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Still think vitamin B12 deficiency is something that can be ignored? If you have any of the most common symptoms- fatigue, depression, memory loss, painful “pins and needles” in the hands and feet- then you may be surprised to learn that there’s a lot more to pernicious anemia than beats the eye.
Vitamin B12- You need this!
Vitamin B12 is essential for so many primary biological functions that are necessary for survival- your nervous system, hormonal balance, cognitive functioning, metabolism, cell formation, to name just a few. It’s no wonder that when vitamin B12 levels are even marginally low, the results can range from annoying and disturbing to debilitating and catastrophic.
In years past, pernicious anemia from severe vitamin B12 deficiency used to be fatal. Today, thanks to vitamin B12 supplementation, we are able to maintain normal levels of vitamin B12, even in spite of vitamin B12 malabsorption from autoimmune disorders and gastrointestinal illnesses.
But until you learn to recognize the earliest symptoms of vitamin B12 deficiency, you’re at risk for pernicious anemia and all the damage that it can cause throughout your system.
Symptoms of low B12
Here are 99 ailments that often occur in people with moderate to severe vitamin B12 deficiency, including comorbid conditions and direct symptoms.
Symptoms of anemia- peripheral (megaloblastic) anemia from vitamin B12 deficiency
Vitamin B12 is one of the most important nutrients for the body- and the hardest to digest, for many people. A water-based B vitamin, cobalamin is essential for the nervous system, blood cells, and for DNA. Yet an increasing number of people don’t get enough vitamin B12 from food, and as a result feel fatigued and disoriented from pernicious anemia.
What does vitamin B12 do?
Vitamin B12 is essential for survival; it is involved in some of the most vital processes that take place in the body.
Vitamin B12 helps to maintain production of healthy red blood cells. Without enough vitamin B12 in your system, your body starts producing overlarge irregular-shaped blood cells that cannot function properly, resulting in a depletion of oxygen-carrying hemoglobin.
Vitamin B12 also aids in converting carbohydrates into necessary energy, ensuring that you have plenty of stamina and mental focus during the day.
Vitamin B12 enhances your nervous system functioning by helping to maintain myelin, a fatty coating that surrounds each individual nerve cell.
Vitamin B12 supports cell reproduction and renewal in preventing common signs of aging.
Foods that are high in vitamin B12 include meats, seafood, poultry, dairy, and eggs. Among these, organ meat and shellfish provide the richest natural source of vitamin B12.
While it’s possible to find vegan products that are fortified with vitamins such as B12, these are not natural forms of the vitamin, and don’t provide the maximum amount needed to maintain healthy vitamin B12 levels.
To prevent deficiency, vegans and vegetarians are recommended to take vitamin B12 supplements on a regular basis.
Vitamin B12 is one of the few nutrients that require a cofactor for proper absorption. It’s not a simple matter of eating plenty of foods the contain vitamin B12, such as beef, chicken, seafood, and dairy products. To complete the digestion process, your body uses a digestive enzyme called intrinsic factor, which bonds to the vitamin and escorts it through your digestive system.
Vitamin B12 deficiency is anemia
If your vitamin B12 levels have been low for a very long period of time, you may have pernicious anemia, a type of megaloblastic anemia that occurs when people are unable to produce intrinsic factor.
Pernicious anemia can result from an autoimmune disorder or it can occur as a result of damage to the stomach lining (gastritis).
If you have pernicious anemia, then you can’t get enough vitamin B12 from swallowing pills or other dietary supplements. Only supplementation with a highly-absorbable form of vitamin B12 that enters directly into the blood stream can reverse the symptoms of severe vitamin B12 deficiency.
Risk factors for pernicious anemia include:
Gastric bypass surgery
Removal of ilium for Crohn’s disease
Metformin for diabetes
Protein pump inhibitors (PPI’s) for GERD, acid reflux, chronic heartburn, or ulcer
By the time you start to notice the signs of vitamin B12 deficiency, you are already on a dangerous decline, as it takes years for the symptoms to manifest themselves. Also, blood tests for vitamin B12 deficiency don’t give you ample warning to up your vitamin B12 intake, as they only test for extremely low levels of vitamin B12, and aren’t always even accurate in such screenings.
