Vitamin B12 Deficiency

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KEY POINTS

• Vitamin B12 is needed for building red blood cells and keeping your nervous system healthy. Without enough vitamin B12, your nerves may be damaged or you may develop anemia.
• Treatment may include diet changes, supplements, or shots of vitamin B12.
• To help prevent vitamin B12 deficiency, eat meat, fish, poultry, dairy products, and eggs, or products fortified with vitamin B12. Limit how much alcohol you drink.

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What is vitamin B12 deficiency?

Vitamin B12 is an important vitamin needed for building red blood cells and keeping your nervous system healthy. Vitamin B12 is also called cobalamin. Vitamin B12 is found in meat, fish, eggs, and dairy products.

Vitamin B12 deficiency damages the fatty substance called myelin that covers your nerves. Myelin helps nerve messages move quickly between the brain and other parts of the body. The damage makes it harder for the nerves to send signals to the body. If vitamin B12 deficiency lasts for 6 months or more, the nerve damage may be permanent.

What is the cause?

Vitamin B12 deficiency may have many causes. Your intestines may have trouble absorbing vitamin B12. This may be due to:

• A problem that you are born with
• Being over 50 years old
• Infections by parasites such as giardia or tapeworms
• Pancreas disease, Crohn’s disease, or celiac disease
• Certain medicines, such as cancer medicines or medicines that reduce stomach acid
• Weight loss surgery

Other possible causes include:

• Alcohol use disorder, which can cause too much vitamin B12 to leave your body
• Thyroid disease
• Eating disorders
• Pregnancy
• Not getting enough vitamin B12 from the foods you eat, especially if you are vegetarian

What are the symptoms?

Symptoms of vitamin B12 deficiency may include:

• Shakiness or trouble walking
• Tingling in your hands and feet
• Feeling unusually weak and tired
• Swollen, red tongue
• Shortness of breath
• Confusion, memory loss, and mood changes
• Loss of bladder or bowel control

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You will have blood tests to check for possible causes.

How is it treated?

Treatment depends on how serious the deficiency is. If you have a mild case, your provider may recommend that you eat foods fortified with vitamin B12 or take a dietary supplement that contains vitamin B12. More serious cases may be treated with shots of vitamin B12 or high doses of vitamin B12 taken by mouth.

You will have follow-up visits with your provider to check if your treatment is working.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent vitamin B12 deficiency?

To help prevent vitamin B12 deficiency:

• Eat meat, fish, poultry, dairy products, and eggs, or products fortified with vitamin B12.
• If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.
• If you are over 50 years old, ask your healthcare provider if you should take a multivitamin or other supplement.
• If vitamin B12 deficiency is caused by a disease, treating the disease may help prevent vitamin B12 deficiency.