How do you know you are deficient in Vitamin B12?

Written by Dr Harold Gunatillake –Health writer

How can one tell or suspect that you lack vitamin B12?

You may develop pins and needle sensations in your hands, and lower extremities unsteady walking disability, headaches, pale skin or being breathless and fatigued for no reason. Then, think that you may be suffering from Vitamin B12 deficiency. Fatigue may be common in other illnesses or just due to lack of exercise, but fatigue or tiredness with vitamin B12 deficiency is accompanied with other symptoms mentioned. With further time with no diagnosis made, you may get confused; have cognitive impairment, paranoia, delusions, mania, psychosis, memory loss, incontinence when passing urine and loss of taste and smell.

Vitamin B12 deficiency can cause severe irreversible damage to the brain and nervous system, if the blood levels go down to its lowest limits. It is at levels only slightly lower than normal that produces the symptoms detailed earlier.

It takes time for B12 deficiency to show early symptoms as they are slow to appear at the onset. In some the symptoms may come on relatively quickly. So the doctors find it difficult to suspect during the early stages other than from a blood test. It is sensible for elderly people to request for the specific blood test on their annual routine medical check-ups.

Why do you get these disabilities due to insufficient vitamin B12 in your body? The human body needs this vitamin to make healthy red blood cells, for proper functioning of nerves, bones, DNA and other intra-cellular and extra-cellular functions. A human body needs at least 2.4 micrograms of B12 daily and most of it is obtained from the food you eat. If you do not have a good nutritious diet B12 deficiency may and anemia could be the first indications.

Most of our B12 comes from animal products like red meat including liver, white meat, seafood, dairy products like milk, eggs, yogurt and cheese, and those who eat these foods daily may not get B12 deficiency, unless they suffer from chronic bowel diseases like Crohn’s celiac, malnutrition or chronic alcoholism, invariably you will not be absorbing sufficient B12 from your nutrition.

Seafood including trout, salmon, sardines and oysters are rich sources of B12. Plants don’t make B12, unfortunately. Clam mollusks contain 84.1 micrograms and oysters contain 13.3 micrograms per 3 ounces. Vitamin B12 is also found in cod, catfish, crab and swordfish

Vegans and seniors may get B12 deficiency with age. Vegetarians consuming milk and eggs in their diet are unlikely to develop B12 deficiency. Vegans need to eat a cereal fortified with B12 and take supplements

Vegans and seniors can take B12 supplements available in tablet form, today. In the past only injection were available and doctors used to inject a vial (cytamen) every month. Weekly given B12 nasal sprays are available in certain countries.

If you suspect you have any or more of the symptoms described earlier, you need to see your doctor for a blood test to check B12 level.
Those who have had stomach stapling or other forms of baritric surgery for weight loss may be deficient in B12.

Many medications can make it hard for the gut to absorb B12 due to interference with the ability to breakdown the vitamins from food.
Certain antibiotics, antacids taken for GERD and stomach ulcers, medications taken for seizures and diabetic medications can all interfere with the ability to break down B12.

Those taking metformin to control blood sugar should take B12 tablet daily and also drink plenty of water.

Those women on oral contraceptives need to check their B12 level regularly. Smokers do get Vit B 12 deficiency.

Today, most breads, grains, pasta, egg noodles, rice, cereals, orange drinks and tomato juice are fortified with B12. Standard multivitamin tablets too have B12 incorporated.

Lentils being a cheap popular legume cooked as a curry with rice and bread in Sri Lanka don’t seem to have B12.