The deficiency of vitamin B12 is often associated with a vegan diet. The lack of animal products in the diet excludes vegans from getting vitamin B12 absolutely.
Even the selective vegetarians who eat only dairy products and no meat or egg too have the risk of not getting adequate amounts of the vitamin. The micronutrient Vitamin B12 is only found in animal foods.
It has been reported by health professionals across the United Kingdom and the United States that close to 6% of adults below the age of 60 suffer vitamin B12 deficiency.
However, as age goes up, approximately 20% of the population over 60 years of age suffers from the deficiency.
But to know the root culprit of B12 deficiency and save yourself from potential risks, let’s learn more about the vitamin, its significance, what causes B12 deficiency, and how to avoid the deficiency.
Why Is Vitamin B12 Important?
Vitamin B12 is a water-soluble micronutrient present naturally in most animal-based foods such as poultry, dairy, meat, etc.
It forms a compound with a mineral element Cobalt, forming “cobalamins” which contributes to its form, utilization, and presence in our bodies.
Out of the four major forms of cobalamin, namely Methyl cobalamin, 5- deoxy-adenosyl cobalamin, hydroxocobalamin, and cyanocobalamin, the former two are the metabolically active compounds of the micronutrient.
The latter two are converted to either Methyl cobalamin, 5- deoxy-adenosyl cobalamin to be utilized in the body.
The nutrient is crucial to the development of erythrocytes (red blood cells) and DNA in our body.
B12 is also essential to the sound function of our nervous system. The deficiency of B12 can cause a metabolic slowdown or pernicious anemia.
What Are The Most Common Dietary Sources Of Vitamin B12?
Vitamin B12 occurs naturally in Animal-Based Food sources such as the various types of meats, fish, eggs, poultry, and dairy.
Though the foods are rich in vitamin B12, the bioavailability of the vitamin may vary across the doses. Past the binding power of a protein called intrinsic factor, which is at 1–2 mcg of vitamin B12, the absorption decreases rapidly.
Additionally, dairy products have three times more bioavailable vitamin B12 than meat products do.
For vegans, the best source of vitamin B12 could be Fortified foods with added Vitamin B12 to the vegan milk substitutes, spreads, yeast flakes or extracts, and even breakfast cereals.
Eating them at least two times a day can help chalk out potential risks to deficiency. Similarly, vegan supplements for B12 can also be consumed regularly.
Is Vitamin B12 Deficiency Limited To Vegans?
No! Vitamin B12 deficiency is not limited to vegans, however they’re at a greater risk, as reported by VegansFirst.
Any deficiency of micros or macros in our diet is not only dictated by lower amounts of daily intake but also by poor absorption by the body.
Therefore, besides those who are on a vegan diet with a deficit of Vitamin B12, there are other groups of people who may develop the risk of severe deficiencies, such as:
- Elderly people over 60 years of age
- Those having undergone surgical removal of a part of the alimentary canal that absorbs B12
- Issues with small intestine or health conditions such as Crohn’s disease, celiac disease,
- Bacterial growth, or the presence of parasites in the intestinal region.
- Thinning of the stomach lining due to Atrophic gastritis
- Diabetic patients on the metformin drug treatment that interferes with the absorption of vitamin B12.
- Patients under Long- term antacid drugs or those that have an impact on the digestive capabilities to absorb the vitamin.
- Patients with Pernicious anemia having difficulties with the absorption of vitamin B12.
- Immunocompromised persons with Grave’s disease or other auto-immune disorders.
- Persons under medications of proton pump inhibitors (PPIs) such as lansoprazole (Prevacid), esomeprazole (Nexium), omeprazole (Prilosec OTC), rabeprazole (Aciphex), and pantoprazole (Protonix) or H2 Blocker’s cimetidine and famotidine
Signs and Symptoms of Vitamin B12 Deficiency
If you consume fewer amounts of vitamin B12 than the recommended daily intake (RDI), you are at risk of deficiency.
