vitamin B12 deficiency is a very sneaky condition that presents in multiple different ways and the signs and the symptoms of low B12 well they range from physical changes to even psychological changes now the reason I'm making this video is because it's so important to identify B12 deficiency as early as possible as low B12 can lead to serious health problems if left untreated and was challenging about this is a lot of these signs are very easy to miss and the symptoms overlap with other conditions so they can be very easily missed even by your doctor so
it's important to educate yourself and learn how to identify B12 deficiency as early as possible so in this video I'll go over all the important warning signs of vitamin B12 deficiency that you should never ignore now because of this overlap with other conditions I'm also going to discuss which group of people are in increased risk of developing B12 deficiency and no it's not just the vegans or strict vegetarians that need to be careful there are many other groups of people that are at an increased risk for developing vitamin B12 deficiency so if you have any
of the symptoms I describ in this video and you do fall in the high risk category then I would definitely make sure to have your vitamin B12 levels checked out and if you have family members or friends who you think will find this valuable share this video with them as it's a very important topic on a condition that often goes untreated also if you've been dealing with vitamin B12 deficiency and you present it with a sign or a symptom that I did not cover in in this video let me know in the comments below so
we can all learn from each other experiences so the reason vitamin B12 is so important is because it's an essential co-actor that your body needs to make DNA and it's extremely important in cell metabolism so if these processes are disrupted well that leads to a whole Cascade of Downstream effects on your energy production and your central nervous system and your blood cell production so the very first thing you may notice even with a very mild 12 deficiency is fatigue or low energy now this fatigue happens for two reasons one your body becomes less efficient in
energy metabolism and two inadequate B12 levels lead to anemia or a condition where you do not have enough red blood cells and you need red blood cells to deliver oxygen to your organs but there are thousands of reasons why people get fatigued or low energy but the fatigue that we get from B12 deficiency is usually exertional fatigue so it's the fatigue that comes on pretty quickly and it's pretty shortlived and it comes on even after a mild physical activity or even mild mental strain and another thing to what out for is this fatigue may also
come with shortness of breath or even heart palpitations when you're trying to exert yourself so it's not so much feeling tired or having low energy but it's more so fatigued with any kind of physical or mental exertion now another common presentation of vitamin B12 deficiency is headaches especially migraine headaches and there are studies in children that show that headaches was the most commonly reported symptom of vitamin B12 deficiency and there are other studies that show that serum vitamin B12 levels were significantly lower in migraine patients than in healthy subjects so we don't actually really know
why there's such an association between B12 and headaches or migraines some speculate it could be due to the underlying anemia or nerve disruption which I will talk about in just a moment and there's some to speculate that B12 deficiency and the Associated high levels of homocysteine is what causes endothelial cell damage by increasing the levels of free oxygen radicals next another sign of B12 deficiency is painful tongue swelling or inflammation of the tongue which is also called gtis so this tongue inflammation is usually present in about 25% of B12 deficiency cases and people may describe
it as sort of a burning sensation or itching or even loss of taste or having metallic taste on the tongue now there are many other reasons for why somebody can develop glossitis or tongue inflammation so it could also be caused by things like iron deficiency anemia or viral infection or a fungal infection there's also a lot of medications that can cause glossitis so medications like albuterol or oral contraceptive pills so it's not always vitamin B12 deficiency that causes this and if you do ever get this you definitely need some other test and labs to rule
out other causes next up another sign of vitamin B12 deficiency is skin changes and more specifically you may get poor or pale skin which is once again caused by the underlying anemia and in more severe cases B12 deficiency may actually cause jaundice or yellowing of the skin or yellowing of the whites of the eyes and this happens due to the bow marrow having trouble producing healthy red blood cells which eventually leads to the destruction of immature red blood cells and that in turn causes the buildup of Billy Rubin and Billy Rubin is just the waste
material created when the body breaks down blood cell byproducts another important sign of vitamin B12 deficiency is numbness and tingling of your feet in your hands you may also feel like burning or pinan need sensation so another word for that is neuropathy and this neuropathy can be similar to diabetic neuropathy but in the case of diabetes it's the high blood sugar that damages the nerves so because of this overlap and neuropathy due to B12 deficiency is very often misdiagnosed as diabetic neuropathy in people with diabetes and in some cases you can have both a diabetic
