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9 Causes and Symptoms of Vitamin B12 Deficiency

October 10, 2019


9 Signs and Symptoms of Vitamin B12 Deficiency. Vitamin B12, also known as cobalamin, is an
important water-soluble vitamin (1). It plays an essential role in the production
of your red blood cells and DNA, as well as the proper functioning of your nervous system. Vitamin B12 is naturally found in animal foods,
including meats, fish, poultry, eggs and dairy. However, it can also be found in products
fortified with B12, such as some varieties of bread and plant-based milk. Unfortunately, B12 deficiency is common, especially
in the elderly. You’re at risk of deficiency if you don’t
get enough from your diet or aren’t able to absorb enough from the food you eat. AUTHORITY NUTRITION
9 Signs and Symptoms of Vitamin B12 Deficiency Vitamin B12, also known as cobalamin, is an
important water-soluble vitamin (1). It plays an essential role in the production
of your red blood cells and DNA, as well as the proper functioning of your nervous system. Vitamin B12 is naturally found in animal foods,
including meats, fish, poultry, eggs and dairy. However, it can also be found in products
fortified with B12, such as some varieties of bread and plant-based milk. Unfortunately, B12 deficiency is common, especially
in the elderly. You’re at risk of deficiency if you don’t
get enough from your diet or aren’t able to absorb enough from the food you eat. People at risk of a B12 deficiency include
(2): -The elderly. -Those who’ve had surgery that removes the
part of the bowel that absorbs B12. -People on the drug metformin for diabetes. -People following a strict vegan diet. -Those taking long-term antacid drugs for
heartburn. Unfortunately, symptoms of a vitamin B12 deficiency
can take years to show up, and diagnosing it can be complex. A B12 deficiency can sometimes be mistaken
for a folate deficiency. Low levels of B12 cause your folate levels
to drop. However, if you have a B12 deficiency, correcting
low folate levels may simply mask the deficiency and fail to fix the underlying problem (3). Here are 9 signs and symptoms of a true vitamin
B12 deficiency. 1. Pale or Jaundiced Skin
People with a B12 deficiency often look pale or have a slight yellow tinge to the skin
and whites of the eyes, a condition known as jaundice. This happens when a lack of B12 causes problems
with your body’s red blood cell production (4). Vitamin B12 plays an essential role in the
production of the DNA needed to make red blood cells. Without it, the instructions for building
the cells are incomplete, and cells are unable to divide (5). This causes a type of anemia called megaloblastic
anemia, in which the red blood cells produced in your bone marrow are large and fragile. These red blood cells are too large to pass
out of your bone marrow and into your circulation. Therefore, you don’t have as many red blood
cells circulating around your body, and your skin can appear pale in color. The fragility of these cells also means that
many of them break down, causing an excess of bilirubin. Bilirubin is a slightly red or brown-colored
substance, which is produced by the liver when it breaks down old blood cells. Large amounts of bilirubin are what give your
skin and eyes a yellow tinge (6, 7). 2. Weakness and Fatigue Weakness and fatigue are common symptoms of
vitamin B12 deficiency. They occur because your body doesn’t have
enough vitamin B12 to make red blood cells, which transport oxygen throughout your body. As a result, you are unable to efficiently
transport oxygen to your body’s cells, making you feel tired and weak. In the elderly, this type of anemia is often
caused by an autoimmune condition known as pernicious anemia. People with pernicious anemia don’t produce
enough of an important protein called intrinsic factor. Intrinsic factor is essential for preventing
a B12 deficiency, as it binds with vitamin B12 in your gut so that you are able to absorb
it (8). 3. Sensations of Pins and Needles. One of the more serious side effects of a
long-term B12 deficiency is nerve damage. This can occur over time, as vitamin B12 is
an important contributor to the metabolic pathway that produces the fatty substance
myelin. Myelin surrounds your nerves as a form of
protection and insulation (9). Without B12, myelin is produced differently,
and your nervous system isn’t able to function properly. One common sign of this happening is paresthesia,
or the sensation of pins and needles, which is similar to a prickling sensation in your
hands and feet. Interestingly, the neurological symptoms associated
with B12 deficiency usually occur alongside anemia. However, one study found that about 28% of
people had neurological symptoms of B12 deficiency, without any signs of anemia (10). That said, sensations of pins and needles
are a common symptom that can have many causes, so this symptom alone is not usually a sign
of B12 deficiency. 4. Changes to Mobility
If untreated, the damage to your nervous system caused by a B12 deficiency could cause changes
to the way you walk and move. It may even affect your balance and coordination,
making you more prone to falling. This symptom is often seen in undiagnosed
B12 deficiency in the elderly, as people over the age of 60 are more prone to a B12 deficiency. However, preventing or treating deficiencies
in this group may improve mobility (11, 12, 13). Also, this symptom may be present in young
people who have a severe, untreated deficiency (14). 5. Glossitis and Mouth Ulcers. Glossitis is a term used to describe an inflamed
tongue. If you have glossitis, your tongue changes
color and shape, making it painful, red and swollen. The inflammation can also make your tongue
look smooth, as all the tiny bumps on your tongue that contain your taste buds stretch
out and disappear. As well as being painful, glossitis can change
the way you eat and speak. Studies have shown that a swollen and inflamed
tongue that has long straight lesions on it could be an early sign of vitamin B12 deficiency
(15, 16). Additionally, some people with a B12 deficiency
may experience other oral symptoms, such as mouth ulcers, feelings of pins and needles
in the tongue or a burning and itching sensation in the mouth (15, 17). 6. Breathlessness and Dizziness. If you become anemic due to a B12 deficiency,
you may feel short of breath and a bit dizzy, especially when you exert yourself. This is because your body lacks the red blood
cells it needs to get enough oxygen to your body’s cells. However, these symptoms can have many causes,
so if you notice that you are unusually breathless, you should speak to your doctor to investigate
the cause. 7. Disturbed Vision. One symptom of vitamin B12 deficiency is blurred
or disturbed vision. This can occur when an untreated B12 deficiency
results in nervous system damage to the optic nerve that leads to your eyes (18). The damage can disrupt the nervous signal
that travels from your eye to your brain, impairing your vision. This condition is known as optic neuropathy. Although alarming, it is often reversible
by supplementing with B12 (19, 20). 8. Mood Changes. People with B12 deficiency often report changes
in mood. In fact, low levels of B12 have been linked
to mood and brain disorders like depression and dementia (21, 22). The “homocysteine hypothesis of depression”
has been suggested as a potential explanation for this link (23, 24, 25). This theory suggests that high levels of homocysteine
caused by low levels of B12 could cause damage to the brain tissue and interfere with signals
to and from your brain, leading to mood changes. Some studies suggest that in certain people
who are deficient in B12, supplementing with the vitamin can reverse symptoms (26, 27,
28). It’s important to note that changes to mood
and conditions like dementia and depression can have a variety of causes. Thus, the effects of supplementing in these
conditions remain unclear (29, 30). If you have a deficiency, taking a supplement
may help improve your mood. However, it’s not a substitute for other
proven medical therapies in the treatment of depression or dementia. 9. High Temperature. A very rare but occasional symptom of B12
deficiency is a high temperature. It’s not clear why this occurs, but some
doctors have reported cases of fever that has normalized after treatment with low levels
of vitamin B12 (31). However, it’s important to remember that
high temperatures are more commonly caused by illness, not a B12 deficiency.

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