Vitamin B12 or cobalamin is an essential water-soluble vitamin involved in red blood cell production, nerve functioning, and DNA synthesis. Vitamin B12 supports healthy nervous system cell growth, brain function, and nervous system functioning. Despite its significance, the function of vitamin B12 in health cannot be overstated.
One of the issues of vitamin B12 is that the body will not retain much in the long run, particularly in individuals with any form of underlying illness or on very low-calorie diets. Due to being water-soluble, there is neither excess reserve nor excreted through urine and has to be replaced constantly by diet in an effort to avoid deficiency.
Vitamin B12 deficiency will certainly lead to a series of consequential health problems from weakness and tiredness to fatal diseases such as mood alteration, nerve damage, and memory loss. National Institutes of Health (NIH) quote that unless properly treated, B12 deficiency leads to irreparable damage to nerves, and prevention and early detection via food or supplementation become mandatory. Proper B12 consumption is most crucial in those with vegetarian or vegan food consumption as the chemical can easily be supplied by animal food sources.
Signs of Vitamin B12 Deficiency
Early detection of indications of vitamin B12 deficiency is very critical as part of a bid to avert incurable sickness. Always feeling tired after proper rest is the most widespread symptom of one of them. Vitamin B12 is a key player in the production of red blood cells, and upon deficiency, megaloblastic anemia will be produced, decaying the oxygen-carrying efficiency of blood. Weakness, constipation, loss of appetite, and unintentional weight loss are some of the early signs of deficiency of vitamin B12.
As the deficiency advances, it can affect the nervous system. The changes in the nervous system include numbness and tingling of the hands and feet, disturbances in gait, and impaired balance. Besides physical signs, B12 deficiency is a psychiatric disease. Glossitis (red and sore tongue), mood changes, depression, confusion, and memory loss are some of the overt and covert signs.
A seminal study also attested that subclinical B12 deficiency also disables cognition in people in their late 60s and hence timely diagnosis is an absolute need. Since presentation tends to be a replica of other pathologies, most of most prevalent cases remain undiagnosed, and hence identification and monitoring of such harmful traits become the need of the hour.
Causes and Risk Factors of B12 Deficiency
Understanding regarding the Vitamin B12 aetiology deficiency is crucial for:
Prevention
Early diagnosis
The most prevalent cause is diet, especially among those on a strict vegetarian or vegan diet because B12 exists naturally only in animal foods. The most prevalent cause is pernicious anemia, an autoimmune condition where the body is unable to secrete intrinsic factor, a protein needed to facilitate intestinal absorption of B12.
Gastrointestinal disease like Crohn’s disease, celiac disease, and atrophic gastritis can interfere with the absorption of vitamin B12. Also, individuals who have undergone gastrointestinal surgery, e.g., individuals who have had their stomach stapled, are much more susceptible since there is less stomach acid and surface area for absorption.
Another drug enters the picture. Long term use of metformin (now notoriously prescribed to diabetics) and proton pump inhibitors (PPIs) that shut down the acid in your stomach will prevent your body from being able to properly absorb B12.
A 2020 review in Mayo Clinic Proceedings really found vegans, and bariatric surgery patients to be at highest risk for developing deficiency. Identifying who’s at risk for B12 deficiency will determine prevention diet and screening practice to ensure adequate B12 levels.
Top 10 Vitamin B12 Foods
Having foods rich in vitamin B12 in your regular diet is the ideal option to avoid deficiency. Following is the list of top 10 high vitamin B12 foods with the nutrient data from USDA FoodData Central:
- Clams (84 mcg/3 oz) – One of the most wild food items rich in B12. The serving has over 3,500% RDV.
- Beef Liver (70–80 mcg per 3 oz serving) – So much, much more in B12, use best to rise very quickly.
- Fortified Breakfast Cereals (up to 6 mcg per serving) – Smarter option for those who don’t eat meat or animal products since they are filled with synthetic B12.
- Tuna (2.5 mcg per 3 oz serving) – Also a lean protein source and for omega-3.
- Trout (5.4 mcg per 3 oz serving) – Merges B12 with healthy fat and antioxidant.
- Salmon (2.6 mcg per 3 oz) – Cardio sensation and B12 source.
- Milk (1.2 mcg per cup) – Kitchen staple for regular use of B12.
- Yogurt (1.1 mcg per 6 oz) – Probiotic-and-B12-enriched snack.
- Eggs (1.1 mcg per two large eggs) – Primarily in the yolk.
- Swiss Cheese (0.9 mcg per oz) – One of the wealthiest sources available in dairy.
