Doctor says fatigue is not warning sign of vitamin B12 deficiency; reveals earliest symptoms, why vegetarians have it

Vitamin B12 deficiency can cause dizziness, memory loss, and coordination problems, often mistaken for stress. A simple blood test can confirm the deficiency.

Vitamin B12 is an essential nutrient that plays a key role in producing healthy red blood cells, supporting nerve health, and boosting brain function, memory, focus, and mood balance. It also helps convert the food you eat into energy and prevents anaemia, a condition that can leave you feeling tired and weak.

Since the human body cannot produce vitamin B12 on its own, it must be obtained from food or vitamin supplements. But when should you start taking these supplements or enrich your diet with foods that have vitamin B12? How can you know that you are vitamin B12 deficient?

Why do vegetarians have vitamin B12 deficiency?

To better understand vitamin B12 and its deficiency, HT Lifestyle spoke with Dr Mahesh Neelakanthanavar, consultant in general medicine at HCG Suchirayu Hospital, Hubli. According to Dr Mahesh, vitamin B12 is mainly found in animal-based foods. This is the reason why vitamin B12 deficiency, also called cobalamin deficiency, is more common among vegetarians and vegans.

Vitamin B12 is mainly found in animal products; therefore, vegetarians are more prone to deficiency. (Unsplash)

Moreover, Dr Mahesh explained that for the human body to absorb vitamin B12 from food, two important steps must take place:

1. First, hydrochloric acid in the stomach breaks vitamin B12 away from the food it is associated with. This step is essential to free the vitamins.

2. Subsequently, the released B12 binds with intrinsic factor, a protein produced by the stomach. Only after this pairing does the intestine properly absorb vitamin B12, allowing the body to utilise it.

The earliest symptom of vitamin B12 deficiency

According to Dr Mahesh, vitamin B12 is directly linked to nerve cells; a drop in levels affects them first. Therefore, the earliest symptom of B12 deficiency is often:

• pins-and-needles sensation
• mild numbness
• a burning feeling in the feet and hands.

“Normally, people dismiss this as poor circulation, stress, or posture-related issues and delay diagnosis,” Dr Mahesh noted.

Another early neurological sign can be loss of balance or unsteadiness while walking, he emphasised.

People with vitamin B12 deficiency find it difficult to concentrate, have memory problems, experience mild forgetfulness, confusion, irritability, or low mood. (Freepik)

“People may feel clumsy, struggle with coordination, or experience dizziness without a clear reason. This happens as vitamin B12 is essential for maintaining the protective covering of nerves (myelin). Without it, nerve signals slow down or misfire. You may find difficulty in concentration, memory, mild forgetfulness, confusion, irritability, or low mood. These symptoms are sometimes mistaken for stress or ageing. In reality, these cognitive symptoms may be linked to a drop in B12 levels, which can affect brain function,” Dr Mahesh explained.

He further warned that nerve-related symptoms can appear even when blood counts are still normal. “If B12 deficiency is left untreated, then your nerve damage becomes permanent even after B12 levels are corrected,” he explained.

Who are more prone to vitamin B12 deficiency?

According to Dr Mahesh, some people are more prone to vitamin B12 deficiency, especially:

• Vegetarians and vegans
• Older adults
• People with gut issues like gastritis or IBS
• Those who have undergone gastric surgery
• Individuals on long-term acid-reducing medicines or metformin

“This deficiency is very common in India because dietary patterns, absorption issues, and also socio-economic conditions also play a role. But the best part is: a simple blood test can confirm the deficiency, which can be corrected before it's too late. It is a common health ailment and can be treated very easily at less expense,” Dr Mahesh advised.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.