Vitamin B12 Deficiency: Causes, Symptoms & Treatment

In addition to carbohydrates, fats and proteins, the human organism also requires various vitamins. Among these is vitamin B12. A vitamin B12 deficiency can trigger numerous complaints and should be treated.

What is vitamin B12 deficiency?

Vitamin B12 plays an important role in health. Its requirement can be described as very low, but it should still not be lacking. Namely, the vitamin contributes to blood formation, cell growth, cell division, formation of the sheath of neurons, production of DNA and RNA, as well as the absorption of folic acid. The important functions of the vitamin explain at the same time the seriousness of a deficiency. This can occur due to various factors. Contrary to many rumors, not only vegans and vegetarians suffer from a vitamin B12 deficiency. All in all, a doctor should be consulted if a deficiency is suspected. Otherwise, there is a risk of serious consequences in the long term.

Causes

The causes may possibly lie in the diet. B12 can be found namely only in animal products. Accordingly, the risk of developing a B12 deficiency is higher for people who avoid meat and or milk and eggs. However, due to suitable preparations, such a diet does not pose a fundamental problem. In addition, B12 is found primarily in innards, which are consumed relatively rarely in Germany. The preparation of food can destroy the vitamin. Therefore, a deficiency is quite possible and common even in people who do not avoid animal products. In some situations, the need for the vitamin may increase. If it is not met, a deficiency may occur. In the case of stress, physical work, heartbreak, grief or anxiety, the organism needs more vitamin B12, which can be attributed to poorer processing due to stress. Furthermore, the body uses B12 for the production of various hormones. In such situations, an increased release of adrenaline or dopamine is normal, and the store is used up more quickly. In pregnancy, the requirement usually doubles. Furthermore, a functional disorder can be the cause of the symptoms. This is because the vitamin is only absorbed through the oral mucosa or the intestines. Intestinal irritation, alcohol abuse or chronic intestinal diseases sometimes severely restrict the absorption capacity. In addition, some medications can inhibit absorption.

Symptoms, complaints, and signs

Vitamin B12 deficiency manifests itself in various ways. If it is already pronounced, depression, fatigue and pallor, confusion, brain weakness, tingling in the hands and feet, injuries to the mucous membranes, paralysis and burning of the tongue occur. The typical pallor results from anemia due to the involvement of B12 in the production of red blood cells. A deficiency can thus assume serious proportions. It is often diagnosed at a late stage. Accordingly, it can be helpful to openly address one’s own suspicions. After all, the level of B12 can be detected perfectly. A deficiency does not develop overnight. The human organism is capable of storing sufficient levels of vitamin B12. That is why the symptoms only become noticeable after several months to years. Until then, the body’s own resources are sufficient to cover the need. That is why it is unlikely to immediately develop a vitamin B12 deficiency when changing the diet to a purely plant-based diet.

Diagnosis and course of the disease

Diagnosis can be made in several ways. A blood test is common. This usually does not measure B12 directly. For children, a urine test is suitable for determining any deficiency. Without treatment, anemia due to vitamin B12 deficiency can lead to cardiovascular complications: In the long term, increased stress on the heart is possible. Reduced oxygen transport also increases the risk of circulatory collapse. The latter can lead to further complications – for example, falls that may result in injuries.

Complications

Vitamin B12 deficiency in itself can also cause complications. Without treatment, permanent neurological disorders are also possible. Adequate compensation of the deficiency should therefore be carried out as early as possible.Neurological symptoms manifest themselves in vitamin B12 deficiency, for example, as a numb feeling or tingling in the arms or legs. In addition to the general symptoms of anemia, vitamin B12 anemia may present with other signs. These include fatigue, pallor, indigestion, feeling weak, bleeding gums and lightheadedness. In addition, the rate of heartbeat and breathing may increase. Psychological complications include memory impairment, confusion, concentration problems, and depressed mood. In some cases, psychotic perceptions in the form of hallucinations, mind wandering or similar symptoms are also possible. In addition, severe vitamin B12 deficiency may manifest itself with personality changes. In particular, the concentration and memory problems may cause a deterioration in professional or school performance. Overall, the various symptoms may also contribute to the affected person’s social withdrawal.

When should you see a doctor?

