Low Vitamin B12 Symptoms May Mimic MS or Alzheimer's Dementia

Vitamin B12 or Cobalamine - Photo by Ymwang42

Vitamin B12 deficiency symptoms can easily be overlooked on routine physical examinations and acute care appointments. The vitamin is necessary for normal functioning of the brain and nervous system as well as in the formation of blood. People who have low levels of vitamin B12 may initially experience vague symptoms that may spiral into serious health concerns if left untreated.

The incidence of vitamin B12 deficiency may be more difficult to determine due to folic acid fortification in grains and cereals since 1998. Low vitamin B12 levels and folic acid deficiency tended to be found together previously. Low folic acid levels produced anemia. Diagnosing anemia is relatively simple because it shows up on very basic bloodwork tests. Those who have vitamin B12 deficiency may not have anemia but can still experience progressive neurologic symptoms.

According to several studies, only 56-77% of people with low vitamin B12 levels have megaloblastic anemia. A 2013 study found that people who experience neurologic symptoms from vitamin B12 deficiency may be less likely to experience anemia and often test positive to H. pylori, a bacteria that causes stomach ulcers in many people.

Vitamin B12 Found in Animal Products and Some Cereals - Photo by Zoe

What are the symptoms of vitamin B12 deficiency?

Symptoms of low vitamin B12 include but are not limited to:

• numbness or tingling in the hands/feet
• generalized weakness that can progress to difficulty walking
• balance problems
• tension-type headache
• dementia, confusion (1.5% of dementia cases who are found to have untreated vitamin B12 deficiency are fully reversible with vitamin B12 treatment)
• depression
• personality, behavioral changes
• vision loss
• hallucinations, paranoia, psychosis
• anorexia, flatulence
• diarrhea, constipation
• failure to thrive
• developmental delays

Vitamin B12 deficiency also has the potential to increase one's risk for heart disease and stroke. A study published in 2009 looked at people in the Indian culture and found that those with coronary artery disease tended to have significantly lower vitamin B12 levels than those who did not have heart disease. Vitamin B12 tends to lower homocysteine levels, a compound often found in higher than normal levels in people with heart disease, stroke, and dementia.

This video shows several people who experienced multiple symptoms related to low vitamin B12 levels

Vitamin B12 Shot - Photo from Wikimedia Commons

What can cause low vitamin B12 levels?

Vitamin B12, also called cobalamine, is a water-soluble micronutrient naturally found in animal products and in some fortified foods. Low vitamin B12 levels may result from inadequate dietary intake, such as with people who observe a strict vegan diet. Babies who are fed breastmilk by mothers who observe a strict vegan diet may have low vitamin B12 levels, even if the mother does not have symptoms of the deficiency.

Older adults tend to have less hydrochloric acid in the stomach region, which may lead to poor absorption of vitamin B12 and resulting deficiencies of the vitamin. People with other conditions causing poor absorption of nutrients, such as those with a history of gastric surgery, Crohn's disease, HIV infection, or celiac disease, may experience vitamin B12 deficiency despite adequate dietary intake of the nutrient.

Some medications may cause poor absorption of vitamin B12, including:

• Some antibiotics
• Proton pump inhibitors
• H2 receptor agonists
• Some drugs used to treat diabetes

Information in this article is for informational purposes only and should not be considered medical advice. Those who are experiencing any symptoms of vitamin B12 deficiency should speak with his or her healthcare provider.

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References:

• Centers for Disease Control and Prevention online article Manifestations of Low Vitamin B12 Levels accessed on 11/13/13.
• Kumar, Jitender et. al, Clinical Chemistry & Laboratory Medicine, March 2009, Vol. 47, Issue 3, Vitamin B12 deficiency is associated with coronary artery disease in an Indian population.
• National Institutes of Health article Dietary Supplement Fact Sheet: Vitamin B12 accessed on 10/16/13.
• Ozcan, Tuba Aydemir et. al., Journal of Neurological Sciences, 2013, Vol. 30, Issue 3, Helicobacter Pylori Infection in Patients with Neurological Symptoms of Vitamin B12 Deficiency