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Vitamin B12 deficiency at a glance
- As plant-based foods contain almost no vitamin B12, a vegan diet alone cannot meet daily B12 needs.
- Alongside a vegan diet, specific health conditions and medications can also lead to B12 deficiency.
- It may take several years before the body’s B12 stores are depleted, and deficiency symptoms appear.
- Treatment for a deficiency involves vitamin B12 taken orally or through injections.
- Delayed treatment of B12 deficiency may lead to irreversible nerve damage in some cases.
What role does vitamin B12 play in the body?
Vitamin B12 is the collective term for a group of compounds with similar effects, known as cobalamins, involved in various bodily processes. They are essential for blood formation, cell division, and healthy nerve function.
Additionally, vitamin B12 contributes to:
- normal homocysteine metabolism,
- normal psychological function,
- normal energy metabolism, and
- reduced fatigue and tiredness.
How is the body supplied with B12?
The human gut hosts bacteria that produce cobalamin. However, the body can absorb only minimal amounts of it. Therefore, sufficient dietary intake is essential. According to the German Nutrition Society (DGE), the daily requirement from age 13 is four micrograms, increasing to 4.5 and 5.5 micrograms for pregnant and breastfeeding women, respectively.1
Good sources of this water-soluble vitamin primarily include animal products like meat, fish, eggs, and dairy. Most plant-based foods contain little or inactive forms of B12, which the body cannot absorb properly, making them unsuitable for meeting daily B12 requirements.
Causes: How does a vitamin B12 deficiency develop?
Various factors can lead to vitamin B12 deficiency, including insufficient dietary intake. Additionally, some health conditions can impair absorption in the gut or cause a significant increase in B12 consumption.
Why are vegans susceptible to vitamin B12 deficiency?
Vitamin B12 is found in notable amounts only in animal-based foods. An adequate supply cannot be achieved through a purely plant-based diet. Consequently, vegans are likely to develop a deficiency unless they take Vitamin B12 as a supplement. Pregnant women should also consider this for their infants if they follow a vegan diet.
Which health conditions lead to vitamin B12 deficiency?
- Pancreatic conditions can interfere with B12 absorption.
- Chronic gut diseases like Crohn’s disease hinder the absorption of B12 and other nutrients.
- Surgical removal of parts of the small intestine or stomach can result in B12 deficiency.
- Older adults may produce less stomach acid, increasing deficiency risk.
- Parasitic infections (e.g., fish tapeworms), and chronic kidney or liver diseases can also lead to significant B12 loss.
- Medications like Metformin, used to treat Type 2 diabetes, can contribute to B12 deficiency.
What is the role of the intrinsic factor?
The intrinsic factor is a protein necessary for vitamin B12 absorption. Certain types of gastritis (inflammation of the stomach lining) can reduce the production of intrinsic factor, increasing the risk of deficiency.
Symptoms: How can you tell if you’re lacking vitamin B12?
The liver can store around five milligrams of cobalamin. This reserve can compensate for dietary shortfalls for a long time, often delaying deficiency symptoms for years.
Possible signs of a vitamin B12 deficiency
Over time, a deficiency may present with various non-specific symptoms. Common signs include:
- Pale skin and mucous membranes
- Depressive moods
- Hair loss
- Coordination issues
- Headaches
- Tingling and numbness in hands and feet
- Shortness of breath
- Paralysis
- Fatigue
- Muscle weakness
- Dizziness
- Vision problems
Consequences: What happens if B12 levels are too low?
The body requires vitamin B12 to produce red blood cells. A B12 deficiency can therefore disrupt blood formation, causing anaemia, and can also lead to nerve damage. Long-term consequences may include impaired brain function and confusion. Some studies even suggest that a B12 deficiency may raise the risk of dementia.3
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Treatment: What can quickly help with B12 deficiency?
Diagnosing a deficiency involves measuring blood B12 levels, along with red blood cell size and folate levels. If B12 levels are low, treatment typically involves oral B12 supplements. However, if nerve damage has occurred, high-dose B12 injections may be necessary.
What should you eat for a vitamin B12 deficiency?
Dietary choices can help address a deficiency. Foods rich in B12 include liver, rabbit, and fish such as mackerel and herring. Other sources like pork, beef, eggs, and cheese can also replenish the body’s B12 stores.
How dangerous is a vitamin B12 deficiency?
Vitamin B12 deficiency can often be treated effectively if detected early. Anaemia typically resolves within weeks. However, existing neurological damage and related symptoms may be irreversible if the deficiency is addressed too late.
How can you prevent a vitamin B12 deficiency?
Ideally, a B12 deficiency should be avoided through sufficient intake. For most people, regular consumption of animal products will prevent a deficiency. In contrast, vegans need to take B12 supplements in the appropriate dose to avoid deficiency.
Vegetarians can generally meet their B12 needs through diet but should ensure they consume enough. This also applies to individuals with chronic gastrointestinal conditions, for whom B12 supplementation may be advisable if diet alone is insufficient.
Important to know
If you are not a medical professional and have complaints, specific health conditions, or suspect deficiencies, please make sure to consult a doctor to discuss this.
- 1 Deutsche Gesellschaft für Ernährung e.V.: Schätzwerte für eine angemessene Vitamin-B12-Zufuhr (letzte Überarbeitung: 2018). URL: https://www.dge.de/wissenschaft/referenzwerte/vitamin-b12/?L=0 (zuletzt aufgerufen am: 10.09.2024).
- 2 Deutsche Gesellschaft für Ernährung e.V.: Ausgewählte Fragen und Antworten zu Vitamin B12 (letzte Überarbeitung: 2018). URL: https://www.dge.de/gesunde-ernaehrung/faq/vitamin-b12/ (zuletzt aufgerufen am: 10.09.2024).
- 3 Shazia Jatoi, Abdul Hafeez, Syeda Urooj Riaz, Aijaz Ali, Muhammad Ishaq Ghauri and Maham Zehra: Low Vitamin B12 Levels: An Underestimated Cause Of Minimal Cognitive Impairment And Dementia (Veröffentlichung: 13.02.2020). URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077099/ (zuletzt aufgerufen am: 10.09.2024).
