Most people are familiar with the hematological effects of vitamin B12 deficiency.  The vitamin is important in the formation of new red blood cells, and its continued deficiency causes anemia, as well as an enlargement of the developing red blood cells in the bone marrow known as megaloblastic anemia.

Vitamin B12 Deficiency and Anemia

The autoimmune disease pernicious anemia is most often associated with vitamin B12 deficiency.  In this disease the body loses the ability to make a special protein in the stomach known as intrinsic factor.  Intrinsic factor is needed to combine with incoming vitamin B12 and usher it into the body through the mucosal cells of the small intestine.

With no intrinsic factor it becomes impossible to absorb vitamin B12 from the diet into the body.  Historically, a diagnosis with pernicious anemia was like a death sentence, until it was discovered that the disease responded to eating large amounts of raw liver.

It turns out that even with no intrinsic factor, if sufficient amounts of B12 are ingested it can be absorbed non-specifically at a low rate through the whole length of the small intestine.  As long as the person produced normal amounts of hydrochloric acid to help separate vitamin B12 in food from the proteins it is complexed with, enough could be absorbed to counteract the deficiency.

Any kind of anemia can cause tiredness, as the body doesn’t have enough red blood cells to provide sufficient oxygen to all the other cells for their metabolic requirements.

Vitamin B12 Sources

Neurological Effects of Vitamin B12 Deficiency

Other very serious effects of vitamin B12 deficiency are neurological.  They include problems with balance, memory loss, numbness of the legs and even dementia.  Besides intrinsic factor, other proteins like transcobalamin and haptocorrins are needed for the vitamin to be transported into our cells.

Risk Factors

A malfunction or deficiency of any of these steps will lead to a deficiency in vitamin B12.  Our modern lifestyle and eating habits can also contribute to this situation.  Taking proton pump inhibitors for stomach ulcers affects the amount of hydrochloric acid produced in the stomach, and this will lead to B12 deficiencies down the line.

Strict vegetarians are at risk as well, as vitamin B12 is manufactured by bacteria, but only taken up by animals, as plants do not use or need it at all.  Even diabetics taking metformin are at risk, as this chemical inhibits the absorption of vitamin B12.

Hyperpigmentation from B12 Deficency

In some patients a dark discoloration of the skin was observed, specifically across the knuckles and the joints of the fingers.  The same things was seen at the feet.  In some cases the hyperpigmentation was observed in the crease at the back of the neck, and in the face.

These patients consulted their doctors for what they thought was just a cosmetic problem.  Blood examinations revealed low vitamin B12 concentrations in the serum, and megaloblastic anemia.  In other words, these skin problems were a visible sign of more serious hidden deficiency symptoms.

Not all patients showed this hyperpigmentation, but when it was present it was a reliable indicator of vitamin B12 deficiency.  We all react differently to vitamin deficiencies, and it is not really known what causes some people to experience mostly the hematological effects, while others show neurological or skin effects first.

Unexplained darkening of the skin in creases and joints accompanied by tiredness would be a good reason to consult one’s doctor, keeping in mind that vitamin B12 deficiency is not the only thing that causes hyperpigmentation.

Vitamin B12 Supplements

Oral vitamin B12 supplements are available in in such high concentrations that even someone with no intrinsic factor would be able to benefit from them.  Even better, sublingual supplements are made to dissolve under the tongue and be absorbed through the mucous membranes in that area, bypassing the digestive system altogether.  B12 injections accomplish the same thing, delivering the vitamin straight into the bloodstream.

Many people ask me whether I recommend them to take vitamin B12 injections or not, after their doctor has advised to take these due to their B12 deficiency symptoms. Before we jump into the basics of vitamin B12, let us first take a look at the various benefits of this important vitamin.

Benefits of B12

• B12 helps our body to replicate DNA.
• Red blood cells formation.
• Growth of essential body tissues.
• Creation of a fatty protective substance around our nerve cells. This substance is called Myelin, and it helps our body to properly transmit the signals from the brain to the rest of the body. This is also why many of the B12 deficiency symptoms directly relate to the nervous system.
• Metabolism boosting. That’s the reason why many people link vitamin B12 injections with weight loss, although there is absolutely no direct correlation with the injection. The truth is that B12 boosts up your metabolism and make you far more likely to lose some calories and get active, so it certainly helps in some way, but you can get these benefits from any source of B12, not just injections.
• Lowers the levels of Homo cysteine in our body. This amino acid has been linked by scientists many times, for promoting a greater risk for developing heart stroke, cancer, Alzheimer, and many other modern world’s diseases and ailments.

These are just the main benefits of B12 vitamin. The good news is that it is fairly easy to get these benefits even from a plant based diet, as long as you eat your fruits and veggies unwashed, as B12 is originated in a bacteria in the soil, and when washed with water, the plant loses all of its B12 content, as it is present only on its outer exterior part.

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Checking for a deficiency is fairly easy. Just ask for a blood test the next time you visit your doctor. You will probably get the results within a few days, and not only will you get to know whether you are deficient in B12 or not, but also if you’re deficient with other vitamins and minerals as well.

Do You Really Need B12 Injections?

The only reason that you would need a B12 injection is if your body is unable to absorb B12 from food sources. If your deficiency is a result of any other reason, you might want to pass on these injections and go for less radical ways of treatment, such as sub lingual tablets, intra nasal sprays, intra nasal gel, and of course regular foods that are rich in vitamin B12.

These shots are rather painful, and you can get the exact same benefits of vitamin B12 from any other source, like the ones listed above. If the doctor still insists that you take these injections, ask the doctor to explain his position. Most of the time they simply go for the old school treatments, and this one is one of them, since it has been the main treatment for a deficiency among doctors for ages.

