Vitamin B12 Deficiency – Causes, Symptoms, and Treatment

Vitamin B12 does more things to the human body. It helps to create DNA and red blood cells for example.

Since your body does not create vitamin B12, you have to get it from animal-based foods or supplements. You should do that one thing on regular basis. While B12 is stored in the liver for up to five years, you can eventually get deficient if the diet does not help to manage the levels.


How Much Vitamin B12 to Get?

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This answer depends on things including you’re eating habits, age, medical conditions, and what medications you consume.

The average suggested quantity, measured in microgram differ by age:

Infant’s age – 6 months: 0.4 mcg

Babies age 7-12 months: 0.5 mcg

Babies aged 1-3 years: 0.9 mcg

Kids age 4-8 years: 1.2 mcg

Kids age 9-13 years: 1.8 mcg

Teens age 14-18: 2.4 mcg (2.6 mcg per day if pregnant and 2.8 mcg per day if breastfeeding)

Adults: 2.4 mcg (2.6 mcg per day if pregnant and 2.8 mcg per day if breastfeeding)

Most people have sufficient vitamin B12. But some people don’t have. What you do or do not eat, along with some health conditions and medications, could be the cause. When left untreated, a B12 deficiency can cause problems with your nerves, heart, or brain.


Causes of Vitamin B12 Deficiency


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Some older people get a condition named atrophic gastritis. That is when your stomach does not create sufficient hydrochloride acid. It helps you absorb B12 from food.

It is commonly easy to absorb B12 from fortified foods or supplements when you get atrophic gastritis. That is why it is recommended that people 50 and older get their B12 from these sources. Sometimes older adults need more doses to keep their level up. Ask your physician what is right for you.


Intestinal Disorders

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Some health conditions make it difficult for the small intestine to absorb B12. They have:

Inflammatory bowel disease (IBD), such as

Celiac disease

Crohn’s or ulcerative colitis

Symptoms can include:

Difficulty thinking clearly

In megaloblastic anemia, the red blood cells are higher t


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Some drugs may reduce your B12 levels, especially if you utilize them for more time. these include medications for:



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These drugs may block the stomach acid that helps you absorb B12. They include proton pump lower and H2 receptor agonist. These are utilized to treat peptic ulcer disease and acid reflux.



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Experts think more use of metformin can cause malabsorption problems.



There is increasing evidence that antiepileptic drugs may impact how you absorb B12.



An antibiotic named chloramphenicol may lead to problems with B12 absorption.

If you take these medicines each day, your physician may wish to check B12 levels each year. They may change or recommend a supplement if your levels get lower.


Stomach Surgery

Your body can not absorb B12 if a part of the intestine or part of the stomach is taken out. That can occur if you have surgery for cancer, weight loss, or different health conditions.

If you have surgery on the gastrointestinal tract, your physician will wish to keep an eye on B12 levels. They can provide you with shots of B12 if they get too low.


Vegan or Vegetarian Diet

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Most natural B12 vitamin sources come from animal products. That includes dairy, meat, and eggs. But it’s possible to have sufficient B12 on a strict vegetarian or vegan diet. The easiest way to do that is to take a weekly supplement or daily supplement. Check with your physician what dose is right for you.

Here are some other plant-based Vitamin B12 sources:

Fortified cereals


Fortified non-dairy milk

Vitamin waters or energy drinks

Getting sufficient B12 is very important if you are breastfeeding or pregnant.

That is because a deficiency could impact you and your baby. Ask your physician what kind of supplements you and your kid need.



Long-term use of some medications may also stop the body from absorbing vitamin B12 and cause deficiency. Some medications linked with poor vitamin B12 absorption include:


A medication that can help to treat type 2 diabetes

Proton pump inhibitor

A type of medication that helps to suppress stomach acid. A person

may utilize this to treat the conditions like peptic ulcers and gastroesophageal reflux.



A medication people may utilize to treat Mediterranean fever and gout.


Symptoms of Vitamin B12 Deficiency


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If you have a B12 deficiency, you will likely sense fatigued. Your body cells need B12 to function correctly. Getting enough B12 levels can lower normal red blood cell production, which can affect oxygen delivery.

Specifically, a deficiency in folate or B12 can lead to megaloblastic anemia. This condition causes large and abnormal formation of red blood cells and damage DNA synthesis.

