Vitamin B12 Deficiency: What You Should Know

Vitamin B12 is one of eight B vitamins in your body. (Yes, the numbering is strange. There used to be more labeled B vitamins, but scientists short-listed almost thirty of them down to eight.)

Of all the vitamins in the B-complex, though, B12 is the most complicated and arguably the most important. B12 is involved in the metabolism of every cell in your body, and it’s critical for producing red blood cells and keeping your nervous system running.

With that kind of resume, it’s no wonder that a deficiency in B12 can lead to a crazy list of symptoms such as:

  • Weakness, tiredness, or lightheadedness
  • Heart palpitations and shortness of breath
  • Pale skin
  • A sore, red, smooth tongue
  • Constipation, diarrhea, loss of appetite, or gas
  • Nerve problems like numbness or tingling, muscle weakness, and problems walking
  • Vision loss
  • Mental problems like depression, anxiety memory loss, or behavioral changes

How common is a B12 deficiency?

B12 deficiency isn’t some oddball condition that House, MD would diagnose. It’s very well-known. The problem is that it’s a lot more common than we thought. For example:

  • Up 40 percent of people between the ages of 26 and 83 have plasma B12 levels in the low normal range.1 That’s a range where many people can still experience symptoms, even though they’re considered “normal”.
  • In people over 60, some 6% are deficient and 20% are marginal in their status.2 Levels tend to decrease with age.
  • In vegans and vegetarians, the number are considerably higher.

How are we getting it so wrong?

First, conventional medical professionals don’t test serum B12 routinely. Second, even for those that do test, the test they typically use isn’t ideal. It will only show a B12 deficiency in those who are VERY deficient and have been so for a long time.

But long term deficiency is problematic. B12 is critical for a healthy nervous system, and chronic low levels can lead to irreversible nerve damage. That’s not a place you want to go. Naturally, what we want to do as practitioners is to determine if a deficiency exists before things reach that stage.

Laboratory tests like urine MMA or serum homocysteine can give use information about your B12 status sooner, at a time when most people are asymptomatic. Good screening with the proper testing is simply good preventive medicine.

Who should worry about B12 status?

B12 deficiency may be under-diagnosed, but that doesn’t mean you’re at risk. Certain groups of people are more likely to develop a deficiency:

  • Vegetarians and vegans
  • People taking PPi’s or other stomach acid medications
  • People with digestive issues and tummy troubles
  • People with a family history of B12 deficiency

What should you do about it?

  1. Test your levels with your health care provider.
  2. Eat B12 rich foods like shellfish and liver (organic only please). There are no plant-based sources of B12.
  3. Supplement if you’re low.
  4. If you are over 60, get a B12 shot once a month. It is cheap, safe and easy.
  5. If you’re vegan or vegetarian, consult with your health care professional.

Curious about your B12 levels? Contact the clinic for information on testing, supplementation, and B12 shots.

 

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