neuropathy and a separate neuropathy caused by B12 deficiency so I would actually have very low threshold to check B12 levels in those cases as both the diabetes and the use of common diabetes medications like methin can put you at a higher risk for developing B12 deficiency and by the way it's not just metformin that can lead to B12 deficiency there are a few other medications that you need to watch out for and I'm going to talk about them later in this video so this nerve damage happens because vitamin B12 is directly responsible for producing myin
or a protective layer around the nerve and this myin Shields their nerves against damage so vitamin B12 deficiency leads to the loss of this protective nerve barrier and on top of that when your body does not have enough vitamin B12 it also causes a buildup of methylmalonic acid which can be toxic and can cause further damage to the neurons now as this nerve damage progresses it can cause even more neurological impairment so you may start seeing things like poor coordination and abnormal balance and even abnormal reflexes and in some cases you may even affect your
gate or you may have difficulty walking and in very severe cases of long-standing B12 deficiency you may even get painful vision loss which is caused by the damage and inflammation of the optic nerves and on top of that if your vitamin B12 deficiency goes untreated for too long you can even see psychotic features like hallucinations and paranoia and even depression and as some people can even progress to dementia now the good news is the damage to the nerves that is caused by low B12 can be reversed with early and aggressive treatment so that's why it's
so important to identify this as early as possible and another important sign to watch out for is cognitive impairment which can present as poor memory or difficulty concentrating and we have cohort studies that noted that low plasma B12 and folate levels were associated with worse cognitive function and there was another study that was a cross-section analysis of 39,000 people that found that low vitamin B12 was associated with poor memory in men now because these signs and symptoms overlap with so many other conditions how do you know whether you should be worried about a B12 deficiency
well to start you can always have your levels checked out but what's confusing about that is if your B12 level comes back as normal you may still have a deficiency as there's different gradients to what's considered normal for different people and in some cases you may have a true vitamin B12 deficiency despite Stone Cold normal B12 levels and that's called a functional B12 deficiency so in my practice if I'm concerned about a B12 deficiency I usually combine that B12 test with other tests like MMA or methylmalonic acid and I check a few other tests to
make sure we get the true diagnosis but the workout for B12 deficiency and all the additional tests involved is a huge Topic in of itself and I'm going to make a separate video on that later now since the diagnosis is not as straightforward as checking your B12 levels you also need to consider if you are someone who's at a greater risk for B12 deficiency and in those cases an argument can be made for a more aggressive treatment even if you're blood test are borderline or normal so what are the risk factors well you may be
at a much higher risk for deficiency if you take certain medications that interfere with the absorption of B12 and the most common medication I see that does that is myth Forin and just 4 months of taking myth Forin can put you a risk for developing B12 deficiency so I would recommend supplementing with both B12 and folate if if you do take myth form in long term and another medication that will put you at risk for a B12 deficiency are histamine H2 blockers which are common over-the-counter heartburn medications like Pepsi or Zantac and people that suffer
from heartburn may also get put on another class of medication called proton puppin hbers or ppis so these would be drugs like omeprazol or pyc and esol or Nexium and another common one is pantozol or ponics now with these heartburn or reflux medications we us usually don't have to worry about B12 M absorption unless you've been on these medications continuously for at least 12 months next another thing that can put you at risk for developing B12 deficiency is if you ever had bariatric surgery like gastric sleeve or a gastric bypass and the issue there is
actually twofold so first the reection of the stomach or any surgery involving the small intestine may just anatomically interfere with your absorption of B12 and the second issue is these surgeries resect the portions of the stomach called the parietal cells and these parietal cells are important because they produce a very important protein called intrinsic factor an intrinsic factor plays a crucial role in both the transportation and absorption of vitamin B12 if we don't have that intrinsic factor we just cannot absorb vitamin B12 into our bloodstream and in fact there's a rare autoimmune condition called pernicious
anemia where your own immune system attacks these intrinsic factor proteins and they make it difficult for them to bind to vitamin B12 which Downstream prevents B12 from being absorbed in the small intestine and the next risk factor is age and as we get older the likelihood of developing a B12 deficiency goes up quite a bit so how old are we talking about well being 75 and above definitely puts you in higher risk category and I would actually lower that age to 60 as it's estimated that up to 20% of people in the US over the
age of 60 are deficient in vitamin B12 lastly the most well-known reason for B12 deficiency is if you're a vegan or a strict vegetarian to where you don't consume any animal products like meat or dairy which is where most people are able to get their B12 now what I haven't covered in this video is how to properly diagnose B12 deficiency or what are the best ways to treat a B12 deficiency so if you'd like to see a video on those topics let me know in the comments below and I'll make sure to discuss those in
my future videos I hope this was helpful and I'll see you in the next one