When your body does not get sufficient healthy red blood cells to carry oxygen in tissues, you will likely feel tired and weak. It is essential to understand that you can grow fatigued and have different symptoms linked to B12 deficiency when your B12 levels are within range or low.

Yellow or pale skin is another sign that can show B12 deficiency is yellow or pale skin.

Like the condition named deficiency of iron, anemia linked to B12 deficiency may maintain your skin pale because of completely grown healthy red blood cells in the body.

B12 deficiency can also lead to a condition named jaundice, which makes skin and whites of eyes take over a yellowish color. The color is occurred by a high level of bilirubin, a waste product formed when your body breaks down the red blood cells.



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B12 deficiency and insufficiency can cause neurological side effects, including headaches. Headaches generally reported symptoms linked to B12 deficiency in both kids and adults.

Some research has shown that people who frequently felt some types of headaches are more likely to get low B12 levels.


Gastrointestinal Issues

The B12 deficiency may also cause nausea, diarrhea, bloating, constipation, and other gastrointestinal symptoms. This problem can impact both adults and children. Remember, many symptoms are non-specific and could occur by different factors. For example, medications, food intolerance, and infection could all cause diarrhea.


Depressive Symptoms

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B12 is important to the right functioning of the central nervous system, and a deficiency in this nutrient can affect mental health. Particularly, B12 deficiency causes a high risk of growing depression.

Getting low levels of B12 can lead to raised levels of a sulfur consisting amino acid called homocysteine. In turn, this may lead to the growth of depression by raising oxidative stress, cell death, and DNA damage in the body.


Difficulty Focusing And Mental Impairment

A deficiency in b12 negatively affects the central nervous system, people with B12 deficiency may feel foggy-headed and feel difficulty focusing and completing tasks.


Inflammation And Pain Of The Mouth And Tongue

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Glossitis is a medical term that means an inflammation, painful and red tongue. It can be occurred by vitamin B12 deficiency.

For people with vitamin B12 deficiency, glossitis can appear with stomatitis, which is featured by information and sores in the mouth.

Even though stomatitis and glossitis are general in people with B12 deficiency-linked anemia, they can happen without anemia also. It can be an early sign of B12 deficiency.


Paresthesia In Feet and Hands

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Paresthesia is a medical term that means needles pin or burning sensation in some part of the body like the feet and hands. Several adults and children who get B12 deficiency report feeling paresthesia.

Unfortunately, this sign of B12 deficiency coincides with signs related to diabetic neuropathy and nerve damage occurred by high blood sugar that causes numbness and pain in the extremities. People with diabetes taking metformin are at a high risk of growing B12 deficiency because this medication can lower vitamin B12 absorption in the body.

Other Signs and Symptoms of B12 Deficiency

In addition to the signs above, B12 deficiency may direct in the following:


Muscle Weakness and Cramps

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B12 deficiency negatively influences sensory and motor nerve function, which can lead to weakness and muscle cramps.


Impaired Coordination

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Impaired balance or ataxia and coordination is a neurological symptom that can occur by B12 deficiency. As such, a person with B12 deficiency may get difficulty balancing and walking.


Erectile Dysfunction

A male with B12 deficiency may feel erectile dysfunction with increased homocysteine levels in the body.


Vision Disturbances

B12 deficiency may cause vision disturbances, possibly because of damage to the optic nerve.


Detection and Treatment of Vitamin B12

Vitamin B12 deficiency does not have specific symptoms of any condition, it may go misdiagnosed and undetected. If you are feeling any of the above-given symptoms, it is essential to discuss them with our physician.

It is especially relevant if you:

are above the age of 60

follow a limited diet like a vegan diet

breastfeeding or pregnant

suffering from a medical condition that can weaken B12 levels

proton pump limitation or metformin

Additionally, by learning about your signs and providing you with a physical exam, a healthcare professional can rule out a B12 deficiency by ordering blood tests.

These tests can include:

  • folate levels
  • B12 levels
  • homocysteine levels
  • a complete blood counts
  • methylmalonic acid

If you are diagnosed with fewer B12 levels, your healthcare professional will suggest the possible treatment. It may have B12 injections, discussing health conditions, or oral B12 supplements that could be because of deficiency.

B12 injections are commonly suggested for people who cannot absorb B12 in the right way from supplements or food, like those who had gastric bypass surgery or people with some autoimmune diseases. B12 injections and supplements are considered safe and well-tolerated even in large doses.



