[Article updated on 19/09/2023]
Vitamin B12 or cobalamin is a water-soluble vitamin. It plays an important role in the production of red blood cells, DNA and in the proper functioning of the nervous system. Vitamin B12 deficiency affects approximately 10 to 15% of seniors, however this rate is very low among adults. The main causes are mainly diet and malabsorption. Find out everything you need to know on the subject.
What is vitamin B12 deficiency?
Vitamin B12 deficiency or hypovitaminosis B12 means that there is not enough of this nutrient in the body. The latter contributes to the synthesis of DNA and the formation of red blood cells.
In other words, hypovitaminosis B12 can lead to megaloblastic anemia. Apart from that, the lack can be the cause of different diseases if it is not treated in time. This nutrient is incorporated into the body mainly through food. It is important to consume it regularly, because the body can only store it for a limited time.
What are the causes of vitamin B12 deficiency?
Hypovitaminosis B12 is a not very common deficiency. Most of the time, the diet is already sufficient to provide the necessary quantity. However, you may be exposed to a shortage in the following cases:
- You are vegan, vegetarian or vegan: vitamin B12 is mainly found in foods of animal origin, these types of diet limit its levels in the body;
- You suffer from a chronic pathology such as Crohn’s disease, celiac disease, etc.: this type of pathology prevents the intestine from properly absorbing nutrients;
- You are a heavy consumer of alcohol;
- You are taking medicines that interfere with the absorption of vitamin B12, this includes: proton pump inhibitors (esomeprazole, lanzoprazole, omeprazole, rabeprazole), H2 antihistamines (cimetidine, famotidine) and antidiabetics (metformin);
- You have had surgery to remove part of your intestine or stomach;
- You are an elderly person (over 60 years old).
What are the symptoms of vitamin B12 deficiency?
Symptoms only appear when the body has been lacking it for a prolonged period of time. You can suffer from a vitamin B12 deficiency for years without even realizing it.
Severe fatigue and lack of energy
Feeling tired is very common when you are deficient in vitamin B12. The reason is that the deficiency does not allow us to have enough red blood cells. This complicates the transport of oxygen to all the cells of the body, which explains fatigue and lack of strength.
Shortness of breath, palpitation and dizziness
You can become short of breath even with the slightest physical exertion due to the lack of oxygen circulating in your body. But they can also be symptoms of other illnesses, so it’s always better to consult a doctor to determine the exact cause.
Paleness or yellowing of the skin
A deficiency also manifests itself through the color of the skin and the whites of the eyes. They become paler or yellowish, this condition is called jaundice. Vitamin B12 makes the DNA responsible for making red blood cells. Without this DNA, the instructions issued for their productions are incomplete.
Thus, the red blood cells made in the bone marrow become larger in size and more fragile than normal. On the one hand, their large sizes prevent them from leaving the bone marrow, resulting in fewer red blood cells circulating throughout the body and thus pallor of the skin.
On the other hand, their fragility promotes their own destruction, thus causing an excess of bilirubin. It is a yellow substance produced by the liver during the breakdown of red blood cells. The high level of bilirubin gives the yellowish color of the skin and eyes.
Glossitis and mouth ulcer
Glossitis is an inflammation of the tongue. It results in a sore tongue, its redder color and smoother texture than normal. Small bumps may also appear on the taste buds.
Other symptoms may also appear which are mouth ulcers, tingling and burning sensations on the tongue.
Sight problem
This happens when the deficiency attacks the optic nerves. This can interfere with the transmission of nerve messages between the eyes and the brain. So you can see blurry or even lose your sight. This condition is called optic neuropathy. Although alarming, it is reversible after rectifying the deficiency.
Mental disorder
Low levels of vitamin B12 increase the level of homocysteine in the blood and can lead to mental disorders such as mood swings, depression, memory loss, etc.
Tingling or numbness in the feet and hands
Vitamin B12 contributes to the production of a fatty membrane called myelin. The nerves of the brain and spinal cord are coated in myelin serving as both a sort of protective and insulating barrier. But the lack modifies its production. Which makes the nervous system unable to function properly. As a result, tingling in the feet and hands may occur.
Gait and balance problems
Another consequence of B12 deficiency is loss of balance as well as a change in the way you walk and move. You are likely to fall for no apparent reason. Again, this is due to damaged nerves from lack of vitamin B12. This symptom is especially visible in the elderly and young people whose vitamin B12 deficiency is very proven.
What to do in case of vitamin B12 deficiency?
If you suspect a deficiency, what you should do is go to the doctor to find out and do not buy supplements without a prescription.
If you have already been there and the deficiency is confirmed, then all you have to do is follow the prescribed treatments carefully. And regularly consume foods rich in vitamin B12.
How to diagnose a lack of vitamin B12?
Once at the doctor’s office, the latter will examine and question the patient about their state of health in the past and at the present moment. Then, blood tests will be carried out:
- Blood smear: which allows you to see the morphology of the red blood cells, and observe whether yours are large or not.
- Measurement of folate and cobalamin levels in the blood: folate and vitamin B12 deficiencies have more or less the same symptoms, but the treatment is different.
Treatment for vitamin B12 deficiency
To bring your vitamin B12 levels back to normal, the doctor will have you take a supplement. This is done either by injection or orally using tablets. In case of injection treatment, you can learn to do it yourself. However, the tablets are more practical and cost less.
You may also need to take supplements for the rest of your life to prevent anemia relapse. Apart from supplements, you will also be advised to take foods rich in vitamin B12. For vegans, it would be better to take foods fortified with vitamin B12.
Foods to choose to limit the risk of vitamin B12 deficiency
Hypovitaminosis B12 can very well be prevented by taking foods rich in vitamin B12. You can find vitamin B12 in foods of animal origin:
- Beef
- Lamb, veal and beef liver
- Clams
- Egg
- Sardines, tuna, trout, salmon
- Milk and dairy products
- Foods fortified with vitamin B12: check on the product label