Vitamin B12, also known as cobalamin, is an important water-soluble vitamin. It is naturally found in animal foods, including meats, fish, poultry, eggs, and dairy. However, it can also be found in products fortified with B12, such as some varieties of bread and plant-based milk.
Signs & Symptoms of Vitamin B12 Deficiency
Pale or Jaundiced Skin
Vitamin B12 plays an essential role in the production of the DNA needed to make red blood cells. Without it, the instructions for building the cells are incomplete, and cells are unable to divide.
This causes a type of anemia called megaloblastic anemia, in which the red blood cells produced in your bone marrow are large and fragile & pass out of your bone marrow and into your circulation. Therefore, you don’t have as many red blood cells circulating around your body, and your skin can appear pale in color.
The fragility of these cells also means that many of them break down, causing an excess of bilirubin. Bilirubin is a slightly red or brown-colored substance, which is produced by the liver when it breaks down old blood cells. Large amounts of bilirubin are what give your skin and eyes a yellow tinge.
Weakness and Fatigue
They occur because your body doesn’t have enough vitamin B12 to make red blood cells, which transport oxygen throughout your body. In the elderly, this type of anemia is often caused by an autoimmune condition known as pernicious anemia.
People with pernicious anemia don’t produce enough of an important protein called intrinsic factor.
Intrinsic factor is essential for preventing a B12 deficiency, as it binds with vitamin B12 in your gut so that you are able to absorb it.
Sensations of Pins and Needles
One of the more serious side effects of a long-term B12 deficiency is nerve damage.
This can occur over time, as vitamin B12 is an important contributor to the metabolic pathway that produces the fatty substance myelin. Myelin surrounds your nerves as a form of protection and insulation. Without B12, myelin is produced differently, and your nervous system isn’t able to function properly.
A common sign of this happening is paresthesia, or the sensation of pins and needles, which is similar to a prickling sensation in your hands and feet.
Changes to Mobility
If left untreated, the damage to your nervous system caused by a B12 deficiency could cause changes to the way you walk and move.
It may even affect your balance and coordination, making you more prone to falling. This symptom is often seen in undiagnosed B12 deficiency in the elderly, as people over the age of 60 are more prone to a B12 deficiency. However, preventing or treating deficiencies in this group may improve mobility.
Glossitis and Mouth Ulcers
Glossitis is a term used to describe an inflamed tongue. If you have glossitis, your tongue changes color and shape, making it painful, red, and swollen.
The inflammation can also make your tongue look smooth, as all the tiny bumps on your tongue that contain your taste buds stretch out and disappear. Painful glossitis can change the way you eat and speak.
Additionally, some people with a B12 deficiency may experience other oral symptoms, such as mouth ulcers, feelings of pins and needles in the tongue, or a burning and itching sensation in the mouth.
Breathlessness and Dizziness
If you become anemic due to a B12 deficiency, you may feel short of breath and a bit dizzy, especially when you exert yourself. This is because your body lacks the red blood cells it needs to get enough oxygen to your body’s cells.
However, these symptoms can have many causes, so if you notice that you are unusually breathless, you should speak to your doctor to investigate the cause.
Disturbed Vision
One symptom of vitamin B12 deficiency is blurred or disturbed vision. This can occur when an untreated B12 deficiency results in nervous system damage to the optic nerve that leads to your eyes.
The damage can disrupt the nervous signal that travels from your eye to your brain, impairing your vision. This condition is known as optic neuropathy. Alarming, it is often reversible by supplementing with B12.
Mood Changes
Low levels of B12 have been linked to mood and brain disorders like depression and dementia.
High levels of homocysteine caused by low levels of B12 could cause damage to the brain tissue and interfere with signals to and from your brain, leading to mood changes. Some studies suggest that in certain people who are deficient in B12, supplementing with the vitamin can reverse symptoms.
If you have a deficiency, taking a supplement may help improve your mood. However, it’s not a substitute for other proven medical therapies in the treatment of depression or dementia.
High Temperature
A very rare but occasional symptom of B12 deficiency is a high temperature.
It’s not clear why this occurs, but some doctors have reported cases of fever that have normalized after treatment with low levels of vitamin B12.
The Bottom Line
Vitamin B12 deficiency is common and can present itself in various ways, making it difficult to identify.
If you’re at risk and have any of the symptoms above, speak to your doctor.