Warning Symptoms of Vitamin B12 Deficiency and How to Fix It

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Warning Symptoms of Vitamin B12 Deficiency and How to Fix It

According to recent research, one in every four adults in the United States suffers from vitamin B12 deficiency. This vitamin is dubbed the energy vitamin and its shortage can result in an array of health problems, including some potentially very serious conditions. Despite being a water-soluble vitamin, B12 gets stored in your liver, kidneys and other body tissues, so the deficit can go unnoticed for a number of years. That is where the danger lies. By the time the condition gets detected, there might be some irreversible damage done already.

B12 is important for the functioning of the nervous, digestive, vascular and reproductive systems. It regulates hormone production, supports a healthy immune system, builds the red blood cells and DNA. It is connected with your cognitive abilities and mood stability. Its influence spreads all the way from being happy to passing on your genetic material. So I’m sure you’ll agree that it’s a good idea to be on the lookout, and spot the minefield before it explodes. B12 deficiency can also cause anemia, a medical condition in which the red blood cell count or hemoglobin is less than normal.

The causes of vitamin B12 deficiency

You get B12 deficiency because you are either not consuming enough vitamin B12, or you are unable to absorb it. As B12 appears mostly in animal products, strict vegetarians and vegans are among those at risk of developing the condition. So the first thing to look at is your diet. If you are a vegetarian or a vegan you should read my post about the 6 important things to remember in vegan diet.

Diet Lacking in vitamin B-12

The major food sources of B12 are meat, fish, dairy products and eggs. By eating a balanced omnivorous diet, you should get enough of this vitamin the natural way. If this doesn’t happen, you can develop anemia, which means that you have less red blood cells – these carry oxygen to the cells and in this way support the metabolism that provides energy for all of the body’s functions.

You may also develop anemia due to iron deficiency and you can read my other post about the top signs of iron deficiency and how to increase iron levels in your blood.

Related: the complete guide to choosing the best iron supplement.


Impaired Absorption

If you are not absorbing vitamin B12, the reason for that can be anything from stomach problems to auto-immune conditions. You’re also more likely to be vitamin B12 deficient if you are over 50 – when we get older, our absorption is not optimal any more due to the lack of stomach acid. Food has difficulty getting absorbed if you are suffering from ulcers, Crohn’s disease, celiac disease, gastritis, or if you had a section of your gut surgically removed. The latter can be a part of a weight-loss surgery.

Certain prescription drugs can affect your ability to absorb vitamin B12, including anti-ulcer drugs, antacids and Metformin – a drug taken by diabetic patients.

A very common cause of B12 deficiency is also pernicious anemia. This auto-immune condition is marked by a lack of a protein known as the intrinsic factor, which is needed for the absorption of vitamin B12.

Other reasons include overindulgence in coffee (more than four cups per day reduce your vitamin B12 levels), bacterial infections and exposure to nitrous oxide AKA the laughing gas.

Symptoms of vitamin B-12 deficiency

The symptoms are often not very specific, so vitamin B12 deficiency can go unnoticed for a long period of time. It is also easily mistaken for other conditions, and therefore remains misdiagnosed.

A careful interview and a blood test are required. You are considered to be B12 deficient if your concentration of vitamin is less than 150 pmol/L. If you are between 150 pmol/L and 200 pmol/L, the serum MMA (Methylmalonic Acid) is also checked to establish the need for further investigations. B12 is scientifically known as cobalamin, so this name is sometimes used to describe the condition or its cause.


The most common symptoms include:

– fatigue and lack of energy
– shortness of breath
– headache
– cognitive problems, such as memory loss and difficulty concentrating
– pale or yellow skin (jaundice)
– stomach upset and weight loss
– changed sensation in the limbs (pins and needles, desensitization)
– muscle weakness
– mood swings
– dry mouth
– ringing in the ears (tinnitus)
– difficulty sleeping – B12 affects the production of melatonin which is known as the ‘sleep hormone’
white nails may also be a sign of anemia

In severe cases it can lead to depression, psychosis or dementia. The symptoms can develop gradually and intensify over time. Since B12 is involved in so many of the body’s functions, the lack of it can lead to numerous life-threatening conditions. Reduction in B12 has been linked to cardio-vascular disease, cancer, stroke and birth defects.

