Vitamin B12 Deficiency and Supplementation

Vitamin B12 deficiency is a common condition that is largely untreated. When left untreated this deficiency can cause a plethora of negative symptoms including neurological issues, cognitive issues, immune dysregulation, and fatigue or weakness. If you experience difficulty concentrating, low energy, memory loss, tingling in your extremities or feel weak and tired, you should consider talking to your doctor about Vitamin B12 deficiency. In my practice, I see so many patients who suffer from depression and low energy who are found to have low B12 when we check labs.

What is Vitamin B12?

Vitamin B12 is a nutrient that works to maintain the health of the brain and nervous systems as well as (in conjunction with other nutrients) works to create red blood cells and DNA. It is essential in many of our body’s energy and waste management processes. This nutrient is not created by the body, and must be consumed. Vitamin B12 is found almost entirely in animal products as it is produced in the intestinal tract of animals; this makes it especially important for those on vegetarian or vegan diets.

Why do People Become Deficient in Vitamin B12?

There are many reasons people become deficient in Vitamin B12. One of these reasons is that they simply do not get enough Vitamin B12 in their diet. As previously mentioned, Vitamin B12 is a nutrient produced in the intestinal tract of animals. Individuals who consume little or no animal products in their diet may find themselves deficient in B12. Vegetarians and vegans are commonly deficient in B12 and should find some form of supplementation.

Another cause for B12 deficiency is an abnormality in the intestinal absorption process, meaning that a condition is preventing the absorption of the nutrient. Conditions responsible for this could include gastritis, ulcerative colitis, Crohn’s Disease, Celiac Disease, and an autoimmune condition call pernicious anemia. Excessive use of alcohol can prevent nutrient absorption and can lead to B12 deficiency as well. Really, anything that affects absorption can drop a person’s B12 levels.

Certain medications are associated with B12 deficiency. Proton Pump Inhibitors, often referred to by doctors as PPIs are used to treat acid reflux and increase an individual’s risk for B12 deficiency. Some PPI medications include Prilosec (omeprazole), Nexium (esomeprazole), Prevacid (lansoprazole), and Protonix (pantoprazole). Medications used to treat Diabetes, such as Metformin, can also increase the risk of deficiency.

Individuals who have had weight-loss surgery such as gastric bypass are at higher risk of becoming deficient in B12. Weight-loss surgery can impact the absorption of food and nutrients, hence increasing the risk of nutrient deficiencies.

Age is another risk factor associated with B12 deficiency. Harvard Health: Vitamin B12 deficiency can be sneaky, harmful suggests that individuals over 50 talk to their doctor about taking a Vitamin B12 supplement.

How Many People Suffer from Vitamin B12 Deficiency?

Vitamin B12 deficiency is surprisingly common. B12 deficiency: a silent epidemic with serious consequences references data suggesting that of individuals ages 26-83, 9% are deficient in Vitamin B12, 16% are nearly deficiency, and 40% have levels in the low range. Further, the study suggests that 40% of individuals over the age of 60 experience deficiencies in Vitamin B12.

The Effects of Vitamin B12 Deficiency

Mayo Clinic: Vitamin B12 offers an evaluation of research in Vitamin B12 deficiency and has found scientific evidence supporting the multiple symptoms that can be experienced by Vitamin B12 deficiency.

Vitamin B12 deficiency can cause negative symptoms in several different body systems. In addition to fatigue, weakness, anemia, and issues with immunity the following symptoms can also occur:

Neurological Symptoms: Numbness & tingling in extremities, balance issues, shaky movements, vision problems, muscle weakness.

Cognitive Symptoms: Memory loss, difficulty concentrating, paranoia, hallucinations, depression, dementia, psychosis.

How is Vitamin B12 Deficiency Treated?

The first step in treating Vitamin B12 deficiency is getting confirmation of the condition. B12 deficiency is diagnosed based on a blood test that is ordered by your physician and tested at a laboratory. Vitamin B12 is often reported in a unit called pg/mL. Many labs in the United States have a “normal” level somewhere above 200 pg/mL; in many other parts of the world, anything less than 500 pg/mL is considered abnormal. For this reason, I will often supplement anyone with a level less than 500 pg/mL and symptoms that might improve through supplementation.

Depending on the severity of the deficiency, B12 deficiency can be treated with use of prescription medication or over the counter supplementation. If the deficiency is due to a vegetarian or vegan diet, an individual can supplement with B12 fortified foods and with the use of oral supplementation. For individuals with an absorption issue, prescription injections are likely required. For those with no known absorption issue, oral B12, readily available at most grocery and health food stores, is a great supplement.

Questions to ask your Doctor:

Keep in mind that every person is different and that any concerns about Vitamin B12 deficiency should be discussed with your doctor. If you are concerned that you may have Vitamin B12 deficiency you may consider asking your doctor the following questions:

Am I at risk for Vitamin B12 deficiency?

Would you recommend checking my Vitamin B12 level?

Should I start taking Vitamin B12 supplementation?

It is important to understand that treatment of any medical condition should involve the expertise of a medical provider. Talk to your doctor if you are experiencing any of the symptoms previously mentioned or are concerned you may be at risk for developing Vitamin B12 deficiency.

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