If the vitamin B12 level in the body falls, this leads to quite unspecific symptoms such as tiredness, hair loss, or concentration problems. Vitamin B12 deficiency is common in people who follow a vegan diet, take certain medications, or have gastrointestinal disorders.
Symptoms: How does a vitamin B12 deficiency become noticeable?
Anyone who has been well supplied with vitamin B12 for a long time and – for example, due to a change in diet – comes into a deficiency situation will not notice anything at first. Because the body stores the vitamin for up to several years, mainly in the liver. When these supplies are exhausted, complaints creep in.
The symptoms of a vitamin B12 deficiency include fatigue, poor memory, but also hair loss, dry skin, and dry mucous membranes. These symptoms do not necessarily mean that you have a vitamin B12 deficiency. The doctor may also detect anemia during tests. This means that there are too few red blood cells per milliliter in the blood. Vitamin B12 is required for their formation and maturation, but also the division of hair root, skin, or mucous membrane cells. And the micronutrient also plays a role in the metabolism of nerve cells. A deficiency can therefore also lead to symptoms such as depressive moods and poor memory.
Risk groups: who are particularly at risk of vitamin B12 deficiency?
People who eat vegan and do not take supplements with vitamin B12 develop a deficiency relatively quickly. Because only animal foods, i.e. meat, fish, and dairy products, contain a sufficient amount to cover the daily requirement of vitamin B12. Vegetarians are less at risk if they eat enough dairy and eggs. Nevertheless, phases of life with high demand, such as pregnancy and breastfeeding, are also considered critical for them.
Medications can also lead to a vitamin B12 deficiency, such as acid blockers (proton pump inhibitors). They prevent stomach acid from being formed in the event of heartburn or gastric mucosal inflammation, and without stomach acid less vitamin B12 is released from food. In addition, the drugs prevent stomach cells from forming a special protein. Without this so-called intrinsic factor, hardly any vitamin B12 can get from the intestine into the body. Metformin, a drug commonly used to treat type 2 diabetes, has similar effects. It inhibits a transport route through which vitamin B12 enters the intestine. Last but not least, various diseases of the gastrointestinal tract or surgical interventions such as stomach reduction can lead to a vitamin B12 deficiency.
What is the treatment for a vitamin B12 deficiency?
First of all, a doctor must diagnose vitamin B12 deficiency. To do this, he takes blood and has the so-called holo-transcobalamin (holoTC), i.e. the metabolically active form of the vitamin, determined in the laboratory. This value is considered more accurate compared to the total vitamin B12. If the normal levels of the vitamin in the blood are not reached, doctors advise, as a first step, to change your diet. If this is not possible or if there are severe deficits, patients must take vitamin B12 as a dietary supplement. Only in the case of a very serious vitamin B12 deficiency do they receive the vitamin as an injection.