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Health Update: Vitamin B12 Deficiency

Health Update: Vitamin B12 Deficiency

Vitamin B12, also known as cobalamin, is an important water-soluble vitamin. It plays a crucial role in the production of your red blood cells and DNA, as well as the correct functioning of your nervous system. Since your body doesn't make vitamin B12, you have to obtain it from animal-based foods or from supplements. This is something you should try to do on a regular basis, because your body doesn’t store vitamin B12 for a long period of time. Vitamin B12 is naturally found in animal foods, including meats, fish, poultry, eggs and dairy. However, it can also be acquired in products fortified with B12, such as some varieties of bread, cereals and plant-based milk. Regrettably, B12 deficiency is common, especially as you age. You’re at risk of deficiency if you don’t get a sufficient amount from your diet or aren’t able to absorb enough from the food you eat.

People at Risk of a B12 Deficiency include:

  •  The elderly
  •  Those who’ve had surgery that removes the part of the bowel that absorbs B12
  •  People on the drug metformin for diabetes
  •  People following a strict vegan diet
  •  Those taking long-term antacid drugs for heartburn
  •  Atrophic gastritis, in which your stomach lining has thinned
  •  Pernicious anemia, which makes it hard for your body to absorb vitamin B12
  •  Conditions that affect your small intestine, such as Crohn's disease, celiac disease, bacterial growth, or a parasite
  •  Immune system disorders, such as Graves' disease or lupus


Unfortunately, symptoms of a vitamin B12 deficiency can take years to be recognized, and diagnosing it can be complicated. A B12 deficiency can sometimes be confused with a folate deficiency. Low levels of B12 can cause your folate levels to decline. However, if you have a B12 deficiency, correcting low folate levels may mask the deficiency and fail to remedy the underlying health issue. 

If you have vitamin B12 deficiency, there is a possibility that you could become anemic. A mild deficiency may cause no symptoms. But if untreated, it may lead to symptoms such as:

  •  Weakness, tiredness, or lightheadedness
  •  Heart palpitations and shortness of breath
  •  Pale skin
  •  Jaundice
  •  A smooth tongue
  •  Constipation, diarrhea, loss of appetite, or gas 
  •  Nerve problems like numbness or tingling, muscle weakness, and problems walking
  • Vision loss
  • Mental problems like depression, memory loss, or behavioral changes 


If you have pernicious anemia or have trouble absorbing vitamin B12, you will most likely need shots of this vitamin initially. You may need to continue to receive theses injections on a regular basis or take a supplement. If you don’t consume animal products, you have options. You can change your diet to include vitamin B12-fortified grains, a supplement or B12 injections, or a high-dose oral vitamin B12 if you are deficient. Older adults who have a vitamin B12 deficiency may need to take a daily B12 supplement or a multivitamin that contains B12. For most people, treatment resolves the problem. But, any nerve damage that happened due to the deficiency could be permanent.


Most people can prevent vitamin B12 deficiency by eating enough meat, poultry, seafood, dairy products, and eggs. If you don't eat animal products, or you have a medical condition that limits how well your body absorbs nutrients, you can take vitamin B12 in a multivitamin or other supplement and consume foods fortified with vitamin B12. If you are a strict vegetarian or vegan, it’s important to eat breads, cereals, or other grains that have been fortified with vitamin B12, or take a daily supplement. A standard multivitamin delivers 6 micrograms, more than enough to cover the average body’s daily need. If you are over age 50, the Institute of Medicine recommends that you get extra B12 from a supplement, since you may not be able to absorb enough of the vitamin through foods. A standard multivitamin should be sufficient.

Bottom line is that a Vitamin B12 deficiency is common and can present itself in various ways, making it difficult to identify. If you’re at risk and have any of the symptoms above, speak to your doctor. For most people, a B12 deficiency should be easy to prevent simply by ensuring you are getting enough B12 in your diet.