Vitamin B12, also called cobalamin, is an essential vitamin most commonly found in meat, dairy products and shellfish. Vitamin B-12 is critical to maintaining healthy red blood cells, proper nerve function and is necessary to produce DNA, which carries the genetic instructions used to maintain proper growth, development and reproduction in all living things.
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However, vitamin B12 deficiency is a common condition, especially among the elderly, and diagnosing it can be difficult. The symptoms of a vitamin B12 deficiency can take years to show up, and are sometimes improperly diagnosed as a folate deficiency.
This is because low levels of B12 may cause folate levels to fall. A 2007 article from the American Journal of Clinical Nutrition states that increasing folate levels may just mask B12 deficiency, failing to correct the real problem.
According to the American Academy of Family Physicians, as many as 15 percent of adults over the age of 65 may experience B12 deficiency. This could lead to a significant decrease in red blood cells called pernicious anemia, which can have serious implications for health.
Read more: Anemia
People at Risk
According to the Journal of Agricultural and Food Chemistry, the people most at risk for B12 deficiency include; the elderly, those who follow a strict vegan diet, anyone who has had part of the bowel that absorbs B12 removed and diabetics taking the drug Metformin.
If you think you might have a vitamin B12 deficiency, here are some signs and symptoms to look out for.
1. Fatigue and Lightheadedness
Red blood cells contain hemoglobin, which is what carries oxygen throughout the body. When the body lacks vitamin B-12, this can impact the production of sufficient healthy red blood cells, which may reduce oxygen levels below what is needed for the body to function well.
The National Institutes of Health explains that this lack of oxygen may cause people to experience fatigue, loss of energy and lightheadedness upon standing or with exertion.
2. Shortness of Breath
Just as a lack of red blood cells can cause fatigue, it may also be experienced as shortness of breath. People deficient in B12 can feel short of breath during exercise or from just walking up stairs.
3. Pale Skin
While many people naturally have a fair complexion, a noticeable loss of skin color may indicate a B-12 deficiency. Generalized paleness due to B12 deficiency can affect the entire body, including finger nails and even the inner lining of the mouth and eyes. This can be caused by a reduction in red blood cells circulating throughout the body.
4. Neurological Symptoms
When a vitamin B-12 deficiency goes without treatment for long periods, nerve damage can occur. This nerve damage can be experienced as mental confusion, depression, loss of balance, an inability to concentrate, numbness and tingling of the hands and feet and, in extreme cases, dementia, according to the National Institutes of Health.
Read more: Vitamin B12 Benefits & Side Effects
5. Gut Symptoms
B-12 deficiency can also affect the intestinal tract. People with mild anemia may notice the occasional bout of constipation or diarrhea. However, when anemia due to B-12 deficiency becomes severe enough, it can lead to loss of appetite, severe constipation, diarrhea and abdominal cramping and bloating, according to the National Institutes of Health.
6. Unusual Bleeding
People with a B-12 deficiency may begin to notice unusual bleeding. The first place a person may notice blood is in the sink when brushing his teeth. Bleeding gums and a swollen red tongue can indicate B-12 deficiency anemia.
Rectal bleeding or bloody stool can also indicate B-12 anemia. Women may also notice excessively heavy menstrual periods. People experiencing unusual bleeding should alert their physician so that they can decide whether further testing is necessary.
Rarely, vitamin B12 Deficiency can cause a fever. Although it’s not well understood why this happens. According to an article in the Iranian Journal Medical Sciences, a case of otherwise unexplained fever normalized after the patient was treated with vitamin B12. It’s important to remember that a fever is most commonly a symptom of illness, and not a vitamin B12 deficiency.