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Vitamin B12 deficiency can be preventable with a diet rich in sufficient poultry, meat, dairy products, seafood, and eggs. If you don’t like animal products or you get a medical condition that lower how well your body absorbs nutrients, you can take vitamin B12 from a multivitamin or other supplements and foods fortified with vitamin B12.

If you decide to consume vitamin B12 supplements, let your physician so, they can tell you how much your body requires, or assure you they will not impact any medicines you are taking.

Folic acid supplements may affect vitamin B-12. Ensure to tell your physician if you take folic acid. You may require to consume vitamin B-12 separately from the above supplements and drugs, one in the morning and one at night, so you can get the complete dose of vitamin B-12.

Do not consume vitamin B-12 supplements if you get allergies or sensitivities to cobalt, vitamin B-12, and any different ingredients. Vitamin B-12 is safe to consume in suggested dosages if you are breastfeeding or pregnant.


Health Benefits

Vitamin B12 has different health benefits. It is called to help mood, memory, iron levels, nervous system, hair, skin, nails, and heart health.


Blood Health

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Vitamin B12 is an essential factor in helping the body create healthy red blood cells. When the body is deficient in or provides low vitamin B12, this can cause red blood cells to grow improperly.

As a result, the red blood cells evolve the biggest and most irregular shape. It stops them from moving from the bone marrow to the bloodstream

Anemia can cause fatigue, weakness, and another disease over time because your body does not get sufficient red blood cells to provide oxygen to organs.


Brain Health

Research shows that vitamin B12 can help with the nervous system and brain function, mood, memory, and depression.


Form Red Blood Cells

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Red blood cells provide oxygen from the lungs to tissue from the body. They also carry carbon dioxide, which is a toxic substance of cell functions from those tissue travel back to lungs where it is then removed out.

Vitamin B12 helps in red blood cell production.  If the vitamin B12 rates are too low, red blood cells are impaired, including megaloblastic anemia.

Megaloblastic anemia means anemia that lacks red blood cells caused by vitamin B12. It causes symptoms like difficulty concentrating, fatigue, dry skin, and clumsiness.

While there are additional reasons an individual may generate anemia like extra bleeding or low iron, containing healthy vitamin B12 levels.


Prevent Osteoporosis

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Balancing enough vitamin B12 levels may help your bone health. B12 deficiency also had lesser than normal bone mineral density. Bone with low mineral density can get fragile and delicate with time, causing to increase in osteoporosis risk.


May Lower Your Chance of Macular Degeneration

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Macular degeneration is an eye problem that primarily impacts your central vision. Balancing enough vitamin b12 levels may help to prevent macular degeneration risk related to age.

Researchers think that vitamin B12 supplementing may reduce homocysteine, which is an amino acid type that is present in bloodstreams. Raised homocysteine levels have been linked with an elevated risk of age-related eye problems.


May Improve Mood and Depression

Vitamin B12 may help your mood. The effect of vitamin B12 on mood is not yet completely understood. However, this vitamin plays an important role in metabolizing and synthesizing serotonin, a chemical responsible for managing mood.

Therefore, vitamin B12 deficiency may cause lower serotonin production, which may lead to a depressed mood.


Boost Energy

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Vitamin B12 supplements also boost energy. All B vitamins are necessary for energy production in the body as they do not provide energy themselves.

Presently, there is no scientific proof to recommend that vitamin B12 supplements can increase energy in those with enough vitamin levels.


May Prevent Birth Defects

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Pregnant women should have enough doses of vitamin B12. That is because the synthesis may help to prevent severe birth defects like partial paralysis and abnormally developed skull. Enough amount of vitamin B12 is essential for a healthy pregnancy.

If someone with less B12 levels becomes pregnant, they have more chance of giving birth to a child with a neural tube defect. This class of birth to a child with a neural tube defect. This class of birth defects has anencephaly, a fatal condition where the brain of a baby and skull are unhealthy and underdeveloped. Along with managing the right vitamin B12 levels, consuming folic acid before and after conception can lower the chance of a baby getting neural tube defects.


Supports Healthy Skin, Nails, Hair

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Enough vitamin B12 is important for cell production and healthy skin, hair, and nails.

Having low vitamin B12 levels can lead to different dermatologic symptoms, including nail discoloration, hyperpigmentation, vitiligo, hair changes, and skin color loss in patches.

