Vitamin B12 Deficiency is Emerging as Silent Epidemic: Know Causes & Manifestations

Medically Reviewed by:Dr. Kanika
Vitamin B12 Deficiency is Emerging as Silent Epidemic: Know Causes & Manifestations

Vitamin B12 is an essential nutrient which promotes the health of your blood cells and nerve cells. Additionally, it aids in the synthesis of DNA, the genetic material found in every cell in your body. You must eat foods and beverages that contain vitamin B12 in order to obtain it because your body cannot produce vitamin B12 on its own. Meat, cheese, and eggs are examples of animal items that contain vitamin B12. It is also present in foods that have been fortified or foods that have had specific vitamins and nutrients added to them, like bread, nutritional yeast, and some cereals.

The recommended daily intake of vitamin B12 for adults is 2.4 micrograms (mcg), with higher requirements for those who are pregnant or nursing. Depending on their age, infants and kids require different amounts of vitamin B12. Some individuals cannot absorb enough vitamin B12, regardless of their intake, while others don't get enough of it from their diet. Because of this, vitamin B12 insufficiency is somewhat frequent, particularly among elderly individuals.

A vitamin B12 deficiency occurs when the body isn't obtaining or absorbing enough of the vitamin B12 it needs to operate correctly from the food it consumes. If vitamin B12 insufficiency is left untreated, it can lead to neurological, psychiatric, and physical issues.

The general people are not well informed about the symptoms of Vitamin B12 deficiency or the potential harm that low levels might cause to the body. In India, vitamin B12 deficiency was becoming a quiet epidemic affecting both men and women. However, this is also true in many other nations, and the main causes of this are bad eating habits, lifestyle choices, and medical disorders that prevent the body from absorbing and consuming this vital nutrient in the right amounts. 

What is Vitamin B12 Deficiency?

Vitamin B12, also known as cobalamin, plays an important role in numerous body functions, including red blood cell production, DNA synthesis and neurological health. Vitamin B12 deficiency occurs when your body is either not getting sufficient or not absorbing sufficient vitamin B12 from the food that you eat that it needs to function properly. Vitamin B12 deficiency can cause a wide range of symptoms and health complications, ranging from mild fatigue and weakness to severe neurological disorders and anemia.

What are the Causes of Vitamin B12 Deficiency?

Inadequate consumption of vitamin B12 or improper absorption of the vitamin by the body might result in vitamin B12 deficiency. The following circumstances or conditions can result in a vitamin B12 deficiency:

  • Lack of vitamin B12 in your diet: Inadequate consumption of foods fortified with vitamin B12 or insufficient amounts of naturally occurring vitamin B12 can result in vitamin B12 insufficiency.
  • Gastritis: Vitamin B12 deficiency is frequently caused by the inflammation of the stomach lining, known as gastritis. It can result in a deficit of vitamin B12 because your stomach does not produce enough hydrochloric acid, which is necessary for the absorption of vitamin B12.
  • Pernicious anemia: Individuals who suffer from this uncommon illness are unable to produce the stomach protein known as the intrinsic factor. Your body needs an intrinsic factor to absorb the vitamin B12. Pernicious anemia patients are deficient in the vitamin B12.
  • Digestive diseases: Conditions affecting the digestive tract, such as celiac disease and Crohn's disease, might hinder your body's ability to absorb vitamin B12.
  • Surgery: Absorption of vitamin B12 may be compromised in patients who have had gastrointestinal surgery, such as a gastric bypass (weight loss surgery).
  • Alcohol use disorder: This condition can harm your digestive tract and result in a vitamin B12 deficiency.
  • Transcobalamin II deficiency: This is a rare genetic condition which impairs the transport of vitamin B12 within the body.

What are the Clinical Manifestations of Vitamin B12 Deficiency?

The symptoms of vitamin B12 deficiency can develop gradually and can get worse over time. Certain individuals do not pose any symptoms despite having a low level of vitamin B12 in their bodies. Vitamin B12 deficiency can cause physical, neurological and psychological symptoms. 

The following are the general physical symptoms of vitamin B12 deficiency:

  • Fatigue, weakness and tiredness
  • Anemia 
  • Nausea, vomiting, diarrhea
  • Loss of appetite
  • Weight loss
  • Mouth ulcers or soreness in the tongue and mouth
  • Yellowish discolouration of skin

The following are the neurological symptoms of vitamin B12 deficiency:

  • Tingling or numbness in hands and feet
  • Vision abnormalities
  • Loss of memory and confusion
  • Trouble in walking and speaking while compared to what you previously did

The neurological symptoms associated with Vitamin B12 deficiency are not reversible.

