Vitamin B12 Deficiency Symptoms

Vitamin B12 deficiency symptoms present as neurological symptoms and if severe can eventually cause nerve damage and possibly brain damage. Before you become very alarmed however, this takes many years to reach that point.

Signs of vitamin B12 deficiencies take about two years or more before they are noticed. The symptoms listed below may start a bit sooner.

The causes of this can be due to anemias, chronic alcoholism, gastric bypass surgery, and lack of intrinsic factor. Lack of intrinsic factor is perhaps the most common cause. This may be either an inheirited problem, or it can be the result of drugs such as H2 blockers and proton pump inhibitors. These are medications that reduce stomach acid which is needed for intrinsic factor to bind to B12 in food sources and carry it across the gut to the rest of the body.

An additional medication that could cause B12 deficiency can be metformin which is a common medication used in diabetes. At the present time, studies have indicated that 10-30% of diabetics who take metformin are at risk for vitamin B12 deficiency symptoms. A good way to counter act this effect is to take sublingual vitamin B12 .

The following are vitamin b12 deficiency symptoms:

  • Confusion or change in mental status
  • Tingling in hands and feet
  • Unexplained worsening of neuropathies, such as carpel tunnel syndrome
  • Decreased sense of vibration
  • Worsening memory
  • Worsening headaches or migraines
  • Worsening mood such as depression and/or anxiety symptoms
  • Diarrhea
  • Fatigue
  • Weakness
  • Gait disturbance in severe cases

Severe B12 Deficiency

vitamin deficiency symptoms

The MRI above shows a brain. On the right is a normal brain. The red circle is around the cerabellum which helps control many movements including walking.

On the left is an example of atrophy of the cerabellum. This occurs over several years and can happen in the presence of severe, long term vitamin B12 deficiency symptoms. Most commonly this is seen in alcoholism.

Read more about: what does vitamin B12 do?

Vitamin B12 Benefits

Vitamin B12 benefits range from maintaining memory to combating fatigue. If you have become deficient and need supplementation, some of the benefits can begin almost immediately.

One of the most common symptoms of vitamin B12 deficiency is fatigue. When patients start vitamin B12 injections as supplementation, one of the first things I hear is "My fatigue is so much better!" This can happen within the first two weeks of starting injections.

Other vitamin B12 benefits include:

  • improved concentration
  • improved memory
  • improved mood (depression and anxiety)
  • less neuropathic pain
  • less tingling (paresthesias)

Another benefit may be reducing the pain that MS (multiple sclerosis) patients feel from nerve damage caused by MS. Many of these people have pain in their arms and legs in addition to weakness. This is because there are different nerve fibers for sensation than there are for muscle strength.

Several studies have shown that many MS patients surprisingly have vitamin B12 deficiency symptoms.

If you have been diagnosed as having this vitamin B12 deficiency symptoms, you most probably will NOT benefit from oral B12. This is due to lack of absorbtion of B12 thru the intestines (one of the reasons you are deficient!) To get maximum vitamin B12 benefits, I always recommend that my patients start on vitamin B12 injections. After one year of injections, then I recommend sublingual vitamin B12 .

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1. Valuck RJ, Ruscin JM. A case-control study on adverse effects: H2 blocker or proton pump inhibitor use and risk of vitamin B12 deficiency in older adults. J Clin Epidemiol 2004;57:422-8. [PubMed abstract]
2. Ruscin JM, Page RL 2nd, Valuck RJ. Vitamin B(12) deficiency associated with histamine(2)-receptor antagonists and a proton-pump inhibitor. Ann Pharmacother 2002;36:812-6. [PubMed abstract]
3. Den Elzen WP, Groeneveld Y, De Ruijter W, Souverijn JH, Le Cessie S, Assendelft WJ, et al. Long-term use of proton pump inhibitors (PPIs) and vitamin B12 status in elderly individuals. Aliment Pharmacol Ther 2008;27:491-7. [PubMed abstract]
4. Termanini B, Gibril F, Sutliff VE, Yu F, Venzon DJ, Jensen RT. Effect of long-term gastric acid suppressive therapy on serum vitamin B12 levels in patients with Zollinger-Ellison syndrome. Am J Med 1998;104:422-30. [PubMed abstract]
5. Force RW, Nahata MC. Effect of histamine H2-receptor antagonists on vitamin B12 absorption. Ann Pharmacother 1992;26:1283-6. [PubMed abstract]
6. Liu KW, Dai LK, Jean W. Metformin-related vitamin B12 deficiency. Age Ageing 2006;35:200-1. [PubMed abstract]
7. Buvat DR. Use of metformin is a cause of vitamin B12 deficiency. Am Fam Physician 2004;69:264. [PubMed abstract]
8. Oh R, Brown DL. Use of metformin is a cause of vitamin B12 deficiency. Author Reply Am Fam Physician 2004;69:264, 266. [PubMed abstract]

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