6 minYou eat a healthy, varied diet and pay close attention to what's on your plate. Yet your body can still develop a vitamin B12 deficiency without you noticing. People who eat little or no animal products, such as vegetarians, vegans or those with a largely plant-based diet, are particularly at risk. But even if you do eat enough B12, its absorption can sometimes be disrupted. In this blog, you can read why a deficiency can so easily go unnoticed and when it is wise to be extra alert.
In this article, you can read
- Which bodily processes vitamin B12 is important for;
- The four causes of vitamin B12 deficiency;
- Why a deficiency can go unnoticed
- The problems caused by vitamin B12 deficiency;
- That symptoms associated with vitamin B12 deficiency can be different for everyone.
What is vitamin B12?
Vitamin B12 is an essential vitamin that the body needs for the production of red blood cells, proper functioning of the nervous system and the release of energy from food. Another name for vitamin B12 is cobalamin. Cobalamin (vitamin B12) is naturally present in food, but practically only in animal products. Because the body cannot produce B12 itself, it must be obtained through food or supplements.
Why is vitamin B12 important?
Vitamin B12 is important for brain function and memory, but it also plays a role in many other processes in the body. Vitamin B12 contributes to:
- Your fitness;
- Your natural energy levels;
- Your ability to concentrate, learning performance and mood;
- Reducing fatigue;
- The production of red blood cells;
- Normal functioning of the immune system;
- Proper functioning of the nervous system;
- Normal energy metabolism;
- Normal homocysteine metabolism;
- The process of cell renewal;
- Good resistance.
Quite a list. It is not without reason that it is the best-known vitamin in the B vitamin family.
Read our blog about B12 during pregnancy.
The causes of vitamin B12 deficiency
Insufficient B12 in the diet
If you eat healthily, you may think that you are getting all the nutrients you need. Especially if you pay attention to vegetables, fruit and protein. However, with some vitamins, it's a little different.
Vegetarians and vegans can develop a deficiency due to reduced intake of vitamin B12. This is because vitamin B12occurs naturally mainly in animal products such as meat, fish, dairy and eggs. It is slightly easier for vegetarians to get enough B12 than for vegans. Fortunately, there are more and more foods on the market that are fortified with vitamin B12, such as breakfast cereals, plant-based milk and meat substitutes.
Curious about which foods contain B12? Read our blog about B12 and nutrition
Impaired absorption in the body
Even if you get enough vitamin B12 through your diet, that does not mean that your body automatically absorbs it properly. The absorption of B12 is a complex process involving several steps.
In the stomach, stomach acid causes vitamin B12 to be released from food. B12 then binds to a transport protein, which protects the vitamin from degradation. In the small intestine, this bond is broken again, after which B12 attaches itself to another protein that is necessary for absorption through the intestinal wall.
If there is a disruption anywhere in this process, the absorption of B12 may be reduced. This is more common in older people or in people who take certain medications, for example. In such cases, the problem is not with the food itself, but with the body's ability to absorb it.
A metabolic disorder
Although vitamin B12 is absorbed in the small intestine, problems in the stomach can prevent the vitamin from reaching the small intestine. If the enzyme pepsin is lacking in the stomach due to a metabolic disorder, vitamin B12 cannot be absorbed properly. This means you can have a vitamin B12 deficiency, even if you eat enough animal products that contain vitamin B12.
Vitamin B12 deficiency due to medication use
Because vitamin B12 needs stomach acid to be released in the stomach and thus absorbed by the body in the small intestine, long-term use of antacids can cause a vitamin B12 deficiency.
Long-term use of metformin, a medication used by type 2 diabetes patients, also causes vitamin B12 deficiency.
Stichting B12-tekort (Vitamin B12 Deficiency Foundation) has compiled a list of all medications that cause vitamin B12 deficiency in this article. In addition to antacids and metformin, you will also find a specific type of cholesterol-lowering drug, antibiotic and a medication for gout. Because vitamin B12 deficiency is often associated with a medical condition, the symptoms of vitamin B12 deficiency are not always recognised as such.
Symptoms and treatment of vitamin B12 deficiency
Your body can develop a vitamin B12 deficiency without you noticing. This is because the deficiency usually develops gradually and the initial symptoms are often subtle and difficult to recognise. In addition, the type and severity of the symptoms vary from person to person, which means that a B12 deficiency is not always immediately noticeable. A deficiency can manifest itself in various symptoms:
- Fatigue
- Reduced appetite
- Tingling
- Numb fingers and toes
- Muscle cramps
- Balance problems
- Memory loss
- Concentration problems
- Inflamed tongue
- Menstrual complaints
- Depression
For example, one person may only experience some fatigue, while another may experience psychological symptoms, such as concentration problems, or severe symptoms such as depression. And with some of these symptoms, something else is often thought of first. For example, depression is more likely to be attributed to a vitamin D deficiency, muscle cramps to a magnesium deficiency and fatigue to an iron deficiency.
In addition, research has shown that being overweight is linked to low vitamin B12 levels. It is not known whether a vitamin B12 deficiency can lead to weight gain.
A vitamin B12 deficiency can sometimes go unnoticed. In the long term, this can be problematic for the proper functioning of the brain and nerves. In the case of a severe vitamin B12 deficiency, a doctor will need to treat it with injection therapy.
If you are unsure or recognise signs that may indicate a deficiency, it is a good idea to have your levels checked.
How can you prevent a B12 deficiency?
Supplements can be a solution if you have symptoms that may indicate a vitamin B12 deficiency or if you do not eat animal products. Because vitamin B12 is a water-soluble vitamin, any excess is excreted in your urine when your body does not need it. Vitamin B12 therefore has no maximum intake (no upper limit per daily dose).
Conclusion
A vitamin B12 deficiency often occurs because you eat little or no animal products, which is especially common among vegetarians and vegans. Certain illnesses and medications can also reduce your body's ability to absorb B12. Because the symptoms, such as fatigue or memory problems, vary from person to person and are sometimes vague, you may not always notice a deficiency right away. That is why it is wise to get enough B12 through your diet every day and, if necessary, supplement it with a supplement.
If you suspect a deficiency, it is always advisable to consult a doctor.
