Have you been experiencing a personal energy crisis lately? If so, you may want to have your levels of vitamin B12 checked. Ditto if you’ve been having symptoms like muscle weakness, constipation, numbness, tingling in your hands and feet, balance problems, depression, brain fog, memory lapses, or unexplained swelling or soreness in your mouth.
Your body needs this water-soluble vitamin for proper formation of red blood cells, neurological function, and synthesis of DNA (the genetic material in all cells), among other reasons. Yet, many people don’t have nearly enough of this vital nutrient in their bodies.
“It’s a bigger problem than most people think — B12 deficiencies are under-diagnosed and under-recognized,” says Lisa Hark, a Philadelphia-based family nutrition expert and co-author of Nutrition for Life. Research from the prestigious Framingham Study found that 12 percent of older adults were deficient in B12.
Unlike other nutrient deficiencies, lack of B12 often goes unrecognized because the symptoms generally develop gradually, are somewhat vague.
Who’s At Risk?
Anyone can develop a B12 deficiency, but your risk is especially high if you have a digestive disorder like celiac disease or Crohn’s disease or if you have pernicious anemia (an autoimmune disease that prevents the body from making the intrinsic factor that’s needed to absorb vitamin B12). Vegetarians and vegans are also at risk because only foods that are derived from animals contain B12 naturally.
Medications that are used to treat heartburn, gastroesophageal reflux disease (GERD), and peptic ulcer disease — such as proton pump inhibitors and histamine H2 receptor antagonists — can slow or block the release of acid into the stomach, thereby interfering with the body’s ability to absorb B12 from food. In addition, Metformin, a drug that’s used to treat diabetes, may also reduce B12 absorption.
A blood test, which your family doctor can order, can usually reveal if you’re deficient in B12. But if there’s any question about a false-normal reading (which can and does happen sometimes), it’s smart to have your levels of homocysteine (an amino acid) and methylmalonic acid (a substance produced when amino acids in the body break down) checked, Hark says. Measures of these substances can get out of whack when a B12 deficiency is present.
Treatment for B12 deficiency depends on the cause. If it’s simply because you’re not consuming enough foods rich in B12, increase your intake of fish, shellfish, beef and beef liver, poultry, fortified cereals, milk, yogurt, and eggs.
“If you’re a vegetarian, hemp milk and soy milk are often fortified with B12,” Hark notes, or you can take supplements. The recommended daily intake is 2.4 mcg.
If you’re deficient because your body is not producing enough stomach acid or you’re taking acid-blocking medications, supplements may not work. You may have trouble absorbing the vitamin without enough stomach acid, Hark warns. In that case, a once-a-month injection of B12, available by prescription, may be recommended.
For those who don’t like shots, there’s also a daily sublingual (under the tongue) tablet that passes through the mucous membrane in the mouth and into the bloodstream and a nasal spray that’s used once a week. Keep in mind that a B12 deficiency that’s due to absorption problems requires treatment for life.
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