What are vitamin b12 deficiency symptoms?


Vitamin b12 deficiency symptoms can range from mild to severe. In this article we discover what to look for.



Vitamin bBecause the process by which the body absorbs this vitamin from foods is complex and easily sidetracked, symptoms of vitamin b12 deficiency are common in people who do not take supplements or eat fortified foods.

Key vitamin b12 deficiency symptoms

Some of the early vitamin b12 deficiency symptoms include nervousness, poor appetite, weakness in the legs and general fatigue. These symptoms are usually followed by anemia. A lack of vitamin B12 leads to anaemia because it is needed by the human body for the proper assimilation of iron and for the formation of red blood cells.

In some cases, vitamin b12 deficiency symptoms are not followed by anemia, but could be much more serious. One of the vitamin B12 functions is to insulate and protect nerve and brain cells from damage. Lack of B12 can cause numbness and tingling in the hands and feet, trouble with balance or coordination, difficulty walking and eventually brain damage.

Low levels of B12, B6 and folate are found in persons with high homocysteine levels. High homocysteine levels are related to early development of heart and vascular diseases. A chronic shortage of this vitamin may not lead to obvious vitamin b12 deficiency symptoms, but may increase the risk of developing heart disease in later life. The best insurance is supplementation with B12 and other B complex vitamins.

Substances That Interfere With Absorption of B12

Many substances can interfere with the proper absorption of B12. The list that follows may be incomplete.


  • Alcohol and tobacco have a cancelling effect or increase the need for many nutrients. Excessive alcohol consumption can decrease absorption of B12 from the gastrointestinal tract.

  • Alcoholics often exhibit vitamin b12 deficiency symptoms. Nicotine, from tobacco, also reduces blood levels of B12. The effectiveness of supplementation for smokers has not been studied. The best choice here is to quit smoking and limit alcohol intake.

  • Antibiotics used to treat tuberculosis and Inflammatory Bowel Diseases can reduce absorption of B12 by as much as 55%. Other antibiotics can also interfere with absorption. Most do not present a serious risk, but people taking Chloramphenicol should be monitored regularly for signs of anemia and other signs of vitamin b12 deficiency.

  • Colchicine, a drug used primarily to treat certain types of heart disease and gout which is being studied as a possible anti-cancer drug, can inhibit the absorption of B12 and several other nutrients. Blood levels should be monitored in patients using this drug for prolonged periods of time.

  • Cholestyramine, used to treat high cholesterol and to prevent diarrhea in post surgical Crohn’s patients, can interfere with B12 absorption. Supplementation is suggested.

  • Pepcid, Zantac and other H2 receptor antagonists, commonly used for the relief of heartburn and acid reflux, interfere with the absorption of B12 from food, but not from dietary supplements.

  • Prilosec, Prevacid and other proton pump inhibitors have a similar effect. Stomach acid is necessary to release B12 from the protein to which it is bound in food sources. Anything that interferes with stomach acid secretion for a prolonged period can lead to vitamin b12 deficiency symptoms, particularly if the diet is poor, other risk factors are present, or if supplements are not included.

  • Diabetics have an increased risk for heart disease. Metformin, an anti-diabetic drug, can add to their risk by reducing blood levels of B12 and folic acid and increasing homocysteine levels. Even if symptoms of vitamin b12 deficiency are not present, supplementation can reduce the risk of anemia, which has been noted in some cases, as well as lowering the overall risk of heart disease. Calcium supplementation is also recommended for person’s using Metformin.

  • Anticonvulsants, anti-retroviral drugs, laxatives and even coffee and contraceptives can interfere with absorption of B12.

In conclusion, to avoid developing Vitamin b12 deficiency symptoms and to protect long term health, supplementation is the best solution.

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