B12 Deficiency Symptoms

Vitamin B12 deficiency symptoms can sneak up on us but hit hard because B12 performs critical jobs in our body.

Unfortunately, some popular diets are very low in B12 and how well we absorb B12 varies throughout our life.

So how can we make sure the whole family from grandma to the kids get enough B12 to stay healthy?

Well in this guide I'll share everything I've learned about the :

• Big Benefits Of B12
• B12 Deficiency Signs
• Low B12 Complications
• Key Partners For B12

And then explain :

1. How Much B12 We Need
2. High Risk Diets
3. Times We Are At Risk
4. Best Food To Boost B12
5. Benefit Of B12 Supplements

The guide is chock-full of info do use the index to find something specific.

NB I am not a doctor. This is not medical advice. Talk to a doctor to check for B12 deficiency.

Benefits Of B12

You really will feel the difference when you have healthy B12 levels. B12 is an all round game-changer :

1. Keeps energy up.
2. Boosts mood.
3. Improves mental clarity.
4. Feeds skin, hair and nails.
5. Speeds up healing.
6. Nurtures nervous system.
7. Strengthens body.

Signs of B12 Deficiency

The signs of B12 deficiency start subtle before taking hold. Watch out for :

1. Fatigue & Weakness
2. Brain Fog
3. Mood Changes
4. Skin Issues
5. Nail & Hair Problems
6. Numbness Or Tingling

Fatigue & Weakness

Feeling wiped out all the time, even after rest and a good night’s sleep.

Brain Fog

Trouble concentrating, memory lapses or feeling strangely “spacey.”

Mood Changes

Sudden bouts of irritability, anxiety or depression can be linked to low B12.

Skin Issues

Hyperpigmentation e.g. on hands, feet or pale / yellowish skin or a smooth tongue that feels sore.

Nail & Hair Issues

Brittle nails, thinning hair or nails that grow slowly or look spoon-shaped.

Numbness & Tingling

A sharp pins-and-needles sensation in hands or feet due to nerve issues.

Dizziness Or Balance Problems

Feeling unsteady or lightheaded.

Complications of B12 Deficiency

If left unchecked, B12 deficiency can snowball into bigger health concerns and exacerbate other health issues :

1. Anemia
2. Neuropathy
3. Dementia
4. Menopause Issues
5. Mental Health Impact
6. SIBO & Gastritis
7. Recurrent Infections
8. Thinning & Frizzy Hair
9. Bad Back & Joint Pain

Anemia

Low B12 can cause megaloblastic anemia where red blood cells are too big and don’t work properly, leading to severe fatigue and shortness of breath.

Neuropathy

Long-term B12 deficiency can cause tingling, numbness or burning pain often in your hands or feet - like pins and needles that won’t quit. It can also cause shaking hands and tremors.

Dementia

Chronic B12 deficiency can contribute to cognitive decline & dementia. It’s not the sole cause but makes things worse.

Mental Health

Can worsen depression and anxiety and in severe cases can mimic the symptoms of psychosis.

SIBO & Gastritis

B12 deficiency can make SIBO and gastritis symptoms worse but they also in turn contribute to B12 deficiency so you can get stuck in a vicious circle.

Repeat Infections

B12 supports a load of immune system jobs and low B12 can contribute to poor control of residual low level viral, bacterial and fungal infections that keep coming back e.g.

• Gum disease
• Cold sores
• Plantar warts / verrucas
• Candida
• Dandruff.

Thinning Frizzy Hair

B12 deficiency can quietly undermine hair health, contributing to thinning and frizziness by disrupting iron and protein use, both vital for thick, glossy locks.

Joint & Back Pain

Low B12 levels don't cause joint and back pain but damaged nerves from persistent deficiency can make the pain worse and slow down healing.

Key B12 Partners

B12 is a team player, it depends on other resources in our body and other resources depend on B12.

One of the most critical resources is a molecule called Intrinsic Factor (IF) which our stomach produces to let us absorb B12 in our small intestine.

With low IF or a poorly gut e.g. from gastritis, IBS, Crohn's or low stomach acid from acid reflux meds we may not absorb enough B12 despite eating enough or taking supplements.

