Vitamin B12 Deficiency, Causes, Symptoms, and Treatment

Vitamin B12 is a vital vitamin that may be harder to digest and use as we age leading to vitamin B12 deficiency. This in depth article will tell you everything you need to know about B12.

What You Need to Know

There are several types of vitamin B and they all have different functions within the body, including helping to break down energy from food, keeping the skin, eyes and nervous system healthy, and helping to form red blood cells.

Provided that you eat a well-balanced diet, including wholegrains and cereals, you should be getting all that you need. However, as we get older it becomes harder to absorb vitamin B12, which is found in meat, cod, salmon, milk, cheese, eggs and some fortified cereals.

People who are deficient are at increased risk of anaemia and neurological problems such as memory loss.

Vitamin B12 is essential for good health, but some people may not be getting enough. This article tells you about symptoms of a vitamin B12 deficiency and how it can be treated.

Do you get enough vitamin B12? You’ll want to make sure that you do, in order to stay healthy.  Vitamin B12 does a lot of things for your body.  It helps make your DNA and your red blood cells, for example.  Since your body doesn’t make vitamin B12, you have to get it from animal-based foods or from supplements.  And you should do that on a regular basis, because your body doesn’t store vitamin B12 for a long time, however, as we age it gets more difficult to absorb enough from our food.

How Much do you Need?

The answer depends on things including your age, your eating habits and medical conditions, and what medications you take.

The average recommended amounts, measured in micrograms (mcg), vary by age:

  • Infants up to age 6 months: 0.4 mcg
  • Babies age 7-12 months: 0.5 mcg
  • Children age 1-3 years: 0.9 mcg
  • Kids age 4-8 years: 1.2 mcg
  • Children age 9-13 years: 1.8 mcg
  • Teens age 14-18: 2.4 mcg (2.6 mcg per day if pregnant and 2.8 mcg per day if breastfeeding)
  • Adults: 2.4 mcg (2.6 mcg per day if pregnant and 2.8 mcg per day if breastfeeding)
  • Older adults may need much more.

Food Sources of Vitamin B12

You can get vitamin B12 in animal foods, which have it naturally, or from items that have been fortified with it.Animal sources include dairy products, eggs, fish, meat, and poultry.  If you’re looking for a food fortified with B12, check the product’s Nutrition Facts label.

Vitamin B12 Deficiency

Vitamin B12 or B9 (commonly called folate) deficiency anaemia occurs when a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that cannot function properly.  Red blood cells carry oxygen around the body using a substance called haemoglobin.  Anaemia is the general term for having either fewer red blood cells than normal or having an abnormally low amount of haemoglobin in each red blood cell. There are several different types of anaemia and each one has a different cause.For example, iron deficiency anaemia happens when the body does not contain enough iron.

Symptoms of vitamin B12 or folate deficiency

Vitamin B12 and folate perform several important functions in the body, including keeping the nervous system healthy.  A deficiency in either of these vitamins can cause a wide range of problems, including:

  • extreme tiredness
  • a lack of energy
  • pins and needles (paraesthesia)
  • a sore and red tongue
  • mouth ulcers
  • muscle weakness
  • disturbed vision
  • psychological problems, which may include depression and confusion
  • problems with memory, understanding and judgement

Some of these problems can also happen if you have a deficiency in vitamin B12 or folate but do not have anaemia.

Causes of a vitamin B12 or folate deficiency

There are a number of problems that can lead to a vitamin B12 or folate deficiency.These include:

  • pernicious anaemia – where your immune system attacks healthy cells in your stomach, preventing your body absorbing vitamin B12 from the food you eat; this is the most common cause of vitamin B12 deficiency in the UK
  • a lack of these vitamins in your diet – this is uncommon, but can happen if you have a vegan diet, follow a fad diet or have a generally poor diet for a long time
  • medicine – certain medicines, including anticonvulsants and proton pump inhibitors (PPIs), can affect how much of these vitamins your body absorbs

Both vitamin B12 deficiency and folate deficiency are more common in older people, affecting around 1 in 10 people aged 75 or over and 1 in 20 people aged 65 to 74.

Treating vitamin B12 or folate deficiency anaemia

Most cases of vitamin B12 and folate deficiency can be easily treated with injections or tablets to replace the missing vitamins.

Vitamin B12 supplements are usually given by injection at first.

Then, depending on whether your B12 deficiency is related to your diet, you’ll either require B12 tablets between meals or regular injections.

These treatments may be needed for the rest of your life.

Folic acid tablets are used to restore folate levels. These usually need to be taken for 4 months.

In some cases, improving your diet can help treat the condition and prevent it coming back.

Vitamin B12 is found in meat, fish, eggs, dairy products, yeast extract (such as Marmite) and specially fortified foods.

The best sources of folate include green vegetables, such as broccoli, brussels sprouts and peas.

Complications of vitamin B12 or folate deficiency anaemia

Although it’s uncommon, vitamin B12 or folate deficiency (with or without anaemia) can lead to complications, particularly if you have been deficient in vitamin B12 or folate for some time.

Potential complications can include:

  • problems with the nervous system
  • temporary infertility
  • heart conditions
  • pregnancy complications and birth defects

Adults with severe anaemia are also at risk of developing heart failure.

Some complications improve with appropriate treatment, but others, such as problems with the nervous system, can be permanent.

Who Needs to See a Doctor 

Your body doesn’t naturally produce vitamin B-12. It comes from animal products like fish, meat, and dairy. People who are at risk for vitamin B-12 deficiency are:

  • older adults
  • children
  • vegans
  • strict vegetarians
  • people with diabetes
  • people who’ve had gastric bypass surgery

Some conditions may also affect your body’s ability to absorb B-12. Talk to your doctor if you have:

  • pernicious anemia
  • celiacc disease, where your body’s immune system reacts to gluten by damaging the lining of the intestine
  • Crohn’s disease, an autoimmune condition that causes persistent inflammation of the gastrointestinal tract
  • atrophic gastritis, a condition where your stomach lining narrows and limits stomach acid production

Medications that may also affect the body’s vitamin B-12 levels include:

  • chloramphenicol, or Chloromycetin
  • proton pump inhibitors, such as Prilosec and Prevacid
  • H2 receptor blockers, such as Tagamet, Pepcid, and Zantac
  • metformin, for diabetes
Vitamin B12 and Folate are easily available from reputable companies and online from Amazon but talk to your doctor before self prescribing.  Only buy from reputable companies that you know or better still stick with your local pharmacy or doctor.
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