Why is vitamin B12 important?

B12 is used on a daily basis and is involved in virtually every system in our bodies, making it one of the most important nutrients. It’s required for the formation of healthy red blood cells and to build nerve tissues. It’s also involved in the production of DNA.

Foods rich in vitamin B12 Vitamin B-12 is typically found in animal products, such as meat, seafood, eggs, and dairy products. Most people get adequate amounts of B-12 through their diet. However, because the vitamin is primarily contained in meat and dairy, vegetarians and vegans are strongly advised to take a high-dose supplement. B-12 is also stored in the liver.

Vitamin B-12 deficiency
It’s estimated that anywhere from 5% to 20% of people suffer from B-12 deficiency, making it a relatively common disorder affecting millions of people in the U.S. Yet those who are affected may not realize they have this problem. Because it can manifest as a variety of different symptoms, sufferers often go years without being correctly diagnosed, if at all. “B-12 deficiency frequently flies under the radar of physicians when they consider a patient t who presents with unusual symptoms,” says professor. Ralph Green of the University of California-Davis. (Hawkins-Simons, 2019) So patients may want to bring this up with their physician if they think it could be an issue for them.

Signs & symptoms of B-12 deficiency
Because vitamin B-12 is so important in such a variety of bodily processes, B-12 deficiency can manifest itself in a variety of mysterious symptoms, such as:

  • Muscle spasms & twitchiness
  • Clumsiness
  • Shaky hands *
  • Fatigue
  • Weakness or feeling faint
  • Confusion/dementia
  • Trouble concentrating
  • Dizziness and balance problems
  • Impotence
  • Memory loss/nominal aphasia (struggling to find the right word)
  • Irritability or anxiety
  • Numbness, tingling, burning, or other strange sensations throughout the body, especially in the limbs (hands, arms, legs and feet)
  • Tinnitus (ringing in the ears)
  • An aversion to bright lights
  • Worsening vision
  • Heart palpitations
  • Shortness of breath
  • Diarrhea
  • A lump in the throat
  • A swollen or deeply creased tongue

As with all symptom lists, the presence of one or more of these symptoms does not mean you have the disorder; it’s just one of many possibilities.

B-12 deficiency is commonly mistaken for these other conditions:

  • Depression
  • Chronic fatigue
  • Fibromyalgia
  • Hypochondria
  • Irritable-bowel syndrome
  • Multiple sclerosis
  • Premenopausal and menopause
  • Thyroid problems

Testing for vitamin B-12 deficiency
One of the things confounding diagnosis is the lack of a reliable test for B-12 deficiency. The routine blood test used is only slightly better than flipping a coin at accurately determining low levels of vitamin B-12. There also aren’t any established cutoff points to determine what meets the criteria of deficiency, so it’s often up to a doctor’s interpretation of the results. A newer test that measures holotranscobalamin, also known as active B12, is becoming increasingly more available in Europe, and is moderately more accurate in determining B-12 deficiency, since “it measures only the small percentage of B-12 that’s metabolically active and taken up by the cells,” says scientist Dominic Harrington. Yet it too isn’t foolproof and still has a sizeable error rate.

Because of this, experts recommend that anyone showing the signs and symptoms of B-12 deficiency be treated for the condition, even if their test results look normal. However, do not start taking B-12 supplements without first checking with a doctor, since they may raise serum levels of B-12 and interfere with a proper diagnosis.

Causes & risk factors for vitamin B-12 deficiency
One of the primary causes of B-12 deficiency is an increasing number of people who refrain from consuming animal products. A 2010 study in the U.K. found that nearly a quarter of vegetarians and three-quarters of vegans were found to be B-12 deficient. However, deficiency is commonly caused by an inability to absorb the nutrient, even if people are getting enough in their diet.

Pregnancy is another thing that can cause B-12 deficiency, since the demands of the fetus can often deplete the mother’s supplies. Some women lose their appetite for certain foods, which can further contribute to deficiency,. Blood loss during delivery and breastfeeding afterwards can also drain reserves.

Seniors have higher rates of B-12 deficiency, largely because they can have a harder time absorbing it. Lower levels of stomach acid and atrophy of the stomach lining that come with aging can make it more difficult to absorb the nutrient.

Pernicious anemia, an autoimmune disorder, also causes inflammation and damage to the stomach lining, and results in the loss of cells that produce both stomach acid and intrinsic factor, a protein required for B-12 absorption. Thus people with this condition also typically suffer from B-12 deficiency.

Some other potential risk factors for B-12 deficiency are:

  • Nitrous oxide exposure: One of the more unusual causes, nitrous oxide, or laughing gas, lowers people’s reserves of B-12. Thus people who abuse this substance for recreational purposes by inhaling “Whip-Its” may suffer from B-12 deficiency.
  • Medications such as proton pump inhibitors (for indigestion) and metformin (diabetes), among others.
  • Helicobacter pylori (a bacterial infection)
  • A family history of B-12 deficiency
  • Abdominal surgery, and gastric bypass or ileostomy in particular, which can disrupt gut bacteria and absorption of B-12

The consequences of B-12 deficiency

Left untreated, B-12 deficiency can lead to serious, even life-threatening problems. Because it affects so many bodily functions, it not only contributes to serious health problems, but can cause diminished brain functioning and fatigue that lead to mental health and social problems.

Martin Hooper, who heads the pernicious Anemia Society, says he receives “12 to 20 calls a day from people whose condition has led to marital strife, mothers being unable to care for their children, children who have trouble concentrating and are labeled as behavioral problems, forced career changes, unemployment – even suicidal thoughts.” (Hawkins Simons, 2019)

Treating vitamin B-12 deficiency
Vegetarians and vegans can typically do fine simply by taking a high-dose B-12 supplement. However, those with pernicious anemia or other conditions that prevent proper absorption will need B-12 injections, which are an inexpensive treatment.