Vitamin B12 Deficiency Can Go Unnoticed

Written for The Healthy Planet by TJ Williams, DC, PhD

An estimated 47 million people in the U.S. have a vitamin B12 deficiency and most of them don’t even know it as symptoms can go unnoticed for years or are attributed to other causes. This is why vitamin B12 deficiency has been referred to as a silent epidemic. And one with serious consequences because every single cell in the body relies on B12. It is crucial to the nervous system and plays a significant role in the creation of DNA, RNA, and red blood cells, among various other functions such as producing energy and regulating mood, digestion, and metabolism.

Despite its importance in the body, vitamin B12 deficiencies are easily overlooked or confused with other conditions. Often the symptoms are seen as a result of our busy and over-stressed lifestyles. These symptoms include:

  • chronic fatigue, lethargy, and weakness
  • digestive issues, including nausea, cramping, diarrhea, or constipation
  • shortness of breath, difficulty breathing, or dizziness
  • muscle aches, joint pain, & trouble exercising
  • tingling or numbness in fingers or toes
  • trouble concentrating, poor memory, and/or mental fogginess
  • skin issues, such as acne, eczema, & psoriasis
  • mood changes, like increased depression or anxiety or signs of nervousness like rapid heartbeat or palpitations
  • poor dental health, including mouth sores and bleeding gums

Vitamin B12 deficiencies are frequently missed for two reasons. First, most physicians do not routinely test for it. Second, the blood tests used to detect vitamin B12 deficiency aren’t as clear cut or helpful as they are for other nutritional deficiencies. A diagnosis of vitamin B12 deficiency is typically based on the measurement of serum B12 levels within the blood. However, this test picks up two kinds of B12: active, which can be used, and inactive, which is useless. The trouble is that the test can’t tell the difference. It just bundles both of them together and gives you a total. The test could be recording as much as 80% inactive B12. The limitations of this test have been understood for decades, which explains why studies show that around 50% of patients with diseases related to vitamin B12 deficiency have normal B12 levels when tested.

While there are more sensitive tests available to detect vitamin B12 deficiency, a more practical approach if you are concerned you might be deficient is to simply supplement your diet with B12 and see if your symptoms improve. Vitamin B12 supplementation is completely non-toxic and inexpensive. Plus, unlike some other vitamins, B12 can be consumed in large doses because excess is excreted by the body or stored in the liver for use when supplies are scarce.

While it is possible to get enough vitamin B12 through your diet, certain conditions, diseases, medications, and genetic defects can affect the body’s ability to extract it from food and get it into the bloodstream to be delivered where it is needed. These same issues make it difficult to raise someone’s B12 level with oral supplementation alone. For this reason, injections are the gold standard for correcting a B12 deficiency. This is especially true if you suffer from Crohn’s, celiac, ulcerative colitis, IBS, diabetes, heart disease, food sensitivities, GERD, or pernicious anemia, drink alcohol, take a proton-pump inhibitor, acid-reducing medication, or a diabetes drug like metformin, have a history of infertility or miscarriage, or are over the age of 60, because, due to an impaired digestive system, you are likely unable to absorb enough B12 through your diet or oral supplements.

If you would like more information on vitamin B12 deficiency, testing, or treatment, please contact us at (314) 293-8123 or visit us at the

Dr. TJ Williams is the Clinic Director for the Institute of Natural Health and the host of the radio program Wellness 101, which provides common-sense, science-based strategies for a healthy life. Wellness 101 airs Sundays at 3:00pm on FM NewsTalk 97.1.

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