In the case of vitamin B12 deficiency, the affected person should always contact a physician, as there is no independent cure. To prevent further complications and further worsening of symptoms, a doctor should be contacted at the first symptoms and discomfort of the disease. A doctor should be consulted if the affected person permanently suffers from fatigue, pallor and depression. Confusion or severe tingling in the hands may also indicate the disease. If these symptoms persist over a longer period of time and occur without any particular reason, a doctor should be consulted in any case. The symptoms can also occur if the affected person has changed his or her diet, as this can also lead to a vitamin B12 deficiency. In most cases, a vitamin B12 deficiency can be detected relatively easily by a blood test and can also be treated. In this case, a general practitioner can be contacted, who will perform the examination.

Treatment and therapy

It is essential to treat a deficiency. If it is severe, injections are often resorted to, which quickly replenish the store. Such a method is often also necessary if there is a dysfunction of the intestine. In this case, taking tablets would have no effect. Furthermore, lozenges can be consumed. Because the vitamin is also absorbed through the oral mucosa, this is an effective method that is also suitable for children. Many of the preparations are purely herbal and are therefore also recommended for vegetarians and vegans. To treat the deficiency, preparations with a very high dosage are usually used. These usually have to be taken daily. At the beginning of the treatment it is a high dosage, which exceeds the actual daily requirement. As soon as the deficiency has disappeared, maintenance therapy sets in, the aim of which is to cover the daily requirement. Those who opt for an injection may only need to take the fluid once a month. With practice, syringes can be administered at home without medical assistance. Good syringe handling is especially important for people with poor B12 utilization. This is because in such a case it is likely that even after the deficiency has been eliminated, the need for an additional B12 supply will remain. Otherwise, a new deficiency would develop. In addition to the therapy of the symptoms, the causes are investigated at the same time. If handling with injections is not successful, lozenges remain as an alternative. Particularly in the case of a disorder of utilization, high-dose preparations must be taken. These are usually prescribed by the attending physician. Because vitamin B12 cannot be overdosed, undesirable side effects can be ruled out.

Prevention

Vitamin B12 deficiency can be prevented. Overall, the vitamin is found only in small amounts in foods. Therefore, it may be useful to resort to lozenges. This applies in particular to risk groups such as pregnant women, alcoholics, vegans, vegetarians, smokers and nursing mothers. Many of the preparations are natural and have no side effects.

Aftercare

As with general vitamin deficiency, there are no strict guidelines for follow-up in successfully treated hypocobalaminemia.The symptoms caused by the deficiency usually disappear completely on their own after a short time. In Western countries and industrialized nations, irreversible damage caused by vitamin deficiencies requiring treatment is extremely rare. For successful follow-up care, it is crucial to pay attention to a balanced diet. Nutritional counseling can complement treatment in this regard. A thorough examination of the underlying processes by the patient enables self-determined, safe prevention. Provided the underlying cause of hypocobalaminemia is a disease that cannot be cured, the use of nutritional supplements must be continued permanently. Regardless of the cause of the vitamin B12 deficiency, regular monitoring of the B12 level in the body should take place during follow-up care. Both urine tests and blood tests, which the patient can perform independently at home, are suitable for this purpose. In this way, a renewed drop in levels can be detected and prevented at an early stage. If the B12 store has been completely and correctly replenished in the course of treatment, no further follow-up treatments are necessary apart from regular checks of the blood values. If symptoms recur immediately, a physician must be consulted again.

What you can do yourself

If a vitamin B12 deficiency is suspected, a visit to the doctor is recommended. Slight deficiency symptoms can usually be remedied by just changing your diet. The B12 vitamin is found in animal products such as milk, cheese, eggs, fish and meat. Liver, oysters and trout in particular have a high vitamin B12 content. Vegans compensate for a vitamin B12 deficiency by means of soy milk, sea buckthorn berries or supplements from the pharmacy. Severe deficiency symptoms must be treated by means of dietary supplements. Tablets or pills supply the organism with sufficient vitamin B12 and counteract the symptoms. Accompanying the change in diet, the individual complaints must be identified and remedied. It is best for those affected to keep a diary of their symptoms and also record the food and drinks they consume each day in a food diary. If the symptoms persist despite a change in diet, the doctor must be consulted. A severe and long-lasting vitamin B12 deficiency can cause permanent damage that can only be compensated for. Typical symptoms are visual disturbances or skin changes that can be treated with aids or cosmetic measures. Which measures are useful in detail can be explained by a specialist or a nutritional physician.