Memory problems, tingling limbs and fatigue – could a vitamin B12 deficiency be to blame?

Problems with concentration, chronic fatigue or tingling in the hands and feet are often put down to stress, exhaustion or the natural process of ageing. In some cases, however, the cause of these complaints may be a vitamin B12 deficiency – a nutrient essential for the proper functioning of the nervous system and for the production of red blood cells. Early recognition and appropriate treatment of a deficiency are hugely important for limiting the risk of permanent neurological complications.

What is vitamin B12 and why is it so important?

Vitamin B12, also called cobalamin, is essential for the body to function properly. Although the requirement for it is relatively small, a deficiency can lead to serious health consequences, including malabsorption and numbness in the limbs.

Cobalamin is essential for the correct formation of DNA, the maturation of red blood cells and maintaining the normal work of the nervous system. It also takes part in the metabolism of homocysteine – an amino acid whose raised concentration is linked with an increased risk of cardiovascular disease [1,2].

The human body cannot synthesise vitamin B12 on its own, so it has to be supplied through the diet or (in justified cases) in the form of food supplements or medicines.

The natural sources of vitamin B12 are above all products of animal origin, such as meat, fish, eggs and dairy.

What are the causes of vitamin B12 deficiency?

A vitamin B12 deficiency does not always result from an incorrect diet. Far more often the problem concerns disturbances in its absorption or an increased requirement of the body.

Malabsorption

The most common cause of vitamin B12 deficiency is pernicious anaemia (Addison-Biermer disease), in which the body produces antibodies against the intrinsic factor needed for the absorption of cobalamin.

A deficiency may also be caused by:

• chronic inflammation of the stomach lining;

• diseases of the small intestine (e.g. coeliac disease or Crohn’s disease);

• surgical procedures in the area of the stomach and intestines;

• long-term use of proton pump inhibitors or metformin.

Elimination diet

The risk of a deficiency increases in people following a vegan diet, because vitamin B12 is practically absent from plant products. People on a plant-based diet should also monitor its concentration, especially if their intake of dairy and eggs is small.

Older age

With age the secretion of stomach acid decreases, which makes it harder to release vitamin B12 from food. That is why people over the age of 60 belong to the groups at particular risk.

People taking certain medicines

Long-term use of metformin, often used in the treatment of type 2 diabetes, is linked with an increased risk of vitamin B12 deficiency. For this reason both the Polish Diabetes Association and the American Diabetes Association draw attention to the need for periodic assessment of vitamin B12 concentration in patients who have been using this medicine for many years [7,8].

Symptoms of vitamin B12 deficiency

A deficiency usually develops gradually. The body stores considerable amounts of vitamin B12 within the digestive system (in the liver), so the first symptoms may appear only several years after the problem begins.

Neurological symptoms

It is neurological disturbances that are among the most characteristic symptoms of a deficiency.

The most common symptoms affecting the nervous system are:

• tingling in the hands and feet;

• numbness in the limbs;

• disturbances of sensation;

• reduced muscle strength;

• balance disturbances;

• difficulty walking.

An untreated cobalamin deficiency may lead to permanent nerve damage.

Problems with memory and concentration

More and more studies indicate that a vitamin B12 deficiency may affect cognitive function. Patients complain of memory problems, difficulty concentrating, slowed thinking and a decline in their ability to carry out everyday duties.

These symptoms are not, however, characteristic of a B12 deficiency alone, so they always require differential diagnosis.

Chronic fatigue

One of the most frequently reported symptoms is persistent fatigue and a drop in physical capacity. This results, among other things, from the development of megaloblastic anaemia, in which the body produces abnormal red blood cells with a limited ability to transport oxygen.

How is a vitamin B12 deficiency diagnosed?

A proper diagnosis requires a combination of the medical history, an assessment of the symptoms and laboratory tests. The vitamin B12 result on its own does not always make it possible to confirm or rule out a deficiency unambiguously.

Depending on the clinical situation, a doctor may order measurement of:

• vitamin B12 concentration;

• methylmalonic acid (MMA);

• homocysteine;

• antibodies against intrinsic factor.

The interpretation of the results should always take place in the context of the patient’s symptoms.

What does the treatment of vitamin B12 deficiency look like?

Treatment of a cobalamin deficiency depends on the underlying cause of the problem. In the case of malabsorption, intramuscular preparations are most often used in line with a doctor’s recommendations. In some patients, on the other hand, high doses of oral vitamin B12 prove effective.

People for whom supplementation has been recommended by a specialist may consider choosing products containing an appropriately selected dose of vitamin B12, such as BestB12. It is worth matching the choice of a particular product to individual needs and to the recommendations of a doctor or pharmacist.

The manufacturer’s range also includes Food supplements – BEST LAB and Supplements for the nervous system – BEST LAB, which may complement a healthy lifestyle. It should be remembered, however, that a food supplement does not replace a varied diet or the treatment recommended by a doctor.

FAQ – frequently asked questions

Below you will find answers to the questions that come up most often among people who suspect a vitamin B12 deficiency.

What happens when vitamin B12 is lacking?

A vitamin B12 deficiency may lead to the development of megaloblastic anaemia and to disturbances in the functioning of the nervous system. The most common symptoms include chronic fatigue, weakness, tingling in the limbs, memory problems, disturbances of concentration and difficulty maintaining balance. A long-term, untreated deficiency may result in permanent nerve damage.

What are the 10 symptoms of vitamin B12 deficiency?

The most frequently described symptoms include: chronic fatigue, muscle weakness, mental disturbances, pale skin, tingling in the hands and feet, numbness in the limbs, memory disturbances, problems with concentration, dizziness, balance disturbances, and also breathlessness linked with anaemia.

How can vitamin B12 be replenished as quickly as possible?

The most effective method depends on the cause of the deficiency. In people with malabsorption, treatment with intramuscular preparations is often necessary. In many other cases, appropriately selected oral products containing high doses of vitamin B12 prove effective. The method of treatment should be decided by a doctor on the basis of the symptoms and the laboratory test results.

References