12 Early Warning Signs of a Vitamin B12 Deficiency That Should Never Be Ignored

According to recent research, one in four adults in the United States alone suffers from a vitamin B12 deficiency. That’s a huge percentage, given that most people think they get enough of the vitamin from meat and dairy.
Vitamin B12 is the only water-soluble vitamin that can be stored in the liver for many years. It only gets released from the liver when our serum B12 levels are low. Because B12 is such an important nutrient in the body, the body always makes sure that it has some in stock.
What Is the Function of Vitamin B12?
Vitamin B12 benefits your mood, energy level, memory, heart, skin, hair, digestion, and more. It is essential for addressing adrenal fatigue, multiple metabolic functions, as well as maintaining a healthy nervous and cardiovascular system.
I always like to highlight the role of B12 in regard to the nervous system, because, without it, our nervous system would be shot. Not only does vitamin B12 help maintain the health of nerve cells and neurotransmitter signaling, but it plays a significant role in the synthesis and maintenance of myelin, a protective covering of our nerves. This is why so many people with vitamin B12 deficiencies also suffer from cognitive decline.
Problems with the nervous system can affect all avenues of our health – so it’s important we keep our vitamin B12 levels high.
Vitamin B12 also works closely with vitamin B9 (folate or folic acid) to help create red blood cells and improve the usability of iron in the body. These two vitamins work together to create S-adenosylmethionine (SAMe), a compound that helps regulate hormones, immune function, and mood (3✓).
What Causes Vitamin B12 Deficiency?
Most researchers test and treat vitamin B12 deficiencies in the developing world, which has led to a minor lack of research and focus of current deficiencies in North America. There still hasn’t been a major population study in the United States, aside from the one conducted by Tufts University in the year 2000. What they found was that up to 39 percent of the population likely suffers from a vitamin B12 deficiency.
Since Vitamin B12 cannot be produced by the body and has to be ingested, it is often the case that people simply aren’t getting enough in their diet, or that something is impeding the absorption of B12 in the body.
Microorganisms, primarily bacteria, are the only organisms known to manufacture B12. They live in the water, soil, and digestive tracts of animals. In animals, B12 often attaches to a protein either for transport or storage.
Most meat-eaters receive plenty of B12 from the animal products they consume, whereas vegetarians and vegans can consume this vitamin by eating algae, nutritional yeast, and seaweed. These sources are often not enough, so it is suggested that vegans and vegetarians also take a high-quality B12 supplement.
Thoroughly washing produce and consuming highly processed foods is another way we have made our food completely devoid of vitamin B12. The triple-washed salad likely has zero remaining beneficial bacteria on it that could nourish our B12 needs in the body.
We can also get a vitamin B12 deficiency (yes, both meat-eaters and vegetarians and vegans) from having poor digestibility of the vitamin itself. If you’ve ever drunk a lot of alcohol, gone through rounds of antibiotics at some point in your life, or have dealt with digestive issues most of your life, B12 will have a very hard time absorbing in the body. Alcohol, antibiotics, and poor diet leading to poor digestibility can all destroy the intrinsic binding factor in our stomach which is needed for B12 absorption. This is also the case why so many people are B12 deficient.
Aside from stomach problems, B12 may also not absorb properly if you suffer from any auto-immune conditions like pernicious anemia, Chron’s or Celiac’s disease, or if you’re over the age of 50. When you get older, it becomes increasingly difficult for the body to absorb vitamin B12 from foods, because you produce less stomach acid, which is vital for nutrient absorption.
What Are The Symptoms of Low Vitamin B12?
Since the symptoms of vitamin B12 deficiency are often not very specific, the deficiency can go unnoticed for a very long period – that is, until symptoms start showing up. A vitamin B12 deficiency can also be easily mistaken for other conditions, and may, therefore, remain misdiagnosed.
Research suggests that methylmalonic acid (MMA) and holotranscobalamin (holoTC) testing may be more accurate at reading low B12 levels because they represent active B12. Don’t just get basic B12 testing at the doctor’s office – ask for these two specific readings, as they will show much more about your B12 levels.
A vitamin B12 deficiency could manifest itself in the following ways:
- Loss of balance and confusion
- Anemia (megaloblastic anemia and pernicious anemia)
- Numbness or tingling in the arms and legs
- Weakness
- Nerve problems like numbness or tingling, muscle weakness and problems walking
- Constipation, diarrhea, a loss of appetite, or gas
- Vision loss
- Ringing in the ears (tinnitus)
- Mental health problems in more severe cases (like psychosis, depression, and anxiety)
- Dementia
- Alzheimer’s disease
- Heart disease
It’s not a vitamin that one should ignore. If you’re experiencing any of these symptoms or a combination of them, you should get tested immediately.
Thoroughly washing produce and consuming highly processed foods is another way we have made our food completely devoid of vitamin B12. The triple-washed salad likely has zero remaining beneficial bacteria on it that could nourish our B12 needs in the body.
We can also get a vitamin B12 deficiency (yes, both meat-eaters and vegetarians and vegans) from having poor digestibility of the vitamin itself. If you’ve ever drunk a lot of alcohol, gone through rounds of antibiotics at some point in your life, or have dealt with digestive issues most of your life, B12 will have a very hard time absorbing in the body. Alcohol, antibiotics, and poor diet leading to poor digestibility can all destroy the intrinsic binding factor in our stomach which is needed for B12 absorption. This is also the case why so many people are B12 deficient.
Aside from stomach problems, B12 may also not absorb properly if you suffer from any auto-immune conditions like pernicious anemia, Chron’s or Celiac’s disease, or if you’re over the age of 50. When you get older, it becomes increasingly difficult for the body to absorb vitamin B12 from foods, because you produce less stomach acid, which is vital for nutrient absorption.
How Long Does It Take to Recover From a B12 Deficiency?
Recovering from a vitamin B12 deficiency takes time. It is often the case that individuals do not experience any improvement during the first couple months of treatment.
Improvement could take up to three months if you’re dealing with a minor deficiency, or up to 6-12 months if your deficiency is well below average.
While the normal range for vitamin B12 can vary depending on the lab and country you live in, it is best to aim for the higher end of the spectrum. Since the body will rid itself of any excess B12 it can’t use, you don’t need to worry about taking a bit more than you might need.
A normal level of vitamin B12 ranges between 190 and 950 picograms per milliliter (pg/mL) (9). With that being said, between 200 and 300 pg/mL is considered borderline deficient, and you should supplement if you’re lower than 300.
The Best Vitamin B12 To Supplement
The best vitamin B12 to supplement, hands down, is one that contains both methylcobalamin and adenosylcobalamin. Methylcobalamin and adenosylcobalamin are the two most bioactive forms of vitamin B12 and are both necessary when taking a B12 supplement.
If you come across any B12 supplements that are just cyanocobalamin, don’t even consider purchasing them! They are low quality, and none of the products will get absorbed (leaving you B12 deficient).