If you’ve been feeling a lack of energy lately and you don’t know why, there could be a simple answer: You might be vitamin B12 deficient. The reason could be you aren’t getting enough through your diet, or your body isn’t doing a good job of absorbing the vitamin.
Whatever the cause may be, it needs to be addressed. A vitamin B12 deficiency can affect you in a variety of ways, leading to everything from memory loss to diminished taste and smell to depression.1
Why Vitamin B12 Is So Important
Your body needs vitamin B12 to function properly. It plays a key role in forming nerves and red blood cells. But unlike some other vitamins, your body can’t make B12 on its own. The only way you can get it is through your diet, or by taking a supplement.
Vitamin B12 deficiency is surprisingly common. As many as 20 percent of people age 50 and older are borderline vitamin B12 deficient, and more than 3 percent have a deficiency.2
Who Is at Risk for a Vitamin B12 Deficiency?
Vegans and vegetarians are at the highest risk for a vitamin B12 deficiency. That’s because plants don’t contain vitamin B12. Vegans and non-dairy vegetarians need to either eat vitamin-fortified grains or use a supplement.3
If you’ve had any sort of weight-loss surgery, you might also be at risk. The reason is that this type of procedure makes it harder for your body to absorb the vitamin through food.4
Also, people who have digestive problems may have a hard time absorbing vitamin B12. And since stomach acid is needed in order to absorb the vitamin, people who take medications that reduce acid may also be at risk for a deficiency.5 Other common medications, including anti-seizure drugs, can also put you at risk.
If you’re pregnant and not taking a supplement, you could be at risk as well. Pregnant women, as well as women who breastfeed, have an increased need for vitamin B12 and are at a higher risk for a deficiency.
How to Tell if You Are Vitamin B12 Deficient
Symptoms associated with a vitamin B12 deficiency can appear either suddenly or gradually. And, since they are so closely related to other problems, it can be challenging for a doctor to diagnose a deficiency.
For example, yellowish skin can be a sign of a vitamin B12 deficiency, but it could also be a sign of hepatitis. Tingling in the extremities, another B12 deficiency symptom, is more closely related to peripheral neuropathy – a condition common in diabetics. Other B12 deficiency symptoms typically associated with other health issues include weakness, fatigue, cognitive problems, and paranoia.7
One of the health problems most closely linked to a vitamin B12 deficiency is known as pernicious anemia. The main cause is a lack of a specific protein known as “intrinsic factor.” Your stomach secretes intrinsic factor, which joins with B12 to send the vitamin through your small intestine, where it’s absorbed into your bloodstream. If you don’t have enough intrinsic factor, the B12 you ingest will simply pass right through you, offering no benefit at all.8
Another contributing factor to pernicious anemia is a lack of red blood cells. This is also due to a vitamin B12 deficiency.
If you have this condition, you will likely feel weak and fatigued. But the long-term consequences are even worse. In severe cases, pernicious anemia can lead to memory loss, digestive tract problems, and nerve damage. It can even result in damage to the brain, heart, and other organs.9
There is some good news. As long as pernicious anemia is spotted and addressed by your doctor, you can expect to recover fully and lead a normal life. Vitamin B12 is the remedy for pernicious anemia. It can be given via supplements, shots, and even nasal sprays.10
The Importance of Folic Acid
Another problem associated with a lack of vitamin B12 involves a substance known as folic acid. Sometimes, folic acid and “folate” are used interchangeably, but they’re actually different. They’re both forms of vitamin B9, but unlike folic acid, folate is naturally found in food. Folic acid, on the other hand, is added to foods. It’s also available in supplement form.
The connection between folate and vitamin B12 is important. Together, they work to help your body produce red blood cells and properly process iron. Not getting enough folate can lead to a host of issues, including bad breath, diarrhea, appetite loss, and shortness of breath. If you don’t feel as sharp mentally as you normally do, you might not be getting enough folate.12
Pregnancy and Folate
If a pregnant woman doesn’t have an ample supply of both folate and vitamin B12, there is an increased chance of complications, including premature birth.
If the fetus doesn’t have enough folate, the risk of spinal cord and brain defects increases as well.
Pregnant women, or those considering becoming pregnant, may need to take a folate supplement.13
Diagnosing a Vitamin B12 Deficiency
If your doctor suspects you might be suffering from a lack of vitamin B12, they’ll likely order blood tests to check for two main things: how many red blood cells you have, and how they look. If you have a deficiency, your red blood cells may look larger than normal. They will also look like they haven’t developed correctly. If you have an advanced B12 deficiency, a test will also show a lack of both platelets and white blood cells. The tests will also tell the doctor how much vitamin B12 and folate is in your blood.
An additional test can determine the amount of methylmalonic acid in your body. Too much of this compound – which works with B12 to promote proper cell function in your body – can be a sign of a vitamin B12 deficiency.
If the tests show you are deficient in vitamin B12, your doctor will then perform other tests. These will be needed in order to find the reason for the problem.
Addressing a Vitamin B12 Deficiency
If your deficiency is minor, your doctor may recommend that you change your diet in order to get more B12 in your system. They may, for instance, tell you to increase your intake of the following foods:
- Low-fat milk
- Non-fat Greek yogurt (plain)15
One Last Thought
As you can see, a vitamin B12 deficiency can be very serious in some cases. That’s why it’s so important to see a doctor if you’re feeling sluggish and can’t figure out the reason. Finding a deficiency is key to addressing the problem so that you can finally get back to feeling healthy and happy!