Key Signs and Symptoms of Vitamin B12 Deficiency

Vitamin and minerals might be small compounds but they play a critical role in our health.

In some cases, not getting enough of a given vitamin can be dangerous and can even have long-term negative effects.

To make matters worse, people often don’t know the symptoms that come with being short of a given vitamin.

Take vitamin B12 deficiency and tingling as an example. Some people may experience this type of tingling, without ever realizing that it is connected to vitamin B12 deficiency.

Now, vitamin B12 deficiency may not be as well-known or as common as vitamin D deficiency but vitamin B12 is still important. In fact, it may even be more relevant, simply because many people already know the symptoms of vitamin D deficiency.

So, this post takes a look at the science behind vitamin B12 deficiency, along with some of the key signs and symptoms, such as vitamin B12 deficiency and tingling.

What does Vitamin B12 Do?

Vitamin B12 has a range of roles within the body, affecting multiple systems. In particular, vitamin B12 impacts your blood, nervous system and gastrointestinal tract.

For example, some of the key functions of vitamin B12 include helping to keep the blood cells healthy and aiding in the production of DNA (1).

Vitamin B12 is absorbed through stomach acid, which separates the vitamin B12 from food into a usable form. As a result, some conditions can affect the absorption of vitamin B12 (2).

The way that vitamin B12 affects the body may also mean it may have other impacts on health. For example, some researchers have looked into the impacts of vitamin B12 supplementation on disease risk, although the research is still in its early stages (3).

Like other vitamins (with the exception of vitamin D), our bodies don’t make vitamin B12. Instead, we need to get it from our food or from supplements.

In most cases, a person with a healthy diet will already be getting enough vitamin B12.

However, this isn’t necessarily true for everyone.

For example, some people aren’t consuming enough of the vitamin, while others may not absorb vitamin B12 effectively from their food.

Both issues can contribute to vitamin B12 deficiency.

Research indicates that the deficiency is relatively common, especially in older adults.

For example, one estimate suggests that 3.2% of adults above 50 years of age may have low levels of vitamin B12. As much as 20% of this population may be on the borderline of being deficient (4). Another estimate suggests that between 1.5% and 15% of the public is deficient in vitamin B12 (5).

While vitamin B12 deficiency can happen at any age, the observed pattern means that older people need to be particularly aware of B12 deficiency.

Now, much of our vitamin B12 comes from animals (like red meat and eggs). You can get some vitamin B12 from plant sources but these sources typically contain relatively little B12. Because of this, vegans will often be deficient in vitamin B12, especially if they aren’t paying close attention to their nutrients.

The site for The Vegan Society offers important information about B12 that vegans should be aware of. 

Some foods are also fortified with vitamin B12 and you can find this out by paying attention to the ingredients label (6).

At the same time, many people decrease their meat consumption as they age. In some cases, this may not even be a conscious decision but something that just happens gradually.

That pattern of behavior could also contribute to vitamin B12 deficiency.

Vitamin B12 deficiency can also happen for other reasons. For example, the deficiency is connected to anemia, which affects the body’s ability to effectively absorb vitamin B12 (7).

Additionally, B12 absorption relies on stomach acid. As a result, people on medication that suppresses this acid will often be deficient in vitamin B12 and so will people with some long-term intestinal conditions (such as celiac disease) (8).

The site Evidence-Based Medicine Consult highlights key medications that you should be aware of. Some of these impact absorption, while others may reduce B12 levels in other ways.

So, while diet is the main cause of vitamin B12 deficiency, you may still be deficient even if you are consuming sufficient amounts of the vitamin. This makes it important to pay attention to the symptoms, particularly vitamin B12 deficiency and tingling.

Signs and Symptoms of Vitamin B12 Deficiency

There are a number of significant symptoms of vitamin B12 deficiency. These will often develop relatively slowly but they can come on fast in some cases too.

Because vitamin B12 affects so many systems in the body, the impacts of a vitamin B12 deficiency tend to be widespread as well. In particular, some of the symptoms of a deficiency relate to physical health, while others are associated with mental health.

Key symptoms are the following (9,10):

• Tingling or numbness in hands, legs or feet
  
• Challenges with walking
  
• Fatigue
  
• Weakness
  
• Digestive issues
  
• Weight loss
  
• Thinking and reasoning problems
  
• Memory loss
  
• Hallucinations or paranoia
  
• Anemia
  
• Yellowed Skin

As with other vitamin deficiencies, many of these symptoms can occur with multiple other conditions. For example, fatigue can simply be an indication of not getting enough rest or it can be an indicator of something much more serious.

Additionally, some of these symptoms are fairly common in other conditions that older adults suffer. Memory loss and paranoia are both examples of this. As a result, many people don’t associate these symptoms with vitamin B12 deficiency.

However, vitamin B12 deficiency and tingling is a particularly important symptom to look out for.

Tingling is a relatively uncommon symptom and one that isn’t associated with as many other conditions. So, if you are experiencing this type of tingling, it may be a particularly significant indication of vitamin B12 deficiency.

Identifying and treating vitamin B12 deficiency is critical because long-term deficiency can lead to severe blood diseases or neurological problems (11).

What You Can Do

If you are concerned about vitamin B12 deficiency, one of the first things to do is to get your levels checked and your physician may be able to do this for you.

Vitamin B12 levels aren’t typically checked as part of a routine blood test, especially if there is no evidence of anemia in the patient. However, the tests are fairly inexpensive and many doctors will be willing to do so on request.

It’s also important to note that there is no consensus about precisely what your B12 levels should be.

For example, above 250 pg/ml is often considered normal. Yet, you can still get symptoms of deficiency at 350 pg/ml, so the assumption may not be entirely accurate (12).

Thankfully, you can’t really have too much vitamin B12, as it is water soluble. This means that any excess is excreted, rather than stored (13).

As a result, you can focus on improving vitamin B12 levels, even without actively monitoring via blood tests. For some people, doing so could involve getting more animal products in your diet, while others may choose to rely on supplements instead.

Indeed, supplements may be the best option in many cases, simply because some conditions interfere with vitamin B12 absorption (14). Nevertheless, if you have a condition that dramatically affects your ability to absorb vitamin B12, you may need to talk to your doctor about solutions, as supplements need to be absorbed too (15).

I have a question for you. What supplements do you personally take? Please let me know in the comments below.