Vitamin B-12 is an essential nutrient, this means its required for a normal body to function.

If it cannot be produced by the body, it is necessary to obtain the B-12 our bodies needs through the food we eat and/or dietary supplements.

​

Symptoms of a Vitamin B-12 Deficiency

​

The symptoms of a vitamin B-12 deficiency are similar to fibromyalgia, ME/CFS, Lyme disease and multiple chemical sensitivities. While a B-12 deficiency is not thought to be the cause of these illnesses, it has been implicated as a possible factor in a number of different chronic illnesses.

​

The symptoms of a vitamin B-12 deficiency may include:

• Fatigue, weakness

• Memory loss

• Depression

• Confusion

• Insomnia

• Shortness of breath

• Poor sense of balance

• Vision problems

• Diarrhoea or constipation

• Loss of appetite

• Cognitive functioning problems

• Beefy, red, smooth and sore tongue

• Sore mouth and/or bleeding gums

• Numbness and tingling of hands and feet

• Loss of hearing and tinnitus

• Pale, possibly yellowish pallor in light-skinned individuals; blotchy pigmentation in dark-skinned

​

As B-12 levels rise, homocysteine levels decrease.

Vitamin B-12 is produced exclusively in the digestive tracts of animals. The richest dietary sources of B-12 are beef liver and clams. Other good natural sources include meat, fish, eggs and dairy products. 

Some breakfast cereals are fortified with B-12; however, they do not contain adequate amounts to be used as the sole dietary source.

​

Are You Getting Enough B-12?

​

A better question might be “Are you absorbing enough B-12?”

As B12 levels decrease, homocysteine levels increase.  If B12 levels are low but still in range indicating a functional deficiency (this is a deficiency but blood tests appear in ‘normal’ range) then second line testing of homocysteine and MMA can confirm B12 and/or folate deficiency.

​

• Digestive disorders such as celiac disease, Crohn’s disease, irritable bowel syndrome, bacterial overgrowth in the small intestine or a parasite.

• Gastric bypass surgery.

• Acid-reducing medications – Medications commonly prescribed for heartburn, GERD, acid reflux and peptic ulcers, such as proton pump inhibitors like Prilosec, Prevacid and Nexium, or H2 (histamine2) receptor antagonists like Pepcid and Zantac, suppress the secretion of stomach acids, also blocking the secretion of intrinsic factor.

​

​

​

​

​

 

 

 

• Diabetes medications – Drugs like Metformin, used to treat diabetes, are known to impair intestinal absorption.

• Aging – The older we get the more likely we are to be deficient in B-12.(3) The Institute of Medicine (IOM) recommends that adults over 50 supplement their diets with vitamin B-12.

​

• Vegetarian and vegan diets – Since B-12 is only found naturally in animal foods, it is important for people on these diets to supplement their diets with B-12.

• Pernicious anaemia – An autoimmune disease that develops when the body lacks the intrinsic factor necessary to naturally absorb vitamin B12 from food.

​

Diagnosing a Vitamin B-12 Deficiency

​

A B-12 deficiency can be difficult to diagnose because serum blood levels of B-12 may test normal. Having circulating B-12 in the blood doesn’t mean it is being utilized properly by the body’s cells.

​

​

Adensylcobalamin (Dibencozide) 

Promotes metabolism of essential fatty acids to produce more energy. Reacts with cells to provide muscles and nerves with bursts of energy.

​

Cyanocobalamin

The most common form of B-12 found in oral supplements and injections. Becomes active in the liver, creating enzymes to help with blood formation, cell reproduction, iron utilization, and tissue synthesis. Promotes the digestion and absorption of foods.

​

Hydroxocobalamin

Helps remove heavy metals from the system and supports overall detoxification. Is FDA-approved as an antidote for cyanide poisoning. Important for smokers because it removes the cyanide found in cigarette smoke. Also assists with methylation (gene regulation) and energy production.

​

How do you know which form(s) of B-12 you need? You don’t have to decide. By combining all four forms of the vitamin, B-12 provides you with the best of each.

Injections or Pills – Is There a Difference?

Vitamin B-12 can be administered either orally or by injection. Since no one wants to get a shot unless they absolutely have to, it’s important to determine whether oral tablets are as effective as injections.

​

You should be aware that cobalamin, which is in all four forms of B-12, is an intense red colour. As the tablet is dissolving, you may notice that your teeth, gums and sometimes even your lips appear to be red. Once the tablet has dissolved, the redness will begin to disappear on its own or you may want to brush your teeth to speed the process – particularly if you are going out.

​

No-one knows why Fibromyalgia sufferers develop a B-12 deficiency, but we do know if you develop a deficiency you must treat it and if you start feeling weaker than normal or a flare hangs around longer that it ever has before then you should go to your General practitioner. 

​

​

​

​

 

​

​

​

 

 

​

​

 

​

​

​

​

​

​

​

 

​

​

​

​

​

​

​

​