B12 Deficiency Symptoms

Vitamin B12 is an essential component that helps your body maintain the health of your nerve and blood cells. It also aids in the production of DNA, the genetic material found in all your cells. You must consume vitamin B12-containing foods and beverages to obtain it because your body cannot produce it on its own. Vitamin B12 is present in animal products such as meat, dairy, and eggs. It’s present in fortified meals including cereal, bread, and nutritional yeast.

The average adult needs 2.4 micrograms (mcg) of vitamin B12 daily, and those who are expecting, or nursing require more.


Daily Vitamin B12 Requirements

Average daily intakes of vitamin B12 from food 


In Adult Males – 5.94 mcg 

In Adult Females – 3.78 mcg 

For children aged (2–19 years) -3.76 mcg to 4.55 mcg 

The quantity of vitamin B12 required by newborns and children changes with age.

In Pregnant and lactating mothers

To address fetal storage, the recommended dietary requirement during pregnancy is increased from 2.0 mcg/day to 2.2 mcg/day. The World Health Organization (WHO) recommends increasing the dose by 0.4 mcg/day to 1.4 mcg/day. During breastfeeding, vitamin B12 metabolism includes the process of secretion and development in milk.


Vitamin B12 Absorption 

The body must undergo two things to absorb vitamin B12 from the food that you eat. First, the hydrochloric acid in your stomach extracts vitamin B12 from the food you consume. Following that, vitamin B12 mixes with intrinsic factor, a protein produced by your stomach. Your digestive system will then be able to absorb Vitamin B12.

Some patients develop pernicious anemia, which implies their stomach does not produce intrinsic factors. As a result, their bodies are unable to adequately absorb vitamin B12, resulting in a vitamin B12 deficit.

Vitamin B12 insufficiency can occur at any age. Age-related differences in vitamin B12 insufficiency are more common in people 60 years of age or older than in other age groups.

Vitamin B12 is not synthesized by the human body and must be received through food. Vitamin B12 is generally obtained by the body through the ingestion of foods derived from animals.

A lack of animal products such as eggs, meat, milk, fish, poultry, and some forms of edible algae can lead to a deficit.

Vegans and, to a lesser extent, vegetarians are in danger of B12 deficiency if they do not eat a vitamin supplement or vitamin-fortified foods.

Children are more vulnerable to B12 insufficiency owing to poor dietary intake because they have fewer vitamin reserves and a greater vitamin need per calorie of food consumption.

The body’s demands may be enhanced because of AIDS and hemolysis (the destruction of red blood cells), which encourages greater red cell synthesis.


Vitamin B12 Deficiency

vitamin b b12 deficiency symptoms and signs

A lack of vitamin B12 or folate can result in a variety of symptoms. These normally appear gradually, but if left untreated, they might worsen.

Anemia is a condition where there are either abnormally few red blood cells or abnormally few hemoglobin-containing red blood cells.


Anaemia Can Cause the Following Symptoms:

  • Severe exhaustion (fatigue)
  • Insufficient energy (lethargy)
  • Breathlessness
  • Feeling dizzy
  • Headaches
  • Pale Skin
  • Heartbeats that are perceptible (palpitations)
  • Hearing noises from within the body rather than from outside sources (tinnitus)
  • Appetite loss and weight loss
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Symptoms of a Vitamin B12 Deficiency

vitamin b b12 deficiency symptoms and signs

Vitamin B12 insufficiency develops slowly and worsens over time, and it is sometimes misdiagnosed as another ailment. It is common for it to go unnoticed since the body develops accustomed to feeling ill. B12 insufficiency might take several years to develop.


Other signs of anemia induced by vitamin B12 deficiency include:

  • A faint yellow hue to your skin
  • A painful and red tongue (glossitis)
  • Ulcers in the mouth
  • Needles and pins (paraesthesia)
  • Alterations in your walking and movement
  • Vision impairment
  • Irritability
  • Depression
  • Changes in your thinking, feelings, and behavior
  • A reduction in mental faculties such as memory, comprehension, and judgment (dementia)

Even those with a vitamin B12 deficit who have not yet had anemia might experience some of these symptoms.


