Vitamin B12 deficiency, also known as ‘cobalamin deficiency’ or the tongue-twisting ‘hypocobalaminemia’, is simply a low level of this particular vitamin in the blood. But it can have serious and devastating effects – if left untreated, B12 deficiency can even lead to premature death, so it isn’t something to be taken lightly.
B12 Deficiency Symptoms
For people with only a slight deficiency, the risks are low – unless the level of B12 in the blood drops further. If the deficiency never worsens, symptoms tend to be minor, but they might include fatigue, depression and impaired memory.
Unfortunately these symptoms can be caused by lots of other illnesses, so they’re too nonspecific to safely diagnose B12 deficiency based on them alone. This means that unless you make an effort to keep your B12 intake high through supplementation, you probably won’t know you’re suffering from vitamin B12 deficiency until the situation becomes serious.
If the condition develops further, a range of unpleasant symptoms present themselves, which can include any combination of the following:
- Poor or absent reflexes
- Impaired soft touch and vibration sensation
- Shortness of breath
- Pale appearance
- Bleeding gums
- Changes in personality
- GAVE syndrome (a gastrointestinal problem)
- Bruising more easily than normal
- Poor memory
Symptoms In Infants
The most common symptoms of B12 deficiency in infants are:
- Weight loss
- Reverse development
- A general sense that they are not thriving and flourishing as you would expect.
The Effects Of Vitamin B12 Deficiency
Apart from a significantly lower quality of life (thanks to the symptoms that hypocobalaminemics present), cobalamin deficiency can have a number of unpleasant long-term effects.
If the condition is left untreated for more than six months, it is likely that irreversible damage will be done to the nervous system. If the deficiency is caused by pernicious anemia (see below) and left untreated, then the affliction will kill most sufferers within three years.
There is also a possible link between B12 deficiency and Alzheimer’s disease, although there is still significant debate over this.
It is however certain that B12 deficiency will cause severe and permanent damage to the brain and nervous tissue. The longer the condition is left untreated, the worse the damage is likely to be and the smaller the chance of recovery.
So you should see a doctor asap if you have any of the symptoms listed above, especially if you have multiple symptoms. The sooner you find out you have a problem, the sooner your treatment can begin.
The Causes Of B12 Deficiency
There are two primary causes of cobalamin deficiency: insufficient dietary intake of B12 and impaired absorption of the vitamin.
Vegetarians And Vegans
Vegans and vegetarians stand the greatest risk of not ingesting enough vitamin B12 from their diets, as the best natural sources tend to be meat and animal products.
Newborn babies with vegetarian mothers should also be checked by a professional to ensure they’re not suffering from B12 deficiency. Deficiency in infancy can lead to stunted development, as well as lasting brain and nerve damage.
Fortunately, taking regular B12 supplements should solve the problem for non-meat eaters. These supplements are fairly cheap and in come in a great deal of variety – simple oral tablets like these vegetarian ones are available, as well as vegan sublingual tablets. You can also find vegan B12 mouth sprays, vegan multivitamins, vegan skin patches, vegetarian B12-fortified foods and more.
Impaired B12 absorption can be caused by a number of underlying issues, all requiring different treatments. Perhaps the most common problem is pernicious anemia, where your body can no longer produce and secrete an important protein called intrinsic factor (IF). Without IF, your ability to absorb B12 from dietary foods is greatly reduced.
The underlying condition cannot be cured and requires lifelong treatment. This usually involves a few injections of vitamin B12 to begin with, which should boost blood levels to a healthy point and alleviate any symptoms.
This is followed up either with further regular injections or with daily high dosage oral B12 supplementation. If a high enough dose is given, the gut is capable of absorbing enough B12 through a process known as passive diffusion, even without IF.
Achlorhydria is a lack of gastric acid in the stomach, which prevents B12 (and various other vitamins) from being absorbed from food effectively. It most often affects the elderly, putting them at greater risk of B12 deficiency.
People suffering from achlorhydria cannot get sufficient B12 because it’s bound to proteins in food, and without enough gastric acid, you can’t break it down. Fortunately this is easily treatable with vitamin tablets, as the B12 in supplements is unbound and thus readily available.
If the supplements contain the methylcobalamin form of B12 rather than cyanocobalamin, then even less work needs to be done.
Other groups with an above average risk of vitamin B12 deficiency are diabetics (the drug metformin can interfere with absorption of B12), patients with conditions that affect their small intestine (which includes celiacs, sufferers of Crohn’s disease and people with various parasitic infections), and substance abusers of alcohol or nitrous oxide.
There are also some hereditary causes of B12 deficiency.
If you fit into any of the above categories, you should consult your doctor for advice on the best way to supplement your intake of vitamin B12, whether as prevention or cure.
There’s a lot of bad science and false information being spread around when it comes to birth control. Recent research suggests that there is no link between oral contraceptives and B12 deficiency. We wrote an article about it recently – How Birth Control Affects B12 Levels.
If you’d like to see the B12 supplements that we recommend, please take a look at our Recommended B12 Supplements page. This includes oral and sublingual tablets, skin patches, sprays, fortified foods, multivitamins and even lollipops!
We’ve also compiled a list of good external websites for more information on the conditions and technical terms mentioned above. These are in addition to the Wikipedia pages already linked to in this article.
For more information on…
- GAVE Syndrome, see here or, for a more technical account, here.
- Pernicious anemia, see here or take a look at the Pernicious Anaemia Society.
- Alzheimer’s disease and its connection to B12, see here or visit the Alzheimer’s Association website for more general information.
- Intrinsic factor (IF), see here.
- Achlorhydria, see this exhaustive website (use the tabs at the top to navigate the achlorhydria section).
- Metformin, see here for everything you might ever want to know.
- Celiac disease, see here or visit the Celiac Disease Foundation.
- Crohn’s disease, see here.
We hope that helps!
From top to bottom, images are courtesy of cooldesign, Nutdanai Apikhomboonwaroot, sheelamohan, nirots, jscreationzs, Boians Cho Joo Young, and Keattikorn, all at FreeDigitalPhotos.net.