Vitamin B12 deficiency is a major problem nowadays. Excess sugar, smoking and the pill can affect absorption. Drugs like Metformin and stomach acid lowering drugs like Losec also hinder absorption, as does old age. But all ages can be affected – American president John F. Kennedy said he would “never have become president without injections of B12”. He was only 43 when elected.
The last NZ Nutrition Survey found that most of us had an adequate intake of B12 from food, but absorption wasn’t measured, and this is where the problem lies. Absorption is highly complex and easily disrupted. In western countries, around 39% of adults over the age of 26 have low blood levels, this increases to 80% in India where there are many vegans. But again, this is not measuring body and brain cell absorption.
So check and see if you have any of the nine common symptoms of B12 deficiency, and if so, read on to see what you can do about it.
Nine symptoms of B12 deficiency
- Numbness, burning, or pins and needles in hands or feet. B12 deficiency eventually causes nerve damage leading to these symptoms, (however B12 is not the only cause of these symptoms).
- Poor balance, shaky hands, clumsiness or falling. Nerve damage B12 deficiency often affects our steadiness and walking balance and makes us more prone to hand tremors, falling or bumping into things.
- Easily puffed on exertion and sometimes feel dizzy. This is a sign of anaemia – the main problem caused by B12 deficiency. It’s caused by our body failing to make sufficient red blood cells to carry oxygen to our muscles. B12 is needed by our DNA to make new red blood cells. (This symptom can also be caused by cardiovascular blockages or a weak heart.)
- Depression, confusion, forgetfulness and insomnia. Low levels of B12 are frequently found in people who suffer mood and brain disorders like depression, confusion, forgetfulness, slow thinking, halting speech, poor concentration and insomnia. Supplementing with B12 can speedily reverse these symptoms.
- Rapid heart rate or irregular heartbeat. A rapid or irregular heartbeat is often caused by mental anxiety or panic attacks. These are side effects of the brain disorders listed above. High blood homocysteine is usually also found.
- Pale skin or yellow tinge to whites of eyes. B12 deficient people often look pale, or have a slight yellow tinge to their skin or whites of their eyes – a condition known as jaundice. Again this is due to weak red blood cell production. The continual breakdown of weak red blood cells releases excess bilirubin (the yellow substance in bile) and this is what gives skin and eyes a yellow tinge.
- Weakness and low energy. Muscle weakness or stiffness, low energy and overall weariness are common symptoms of B12 deficiency. Again, this is because our body doesn’t have enough B12 to make healthy red blood cells to transport oxygen to our muscles. This can also result in weight loss, low blood pressure, and in young people, infertility.
- Inflamed red tongue. Lack of B12 can make our tongue red and swollen and feel painful or numb. This can also affect the way we speak and greatly lessen our taste of food.
- Blurred vision. This can occur when prolonged B12 deficiency causes nerve damage to our optic nerve. Fortunately it can often be reversed by supplementing with B12.
The Japanese regularly monitor the B12 levels of their elderly and treat dementia symptoms with this vitamin. As a result, the Alzheimer’s death rate in Japan is only 2.5%, six times lower than the 15% death rate in NZ and 10 times lower than the USA rate of 25%. In one USA study, over 60% of early dementia patients made a complete recovery with B12 supplementation. Monitoring and treating B12 deficiencies would appear to be a more cost effective health measure in NZ than monitoring and treating high cholesterol.
Food sources of vitamin B12
B12 is not found in grains, fruit or vegetables but in animal products such as milk, eggs and meat. Liver, pipis and sardines are rich sources. (There is a full NZ food table on page 90 of my Stay Healthy Book). The recommended intake in NZ is 2.4mcg daily.
Blood testing and supplementing
Blood tests are unreliable in checking B12 status – our blood level can be fine, but absorption by our body and brain cells poor. Japanese doctors consider B12 blood levels of 350-1000 pmol/L to be the normal range.
A more reliable method is the little known MMA (methylmalonic acid) test. Doctors consider an MMA level above 0.3umol/L to be a reliable indication of B12 deficiency, especially if homocysteine levels are also high. This test can be done overseas with a fasting urine test, followed by a blood test if confirmation is required, but NZ seems to offer only blood tests at this stage. The cost is around the $120 mark.
A simpler method is to just inject the vitamin and see if there’s any improvement. The medical procedure for this is to inject 1000mcg of B12 cobalamin every day (usually into a muscle) for three days, then once a week for a month. This can be done by a nurse at a medical centre. If an improvement is noted, then oral supplements can be taken, or a two monthly injection of 1000mcg continued indefinitely.
The normal cobalamin form of B12 can be difficult for the elderly to absorb, as a supplement, but there is another supplement form called methylcobalamin, which although expensive, is easily absorbed by the body.