15 Symptoms of Vitamin B12 Deficiency

Stuart SchlossmanVitamins and Supplements

 

As we age, vitamin
B12 becomes even more important — our mood, memory, nerve cells, and blood
cells depend on it. A B12 deficiency can cause lightheadedness, fatigue,
shortness of breath, confusion, and more.

Vitamin B12 is a nutrient that does its job quietly and efficiently inside our cells. We need vitamin B12 to make new DNA and keep nerve cells and blood cells healthy. It also helps our cells break down proteins and fats for energy. 

Most of us get enough vitamin B12 in our diet and absorb it through the digestive system. But some diets and certain health conditions, especially as we age, may lead to a deficiency of this important vitamin.

What is vitamin B12? 

Vitamin B12, also called cobalamin, is one of the B-complex vitamins. It’s not made by the body, so we need it in our diet. Vitamin B12 is not made by plants, either. It’s found in animal products, in foods where B12 has been added, or in supplement form. 

Teens and adults need about 2.4 micrograms of Vitamin B12 every day. Pregnant people need around 2.6 micrograms, and those who are breastfeeding need 2.8. Infants and children need 0.4 to 1.8 micrograms, depending on their age.

Vitamin B12 is more easily used by the body in certain forms. For example, it’s in meat, poultry, fish, and eggs but is most easily used by the body in dairy products. And vitamin B12 is more readily available for the body in supplement form than it is in foods. Vitamin B12 is also present in breast milk and added to infant formula. Extra B12 is stored in the liver, in case our cells need to use it in the future.

Symptoms of B12 deficiency

Not having enough B12 can affect how well the body makes new blood cells, nerve cells, and DNA.

Anemia

Low B12 levels cause a kind of anemia, or low blood count. Sometimes the blood cells become large, or macrocytic, before a person becomes anemic.

Symptoms of anemia might include:

  • Feeling tired or having low energy

  • Pale skin

  • Feeling short of breath, especially with movement

  • Having less of an appetite or losing weight without trying

  • Headaches

  • Feeling dizzy or like you might faint

  • Fast or irregular heartbeat

Some people with B12 deficiency also have mouth sores or a swollen, painful tongue

Nerve damage

Vitamin B12 is also important for nerve cells to function. B12 deficiency can affect the central nervous system (the brain and spinal cord) or peripheral nerves that go to the rest of the body. 

Symptoms of nerve damage from B12 deficiency can include:

  • Tingling, or a pins-and-needles sensation

  • Depression, irritability, or confusion

  • Changes in vision

  • Memory loss

  • Problems with balance

If a pregnant person doesn’t have enough B12 and folate, a baby may be born with a neural tube defect. This happens when the brain or spinal cord develop incorrectly. Because vitamin B12 is also present in breast milk, a breastfed baby whose parent has a low B12 level could have delayed development, slow weight gain, or anemia.

Vitamin B12 and DNA

Our cells need vitamin B12 to make new DNA. When cells can’t make or repair DNA, they start to divide incorrectly. Low B12 and folate levels play a role in DNA damage, which may lead to diseases like cancer. This is also why low vitamin B12 is thought to affect heart disease, stroke, and dementia.

What causes B12 deficiency?

The body stores extra vitamin B12 in the liver. So, it may take years for someone to develop symptoms from a B12 deficiency. But there are certain conditions that put some people more at risk.

Not consuming enough

Vitamin B12 comes from animal products like eggs, dairy products, poultry, fish, and meat. It’s also added to some foods like cereals and nutritional yeast. Most people in the U.S. consume enough vitamin B12. 

But you could be at risk for B12 deficiency if you follow a strict vegan or vegetarian diet and don’t take a supplement or eat other foods that are fortified with vitamin B12. The infants of pregnant or breastfeeding people who don’t get enough vitamin B12 are also at risk.

The amount of vitamin B12 can be found on the nutrition label of foods where it has been added and doesn’t occur naturally

Not absorbing enough

Some people consume enough vitamin B12 but their body can’t absorb it. Some health conditions that may affect B12 absorption include:

  • Weight-loss surgery or other surgery on the stomach and intestines

  • Low stomach acid, occurring with age or from taking medications to reduce stomach acid.

  • Inflammation in the stomach or small intestine from gastritis, celiac disease, or Crohn’s disease

  • Pernicious anemia, an autoimmune condition where the stomach doesn’t make a protein that is needed to absorb B12

  • Taking metformin for diabetes may decrease B12 absorption

  • Drinking alcohol can interfere with the body’s ability to absorb enough B12

How is B12 deficiency diagnosed?

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