Are You Vitamin B12 Deficient?

A young woman in her twenties began to have numbness and tingling in both of her legs. The feelings increased in intensity over several months. Slowly, she began to feel unsteady on her feet and eventually started falling over. When she also lost control of her bladder and began peeing her pants at such a young age, she finally took herself to the doctor.

Her diagnosis? Vitamin B12 deficiency.

The young woman was lucky. Supplementation reversed her symptoms, but not everyone is so fortunate. In many, the neurological damage is irreversible.

If you are vegetarian or vegan like many serious yogis, theres a good chance you might be vitamin B12 deficient, too. In a UK study last year, 52% of vegans and 7% of vegetarians were found to have deficient levels. Another 21% and 17% of vegans and vegetarians, respectively, had a serum vitamin B12 at the borderline low level.

Reprinted from J Med Case Reports. 2011; 5: 166.

That borderline level can be dangerously deceptive. Weve learned that tissue levels of B12 can be too low even when blood levels appear to be okay. Anyone with a borderline level needs to have another test or two looking at B12 function to determine whether or not they are getting enough of this important vitamin.

Unfortunately, it seems we non-meat-eaters arent paying enough attention to vitamin B12. Only 19% of those in the UK study reported taking a regular B12 supplement.

Among supplement users, 11% of vegetarians and 37% of vegans didnt meet the average daily requirement for vitamin B12 intake. That means even the supplement takers in the study werent getting enough of this important vitamin. Maybe thats because their supplements contained an inactive plant-based form of B12. We now know that this form is not only ineffective, but it also interferes with the absorption of naturally occurring B12 in food. If youre taking the wrong B12, youre not only not helping yourself, youre hurting yourself.

Vitamin B12 is crucial for brain cells and the tissues supporting all nerves. Its important for DNA synthesis and the synthesis of some brain chemicals involved in mood disorders and memory. Vitamin B12 is needed to make blood cells and low levels can cause anemia and troubles with immunity. Anemia is usually a late manifestation appearing long after nerve troubles. The young woman above, for example, had completely normal blood counts.

Symptoms of Vitamin B12 Deficiency

Numbness and tingling in the arms, legs, feet, or hands
Clumsiness with difficulty handling utensils and dropping things
Memory problems
Difficulty concentrating
Difficulty walking
Dry vaginal and vulvar mucosa
Frequent vaginal yeast infections
Possibly abdominal pain and nausea

If youre vegetarian or vegan – even if youre taking a supplement and think you have it covered – consider getting a blood test for vitamin B12. If you have any of the symptoms listed in the table above, please dont waste any time.

The treatment is a high dose of the proper kind of B12 taken as a pill. Doctors used to give shots, but weve learned thats overkill and pills (the right ones!) work just fine. If youre found to be deficient, dont mess with the over-the-counter unregulated brands that might contain the ineffective plant-based form or a similar non-working analogue. Your doctor can prescribe prescription strength, guaranteed quality vitamin B12 to treat your deficiency and, with any luck, relieve your symptoms.

Next time well talk about ways to prevent vitamin B12 deficiency on a vegan or vegetarian diet.


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  2. Herrmann W, Obeid R. Causes and early diagnosis of vitamin B12 deficiency. Dtsch Arztebl Int. 2008 Oct;105(40):680-5. Epub 2008 Oct
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  4. Dali-Youcef N, Andrès E. An update on cobalamin deficiency in adults. QJM. 2009 Jan;102(1):17-28. Epub 2008 Nov 5.
  5. Rabhi S, Maaroufi M, Khibri H, Belahsen F, Tizniti S, Berrady R, Bono W. Magnetic resonance imaging findings within the posterior and lateral columns of the spinal cord extended from the medulla oblongata to the thoracic spine in a woman with subacute combined degeneration without hematologic disorders: a case report and review of the literature. J Med Case Reports. 2011 Apr 27;5:166.

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