Vitamin B12 deficiency can be subtle, harmful

What harm can having reduced vitamin B₁₂  do? According to a case report from Havard Massachusetts General Hospital, deficiency in vitamin B₁₂  can lead to musculoskeletal pain and neurological issues. The research was collated over the course of two months, where a 62-year old man developed pins and needles in the hand, experienced severe joint pain and became progressively short of breath. It turns out, the cause was a lack of vitamin B₁₂ in his bloodstream. Fortunately, for the 62-year old man, he didn’t experience deep depression, paranoia, delusions, memory loss, incontinence, loss of taste and smell.

What does vitamin B₁₂ do?

The human body needs vitamin B₁₂ to make red blood cells, nerves, DNA, and carry out other functions. Vitamin B₁₂ can’t be made by the body. Instead, it must be obtained from eating certain foods or taking supplements. The average adult should get 2.4 micrograms of vitamin B₁₂ every day.

Here lies the problem: Many people don’t consume enough Vitamin B₁₂ to meet their recommended daily allowance, while others cant absorb enough. As a result, Vitamin B₁₂ t deficiency is relatively common, especially among the older generation. The National Health and Nutrition Examination Survey estimated that 3.2% of adults over age 50 have a seriously low B₁₂ level, and up to 20% may have a borderline deficiency.

Are you at risk?

There are many causes for vitamin B₁₂ deficiency. Interestingly, two of them are often undertaken to help improve health: a vegetarian diet and weight-loss surgery.

The only foods that provide vitamin B₁₂ are meat, eggs, poultry, dairy and other foods from animals. Vegans and vegetarians may be predisposed to developing B₁₂ deficiency if they don’t regularly eat grains that have been fortified with the vitamin or take a vitamin supplement. Certain operations may also interfere with the body’s ability to extract vitamin B₁₂ from food.

Certain conditions can interfere with food absorption, such as celiac or Crohn’s disease, which can cause B₁₂ trouble. Some commonly prescribed heartburn drugs, which reduce acid production in the stomach (stomach acid is essential to the absorption of vitamin B_12). This condition is more likely to occur in older people due to the reduction in stomach acid production that often occurs with ageing.

Recognising a B₁₂ deficiency

Vitamin B₁₂ deficiency can be slow to develop, causing symptoms to appear gradually and intensify over time. It can also come on relatively quickly. Given the array of symptoms it can cause, the condition can sometimes be overlooked or misdiagnosed with other conditions.

Vitamin B₁₂deficiency symptoms may include:

• strange sensations, numbness, or tingling in the hands, legs, or feet
• difficulty walking (staggering, balance problems)
• anemia
• a swollen, inflamed tongue
• yellowed skin (jaundice)
• difficulty thinking and reasoning (cognitive difficulties), or memory loss
• paranoia or hallucinations
• weakness
• fatigue

While an experienced physician may notice the symptoms and be able to detect a vitamin B₁₂ deficiency with a good interview and physical exam, a blood test is the gold standard to confirm the condition.

Getting an early diagnosis and treatment can make a huge difference. If left untreated, the deficiency can cause neurological problems and blood diseases.

Checklist

It’s a good idea to ask your doctor about having your B₁₂ level checked if you:

• are over 50 years old
• take a proton-pump inhibitor (such as Nexium or Prevacid) or H2 blocker (such as Pepcid or Zantac)
• take metformin (a diabetes drug)
• are a strict vegetarian
• have had weight-loss surgery or have a condition that interferes with the absorption of food

A serious vitamin B₁₂ deficiency can be corrected with weekly shots of vitamin B₁₂ or daily high-dose B₁₂ pills. Generally, a mild B₁₂ deficiency can be corrected with a standard multivitamin.