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Do You Have a Vitamin B12 Deficiency?

Do You Have a Vitamin B12 Deficiency?

Our primary care doctors in Delray Beach have cautioned you before about the possible downsides of taking supplements—including vitamins—in an effort to improve your health. Because vitamin supplements are unregulated, they could end up causing more harm than good.

But, especially if you’re older, you might be deficient in a crucial vitamin that could have serious implications for your wellbeing. And supplementation with this vitamin (after checking with us first, of course) may be your only option to avoid the serious issues that can result from a vitamin B12 shortfall.


The supplement exception

We counsel getting the proper amount of nutrients from food sources rather than supplements. That’s because food sources provide a complex interaction of nutrients.

“When you take things out of the food matrix and put a single ingredient into a pill, it doesn’t have the same effect [as getting it from food],” Katherine Tucker, director of the Center for Population Health at the University of Massachusetts Lowell, tells AARP.

But vitamin B12 is an exception to the rule. First of all, you can’t get vitamin B12 from plant foods, only from animal sources including meats, poultry, dairy products, and eggs, so vegetarians are at risk of a B12 deficiency. But even then, it’s difficult to get the full amount we need solely from food sources.

Other possible reasons why you might have a shortfall include:

  • Crohn’s or celiac disease
  • frequent use of antacids, including proton pump inhibitors (PPIs)
  • pernicious anemia
  • heavy alcohol intake
  • gastric bypass surgery


Age matters

Second, as we get older, we gradually lose the ability to synthesize this essential vitamin on our own. It’s estimated that up to 20 percent of people over the age of 60 are deficient in B12.

That’s because our digestive system becomes less efficient over time, and we no longer produce enough hydrochloric stomach acid, the component necessary to access this crucial vitamin. The technical term for this is “malabsorption.”

“Malabsorption issues can arise at different ages,” Tucker told AARP. “But generally, people should start paying attention to this [problem] after age 50.”

Frequent use of antacids, diabetes medications, and ulcer medications can also interfere with absorption of B12.


Critical vitamin

The problem with a B12 deficiency is that its symptoms can mimic so many other conditions, especially in older adults. They also may be mild, especially at first, so they’re often attributed to “getting older.”

Such symptoms can include:

  • a smooth, swollen, or inflamed tongue (glossitis)
  • weakness, tiredness, lightheadedness
  • numbness, tingling, muscle weakness
  • shortness of breath
  • balance issues or problems walking
  • heart palpitations
  • pale or yellowing skin
  • constipation, diarrhea, gas, or loss of appetite
  • vision loss
  • joint pain
  • incontinence
  • loss of taste and smell
  • mental problems, including depression, confusion, or memory loss
  • changes in behavior

According to a report in Harvard Health Publishing, “Early detection and treatment is important. If left untreated, the deficiency can cause severe neurologic and blood diseases.”


Simple fix

The problem with a vitamin B12 deficiency is that it’s not easy to detect. A simple blood test will reveal B12 levels, but there’s no reliable measure for how much is too little, according to a study published in the National Institute for Health’s (NIH) National Library of Medicine (NIM).

“At present,” the authors write, “there is no consensus or guideline for this deficiency. It is most often based on the clinical symptoms together with [a] laboratory assessment and the response to treatment to make [a] definitive diagnosis.”

Once a deficiency is detected, however, the good news is that it’s a fairly easy issue to correct with supplements, but “prompt treatment is required to reverse the damage before it becomes extensive or irreversible,” the report states.

Depending on the severity of your symptoms, it may be best to start off with B12 injections, sublingual (under the tongue) doses, or skin patches. Later these approaches can be supplemented by a high-quality vitamin supplement taken daily.


Other sources

The recommended adult daily intake is 2.4 micrograms (mcg) of B12 but you may need more as you get older because of malabsorption issues.

In addition, you can find many products fortified with vitamin B12, including some cereals. Meats of all kinds—including red meat, ham, poultry, liver, and seafood—contain the highest amounts, but B12 is also present in such animal products as milk, yogurt, cheese, and eggs.

As always, we suggest you discuss your diet, any symptoms that may be concerning you, and any underlying health issues with us before you start taking a supplement. But if you’re experiencing any of the symptoms listed above, it’s worth checking with us to see if a simple vitamin B12 deficiency could be the cause, instead of “just getting older.”

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