Deficiency of this vitamin can lead to increased risk of diabetes, fatigue, and discoloration

Doctors South First spoke to shed light on the importance of Vitamin B12 and the problems that arise from a deficiency of it.

ByChetana Belagere

Published Oct 27, 2023 | 8:00 AMUpdatedOct 27, 2023 | 8:00 AM

Vitamin B12 deficiency can have symptoms ranging from anaemia to discoloration to tingling of extremities, and more. (Commons)

Forty-three-year-old Sangeetha (name changed), working as a software engineer, found that her routine, which she had been following for the past six years, suddenly left her feeling lethargic.

Her health concerns began with persistent fatigue and lethargy, and continued into irritability and difficulty concentrating. She then noticed a tingling sensation in her fingers and toes, which raised the final alarm bells.

The diagnosis

Sangeetha immediately consulted her physician in Bengaluru, who asked her to get a battery of blood tests done, including her vitamin levels. The results confirmed the physician’s suspicions — Sangeetha had a severe Vitamin B12 deficiency, with levels well below the recommended range. She was also diagnosed as a diabetic.

How serious is a Vitamin B12 deficiency? Doctors South First spoke to shed light on the importance of Vitamin B12 being an early sign of diabetes and other problems that can arise from a lack of B12.

“These days, we are seeing a deficiency of Vitamin B12 and this is across age groups. While youngsters, especially women, go in for various kinds of diets, they do not eat enough foods containing B12. In older people, it is noticed that prescription medications also can lead to a Vitamin B12 deficiency,” Dr Sanjay Gururaj, Paediatrician at SHRC Hospital, Bengaluru, explains to South First.

Also read: India is set to host its first-ever low-carb diet conference.

What is Vitamin B12?

Vitamin B12, also known as cobalamin, is a water-soluble vitamin that plays a crucial role in several vital functions within the body.

Dr Gururaj explains that this vitamin is essential for the production of red blood cells in the bone marrow that is crucial for oxygen transportation to various tissues and organs. A low B12 level can lead to anaemia as well, he adds.

Meanwhile, it is essential for the proper functioning of nerve cells as well. A deficiency in this vital nutrient can mimic the symptoms of diabetic peripheral neuropathy, including tingling and numbness in the hands and feet. It can also lead to fatigue, weakness, and anaemia.

Speaking to South First, Dr Sudhir Kumar, Consultant Neurologist from Apollo Hospitals, Hyderabad, advises, “Maintaining adequate levels of Vitamin B12 is crucial, especially for individuals with diabetes. Regular monitoring of B12 levels is essential, as diabetes itself can affect the absorption of this vitamin.”

Also, doctors explained that B12 helps in the metabolism of carbohydrates, fats, and proteins. It helps convert food into energy that the body can use for various function. This is one of the primary reasons why fatigue is a common symptom in B12 deficiency.

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What causes Vitamin B12 deficiency?

In most case, food is the primary problem, where most people do not consume a Vitamin B12-rich diet. Restrictive diets like going vegan or going on a completely vegetarian diet can lead to a B12 deficiency.

Additionally, research has proven that some common medications, like diabetes medications, birth control pills, and stomach acid medications like Omeprazole, can lead to a Vitamin B12 deficiency, adds Dr Gururaj.

Signs of Vitamin B12 deficiency. (Creative Commons)

Signs of Vitamin B12 deficiency. (Creative Commons)

“Low stomach acid can cause this too. One needs an acidic stomach to help the body effectively absorb B12 from food. So, low stomach acid, which is very common these days, could be one of the reasons. Also, digestive disorders like Chron’s disease or autoimmune conditions can also lead to a B12 deficiency. Gluten intolerance, celiac disease, being underweight due to malnutrition are few other causes,” Dr Gururaj states.

Interestingly, a recent study published in the Journal of the Science of Food and Agriculture has unearthed a compelling connection between Vitamin B12 deficiency and chronic inflammation — a condition closely linked to a host of serious health issues, including cardiovascular disease, diabetes, and neurodegenerative disorders.

The study focused on examining the impact of circulating B12 concentration on the levels of two pivotal inflammatory markers in both humans and mice: interleukin (IL)-6 and C-reactive protein (CRP). These markers play a pivotal role in initiating and perpetuating the inflammatory response within the body.

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Symptoms of B12 deficiency

The symptoms of B12 deficiency, doctors say, can range from anaemia and fatigue, to nerve damage and tingling in the fingers and toes, to depression and mood changes, as well as shortness of breath, a smooth tongue, vision changes, digestive changes and even discoloration of the tongue and fingers.

Dr Sudhir Kumar had taken to X recently to discuss the symptoms of B12 deficiency and said, in 2022, that recurrent seizures can also be a sign of Vitamin B12 deficiency, despite it being a very obvious symptom.

Meanwhile, Dr Kumar explains to South First that Vitamin B12 deficiency can manifest in surprising ways, including skin and tongue discoloration. Many people are not aware that a deficiency of Vitamin B12 can cause discoloration of skin and tongue too.

“Hyperpigmentation (darkening of skin colour and mucosa) affecting tongue and hands is quite common in people with vitamin B12 deficiency,” Dr Sudhir said in his tweet.

However, skin returns to normal after treatment with Vitamin B12 injections. Vitamin B12 injections can enhance energy, support brain activity, elevate mood, optimise metabolism, and aid in weight loss. However, injections should be taken only on doctor’s recommendation.

Additionally, doctors say that neurologists should have a comprehensive understanding of Vitamin B12 for several important reasons. The deficiency can also lead to a wide range of neurological symptoms and complications.

“These can include peripheral neuropathy (tingling and numbness in hands and feet), cognitive impairments, memory problems, and even severe neurological conditions like subacute combined degeneration of the spinal cord. Neurologists are often the first point of contact for patients with such symptoms, making it crucial for them to recognise and investigate potential B12 deficiency,” explains Dr Sudhir Kumar.

Also read: Scientists confirm link between Alzheimer’s and gut disorders

How to increase B12 levels

Doctors recommend routine screenings for Vitamin B12 levels, especially among vulnerable groups such as vegetarians, vegans, and the elderly.

Incorporating foods rich in B12, such as lean meats, fish, dairy products, green vegetables, and eggs, into one’s diet can increase B12 levels.

Dr Sylvia Karpagam, a food and nutrition advocate and community health doctor, took to X earlier and explained that Vitamin B12 is primarily obtained from animal-based foods like meat, fish, and eggs.

Karpagam, citing a research paper said, in her tweet, “Vitamin B12 enters the human food chain exclusively through animal products, either as meat or animal products such as milk/milk products/eggs. In general, vegetarians or more particularly, vegan communities, are a high-risk group of being Vitamin B12 deficient.”

Doctors have time and again stressed on the need to ensure a balanced diet that not only focuses on the macros — carbohydrates, fats, proteins — but also on minerals, vitamins, and essential amino acids. Deficiencies in any of these nutrients can result in illnesses, some that are correctable and some that aren’t.

As always, prevention is better than cure, which is why doctors suggest regular medical health check-ups, to catch any health concerns early on.