B12 deficiency

What if I told you that for a large number of degenerative diseases and conditions which are currently considered difficult to treat by conventional medicine, there can be a simple nutrient deficiency as the primary cause. These diseases and conditions may include dementia and Alzheimer’s, depression, cardiovascular disease, ADD and ADHD, autism, and many auto immune diseases. Essentially many of the signs and symptoms of these health issues are similar to those of B12 deficiency, and identification of this issue may often be overlooked in favor of more complex treatment strategies.

Conservative estimates place B12 deficiency at around 40% of the population aged over 60, however a closer look at the literature indicates this number may be far higher and also affect a large proportion of the younger population. The issue with the identification of B12 deficiency is two-fold. Firstly the reference ranges for B12 go too low, allowing sub-optimal levels to be considered normal. And secondly, standard blood tests only assess the level of B12 in the blood, not in the cell where B12 exerts its actions. Thus you could have high levels of serum B12, but if there are issues getting that B12 into the cell or utilizing the B12 once within the cell, then you essentially have a functional B12 deficiency. Measuring methylmalonic Acid (MMA) or homocysteine may be more reliable markers of B12 status as they indicate the end result of B12 utilisation.

B12 is a notoriously difficult nutrient to absorb, and may be impacted by:

  • Low stomach acid
  • Low levels of intrinsic factor
  • Alterations in the gut microbiome
  • Poor gut integrity
  • Alcohol consumption
  • Pernicious anaemia
  • Medications (especially those that lower stomach acidity as well as the diabetic drug Metformin)

Although being a vegetarian or a vegan can put you at risk of B12 deficiency (B12 is found in nature only in animal products), due to the many factors listed above you can have a diet high in animal products and still be B12 deficient.

Symptoms of B12 deficiency may include:

  • Weakness or tiredness
  • Shortness of breath
  • Palpitations
  • Pale skin
  • Numbness or tingling
  • Problems walking
  • Mood disorders
  • Confusion
  • A smooth tongue
  • Disturbed vision

If you have any (or especially many) of the symptoms listed above, it may be worth getting your B12 tested as well as the metabolic markers MMA and homocysteine.

Treatment of B12 deficiency will initially involve supplementation to correct the primary issue. In extreme cases this may need to be in the form of an intra-muscular injection, however for many a sublingual tablet at the appropriate dosage will be sufficient. The standard form of B12 found in many supplements is cyanocobalamin, however it seems the form methylcobalamin is better absorbed and utilised for most people.

Most important in the treatment of B12 deficiency is to identify the underlying cause, and this will often be best achieved with the assistance of the appropriate health practitioner.

In wellness,


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