Vitamin B12 deficiency is relatively common, especially in older adults, people who follow a strict vegan diet without supplementation, and those with certain digestive conditions. Because symptoms often develop gradually, they can be overlooked.
Common signs and symptoms include:
- Persistent fatigue or weakness.
- Pale or slightly yellow-tinged skin.
- Numbness or tingling in the hands or feet.
- Difficulty with balance or walking.
- Memory problems, confusion, or difficulty concentrating.
- Depression or changes in mood.
- A sore, red, smooth tongue or mouth ulcers.
- Shortness of breath or dizziness, especially if anaemia develops.
- Blurred vision (less common, due to nerve involvement).
- Heart palpitations, which can occur with significant anaemia.
These symptoms are not specific to B12 deficiency and can be caused by many other conditions, so symptoms alone cannot confirm the diagnosis.
Who is at higher risk?
- Older adults.
- People following vegan diets without B12-fortified foods or supplements.
- People with conditions that reduce B12 absorption, such as Pernicious anaemia or certain bowel disorders.
- People who have had stomach or intestinal surgery.
- People taking some medications long term, such as metformin or acid-suppressing medicines.
Diagnosis and treatment
A healthcare professional can diagnose B12 deficiency with blood tests, sometimes including vitamin B12 levels and other tests if needed.
Treatment depends on the cause and severity. It may involve:
- Oral vitamin B12 supplements.
- Vitamin B12 injections for people with severe deficiency or poor absorption.
- Addressing the underlying cause where possible.
If you have persistent numbness, difficulty walking, or memory changes, it’s important to seek medical evaluation promptly. Treating B12 deficiency early can help prevent permanent nerve damage in some cases.
