What you need to know about vitamin B12 deficiency


Vitamin B12 is a water soluble vitamin that is required for a number of biochemical reactions in our body.  It plays a role in metabolism, the formation of red blood cells, and in the maintenance of our nervous system. It also can reduce levels of homocysteine, which is an independent risk factor for heart disease and stroke. It is found exclusively in animal food products like meat, dairy and eggs. Dietary vitamin B12 tends to be bound to protein, and is released with the help of our stomach acid and an enzyme called pepsin. The free vitamin B12 then binds with an intrinsic factor in the stomach, travels through the small intestine and get’s absorbed in the ileum (a part of our small intestine).

Deficiencies in vitamin B12 can occur:

  • if your diet is lacking in animal products (i.e. vegan or vegetarian)
  • if you have pernicious anemia—an autoimmune condition where the body destroys stomach cells that produce intrinsic factors
  • if you are over the age of 50 due to a decrease absorption of vitamin B12 from food
  • if you’ve had a portion of your stomach or small intestine surgically removed
  • if you have a digestive disorder that reduces your ability to absorb vitamins and minerals i.e. Celiac’s disease or Crohn’s disease
  • Some medication can reduce vitamin B12 levels (i.e. proton pump inhibitors, birth control pill, metformin)


Signs and symptoms of vitamin B12 deficiency include:

-anemia (macrocytic anemia)

-neurological conditions causing weakness and numbness in the arms and legs

-poor memory


-swollen, enlarged tongue

-mouth ulcers

-loss of balance

-low energy or fatigue

-ringing in the ears

You can visit your family doctor or naturopathic doctor to get tested for vitamin B12 deficiency. I offer in-office vitamin B12 injections, which bypass the digestive tract and allow for better absorption. Most people feel an increase in energy after receiving the injection as well as an improvement in their sleep pattern due to vitamin B12’s role in melatonin production.


In health and beauty,

Dr. L


Gaby Alan. Nutritional Medicine. Frtiz Perlberg Publishing; Concord NH; 2011.