For vegans, Vitamin B12 is not so easy to come cross in the daily diet unless taking b12 shots or supplements.  Much research has been done to find out which plants contain it, but they are few and not so easy to come by. Some of the suggested plant sources of B12 are fermented Soya products and some kinds of seaweed and algae. Considering how much of it is needed to keep the human body in proper function, these sources hardly suffice.

You may be wondering what the human body uses B12 for. It’s necessary for production of red blood cells, a healthy nervous system and of course a necessary vitamin for a developing child. What happens if you don’t get it or don’t get enough of it? Most common is anemia – your body will not be producing enough red blood cells and you will be constantly weak and maybe even have fainting spells. You will suffer from fatigue, also a symptom of anemia. At advanced stages of lack, you may have serious depression and mania. Because it’s vital for a healthy nervous system, long term lack may eventually lead to damage to the central nervous system and also the brain.

So where can vegans get this all-necessary part of there diet?

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There are some recommended sources:

1. The easiest and fastest one is supplements. Your pharmacist should be able to issue these over the counter without a prescription. Mostly, you will get it in a rounded vitamin pill – one that has several vitamins in it. Make sure to know what amount of B12 each pill contains. The required daily amount is 5 – 10 micrograms. You can also get it as a single supplement and this is recommended if your daily diet does not include any foods that are rich in B12.  You need to be careful though – some vitamins diminish absorption of B12 (e.g. Vitamin C), so be careful to take them at different times. Another interesting fact about B12 is that taken in high amounts, the absorption rate is reduced. Take the recommended daily dosage and feel free to skip some days without it so that your body is forced to maximize on what it already has. Seaweed supplements will also contain B12. One of the quickest and most effective ways is to take the sublingual B12 pill. You place the pill under your tongue and leave it there until it is completely dissolved. This way, it goes straight into the blood stream, bypassing the digestive system where it would have otherwise have been absorbed in micro amounts.
2. The next best and more commonly used these days is a B12 shots. Non-vegans are using it as well, to increase energy levels and reduce stress. To get this one, you need to visit your GP and he will decide if you need one or not after he takes a blood sample.
3. Fortified foods are the other great and fast source. Some fortified foods that you can take are cereals and soy products. Be sure to read the labels and make sure that they do indeed contain B12 and that it’s in the right amounts.
4. Fortified Brewer’s and Nutritional Yeast are also sources, but only if they are fortified with it. The only danger with these is that you must be absolutely sure of what you are getting. Make sure, like the supplements, that it’s fortified and to the right amounts. Also, too much of it can lead to deficiency. Again, if you decide to take this option, skip between days.
5. Fortified drinks are also becoming more and more popular for vegans who need B12. Vitamin water, for example, contains B12. If you decide to use drinks however, do your research. Use the internet to see exactly which drinks are fortified and in which amounts.
6. When it comes to foods, free range eggs contain B12. Milk as well as cheese too. Processing and the manufacturing process can destroy it however, so get them as natural as possible. The best way to take in the eggs is to boil them – a boiled egg contains 0.7 micrograms. Don’t over-boil the milk. If you have access to cheese directly from a farm, that’s a great way of making sure that you’re taking in the least processed versions. Sunflower margarines and any other plant source margarines may contain B12 too – just check the label.

For vegans, because they don’t take meat and meat products, it’s absolutely vital that they pay attention to this vitamin. One thing to keep in mind in that B12 gets damaged when exposed to light. Keep your B12 sources stored away in a dark cupboard.

Sources

1. Simply Vegan: Quick Vegetarian Meals by Debra Wasserman. Nutrition section by Reed Mangels Ph.D., R.D. (ISBN 0-931411-30-0)
2. USDA National Nutrient Database for Standard Reference, Release 20.
3. http://www.vegetarianvitaminsguide.com/vegan-nutrition/vegan-sources-of-vitamin-b12
4. The Vegetarian Society of the United Kingdom – Information Sheet;
   Parkdale, Dunham Road, Altrincham, Cheshire, England WA14 4QG
5. Institute of Medicine, Food and Nutrition Board: Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B-6, Folate, Vitamin B-12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy press, 1998.

As people age, they make less and less vitamin B12 with each passing year. Living under a great deal of stress, as most people now do, and taking certain medications, often create a deficiency in this vitamin because the body is unable to ingest it correctly from the food that is eaten. This is why sublingual b 12 vitamins can be so important.

Vegans, individuals who do not eat any animal products whatsoever, are also at risk of B12 deficiency because B12 is mainly found in meat and animal products that they do not eat. Careful diet planning is essential for vegans and vegetarians and supplements are often recommended to help make sure that the body is healthy.

Signs and symptoms of a vitamin deficiency can take as much as five years to appear. A pro-active course of action is the wisest decision; sublingual methylcobalamin B12, a form of b12 that is especially helpful for the nervous system, and often with folic acid, is a quick, easy and relatively inexpensive way to stave off any hint of deficiency.

In the past, the only way for the body to absorb vitamin B12 effectively was thought to be injections, which were none to pleasant and quite expensive. Fortunately, research has revealed that the body can and does absorb the vitamin when it is taken sublingually, or under the tongue.

These same studies showed that larger doses of B12 were needed to get the same degree of absorption as that taken by injection; however, the amount is still tiny and easily attained without a great worry of overdosing since large quantities of B12 have not shown it to become toxic to a human.

Vitamin B12 is extremely important. A body cannot function without it. It regulates the sleep-wake cycle, metabolizes carbohydrates and enables the body to use fat as energy. B12 is also important in the regulation of cholesterol. When B12 and folate work together homocysteine is metabolized and cholesterol levels drop. Homocysteine is an amino acid.