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Could You Be B12 Deficient? : The Dangers of B12 Deficiency + What You Need to Know Now

Health Tips

Could You Be B12 Deficient? : The Dangers of B12 Deficiency + What You Need to Know Now

Brittany Carlson

What are symptoms of B12 deficiency?

B12 deficiency causes neurologic, psychiatric, and hematologic symptoms.  A variety of neurologic symptoms present because a deficiency in B12 disrupts or destroys the fatty protective lining of our nerves and brain called myelin.  B12 deficiency causes demyelination similar to multiple sclerosis, and both are demyelinating diseases.  Common neurologic symptoms of B12 deficiency are paresthesias (numbness, tingling, burning) to legs or arms, balance or gait problems, tremor, poor memory, confusion, and dementia. 

Because B12 is a precursor for the neurotransmitters in the brain, an array of psychiatric disturbances develop when B12 deficiency develops.  Patients can get wrongly placed on psychiatric medications verses needed B12 therapy.    Patients with low B12 or deficiency can develop depression, suicidal ideations, irritability, anxiety, and psychosis.  Young children develop developmental delay or regression, and may get misdiagnosed with autism.  Older children with low B12 or a deficiency have learning difficulties and fall behind in school.  The hematologic or blood signs of B12 deficiency are anemia.  Anemia can cause fatigue, weakness, dizziness, and fainting spells.

How can B12 deficiency be treated?

B12 deficiency can be treated by simple self administrated subcutaneous injections like diabetics, or high dose B12 lozenges or other oral preparations.  We find that injections work the best and actually are cheaper, but patients will need a prescription from their doctor for the injectable form.  We recommend hydroxocobalamin verses cyanocobalamin.  People can be treated weekly, tri-monthly or bi-monthly with injections depending on the cause.  People who use oral supplementation typically take it daily, and I recommend methylcobalamin verses cyanocobalamin. 

Where can I get B12?

B12 is found in animal products, over-the-counter preparations and prescription preparations (injections, pills, nasal sprays).  Transdermal preparations are also advertised but no major studies have been done on their efficacy.  People who are carnivores can also become B12 deficient, because of malabsorption syndromes, chemotherapy, radiation, specific medications, genetic mutations, gastrointestinal surgeries, and autoimmune disorders. 

How can B12 deficiency be prevented?

By knowing the signs, symptoms, and risk factors, as well as getting screened annually.  People who have any signs, symptoms or risk factors need to get tested.  At risk patients need to be screened annually and take high dose over-the-counter B12 for prevention.  The tests are as follows:  serum B12, methylmalonic acid, homocysteine.  If you find you are B12 deficient, your health care provider will work with you to find the underlying cause. People who are not symptomatic can take high-dose oral B12 1,000 mcg (sublingual or lozenges) daily for prevention.

When did B12 deficiency become a major problem and why?

B12 deficiency has always been a problem.  People died from B12 deficiency before the 1930’s because the vitamin was not yet discovered.  It is becoming more prevalent in today’s society because besides malabsorption syndromes (i.e. Crohn’s disease, celiac [gluten enteropathy], atrophic gastritis), there are many other factors that can cause or contribute to B12 deficiency.  For instance certain medications proton-pump inhibitors (omeprazole), metformin (Glucophage), nitrous oxide (used for medical and dental procedures), cause or contribute to B12 deficiency. People can become B12 deficient from an autoimmune disease (pernicious anemia) or from Helicobacter pylori (H. pyloir) a stomach bacteria.  B12 deficient moms who breast feed can pass it on to their infant (maternal B12 deficiency) which can result in injury to the child’s brain and nervous system.  People who follow a vegan or vegetarian diet can become deficient because B12 is only found in animal products.  Other people can become B12 deficient because of genetic mutations or polymorphisms in the MTHFR and MTRR genes.  People who have eating disorders can also become B12 deficient as well as gastric bypass patients for weight loss will become B12 deficient overtime. 

More Information on the Author: 

Sally Pacholok has 36 years of experience in the health care field. For the past 28 years, she has practiced emergency nursing in addition to conducting extensive research into B12 deficiency. She is a frequent guest on nationally syndicated talk shows, a lecturer, and the co-author of Could It Be B12? An Epidemic of Misdiagnoses (2nd edition, 2011)—the winner of the Indie Excellence Award for best health book. Could It Be B12? has been translated into Dutch and Slovenian.  Last spring, Pacholok co-authored What’s Wrong With My Child? From Neurological and Developmental Disabilities to Autism…How to Protect Your Child from B12 Deficiency (2015).  

In 2009, Sally and Dr. Jeffrey Stuart created B12 Awareness (  Pacholok educates the public and health care professionals worldwide about B12 deficiency, and has appeared in two documentaries. In 2014, film producer Elissa Leonard wrote and directed the movie Sally Pacholok, which is based on Pacholok’s life-long battle to raise awareness about B12 deficiency and the consequences of its misdiagnosis. It is an Erin Brochovich type whistle-blower romance educating the audience to the sins and consequences of untreated B12 deficiency.  Presently it is in the film festival circuit.  It won best feature film at the D.C. Independent Film Festival on February 28, 2015.