B-12: The important vitamin your patients might be deficient in

B-12 is one of the crucial B vitamins. It is needed for a variety of critical bodily functions, including the production of red blood cells, brain and nervous system function.¹

As a DC, you are most likely familiar with B vitamins and specifically B-12. But this vitamin becomes especially important because many of your patients could be deficient. While B-12 is common in many foods, some patients may have trouble absorbing it. This results in anywhere from 1.5-15% of the population being deficient in vitamin B-12.²

However, there are some recommendations to make to your patients to ensure they are getting enough of this critical nutrient.

Safe, water-soluble B-12?

Like all B vitamins, B-12 is water soluble, meaning that it dissolves in water and travels throughout the body via the bloodstream. Because it is water soluble, any excess can be excreted out of the body through urine. This makes B-12 a relatively safe vitamin to recommend because it cannot build up in the body and cause overdose symptoms like iron or vitamin D.

It is naturally present in many foods but is also added into foods or taken in supplement forms.

How do B-12 vitamins impact the body?

B vitamins, overall, are responsible for cell metabolism, brain function and energy levels.³ In essence, they are the building blocks of a healthy body and can impact everything from hormones to heart health.

B-12 specifically impacts the brain and nervous system. It’s also critical to the creation and regulation of DNA. But the bodily functions it impacts most is cell metabolism and the creation of red blood cells.

Without B-12, cells would not be able to absorb folic acid, not metabolize and therefore, not release energy.¹ This is why a common symptom of B-12 deficiency is fatigue.

Red blood cells also depend on B-12. In order to multiply properly, red blood cells need B-12. Without it, patients could become short on red blood cells and develop anemia.¹

In short, B-12 is a large part of maintaining a healthy and functioning body.

Symptoms of B-12 deficiency

Because B-12 impacts so much of the body, there are a variety of symptoms and conditions that can develop as a result of a deficiency.

Not getting enough B-12 can result in¹:

• Depression
• Confusion
• Memory problems
• Fatigue
• Constipation
• Loss of appetite
• Weight loss
• Numbness or tingling in the extremities
• Balance problems
• Psychosis
• Mania
• Dementia
• Greater infection tendency

A B-12 deficiency can also lead to anemia because it’s critical to the production of red blood cells. The symptoms of anemia are:

• Fatigue
• Shortness of breath
• Irregular heartbeat
• Sore mouth or tongue
• Weight loss
• Pale or yellow skin
• Diarrhea
• Menstrual problems

Because a B-12 deficiency can cause serious damage and unpleasant symptoms, it’s important to screen your patients for these symptoms and ask about their diets or supplements.

High risk groups for a B-12 deficiency are vegans/vegetarians and people with pernicious anemia. People with plant-based diets can suffer deficiency because B-12 is most commonly found in animal products. Those with pernicious anemia do not have enough intrinsic factor in their systems to allow the body to absorb enough B-12.²

How to get enough B-12

B-12 is found naturally in many foods. It is found mostly in animal products and some fortified foods.

The most common sources of B-12 are ² :

• Pork
• Beef
• Ham
• Poultry
• Lamb
• Fish
• Dairy products like milk, cheese and yogurt
• Eggs
• Liver
• Clams
• Fortified nutritional yeasts

Because it is primarily found in animal products, it can be difficult for vegans, vegetarians or other plant-based dieters to get enough B-12. It can also be difficult for some people to eat enough B-12 to counteract their current deficiency or because some medications continue to deplete their bodies of B-12.

This is where supplementation comes in. There are many quality B-12 supplements on the market that can help your patients get enough B-12. You can recommend a supplement that contains just B-12 or one that contains B-12 along with other critical B vitamins.

Since all B vitamins are water soluble, there are no current risks associated with supplementation.

Recommended dosages of B-12 vitamins

B-12 dosages vary by age. Infants and children need anywhere from 0.4-1.8 mcg. Adults need around 2.4 mcg, with pregnant and breastfeeding women needing up to 2.8 mcg.²

Overall, B-12 is important to building a happy and healthy body and something to monitor for patient wellness.

References:

1. https://www.medicalnewstoday.com/articles/219822#what-is-vitamin-b12
2. https://ods.od.nih.gov/factsheets/VitaminB12-Consumer/
3. https://www.healthline.com/health/food-nutrition/vitamin-b-complex