In turn B12 deficiency can be the hidden trigger behind other problems :

• Homocysteine Regulation: B12 helps break down homocysteine. High levels from low B12 increase heart disease risk.
• Other B Vitamins: B12 teams up with B6 and folate for energy, brain health & nerve function.
• Iron: B12 supports red blood cell production by iron. A B12 deficiency can worsen anemia.

Diets at Risk of B12 Deficiency

B12 is only in in certain food. The richest sources of B12 are good quality meat and seafood so some popular diets carry a higher risk of significant B12 deficiency including :

1. Vegans
2. Vegetarians
3. Pescatarians
4. Low-Meat Diets
5. Highly Processed Diets

Vegans

Vegan diets free from animal food have no natural B12 sources - supplements or fortified foods are a must.

Vegetarians

Eggs and dairy provide some B12 but typically you need to eat eggs, cheese & yoghurt daily to hit your weekly target.

Pescatarians

Shell food and fish are good sources of B12 and deliver most of the RDA in a single helping but one big weekly hit of fish e.g. a salmon steak - which I always used to do - won't work because we need to drip feed B12 in daily.

Low Meat Diets

If you only eat meat once or so a week you could end up going slightly short.

Junk Food Diets

Relying on junk food can lead to big nutrient gaps. Most processed meat is not a good source of B12.

Low B12 In Women

Women’s B12 needs vary across our life and deficiency can hit harder depending where we're at:

1. Teens
2. Fertility
3. Pregnancy
4. Postpartum
5. Menopause
6. Older Age

Teens

Growing bodies need B12 for energy and brain development. Vegan teens or those with poor diets are at higher risk.

Fertility

Low B12 can affect ovulation and egg quality making conception harder.

Pregnancy

B12 demand spikes to support foetal growth, especially of the brain and nervous system. Deficiency can increase risks of miscarriage or birth defects like neural tube defects.

Postpartum

Nursing mothers need extra B12 for their baby and low levels can lead to fatigue or developmental delays.

B12 is still critical for non-nursing mums as low levels impact mental health and postpartum recovery.

Menopause

Hormonal shifts and declining stomach acid during menopause can reduce B12 absorption and deficiency can worsen mood swings and brain fog.

Older Age

B12 absorption naturally declines with age due to lower stomach acid or Intrinsic Factor and increases risks of anemia, neuropathy, or dementia.

Low B12 In Men

Men aren’t immune to B12 deficiency either - here’s how it can affect them :

1. Teens: teen boys also need B12 for growth and energy. Poor or vegan diets can lead to low levels.
2. Fertility: Low B12 affects sperm quality & count impacting fertility.
3. Older Age: older men also absorb less B12 raising risks of nerve issues, anemia & cognitive decline.

Low B12 In Kids

Our kids need B12 for growth, brain development, and energy. B12 deficiency can show up as:

1. Fatigue, irritability.
2. Lack of appetite.
3. Delayed growth.
4. Missed developmental milestones.
5. Pale skin or weakness.
6. Poor focus & concentration.
7. In severe cases, neurological issues like poor coordination.

Vegan and veggie kids and picky eaters are at higher risk as are exclusively breastfed babies of low-B12 mothers.

There is some emerging but still limited research suggesting links between low B12 and neural disorders e.g. ADHD.

How Much B12 Do We Need?

The NIH recommended B12 daily allowances in mcg are :

• 0-6 Months : 0.4
• 7-12 Months : 0.5
• 1-3 Years : 0.9
• 4-8 Years : 1.2
• 9-13 Years : 1.8
• Teens : 2.4
• Men & Women : 2.4
• Nursing Mothers : 2.8

The RDA provides some B12 for immediate use and some for storage.

Some people absorb less B12 due to gut issues e.g. SIBO and it is worth keeping an eye on levels if at risk of going short and working with your doctor to identify personal needs.

B12 absorption issues e.g. in old age can be so severe that high dose supplements which bypass the usual absorption process are prescribed.

Do not exceed the RDA without taking qualified medical advice.

Best Foods to Boost B12

Huge amounts of B12 - 5000 mcg!! - can be stored in our liver and some food e.g. kidneys, mussels are super rich in B12 so it would seem a good idea to stock up with these.