Symptoms that indicate vitamin B12 deficiency include:
Constant fatigue, even after sleeping well
Slow talking and thinking
Painful numbness and tingling in the hands and feet
Muscle spasms, eye twitches
Difficulty walking in a straight line
Sore, burning red tongue
How much B12 do I need?
The recommended daily allowance for vitamin B12 consumption for healthy people who don’t have a deficiency is a scant 2 or 3 micrograms per day. Why then do most vitamin B12 supplements contain a whopping 1,000mcg of vitamin B12 in one weekly dose?
If you are unable to produce intrinsic factor, then you can only digest about 1% of all the vitamin B12 you get from foods, pills, or other supplements.
So, to get the amount you need to keep your B12 levels at a normal rate, you need to take about 100 times the amount any other person would need to stay healthy.
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Have you ever been tested for vitamin B12 deficiency? Do you suffer from chronic fatigue that you can’t explain?
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Thousands of people in the US suffer from vitamin B12 deficiency; some questions people often have are, “How did my B12 levels get so low? I eat healthy and I don’t have any chronic illnesses, so how did I become anemic?” That’s a complex question to answer, because there are many ways that people become gradually deficient in this crucial B vitamin.
First, why is vitamin B12 important?
Vitamin B12 (cobalamin) is a water-soluble B vitamin that is essential for basic survival.
Vitamin B12 helps to keep your nervous system functioning normally, as it sustains myelin, a fatty coating that protects your nerve cells and enhances intercellular communication.
Vitamin B12 also supports a healthy metabolism in converting fuels into much-needed energy and synthesizing DNA.
Vitamin B12 is required for proper red blood cell formation, as it helps to maintain a healthy level of normal-sized functioning red blood cells for oxygen transportation to your brain, organs, and cell tissues throughout your body.
Vitamin B12 helps to control levels of homocysteine, a hormone that has been linked with increased risk for heart attack, stroke, and Alzheimer’s disease.
How do you get vitamin B12?
So we know that vitamin B12 is important; now the question is, “What foods are high in vitamin B12?”
The richest sources of vitamin B12 are animal-based foods such as meat, poultry, seafood, milk, and eggs.
Still, if you have vitamin B12 malabsorption, a common risk factor for vitamin B12 deficiency, then you must take supplemental forms of vitamin B12 in order to prevent pernicious anemia. (More on vitamin B12 malabsorption later.)
It’s always good to test for low vitamin B12, but the best way to know if you’re getting enough is by paying close attention to telltale symptoms of severe vitamin B12 deficiency.
Since vitamin B12 depletion happens slowly, you may not realize you’re experiencing a deficiency until you start to notice yourself always feeling tired, depressed, or just generally slower than usual.
Here are some of the most common symptoms of low vitamin B12:
Constant overbearing fatigue
You’re talking slower than normal
Painful numbness and tingling in the hands and feet
Burning, sore red tongue
Difficulty walking in a straight line
Constantly dropping things
If you keep a vegan diet, or refrain from eating many animal-based foods, then you are a risk factor for vitamin B12 deficiency, simply because there are no vegetable-based foods that supply sufficient amounts of vitamin B12 to prevent anemia.
If you’re not a vegan, and you have no chronic illnesses, then you may still be at risk, as there are a number of medications that interfere with your ability to digest vitamin B12 naturally from foods, resulting in vitamin B12 malabsorption- a major cause of vitamin B12 depletion that often slips off the radar.
Some medications that lead to vitamin B12 malabsorption include:
Metformin (for diabetes)
Protein pump inhibitors (for acid reflux, heartburn)
If you have had a gastric bypass for weight loss, then you may be at risk for vitamin B12 deficiency. Also, gastrointestinal surgeries recommended for treating Crohn’s disease, such as removal of the ileum, necessitate frequent vitamin B12 supplementation in order to prevent pernicious anemia.
Peripheral neuropathy (nerve damage) from vitamin B12 deficiency is one of many ailments that occur with long-term alcohol abuse.