Below top 10 vitamin B12 foods present diverse alternatives to meet your diet needs if you are an omnivore or you have a limited diet.
Vitamin B12 Vegetables and Fruits
On fruit B12 and vegetable B12, one common myth that has to be broken: bioavailable vitamin B12 is found in natural plant food except for one, i.e., fortified foods. Vitamin B12 is a bacterial by-product and naturally occurs only in animal food like meat, milk, and eggs. Thus, the subjects on the plant-based diet or vegan diet will have to depend on fortified foods for their B12 requirement.
Among some of the fortified plant milk alternatives are:
- Fortified soy milk
- Fortified almond and oat milks
- Fortified nutritional yeast
They are artificially supplemented with B12, most commonly in the form of cyanocobalamin of good bioavailability.
Although certain foods such as spirulina, fermented soy (tempeh). And certain algae foods seem to be sold as natural forms of vitamin B12, they consist of B12 analogs. Chemically equivalent vitamins to vitamin B12 but not biologically equivalent. Instead of supplementation, interference with the absorption of B12 can come from the analogs. As seen in an article published in the journal Nutrients in 2017.
Because of bioavailability issues, people who subsist on plant foods will have to place fortified food. Or supplements at the top of their list in attempting to obtain sufficient vitamin B12 and ward off deficiency.
B12 Deficiency: Foods to Avoid
Although giving priority to what is to be consumed in an effort to enhance B12 is absolutely necessary. One is also supposed to talk about the foods that are poor in B12 to avoid them. There are specific groups of foods that worsen the symptoms. Or complicate the consumption of vitamin B12, making it harder to maintain.
One of them is chronic alcoholism. Alcohol leads to inflammation of the gut and reduces the function of the stomach to secrete intrinsic factor. Which is a component essential in the absorption of B12. Malabsorption as well as the nutritional deficiencies such as B12 are commonly found in chronic alcoholism.
Extensively processed low fiber, low B12 and other vitamins containing foods will substitute for other foods in the diet and lead to sub-optimum total vitamin intake. They contain very little if any Vitamin B12 and cause systemic inflammation that may hasten neurological presentation of deficiency.
Also, tannin present in tea and coffee can inhibit B12 absorption when taken excessively or with food intake, and these foods should thus be eschewed during deficiency.
Determination of foods to eschew while consuming B12 deficiency is of maximum concern crucial for guaranteeing facilitation with diet as well as avoidance of eventual sequelae.
Who Should Consider Supplementation?
In others who cannot achieve their requirement of B12 from diet, vitamin B12 supplements can serve as an ideal substitute. Supplementation is needed most in high-risk groups such as older adults, vegetarians, vegans, patients with gastrointestinal disease, and bariatric surgery patients.
There are two general classes of supplementation: oral supplements and B12 deficiency shots. Oral supplements are available in cyanocobalamin or methylcobalamin form, with cyanocobalamin being more frequently used and investigated of the two. Once-daily oral dosing of such a supplement is in the range of 250 to 1,000 micrograms. Depending on deficiency but is tolerated well considering that B12 is virtually nontoxic and water-soluble.
In more extreme cases, or when malabsorption must be bypassed. Such as removing part or all of the stomach, for example, or pernicious anemia—intramuscular B12 injection is typically advised. B12 injections circumvent the digestive tract and shoot the vitamin directly into the body for quicker rebuilding.
WHO and NICE clinical guidelines also support routine supplementation in at-risk populations.
Universal recommendation of routine supplementation in the absence of diagnosis and identification of cause may result in delay in appropriate therapy. Therefore, you should go for consulting a physician.
Briefly, vitamin B12 deficiency is a preventable yet deadly illness that. If not treated, will result in permanent damages to the physical and nervous systems. Good to find the illness in its initial stages because weakness, memory failure. And destruction of nerves might at first be difficult to identify and therefore confused with a different disease. A well-nourished diet enriched with nutrients is the best preventive measure. Against healthy levels of B12.
Preventive education against B12 deficiency starts with selective food selection. For those who consume animal foods, adding food that is high in B12. Like clams, beef liver, milk, and eggs should be practiced. Fortified foods and supplements must be added by vegetarians and vegans to counter nutritional deficits very effectively.
Sum up,
The patient should also be cautious and read food labels. Particularly when selecting plant foods or cereals for breakfast, to check if they are vitamin B12 fortified.
If symptoms are there, one has to get a checkup and take doctor consultation. With precautions and preventive measures, you can manage and treat B12 deficiency.
