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 in the proper functioning of your nervous system.


Vitamin B12 is found naturally in foods of animal origin, such as meat, fish, poultry, eggs and dairy products. However, it can also be found in products fortified with B12, such as some varieties of bread and milk of vegetable origin.


Unfortunately, B12 deficiency is common, especially in the elderly. You run the risk of being deficient if you do not get enough of your diet or can not absorb enough of the food you eat.


Tired woman resting her head on the desk


People at risk of B12 deficiency include (2):



  • The elderly

  • Those who have had surgery that removes the part of the intestine that absorbs B12

  • People on the drug metformin for diabetes

  • People following a strict vegan diet.

  • Those who take long-term antacid medications for heartburn


Unfortunately, the symptoms of a vitamin B12 deficiency can take years to appear, and the diagnosis can be complex. A deficiency of B12 can sometimes be mistaken for a folate deficiency.


Low levels of B12 cause your folate levels to fall. However, if you have a vitamin B12 deficiency, correcting low levels of folate can simply mask the deficiency and not solve the underlying problem (3).


Here are 9 signs and symptoms of a true vitamin B12 deficiency.


1. Pale or jaundiced skin.


People with 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 the lack of B12 causes problems with the production of red blood cells in your body (4).


Vitamin B12 plays an essential role in the production of the DNA necessary to produce red blood cells. Without it, the instructions to build the cells are incomplete, and the cells can not be divided (5).


This causes a type of anemia called megaloblastic anemia, in which the red blood cells produced in the bone marrow are large and fragile.


These red blood cells are too large to move from the bone marrow to the circulation. Therefore, you do not have as many red blood cells circulating around your body, and your skin may have a pale 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).


Summary: If you have a B12 deficiency, your skin may look pale or jaundiced.


2. Weakness and fatigue.


Weakness and fatigue are common symptoms of vitamin B12 deficiency.


They occur because your body does not have enough B12 to make red blood cells, which carry oxygen through your body.


As a result, he can not transport oxygen efficiently to the cells of his body, which makes him 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 do not produce enough important protein called intrinsic factor.


Intrinsic factor is essential to prevent a deficiency of B12, since it binds with vitamin B12 in the intestine so that it can absorb it (8).


Summary: When you are B12 deficient, your body can not produce enough red blood cells to effectively transport oxygen throughout the body. This can make you feel tired and weak.


3. Sensations of Pins and Needles.


One of the most serious side effects of a long-term B12 deficiency is nerve damage.


This can happen over time, since vitamin B12 is an important contributor to the metabolic pathway that produces the myelin fatty substance. Myelin surrounds the nerves as a form of protection and isolation (9).


Without B12, myelin is produced differently and your nervous system can not function properly.


A common sign that this occurs is paresthesia, or the feeling of pins and needles, which is similar to a feeling of itching on the hands and feet.


Interestingly, the neurological symptoms associated with B12 deficiency usually appear along with anemia. However, one study found that approximately 28% of people had neurological symptoms of B12 deficiency, without any signs of anemia (10).


That said, the 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.


Summary: B12 plays an important role in the production of myelin, which isolates the nerves and is critical for the function of the nervous system. A common sign of potential nerve damage in B12 deficiency is a feeling of pins and needles.


4. Changes in mobility.


If left untreated, damage to your nervous system caused by a B12 deficiency could cause changes in the way you walk and move.


It can even affect your balance and coordination, making you more likely to fall.


This symptom is often seen in undiagnosed B12 deficiency in the elderly, since people over 60 are more prone to B12 deficiency. However, preventing or treating deficiencies in this group can improve mobility (11, 12, 13).


In addition, this symptom may be present in young people who have a severe untreated deficiency (14).


Summary: The damage caused by B12 deficiency not treated in the long term can affect your balance and cause changes in the way you walk and move.


5. Glositis and buccal.


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.


Inflammation can also make your tongue look soft, since all the small lumps on the tongue that contain your taste buds stretch and disappear.


In addition to being painful, glossitis can change the way you eat and talk.


Studies have shown that a swollen and inflamed tongue that has long straight lesions could be an early sign of vitamin B12 deficiency (15, 16).


In addition, some people with vitamin B12 deficiency may experience other oral symptoms, such as ulcers in the mouth, pins and needles sensation in the tongue, or burning and itching sensation in the mouth (15, 17).


Summary: An early sign of B12 deficiency can be a red and inflamed tongue. This condition is known as glossitis.


6. Breathing and dizziness.


If you become anemic due to a B12 deficiency, you may feel short of breath and a bit dizzy, especially when you try hard.


This is because your body lacks the red blood cells it needs to get enough oxygen for your body cells.


However, these symptoms can have many causes, so if you notice that you are unusually breathless, you should talk to your doctor to investigate the cause.


Summary: The anemia caused by vitamin B12 deficiency can make some people feel breathless and dizzy. This occurs when the body can not transport enough oxygen to all its cells.


7. Disturbed vision


A symptom of vitamin B12 deficiency is blurred or altered vision.


This can occur when a deficiency of untreated B12 results in damage of the nervous system to the optic nerve leading to your eyes (18).


The damage can interrupt the nerve signal that travels from your eye to your brain, which affects your vision. This condition is known as optic neuropathy.


Although it is alarming, it is often reversible by supplementation with B12 (19, 20).


Summary: In rare cases, damage to the nervous system caused by a B12 deficiency can affect the optic nerve. This can result in blurred or disturbed vision.


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 such as depression and dementia (21, 22).


The "hypothesis of homocysteine ​​of depression" has been suggested as a possible 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 brain tissue and interfere with signals to and from your brain, leading to changes in mood.


Some studies suggest that in certain people with B12 deficiency, supplementation with the vitamin can reverse symptoms (26, 27, 28).


It is important to keep in mind that changes in mood and conditions such as dementia and depression can have a variety of causes. Therefore, the effects of supplementation in these conditions remain unclear (29, 30).


If you have a deficiency, taking a supplement can help improve your mood. However, it is not a substitute for other proven medical therapies for the treatment of depression or dementia.


Summary: Some people with B12 may show signs of a depressed mood or conditions characterized by a decrease in brain function, such as dementia.


9. high temperature


A very rare but occasional symptom of B12 deficiency is a high temperature.


It is 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 is important to remember that high temperatures are more commonly caused by a disease, not by a B12 deficiency.


Summary: On very rare occasions, a symptom of B12 deficiency can be a high temperature.


The bottom line


Vitamin B12 deficiency is common and can occur in several ways, which makes identification difficult.


If you are at risk and have any of the above symptoms, talk to your doctor.


For most people, a B12 deficiency should be easy to prevent simply by making sure you are getting enough B12 in your diet.



Reference: https: //www.healthline.com/nutrition/vitamin-b12-deficiency-symptoms






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