Many people are familiar with iron deficiency, which is a leading cause of anemia, and you’ve probably heard of vitamin C deficiency, which can lead to scurvy if left unresolved for an extended period of time. But did you know that your body can be deficient in any number of critical nutrients – and that such deficiencies can interfere with your life and health? The U.S. Government’s National Institutes of Health (NiH) estimates between 1.5 and 15 percent of the population to be B-12 deficient. According to recent studies, diagnoses of this particular deficiency have been on the rise. This could be due to an actual increase in the number of cases or simply a matter of more regular screening. Either way, it’s important for women – and men – to know the signs and symptoms and to consult their physicians if they suspect they may be B-12 deficient.
And B-12 is what, exactly?
B-12 is one of the eight B vitamins. A properly-functioning body absorbs it from food during digestion. Hydrochloric acid in the stomach separates the nutrient from an animal protein, then recombines it with a new protein, called intrinsic factor, which the stomach manufactures. B-12 is critical to blood and nerve health. It also helps the blood produce DNA. Further, B-12 is key in preventing megaloblastic anemia, a form of anemia that causes incomplete or interrupted formation of red blood cells. Since red blood cells carry oxygen through the blood system and supply it to the body’s many bones, organs, muscles, and other tissue, immature or improperly formed cells are a huge problem. Faulty cells can’t transport oxygen properly, and the body can’t function well without an adequate amount of oxygen. The net result is exhaustion. Prolonged drops in B-12 levels can impair brain function and muscle efficiency, and can cause lasting damage to the nervous system.
So how does deficiency happen?
A person can become B-12 deficient in a number of ways. The first is by simply not taking in enough of the vitamin. The NiH recommends that adults and teens ages 14 and up receive an average of 2.4 micrograms of B-12 per day. Women who are pregnant or nursing need a bit more; children 13 and under need less. The good news is that many foods contain B-12 naturally. Clams and beef liver are the B-12 superstars, but fish, shellfish, poultry, and meats can also supply the body’s requirements, as can dairy products such as milk and cheese. Additionally, some commercial foods, such as breakfast cereals, are fortified with B-12.
It’s also available as an over-the-counter supplement in tablet and sublingual (dissolvable under the tongue) forms and by prescription as injectable liquid or a nasal gel. Many multi-vitamins also contain B-12. Because plants don’t contain B-12, people who maintain vegetarian or vegan diets have a high risk of B-12 deficiency, but that can usually be managed quite easily through supplements.
Folks who consume plenty of B-12 can still become deficient, however. Not everyone can absorb the vitamin from food, and a small number can’t absorb it from tablets or even sublingually. Additionally, some medications can inhibit B-12 absorption or use, including certain antibiotics, reflux medications, and antihistamines as well as metformin, a common diabetes drug. Because the stomach plays such a critical role in absorption, individuals who have had gastric surgery or who have conditions such as celiac disease or Crohn’s disease often have difficulty absorbing B-12.
Further, the amount of hydrochloric acid in the stomach tends to decrease as we age, so the amount of B-12 we can absorb naturally may decrease as well. Failure to absorb leads to yet another form of anemia, called pernicious anemia, in which the body doesn’t make enough red blood cells. The net impact on the body is similar to other types of anemia.
What am I looking for and what do I do?
Common symptoms of B-12 deficiency include weakness, unexplained weight loss, tiredness or fatigue, loss of appetite, and constipation. Sufferers may also experience problems with balance, tingling in the hands and feet, confusion or memory issues, and tongue soreness. Many people report feelings of depression. If these symptoms sound familiar, a visit to your primary care physician is in order. Blood work can check for B-12 deficiency, as well as several other conditions that present similar symptoms. If your doctor finds that you’re deficient, the first step will probably be an over-the-counter supplement. If symptoms persist and your blood levels don’t improve, your doctor may move you to a prescription-strength oral, nasal, or injectable. Once you’ve been diagnosed and your levels become normal again, it’s important to follow your doctor’s instructions about maintaining an adequate intake of B-12 – and to have your levels checked at your annual physical (or more regularly, if your doctor orders it).
Ultimately, B-12 deficiency is highly manageable. Left untreated, however, it can become a real detriment to your ability to function normally and a serious threat to your health. If you’re not sure whether your multi-vitamin contains B-12, go check the label while you’re thinking about it. And if you’re not in the habit of scheduling an annual physical, this is a good time to start doing it, even if you feel perfectly fine. If an ounce of prevention is really worth a pound of cure, those physicals will pay off in no time.
Clams and beef liver are the B-12 superstars, but fish, shellfish, poultry, and meats can also supply the body’s requirements, as can dairy products such as milk and cheese.