Additional signs of anemia induced by a lack of folate might include:

  • Decreased sensation of taste
  • Diarrhea
  • Tingling and numbness in the feet and hands
  • Muscle wasting
  • Depression

Angular cheilitis, mouth ulcers, bleeding gums, hair loss and thinning, premature greying, a tired appearance, dark circles around the eyes, and brittle nails are all possible indications.


Deep Muscle-Tendon Responses Are Reduced or Lost

Babinski, Rossolimo, and other pathological reflexes, as well as severe paresis.

The occurrence of peripheral sensory-motor complaints or subacute mixed spinal cord degeneration strongly implies B12 insufficiency rather than folate deficiency.

If B12 does not adequately manage methylmalonic acid, it stays in the myelin sheath, producing fragility.

Dementia and depression have also been linked to this shortage, presumably due to a lack of methionine synthesis due to an inability to transform homocysteine into this product.

Methionine is an essential cofactor in the synthesis of numerous neurotransmitters. Each of these symptoms can occur alone or in combination with others.


Pernicious Anemia

Anemia is caused by bone marrow promegaloblastosis. This is because DNA synthesis is inhibited.


Gastrointestinal Symptoms

vitamin b b12 deficiency symptoms and signs

Gastrointestinal symptoms include bowel motility changes such as moderate diarrhea or constipation, as well as a lack of bladder or bowel control. These might be the result of poor DNA synthesis preventing replication at a place with a high cell turnover.

This might potentially be caused by an autoimmune assault on stomach parietal cells. There is a link between “watermelon stomach” and pernicious anemia.


Risk Of Metabolic Disease in Offspring

Vitamin B12 is an important vitamin for sustaining the fetus growing metabolic demands throughout pregnancy.

Vitamin B12 deficiency in pregnant women is becoming more widespread, and it has been linked to serious maternal health consequences such as increased obesity, a higher BMI, insulin sensitivity, gestational diabetes, and type 2 diabetes later in life.

The one-carbon metabolic cycle involves both vitamin B12 and folate. Methionine synthase, an enzyme involved in the methylation of homocysteine to methionine in this cycle, requires vitamin B12 as a cofactor.

DNA methylation affects gene function and is an important epigenetic regulatory mechanism in mammals.


The Consequences of Cardiometabolic Disease

vitamin b b12 deficiency symptoms and signs

Vitamin B12 and metabolic illness consequences, including obesity, insulin resistance, and the development of cardiovascular disease.

A study found that supplementing with vitamin B12 over 10 years resulted in decreased levels of weight growth in overweight or obese people.

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Various factors might explain the link between obesity and low vitamin B12 levels.

Because vitamin B12 is a significant dietary methyl donor involved in the one-carbon cycle of metabolism, and because a recent genome-wide association study found that higher DNA methylation is related to increased BMI in adults, a vitamin B12 shortage may alter DNA methylation and increase non-communicable disease risk. 

In the one-carbon cycle, vitamin B12 is also a co-enzyme that transforms methyl malonyl-CoA to succinyl-CoA. If this process is prevented, methyl malonyl-CoA levels rise, blocking the rate-limiting enzyme of fatty acid oxidation, and resulting in lipogenesis and insulin resistance.

It is believed that repeated short-term restricted diets and higher vitamin B12 need because of increased development and body surface area cause lower vitamin B12 concentrations in the obese population.

It has also been suggested that poor eating habits, such as consuming a diet low in micronutrient density, are the reason for decreased vitamin B12 concentrations in obese people. Finally, vitamin B12 is required for the formation of red blood cells, and a shortage of vitamin B12 can result in anemia, which causes exhaustion and a lack of drive to exercise.

A lack of vitamin B12 can affect homocysteine remethylation in the methionine cycle, leading to elevated homocysteine levels. Homocysteine-reducing therapies have improved coagulation factors and cardiovascular reactivity, which is consistent with the growing body of research correlating excessive homocysteine concentrations to an increased risk of heart disease.

Adults with metabolic syndrome who had low levels of vitamin B12 had greater homocysteine levels than those in healthy controls. Therefore, it’s probable that a vitamin B12 shortage increases an obese person’s chance of getting cardiovascular disease.

