Health: Vitamin B12 Deficiency: Symptoms and Causes

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Vitamin B12 is vital for humans: it plays an important role in various metabolic processes, is involved in the breakdown of some fatty acids, supports blood formation, and is important for normal nerve function. It is also necessary in the genome for the production of DNA. There is no “one” vitamin B12; The name is a collective term for different compounds that have the same chemical building blocks, the so-called cobalamins. This is why medicine also talks about cobalamin when it comes to vitamin B12.

We humans mostly get vitamin B12 in our food. It binds to animal proteins. Therefore, under certain circumstances, a vegan or vegetarian lifestyle can lead to a vitamin B12 deficiency. Cobalamin deficiency can be serious – but you can counteract the deficiency by following a proper diet or by taking extra vitamin B12.

How much vitamin B12 is needed?

How much vitamin B12 the body needs depends on age. According to the German Society for Nutrition (DGE), the estimated values ​​for adequate vitamin B12 intake during childhood increase from 0.5 mcg per day for infants to 4.0 mcg per day for adolescents aged 13 and over. The same value applies to adults. The need for pregnant and lactating women increases. The reasonable daily dose is 4.5 micrograms for pregnant women and 5.5 micrograms for breastfeeding women.

Vitamin B12 deficiency: typical symptoms

If these values ​​are not reached, different symptoms can appear depending on the severity of the vitamin deficiency:

  • Fatigue and weakness
  • Pale skin color
  • lower efficiency
  • depressed mood
  • Forgetting
  • Headache
  • Dizziness
  • yellowish skin
  • Chest pain and difficulty breathing
  • mouth ulcers
  • Shortness of breath
  • Burning of the tongue
  • Tingling or numbness, especially in the legs
  • walking problems
  • Impotence
  • In the fetus: malformations
  • In infants: growth retardation, hypotension, tremors or convulsions
  • In the elderly: nerve damage and dementia

Since vitamin B12 is also necessary for the formation of red blood cells, a deficiency in vitamin B12 can lead to anemia. Anemia is also called anemia. The medical encyclopedia “MSD Evidence” writes: “It may not develop until three to five years after the onset of deficiency, as too much vitamin B12 is stored in the liver.” The vitamin is stored mostly in the liver, and to a lesser extent in the kidneys, muscles, brain, and spleen.

However, the DGE warns that people who don’t have an adequate supply of vitamin B12 beforehand can feel deficiency symptoms early on. This happens, for example, with breastfed babies whose mothers eat a vegetarian diet during pregnancy and breast-feeding, and for whom an adequate supply of vitamin B12 is not ensured.

Causes of vitamin B12 deficiency

The MSD Handbook sees two main causes for deficiency symptoms: either the body doesn’t have enough vitamin B12 or it doesn’t absorb or store enough of the vitamin.

Vitamin B12 can only be produced by microorganisms. Through the food chain, it reaches the animal and then the human organism. People who don’t eat any products of animal origin – that is, they eat plant food – have a hard time getting this vital substance, so you need to take care to get enough vitamin B12. Chronic alcohol consumption can also lead to a vitamin B12 deficiency.

However, some people have problems absorbing or storing cobalamins despite being fed to animals. The medical information portal “Neurologienetz” mentions various reasons for this, including chronic gastritis (especially in old age), diseases of the small intestine, problems with the pancreas, or the consequences of surgical interventions in the gastrointestinal tract.

Medications such as levodopa, metformin, nitrous oxide, colchicine or chloramphenicol and neomycin can also lead to vitamin B12 deficiency, according to “Neurologienetz.”

Older adults may also not be able to absorb enough vitamins because they produce stomach acid. The MSD Manual states that “low stomach acid reduces the body’s ability to remove vitamin B12 from meat protein.”

Diagnosis: How is vitamin B12 deficiency recognized?

Anyone who eats only plant foods should have their vitamin B12 stores checked regularly by a doctor. In order to identify a vitamin B12 deficiency, a doctor will usually do a blood test. If a routine blood test shows pre-enlarged red blood cells, this is a sign of deficiency. If the typical symptoms (as described above) are already apparent, it is also recommended to measure the vitamin B12 level in the blood.

Especially in younger people, confirmed vitamin B12 deficiency follows further tests and investigations to find out why the level is low.

Prevention and treatment of vitamin B12 deficiency

For people who do not have absorption disorders and do not follow a vegetarian diet, a balanced diet is sufficient to consume enough vitamin B12. Good suppliers of vitamin B12 are meat, fish and seafood as well as eggs and dairy products such as yogurt. Vegetarians can get the vitamin in the form of seaweed, certain types of mushrooms, and products that contain cyanobacteria. According to the DGE, the amounts of vitamin B12 present can vary widely.

Other than that, the following applies: Prevention and treatment of vitamin b12 deficiency both work by taking supplemental vitamin b12 supplements. Older adults who produce too little stomach acid to absorb vitamin B12 can easily absorb the vitamin from supplementation. Dietary supplements are usually swallowed as tablets or capsules. Since the vitamin B12 content can also be derived from algae, there are purely vegan alternatives for vegetarians and vegans.

If severe symptoms such as nerve damage or anemia occur, a high dose of B12 can also be injected directly into the muscle. These injections, which patients can also take themselves, are injected daily or weekly for several weeks. At some point, the vitamin B12 level is normalized.

Vitamin B12: Is an overdose possible?

What happens when you take too much vitamin B12? The DGE writes: “According to current knowledge, a high intake of vitamin B12, which is naturally found in food, is not harmful.” And according to the “MSD Handbook,” too much B12 supplementation doesn’t do any harm either. If there is too much vitamin B12 in food, the body will not automatically absorb more of it. As in the case of a vitamin C overdose or a vitamin D overdose, he simply excretes the vitamin. But this also means that high-dose supplements do not bring any additional health benefits.

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