Maintaining proper vitamin B12 levels is one of the 70 habits featured in my e-book 70 Powerful Habits For A Great Health which will guide you how to take positive steps to improve your wellness and overall health.


How do you prevent and treat a vitamin B12 deficiency?

We should get 2.4 micrograms of vitamin B12 per day. As mentioned before, the easiest way to prevent vitamin B12 deficiency is by eating the right food. Different meats, sea food, milk and eggs all contain it. If you eat meat and seafood, check its origin and support organic and free-range options.

Vegetarians and vegans have to make sure that they get enough of this vitamin. The non-animal options include consuming nutritional yeast and vitamin B12 fortified products, such as B12 fortified almond milk and cereals, and some breads.

There has been some controversy around eating cereals, as they are often highly processed and are packed with sugars. They are not considered healthy and are best replaced with oats and oatmeal. Tempeh (one of my top 10 fermented foods), miso and seaweeds have also been reported to contain B12.

A very good source is also spirulina – a high-protein super food that is made of two species of blue-green algae. Spirulina has a very high nutritional value and contains 60% proteins, so it’s perfect for strict vegetarians.  Spirulina is a rich source of nutrients and antioxidants, such as beta carotene, selenium, zinc, iron and vitamins C, E and B complex. Eating seaweeds in general has great health benefits which I mentioned in my previous post on how to boost your health by eating seaweeds and algae. Spirulina is also one of the superfoods mentioned in my e-book about superfoods which is part of the Natural Health Revolution Program. This program will help you to achieve your health, nutrition or weight loss goals.

If you cannot get enough of vitamin B12 through nutrition, you will have to start taking B12 supplements and B12 containing multivitamins. In severe cases, you might need vitamin B12 injections. This is also the case for people suffering from pernicious anemia.

To avoid permanent neurological damage, it is very important to recognize and treat the disease in its early stages. Be proactive, especially if you fall into one of the risk groups: you are over 50, vegetarian or vegan, after a weight-loss surgery or taking metformin. If you suspect vitamin B12 deficiency, talk to your doctor, and consider changing your diet or start with the supplements. Vitamin B12 is one of of the 5 essential nutrients you may be missing from your diet – to find out what are the other common nutritional deficiencies, read my post about the 5 essential nutrients you may be missing from your diet.

Read my other related articles:

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39 Responses to Warning Symptoms of Vitamin B12 Deficiency and How to Fix It

  1. Grace says:

    Beet root and cabbage (wine color) are also high in B12.

    • Jen M says:

      Plant sources are not a good source of B12. Spirulina and plant sources are not bioavailabile. Spirulina carries analogues and actually can block absorption.

  2. Atell Rohlandt says:

    Thanks for the helpful information and tips. I noticed Grace mentioned vegetable options that are high in B12 and that’s going to be very handy for vegetarians/vegans. I’ve been struggling with a lot of the symptoms listed here and will most definitely look at my B12 consumption.

  3. Betsy Kimble says:

    I have been on thyroid meds since 1994, and had major eye problems from Graves’ Disease- (Only one eye bulged) so they put me on prednisone (sp)in 2007, and my weight went from 118 to 202 in less than 6 months- Plus I had the moon face,multiple chins, went from a size 7 to wearing old mens’ size 44 trousers….it was bloody awful. I also was lethargic, mean spirited & unable to control my temper- I was told that Vitamin B12 would help alleviate those problems- I tried taking supplements and found that they made me anxious, nervous, my arms & hands had the shakes, my pulse raced, and my heartbeat was thumping and put me into panic mode- ( I do not drink beverages with caffeine). When I stopped the steroids in 2010, I lost 50 pounds but am unable to shed the remaining 44 pounds- Can you explain why body rejects B12???

    • Jenny says:

      I don’t think I know the answer Betsy. It might be side effects or interaction with other medication, I’m not sure, but your doctor needs to know about it.

