In more than half of those affected, a vitamin B12 deficiency is often discovered only years later. This can have consequences: If the nutrient deficiency is not detected and addressed in a timely manner, the risk of secondary diseases such as blood disorders and nerve damage increases. Scientists from Saarland University Hospital discuss these consequences in a recent publication. According to scientists, one reason for the late diagnosis of vitamin B12 deficiency is the range of possible symptoms.
Nervous system
How to recognize a vitamin B12 deficiency before it's too late
First signs
Initial signs such as tiredness, fatigue and difficulty concentrating are fairly generic and are therefore usually not associated with a vitamin B12 deficiency. However, if this remains untreated, it can have serious consequences; for example, there is an increased risk of blood disorders and nerve damage. The latter can manifest itself in, for example, problems with memory, unsteady gait or abnormal sensations in the hands or feet. People at risk should therefore consider a possible vitamin B12 deficiency, especially if symptoms are present1.
Which groups are at risk
The possible causes of a vitamin B12 deficiency are just as varied as the symptoms: the obvious one is an insufficient intake of vitamin B12 through food. This risk is increased for those with a vegetarian or vegan diet, as plant-based foods contain almost no vitamin B12. However, even with sufficient vitamin B12 intake through food, a deficiency is not uncommon, as it is often caused by problems with vitamin absorption in the intestine.
Vitamin B12-inhibiting medications
Some commonly prescribed medications may hinder the absorption of the nutrient in the intestine and thereby cause a deficiency. This can be the case, for example, when taking stomach acid inhibitors such as pantoprazole or omeprazole2 or diabetes medication metformin3. Diseases such as chronic inflammatory bowel disease or inflammation of the stomach lining, so-called atrophic gastritis, can also cause a vitamin B12 deficiency. In older people, a vitamin B12 deficiency can also be caused by an age-related weakening of digestive processes1,4. A targeted blood test allows doctors to determine whether there is a deficiency and to initiate appropriate treatment.
Prescribing high-strength vitamin B12 tablets
To compensate for a deficiency, high-strength vitamin B12 medication is required1. Tablets containing 1,000 μg of vitamin B12 per day have been shown in studies to be effective, even in cases of vitamin B12 absorption impairment in the intestine5. With correspondingly high doses, some of the vitamin B12 molecules can bypass barriers inhibiting absorption and effectively compensate for a deficiency. You should also make sure that you choose medication from the pharmacy when treating a vitamin deficiency. In contrast to dietary supplements, medicines are approved to treat a deficiency and are officially tested for effectiveness, quality and safety.
Self-test: Do I have a vitamin deficiency?
Would you like to assess your personal risk of vitamin B12 deficiency? This online test provides helpful information as to whether you are at risk of a deficiency that requires medical advice.
1Obeid R, Hübner U, Geisel J. Diagnose und Therapie des Vitamin-B12-Mangels. Risikogruppen besonders gefährdet. Trillium Diagnostik 2023; 21 (3), 168–171; https://doi.org/10.47184/td.2023.01.xx
2Lam JR, Schneider JL, Zhao W et al.: Proton Pump Inhibitor and Histamine 2 Receptor Antagonist Use and Vitamin B12 Deficiency. JAMA 2013; 310 (22): 2435–2442; doi: 10.1001/jama.2013.280490
3Yang W et al. Associations between metformin use and vitamin B12 level, anemia and neuropathy in patients with diabetes: a meta-analysis. J Diabetes 2019; 11 (9): 729–743; https://doi.org/10.47184/td.2023.01.xx
4Andrès E et al. Food-cobalamin malabsorption in elderly patients: clinical manifestations and treatment. Am J Med 2005 Oct; 118 (10): 1154–1159; doi.org/10.1016/j.amjmed.2005.02.026
5Eussen SJPM et al. Oral cyanocobalamin supplementation in older people with vitamin B12 deficiency. Arch Intern Med 2005; 165 (10): 1167–1172; doi: 10.1001/archinte.165.10.1167
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