It is NOT so simple!

We mentioned earlier a little glycoprotein called Intrinsic Factor (IF) which our stomach produces to let us absorb B12 in our small intestine.

IF caps how much B12 we absorb and store at each meal - so the B12 store in our liver is like a savings account that lets you build up a huge hoard but only in tiny deposits per meal.

The food list below shows you how much B12 you can absorb from each of the B12 rich foods in one meal.

But remember IF sets a cap per meal of 2 mcg and we can only sneak a tiny bit more in, so it's better to spread B12 rich food over meals and not waste it.

We'll get more over the day from a glass of milk at breakfast and chicken drumsticks at lunch than we would if we had them both at lunchtime.

B12 Rich Meat

Per 6oz / 160g helping :

• Lamb Shoulder - 2.4 mcg
• Pork Shoulder - 2.2 mcg
• Beef Sirloin - 2.06 mcg
• Lamb Loin - 2.06 mcg
• Venison - 2.05 mcg
• Pork Tenderloin - 2.04 mcg
• Beef Chuck Roast - 2.03 mcg
• Turkey Breast - 2.02 mcg
• Chicken Drumstick - 2.01 mcg
• Beef Round - 2.01 mcg

B12 Rich Seafood

Per 5oz / 142g helping :

• Shrimp - 2.3 mcg
• Sardines - 2.21 mcg
• Mackerel - 2.20 mcg
• Trout - 2.14 mcg
• Tuna - 2.04 mcg
• Salmon - 2.04 mcg

Other B12 Rich Food

• Fortified Nutritional Yeast (2 tablespoons) - 2.02 mcg
• Whole Milk (½ cup) - 0.85 mcg
• Swiss Cheese (2 oz) - 0.65 mcg
• Plain Yogurt (5 oz) - 0.55 mcg
• 1 Boiled Egg - 0.45 mcg
• Cottage Cheese (4 oz) - 0.45 mcg
• Cheddar Cheese (2 oz) - 0.35 mcg
• Mozzarella (2 oz) - 0.35 mcg

We will excrete most of what we eat over the cap. A small portion of beef liver has over 50 mcg of B12 but in one meal will give us barely 3 mcg!

B12 Supplements

Eating some B12 rich food at plenty of meals most days will keep most of us on track but some people will struggle.

Vegans have limited options and elderly people have an extra challenge.

As we age that little IF cap per meal can drop so we only absorb 1 mcg per meal. That means elderly people need to be getting some B12 rich food in each meal to hit the daily RDA.

This is where high dose B12 supplements can help with deficiency.

How High Dose B12 Supplements Work

We've seen IF limits how much B12 we absorb in one meal or supplement but something called passive absorption can sneak a tiny percentage - 1-2% - of any extra B12 we give it.

Even in super rich B12 food e.g. mussels, that tiny extra is not a big deal for rebuilding low B12 levels in our liver.

But a high dose supplement e.g. 1,300 mcg can make a difference because 2% of 1,300 mcg is an extra 26 mcg!

The main options available for high dose B12 supplements are :

1. Methylcobalamin
2. Cyanocobalamin
3. B12 Shots
4. Liquid B12

Only take high dose supplements under the guidance of your doctor.

Methylcobalamin

A natural, active form of B12 that’s easy for our body to use. Available in pills, sublingual tablets that dissolve under the tongue or gummies.

Cyanocobalamin

A synthetic form of B12 found in many supplements. It is cheaper but still effective for most people.

B12 Shots

Injections prescribed by a doctor for severe deficiency or absorption issues e.g. age, pernicious anemia. They bypass the IF cap in our gut to build levels back up quickly.

Liquid B12

Drops or sprays that can be absorbed through the mouth - good for those who don’t like pills or have mild absorption issues.

B12 Benefits Summary

And there you go, a guide to the big benefits of B12 for the whole family covering key signs of deficiency and the best B12 rich food to gently boost B12 levels daily PLUS how B12 supplements can help .

I do hope it helps you and your family enjoy a deliciously nutrient rich diet.

Please remember this is not qualified medical active. Talk to your doctor about all health concerns.

For more simple practical tips check out my other healthy living posts and follow me on Pinterest.