Understanding Vitamin B12 Deficiency (Causes, Symptoms, Treatment)

Vitamin B12, or cobalamin, is a vitamin essential for the proper growth and maintenance of the body.
In its natural state, vitamin B12 is produced only by certain bacteria found mainly in soils and which accumulate in herbivorous animals. Vitamin B12 in the food chain comes mainly from the consumption of these animals.

Vegan, vegetarian, flexitarian, or those with limited assimilation are directly affected by the risk of vitamin B12 deficiency.

In this article, we will review the causes of deficiencies, the symptoms that accompany them and the means of treating them.

Causes of Vitamin B12 Deficiency

Vitamin B12 deficiency (hypovitaminosis B12) is often associated with insufficient consumption of animal protein and a lack of corrective supplementation with suitable food supplements.

There are actually many other factors that influence the assimilation of vitamin B12 and can lead to deficiencies even with satisfactory theoretical intakes:

• Treatments and taking medication

Some medications have a negative impact, often varying from one individual to another. This is the case with metformin, prescribed as a long-term treatment for Type 2 diabetes. It is regrettable that, with some exceptions, these risks are never explicitly described in legal notices. It is always prudent to ask your pharmacist about this.

• Age

Consistent statistical studies show that a significant proportion of elderly people have a vitamin B12 deficiency: 10 to 20% from the age of 50 and this percentage increases with age.

The main cause is the decrease in gastric acidity which disrupts the process of conversion of vitamin B12 in the body .

• Diseases:

Specific pathologies identified as Biermer's disease (or Biermer's anemia) causing so-called "pernicious" anemia.
In this case, the deficiency results from a lack of secretion of a specific molecule called intrinsic factor, which is essential for the transport of vitamin B12 in the intestine and its passage into the blood. The percentage of vitamin B12 assimilated is directly linked to the amount of intrinsic factor available.

• Pregnant women and athletes and children

For safety reasons, pregnant women and athletes are considered to have increased daily requirements for vitamin B12.
For young people, any lack of vitamin B12 can have a direct impact on growth and proper development. These situations require special attention to covering daily vitamin B12 intake .

A general situation to monitor for everyone

Vegans and vegetarians are becoming increasingly aware of the need to take vitamin B12 supplements.

This awareness does not exist among omnivores, while a significant proportion (around 20%) have structurally insufficient vitamin B12 intake, linked to meat foods with a low B12 content.

The paradox could soon be to observe more deficiencies among omnivores than among vegans!

Symptoms of Vitamin B12 Deficiency

Mild vitamin B12 deficiency is not easy to diagnose because it presents symptoms similar to other pathologies.

However, the symptoms fall into two main categories:

1. Anemia
2. Neurological disorders

Anemia due to vitamin B12 deficiency (intake or assimilation)

Vitamin B12 deficiency can lead to anemia.

This results in a decrease in the hemoglobin level (below its threshold value) due to a lack of red blood cell production. Oxygen is then transported less well in the blood and the symptoms observed are those of all types of anemia:

• Tingling
• Numbness in the feet and hands is among the first sensations
• Fatigue
• A general weakness
• Increased heart rate
• Dizziness

The multiplicity of possible causes behind these symptoms makes it difficult to identify a vitamin B12 deficiency without a blood test.

Neurological disorders linked to vitamin B12 deficiency

Vitamin B12 is directly involved in the development and regeneration of nerve tissue. Therefore, its deficiency leads to a breakdown of the protective sheaths of neurons (myelin).

This will result in:

• Tremors;
• Dizziness
• Irritability, mood swings;
• Vision problems, progressive blindness;
• Memory problems;
• Motor difficulties;
• Nerve damage;

Repeated tingling in the extremities is a common (but non-specific) first sign of a possible vitamin B12 deficiency. It is therefore best to consult a professional as soon as symptoms appear.

