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What happens when your vitamin B12 is low?


Vitamin B12 is an essential nutrient that the body cannot produce on its own. It is also referred to as cobalamin and must be obtained through diet. Vitamin B12 is stored in the liver and, if there is a minor deficiency, it can be replenished. However, when levels become too low, serious symptoms may arise, which can take years to develop.

Vitamin B12 performs several functions in the body, including the production of DNA and red blood cells. As we age, it becomes more difficult to absorb this vitamin, and this can also occur if you have undergone weight loss surgery, had part of your stomach removed, drink excessive amounts of alcohol, or have taken antacids for an extended period.

A lack of vitamin B12 is called vitamin B12 deficiency anemia, and it results in the body producing larger red blood cells that are not able to function properly. Blood tests and microscopic examinations of blood cells can determine the levels of hemoglobin, red blood cells, and vitamin B12 in the blood. Treatment for vitamin B12 deficiency varies based on the doctor’s findings and can include a balanced diet and vitamin B12 supplements.

What are the signs of low vitamin B12?

Some special signs associated with Vitamin B12 deficiency include:

  • Yellowing of the skin
  • Redness and pimples on the tongue
  • Cold sores, loss or change in touch sensation
  • Blurred vision
  • Loss of vision
  • Change in gait
  • Instability of mind (mood swings), irritability, depression, or psychosis, etc.
  • Decreased mental abilities, such as memory, comprehension, and decision-making
  • Dementia

Vitamin B12 deficiency can also lead to anemia, with symptoms including:

  • Extreme tiredness or lethargy
  • Breathlessness
  • Feeling faint
  • Headache
  • Tinnitus
  • Loss of appetite

When to see a doctor?

If you are experiencing symptoms of vitamin B12 deficiency anemia, it is important to see your doctor. This condition can be diagnosed based on your symptoms and blood test results.

Early diagnosis and treatment of vitamin B12 deficiency is important, as many symptoms can be treated. However, if left untreated, the problems caused by the deficiency can become incurable. The longer the delay in treatment, the greater the risk of permanent damage.

What are the most common causes of B12 deficiency?

  1. Lack of Vitamin B12 in the diet:

The most common cause of vitamin B12 deficiency is a lack of this nutrient in the diet. Vitamin B12 is only available in animal foods such as meat, fish, eggs, and milk and milk products. If you follow a strict vegetarian diet and do not eat any animal-derived foods, including meat, milk, cheese, and eggs, you may be deficient in vitamin B12.

  1. Low Absorption:
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Vitamin B12 is absorbed through the small intestine, but the process is started by the stomach. Conditions that affect the stomach or small intestine can therefore interfere with proper absorption of vitamin B12. For example:

  • Heavy drinking can affect the lining of the stomach, hindering the absorption of vitamin B12 and leading to a deficiency.
  • Intestinal diseases, such as Crohn’s disease and celiac disease, can inhibit proper absorption of vitamin B12 in the small intestine, leading to a deficiency even when enough vitamin B12 is present in the diet.
  • Some medicines can also inhibit the absorption of vitamin B12. Common medications that can cause low vitamin B12 levels are metformin (a diabetes medicine), colchicine (a gout medicine), and chloramphenicol (an antibiotic used to clear up infections).
  • Many heartburn-associated medicines can also cause low vitamin B12 levels.”

What diseases can cause low B12?

The following conditions increase the chances of Vitamin B12 deficiency:

  • Vitamin B12 deficiency is common in the elderly
  • Atrophic gastritis, in which the lining of the stomach becomes thin
  • Stomach ulcers
  • Surgery to remove part of the stomach or small intestine
  • Pernicious anemia, which makes it difficult for the body to absorb Vitamin B12
  • Immune system disorders, such as Graves’ disease
  • Indigestion medicines

How to avoid Vitamin B12 deficiency?

Strict vegetarians (those who do not eat eggs) can overcome Vitamin B12 deficiency by consuming fortified breakfast cereals and supplements containing additional Vitamin B12. Generally, people can get all the components of Vitamin B12 through a balanced diet containing dairy products, meat, and fish. Vitamin B12 is not found in food obtained from plants.

What Foods Are Highest in B12?

  • Chicken
  • Lamb meat
  • Fish
  • Dairy products, such as milk, curd, and paneer
  • Some nutritional yeast products
  • Eggs
  • Soymilk and breakfast cereals enriched with added vitamins and minerals

It is always better to get the required amount of nutrients through a balanced diet before needing treatment. Consuming a healthy diet can easily avoid the problems caused by Vitamin B12 deficiency.

How is Vitamin B12 deficiency diagnosed?

