
Vitamin B12: Small but indispensable.
Vitamin B12 plays a major role behind the scenes in
your body. From your nerves and blood to your energy levels, this
vitamin is involved in all these functions. Your body cannot produce B12
itself, so you rely on food or supplements. A deficiency often develops
slowly and is therefore easily overlooked, especially as we age. Here
you can read about what B12 does, how a deficiency develops, which signs
you should watch out for, and what you can do to correct it.
What exactly does B12 do?
Cobalamin, also known as B12, supports numerous
processes. For example, it helps your nervous system function properly.
Nerves have a protective sheath (myelin) that transmits signals at
lightning speed. A B12 deficiency can damage this sheath, leading to
symptoms such as tingling, numbness, or coordination problems.
Furthermore, vitamin B12 is needed for the formation of red blood cells, which transport oxygen throughout your body. If you have too little of it, your body can circulate less oxygen. This manifests as fatigue, shortness of breath, and in more severe cases, anemia. Your brain also functions better with sufficient B12: it supports memory, concentration, and mood. Finally, B12 plays a role in energy production; too little B12 can make you feel exhausted, even if you sleep well.
How can a deficiency develop?
Diet is a key factor. Vitamin B12 is found exclusively
in animal products such as meat, fish, eggs, and dairy products. If you
eat a vegetarian or vegan diet and don’t take a supplement, you can
quickly develop a deficiency.
Absorption can also be impaired. In the stomach, vitamin B12 is extracted from food and then bound to intrinsic factor so that the intestines can absorb it. Stomach or intestinal problems, such as celiac disease or Crohn’s disease, disrupt this process. Absorption can also be reduced after gastric bypass surgery or other procedures affecting the digestive tract.
Medications can play a role. Antacids and the diabetes drug metformin are known to reduce vitamin B12 absorption with long-term use. Age also matters: as you get older, you produce less stomach acid, making it difficult to absorb B12 from food. Furthermore, excessive alcohol consumption and the use of nitrous oxide can lead to a deficiency.
Who is at increased risk?
Anyone can develop a vitamin B12 deficiency, but some
groups need to be especially careful. Older people (65+) are
particularly affected; almost a quarter of this group have levels that
are too low. Vegans and some vegetarians usually don’t get enough
without supplements.
Pregnant and breastfeeding women also need more B12, as their bodies supply the baby. People with chronic stomach or intestinal diseases and those taking certain medications long-term are also among the risk groups. For all these groups: Pay attention to any symptoms and get tested if necessary.
What symptoms indicate a deficiency?
A deficiency often begins gradually. You feel tired,
have less energy, and get out of breath more easily. Tingling or
numbness in the hands and feet are common signs. If the deficiency
persists, muscle weakness and balance problems can occur, which may
indicate nerve damage.
Mentally, it can also be noticeable: difficulty concentrating, forgetfulness, or depressive moods. This is sometimes dismissed as “simply getting older,” although vitamin B12 can play a role. Physical signs include pale skin, headaches, and a sensitive or painful tongue, consistent with advanced red blood cell production.
How is the diagnosis made?
Since these symptoms can resemble many illnesses, a
blood test provides clarity. Your family doctor can have your B12 level
checked. Sometimes the active form, holotranscobalamin, is also
measured. This test better reflects how much B12 your body can actually
use.
In cases of doubt, additional tests for methylmalonic acid and homocysteine can be performed, as these levels rise in cases of deficiency. If malabsorption is suspected, further examination of the stomach and intestines may be necessary to determine the cause.
Treatment: What really helps?
The approach depends on the cause and severity. If you
still absorb vitamin B12 well and the deficiency is mild, tablets or
orally disintegrating tablets may suffice. In cases of pronounced
deficiencies or absorption disorders, injections are often the best
option. They bypass the intestines and deliver B12 directly into your
bloodstream. Sometimes this is temporary, but in cases of persistent
absorption disorders, injections may be necessary for life.
