Vitamin B12 is part of the B complex of vitamins alongside vitamin B9 or folate. They are essential vitamins which means that the body is unable to make them itself and must obtain through our diet. Vitamin B12 is required for the formation of red blood cells as well as for forming a coat around nerve cells called myelin.
Effects of Vitamin B12 Deficiency
Having low or deficient B12 levels can cause anaemia and neurological damage and can lead to a number of symptoms, some of which can be serious. It is important to know that even slightly lower-than-normal levels of vitamin B12 can trigger symptoms. These effects and symptoms are often non-specific and it may not be obvious that they are due to vitamin B12 deficiency. Symptoms include:
- memory problems
- mood changes
- difficulty concentrating
- sore tongue
- heart arrhythmias
- numbness and tingling in hands and feet
- difficulty maintaining balance
- infertility and menstrual problems
Causes of Vitamin B12 Deficiency
Several groups of people may be at an increased risk of vitamin B12 deficiency:
- Vegans face a risk of vitamin B12 deficiency, as their diet excludes animal-sourced food products. Pregnancy and lactation can worsen deficiency in vegans. Unless a vegan diet is carefully planned, it is difficult to get enough vitamin B12 through plant foods alone. For this reason, it is recommended for those following vegan diets to supplement with B12.
- People with pernicious anaemia may lack vitamin B12. Pernicious anaemia is an autoimmune disease that affects the blood. Patients with this disorder do not have enough intrinsic factor (IF), a protein in the stomach that allows the body to absorb vitamin B12.
- Other at-risk groups include people with small intestine problems, for example, someone with a surgically shortened small intestine. Crohn’s disease is also a risk factor for vitamin B12 deficiency due to frequent involvement of the terminal ileum.
- Gastritis, celiac disease, and inflammatory bowel disease (IBD) may lead to a deficiency because these conditions reduce nutrient absorption.
- People with chronic alcohol use may lack vitamin B12, as their bodies may not absorb nutrients efficiently.
- People with diabetes who are treated with metformin should have their B12 levels tested by their healthcare professional regularly. This is because metformin reduces the absorption of vitamin B12.
- Other medications can also cause low vitamin B12 such as proton pump inhibitors and H2 receptor agonists like Omeprazole which are often used for gastritis and peptic ulcer disease.
Treatment of Vitamin B12 Deficiency
Treatment for vitamin B12 deficiency includes oral vitamin B12 supplements or vitamin B12 injections once any underlying causes have been excluded or treated.
If you are concerned about your B12 levels, please discuss your concerns and the results of any blood tests with your GP or usual healthcare professiona