    • Claire A. Wilski says:

      I am not a doctor. I am 67 year old female that tends to be super sensitive to SALICYLATES. Most people and actually most Doctors don’t understand Salicylate Intolerance yet. Look up FOODS CONTAINING SALICYLATES on the internet. Salicylates are in many foods and DRUGS and are cumulative. If you ingest too much of them they can send you over the top and cause some of the symptoms you described. It is totally worth your while to look into this as a possible contributor to what you are experiencing. Salicylates are most likely in the B12 suppliments (or any other drug you take). My Doctor basically has given up on me because I cannot tolerate any drug he has prescribed for me. The Feingold Diet helps people with this kind of problem. Also can look it up on the internet. You have to help yourself by doing a little investigative work. Doctors just don’t have time to step outside the box these days and look further into things for us. Frustrating for sure.

      • Al Jeratso says:

        Hard to admit it but some medical practitioners are more focused on the business side of their medical practice at the expense of human health and Medicare funds.

        • Donna Ledford says:

          I’m learning that the hard way. Buts it’s so true. A lot of the doctors make sure they cover their own butts. Not really caring about their own patients That’s really sad

      • Jeannie says:

        I can’t tolerate b12 either and I have the mthfr mutation c667T so why can’t I tolerate the methyl b 12? It’s very frustrating! I get body aches feel very anxious and unwell. I also have hashimoto’s

    • susan leonard says:

      you also need to take Pernicious Anemia into account…..my mother had it and my sister has it……it is a very little mentioned disease……
      And the effects of it are awful……i am surprised it is not mentioned here…..but look it up…..because if you did have it…you have frequent B12 injections…..and then all your close female relatives…daughters…granddaughters should be checked every 12 months for it

    • Surya says:

      Try taking the methylcobalamin form of b12..if you are taking cynocobalamin you might see some side effects..

  4. Marilyn says:

    I was diagnosed 7 years ago with a B12 deficiency and later, iron anemia. It took a couple of years before we realized that it is a symptom of a low thyroid. Thyroid hormones are sometimes called the metabolism hormone. When you don’t metabolize the food you eat, you don’t get these necessary vitamins and minerals. I was doing the shots monthly, but my thyroid doctor recommended B-12 dots. They are sub-lingual, meaning that you absorb the vitamin directly into the blood stream, bypassing the stomach. I use 4 a week and my B12 levels never looked better. Plus instead of the up and down of the shot, my levels stay more even. I feel great.

    • Jenny says:

      Great to hear that!

    • M Stillwell says:

      What are B-12 dots ? I have never heard of them. I have taken shots for four consecutive weeks and then have been on over the counter B12 Sublingual tabs for about 4 months blood test and told to stay on them and have recheck in four months.

  5. Sharad Kulkarni says:

    Will someone explain: Does deficiency of B12 play any part in patients with Hepatitis B. How far it important in the treatment of such patients?

  6. E Black says:

    it should be noted that if you have an absorption problem, you may need to get the b12 (and b6) in a methylated form. You may also have a gene mutation called MTHFR, which has several varieties. I recently began taking Thorne Methylguard b vitamin supplement and I can’t begin to tell you how much better I feel. I have a group on Facebook for MTHFR. If you have experienced miscarriage and have a b vitamin deficiency I highly recommend asking your ob to test you for MTHFR

    • Christina says:

      You are actually the first person I’ve seen that has ever mentioned this condition. My ob tested me for it a couple of years ago and I have a what he called a “double whammy” as I apparently inherited it from both sides and have double gene mutation.

  7. Lanieta Leweniqila says:

    I have an enlarged thyroid and am not sure weather hypo or hyperthyroid. Iam pretty sure i lac the vitamins stated.Here in Fiji we do not have detailed blood test the doctors opt for surgery.I like going through and reading herbal remedies and i believe can be cured and reverse the disease through naturally. What do you recommend?

    • Jenny says:

      Hi Lanieta, thyroid disorders require a clear diagnosis from a health specialist (preferably endocrinologist). The treatment for Hypothyroidism and Hyperthyroidism is completely different. You first need to know for sure what your disorder is in order to decide about the treatment plan.

    • Nagarajan says:

      Hi Lanieta..why don’t you try japanese water treatment for your thyroid problem..it is natural and effective for both hyper and hypo..think twice before removing thyroid gland..

  8. Angela says:

    Also, if you have a genetic blood disorder such as MTFR you are unable to properly absorb b vitamins. It’s unknown to many medical professionals and you’re blood work could say you have high b vitamins. It’s just that your body isn’t processing them. It can lead to stroke, high blood pressure, dementia, trouble in conceiving, or going full term. Sometimes you won’t notice anything until later in life.