An underlying autoimmune disorder can also be the basis of low vitamin B12. Autoimmune intrinsic factor dysfunction causes your body to attack intrinsic factor, a digestive enzyme that bonds to vitamin B12 and helps to distribute it into your blood supply. People with autoimmune pernicious anemia cannot get vitamin B12 from foods, regardless of diet, and must use supplemental forms of vitamin B12 for survival.
If you have any other autoimmune disorder, such as celiac disease, fibromyalgia, or lupus, then your risk for autoimmune vitamin B12 deficiency is higher than normal.
Finally, any kind of damage to your stomach, intestines, or esophagus can interfere with your ability to absorb vitamin B12, increasing your chance for pernicious anemia. If you suffer from chronic heartburn, gas, and bloating, then that may be an important clue in determining why you often feel tired, anxious, or agitated.
Illnesses that cause frequent vomiting, such as migraines, fibromyalgia, and Crohn’s, are linked with comorbid vitamin B12 deficiency.
As we age, our bodies tend to slow down; that includes a reduction in the amount of digestive enzymes we produce- proteins needed to absorb vitamin B12. For many healthy individuals over 60, signs of depression and forgetfulness are often discounted as the first symptoms of senility, without even checking vitamin B12 levels.
For that reason, health experts recommend strict vitamin B12 supplementation for all senior citizens, even if they don’t think they need it, as the symptom don’t manifest themselves until vitamin B12 levels reach a dangerous low.
Don’t ignore symptoms of vitamin B12 deficiency, even if you are “healthy” and “normal.” Plenty of people have vitamin B12 deficiency, and don’t even know it- not until they start experiencing severe ailments.
Get a blood test, take your vitamin B12, and keep track of your mood and energy levels each day; this will be your best Richter scale for determining how much vitamin B12 you need in order to prevent anemia and maintain good health.
Signs and symptoms of menopause are sometimes associated with vitamin B12 deficiency, or malabsorption of vitamin B12 from the foods you eat. To boost energy, sleep better, and balance your mood, it’s important to take extra doses of vitamin B12 during the menopause years.
Menopause and vitamin B12 deficiency
Menopause is a phase that may stretch for several years; many women experience their first signs of perimenopause (early menopause) in their 40s, while still menstruating. During the early stages, you experience fluctuation hormone levels that cause mood swings, headaches, hot flashes, memory loss, and brain fog.
All of these are symptoms that may also indicate depleted levels of vitamin B12!
Hidden vitamin B12 deficiency
Vitamin B12 deficiency is difficult to catch and treat, as the symptoms are masked by conditions such as menopause, clinical depression, hypothyroidism, or hypoglycemia- all of which cause ailments that are strikingly similar to the ones you experience when your vitamin B12 levels drop to a dangerous low, either from malabsorption issues or change in diet.
Too often, severe vitamin B12 deficiency, a.k.a., pernicious anemia, slips right off your doctor’s radar, especially during the menopause years. And it’s easy to understand why, especially when you consider that the most common symptoms- fatigue, achiness, poor memory, dizziness, and depression- are present in both vitamin B12 deficiency anemia and the many stages of menopause.
For that reason, premenopausal women and females already experiencing menopause are advised to test often for vitamin B12 deficiency, and recognize the symptoms, before their B12 levels drop to a dangerous low.
Symptoms of vitamin B12 deficiency
Untreated, vitamin B12 deficiency from pernicious anemia can lead to neurological disorders, chronic fatigue, mood problems, and increased risk for heart attack and stroke.
That’s because vitamin B12 is essential for so many biological functions necessary for good health- reproduction, nervous system functioning, cognitive integrity, and metabolic energy.
So, when vitamin B12 levels plummet, you begin to experience a variety of health problems that affect all parts of your body, including those already ailing from symptoms of menopause.
Did you have vitamin B12 deficiency or pernicious anemia during your pregnancy? If you’re currently breastfeeding your baby, it’s crucial that you continue to check your vitamin B12 (cobalamin) levels. Here’s the scoop on taking care of baby with vitamin B12 deficiency.
