Untreated Vitamin B12 deficiency can cause severe neurological damage (numbness, balance issues, memory loss, vision problems), anemia with fatigue and paleness, cognitive decline resembling dementia, mood changes (depression, irritability), infertility, and in severe cases, heart failure, increased cancer risk, and neural tube defects in pregnancy. Some nerve damage can become permanent, highlighting the importance of early treatment.
If you have vitamin B12–deficiency anemia, you may have the typical symptoms of anemia at first, such as fatigue, paleness, shortness of breath, headaches, or dizziness. If left untreated, you may start to notice brain and nervous system symptoms.
Intramuscular hydroxocobalamin and oral cyanocobalamin are treatment options for the management of clinically relevant vitamin B12 deficiency during pregnancy.
A low B12 level can cause fatigue, weakness, nerve issues like numbness or tingling, cognitive problems (memory loss, confusion, brain fog), mood changes (depression, irritability), and anemia, leading to pale skin and shortness of breath; if untreated, it can result in severe nerve damage, balance problems, and even dementia.
No significant interactions are reported between amlodipine and Vitamin B12 specifically, but multivitamins with minerals might decrease amlodipine's effectiveness, so always tell your doctor about all supplements, including B12, as they can affect your blood pressure and medication response. While B12 itself seems safe, other supplements like St. John's Wort can interact, and potential B vitamin effects on blood pressure meds aren't fully understood, making professional advice crucial.
Common side effects
Possible interactions include:
The worst symptoms of B12 deficiency involve severe neurological damage, including severe memory loss, confusion, dementia, psychosis, hallucinations, balance problems, trouble walking, and irreversible nerve damage (neuropathy), alongside serious mental health issues like severe depression or irritability, with physical signs including extreme fatigue, pale skin, and a sore, smooth tongue. These severe cognitive and neurological issues are the most concerning because they can become permanent if left untreated.
B12 deficiency can trigger specific food cravings, most notably for meat, fish, or eggs, as the body seeks animal-based sources to replenish the vitamin, especially in those on vegetarian/vegan diets or older adults. While cravings for sugary or salty foods can also signal general B-vitamin issues, the distinct urge for protein-rich animal products is a key indicator, but professional testing is crucial for confirmation.
Stage 1 is decreased levels of vitamin B12 in the blood. Stage 2 is low concentration of vitamin B12 in the cell and metabolic abnormalities. Stage 3 is increased levels of homocysteine and MMA and decreased DNA synthesis resulting in neuropsychiatric symptoms. Stage 4 is macrocytic anemia.
Cutaneous manifestations associated with vitamin B12 deficiency are skin hyperpigmentation, vitiligo, angular stomatitis, and hair changes. A diagnosis of vitamin B12 deficiency is often overlooked in its early stages because these signs are not specific to vitamin B12 deficiency alone.
Infants born to vitamin B-12-deficient women may be at increased risk of neural tube closure defects, and maternal vitamin B-12 insufficiency (<200 pmol/L) can impair infant growth, psychomotor function, and brain development, which may be irreversible. However, the underlying causal mechanisms are unknown.
If your vitamin B12 deficiency is not caused by a lack of vitamin B12 in your diet, you'll usually need to have an injection of hydroxocobalamin every 2 to 3 months for the rest of your life.
For the patients with a very low serum B12 level (<100ng/l) and anaemia, macrocytosis or neurological symptoms, the treatment is simple: load the patient with vitamin B12 parenterally (by IM injection) and continue with maintenance vitamin B12 by IM injection every 3 months indefinitely (see below for more details).
Disturbed or blurred vision can also occur as a result of a Vitamin B12 deficiency.
Contrary to common assumptions, Vitamin B12 deficiency doesn't directly lead to weight gain. However, it can indirectly influence weight through its impact on energy metabolism. Insufficient B12 can lead to fatigue and weakness, which may reduce physical activity levels and, in turn, lead to weight gain.
Some people can develop a vitamin B12 deficiency as a result of not getting enough vitamin B12 from their diet. A diet that includes meat, fish and dairy products usually provides enough vitamin B12, but people who do not regularly eat these foods can become deficient.
Organ meats and shellfish are the richest dietary sources, with a 3-ounce (85 g) serving of cooked clams providing approximately 84.1 µg, while beef liver contains about 70.7 µg. Fatty fish, such as trout and salmon, supply 5.4 µg and 4.8 µg per 3-ounce serving, respectively.
Symptoms include weak muscles, numbness, trouble walking, nausea, weight loss, irritability, fatigue, and increased heart rate.
Causes of Vitamin B12 deficiency
Vitamin B12 deficiency can also cause symptoms that affect your brain and nervous system (neurological symptoms), including: numbness. muscle weakness. psychological problems, which can range from mild depression or anxiety, to confusion and dementia.
Before starting the Vitamin injections I will make sure to tell my Physician if I am pregnant, lactating or have any of the following conditions.
There is general consensus that gastric acid–lowering drugs, including proton pump inhibitors (PPIs) and H2-receptor antagonists (H2RAs), and the antidiabetes drug metformin can reduce circulating vitamin B-12 concentrations with prolonged use.
The B12 injection is generally very safe. However, some people may experience some pain, swelling or redness at the injection site, and in much rarer cases headaches, itching or nausea. If any of these symptoms persist or worsen please contact your GP or 111.