Supplementing with vitamin B12 has been shown to enhance dermatologic symptoms in people with B12 deficiency.


Foods You Should Eat if You Have a B12 Deficiency

Fish and Shellfish

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It is how much B12 you get in a 3-ounce serving of these foods:

  • Steamed mussels – 20.4 micrograms
  • Clams (Cooked) – 84.1 micrograms
  • Steamed Alaska king crab – 9.8 micrograms
  • Atlantic mackerel (Cooked) – 16.1 micrograms
  • wild rainbow trout (Cooked) – 5.4 micrograms
  • Salmon (Cooked) – 2.4 micrograms


Red Meat

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It has lamb and beef. Like humans, high amounts of B12 are stored in their livers. Here is what you can have from a 3-ounce serving of the following:

Cooked beef liver provides 70.7 micrograms

Steak, Grilled lean beef: 6.9 micrograms

More red meat can increase the chances of some health conditions. They have heart and blood vessels and some type of cancer. You may wish to lower it to fewer servings each week. Ask your physician how much safe it is for you.



Cows also provide B12 in their milk. You will find it in:

Low-fat yogurt (8 ounces): 1.2 micrograms

Low-fat milk, (1 cup): 1.2 micrograms

Swiss cheese, (1 ounce): 0.9 micrograms



You can get some B12 in turkey and chicken

  • chicken liver – 1 ounce (Cooked): 4.7 micrograms
  • turkey liver – 3 ounces (Cooked): 23.9 micrograms
  • ground lean turkey – 3 ounces (Cooked): 1.6 micrograms
  • Roasted chicken breast – 3 ounces: 0.3 micrograms
  • Roasted turkey – 3 ounces: 0.8 micrograms



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One hard-boiled egg provides around 0.6 mg of B12. That is 25% of your everyday value. But you will need to consume the whole egg. Most of the B12 comes from the yolk. If you get a deficiency, eggs should not be your primary source of B12. There is not much evidence that they can increase B12 levels.


Vegetarian or Vegan Sources

It is difficult to get B12 from your food if you are on a strictly plant-based diet. That means you do not consume any animal products or have dairy and eggs. Your physician will likely recommend taking a weekly or daily dietary supplement to keep your levels up. They can let you know what does it correct for you. You can have B12 from some plant-based sources. These have fortified foods with extra nutrients.

  • Fortified cereals 1 serving: 0.6-2.1 micrograms
  • Fortified non-dairy milk like soy or oat, 1 cup: 0.6-2.07 micrograms
  • Nutritional yeast 1 tbsp: 4.8 micrograms

Always read the label of nutrition and check how much B12 you are getting in each serving. Some fermented foods and seaweed get B12. It comes from their exposure to the bacteria. You should not depend on them for all the B12 requirements. But you can still include them in your diet. They include:



It is a fermented cake of soybean. Research tells that one serving may have around 0.7 to 8.0 mcg. But it is difficult to understand exactly how much you will have from the grocery store.



These are seaweed-dried sheets. You have possibly seen them used to prepare sushi. Research shows it might be good to get 2.4 mcg of B12 from 4 mg of nori. But you would need to consume more than 13 sheets to meet your daily consumption. If you have been vegan or a strict vegetarian for more than some years, ask your physician to check your B12. A simple blood test can tell if your levels are where they should be.


Side Effects of Vitamin B-12

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Oral vitamin B-12 is safe to consume at suggested doses for healthy people. Injectable vitamin B-12 utilized to treat the deficiencies can cause the following side effects:

  • Itching
  • Headache
  • Nausea
  • Vomiting
  • Mild Diarrhea
  • Skin Rash
  • Dizziness
  • Vein Thrombosis
  • Sensation Of Swelling
  • Polycythemia Vera
  • Congestive Heart Failure
  • Pulmonary Edema

Vitamin B-12 can lead to a very rare but chronic allergic reaction like anaphylaxis. It includes face swelling, throat, tongue, and difficulty breathing and swallowing. If this happens after you consume vitamin B-12, immediately call your local medical emergency service.

Some agents are connected to lower serum levels of vitamin B-12 or absorption if you take any of the following:

  • metformin
  • colchicine
  • vitamin C
  • chloramphenicol
  • aminosalicylic acid
  • proton pump inhibitors
  • H2 blockers


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