Vitamin B12 plays a vital role in keeping us healthy. It is involved in the repair of DNA. In this way, Vitamin B12 helps to maintain the integrity of our genome. In particular, B12 is important for the health of the brain, nerves, blood cells, fatty acids metabolism, gastrointestinal tract, and heart. That’s why there are many benefits of B12. Unfortunately, Vitamin B12 deficiency is quite common. In this article you will learn the symptoms of Vitamin B12 deficiency and how to diagnose it. Also, you will become aware of B12 foods and learn about the health benefits of Vitamin B12 supplements.
What are Symptoms of Vitamin B12 Deficiency?
Symptoms of B12 deficiency are non-specific. That’s why you – and your physician – need to stay vigilant and suspect Vitamin B12 deficiency if any of the following symptoms are present:
- Lack of energy
- Anemia
- Burning of the tongue
- Poor appetite
- Tingling and numbness in the feet and hands due to peripheral neuropathy
- Muscle weakness
- Memory loss
- Depression
- Abnormal gait and lack of balance
- Constipation alternating with diarrhea
- Vague abdominal pain
- Increase in the level of Homocysteine which is a risk factor for heart disease, stroke, and dementia. (Low folic acid is the other contributory factor for elevated Homocysteine level.)
What are the Causes of B12 Deficiency?
- Vegan and vegetarian diet
- Metformin (a diabetic drug)
- Stomach-Acid Suppressing medicines such as Prilosec (omeprazole), Prevacid (lansoprazole), Protonix (pantoprazole), Aciphex (rabeprazole), Pepcid (famotidine), Zantac (ranitidine), Tagamet (cimetidine) etc.
- Antibiotics
- Stomach surgery
- Gastrointestinal disorders such as atrophic gastritis, small intestinal resection or bypass, gluten enteropathy, Crohn’s disease, chronic pancreatitis, and malignancy.
- Pernicious Anemia, which is an autoimmune disorder in which there is interference with the absorption of vitamin B12 in your food.
How Do I know If I’m Low in B12?
B 12 deficiency can be diagnosed by a blood test.
A blood level less than 400 pg/ml indicates deficiency. You can add a blood test of MMA (Methyl Malonyl Acid) which is elevated if you have B12 deficiency.
Another blood test, Homocysteine level, is elevated if you have B12 deficiency.
What Is Subtle B12 Deficiency?
Subtle B12 deficiency may be present even if the blood tests are in the normal range.
A practical – and inexpensive – approach is to take a B12 supplement for one week if you have any of the symptoms of B12 deficiency. If your symptoms improve, you probably have B12 deficiency.
In my clinical experience, patients do much better when their B12 level is close to 1000 pg/ml. (Normal range is 400 -1000 pg/ml).
Diagnosis of B12 Deficiency Is Often Missed. Sad but True!
B12 deficiency often remains undiagnosed simply because physicians don’t think of it as a possibility.
For example, when a diabetic patient complains of tingling in their feet, physicians do all the work-up to diagnose diabetic peripheral neuropathy. Then, they start the patient on a drug treatment without even checking the B12 level, even if you are on metformin. Peripheral neuropathy in diabetic patients on metformin is often due to two factors: diabetes itself and B12 deficiency.
Similarly, if you complain of “tiredness,” many healthcare providers (especially in a HMO setting) will not check your Vitamin B12 level.
Along the same lines, if you complain of memory loss, your physician will likely order an expensive diagnostic work-up including MRI of the brain. Your physician may even diagnose you with Alzheimer’s dementia – and place you on drugs – without even checking your B12 level. Sad but true!
Is There A Danger of Vitamin B12 Overdose?
No, because B12 is water-soluble. Therefore, any excess amount of B12 gets excreted through the urine.
What If Vitamin B12 Level is High?
