B12 deficiency: Eight symptoms that signal you’re ‘dangerously’ low in vitamin B12

Dr Dawn Harper on signs of vitamin B12 and vitamin D deficiency

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Vitamin B12 provides a long list of benefits, such as releasing energy from food and supporting normal nervous system function. Naturally, people tend to overlook these benefits until they become low in B12. When this happens, the body tends to malfunction, although the effects take time to show.

What should I look for?

“Low levels of vitamin B12 can be difficult to spot until it’s too late and you are dangerously lacking, and a surprisingly high percentage of people are deficient,” warns Holland and Barrett.

In the United Kingdom, it is estimated that six percent of adults younger than 60 years have a vitamin B12 deficiency and that figure is close to 20 percent in those older than 60. 

When your body is low in vitamin B12, it can show in a variety of ways, including:

  • Extreme fatigue
  • A lack of energy
  • Feeling weak
  • A sore and red
  • ‘Foggy’ brain
  • Confusion
  • Problems with understanding, judgement and memory
  • Disturbed vision.

How to respond

See a GP if you’re experiencing symptoms of vitamin B12 deficiency, advises the NHS.

See a GP if you’re experiencing symptoms of vitamin B12 or folate deficiency anaemia.

These conditions can often be diagnosed based on your symptoms and the results of a blood test.

It’s important for vitamin B12 deficiency to be diagnosed and treated as soon as possible.

“Although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible if left untreated,” warns the NHS.

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“The longer the condition goes untreated, the higher the chance of permanent damage.”

What causes low B12?

There are several factors that can contribute to a vitamin B12 deficiency. Pernicious anaemia is the most common.

Pernicious anaemia is an autoimmune condition – which means your body’s natural defence system is attacking healthy body cells.

It affects the stomach, attacking the cells that help the body absorb vitamin B12.

People can develop a vitamin B12 deficiency by not getting enough from the food and drinks they consume.

“A diet including fish, meat and dairy products normally provides an adequate amount of vitamin B12, but people who exclude some or all of these foods, like vegans,” explains Holland and Barrett.

According to the health body, a generally very poor diet with these foods can also cause deficiency.

“It’s worth noting that vitamin B12 stores in the body can last for around 2-4 years without being replenished,” it adds.

“This means that a dietary change can take place a long time before any deficiency occurs.”


The treatment for vitamin B12 deficiency depends on what’s causing the condition.

“Most people can be easily treated with injections or tablets to replace the missing vitamins,” notes the NHS.

There are two types of vitamin B12 injections:

  • Hydroxocobalamin
  • Cyanocobalamin.

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