Vitamin B12

Maintaining healthy levels of vitamin B12 may have a number of benefits, including:

• Preventing anemia
• Supporting a healthy pregnancy
• Supporting bone health
• Reducing osteoporosis risk
• Improving mood
• Preventing memory loss

The ability to absorb vitamin B12 declines as we age, especially in individuals over 60 years old. Individuals with certain autoimmune and digestive disorders are more likely to suffer from a vitamin B12 deficiency.

Potential risk factors for cobalamin deficiency include:

• Family history of B12 deficiency
• Surgery leading to the removal/restriction of the stomach or intestine, such as gastric bypass surgery
• Autoimmune diseases, including type 1 diabetes
• Crohn’s disease
• HIV
• Certain medications, including proton-pump inhibitors
• Highly restrictive diets, such as strict veganism
• Advanced age

Early signs of a possible vitamin B12 deficiency include:

• Weakness
• Numb or tingling sensation in extremities
• Difficulty walking
• Elevated heart rate
• Smooth and tender tongue
• Fatigue (lack of energy)
• Nausea
• Decreased appetite
• Weight loss
• Irritability
• Diarrhea

Vitamin B12 deficiency is rare in healthy individuals, but when it occurs, it is important that it be addressed swiftly. Prolonged deficiency can lead to pernicious anemia and fatigue, with more severe deficiencies impairing neurological function. 

More severe B12 deficiencies that go untreated can lead to

• Tinnitus
• Severe joint pain
• Memory problems
• Depression
• Anxiety
• Poor muscle function
• Ataxia
• Changes in reflexes
• Infertility
• Delayed growth/development in children

In cases of severe vitamin B12 deficiency, frequent intramuscular injections of large doses of a form of cobalamin may be used to restore vitamin levels to healthy amounts, followed by smaller, less frequent maintenance doses of injections or oral supplements. They can also be used to prevent future deficiencies.

Vitamin B12 injections are an excellent way to supplement cobalamin, as they bypass the digestive system. This allows for greater bioavailability and absorption, particularly in individuals who have difficulty absorbing it from their diet.

Supplemental cobalamin is available in multiple forms, including methylcobalamin and hydroxocobalamin. Individuals considering B12 injections should discuss their options with a physician before starting.