Low amounts of vitamin B12, on the other hand, may raise the levels of proinflammatory proteins, which may lead to an ischemic stroke.



vitamin b b12 deficiency symptoms and signs

One of the most common causes of anemia is a lack of vitamin B12. It is commonly considered that there is a higher risk of getting anemia in regions where vitamin B12 deficiency is frequent.

Except for old people, vegetarians, cases of malabsorption, and some hereditary illnesses, vitamin B12 deficiency may not have a major overall impact on the occurrence of anemia worldwide.

Anemia is described as a condition in which the body’s tissues and organs do not receive adequate oxygen, resulting in a lack of red blood cells.

The characteristic of megaloblastic anemia, which is brought on by vitamin B12 deficiency, is that the red blood cells are bigger than usual and are unable to carry oxygen to the internal tissues. The clinical case reveals a changed DNA synthesis in which vitamin B12 is required for the generation and maturing of red blood cells in the bone marrow.

Older patients frequently describe symptoms of anemia, such as fatigue and weakness, shortness of breath, inability to be active, feeling dizzy, headaches, pallor, dry lips, and a change in taste.


Potential Complications Include:

Although uncommon, vitamin B12 or folate insufficiency with or without anemia might lead to difficulties, especially if you’ve been low for a long period.

  • Difficulties with the nervous system
  • Transient infertility 
  • Heart problems
  • Complications of pregnancy and birth defects
  • Adults suffering from severe anemia are at risk of getting heart failure
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Some consequences improve with adequate treatment, while others, such as nervous system issues, might be permanent.



If vitamin B12 insufficiency is not treated, it can have long-term negative consequences on the neurological system and brain. The following are more serious adverse effects of vitamin B12 deficiency:

  • Neuropathy of the extremities
  • The spinal cord is degenerating
  • Paralysis
  • Urinary incontinence and/or bowel incontinence
  • Erectile dysfunction (ED)
  • Depression
  • Delusions and paranoia
  • Memory loss


Vitamin B12 Can Be Obtained in The Following Forms:

vitamin b b12 deficiency symptoms and signs

Most individuals may avoid vitamin B12 deficiency by eating vitamin B12-rich foods and drinks.


Food for animals:

Red meat, fish, poultry, eggs, milk, and other dairy items all contain vitamin B12.


Foods fortified with vitamins:

Fortified foods contain vitamins and minerals that are not normally present. Certain breakfast cereals, nutritional yeast, plant milk, and bread are types of fortified foods. Check the nutritional data on the product label to determine if it has been fortified with vitamin B12.


Dietary supplements containing vitamin B12:

Vitamin B12 is found in several multivitamins. Some pills simply contain vitamin B12. Consult your doctor or pharmacist to determine which supplement is best for you. 


You may also assist avoid vitamin B12 insufficiency by doing the following:

Avoid drinking alcohol:

Regular drinking can harm your digestive system and hinder your body’s ability to absorb vitamin B12.

Manage your digestive disease as best you can: If you have a digestive condition, such as Crohn’s or celiac disease, make sure to follow your doctor provider’s advice to stay healthy.



Injections or pills to restore the deficient vitamins may usually be used to treat the majority of cases of cobalamin and folate insufficiency. Injections are often used to provide vitamin B12 supplements. Then, if your diet is the cause of your vitamin B12 shortage, you will either need vitamin B12 pills taken between meals or frequent injections. These therapies might last the remainder of your life.

Folic acid supplements are used to replenish folate levels. These are frequently prescribed for a period of 3-4 months. In certain circumstances, changing your diet might help you treat the disease and keep it from returning.

Green foods such as broccoli, peas, and Brussels sprouts are excellent providers of folate.


When To Contact Your Physician

If you have symptoms of vitamin B12 insufficiency or are at risk of developing vitamin B12 deficiency, see your doctor to see if a blood test to determine your vitamin B12 level is necessary. Reach out to your doctor if you have a vitamin B12 deficiency diagnosis and are exhibiting any new or alarming symptoms and be sure to adhere to any dietary or prescription recommendations made. Delaying treatment puts you in danger.


Further Reading:





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