Nutrition remains important. Those who eat meat, fish, dairy products, and eggs generally get enough. If you follow a plant-based diet, a supplement is practically essential. Fortified plant-based products can help, but often don’t provide enough to meet your entire nutritional needs.
What can you do yourself?
Eat a varied diet and make sure you get plenty of B12
from your diet, or choose a suitable supplement if you don’t consume
animal products. If you’re taking antacids or metformin, talk to your
doctor about whether additional monitoring is necessary.
- Do you notice signs like persistent fatigue,
tingling, or memory problems? Get your blood tested, especially if
you’re over 65. Since a deficiency develops slowly and the symptoms can
be subtle, it’s worth investigating afterward. Timely treatment can
alleviate symptoms and prevent damage. Vitamin B12: Small but essential.
Vitamin B12 plays a major role behind the scenes in your body. From your nerves and blood to your energy levels, this vitamin is involved everywhere. Your body can’t produce B12 on its own, so you rely on food or supplements. A deficiency often creeps in slowly and is therefore easily overlooked, especially as we age. Here you can read about what B12 does, how a deficiency develops, which signs to watch out for, and what you can do to correct it.
Medications can play a role. Antacids and the diabetes drug metformin are known to reduce vitamin B12 absorption with long-term use. Age also matters: as you get older, you produce less stomach acid, making it difficult to absorb B12 from food. Furthermore, excessive alcohol consumption and the use of nitrous oxide can lead to a deficiency.
Who is at increased risk?
Anyone can develop a vitamin B12 deficiency, but some
groups need to be especially careful. Older people (65+) are
particularly affected; almost a quarter of this group have levels that
are too low. Vegans and some vegetarians usually don’t get enough
without supplements.
Pregnant and breastfeeding women also need more B12, as their bodies supply the baby. People with chronic stomach or intestinal diseases and those taking certain medications long-term are also among the risk groups. For all these groups: Pay attention to any symptoms and get tested if necessary.
What symptoms indicate a deficiency?
A deficiency often begins gradually. You feel tired,
have less energy, and get out of breath more easily. Tingling or
numbness in the hands and feet are common signs. If the deficiency
persists, muscle weakness and balance problems can occur, which may
indicate nerve damage.
Mentally, it can also be noticeable: difficulty concentrating, forgetfulness, or depressive moods. This is sometimes dismissed as “simply getting older,” although vitamin B12 can play a role. Physical signs include pale skin, headaches, and a sensitive or painful tongue, consistent with advanced red blood cell production.
How is the diagnosis made?
Since these symptoms can resemble many illnesses, a
blood test provides clarity. Your family doctor can have your B12 level
checked. Sometimes the active form, holotranscobalamin, is also
measured. This test better reflects how much B12 your body can actually
use.
In cases of doubt, additional tests for methylmalonic acid and homocysteine can be performed, as these levels rise in cases of deficiency. If malabsorption is suspected, further examination of the stomach and intestines may be necessary to determine the cause.
Treatment: What really helps?
The approach depends on the cause and severity. If you
still absorb vitamin B12 well and the deficiency is mild, tablets or
orally disintegrating tablets may suffice. In cases of pronounced
deficiencies or absorption disorders, injections are often the best
option. They bypass the intestines and deliver B12 directly into your
bloodstream. Sometimes this is temporary, but in cases of persistent
absorption disorders, injections may be necessary for life.
Nutrition remains important. Those who eat meat, fish, dairy products, and eggs generally get enough. If you follow a plant-based diet, a supplement is practically essential. Fortified plant-based products can help, but often don’t provide enough to meet your entire nutritional needs.
What can you do yourself?
Eat a varied diet and make sure you get plenty of B12
from your diet, or choose a suitable supplement if you don’t consume
animal products. If you’re taking antacids or metformin, talk to your
doctor about whether additional monitoring is necessary.
Do you notice signs like persistent fatigue, tingling, or memory problems? Get your blood tested, especially if you’re over 65. Because a deficiency develops slowly and the symptoms can be subtle, it’s worth investigating afterward. Timely treatment can alleviate symptoms and prevent damage.