Our body needs different amounts of the micronutrient as we grow. Let’s have a look at the RDI, for vitamin B12, measured in micrograms (mcg):
- Age 0-6 months: 0.4 mcg
- Age 7-12 months: 0.5 mcg
- Age 1-3 years: 0.9 mcg
- Age 4-8 years: 1.2 mcg
- Age 9-13 years: 1.8 mcg
- Age 14-18 years: 2.4 mcg
- Adults above 18 years of age: 2.4 mcg
- Pregnant woman: 2.6 mcg per day
- Lactating women: 2.8 mcg per day
Since our body stores close to 1- 5 mg vitamin B12, which is nearly 2000 times the RDI, therefore, any symptoms or signs of vitamin B12 deficiency shall not appear sooner.
In many cases, it may take years to appear. The signs include:
1. Pale Skin
Vitamin B12 plays an important role in the formation of DNA and red blood cells. The deficiency of the micronutrient may cause incomplete cell division causing megaloblastic anemia.
In this disease, the RBCs in the bone marrow bulk up and become more fragile. Their inability to pass through the marrow shall impact the levels of RBC in your body and thus the skin may appear pale.
In case the cells break down, they would increase bilirubin concentration in the body, giving your eyes and skin a yellow tinge.
2. Fatigue and Excess Tiredness
In continuation to the shortage of RBCs discussed above, note that these red blood cells play an important role in transporting oxygen to our body cells and helping them generate energy for our metabolic activities.
The inefficient availability of oxygen to your body cells shall always make you feel tired. It is a type of anemia called the pernicious anemia that generally the elderly suffers from.
3. Neurological Impact
The lack of Vitamin B12 has a significant impact on your nervous system as well. Paresthesia, the sensation of pins and needles in the limbs, is one of the common symptoms of the deficiency.
However, the symptom is not a decisive one to indicate the lack of vitamin B12. If you get a pins and needles sensation without any other symptoms, there might not be a deficiency except for a momentary nervous response.
If spared untreated, the deficiency of vitamin B12 can damage the nervous system permanently. Thereafter a patient might find difficulty in walking or moving.
This may also reflect an inability to set balance and coordination. In case the optic nerve is affected due to the deficiency, the patient may suffer from disrupted vision.
4. Mouth Ulcers
If you have an inflammation in the tongue or feel certain itchiness or burning sensations in the mouth, this could be a sign of Vitamin B12 deficiency.
Glossitis, the term used to refer to a swollen tongue, might also make the tongue appear smooth without the tiny taste buds that give the tongue an irregular surface.
The taste buds stretch out, flattening themselves, and make the process of eating and even speaking painful. The presence of lesions further confirms the deficiency.
5. Mood Swings
Due to the neurological damage that happens due to the lower intake of vitamin B12, mood changes may surface.
The reserves of homocysteine in the body increase at lower reserves of B12, which perpetually interferes with the signals sent from the brain to the other parts of the body.
This condition is also referred to as, “homocysteine hypothesis of depression”.
While depression and dementia may have a myriad of reasons, not excessively associated with vitamin B12 deficiency unless the signs appear in combination with any other symptom like fatigue or smooth tongue.
Who Should Supplement With Vitamin B12 Capsules?
Vitamin B12 is naturally produced by microorganisms and not plants. Due to the current revolution in the food industry to manufacture vegan alternatives rich in the nutrients found in animal-based food.
For instance, certain foods fortified with Vitamin B12, nutritional yeasts are produced to assist vegans in recovering their needs.
In case you cannot get fortified foods or have health concerns that affect the absorption of B12 in the body, consider going for certified supplements recommended by your health advisor.
The bioavailability of vitamin B12 derived from dietary supplements could be higher than those found naturally in animal products by 50 percent.
Vitamin B12 is an important micronutrient that regulates neurological and metabolic activities in our bodies.
Each person must consider supplementing their plates with the vitamin if they have issues in getting the RDI of the supplement.
As we have discussed above in detail, vegans do not comprise the only group that is prone to the deficiency of vitamin B12.
Interestingly, there is no upper limit to vitamin B12 consumption or supplementation because being a water-soluble vitamin the excess of it is passed out of our body through urination without leading to toxicity.