Symptoms of and cure for vitamin B12 deficiency

What is vitamin B12 good for?

Vitamin B12 (cobalamin) is essential for many physiological processes in the body, including DNA synthesis, nervous system function, and red blood cell formation. The vitamin cannot be produced in the body and must therefore be supplied through the diet of animal foods.

Vitamin B12 deficiency and the symptoms that follow can come on insidiously and can appear in various ways, but typically diffuse neurological and/or neuropsychiatric symptoms are seen. Since the neurological disorders, e.g. nerve inflammation/neuropathy, can become irreversible, it is important that they are diagnosed and treated early. (Sources: MDPI, BioMed Central)​.

At a Functional Medicine consultation you can learn more about your genetics and any potential problems – read more here.

Symptoms of vitamin B12 deficiency

As mentioned, the symptoms of B12 deficiency can vary, which can make it challenging to recognize them. However, you will often notice some of the following symptoms if you are deficient in vitamin B12:

• Fatigue and weakness
• Neurological symptoms such as numbness and tingling in the hands and feet
• Problems with balance and coordination
• Psychiatric symptoms such as depression and confusion

(Source: Sundhed.dk)

When is B12 too low? Diagnosis of vitamin B12 deficiency

The diagnosis is often made by measuring serum B12 levels, but additional tests such as methylmalonic acid (MMA) and homocysteine ​​can also be used to confirm the diagnosis.

A thorough medical history and assessment of dietary habits, lifestyle and any gastrointestinal disorders in the individual patient are also important in order to identify the cause of the deficiency. (Sources: BMJ, MDPI)​.

Treatment of vitamin B12 deficiency

Treatment for B12 deficiency depends on the severity and cause. Acute and severe cases are often treated with intramuscular injections of B12, while less severe cases, and the majority of patients, can be treated with high-dose oral B12 supplementation. Long-term treatment may vary, but high-dose oral B12 is often sufficient.

Causes of B12 deficiency

Because vitamin B12 can only be supplied through animal foods, a deficiency of the vitamin can be due to a vegetarian/vegan diet or a one-sided diet, but a deficiency can also be due to an inability to absorb the vitamin in the gastrointestinal tract. This is seen, for example, in the disease pernicious anemia, where the body forms antibodies against a certain type of protein, intrinsic factor, which is essential for absorbing vitamin B12 through the gastrointestinal mucosa, or if you have disorders of the mucous membrane of the small intestine seen in diseases such as gluten allergy (celiac disease) and Crohn’s disease. In addition, with increasing age, you will experience shrinkage of the mucous membrane of the stomach, which may be an explanation for why reduced absorption of the vitamin becomes more frequent with age.

Research has also shown that B12 deficiency may be prevalent among patients with type 2 diabetes treated with metformin, as the medication can lead to reduced absorption of the vitamin when used long-term, and it is therefore important to regularly monitor vitamin B12 levels in this patient group. (Source: Frontiers)​.

Diagnostic challenges

Early in the development of vitamin B12 deficiency, there are no symptoms, but later anemia develops, called megaloblastic anemia. The measurement of vitamin B12 levels is a routine examination, but can be nonspecific and sometimes it may be necessary to take additional samples to measure other markers, including, for example, methylmalonate (MMA), as described above.

Vitamin B12 deficiency can therefore be a complex condition and can have significant health consequences.

Early diagnosis and proper treatment are essential to prevent serious complications.

Regular monitoring of risk groups and attention to symptoms is also essential for effective management of B12 deficiency.