Why is Vitamin B12 Important?

Vitamin B12, or cobalamin, is a crucial water-soluble vitamin that plays a vital role in various bodily functions. Its deficiency can lead to a range of symptoms, both neurological and psychiatric. Severe shortages may result in serious conditions such as deep depression, paranoia, delusions, memory impairment, and sensory losses including taste and smell. Since our bodies cannot synthesize Vitamin B12, we must obtain it through dietary sources or supplements.

Without adequate Vitamin B12, the production and division of red blood cells are hindered, which adversely affects oxygen transport and overall energy levels. A deficiency can manifest through numerous symptoms, including:

• Neurological issues
• Weakness and fatigue
• Tingling sensations in limbs
• Numbness and blurred vision
• Digestive problems
• Mood fluctuations
• Memory decline

What Happens in the Body?

Intrinsic factor, a glycoprotein produced by the stomach's parietal cells, is essential for Vitamin B12 absorption in the terminal ileum (the final section of the small intestine). Once absorbed, Vitamin B12 acts as a cofactor for enzymes involved in DNA synthesis, fatty acid metabolism, and myelin formation.

There are three primary causes for Vitamin B12 deficiency:

1. Autoimmune Disorders: Conditions like pernicious anemia involve the production of antibodies against intrinsic factor, hindering Vitamin B12 absorption.
2. Malabsorption Issues: Various factors can lead to malabsorption, such as gastric bypass surgery or the use of antacid medications, which reduce stomach acid vital for B12 absorption. Damage to the terminal ileum, due to conditions like Crohn’s disease or Celiac disease, can also impede absorption.
3. Dietary Insufficiency: Although Vitamin B12 is stored in the liver, strict vegetarians and vegans are at higher risk of deficiency, as they may not consume adequate amounts.

Assessing Vitamin B12 Levels

Vitamin B12 levels are typically evaluated through serum or plasma tests, with most laboratories indicating deficiency when levels fall below 200 or 250 pg/mL (148 or 185 pmol/L).

Who is at Greater Risk?

Certain groups are more susceptible to Vitamin B12 deficiency, including older adults, strict vegans and vegetarians, and individuals with gastrointestinal disorders such as Crohn’s disease or atrophic gastritis. Long-term use of medications like proton pump inhibitors (PPIs) and metformin can also affect B12 absorption.

What Can Be Done?

Administering Vitamin B12 through injections or infusions is an effective method to ensure adequate intake. This approach bypasses the digestive system, delivering the vitamin directly into the bloodstream.

Regular screening for those at risk is crucial, particularly for individuals with a history of gastrointestinal surgery, inflammatory bowel disease, or long-term use of medications that impact absorption.

As you navigate your daily life, prioritize Vitamin B12 through a balanced diet or supplementation if necessary. Staying informed about nutritional needs helps ensure your body has the essential support to thrive.