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Vitamin B12 Deficiency Symptoms: Much More Than Fatigue

vitamin B12Vitamin B12 is best known and most promoted as a cure for low energy, but this vitamin is important for much more than keeping energy levels up. Without enough vitamin B12, you may suffer from everything from depression and memory loss to canker sores and dizziness.

Many people with vitamin B12 deficiency don’t have fatigue. Vitamin B12 plays crucial roles in maintaining the health of your blood cells, digestive system, brain, and nervous system. And while fatigue (due to anemia) is sometimes a symptom, recent research shows that many people have vitamin B12 deficiency without anemia or significant fatigue. Instead, they have vitamin B12 deficiency symptoms that are more related to impairments in the nervous system.

Deficiency symptoms most often caused by impaired nervous system. In the nervous system, vitamin B12 is necessary for the formation of myelin, a whitish insulating sheath around nerve fibers that increases the speed at which impulses are conducted. It is also needed for the production of some neurotransmitters. Vitamin B12 deficiency can therefore result in defective myelin synthesis and neurotransmitter imbalances, leading to a host of mental, emotional, and physical symptoms related to the nervous system.

Vitamin B12 Deficiency Symptoms

The following are the most common vitamin B12 deficiency symptoms:

Abnormal sensation, typically numbness, tingling or pricking (“pins and needles”) of the lower legs and feet (both sides)
Weakness in the legs
Increased risk of falling
Memory loss
Attention deficits
Psychosis (suspiciousness, persecutory or religious delusions, auditory and visual hallucinations, and disorganized thought-processes)
Sore, swollen, beefy red tongue
Sores at the corners of the mouth
Recurrent canker sores
Burning sensation of the mouth
Shortness of breath on exertion
Decreased bone health and increased risk of fracture
Mild diarrhea or constipation
Impaired vision
Possible increased risk of cardiovascular disease
Possible increased risk of cancer
Lightheadedness or fainting, possibly accompanied by a rapid increase in heartbeat, after standing up from a lying down position

Causes of B12 Deficiency

Causes of vitamin B12 deficiency include not eating animal products, not making enough stomach acid (“achlorhydria”-common with aging), an autoimmune disorder called pernicious anemia, and certain medications, especially acid-blocking medications (proton pump inhibitors and H2 blockers) for gastro esophageal reflux and acid reflux, and Metformin for diabetes.

Treating Vitamin B12 Deficiency Symptoms

Treatment for vitamin B12 deficiency usually starts with injections of the vitamin. Some patients need regular vitamin B12 injections for life, depending on the cause of their deficiency. After vitamin B12 injections have returned the body’s levels to normal, it’s possible to switch to oral vitamin B12 supplements. Vitamin B12 supplements may contain a few different forms of the vitamin, including cyanocobalamin, methylcobalamin, hydroxocobalamin, and adenosylcobalamin. While all these forms of vitamin B12 are capable of treating vitamin B2 deficiency, methylcobalamin is superior for oral use. The typical recommended dose for treating vitamin B12 deficiency is 2000 micrograms per day.

For information on food sources of vitamin B12, see The Top B12 Foods for Every Diet, where you’ll find information on the best dietary sources of vitamin B12 for meat-eaters, vegetarians, and vegans.

Source: Nutrients. Nov 2013; 5(11): 4521–4539.

6/16/2015 4:26:08 AM

Amazing post indeed! I'm 62 and a diabetic patient. I have been taking Metformin so as to keep my blood sugar under control for quite a few years. I'd been experiencing anemia, weakness, fatigue, and tingle in my hands and feet. When I met my doctor, he advised me to take injections, and after taking several injections he made me switch to oral supplements (brilliant! you greatly told this). Now I feel better than any time in my past. However, thanks for the incredible post. Here is another good post and after reading it -, anyone could get some new and useful information related to Vitamin B12 deficiency.

7/14/2014 1:57:55 PM

Let me share my story... I started to experience numbness/lack of feeling in my fingertips, which my doctor attributed to "emotional factors". It went for a while and I wasn't sure what to do. However, being an RD, I recalled that mild neurological symptoms might be caused by sub-clinical deficiency of B12. I happened to have a jar of B-complex pills on a shelf at home. So I thought, I'd try it. And... not only the numbness in my fingertips was gone within days, but my irregular periods became like a clockwork, and shortly I fell pregnant (after trying for a long time). I never did any blood tests, but I'm convinced that I suffered from B12 deficiency for at least a year without even being aware of it. And just an oral supplement, no injections, was enough to fix it. Also, I have to say that from what I know, B12 is more effective when taken in synergy with other B vitamins.