Vitamin B12, also known as cobalamin, is a vital nutrient necessary for nerve function, DNA synthesis, and red blood cell formation. It’s found naturally in animal products like meat, fish, eggs, and dairy. Vitamin B12 deficiency occurs when levels of this vitamin are insufficient for optimal health. Symptoms include fatigue, weakness, numbness or tingling in the hands and feet, difficulty walking, memory loss, and mood disturbances. Deficiency can result from inadequate dietary intake, malabsorption disorders (like pernicious anemia), gastrointestinal surgery, or certain medications. Treatment often involves vitamin supplementation, dietary adjustments, or addressing underlying medical conditions causing the deficiency.

How Much Do You Need?

According to the Indian Council for Medical Research adult men and women need 2.2mg per day.

Food Sources of Vitamin B12

  • Meat: Beef, pork, lamb, and poultry are excellent sources of vitamin B12.
  • Fish and seafood: Salmon, trout, tuna, sardines, shrimp, and clams contain significant amounts of vitamin B12.
  • Dairy products: Milk, cheese, yogurt, and eggs are good sources of vitamin B12.
  • Fortified foods: Many breakfast cereals, plant-based milk alternatives (such as soy milk, almond milk), and nutritional yeast are fortified with vitamin B12, making them suitable options for vegetarians and vegans.

Vitamin B12 Deficiency Symptoms

1. Fatigue

One of the most common symptoms of vitamin B12 deficiency is fatigue. Insufficient levels of B12 can decrease normal red blood cell production, leading to reduced oxygen delivery to the body’s cells and impacting their proper functioning. (1)

2. Pale or Yellow Skin

Similar to iron deficiency anemia, B12 deficiency anemia can result in pale skin due to insufficient healthy red blood cells. Additionally, B12 deficiency can lead to jaundice, characterized by a yellowish rash on the skin and eyes due to elevated bilirubin levels. (2)

3. Headaches

Frequent headaches are one of the most common symptoms of Vitamin B12 in both adults and kids. A study conducted on 140 people found that participants who suffered from migraine had significantly lower levels of Vitamin B12 than those who didn’t suffer from migraine. It was also observed that participants with the highest B12 levels were 80% less likely to have migraine compared with participants with the lowest B12 levels (3).

4. Depression

Deficiency of Vitamin B12 has been linked to depression. Deficiency of Vitamin B12 can lead to an increased level of a sulfur-containing amino acid called homocysteine.  This may contribute to depression by increasing oxidative stress, DNA damage, and cell death in the body. Deficiency of Vitamin B12 can also lead to other conditions like psychosis and mood disorders (4).

5. Gastrointestinal Infection

Deficiency of Vitamin B12 can also cause gastrointestinal infections such as diarrhea, nausea, constipation, bloating, gas in both kids and adults.

6. Lack of Focus and Concentration

Difficulty in focus and concentration can be a symptom of Vitamin B12 deficiency.  Deficiency of Vitamin B12 can negatively impact the central nervous system. Multiple studies have found a connection between Vitamin B12 deficiency and lack of focus and concentration (5).

Causes of Vitamin B12 Deficiency

1. Dietary Deficiency

Vitamin B12 is primarily found in animal products such as meat, fish, eggs, and dairy. Vegans and vegetarians who do not consume enough fortified foods or supplements may be at risk. Even in cases where dietary intake is sufficient, factors such as poor diet choices or eating disorders can contribute to vitamin B12 deficiency.

2. Gastritis

Gastritis, which is characterized by inflammation of the stomach lining, frequently leads to vitamin B12 deficiency. This deficiency can arise from low levels of hydrochloric acid in the stomach, which is crucial for the absorption of vitamin B12.

3. Surgery

Surgeries that involve the stomach or intestines can sometimes interfere with the body’s ability to absorb vitamin B12. This includes procedures such as gastric bypass surgery for weight loss.

4. Alcohol and Smoking

Excessive alcohol consumption can damage the lining of the stomach and impair vitamin B12 absorption. Smoking has been associated with lower levels of vitamin B12, although the exact mechanism is not fully understood.

Treatment of Vitamin B12 Deficiency

1. Dietary Changes

Increasing the intake of foods rich in Vitamin B12, such as meat, fish, eggs, dairy products, and fortified cereals, can help replenish Vitamin B12 levels. For individuals following a vegan or vegetarian diet, fortified foods or Vitamin B12 supplements are recommended.

2. Vitamin B12 Supplements

Oral or intramuscular Vitamin B12 supplements are commonly prescribed to correct deficiency. Oral supplements are effective for mild deficiencies, while intramuscular injections are preferred for severe cases or when malabsorption is a concern.

3. Lifestyle Changes

Adopting lifestyle changes, such as reducing alcohol consumption and quitting smoking, can help improve Vitamin B12 absorption and overall health.

4. Identifying the Underline Condition

Addressing underlying conditions that contribute to Vitamin B12 deficiency, such as pernicious anemia, gastrointestinal disorders, or parasitic infections, is essential. This may involve medication, dietary modifications, or other therapeutic interventions.

Conclusion

B12 deficiency can lead to various symptoms like fatigue, headaches, depression, pale or yellow skin, cognitive impairment, and mouth and tongue pain. Since these symptoms are not exclusive to B12 deficiency, the condition might be overlooked. If you have any of these symptoms, it’s crucial to consult a healthcare provider for proper testing and treatment.

FAQs

1. What is the main cause of vitamin B12 deficiency?

The main causes of vitamin B12 deficiency include inadequate dietary intake, malabsorption disorders (such as pernicious anemia or gastrointestinal disorders), gastrointestinal surgery, certain medications, and conditions affecting the stomach or small intestine.

2. What happens if vitamin B12 is low?

Low levels of vitamin B12 can lead to symptoms such as fatigue, weakness, numbness or tingling in the hands and feet, difficulty walking, memory loss, mood disturbances, and anemia due to decreased red blood cell production.

3. What are the worst symptoms of B12 deficiency?

The worst symptoms of B12 deficiency include neurological complications such as numbness, tingling, difficulty walking, memory loss, and mood disturbances, along with severe anemia and potentially irreversible nerve damage.

4. What are the 4 stages of B12 deficiency?

The four stages of B12 deficiency are:

  • Stage 1: Decreased B12 levels with no clinical symptoms.
  • Stage 2: Initial symptoms like fatigue and weakness.
  • Stage 3: Advanced symptoms including neurological issues like numbness and tingling.
  • Stage 4: Severe complications such as irreversible nerve damage and megaloblastic anemia.

5. How can I raise my B12 levels fast?

To raise B12 levels quickly, you can take oral or intramuscular B12 supplements, consume B12-rich foods like meat, fish, eggs, and dairy, or opt for B12 injections if necessary.

6. Which fruit is rich in vitamin B12?

No fruit naturally contains vitamin B12. However, some fortified fruit juices or cereals may provide small amounts of B12 if they have been enriched with the vitamin.

Vidhi Garg

K11 certified Personal Trainer and Performance Nutritionist

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