Vitamin B12 deficiency in Adults & Children can become serious and debilitating if not diagnosed. Many of the signs and symptoms can be similar to other health problems and sometimes health professionals may be looking for diseases rather than nutrient deficiencies.

Vitamin B12 is also called cobalamin and  cyanocobalamin. It is water soluble and found mainly in foods from animals. It is an essential vitamin and sometimes known as a ‘feel good’ vitamin as, along with other B vitamins it ensures a healthy nervous and energy system. It forms and regenerates red blood cells and is essential for growth and development being necessary to utilize fats, proteins and carbohydrates. It improves concentration, memory and balance and also helps detoxify cyanide from foods and airborne toxins like tobacco smoke.

SIGNS AND SYMPTOMS IN ADULTS

• weight loss
• weakness or fatigue
• muscular soreness
• sore, red tongue
• headaches
• shortness of breath
• abdominal bloating
• Palpitations
• Anaemia
• Depression and other Psychological symptoms
• Problems with memory, understanding and judgement leading to Dementia
• Neurological symptoms such as ‘pins and needles’ in extremities, Peripheral Neuropathy
• unexplained Vision or taste impairment

CAUSES

1. Nutritional – people following a vegan, vegetarian or low protein diet. Low dietary intake over a prolonged time are at risk of deficiency. All of these people should take a Vitamin B Complex supplement that includes B12.
2. Malabsorption – Lack of a protein produced in the stomach called the ‘Intrinsic Factor’ can mean that B12 cannot be absorbed. This is called Pernicious Anaemia and the treatment is high dose B12 injection. Anyone who has had to have part or all of their stomach removed would be in a similar position.
3. Digestive – antacid medications interfere with the absorption as stomach acid is necessary for proper absorption so anyone on antacids or PPI drugs, especially during pregnancy should supplement B12. Inflammation and damage to the intestines can cause inability to absorb B12, as in Coeliac disease, Crohn’s etc. Also some other medications, like anticonvulsants,inhibit absorption. People over the age of 60 with other health problems, poor diet and diminished stomach enzymes and acid may also be at risk. B12 deficiency can also occur due to SIBO when there is slower movement of food through the intestines allowing an overgrowth of the wrong bacteria and these bacteria steal the B12 for their own use. Intestinal parasites can also be a cause.
4. Autoimmune Disease – Pernicious Anaemia is an Autoimmune disorder but other Autoimmune conditions can also be present that will possibly be accompanied by lack of Vitamin B12 – Graves Disease, Hashimoto’s disease, Vitiligo, MS and Addison’s Disease (Adrenocortical Insufficiency) for example.

SUPPLEMENTS AND DIET

Supplements can be in the form of tablets or capsules of Vitamin B12 plus a Vitamin B Complex or sometimes if deficiency is due to insufficient stomach acid then a sub-lingual powder can be just dropped under the tongue and will absorb through the mucous membrane of the mouth.  Supplements of between 50mcg and 2,000mcgs have been reported safe. The outlook once diagnosed and treated is excellent. Probiotics may improve digestion and absorption.

Dietary sources of Vitamin B12 

Beef, Pork, Chicken, Turkey, Venison, Lamb, Liver, Brewer’s Yeast, most fish, sea vegetables, seaweed, oyster and shiitake mushrooms, Miso, Soy sauce, Tempeh, Tofu, Black-strap Molasses, cheese, milk, eggs and some yogurt and fermented foods.

DEFICIENCY OF VITAMIN B12 & OTHER B VITAMINS IN CHILDREN

General Vitamin B deficiency can affect many systems of the body and give misleading symptoms. Also we generally think of Vitamin B12 deficiency to be a problem of older adults but this is not the case. In the uterus the placenta actively concentrates cobalamin (B12) for the foetus resulting in levels twice that of the mother and newborns are usually born with enough to last 6-12 months until they are weaned. If the mother has low levels then both will suffer deficiency. Folic Acid (B9) that is routinely given during pregnancy can mask a B12 deficiency. Therefore a baby born with low levels of B12 who is then a ‘picky eater’ or has food intolerances can easily become deficient and the consequences for an infant can be severe if not detected early.

SIGNS & SYMPTOMS

Nausea, lack of appetite, abdominal pains and even vomiting, bad breath, indigestion and constipation can all be symptoms of other acute conditions but if they become chronic and no other diagnosis has been found then it might be a Vitamin B and B12 deficiency. Other signs may develop such as slow eye hand co-ordination, sluggish movements, legs or arms that jerk, frequent headaches and poor sleep patterns. Failure to grow and develop or problems with concentration and behavioural or neurological problems. Sometimes skin problems, either too dry or very oily, dermatitis and cracks at the corners of the mouth can also be symptoms.

Supplementation

Originally I printed the list of RDA for Vitamin B12 but the doses were so ridiculously low that I deleted it. I would suggest a minimum starting dose of 50 -150 mcg sub-lingually and monitor any improvements. The body is capable of storing access in the liver and it can take 5 years before a deficiency is noticeable so  supplementation should continue long-term for anyone at risk of poor intake or poor absorption.

Much more may be required if there is any underlying disease so it is best to get blood levels checked if you don’t see rapid results with the first 1-2 weeks. The diet needs to be including good daily amounts from the list of foods above.

References from Paediatrics and Therapeutics

and Wiki on Vitamin B

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