As a medical practitioner, I am appalled by the number of patients suffering from B₁₂ deficiency. Patients complain about fatigue, vague pains, tingling, numbness, loss of concentration. Many tests are conducted with no results and the one missed is the test for vitamin B_12. Vitamin B₁₂ is the only vitamin that contains a trace element – cobalt – which gives this vitamin its chemical name – cobalamin – which is at the centre of its molecular structure.

B₁₂ is required

• For the manufacture of red blood cells; deficiency leads to a characteristic kind of anemia
• To support the normal function of nerve cells, and to manufacture myelin, the insulating material that surrounds some of our nerve cells and speeds neural transmission. B₁₂ deficiency impairs brain function. Advanced B₁₂ deficiency causes dementia resembling Alzheimer’s.
• The deficiency leads to difficulty in regeneration of new healthy cells- mimics all of the effects of aging.
• B₁₂ is involved in the metabolismof every cell of the human body, especially affecting DNA synthesis, fatty acid and amino acid metabolism.

Vitamin B₁₂ is produced by some species of bacteria in colon. (The colon is followed by the small intestine & is a part of large intestine and hence the B₁₂ produced there is not absorbed which results in the need of supplementation.

Who should be concerned about B₁₂ deficiency?

1. If you are or were a vegetarians/ a vegan- get yourself tested
2. Babies born to mothers who are vegetarians
3. Risk of B₁₂ deficiency increases with age. So test yourself and fortify your meals
4. Pernicious anaemia- is an autoimmune condition that affects your stomach. In your stomach, vitamin B₁₂is combined with a protein called intrinsic factor. This mix of vitamin B₁₂ and intrinsic factor is then absorbed into the body in part of the gut called the distal ileum. Pernicious anaemia causes your immune system to attack the cells in your stomach that produce the intrinsic factor, which means your body is unable to absorb vitamin B₁₂.
5. Conditions affecting your intestines-E.g. Crohn’s disease (a long-term condition that causes inflammation of the lining of the digestive system)
6. Some types of medicine- E.g. proton pump inhibitors (PPIs) –a medication sometimes used to treat indigestion – can make a vitamin B₁₂ deficiency worse.
7. People suffering from Atrophic Gastritis (the stomach line becomes thin)
8. Surgery where a part of the stomach is removed, including weight loss surgery like bariatric surgery.
9. Smoking, drinking & stress increases the requirement of B₁₂
10. Few autoimmune disorders
11. Chronic illnesses leads to a deficiency of this diseases

Move towards a B₁₂ rich diet if you have the following symptoms

• Weakness, tiredness, dizziness or lightheadedness
• Smooth tongue
• Palpitations and dyspnea
• Pale skin
• Constipation, diarrhea, a loss of appetite, or dyspepsia
• Nerve problems- numbness or tingling, muscle weakness,
• Loss of weight
• Mental problems- memory loss, or behavioral changes, confusions
• Glove & stocking neuropathy (tingling of palms & forearms, feet till knees)- in this scenario B₁₂ deficiency is the majorly deficient apart from other nutrients

 Sources of B12

Sources of B₁₂ are animal products (meat, fish, and dairy products), fortified foods.Ensure sufficient quantities of these foods to maintain your B₁₂ levels. If your count is low, consider oral or injectable forms of the vitamin. But why reach that stage?!

Have the above mentioned foods in your routine.  The best part of this Energy Nutrient is that the excess is excreted by the body or stored in the liver for use when supplies are scarce. Stores of B₁₂ can last for up to a year. Unfortunately sometimes catching the B₁₂ deficiency late can result in permanent damage. Any neurological damage due to B₁₂ deficiency cannot be reversed. Ensure that your B₁₂ levels are maintained at levels 200 to 900 picograms per milliliter (pg/mL).