If you’re experiencing feelings of confusion, fatigue, forgetfulness, or just an overall sense of unease, you might think the solution lies in improving your sleep or managing stress better. However, it’s worth considering that a nutrient deficiency could be the culprit, particularly one involving vitamin B-12.
Though often overlooked, vitamin B-12 is vital for the nervous system’s health and overall brain function, contributing to memory, concentration, mental well-being, and the overall integrity of brain cells. When B-12 levels dip too low, the brain is often affected first, leading to symptoms such as forgetfulness and cognitive fog.
Surprisingly, B-12 deficiency is more prevalent than many realize, impacting about 6% of people under 60 and around 20% of those over 60. The causes of B-12 deficiency can vary widely, including dietary choices, specific medications, malabsorption issues, and age-related factors, with older adults being particularly vulnerable.
“Vitamin B-12 deficiency is among the few reversible causes of cognitive decline,” explained Dr. Majid Fotuhi, a neurologist and adjunct professor at Johns Hopkins University. “Early detection can prevent lasting brain damage and restore mental clarity.”
Below is everything you need to understand about vitamin B-12, including its critical role, how to ensure you’re getting enough, and the potential signs of deficiency.
How Vitamin B-12 Supports A Healthy Brain
Vitamin B-12 has a significant impact on brain health in many ways. It aids in the development and maintenance of myelin—the protective sheath around nerve fibers—which enhances communication between brain cells. It also plays a crucial role in DNA synthesis and maintains the integrity of brain tissue over time.
Additionally, B-12 is vital for the production of neurotransmitters like dopamine and serotonin, which help manage mood, focus, and motivation.
Another significant function of vitamin B-12 is facilitating the breakdown of homocysteine, an amino acid that can accumulate when B-12 levels are insufficient. High levels of homocysteine have been associated with greater oxidative stress and impaired blood vessel function, which can contribute to cognitive decline.
“These roles emphasize why B-12 is essential for clear thinking, memory retention, and mental energy,” stated Fotuhi.
When B-12 levels diminish, nerve signals can slow or become erratic, increasing the risk of nerve cell damage. Over time, a deficiency can lead to confusion, balance issues, slower cognitive processing, and difficulties concentrating. Furthermore, elevated homocysteine levels have been linked with cognitive decline and neurodegenerative conditions, such as Alzheimer’s and other forms of dementia.
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Signs You May Be Experiencing Low B-12 Levels
Low vitamin B-12 levels can manifest in various symptoms throughout your body. Common signs include fatigue and weakness caused by anemia, tingling or numbness in extremities, heart palpitations, memory difficulties, trouble concentrating, imbalance, and mood fluctuations like irritability or apathy.
While anemia is frequently associated with B-12 deficiency, neurological symptoms can occur even in the absence of anemia, according to Dr. Brian J. Copeland, a neurologist at University Medical Center New Orleans.
The symptoms of B-12 deficiency can creep in slowly and may not be immediately noticeable, but may worsen over time.
“Symptoms of a B-12 deficiency might not emerge until levels are significantly depleted,” noted registered dietitian Patricia Kolesa. “Serum vitamin B-12 levels of 200 pg/ml or below indicates a deficiency, although evaluating homocysteine and methylmalonic acid may provide further insight into B-12 activity in the body.
A recent study found that some older adults exhibited cognitive and neurological issues even when their B-12 levels were technically normal, but on the lower end.
If you’re concerned about your memory, experiencing fatigue or weaknesses, facing balance issues, or noticing other mentioned symptoms, consulting a healthcare professional and having your B-12 levels checked could be a beneficial step towards safeguarding your brain health.
“Vitamin B-12 deficiency is quite common, often overlooked, and relatively straightforward to diagnose and treat,” emphasized Dr. Joel Salinas, a clinical associate professor in the department of neurology at the New York University Grossman School of Medicine. “Given that its neurological effects can mirror more serious brain disorders, it is routinely assessed in evaluations for cognitive decline.”
Factors Contributing to the Risk of a B-12 Deficiency
Vitamin B-12 is essential for the production of red blood cells. To ensure your body gets adequate amounts, it’s essential to consume foods rich in B-12 and for your body to absorb it properly. A protein called intrinsic factor, produced by stomach cells, aids in this absorption process. Since the body cannot generate vitamin B-12 by itself, a deficiency can occur if dietary intake is insufficient, absorption is impaired, or supplements are not taken.
“Vegetarians and vegans are at an elevated risk for B-12 deficiency, as this vitamin is primarily found in animal-based foods,” revealed Kolesa.
Individuals with gastrointestinal conditions that hinder B-12 absorption, such as Crohn’s disease or celiac disease, along with those suffering from pernicious anemia or those with a history of gastric or bariatric surgery, or heavy alcohol consumption, may also face risks for low B-12 levels. Age-related factors also heighten the risk, particularly in older adults who experience decreased absorption efficiency.
Additionally, those taking metformin or acid-suppressing drugs such as proton pump inhibitors over extended periods may also develop a B-12 deficiency and should be monitored, according to Salinas.
Steps to Take If You Suspect Low B-12 Levels
To maintain adequate levels of B-12, it’s important to include a variety of B-12-rich foods in your diet. Excellent sources include fish, meat, eggs, dairy, nutritional yeast, and fortified cereals. However, individuals suffering from a deficiency might require B-12 supplements, either orally or through injections. Your primary care physician can conduct a simple blood test to determine if your B-12 levels are low or deficient.
“Oral B-12 supplements are effective for most individuals, while injections are typically reserved for severe cases,” Salinas explained. “Blood testing remains the most reliable method to gauge if dietary intake alone suffices.”
Regular testing is crucial for detecting B-12 deficiencies before they become irreversible. When addressed promptly, symptoms like memory loss, mood disturbances, and concentration difficulties can be completely alleviated. Conversely, if left untreated, individuals risk permanent cognitive deficits, according to Copeland.
“In severe cases, this condition can progress to full-blown dementia with additional symptoms like psychosis,” he added. “This underscores the importance of monitoring vitamin B-12 levels in anyone experiencing unexplained memory loss.”