The following are the psychological symptoms of Vitamin B12 deficiency:

  • Feeling irritated
  • Depression
  • Noticing a change in the way you feel and behave

What are the Different Stages of Vitamin B12 Deficiency?

Vitamin B12 deficiency is categorized into 4 stages. This includes:

  • Stage 1: Decreased levels of Vitamin b12 in blood
  • Stage 2: Decreased levels of vitamin B12 in your cells along with metabolic abnormalities
  • Stage 3: Psychological and neurological symptoms like balance problems, anxiety, confusion etc
  • Stage 4: Macrocytic anemia

How to Diagnose Vitamin B12 Deficiency?

Diagnosing vitamin B12 deficiency can be challenging because symptoms may not always be evident or may resemble those of other nutritional deficiencies. Those who are at a high risk of getting vitamin B12 deficiency will typically have routine blood tests performed by healthcare practitioners to check for the deficit.  A complete blood count (CBC) and a blood test for vitamin B12 are the tests used to identify vitamin B12 deficiency. If a person has less than 150 micrograms of vitamin B12 per milliliter in their blood, they are diagnosed with vitamin B12 deficiency.

How to Manage Vitamin B12 Deficiency?

Vitamin B12 can be used to manage vitamin B12 deficiency. Usually, cyanocobalamin, an artificial version of vitamin B12, is used to treat it. The individual may just require treatment until their vitamin B12 levels return to normal, or they may require vitamin B12 therapy for the remainder of their lives, depending on the underlying reason for the shortage. Treatment options for vitamin B12 include:

  • Oral medications with Vitamin B12 (Vitamin B12 pills or multivitamin pills with B12)
  • Intramuscular injections of Vitamin B12
  • Vitamin B12 nasal gel and Vitamin B12 Nasal spray

What are the Complications of Vitamin B12 Deficiency?

Untreated vitamin B12 deficiency can result in major, long-lasting negative effects that impact the brain and nerve system. The most serious consequences of a vitamin B12  deficiency include:

  • Peripheral neuropathy
  • Spinal cord degeneration
  • Bowel and bladder incontinence
  • Erectile dysfunction
  • Paralysis
  • Depression 
  • Loss of memory
  • Mental health problems like Delusions and paranoia

Are there any Options to Prevent Vitamin B12 Deficiency?

Eating enough meat, poultry, seafood, dairy products, and eggs helps most individuals prevent vitamin B12 deficiency.  You can take vitamin B12 in the form of a multivitamin, nutritional supplement, or foods fortified with vitamin B12 if you don't eat animal products or if you have a medical condition that affects how well your body absorbs nutrients. Inform your physician if you decide to use vitamin B12 supplements so they can determine the appropriate dosage for you or ensure that it won't interfere with any medications you are currently taking.

Conclusion

Your body requires vitamin B12 in order to function properly. By getting adequate vitamin B12 in their diet, most people can avoid developing a deficiency. See your doctor to determine whether you should get a blood test to determine your vitamin B12 level if you are showing signs of vitamin B12 deficiency or if you are at risk of doing so. Get in touch with your healthcare practitioner if you have been diagnosed with vitamin B12 deficiency and are experiencing new or concerning symptoms.

Frequently Asked Questions (FAQs)

Q: What are the warning signs of vitamin B12 deficiency?

A: The warning signs of vitamin B12 deficiency include extreme tiredness, severe headache, breathlessness, pale skin, lack of energy, palpitations and tinnitus. Consult a healthcare professional if you experience any of these symptoms.

Q: What is the main reason for vitamin B12 deficiency?

A: Generally vitamin B12 deficiency develops if you are not eating enough B12-rich foods like fish and shellfish, organ meats, and eggs. For example, it is common among people who follow a vegan or vegetarian diet. Furthermore, specific medical conditions and medications can cause vitamin B12 deficiency.

Q: How dangerous is a B12 deficiency?

A: An essential vitamin, B12, helps produce red blood cells and DNA, the genetic material that makes up every cell in your body. If left untreated, a vitamin B12 shortage can result in neurological, psychiatric, and physical issues.

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