Breastfeeding with B12 deficiency
Even after giving birth, if you breastfeed and have vitamin B12 deficiency at the same time, then your baby is also at high risk for getting vitamin B12 deficiency, regardless of how often you nurse.
Many studies have been conducted documenting the dangers of exclusive breastfeeding while suffering from vitamin B12 deficiency.
In them, researchers noted some disturbing symptoms of vitamin B12 deficiency in infants, such as failure to thrive.
Most of these symptoms were alleviated only after B12 levels were restored to normal throughimmediate supplementation of vitamin B12.
Symptoms of B12 deficiency in infants
In numerous studies, exclusively breastfed infants of mothers with vitamin B12 deficiency showed the following symptoms:
Are constant eyelid twitching and eye spasms driving you batty? Myokymia might be a sign of pernicious anemia caused by low vitamin B12 levels. Learn how to stop eye twitching by halting vitamin B12 deficiency in its tracks.
What is myokymia?
Myokymia is a disorder that causes muscles in your body to twitch involuntarily. Myokymia twitches can affect any groups of nerves or muscles in your body, including your arms, legs, fingers, and back.
It can also occur on your face- hemifacial spasms are muscular twitches that begin on one side of your face, usually the eye. Over time, hemifacial spasms can expand to include the rest of your face, on one side.
Myokymia is a type of nerve damage called trigeminal neuralgia. When your eyelid keeps twitching out of control, it is because the nerves that control the opening and closing of your eyes have been damaged. Eye twitches can occur in either the lower eyelid or upper eyelid,
Causes of myokymia
Causes of eye twitching may include stress, excessive alcohol usage, and staring at a computer screen for long periods of time. Eye spasms can also be a reaction to caffeine, or may signify low levels of cobalamin- vitamin B12.
B12 deficiency symptoms
Vitamin B12 benefits include red blood cell production, protection of the nervous system’s myelin sheathe, cognitive functioning, DNA synthesis, and lowered homocysteine levels.
If your body does not store adequate amounts of vitamin B12, you may get B12 deficiency, and ultimately severe pernicious anemia, a type of megaloblastic anemia blood disease.
B12 deficiency causes emotional and cognitive disorders such as:
If you suspect that you have vitamin B12 deficiency, then consult your physician and request a blood test for B12 levels. If diagnosed with low B12, then your doctor will prescribe vitamin B12 supplements.
If you have pernicious anemia, then you might have to get routine B12 shots indefinitely. Once you start taking vitamin B12, you will notice a decrease in pernicious anemia symptoms immediately, and total reversal of symptoms by the time your B12 levels return to normal.
If you’re planning a pregnancy, you might want to check your B12 levels- numerous reports link vitamin B12 deficiency during pregnancy with miscarriage, spontaneous abortion, and other fertility problems. B12 deficiency anemia- pernicious anemia- makes it harder for women to conceive, as well as for men to produce fertile sperm.
Medical research proves the fertility-B12 deficiency link
One of the most famous studies on fertility and B12 deficiency examined fourteen women of childbearing age who suffered vitamin B12 deficiency:
All women who participated in the study suffered severe vitamin B12 deficiency anemia in addition to low fertility- Four had been trying unsuccessfully to conceive for two to eight years, and eleven experienced repeated miscarriages and spontaneous abortions.
Dr. Michael Bennett, hematologist of the Ha’Emek Medical Center in Afula, Israel, implemented vitamin B12 supplementation to see if it would have any effect on their ability to conceive and have healthy pregnancies.
If fetal loss were to continue despite elevating B12 levels, it would prove that infertility was unrelated to B12 deficiency or pernicious anemia symptoms.
Instead, result showed that ten out of the fourteen test subjects experienced favorable results from vitamin B12 supplements. The results can be found in this study on vitamin B12 and fertility.
Dr. Bennett explains the connection
Bennett notes that B12 deficiency, combined with folate deficiency, led to thrombophilia (blood clotting) in seven of the women studied, thus increasing their risk for miscarriage.
