Have you heard about Vitamin B12? This water-soluble vitamin has a key role in the normal functioning of the brain and nervous system and is probably best known for its role in red blood cell formation. A deficiency in this essential vitamin can lead to debilitating physical and psychiatric symptoms including anaemia, chronic fatigue, loss of appetite, headaches, feeling faint and depression. There is a strong connection between mental health and B12 deficiency and without treatment the disease will progress and symptoms can get worse. A deficiency can also lead to serious irreversible neurological problems. The effect on people’s lives can be devastating and yet treatment is straightforward, accessible and easily administered. Of course, there are many causes of mental illness including biological, psychological and environmental factors but if you have been suffering with psychiatric symptoms and antidepressants don’t seem to be working, or you have other unexplained physical symptoms not related to any other medical condition, it’s important to get tested for a possible B12 deficiency. This is done by a simple blood test that your GP can arrange.
Let’s look at some of the most common psychiatric symptoms that some people with a B12 deficiency may suffer with : –
- Suicidal Ideation
- Memory Loss
- Irritability, Impatience, Mood Swings
- Violent/Aggressive Behaviour
- Brain Fog
A list of the more common physical symptoms : –
- Pins and needles
- Loss of appetite
- Balance issues
- Constipation or diarrhoea
- A smooth, thick red tongue
- Weight loss
If you recognise yourself or someone you know suffering with any of the above symptoms, speak to your GP about getting your B12 levels tested, it could make all the difference.
Recognise Your Risk for B12 Deficiency
There are many causes and lifestyle choices that are linked to a Vitamin B12 deficiency and recognising these could help people take action sooner.
Pernicious anaemia; an autoimmune condition, is the most common cause of Vitamin B12 deficiency in the UK (NHS). Autoimmunity means the immune system, the body’s natural defence system against illness and infection goes into overdrive and starts attacking the body’s own healthy tissues. In the stomach, vitamin B12 combines with intrinsic factor and is then absorbed into the body. With Pernicious anaemia, the immune system attacks the cells that produce intrinsic factor and therefore B12 is unable to be absorbed into the body.
Humans cannot produce vitamin B12 naturally, we have to consume it in our diet. Plant based foods do not contain any vitamin B12. Animal products are the primary source; this is because it is also an essential vitamin required by animals. Once B12 is absorbed by animals, it is passed onto the products that they produce, for example, meat, fish, eggs, milk and cheese. Including these products in your daily diet; assuming no absorption issues exist, should ensure adequate B12 intake. However, for people who don’t eat these foods, for example vegans or who have a very poor diet, deficiency can occur.
Conditions Affecting the Stomach
There are medical conditions that interfere with food absorption, for example coeliac and Crohn’s disease which can result in not enough vitamin B12 being absorbed in the body. People who have undergone stomach surgery, stapling or weight loss surgery are also at risk of becoming low in B12 due to the surgery damaging the cells that produce intrinsic factor and stomach acid, which we know are needed for absorption.
There are some types of prescribed medication that can cause a B12 deficiency. For example, commonly prescribed proton pump inhibitors (PPI’s) which reduces stomach acid. B12 needs stomach acid in order to be properly absorbed into the body. Additionally, Metformin (used for diabetes) can also interfere with B12 absorption.
Elderly people are particularly at risk of developing B12 deficiency. This is because as we age, it is common to develop problems with producing stomach acids and digestive enzymes that are needed to process and absorb vitamin B12.
So what’s the treatment for B12 deficiency?
Treatment depends on the cause of the deficiency. If it is diet related then adding foods that contain vitamin B12 to your diet will help, good sources of b12 include, eggs, meat, fish, milk and other dairy products. If you are a vegan or vegetarian and need an alternative to meat and dairy products for your daily supply of B12, there are many other foods that contain it, yeast extract, for example Marmite and fortified cereals and soy
products. You can also supplement with B12 supplements, they are available in tablet form and also throat sprays which you will find in most health food shops.
If pernicious anaemia is the cause of the deficiency, you will usually be treated with B12 injections, in a form called Hydroxocobalamin. The usual NHS treatment pathway is for a patient to be given a B12 injection every other day for 2 weeks or until your symptoms improve and then following this period you will receive an injection once every 3 months. This is usually given by your GP or practice nurse.
The internet is full of case studies of people who have suffered mental health symptoms needlessly where B12 deficiency was not considered. This can have devastating effects on people’s lives. Many undiagnosed people feel hopeless, desperate and trapped in a life of misery and despair, perhaps taking strong antidepressants, antipsychotics and mood stabilisers and where B12 deficiency is present, these medications simple may not work. A simple and effective treatment is waiting. Be proactive in your search for your mental and physical wellbeing. Ask your GP to check your B12 levels if you have any known risk factors, a family history of B12 deficiency, or you are not responding to psychiatric drugs. Vitamin B12 deficiency is easily detectable and easily treated, nobody needs to suffer in silence.
If you are interested in reading more about Vitamin B12 and its connection to mental health, you can find more detailed information on the following websites.
Could it be B12? An Epidemic of Misdiagnoses by Sally M. Pacholok (2011)
Pernicious Anaemia: The Forgotten Disease: The Causes and Consequences of Vitamin B12 Deficiency by Martyn Hooper (2012)
Living with Pernicious Anaemia and Vitamin B12 Deficiency by Martyn Hooper (2013)
What You Need to Know About Pernicious Anaemia & B12 Deficiency by Martyn Hooper (2015)
Disclaimer – This post was written to provide information for interested parties. It is not intended to be a substitute for the advice from your doctor or other healthcare practitioner. If you have any health concerns, please contact your GP for professional medical advice.
Written by A Green