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.

What are the signs of anemia? Anemia itself is a deficiency of hemoglobin (the oxygen carrying component of the red blood cell) in the blood. This deficiency can be due to a low red blood cell count due to excessive blood loss or some type of disorder causing destruction of red blood cells at a rate quicker than their production. Hemoglobin deficiency can also be caused by a lack of iron – a component needed for hemoglobin production.

Since anemia is the lack of the oxygen-carrying component of the blood – signs of anemia tend to be similar to those shown when the body isn’t getting enough oxygen.

Signs of Anemia include:

• Headache – Like all part of the body, the brain requires oxygen to function properly. Any lowering of oxygen level in the brain can cause a swelling of the arteries of the area, causing headaches.

• Feelings of breathlessness – Your body gauges the rate of your respiration based on the levels of oxygen in your blood. As a natural response to low oxygen levels in your bloodstream, your body tells you that you need to breathe more, hence breathlessness.

• Weakness – You body needs oxygen to function. Without enough oxygen, your body cannot function at “full power.”

• Fatigue – For the same reasons that you would feel weak, you would also experience fatigue.

• Excessive thirst – The reason for excessive thirst isn’t necessarily known, but has been reported by some with anemia.

• Dizziness – Associated with lack of oxygen

• Fainting - Associated with lack of oxygen 

• Rapid or irregular pulse – When your organs are not getting the oxygen required, you body may try to increase blood flow by increasing your heart rate.

• Difficulty concentrating – Usually associated with the brain not getting the required amount of oxygen.

• Ringing in the ears – Can be due to a change in blood pressure and lack of oxygen

• Difficulty sleeping - When your body is not functioning properly is can be difficult to sleep.

• Pale complexion - Associated with lack of oxygen

• Abnormal menstruation – Anemia is a physiological stressor, which can affect the menstrual period.

What Causes Anemia?

The most common cause of anemia is a lack of iron. This deficiency is usually due to a poor diet lacking in the vitamins, minerals and proteins that the body requires to function properly. However, issues that are more serious can also be at the root of the problem. Conditions such as kidney disease, autoimmune disorders, congenital disorders or an issue with the body being able to absorb the nutrients ingested.

What to Do When You Experience the Signs of Anemia

Anemia due to a lack of nutrients can usually be solved with a simple iron supplement.
However, due to the seriousness of other issues that could be at the root of the problem, a visit to your doctor is highly recommended.