In the fetus and child, vitamin B12 deficiency is even more detrimental because it disrupts brain development. This can cause irreversible effects.

Other disease risks

In addition to the risks mentioned above, a vitamin B12 deficiency exposes you to more:

• Cardiovascular diseases (Humphrey et al., 2008)
• Alzheimer's disease (Nourhashemi et al., 2000; Selhub et al., 2000),
• Cervical cancer (Myung et al. 2011)
• Birth defects (in babies of deficient mothers)
• Bone weakening.

How to diagnose vitamin B12 deficiency?

Diagnosis of cobalamin deficiency can be made by a blood test to measure the number of red blood cells.

An alternative is digestive endoscopy, where a flexible tube is used to examine internal structures, including gastric cells, to determine if there is any destruction.

If in doubt, do not hesitate to have your intake and that of your children assessed by a nutrition professional; it is a very reasonable precaution.

How to treat vitamin B12 deficiency

There are two methods for treating a deficiency, depending on the urgency of correcting the problem and its origin. The first involves an oral vitamin B12 supplement, and the second involves an intravenous injection of vitamin B12.

Treating vitamin B12 deficiency with a dietary supplement

The synthesis of vitamin B12 in the laboratory was a turning point in making plant-based diets safer less than 50 years ago.

For the vast majority of diets presenting a risk of vitamin B12 deficiency, regular intake of vitamin B12 in food supplements is the simplest way to prevent risks without too many daily constraints and at a moderate cost.

It also allows, by taking larger doses over several weeks or months, to bring the vitamin B12 level back to a correct level.

Vitamin B12 injection

Intravenous injection is obviously a practice strictly related to medicine and therefore in specific and serious situations.

It is used in cases of critical deficiency, particularly those with non-irreversible nerve damage. Injections may also be used to compensate for poor absorption of vitamin B12. This is particularly the case in cases of pernicious anemia, or after stomach surgery that disrupts the production of intrinsic factor, or long-term drug treatment (Metformin/T2 diabetes, for example).

In the first case, daily or weekly injections are prescribed for a period of time to allow for a return to normal. In the second case, the treatment will be long-term.

What dosage should I choose for a food supplement?

There is no risk of vitamin B12 overdose. It is a highly water-soluble vitamin. Therefore, excess amounts are easily eliminated in the urine, without kidney strain.

However, it is important to choose a dosed supplement. That is, the amount of vitamin B12 provided must be clearly measured and adapted to the frequency of intake.

The reference values for supplementation for an adult are:

• Omnivores: 2.5 micrograms/day (the official NRV level)

• Flexitarians, Vegetarians: 5 micrograms/day taken daily or 1 mg taken weekly
• Vegans: 10 micrograms/day or 1 milligram (mg) twice a week

It should be noted that with age, the absorption of vitamin B12 decreases. Therefore, omnivorous seniors are advised to prevent any risk by taking a 1 mg supplement, taken weekly.

Our food supplements rich in vitamin B12

The Argalys Essentials range has been designed to facilitate the balance of modern diets for everyone. It is therefore quite logical that we have paid particular attention to vitamin B12 in 3 of our formulas. For adults, it is possible to choose a daily supplement with Multivitamins and Minerals or a weekly intake with the Vitamin B12 + Iodine and Selenium formula . For children, we have designed a specific formula with Multikid !

Sources:

• https://www.msdmanuals.com/fr/accueil/disorders-of-nutrition/vitamines/carence-en-vitamine-b12#:~:text=A%20deficiency%20in%20vitamine%20B12,severe%20cases%2C%20shortness%20of%20breath%20and%20dizziness.
• https://www.vivelab12.fr/la-carence-en-b12/
• https://www.revmed.ch/RMS/2008/RMS-175/Hypovitaminose-B12-challenge-diagnostique-et-therapeutique
• https://www.revmed.ch/RMS/2018/RMS-N-590/Presentation-inhabituelle-d-un-deficit-en-vitamine-B12