    • Christina says:

      I’m so glad to see people talking about this condition. My ob tested me for it a couple of years ago and I have a what he called a “double whammy” as I apparently inherited it from both sides and have double gene mutation.

    • Jeannie says:

      Hi Angela, I have the mthfr mutation but I can’t tolerate l methyl folate, nobody has been able to figure it out, have you found anything else out since your 2014 post?

  9. Michelle says:

    I would like to add that I have Crohn’s. As a result have had my ilium removed so therefore do not absorb B12 by eating it. Only fix. B complex shots and we are back on track.

    • Anne chalmers says:

      My sister has the same and gets b 12 shots but my father also has the same and does not get any b12 medication, is it different in men?

  10. Emily says:

    I just started taking a b complex about a week ago and I already feel so much better. I was suffering headaches, fatigue, anxiety, and depression. I still have treatment for my anxiety, but the b complex has just really helped me along!

  11. Phyllis Brueckner says:

    Having gastric bypass or “stomach stapling” can also cause a B12 deficiency, and oral supplements do not help. Monthly injections of the vitamin is the only way to avoid this. One can easily learn the simple technique of doing this at home and even though a prescription is needed, the cost is minimal.

  12. shaz says:

    spirulina does not contain b12 ,

  13. Brent Beckett says:

    This article left out the most detrimental symptom of B12 Deficiency – Death. It happens. A person with this level of deficiency is often misdiagnosed with something such as Alzheimer’s –

  14. sarah says:

    I had alot of dental surgery over the summer. My experience with the laughing gas was scary. I felt like I was dying and I could not speak, my insides were shaky, and my heart was racing. I was a second away from going unconscious when my dentist noticed my body going limp. He turned off the gas and had me breathe oxygen. My legs did not stop shaking for 20 minutes and I was freezing. It must of scared him too because he refused to work on me again until I had my blood checked. I knew I was anemic, but I found out at the doctor’s office that I had a Vitamin B-12 deficiency. The laughing gas was sucking more out. It is rare, but for some, the laughing gas is not funny, it can be deadly. I am taking B-12 now and trying to consume it in Vegan Protein Shakes an Spirluina. I feel better. Seems to make me happier and look less tired. I finished my dental work and braved it all with numbing shots instead of the gas.

  15. Christina says:

    Not sure if this helps or if anyone is interested but I recently heard about a new oral prescription alternative to the injections called Eligen B12. I recently read that it works even if you don’t have intrinsic factor (so even if you don’t have normal gut absorption), which would mean no more shots. Apparently it came out a month or two ago. Has anyone tried it??

  16. Jayasree Anvekar says:

    Boiled rice and its stock which is pink in color, red millet, and whole grain rice which is red in color, an combination of red pearl onions and molasses are rich source of vitamin B12 and iron for vegetarians.

  17. Prakash Deshmukh says:

    Your digestion system is weak then nothing oral will work, what ever food you eat it will go waste. First improve the digestion system and then only take food even tablet won’t work much. Better to go for shot until your digestion system is improved, monthly one is enough if the level is above 200. increase frequency initially if below 200.

  18. Paula says:

    It seems to be a simple blood test that gets overlooked by G Ps these days. As a District Nursing Sister in the 70’s in UK. I had many older patients on regular Vit B12 injections but you don’t hear much about it any more, especially the over 60’s . It should be one of the annual routine tests.

  19. Eula says:

    I suffer from lack of muscle tone, and energy, also from
    Lose of hair. I get cold very easy, ( very cold I keep gloves in my purse. I live in Florida) this happens even in the summer. I also get pins and needles in my arms and legs. I have a good diet. But have no energy and often no enthusiasm to do anything. I do take medications as I have had many surgery’s. Due to a vascular nacreous. And I get dizzy and blurred vision. I have tried to use the B12 in time release but it seems not to help along with a multi vitamin years ago I used liquid B12 that you put under your tongue. That helped a lot. Where can I find this. Thank you my Dr knows all of this. And has put me on blood pressure meds, as I was suffering from severe shackes in my hands . And was hoping to get the liquid. The Blood pressure meds have helped. The dizziness and shakes . However I still have lose of hair , blurred, vision, cold hands, feet and trouble consintrating. Any help finding the liquid
    Thank you

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