Vitamin B12 deficiency is a widespread problem that can lead to serious complications. Its signs are often mistaken for ordinary tiredness or forgetfulness.
Why does the body need vitamin B12?
Vitamin B12 takes part in the formation of red blood cells. Together with folic acid it plays a role in building cells and influences the body’s development – which is why it is especially important during pregnancy.
B12 is also needed for the peripheral nervous system to work properly. A lack of this vitamin, which is essential for the nervous system, energy and blood values, can affect many organs and systems.
Anaemia that develops in adulthood has three important causes: iron, B12 and folic acid deficiency. A diet poor in B12 and folic acid can also lead to anaemia.
How does B12 deficiency show itself?
Many people put long-lasting tiredness down to the change of seasons. But if fatigue lasts more than 2 weeks, it is no longer a seasonal issue. The most common hidden causes include vitamin D, iron (ferritin) and B12 deficiency, as well as an underactive thyroid.
The signs of B12 deficiency can vary:
- anaemia;
- numbness and tingling in the hands;
- forgetfulness, poor concentration;
- headache, dizziness;
- indigestion, constipation, vomiting;
- itchy skin, dermatitis;
- cracks at the corners of the mouth, an inflamed tongue;
- hair loss;
- heart rhythm disturbances;
- depression, irritability.
Who is at risk?
- vegetarians and vegans – B12 drops quickly in them; eating little or no red meat can also lead to B12 and iron deficiency;
- patients with type 2 diabetes – in them B12 deficiency may be linked to peripheral neuropathy;
- people who take metformin for a long time;
- older people, people with gastrointestinal diseases or stomach surgery, and those who take stomach acid–reducing medicines for a long time.
Metformin and B12: what should you know?
Metformin is a medicine used to treat type 2 diabetes, insulin resistance and polycystic ovary syndrome. It should be prescribed only when indicated – after tests have been done and insulin resistance has been checked.
Metformin is not a weight-loss drug – not everyone who is overweight should take it. The medicine must never be taken in excessive doses, and you should not take a double dose to make up for a missed one.
In people who take metformin for a long time, the absorption of vitamin B12 may decrease. That is why it makes sense to check B12 levels periodically in such patients. Complaints such as numbness and burning in the feet may be due not only to diabetic neuropathy but also to B12 deficiency – your doctor will tell the difference.
Even if B12 deficiency is found, do not stop metformin on your own – change your treatment plan together with your doctor.
Don’t take vitamins blindly! Too much of a vitamin can harm the body as much as too little. Tests first, then precise treatment.
Dr. Samir Shukurov
Diagnosis and treatment
The diagnosis is made by checking the level of vitamin B12 in the blood and a complete blood count; if necessary, the doctor orders additional tests. It is also important to find the cause of the deficiency – diet, impaired absorption or the effect of a medicine.
Treatment depends on how severe the deficiency is and what caused it: B12 can be given as tablets or by injection. Vitamin supplements are useful, but the same dose does not suit everyone – tests and a doctor’s assessment are essential for the right choice.
This article is for general information only and does not replace a medical examination.