Could It Be B12 Deficiency?

Vitamin B12 deficiency is a pervasive and growing health crisis in the U.S. and other countries around the globe.

Why Is Vitamin B12 Essential?

Vitamin B12 fuels many of your body’s most important functions, including the following:

  • Proper food digestion and absorption
  • Healthy nervous system function
  • Formation of red blood cells
  • Proper blood circulation
  • Healthy immune system function
  • Mood regulation
  • Mental clarity, concentration and memory function

Your body was simply not built to function without a sufficient supply of vitamin B12, throughout its lifetime. I cannot overemphasize the importance of ensuring that you are getting adequate B12.

Since vitamin B12 is present in natural form only in animal sources of food, strict vegetarians and vegans are very high on the list of those who can expect to be B12 deficient.


Symptoms Of B12 Deficiency

There are a wide range of vitamin B12 deficiency symptoms, from mild to severe, which can affect your body, mind and mood. In general, look for signs of:

  • Fatigue, lack of energy, muscle weakness, tingling in your extremities
  • Mental fogginess or problems with your memory, trouble in sleeping
  • Mood swings, especially feelings of apathy or lack of motivation

Unfortunately, B12 deficiency often goes unrecognized because its clinical manifestations can be very subtle. In fact, one of its manifestations-‘mild memory loss’, can mimic the early stages of dementia.


Even though vitamin B12 is water-soluble, it does not exit your body quickly like other water-soluble vitamins. B12 is stored in your liver, kidneys and other body tissues. As a result, a deficiency may not show itself for a number of years. This time lag is a serious concern, because after about seven years of B12 deficiency, irreversible brain damage can result.

Long-term, chronic B12 deficiency can lead to:

  • Depression and Anemia
  • Dementia and Alzheimer’s
  • Neurological and neuropsychiatric conditions
  • Female fertility and childbearing problems
  • Heart disease and cancer

Causes Of B12 Deficiency?

B12 deficiency is common in elderly patients. One study revealed a prevalence of 12 percent among elderly people. Other studies, focusing on those who are in institutions or who are sick and malnourished, have suggested a higher prevalence of 30 percent to 40 percent.

The common picture of a B12 deficient patient, is an elderly person with pernicious anemia. However, as a Nutritional Therapy Practitioner, it is very important that I consider the co-factors. Deficiencies are not just caused by an inadequate amount of a particular nutrient. Many people are aware that vegans and vegetarians are at a greater risk for B12 deficiency, but what they do not know is that even if a sufficient amount of animal products are being consumed, one may still be deficient due to inadequate co-factors such as intrinsic factor and hydrochloric acid.


Key Co-Factors

Food-B12 Malabsorption

Food-B12 malabsorption is the inability to release B12 from food or it’s binding proteins. Unlike pernicious anemia, it’s more likely to be associated with mild, pre-clinical B12 deficiency.

Food-B12 malabsorption, is caused primarily by atrophic gastritis. More than 40 percent of patients older than 80 years have gastric atrophy that can be related to H. pylori infection.


Inability To Produce Intrinsic Factor

Food-cobalamin malabsorption syndrome is a condition that occurs when your stomach lining loses its ability to produce intrinsic factor – a protein that binds to vitamin B12, and allows your body to absorb it into your bloodstream at the end of your small intestine.

The reason your body needs intrinsic factor, is because vitamin B12 is a very large molecule. It is actually the largest vitamin we know of, and the way it gets absorbed into your body is quite complex. Intrinsic factor, a molecule of protein made by your stomach, grabs onto the B12 molecule, and together they move through your stomach to your small intestine. When they reach the end of your small intestine, the intrinsic factor is absorbed first, pulling the B12 with it into the cells of your large intestine, where they are absorbed for use by the rest of your body.


Other Significant Co-Factors

Inadequate Production Of Stomach Acid

Hydrochloric acid, produced in the stomach, is necessary to release B12 from the food you eat. If your body does not produce enough stomach acid, then you are not producing enough intrinsic factor either, which is essential for B12 absorption.

Ability to produce hydrochloric acid typically reduces with age, which probably explains the high incidence of B12 deficiency in the elderly.

Long-Term Use Of Antacid/Anti-ulcer Drugs

Since hydrochloric acid is a requirement for the absorption of vitamin B12, it follows that if you are taking an antacid, your stomach won’t be able to digest B12 out of your food. This class of drugs includes H2-receptor antagonists like Zantac and Tagamet, and proton pump inhibitors like Nexium and Prilosec.

Use Of The Drug Metformin For Type 2 Diabetes

Use of metformin (brand names include Glucophage, Glucophage XR, Fortamet, Riomet, and Glumetza) may inhibit your B12 absorption, especially at higher doses.

H. pylori Bacterial Infection

If you suffer from a chronic Helicobacter pylori infection, you might be B12 deficient.

Coffee Consumption

Four or more cups of coffee a day, can reduce your vitamin B12 stores by as much as 15 percent.

In addition to the above, Gastric Bypass Surgery and exposure to nitrous oxide (laughing gas), may also result in vitamin B12 deficiency.