I noticed the start of a tongue ulcer, my usual reminder that I’ve not been taking enough vitamin B12, topped up yesterday and glad to report that the swelling has gone overnight.
Vitamin B12 deficiency is not talked about often, so here are some of the main symptoms:
Physical Symptoms
- Fatigue and Weakness: A lack of vitamin B12 can lead to a decrease in red blood cell production, resulting in anemia, which causes fatigue and weakness.
- Pale or Jaundiced Skin: Anemia caused by B12 deficiency can make the skin look pale or cause jaundice (yellowing of the skin and eyes).
- Shortness of Breath and Dizziness: Due to decreased red blood cell count, there is less oxygen being transported to the body’s cells, leading to shortness of breath and dizziness.
- Heart Palpitations and Chest Pain: Anemia can strain the heart as it works harder to pump blood to deliver enough oxygen throughout the body.
- Glossitis and Mouth Ulcers: Inflammation of the tongue (glossitis) and painful mouth ulcers are common symptoms.
- Nerve Problems: B12 deficiency can cause nerve damage, leading to symptoms like tingling, numbness, and a sensation of “pins and needles” in the hands and feet.
- Visual Disturbances: Damage to the optic nerve can cause vision problems.
- Difficulty Walking: Coordination and balance can be affected due to nerve damage, leading to difficulty walking.
Mental and Cognitive Symptoms
- Memory Loss: Cognitive functions can be impaired, leading to memory problems.
- Difficulty Thinking and Reasoning (Cognitive Impairment): This can include problems with concentration, planning, and reasoning.
- Mood Changes: Depression, irritability, and mood swings can occur.
- Psychosis: In severe cases, B12 deficiency can lead to more serious mental health issues like psychosis.
Additional Symptoms
- High Levels of Homocysteine: Blood tests may show elevated homocysteine levels, which is a risk factor for cardiovascular diseases.
- Infertility: Severe, untreated B12 deficiency can sometimes lead to infertility, which is usually reversible with adequate treatment.
- Glossitis and Mouth Ulcers: Inflammation of the tongue and sores in the mouth can occur.
Risk Factors
Certain groups are at higher risk of B12 deficiency, including:
- Older adults
- People with digestive disorders like Crohn’s disease or celiac disease
- Those who have had gastrointestinal surgeries (e.g., gastric bypass)
- Vegetarians and vegans (since B12 is primarily found in animal products)
- Individuals taking certain medications (e.g., metformin for diabetes, proton pump inhibitors for acid reflux)
Diagnosis and Treatment
If B12 deficiency is suspected, a healthcare provider can diagnose it through blood tests measuring B12 levels, complete blood count (CBC), and possibly homocysteine and methylmalonic acid levels. Treatment typically involves dietary changes, oral B12 supplements, or B12 injections, depending on the severity of the deficiency and underlying causes. Sadly too often these tests are not easy to organise via the NHS, so it’s worth just asking your GP if taking a course of B12 supplements would cause any problems.
Addressing vitamin B12 deficiency early is crucial to prevent long-term complications and ensure overall health and well-being. I try to remember to take a 1,000mcg tablet (it’s tiny so no problems swallowing for anyone with concerns); make sure it’s the “methylcobalamin” form which is the natural form rather than other cheaper but synthetic versions.