He believes that taking large amounts of folic acid, a nutrient prescribed to women of childbearing age, often masks B12 deficiency symptoms, making it harder to diagnose and treat.
In his conclusion, Dr. Bennett attributes raised homocysteine levels, a symptom of vitamin B12 deficiency, with repeated fetal loss, and over time, ovulation disorder.
“Correcting this deficiency can rapidly lead to a normal pregnancy,” states Bennett. “This study illustrates the importance of measuring B12 levels…in every patient investigated for infertility or recurrent (miscarriage).”
Vitamin B12 benefits your body in many ways- it helps to produce red blood cells, promotes DNA synthesis, guards the nervous system’s myelin sheath, maintains cognitive functioning, lowers homocysteine levels, and supports metabolism.
Left untreated, vitamin B12 deficiency can cause severe nerve damage, cognitive disorders, and increased risk for heart disease and stroke.
What symptoms are associated with vitamin B12 deficiency?
Since vitamin B12 interacts with so many different areas of the body, many seemingly unrelated symptoms indicate vitamin B12 deficiency. Pernicious anemia masks itself as mood disorders, diabetes, celiac disease, fibromyalgia, hypothyroid, and other chronic conditions.
Some common symptoms of B12 deficiency:
Painful tingling, numbness or “prickly” sensations, mainly in the hands and feet
Sore, swollen tongue
Altered sense of taste
Loss of balance while walking, running, or jumping
The elderly need to increase their intake of vitamin B12, in order to avoid memory loss from vitamin B12 deficiency. Brain loss caused by Alzheimer’s disease and other forms of dementia is sometimes a part of the aging process, but by getting enough vitamin B12 in your blood, you can prevent suffering the symptoms of vitamin B12 deficiency.
Chicago study links low levels of vitamin B12 with memory loss
A 2011 study that focused on 121 community-dwelling participants of the Chicago Health and Aging Project found a strong correlation between vitamin B12 deficiency and memory loss. Scientists measured methylmalonate levels to determine vitamin B12 deficiency.
They found a direct relationship between low levels of vitamin B12, reduced brain volume, and decreased cognitive skills, such as loss of short-term memory.
Scientists noted poorer memory skills, slower thinking processes, and impaired comprehension skills as attributes associated with elevated methylmalonate levels- an indicator of vitamin B12 deficiency.
Also considered were plasma homocysteine levels, which scientists also connected with loss of brain mass. High levels of homocysteine are common in vitamin B12 deficiency.
Scientists concluded that methylmalonate, an indicator of vitamin B12 deficiency, has a direct impact on brain volume, and that vitamin B12 has multiple benefits on brain chemistry beyond just memory skills.
In 2008, a UK study conducted by the University of Oxford produced similar results; namely, that vitamin B12 deficiency is a likely cause of brain atrophy, dementia, and short-term memory loss among the elderly.
For the elderly, eating foods with vitamin B12 isn’t enough
Eating plenty of foods rich in vitamin B12 is always a good idea; such foods include protein sources like beef, chicken, fish, eggs, milk, and cheese. But for the elderly, the problem isn’t really eating enough sources of vitamin B12, but rather digesting them. Part of the aging process involves making less stomach acids that are necessary for absorbing vitamin B12 from foods. As a result, many elderly individuals who include meat in their diet still run a high risk for getting B12 deficiency.
Unless blood tests indicate healthy levels of vitamin B12, senior citizens must supplement with vitamin B-12 (cobalamin) with a routine prescribed B12 shot in order to avoid the symptoms of vitamin B12 deficiency.
Memory loss in B12 deficiency for the young and old
It isn’t just the elderly who should be concerned with memory loss- short-term memory loss is one of many symptoms of vitamin B12 deficiency, regardless of age.
Is there any connection between lupus and vitamin B12 deficiency? That’s a question asked often both by people with low B12 and diagnosed systemic lupus erythematosus (SLE). Both autoimmune diseases share similar symptoms, and it’s important to know how to tell the difference.
