Signs of a Vitamin B-12 Deficiency

Vitamin B-12 is an essential nutrient, meaning that your body can’t make it, so you have to get it from other sources. It helps keep blood and nerve cells healthy, and it helps produce DNA, the genetic material in all of your cells. It also prevents megaloblastic anemia, a blood disorder that leaves you tired and weak.

At Primecare Family Practice in Arlington, Texas, board-certified family practitioners Maryline Ongangi, APRN, FNP-C, and Lewis Nyantika, APRN, FNP-C, conduct health screenings for many different substances, including vitamin B-12. All it takes is a simple blood test to determine if your levels are good or if you have a deficiency. Here’s what the team wants you to know about the importance of B-12 in your body and why you should be concerned about your levels.

The importance of vitamin B-12

Vitamin B-12 (cobalamin) impacts many bodily systems, playing an essential role in red blood cell formation, cell metabolism, nerve function, and the production of DNA, our genetic material.

The most readily available source of B-12 is animal foods, including meat, poultry, fish, and dairy products. B-12 may also be added to some foods, such as breakfast cereals, and can be obtained as an oral supplement.

The body absorbs vitamin B-12 from food in a two-step process. First, the hydrochloric acid in the stomach cleaves the vitamin from the protein it’s attached to. Second, the now-freed vitamin combines with a protein made within the stomach, called intrinsic factor. The body absorbs the combined vitamin-protein together.

The B-12 contained in dietary supplements isn’t attached to any protein, and therefore doesn’t require the first step. However, it still needs to combine with intrinsic factor to be absorbed.

People who have pernicious anemia, an autoimmune disease, aren’t able to make intrinsic factor, so they have trouble absorbing vitamin B-12 from foods and dietary supplements.

Vitamin B-12 deficiency

Vitamin B-12 deficiency isn’t a common problem in the United States; however, those who follow a vegetarian or vegan diet might be prone to deficiency since plant foods don't contain the vitamin.

In addition, it can become harder to absorb B-12 as you age, if you’ve had weight loss surgery or a procedure that removed part of your stomach, or if you drink a lot of alcohol. Other risk factors for a deficiency include:

• Atrophic gastritis, where the stomach lining thins
• Small intestine problems, such as Crohn's disease, celiac disease, bacterial growth, or a parasite
• Immune system disorders, such as Graves' disease or lupus
• Medications such as anti-reflux and diabetes drugs that interfere with the absorption of B-12

Since your body stores 1,000-2,000 times as much vitamin B-12 in the liver as you’d typically eat in a day, and stores it for up to five years, the symptoms of vitamin B-12 deficiency can take several years to appear.

Signs of a vitamin B-12 deficiency

A mild B-12 deficiency may cause no symptoms, but if left untreated, you may experience symptoms such as:

• Weakness or tiredness
• Lightheadedness
• Heart palpitations
• Shortness of breath
• Pale skin
• A smooth tongue
• Constipation, diarrhea, loss of appetite, or gas 
• Nerve problems, including numbness or tingling, muscle weakness, and problems walking
• Vision loss
• Mental health concerns, including depression, memory loss, or behavioral changes

Getting your vitamin B-12 level checked each year at your annual physical can help prevent these problems.

If you haven’t had a blood test in a while, and you’re not sure where your vitamin B-12 level stands, call Primecare Family Practice at 817-873-3710 to schedule an evaluation, or book online with us today.