Your doctor will first perform a physical exam, looking for signs of Vitamin B12 deficiency, such as a rapid pulse and skin tone. Blood tests may be done to determine the number and size of red blood cells. People with Vitamin B12 deficiency have relatively large red blood cells that appear larger than normal.

Other tests are needed to find the cause of Vitamin B12 deficiency in the blood. Sometimes a bone marrow biopsy may be performed to confirm the diagnosis and rule out other causes of anemia and abnormalities in blood cells.

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How can I raise my B12 levels fast?

The treatment of Vitamin B12 deficiency depends on the underlying cause. Vitamin B12 can be provided in the form of injections or tablets.

For anemia caused by Vitamin B12 deficiency, hydroxocobalamin injections are typically used. These injections are given every other day for two weeks or until symptoms start to improve. The treatment plan may vary based on the cause of the deficiency, such as if it is diet-related or not.

If the deficiency is due to an unbalanced diet, Vitamin B12 tablets may be recommended to be taken between meals or twice-yearly injections of hydroxocobalamin. Strict vegetarians may need to take Vitamin B12 tablets for life. If the deficiency has been caused by a long-term unbalanced diet, the tablets can be discontinued once the Vitamin B12 levels return to normal and the diet improves.

For non-dietary anemia, injections of hydroxocobalamin may be needed every three months for life. If there are neurological symptoms such as numbness or tingling, injections may be needed every other month.

Most people recover with treatment, but if nerve damage has occurred, the effects may be permanent. Vegetarians can consider alternative food sources such as fortified breakfast cereal that contain Vitamin B12.

What Diseases Can be Caused by Deficiency of Vitamin B12?

Most problems caused by a Vitamin B12 deficiency can be treated easily and effectively, so illness rarely develops.

Diseases Associated with Anemia

Whatever the cause, any type of anemia can lead to problems with the heart and lungs because they have to work harder to deliver oxygen to the vital organs of the body.

Adults with severe anemia may have the following complications:

  • Abnormally fast heartbeat
  • Heart failure – in which the heart is not able to supply enough blood with the right pressure to the entire body.

Neurological Changes

Vitamin B12 deficiency causes problems affecting the nervous system, such as:

  • Loss of vision
  • Loss of memory
  • Pinching sensation in hands and feet
  • Loss of physical coordination, which affects your whole body and makes it difficult to speak or walk
  • Damage to some part of the nervous system, especially the part of the foot that is affected.

If any problem related to the nervous system arises, then it can be incurable.


Vitamin B12 deficiency can sometimes lead to a temporary inability to conceive. This problem usually goes away with proper treatment for Vitamin B12 deficiency.

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Stomach Cancer

If you have Vitamin B12 deficiency due to pernicious anemia (in which your immune system attacks the healthy cells of the stomach), then the risk of developing stomach cancer increases.

Congenital Diseases

If you are pregnant and the amount of Vitamin B12 in your body is not sufficient, then it can cause serious brain and spinal cord diseases in your baby.

Which Medicines Should Not be Taken with Vitamin B12?

There are a total of 15 drug molecules that are known to interact with Vitamin B12. Of these, 3 may have a moderate and 12 may have a mild reaction if taken with a Vitamin B12 supplement.

Possibility of a Moderate Reaction

  • Aminosalicylic acid
  • Arsenic trioxide
  • Chloramphenicol

Minor Reaction Likely

  • Cimetidine
  • Dexlansoprazole
  • Esomeprazole
  • Famotidine
  • Lansoprazole
  • Nizatidine
  • Omeprazole
  • Pantoprazole
  • Potassium chloride
  • Rabeprazole
  • Ranitidine
  • Ranitidine bismuth citrate

Be sure to consult your doctor for more details.

Should Vitamin B12 be taken daily?

Vitamin B12 supplements are considered safe when taken in the recommended amounts. The recommended daily intake for adults is 2.4 mcg, and your body will only absorb as much as it needs. It is recommended to consult a doctor to determine the right quantity for your individual needs.

What is the main cause of Vitamin B12 deficiency?

The main cause of vitamin B12 deficiency is a lack of vitamin B12 in the diet, which is mainly found in meat, eggs, and milk. The most common cause, however, is pernicious anemia, which occurs when the immune system mistakenly attacks the stomach cells that produce vitamin B12.

Common symptoms of Vitamin B12 deficiency

Common symptoms of vitamin B12 deficiency include weakness and fatigue, which occur because there is not enough vitamin B12 to produce red blood cells that transport oxygen throughout the body. This leads to an inability to properly deliver oxygen to the cells, resulting in feelings of tiredness and weakness.