Vitamin B12 is a water soluble vitamin needed to produce new blood cells and to develop and maintain the myelin sheath, the lining that protects the nerves. B12 is found mainly in animal products like meat, eggs and dairy foods. Some cereals and other foods are enriched with B12 as well, but people that do not eat meat, particularly vegans (vegetarians that eat no eggs or dairy products as well as no meat), may need to take a B12 supplement.
Most people that eat meat or other animal products will get enough B12 from their diet but some people should take a B12 supplement. Elderly people sometimes do not absorb B12 well and people that have had gastric bypass surgery or other forms of bariatric surgery usually need to take B12 as well.
Of course, anyone that experiences B12 deficiency for any reason should take a supplement. Some people may not get enough B12 from their diet or may not absorb B12 well even if there is no obvious reason for them to develop a deficiency.
Symptoms of B12 Deficiency
While many labs list the normal range for B12 as something like 211 to 911, many experts believe that is really much too low. Studies suggest that if one’s B12 level drops below 550, symptoms like depression, fatigue, difficulty concentrating, “foggy” thinking and problems with short-term memory result. If one’s B12 level drops below 400, symptoms like numbness and tingling in the hands and feet may occur. Those symptoms are actually due to nerve damage.
Symptoms of a moderately low B12 level, between 400 and 550, often resemble common symptoms of depression, including feeling blue, lack of energy, trouble with concentration and difficulty thinking clearly.
Diagnosing B12 Deficiency
A B12 deficiency is diagnosed with a simple blood test. You can ask your physician to order it for you. It is usually covered by health insurance but if not, the test is not too expensive if you have to pay for it yourself.
Ideally all doctors would recommend a B12 test for patients that report symptoms of deficiency but unfortunately many do not. They are just as likely, or even more likely, to recommend antidepressants or psychotherapy to patients complaining about such symptoms. Antidepressants and psychotherapy may be appropriate for some patients with these symptoms, but a B12 test is also appropriate.
If you have symptoms of B12 deficiency, you can ask your doctor to order a test for you. Make sure you ask your doctor what the results are. If your B12 level is below 550, you might want to begin taking a B12 supplement.
Be aware that a person can have a B12 deficiency and also have depression due to other causes at the same time. Therefore taking a B12 supplement alone does not always resolve depression. Consult with your doctor about whether or not you should also consider antidepressant medication or psychotherapy to treat your depression. Definitely consider those things if your B12 level improves but your depression does not.
Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/vitaminb12.asp. Vitamin B12.
Health Boundaries Bite. http://www.health-boundaries-bite.com/new_folder/550-B12-Level.html. Vitamin B12 Deficiency.