Recognizing and Correcting Vitamin B12 Deficiency (And Being Extra Thorough)

Vitamin B12 deficiency can be so sneaky, and threatening, and cascade to a slew of problems!

What is Vitamin B12?
Vitamin b12 is an essential nutrient – meaning it needs ingested daily (in the right amounts and actually absorbed) to help support optimal health.

What does Vitamin B12 do?
It helps the body to:

• Produce the red blood cells that carry oxygen throughout our body
• Nerve function, energy release
• Contribute to DNA formation
• Cofacter in helping the liver detox (phase 1 & phase 2 detoxification)
• “Ingredient” in making stomach acid

Where is Vitamin B12 found?
Vitamin B12 is found in animal foods primarily, and then is often fortified into foods like cereals. Adults need about 2.4mcg per day from food assuming they are absorbing Vitamin B12 well, and assuming they are not already deficient for one reason or another.

Who is most at risk for a Vitamin B12 Deficiency?

• Vegetarian or Vegan eating patterns (as it’s primarily found in animal foods)
• In those with an underlying H. Pylori infection (can inhibit vitamin b12 absorption)
• Chronically stressed – downregulating stomach acid production (decreased vitamin b12 absorption)
• Using Metformin (decreased vitamin b12 absorption)
• Using hormonal birth control (decreased vitamin b12 absorption)
• Using histamine H2 blockers (decreased vitamin b12 absorption)
• Using antacid medications like proton pump inhibitors (decreased vitamin b12 absorption)
• Have underlying intestinal parasites (decreased vitamin b12 absorption)
• Have underlying small intestinal bacterial overgrowth (decreased vitamin b12 absorption)
• Drink alcohol often (inflames liver – less B12 released, decreased vitamin b12 absorption)

How is Vitamin B12 deficiency diagnosed?
There are multiple ways – but two most common ways are via bloodwork. Two common tests are a serum vitamin B12 and/or a MMA marker.  If your body doesn’t have enough vitamin B12, it will make extra amounts of MMA. High MMA levels can be a sign of a vitamin B12 deficiency. These are both things I can order as a registered dietitian that are in my scope of practice.

What “do the numbers mean?”
Deficiency is commonly deemed at a vitamin b12 level less than 200pg/mL and this is serious. I would deem anything less than 500pg/mL as poor. Optimal levels for optimal bodily function is near 800-1000pg/mL. If you have less than ideal levels, you could experience:

• Anixety/depression
• Vision problems
• Shortness of breath
• Fatigue
• Swollen tongue
• Difficulty conceiving
• Indigestion (decreased stomach acid)
• Tingling in hands and feet
• Headaches

So the first thing to do is to react and get the levels up to OPTIMAL levels.
Food is pennies in the bucket in terms of a solution to deficiencies. If you have low levels you need either high dose vitamin B12 supplementation or Vitamin B12 injections.

The next step is figure out WHY this vitamin B12 deficiency happened!
Is there something underlying causing absorption issues? For many it’s not decreased oral intake from food (unless vegan) but rather a condition (celiac disease), a pathogen (SIBO, parasite) or a medication induced deficiency (birth control, metformin, antacids) that all mess with its proper absorption.

You know my favorite saying: TEST, DON’T GUESS

Think you have a Vitamin B12 deficiency? It is a cheap blood test. You can self order here and get done at Quest labs. You don’t need a Doctor order.

If low end of normal or deficient, make sure you take a supplemental form of vitamin B12. I do not recommend cyanocobalamin. Get a methylated or adeno form. Click here to order from Fullscript at 10% off and free shipping.

Need to consult one on one? Self schedule online a consult package and let’s test, don’t guess and come up with a protocol that is specific to the root problems.

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