High B12 level may occur if you take high doses of B12 supplements. This is not a problem. You simply reduce the dose of your B12 supplement. However, if your Vitamin B12 level is high – and you are not taking any B12 supplement – your physician needs to check for any underlying health issues. For example, high Vitamin B12 level may be present in liver disease, kidney disease and leukemias.1 Paradoxically, you may experience symptoms of B12 deficiency which happens because you develop relative deficiency of vitamin B12 at the tissue level. This is also called functional Vitamin B12 deficiency.2
Can Vitamin B12 Lower Homocysteine Level?
B12 in high doses along with active form of Folic acid and Vitamin B6 helps to lower homocysteine level.
High levels of homocysteine is a known risk factor for heart disease, stroke, and dementia. Lowering homocysteine level with supplements may lower cardiovascular risk.3
Treatment Of Vitamin B12 Deficiency
It is important to find out the root cause of low B12. Sometimes, the root cause is relatively easy to eliminate such as discontinuing the stomach acid-suppressing drugs. But in general, people are not willing to change their lifestyle if that is the root cause of B12 deficiency. For example, many vegans do not want to include Vitamin B12 foods in their diet. In addition, many of the diseases that cause B12 deficiency are either permanent (such as stomach surgery) or difficult to treat.
Therefore, Vitamin B12 supplements are the mainstay treatment of B12 deficiency. However, it is helpful if one can include Vitamin B12 foods in their diet.
What Are Vitamin B12 Foods?
Animal products are the main natural sources of Vitamin B12. Plant derived food is devoid of B12.
Good dietary sources include egg yolk, salmon, crabs, oysters, clams, sardines, liver, brain and kidney.
Smaller amounts of B12 are also found in beef, lamb, chicken, pork, milk and cheese.
What Are different Forms of Vitamin B12 Supplements?
B12 supplements are readily available as oral pills and lozenges.
It is also available in the form of an injection, for which you need a prescription from a physician.
I prefer the lozenges because the absorption from the oral cavity is excellent, better than from the stomach and intestines if you take pills. Furthermore, you avoid the hassle, cost, and pain of the injections.
Benefits Of Vitamin B12 Supplements
There are numerous health benefits of B12 as it is involved in the health of the DNA. Scientific studies and clinical practice show that B12 supplement (when given to someone with B12 deficiency) may provide the following benefits:
- Energy
- Relief from pins and needle sensation in the feet and hands
- Stronger muscle
- Resolution of sore tongue
- Improvement in appetite
- Better balance and gait
- Improved memory
- Lowering of Homocysteine levels when vitamin B12 is given in combination with Folic acid and Vitamin B6, which may translate into reduced risk of heart disease and stroke.
Unfortunately, most physicians do not realize the health benefits of B12. It is not their fault. They are trained to prescribe drugs. In addition, they are brainwashed to be skeptical of health benefits of vitamins including B12.
ZARY – A Combination Of Active Forms of Vitamin B12 and Folic Acid
As Vitamin B12 and Folic acid have synergistic actions, it makes sense to put them together in a supplement. That’s why I formulated ZARY, which is a combination of active forms of Vitamin B12 and Folic acid. Active forms means that these two vitamins are ready to be utilized by the body without the need for the complex changes that regular dietary Vitamin B12 and Folic acid has to go through before these become available to the cells.
Special Sale On ZARY (Methyl B12 Plus Methyl Folate) For A Limited Time
Use promo code XGSY4X2V during your check out and receive a 20% discount on ZARY.
Can You Take Vitamin B12 And Vitamin D Together?
Yes. Remember Vitamin B12 is water-soluble, and Vitamin D is fat-soluble. Therefore, there is no interference with the absorption if you take these two vitamins together.
In Summary
B12 deficiency is quite common. Unfortunately, it often remains undiagnosed. Symptoms of B12 deficiency are non-specific. It is important to find out the root cause of B12 deficiency symptoms. B12 supplements are the practical way to treat B12 deficiency. It’s so rewarding to see the benefits of Vitamin B12 in a person with B12 deficiency. Fortunately, B12 toxicity is unheard of because it is a water soluble vitamin and any excess amount gets washed out in the urine.