Lupus, or systemic lupus erythematosus (SLE), is an autoimmune disease that can cause damage to your muscles, bones, organs, and skin tissue. Like other autoimmune disorders, lupus causes your body’s immune system to attack healthy cells tissue, causing swelling, inflammation, and pain. Damage to your system may include kidney damage, heart attack, lung damage, joint pain, and blood diseases such as anemia (more on this later).
Vitamin B12 deficiency is one of the most common deficiencies in the US. Even if you eat plenty of sources rich in vitamin B12 (meat, chicken, fish, eggs, and milk), your B12 levels may be at risk if you have had bariatric surgery, take antacid medicine for acid reflux, are among the elderly, have a gastrointestinal autoimmune disease like Crohn’s or celiac disease, or if you are a diabetic taking metformin.
Many symptoms of lupus mimic those of vitamin B12 deficiency, making it difficult to determine low B12 levels without taking a vitamin B12 blood test.
Cognitive functioning and mood disorders. Anxiety, depression, headaches, and short-term memory loss are symptoms common to both lupus patients and vitamin B12 deficiency sufferers.
Chronic fatigue. Chronic fatigue shares a comorbid relationship with lupus and B12 deficiency.
Nerve damage. Vitamin B12 deficiency causes neurological damage such as aching joints and arthritis-like muscular pain. Lupus causes swollen joints, arthritis, and inflamed joints.
Shortness of breath is a symptom of low B12 and lupus.
Hair loss. B12 deficiency may cause premature hair loss and greying. Hair loss is also a symptom common to lupus patients.
Mouth ulcers are typical for vitamin B12 patients and lupus sufferers.
Skin rashes are a side effect of chronic B12 deficiency. Likewise, lupus patients suffer skin rashes across the cheeks and nose (malar rash).
Anemia. One of the most highly correlated symptoms shared by vitamin B12 deficiency patients and lupus patients alike is the susceptibility to anemia. Left untreated, pernicious anemia from vitamin B12 deficiency can lead to severe nerve damage, red blood cell depletion, and cognitive impairments. More than half of all lupus patients suffer from blood disorders like anemia.
Heart disease. Lupus and pernicious anemia patients alike are at high risk for contracting heart disease.
Bone loss (osteoporosis) is a risk factor for lupus patients and individuals with vitamin B12 deficiency.
Read more about B12 deficiency and autoimmune diseases:
Being tired all the time is a symptom of B12 deficiency, but it can also signal hypothyroidism (low thyroid), a thyroid disease that occurs with lowB12 levels. Because hypothyroid symptoms are similar, vitamin B12 deficiency often goes undetected.
B12 deficiency causes fatigue, depression, and other mood disorders often associated with an underactive thyroid. If you’ve been diagnosed with thyroiditis, then it’s also important also to recognize the symptoms of B12 deficiency, and know whether you might require more vitamin B12 (cobalamin).
What is hypothyroidism?
Hypothyroidism is an autoimmune thyroid disease (AITD) that occurs in the thyroid gland, causing inflammation, and reducing its ability to produce sufficient amounts of thyroid hormones. Hashimoto’s disease is one example of thyroiditis that causes low thyroid levels.
Sometimes, thyroid treatment for hyperthyroidism (overactive thyroid), such as radioactive iodine or surgery, can backfire, causing underactive thyroid symptoms.
Vitamin B12 is a water-soluble nutrient that is responsible for making red blood cells, controlling DNA synthesis, regulating the nervous system, and improving cognitive functioning. Without proper levels of vitamin B12, you may suffer neurological damage, dementia, or heart attack resulting from elevated homocysteine levels.
In a study conducted in Sapir Medical Center, Kfar Saba, Israel, patients with autoimmune thyroid disease received blood screening for vitamin B12 deficiency. Researchers noted a significantly high percentage of people with AITD who also had vitamin B12 deficiency caused by pernicious anemia, a disease that inhibits proper absorption of vitamin B12.
Another study conducted in Pakistan by Aga Khan University produced similar results; namely, a 40% prevalence of vitamin B12 deficiency among patients with hypothyroidism.
If you are a patient of hypothyroidism, then physicians strongly recommend routine blood testing for vitamin B12 deficiency, regardless of thyroid hormone levels.